Table of Contents. Introduction Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement.
It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Patch 1 2 ita neverwinter night 2 gamebanshee. Vitamin D obtained from sun exposure, food, and supplements is biologically inert and must undergo two hydroxylations in the body for activation. The first occurs in the liver and converts vitamin D to 25-hydroxyvitamin D 25(OH)D, also known as calcidiol.
The second occurs primarily in the kidney and forms the physiologically active 1,25-dihydroxyvitamin D 1,25(OH) 2D, also known as calcitriol. Vitamin D promotes absorption in the gut and maintains adequate serum calcium and phosphate concentrations to enable normal mineralization of bone and to prevent hypocalcemic tetany. It is also needed for bone growth and bone remodeling by osteoblasts and osteoclasts ,. Without sufficient vitamin D, bones can become thin, brittle, or misshapen.
Vitamin D sufficiency prevents rickets in children and osteomalacia in adults. Together with calcium, vitamin D also helps protect older adults from osteoporosis. Vitamin D has other roles in the body, including modulation of cell growth, neuromuscular and immune function, and reduction of inflammation ,.
Many genes encoding proteins that regulate cell proliferation, differentiation, and apoptosis are modulated in part by vitamin D. Many cells have vitamin D receptors, and some convert 25(OH)D to 1,25(OH) 2D. Serum concentration of 25(OH)D is the best indicator of vitamin D status. It reflects vitamin D produced cutaneously and that obtained from food and supplements and has a fairly long circulating half-life of 15 days. 25(OH)D functions as a biomarker of exposure, but it is not clear to what extent 25(OH)D levels also serve as a biomarker of effect (i.e., relating to health status or outcomes).
Serum 25(OH)D levels do not indicate the amount of vitamin D stored in body tissues. In contrast to 25(OH)D, circulating 1,25(OH) 2D is generally not a good indicator of vitamin D status because it has a short half-life of 15 hours and serum concentrations are closely regulated by parathyroid hormone, calcium, and phosphate. Levels of 1,25(OH) 2D do not typically decrease until vitamin D deficiency is severe ,.
There is considerable discussion of the serum concentrations of 25(OH)D associated with deficiency (e.g., rickets), adequacy for bone health, and optimal overall health, and cut points have not been developed by a scientific consensus process. Based on its review of data of vitamin D needs, a committee of the Institute of Medicine concluded that persons are at risk of vitamin D deficiency at serum 25(OH)D concentrations 125 nmol/L (50 ng/mL) are associated with potential adverse effects (Table 1). Table 1: Serum 25-Hydroxyvitamin D 25(OH)D Concentrations and Health. nmol/L. ng/mL. Health status 125 50 Emerging evidence links potential adverse effects to such high levels, particularly 150 nmol/L (60 ng/mL).
Serum concentrations of 25(OH)D are reported in both nanomoles per liter (nmol/L) and nanograms per milliliter (ng/mL). 1 nmol/L = 0.4 ng/mL An additional complication in assessing vitamin D status is in the actual measurement of serum 25(OH)D concentrations. Considerable variability exists among the various assays available (the two most common methods being antibody based and liquid chromatography based) and among laboratories that conduct the analyses ,.
This means that compared with the actual concentration of 25(OH)D in a sample of blood serum, a falsely low or falsely high value may be obtained depending on the assay or laboratory used. A standard reference material for 25(OH)D became available in July 2009 that permits standardization of values across laboratories and may improve method-related variability ,. Reference Intakes Intake reference values for vitamin D and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of The National Academies (formerly National Academy of Sciences). DRI is the general term for a set of reference values used to plan and assess nutrient intakes of healthy people.
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These values, which vary by age and gender, include:. Recommended Dietary Allowance (RDA): average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%–98%) healthy people. Adequate Intake (AI): established when evidence is insufficient to develop an RDA and is set at a level assumed to ensure nutritional adequacy. Tolerable Upper Intake Level (UL): maximum daily intake unlikely to cause adverse health effects. The FNB established an RDA for vitamin D representing a daily intake that is sufficient to maintain bone health and normal calcium metabolism in healthy people. RDAs for vitamin D are listed in both International Units (IUs) and micrograms (mcg); the biological activity of 40 IU is equal to 1 mcg (Table 2). Even though sunlight may be a major source of vitamin D for some, the vitamin D RDAs are set on the basis of minimal sun exposure.
Table 2: Recommended Dietary Allowances (RDAs) for Vitamin D Age Male Female Pregnancy Lactation 0–12 months. 400 IU (10 mcg) 400 IU (10 mcg) 1–13 years 600 IU (15 mcg) 600 IU (15 mcg) 14–18 years 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 19–50 years 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 600 IU (15 mcg) 51–70 years 600 IU (15 mcg) 600 IU (15 mcg) 70 years 800 IU (20 mcg) 800 IU (20 mcg). Adequate Intake (AI) Sources of Vitamin D Food Very few foods in nature contain vitamin D. The flesh of fatty fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources ,.
Small amounts of vitamin D are found in beef liver, cheese, and egg yolks. Vitamin D in these foods is primarily in the form of vitamin D 3 and its metabolite 25(OH)D 3. Some mushrooms provide vitamin D 2 in variable amounts ,. Mushrooms with enhanced levels of vitamin D 2 from being exposed to ultraviolet light under controlled conditions are also available. Fortified foods provide most of the vitamin D in the American diet ,. For example, almost all of the U.S. Milk supply is voluntarily fortified with 100 IU/cup.
(In Canada, milk is fortified by law with 35–40 IU/100 mL, as is margarine at ≥530 IU/100 g.) In the 1930s, a milk fortification program was implemented in the United States to combat rickets, then a major public health problem. Other dairy products made from milk, such as cheese and ice cream, are generally not fortified. Ready-to-eat breakfast cereals often contain added vitamin D, as do some brands of orange juice, yogurt, margarine and other food products. Both the United States and Canada mandate the fortification of infant formula with vitamin D: 40–100 IU/100 kcal in the United States and 40–80 IU/100 kcal in Canada.
Several food sources of vitamin D are listed in Table 3. Disclaimer This fact sheet by the Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.
Contents. Gameplay Nearly every roll consists of making a single d20 roll, plus a modifier, against a target number. Saving throws have been replaced with Defenses that work like AC; the term 'Saving Throw' now refers to a 55% (DC 10) roll every turn to recover from a persistent effect. Gameplay is divided into encounters. The GM selects monsters and traps up to a total experience value as recommended for the size of the party, and the encounter plays out as a tactical miniatures game. Non-combat encounters consist of 'skill challenges', where skill checks (sometimes of multiple types) are made in sequence.
XP is awarded for non-combat challenges and quests, as well as for combat encounters. Each character can take one standard action (such as an attack), one move action, one minor action, and any number of free actions per turn.
Each character also gets one immediate interrupt or immediate reaction per round, which may be used outside of the regular turn order. Generally each character will use their standard action to make use of an attack power. Characters are highly specialized as noted above, and fit into combat roles of controller (status effect and mass-attack focused), defender (durability and counter-attack focused), leader (buffing and healing focused), and striker (single target damage focused).
Characters level up from level 1 to 30; with the scope of the game changing every ten levels. At level 30 characters are expected to undergo some form of apotheosis, but the game is totally broken at this level anyway. Hey, at least this is one thing it has in common with D&D! All-in-all, 4e has been compared to vidya like and all that shit, which shouldn't necessarily be a bad thing if it wasn't oddly stiffing in a mild way. Summed this up perfectly in their limited edition Dragon Magazine book; the 4e team relies on spacing and managing cooldowns and per-battle abilities, while the 3.5 team just blows all their gold and spell slots on as many game-breaking potions and spells as they want before standing atop a hill and. WoW Although comparing 4e to was the most common thing to do back in the day, in actuality, most of its 'WoWish' aspects were derived from unspoken assumptions and core mechanical aspects of D&D going back throughout its history.
The sourcebook 'Wizards Presents: Races & Classes', a teaser book that covers a lot of the design process leading up to 4e, talks quite extensively about the process - for example, roles have always been part of D&D, ever since we had the Fighting Man, Magic User and Thief, it's just that actually thinking about what makes their combat role work and using that to avoid the tiers system of past editions was new to 4e. Setting The setting of 4e is highly generic and designed to give the DM a relatively blank canvas to paint on. This default setting consists of a wild sort-of-medieval landscape in which isolated human and demihuman communities ( Points of Light) struggle to survive after the fall of a greater empire. This provides an explanation for the large areas of wilderness and many ruins for monsters to hide in, and the need for adventurers as opposed to more regulated militias. The 'ground' setting of 4e has become known as the, after the particular region of the World used for most official non-planar adventure modules. The cosmology, present in 2e and 3e since popularized by, has been replaced by a new metaphysical cosmology, known as the. This multiverse follows a more organic, mythology-based approach to the planes, dividing existence up into the World (what used to be the Prime Material), the (Land of Faerie), the (Land of the Dead), the (Realm of Gods, World of Spirit), the (Font of Creation), and.
Advice is given on how to reset the cosmology back to the Great Wheel in the. The DMG contains an extensive section explaining the tropes of the setting and how they might be used, and also suggesting ways in which the DM can deviate from them to make the setting his own. Perhaps the biggest difference from, say, or is that PoLand has very much shaken off Gygax's beloved 'humanocentric' approach to setting design. And races aren't off lurking in dungeons or skulking around ancient ruins, but vibrant and active parts of the setting. Some of the setting's greatest empires were founded by , , (Ruul) and, whilst there are still thriving demihuman dominated settlements everywhere, especially if you go to other planes.
The setting encourages you to play whatever you want and builds a world where you don't have to always be human. Character Generation Chargen is simplified compared to 3rd Edition (although still time consuming). Skills are all-or-nothing, you either have training in them or you don't. Each character gains a selection of Powers which can be used at will, once per encounter, or once per day, in ascending order of power. These abilities often consist of an attack plus some special effect, such as knocking someone prone, setting them on fire, or moving yourself or your opponent. The races of PHB 2.
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People were upset that the and were not in the core book. Original PHB cover, ended up being used for Dungeon Delve D&D Essentials D&D Essentials was an attempt to appeal to players more comfortable with older editions of D&D. It featured classes more similar in structure D&D 3.5, in particular simplifying martials, but still using the structure of character powers to attempt to maintain the modular nature of D&D 4e. This added even more to an edition already full of; those who weren't fans of 4e in the first place were rarely interested in it, whilst those who were fans found it annoying and derided it as 'dumbing down'. These fans tend to regard Essentials as being ultimately responsible for the death of 4e and its replacement with 5e. Roles Arguablly one of the biggest class-based mechanical changes in 4e was the introduction of Roles. Whilst often compared to, this actually stems from the designer team asking themselves 'Okay; the iconic D&D party is a Fighting Man, a Cleric, a Magic User and a Thief - now, why is this?
What does each class give to the party?' Roles were their answer; a simple 'mission statement' of what a class aims to achieve in combat. The most popular classes are always those that have a strong mission statement, and when that statement gets wobbly, then you end up with problems - hence the infamous Tier system of 3e. Roles became a defining outline for creating classes, both for the designers and the players; a clear shorthand as to what sort of stuff this class should do in order to meaningfully contribute to a battle. Defenders are the 'tanks' of the party. A defender's job is to keep the party alive by intercepting enemies and keeping them away from the squishier members of the group. To this end, WoTC decided that a proper defender should not just be capable of taking hits, but they should also be 'sticky'; they needed some way to mechanically encourage enemies to not want to get away from the defender, and to punish them if they did - what good's a fighter if the enemy just shoves past them, taking a hit in the process, and proceeds to whomp the wizard?
Strikers are the 'critical hitters' of the party. Opportunist attackers, strikers specialize in dealing out lots of damage to opportune targets. They usually can't take so much damage, but they can bring down big foes quick, which is their job. These are second-line warriors, working in tandem with defenders when done well; the defender's the anvil, the striker's the hammer.
Leaders are the 'supporters' of the party. They focus on aiding the other party members, be it by healing, granting extra opportunities, buffing, etc. What makes them different to the 'healbot' cleric of editions past is that WoTC noted a lot of people complained that whilst clerics were useful, they were often boring. So, leaders were designed to have 'double-duty' powers; abilities that would help the rest of the party and still let them get stuck into the fray.
Controllers are the 'tacticals' of the party. They manipulate the overall flow of battle, specializing in winnowing out weaker foes (mowing down minions with Fireball, for example), impeding stronger foes, and in manipulating the battlefield to force enemies to make hard decisions that benefit the party. It bears repeating that Roles do not apply outside of combat. They measure your tactical contributions/speciality in the party during a fight, and that's all. The player with a Leader type class does NOT have to be the party's meta-game leader unless the party wants them to be.
It is perfectly acceptable, if not encouraged, to set up interesting contrasts between a character's Role and their personality. For example, the snooty, supremacist aristocratic whose tactical genius can't be denied, but who is such an asshole that the party only keeps him around because he's useful in a fight, and certainly doesn't let him dictate what they should be doing outside of battle. Alignment As everyone knows, is one of D&D's oldest, right up there alongside 'do women have beards?' , and more virtual and literal ink has been spilled talking about the 'proper' definition of alignment and how it interacts with classes that have mandated alignment requirements.
To this end, 4e made two rather deep cuts to the sacred cow: First, classes would no longer have alignment restrictions of any kind., and could be lawful, could be chaotic, and could be whatever alignment they damn well pleased without losing all their class features. This got some murmuring at first, but it eventually died down, hence its survival into next edition. After all, had similarly relaxed many of these rules, and it didn't immediately collapse from there. Second, and much more controversially, the design team stripped out more than half of the existing alignments, collapsing together 'chaotic and neutral good' into just 'good,' 'lawful and neutral evil' into just 'evil,' and all three neutral alignments into 'unaligned.' Their arguments for these were, essentially, that the existing alignment system promoted debate and hurt feelings, and that a certain stratum of player saw these alignments as straitjackets restricting characterization rather than tools through which to understand it.
And it hearkened back to the very olden days, when alignment was a spectrum instead of a grid, thus: Law - Good - Neutral - Evil - Chaos. Unfortunately, this was very much a 'trying to please everyone, and succeeding in pleasing no one' scenario. People who liked the old alignment system hated the new one, seeing it, fairly or unfairly (and there are some eloquent defenses of it in the PHB) as a dumbed-down, stripped down version of the old one, tearing out more than half the options and leaving nothing to really replace them. People who hated the old alignment system continued to be unhappy with this one, since it was, after all, still an alignment system, only with even fewer options. And even the people who liked it (for indeed, the fractious nature of alignment-based discussions all-but guarantees there are people who see no difference between neutral and chaotic good, or lawful and chaotic neutral) got to get blasted by the heat of the raging flame war this choice unleashed.
Worse, was pretty-tightly tied to the traditional alignment system, and completely-revamping the entire alignment grid from the ground up necessitated plucking it up by the roots after the last edition had instead been content to subject it to malign neglect. And a variety of traditionally-friendly monsters were revamped into evil-or-at-least-dickish ones under the internally-consistent-but-externally-dubious logic that everything in the Monster Manual should exist to get killed, and putting in monsters that don't was just wasting everyone's time, leading to accusations that the alignment system was drastically revamped primarily to justify putting 'it's okay to kill this, really' alignments next to as many critters as possible. It was ultimately undone in the transition back to 5e, along with several of the changes to the setting cosmology 4e made, and, as with many 4e design choices, leaves the impression that, perhaps, the design team's vision might have been better served by just abandoning the old D&D system of alignment altogether. D&D 4e on /tg/.
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/tg/ reacts to 4e. Since its announcement 4e has been a source of controversy and trolling on /tg/. Its supporters consider it to have made D&D simple and fun.
Its critics have numerous objections to the system and setting, often referring to it as 'shit twinkie' (with the implication that they had been expecting a certain type of D&D goodness and sorely disappointed by what was actually delivered). More cogent arguments against 4th Edition by people tend to decry 4th over some of its perceived issues (character homogenization, signed-in-blood role enforcement, etc). This is not surprising, given that the fandom on /tg/ is about as fractious as the fandom on /co/ and /toy/. This was the exact same thing that had happened when 2e switched over to 3e, it's just that A: the internet gave us a much wider sounding-board than the scattered messaging boards and mail column of did, and B: /tg/ is /tg/ and hates on everything, though not nearly to the extent of say,.
However, since the release of 5th edition, /tg/'s actually gone and mellowed out a lot about 4e. The most common statement on the matter is that the calculated 'nostalgia-appeal' motif of 5e makes it honestly feel a little bland compared to 4e, whilst others feel free to admit to actually enjoying 4e's mechanics now that hating on it is no longer the hip thing to do. The common sentiment is that 4e would have actually been well-received if it was presented as a standalone fantasy combat simulator, but attempting to sell it as the successor to 3e doomed it to skub. While no one is blind to its flaws as a game and as a system (the combat is still widely seen as overcooked and mathy, and the D&D elements are often perceived as not really being well married to the game that was forced to use them), it does get some posthumous credit for engaging in daring experimentation rather than playing it safe, even among people who consider the ultimate result a failure. Fandom Though /tg/ frequently jokes that they don't actually exist, 4th has some legit fans.
As hugely popular as was and remains, 4e actually had huge sales throughout its lifespan, only starting to slow late in its lifespan. Since the release of 5th edition, the '4erries' have become both more common and more mellow, focusing mostly on just quietly talking about what they loved and occasionally needling 5e on what they see as negative choices in development - the loss of the and reworking into basically fuzzy demon-bred zombies first and foremost. Of course, spending more energy on hating on another game's flaws than promoting it's own virtues was arguably the original sin of 4e marketing, so. Here we go again. See also. External Links., 88 pages, for the 15 official rulebooks and setting books so far., May 2010, 36 pages., 4e character optimization, exploits and haxx like 'Flensing Weapon + Intimidate = instant win'.
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