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Sample records for protein-energy malnutrition pem

  1. Protein energy malnutrition.

    Science.gov (United States)

    Grover, Zubin; Ee, Looi C

    2009-10-01

    Protein energy malnutrition (PEM) is a common problem worldwide and occurs in both developing and industrialized nations. In the developing world, it is frequently a result of socioeconomic, political, or environmental factors. In contrast, protein energy malnutrition in the developed world usually occurs in the context of chronic disease. There remains much variation in the criteria used to define malnutrition, with each method having its own limitations. Early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

  2. Protein energy malnutrition: analysis of admission and outcome ...

    African Journals Online (AJOL)

    Background: Protein energy malnutrition (PEM) is a common condition in our environment. The morbidity and mortality is still high. Method: A retrospective study of 136 children with PEM, aimed at evaluating the outcome of management of children with severe protein energy malnutrition in Ahmadu Bello University ...

  3. Protein-Energy Malnutrition (PEM is Believed to Lead to an Increased Susceptibility to Infection, or cause Impaired Immunity

    Directory of Open Access Journals (Sweden)

    Mellova Amir Masrizal

    2003-08-01

    Full Text Available Infection, occurring with malnutrition, is a major cause of morbidity in all age groups and is responsible for two-thirds of all death under 5 yr of age in developing countries. Many cells of the immune system are known to depend for their function on metabolic pathways that employ various nutrients as critical factors. The most consistent changes in immune competence in PEM are in cell-mediated immunity, the bactericidal function of neutrophils, the complement system, the secretory immunoglobin A, and antibody response.

  4. Children with protein energy malnutrition: management and out ...

    African Journals Online (AJOL)

    Children with protein energy malnutrition: management and out-come in a ... Sahel Medical Journal ... Demographic data, predisposing factors, clinical types of PEM, outcome of management and time of discharge or death were also extracted ...

  5. Albumin synthesis in protein energy malnutrition

    International Nuclear Information System (INIS)

    Duggan, C.; Hardy, S.; Kleinman, R.E.; Lembcke, J.; Young, V.E.

    1994-01-01

    The dietary treatment of protein-energy malnutrition (PEM) has been designed on an empirical basis, with outcomes for successful management including body weight gain and resolution of apathy. We propose using the measurements of protein synthesis as a more objective measure of renourishment. We will therefore randomize a group of malnourished children (weigh-for-height Z score 13 C-leucine and serial measurements of 13 C-enrichment of albumin. Isotope infusions will be performed on days one and three, following a standard three hour fast. Since albumin synthesis is reduced under the influence of cytokines which mediate the inflammatory response, results will be stratified according to the presence or absence of clinically apparent infections. We hypothesize that the provision of added dietary protein will optimize albumin synthesis rates in PEM as well as attenuate the reduction in albumin synthesis seen in the presence of infections. (author). 20 refs

  6. Serum transferrin levels in children with protein-energy malnutrition

    Directory of Open Access Journals (Sweden)

    Selime Aydoğdu

    2013-03-01

    Full Text Available Objective: Although the diagnosis of patients with severemalnutrition is easy, it is very difficult to recognize patientswith mild and moderate malnutrition. A variety of methodsattempts to develop for early diagnosis of these cases.In this study, we evaluated the serum transferrin and albuminlevels in children with mild, moderate and severeprotein-energy malnutrition (PEM.Materials and methods: Children admitted to our policlinic,aged between 3 and 25 months, 45 subjects withPEM and 39 healthy subjects (control group were evaluated.According to the Gomez, Waterlow and Kanawatisubjects with PEM were divided in 3 subgroups mild,moderate and severe PEM. Anthropometric measurementsand biochemical results of 4 groups were compared.Results: For albumin levels in mild to moderate PEMgroups, 37.7% sensitivity, and 28.5% specificity, positivepredictive value 54%; negative predictive value 16.6%was found. For severe PEM sensitivity, specificity, positivepredictive value and negative predictive value were71%, 62.5%, 45%, and 83.3% respectively.With respect to the levels of transferrin, a significant differencewas found between mild PEM-control and moderatePEM-control groups (p0.05.Conclusion: Our study results showed that albumin isa weak indicator in mild-moderate PEM. In these cases,serum transferrin level reduces before decreasing of albuminlevel, thus it may be an early sensitive finding thatcan be used as a sensitive parameter in the diagnosis ofearly stages of malnutrition.Key words: Protein energy malnutrition, children, albumin,transferrin

  7. Albumin synthesis in protein energy malnutrition

    International Nuclear Information System (INIS)

    Duggan, C.; Hardy, S.; Kleinman, R.E.; Harvard Medical School, Children's Hospital, Boston, MA; Lembcke, J.; Young, V.R.

    1996-01-01

    Assessment of protein nutritional status during re-feeding children with protein energy malnutrition (PEM) can be difficult. We hypothesized that the fractional synthesis rate (FSR) of albumin, as measured by stable isotope technology, would serve as an objective measure of changes in protein status, and that increased amounts of dietary protein (15% of calories vs 10%) would lead to higher FSR. Eight (5 M, 3 F) Peruvian children (mean age 15.5 months) with PEM (mean wt/ht Z score = -2.47) were studied twice during the first week of admission by the flooding dose technique. An intravenous dose of 13 C-leucine (57 mg/kg, 99 atom%) was given and serial blood samples were drawn in intervals up to 90 minutes in order to measure isotopic enrichment of serum albumin. Mean FSR for the day one infusion was 6.11% (range 3.07 - 15.37%) (n = 8). Mean FSR for the follow-up infusion was 7.67% (range 3.63 - 12.37%) (n = 5), and FSR was no different between the two dietary groups. FSR on day one was inversely related to age (r = -0.62), and one patient with Shigella dysentery had the highest FSR (15.9%). We conclude that FSR of albumin can be measured successfully in children with PEM using the flooding dose technique, and that assessment of albumin FSR holds promise to help determine protein requirements and status during recovery from PEM. (author). 14 refs, 6 figs, 3 tabs

  8. Albumin synthesis in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, C; Hardy, S; Kleinman, R E [Massachusetts General Hospital, Boston, MA (United States); [Harvard Medical School, Children` s Hospital, Boston, MA (United States). Combined Program in Pediatric GI and Nutrition; Lembcke, J [Av. La Universidad S/N - La Molina, Lima (Peru). Inst. de Investigacion Nutricional; Young, V R [Massachussetts Inst. of Technology, Cambridge, MA (United States). Lab. of Human Nutrition

    1997-12-31

    Assessment of protein nutritional status during re-feeding children with protein energy malnutrition (PEM) can be difficult. We hypothesized that the fractional synthesis rate (FSR) of albumin, as measured by stable isotope technology, would serve as an objective measure of changes in protein status, and that increased amounts of dietary protein (15% of calories vs 10%) would lead to higher FSR. Eight (5 M, 3 F) Peruvian children (mean age 15.5 months) with PEM (mean wt/ht Z score = -2.47) were studied twice during the first week of admission by the flooding dose technique. An intravenous dose of {sup 13}C-leucine (57 mg/kg, 99 atom%) was given and serial blood samples were drawn in intervals up to 90 minutes in order to measure isotopic enrichment of serum albumin. Mean FSR for the day one infusion was 6.11% (range 3.07 - 15.37%) (n = 8). Mean FSR for the follow-up infusion was 7.67% (range 3.63 - 12.37%) (n = 5), and FSR was no different between the two dietary groups. FSR on day one was inversely related to age (r = -0.62), and one patient with Shigella dysentery had the highest FSR (15.9%). We conclude that FSR of albumin can be measured successfully in children with PEM using the flooding dose technique, and that assessment of albumin FSR holds promise to help determine protein requirements and status during recovery from PEM. (author). 14 refs, 6 figs, 3 tabs.

  9. [Protein-energy malnutrition in clinical practice].

    Science.gov (United States)

    Necheva, G I; Druk, I V; Lialiukova, E A

    2013-01-01

    The analysis of the reasons and mechanisms of development of an protein-energy malnutrition, communication of fetal pathology and development of an protein-energy malnutrition at mature age is submitted. Systemic character of a syndrome is marked out. Importance of a problem of an protein-energy malnutrition at patients with a dysplasia of a connecting tissue is bound to high prevalence of a syndrome at this pathology.

  10. Albumin synthesis in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, C; Hardy, S; Kleinman, R E [Harvard Medical School, Boston, MA (United States); Lembcke, J [Instituto de Investigacion Nutricional, La Molina, Lima (Peru); Young, V E [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States). Lab. of Human Nutrition

    1994-12-31

    The dietary treatment of protein-energy malnutrition (PEM) has been designed on an empirical basis, with outcomes for successful management including body weight gain and resolution of apathy. We propose using the measurements of protein synthesis as a more objective measure of renourishment. We will therefore randomize a group of malnourished children (weigh-for-height Z score <-2.0) to receive either a standard (10% of calories as protein) or increased (15%) amount of dietary protein early in their recovery phase. We will calculate albumin synthesis rates via the flooding dose technique, using {sup 13}C-leucine and serial measurements of {sup 13}C-enrichment of albumin. Isotope infusions will be performed on days one and three, following a standard three hour fast. Since albumin synthesis is reduced under the influence of cytokines which mediate the inflammatory response, results will be stratified according to the presence or absence of clinically apparent infections. We hypothesize that the provision of added dietary protein will optimize albumin synthesis rates in PEM as well as attenuate the reduction in albumin synthesis seen in the presence of infections. (author). 20 refs.

  11. Computed tomography in severe protein energy malnutrition.

    OpenAIRE

    Househam, K C; de Villiers, J F

    1987-01-01

    Computed tomography of the brain was performed on eight children aged 1 to 4 years with severe protein energy malnutrition. Clinical features typical of kwashiorkor were present in all the children studied. Severe cerebral atrophy or brain shrinkage according to standard radiological criteria was present in every case. The findings of this study suggest considerable cerebral insult associated with severe protein energy malnutrition.

  12. Protein-energy malnutrition: a risk factor for various ailments.

    Science.gov (United States)

    Batool, Rizwana; Butt, Masood Sadiq; Sultan, Muhammad Tauseef; Saeed, Farhan; Naz, Rabia

    2015-01-01

    The wheel of industrialization that spun throughout the last century resulted in urbanization coupled with modifications in lifestyles and dietary habits. However, the communities living in developing economies are facing many problems related to their diet and health. Amongst, the prevalence of nutritional problems especially protein-energy malnutrition (PEM) and micronutrients deficiencies are the rising issues. Moreover, the immunity or susceptibility to infect-parasitic diseases is also directly linked with the nutritional status of the host. Likewise, disease-related malnutrition that includes an inflammatory component is commonly observed in clinical practice thus affecting the quality of life. The PEM is treatable but early detection is a key for its appropriate management. However, controlling the menace of PEM requires an aggressive partnership between the physician and the dietitian. This review mainly attempts to describe the pathophysiology, prevalence and consequences of PEM and aims to highlight the importance of this clinical syndrome and the recent growth in our understanding of the processes behind its development. Some management strategies/remedies to overcome PEM are also the limelight of the article. In the nutshell, early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PEM.

  13. Language skills and intelligence quotient of protein energy malnutrition survivors.

    Science.gov (United States)

    Nassar, May F; Shaaban, Sanaa Y; Nassar, Jilan F; Younis, Neveen T; Abdel-Mobdy, Ahmad E

    2012-06-01

    The study was conducted on 33 children aged 3-6 years who suffered from protein energy malnutrition (PEM) during infancy in comparison to 30 matching children to assess the long-term deficits in cognition and language skills. The patients' files were revised to record their admission and follow-up data and history, clinical examination, intelligence quotient and language assessment were done. The study revealed that 2-5 years from the acute attack the PEM patients were still shorter than the controls and their cognitive abilities were poorer. Their mental ages and language skills were mostly determined by their height and the duration of follow-up during their acute illness. Additionally their diet after the 3-5 years is still defective and does not meet their recommended daily allowance. These observations urge us to continue following these patients for longer durations to make sure no permanent damage occurs due to the PEM insult to the growing brain.

  14. Protein energy malnutrition during vaccination has limited influence on vaccine efficacy but abolishes immunity if administered during Mycobacterium tuberculosis infection

    DEFF Research Database (Denmark)

    Hoang, Truc; Agger, Else Marie; Cassidy, Joseph P

    2015-01-01

    Protein energy malnutrition (PEM) increases susceptibility to infectious diseases, including tuberculosis (TB), but it is not clear how PEM influences vaccine-promoted immunity to TB. We demonstrate that PEM during low-level steady-state TB infection in a mouse model results in rapid relapse...

  15. Relationship between protein energy malnutrition and social maturity in children aged 1-2 years

    OpenAIRE

    Nurhayati Nurhayati; Soetjiningsih Soetjiningsih; I Ketut G. Suandi

    2006-01-01

    Background Protein energy malnutrition (PEM) affects physical, psychological, and social development. Objective To investigate the relationship between PEM and social maturity in children aged 1-2 years. Methods We carried out a cross-sectional study at Child Health Outpatient Clinic, Sanglah Hospital, betweenApril-September 2000. We included children living with their parents, with no handicap or chronically ill condition. Data were collected by using structured questionnaires. Nutri...

  16. Free Radicals and Antioxidant Status in Protein Energy Malnutrition

    Directory of Open Access Journals (Sweden)

    M. Khare

    2014-01-01

    Full Text Available Background/Objectives. The aim of this study was to evaluate oxidant and antioxidant status in children with different grades of Protein Energy Malnutrition (PEM. Subjects/Methods. A total of two hundred fifty (250 children (age range: 6 months to 5 years living in eastern UP, India, were recruited. One hundred and ninety-three (193 of these children had different grades of PEM (sixty-five (65 children belong to mild, sixty (60 to moderate, and sixty-eight (68 to severe group. Grading in group was done after standardization in weight and height measurements. Fifty-seven (57 children who are age and and sex matched, healthy, and well-nourished were recruited from the local community and used as controls after checking their protein status (clinical nutritional status with height and weight standardization. Redox homeostasis was assessed using spectrophotometric/colorimetric methods. Results. In our study, erythrocyte glutathione (GSH, plasma Cu, Zn-superoxide dismutase (Cu,Zn-SOD,EC 1.15.1.1, ceruloplasmin (Cp, and ascorbic acid were significantly (P<0.001 more decreased in children with malnutrition than controls. Plasma malondialdehyde (MDA, and protein carbonyl (PC were significantly (P<0.001 raised in cases as compared to controls. Conclusion. Stress is created as a result of PEM which is responsible for the overproduction of reactive oxygen species (ROSs. These ROSs will lead to membrane oxidation and thus an increase in lipid peroxidation byproducts such as MDA and protein oxidation byproducts such as PC mainly. Decrease in level of antioxidants suggests an increased defense against oxidant damage. Changes in oxidant and antioxidant levels may be responsible for grading in PEM.

  17. Serum proteinase inhibitors and other serum proteins in protein-energy malnutrition

    NARCIS (Netherlands)

    Schelp, F.P.; Migasena, P.; Pongpaew, P.; SCHREURS W.H.P

    1977-01-01

    1. The concentrations of serum protein albumin, prealbumin and transferrin were determined in twenty-eight cases of protein-energy malnutrition (PEM) with infection, together with the levels of serum proteinase inhibitors (PI), alpha1-antitrypsin (AT), alpha1-antichymotrypsin (Ach),

  18. A narrative review of recent progress in understanding the relationship between tuberculosis and protein energy malnutrition.

    Science.gov (United States)

    Hood, M L H

    2013-11-01

    Protein energy malnutrition (PEM) and tuberculosis (TB) are the major public health issues, particularly in the developing country setting. Malnutrition is an underlying cause of many deaths and when left untreated devastates normal physical and cognitive development. TB continues to gather momentum as a serious infectious killer. They have both rightly been highlighted as important global health issues by their inclusion in the Millennium Development Goals. But what is known of their relationship with one another? It is historically accepted that PEM and TB have a synergistic relationship adversely having an impact on one another. However, researchers have sought to apply this understanding in an examination of the relationship between TB and PEM with often inconclusive results. This narrative review of recently published research and current knowledge may help delineate the association between PEM and TB mortality. Such results will assist future research in this important area of health--an area lacking evidence-based guidance.

  19. Reverse triiodothyronine in protein energy malnutrition

    Energy Technology Data Exchange (ETDEWEB)

    Hafiez, A A; Abdel-Salam, E; Abbas, E Z; Halawa, F A; El-Hefnawy, N [Cairo Univ. (Egypt)

    1984-08-01

    Serum levels of thyroxine (T/sub 4/), triiodothyronine (T/sub 3/), reverse triiodothyronine (rT/sub 3/) and thyrotropin (TSH) were determined in cases of kwashiorkor and marasmus. Decreased levels of T/sub 4/ and T/sub 3/, and increased levels of rT/sub 3/ with no change in TSH were obtained. Thus in infants suffering from protein energy malnutrition there is a state of thyroid dysfunction as well as a shift in the peripheral T/sub 4/ metabolism being converted to the inert rT/sub 3/ rather than to the physiologically active T/sub 3/.

  20. Reverse triiodothyronine in protein energy malnutrition

    International Nuclear Information System (INIS)

    Hafiez, A.A.; Abdel-Salam, E.; Abbas, E.Z.; Halawa, F.A.; El-Hefnawy, N.

    1984-01-01

    Serum levels of thyroxine (T 4 ), triiodothyronine (T 3 ), reverse triiodothyronine (rT 3 ) and thyrotropin (TSH) were determined in cases of kwashiorkor and marasmus. Decreased levels of T 4 and T 3 , and increased levels of rT 3 with no change in TSH were obtained. Thus in infants suffering from protein energy malnutrition there is a state of thyroid dysfunction as well as a shift in the peripheral T 4 metabolism being converted to the inert rT 3 rather than to the physiologically active T 3 . (author)

  1. Porcine placenta mitigates protein-energy malnutrition-induced fatigue.

    Science.gov (United States)

    Han, Na-Ra; Kim, Kyu-Yeop; Kim, Myong-Jo; Kim, Min-Ho; Kim, Hyung-Min; Jeong, Hyun-Ja

    2013-01-01

    Fatigue can be caused by a deficiency of nutrition or immune function. The goal of this study was to identify the effects of porcine placenta extract (PPE) and its constituents, amino acids (glutamic acid, glycine, arginine, and proline), on protein-energy malnutrition (PEM)-induced fatigue. Mice were administered a PEM diet and came to immunodeficient status. Simultaneously, the mice were administered PPE or amino acids and a forced swimming test (FST) was performed. We analyzed the levels of fatigue-related factors in serum, splenocytes, and muscles. In the FST, PPE or amino acids significantly decreased immobility times compared with the PEM diet. PPE or amino acids also significantly decreased the serum levels of fatigue-related factors after the FST. Additionally, PPE significantly decreased the levels of fatigue-related muscle parameters after the FST. In this in vitro study, PPE increased the mRNA and protein expression of Ki-67 and promoted the proliferation of splenocytes. PPE or amino acids significantly increased the levels of intracellular calcium and the translocation into the nucleus of nuclear factor of activated T-cells cytoplasmic in stimulated splenocytes. PPE or amino acids significantly decreased the production of fatigue-related inflammatory cytokines in the stimulated splenocytes. Additionally, the translocated levels of nuclear factor-κB in the nucleus and the degradation of the inhibitory protein, IκBα, in the cytosol were inhibited by PPE or amino acids. These results demonstrate that PPE and its constituents regulate PEM-induced fatigue through improving levels of immunity and decreasing fatigue-related factors. PPE may be a potential agent for a recovery from fatigue. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Protein energy malnutrition alters mucosal IgA responses and reduces mucosal vaccine efficacy in mice.

    Science.gov (United States)

    Rho, Semi; Kim, Heejoo; Shim, Seung Hyun; Lee, Seung Young; Kim, Min Jung; Yang, Bo-Gie; Jang, Myoung Ho; Han, Byung Woo; Song, Man Ki; Czerkinsky, Cecil; Kim, Jae-Ouk

    2017-10-01

    Oral vaccine responsiveness is often lower in children from less developed countries. Childhood malnutrition may be associated with poor immune response to oral vaccines. The present study was designed to investigate whether protein energy malnutrition (PEM) impairs B cell immunity and ultimately reduces oral vaccine efficacy in a mouse model. Purified isocaloric diets containing low protein (1/10 the protein of the control diet) were used to determine the effect of PEM. PEM increased both nonspecific total IgA and oral antigen-specific IgA in serum without alteration of gut permeability. However, PEM decreased oral antigen-specific IgA in feces, which is consistent with decreased expression of polymeric Immunoglobulin receptor (pIgR) in the small intestine. Of note, polymeric IgA was predominant in serum under PEM. In addition, PEM altered B cell development status in the bone marrow and increased the frequency of IgA-secreting B cells, as well as IgA secretion by long-lived plasma cells in the small intestinal lamina propria. Moreover, PEM reduced the protective efficacy of the mucosally administered cholera vaccine and recombinant attenuated Salmonella enterica serovar Typhimurium vaccine in a mouse model. Our results suggest that PEM can impair mucosal immunity where IgA plays an important role in host protection and may partly explain the reduced efficacy of oral vaccines in malnourished subjects. Copyright © 2017 European Federation of Immunological Societies. Published by Elsevier B.V. All rights reserved.

  3. Cognitive development in children with chronic protein energy malnutrition

    Directory of Open Access Journals (Sweden)

    Chandramouli B A

    2008-07-01

    Full Text Available Abstract Background Malnutrition is associated with both structural and functional pathology of the brain. A wide range of cognitive deficits has been reported in malnourished children. Effect of chronic protein energy malnutrition (PEM causing stunting and wasting in children could also affect the ongoing development of higher cognitive processes during childhood (>5 years of age. The present study examined the effect of stunted growth on the rate of development of cognitive processes using neuropsychological measures. Methods Twenty children identified as malnourished and twenty as adequately nourished in the age groups of 5–7 years and 8–10 years were examined. NIMHANS neuropsychological battery for children sensitive to the effects of brain dysfunction and age related improvement was employed. The battery consisted of tests of motor speed, attention, visuospatial ability, executive functions, comprehension and learning and memory Results Development of cognitive processes appeared to be governed by both age and nutritional status. Malnourished children performed poor on tests of attention, working memory, learning and memory and visuospatial ability except on the test of motor speed and coordination. Age related improvement was not observed on tests of design fluency, working memory, visual construction, learning and memory in malnourished children. However, age related improvement was observed on tests of attention, visual perception, and verbal comprehension in malnourished children even though the performance was deficient as compared to the performance level of adequately nourished children. Conclusion Chronic protein energy malnutrition (stunting affects the ongoing development of higher cognitive processes during childhood years rather than merely showing a generalized cognitive impairment. Stunting could result in slowing in the age related improvement in certain and not all higher order cognitive processes and may also result in

  4. A review of some metabolic changes in protein-energy malnutrition.

    Science.gov (United States)

    Akuyam, S A

    2007-06-01

    Protein-energy malnutrition (PEM) is a major public health problem in the tropical and subtropical regions of the world and often arises during protein and / or energy deficit due to nutritional inadequacy, infections and poor socio-economic and environmental conditions. It is the most common nutritional disorder affecting children in developing countries and the third most common disease of childhood in such countries. PEM has a lasting effect on immune functions, growth and development of children, learning ability, social adjustment, work efficiency and productivity of labour. It seems that many deaths from PEM occur as a result of outdated clinical practices and that improving these practices reduces the rate of morbidity and mortality. This paper reviews various metabolic changes in protein-energy malnutrition (PEM). It gives an overview of the theoretical basis for the understanding of the biochemical derangements in PEM. It aims at stimulating the paediatricians and clinical chemists to read more on the recent advances in this broad subject with the view to improving the understanding of the current laboratory investigation of PEM. This review demonstrates that the metabolic changes in PEM include water and electrolytes imbalance, amino acids and proteins deficiencies, carbohydrates and energy deficiencies, hypolipidaemias, hypolipoproteinaemias, hormonal imbalance, deficiency of anti-oxidant vitamins and enzymes, depression of cell-mediated immune complexes and decrease in amino acids and trace elements in skin and hair. The review therefore suggests that assessment of these conditions in PEM patients could improve the management of this group of patients and hence reduce the rate of morbidity and mortality from PEM.

  5. Protein-energy malnutrition is frequent and precocious in children with cri du chat syndrome.

    Science.gov (United States)

    Lefranc, Violaine; de Luca, Arnaud; Hankard, Régis

    2016-05-01

    Protein-energy malnutrition (PEM) is poorly reported in cri du chat syndrome (CDCS) (OMIM #123450), a genetic disease that causes developmental delay and global growth retardation. The objective was to determine the nutritional status at different ages in children with CDCS and factors associated with PEM. A questionnaire focused on growth and nutritional care was sent to 190 families. Among 36 analyzable questionnaires, growth and nutritional indices compatible with PEM occurred in 47% of patients: 19% before 6 months of age, 24% between 6-12 months and 34% after 12 months. Eight patients received enteral feeding. Speech therapy for swallowing education was performed more often in malnourished children (63% vs. 22%, P < 0.02). PEM is frequent and occurs early in this disease, requiring closed nutritional monitoring. © 2016 Wiley Periodicals, Inc.

  6. Protein energy-malnutrition: does the in vitro zinc sulfate supplementation improve chromosomal damage repair?

    Science.gov (United States)

    Padula, Gisel; González, Horacio F; Varea, Ana; Seoane, Analía I

    2014-12-01

    Protein-energy malnutrition (PEM) is originated by a cellular imbalance between nutrient/energy supply and body's demand. Induction of genetic damage by PEM was reported. The purpose of this study was to determine the genetic effect of the in vitro zinc sulfate (ZnSO4) supplementation of cultured peripheral blood lymphocytes from children with PEM. Twenty-four samples from 12 children were analyzed. Anthropometric and biochemical diagnosis was made. For the anthropometric assessment, height-for-age index, weight-for-age index, and weight-for-height index were calculated (WHO, 2005). Micronutrient status was evaluated. A survey for assessed previous exposure to potentially genotoxic agents was applied. Results were statistically evaluated using paired sample t test and χ (2) test. Each sample was fractionated and cultured in two separate flasks to performed two treatments. One was added with 180 μg/dl of ZnSO4 (PEMs/ZnSO4) and the other remains non-supplemented (PEMs). Cytotoxic effects and chromosomal damage were assessed using the cytokinesis-block micronucleus assay (CBMN). All participants have at least one type of malnutrition and none have anemia, nor iron, folate, vitamin A, and zinc deficiency. All PEMs/ZnSO4 samples have a significant reduction in the micronucleus (MNi) frequency compared with PEMs (t = 6.25685; p < 0.001). Nuclear division index (NDI) increase in PEMs/ZnSO4 (t = -17.4226; p < 0.001). Nucleoplasmic bridge (NPBs) frequency was four times smaller in PEMs/ZnSO4 (χ (2) = 40.82; p < 0.001). No nuclear buds (NBuds) were observed. Cytotoxic effects and chromosomal damage observed in children suffering from PEM can be repaired in vitro with zinc sulfate supplementation.

  7. Protein energy malnutrition associates with different types of hearing impairments in toddlers: Anemia increases cochlear dysfunction.

    Science.gov (United States)

    Kamel, Terez Boshra; Deraz, Tharwat Ezzat; Elkabarity, Rasha H; Ahmed, Rasha K

    2016-06-01

    This work aimed to highlight a challenging asymptomatic problem which is early detection of hearing impairment in toddlers with protein energy malnutrition (PEM) as a neuro-cognitive effect of PEM on developing brain in relation to hemoglobin level. 100 toddlers, aged 6-24 months, fifty with moderate/severe PEM and fifty healthy children, were included in study. Both TEOAEs and ABR testing were used to assess auditory function. Study reported an association between malnutrition and hearing impairment, 26% of cases had conductive deafness secondary to otitis media with effusion using tympanometry; 84.6% showed type B and 15.4% type C which may suggest developing or resolving otitis media. Their ABR showed 46% mild and 53% moderate impairment. 32% of PEM cases had sensory neural hearing loss and with type (A) tympanometry. Those were assessed using ABR; 58% had mild, 34% moderate and 8% profound impairment. 10% of PEM cases had mixed hearing loss with 50% type B and 50% type C tympanometry and their ABR showed moderate to profound impairment. TEOAEs latencies at different frequencies correlate negatively with hemoglobin level. Toddlers with moderate/severe PEM had hearing impairments of different types and degrees. Neuro-physiological methods could be early and safe detectors of auditory disorders especially in high-risk toddlers. Anemia increases risk for auditory dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Practical dietary management of protein energy malnutrition in young children with cow's milk protein allergy.

    Science.gov (United States)

    Meyer, Rosan; Venter, Carina; Fox, Adam T; Shah, Neil

    2012-06-01

    Cow's milk protein allergy (CMPA) affects between 1.9 and 4.9% of infants and young children. This food allergy requires the complete elimination of cow's milk and its derivatives, impacting on nutritional status. The risk of having protein energy malnutrition (PEM) in children with CMPA has been well documented. In 2007, the World Health Organisation published guidelines on the dietary management of PEM, which has impacted on the recommendations and composition on specialist feeds for many chronic diseases, but not on CMPA. The main change in management of the child with PEM is the protein energy ratio and energy requirements. The ideal protein energy ratio lies between 8.9 and 11.5%, which would ensure a deposition of about 70% lean and 30% fat mass. In addition, for optimal catch-up growth between 5 and 10 g/kg/day, energy requirements should be between 105 and 126 kcal/kg/day. Although most current hypoallergenic formulas fall well within the recommendation for protein, there is a problem in achieving energy requirements. As a result, modular additions are often made, disturbing the protein energy ratio or feeds are concentrated, which impacts on osmolality. We therefore aimed to review current guidelines on PEM and how these can be applied in the management of the malnourished child with CMPA. © 2012 John Wiley & Sons A/S.

  9. [Dietary prevention of protein-energy malnutrition during early postoperative period in elderly patients with gastroduodenal diseases].

    Science.gov (United States)

    Baranovskiĭ, A Iu; Protopopova, O B

    2012-01-01

    The modified diet of postoperative rehabilitation program in elderly patients with gastroduodenal ulcers and prognosis of development of protein-energy malnutrition (PEM) is presented. It is shown that early initiated special diet in postoperative period, blocks mechanisms of malnutrition and can significantly improve the functional status of the small intestine and activate, thus, membrane digestion, which leads to normalization of all types of metabolism in elderly patients. In comparison with control group, where 72% of patients in postoperative period had malnutrition, malnutrition in the study group revealed a mild degree in only 17.3% of patients.

  10. Hepatoprotective and nephroprotective effects of Cnidoscolus aconitifolius in protein energy malnutrition induced liver and kidney damage.

    Science.gov (United States)

    Oyagbemi, Ademola A; Odetola, Adebimpe A

    2013-10-01

    This study was designed to evaluate the ameliorative and hypocholesterolemic effects of dietary supplementation of Cnidoscolus aconitifolius leaf meal (CALM) on hepatic injury and kidney injury associated with protein energy malnutrition (PEM). In this study, PEM was induced in weaning male Wistar albino rats by feeding them with low protein diet for 2 weeks. The effects of several recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed were assessed in PEM rats. Plasma biochemical parameters were assessed as well. After the induction of PEM, results obtained showed significant increase in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total proteins (T.P), total bilirubin (T.Bil), triglycerides, total cholesterol, low density lipoproteins (LDL), blood urea nitrogen (BUN), and creatinine with significant reduction in plasma high density lipoproteins (HDL), albumin, sodium (Na(+)), potassium (K(+)), chloride (Cl(-)), bicarbonate (HC03(-)), and phosphate (P04(2-)) in PEM rats. Upon introduction of recovery diets containing 20% soya protein or 20% C. aconitifolius in place of soya protein or 10% soya proteins with 10% C. aconitifolius or commercial rat feed for 4 weeks caused significant (P protein deficient diets has a protective role against hepatic injury and renal damage associated with PEM.

  11. Prognostic significance of low skeletal muscle mass compared with protein-energy malnutrition in liver cirrhosis.

    Science.gov (United States)

    Nishikawa, Hiroki; Enomoto, Hirayuki; Ishii, Akio; Iwata, Yoshinori; Miyamoto, Yuho; Ishii, Noriko; Yuri, Yukihisa; Takata, Ryo; Hasegawa, Kunihiro; Nakano, Chikage; Nishimura, Takashi; Yoh, Kazunori; Aizawa, Nobuhiro; Sakai, Yoshiyuki; Ikeda, Naoto; Takashima, Tomoyuki; Iijima, Hiroko; Nishiguchi, Shuhei

    2017-09-01

    To investigate the impact of low skeletal muscle mass (LSMM) on survival as compared with protein-energy malnutrition (PEM) in patients with liver cirrhosis (LC). A total of 206 individuals with LC were analyzed. We retrospectively examined the impact of LSMM, as defined by psoas muscle mass at the third lumber on computed tomography, on survival as compared with PEM. In terms of comparison of the effects of LSMM and PEM on survival, we used time-dependent receiver operating characteristics (ROC) analysis. Our study cohort included 115 men and 91 women with a median age of 67 years. There were 140 patients with Child-Pugh A, 62 with Child-Pugh B, and 4 with Child-Pugh C. A total of 117 patients (56.8%) had LSMM and 52 patients (25.2%) had PEM. The proportion of PEM in patients with LSMM (31.62%, 37/117) was significantly higher than in patients without LSMM (16.85%, 15/89) (P = 0.0229). In the multivariate analysis for the entire cohort, the presence of hepatocellular carcinoma, lower body mass index, presence of LSMM, lower triglyceride value, poorer renal function, and higher des-γ-carboxy prothrombin value were found to be significant adverse predictors linked to overall survival, while presence of PEM tended to be significant. In the time-dependent ROC analysis, all area under the ROCs for survival in LSMM at each time point were higher than those in PEM except for Child-Pugh B patients. In this comparison of LSMM and PEM on clinical outcomes in LC patients, it was shown that LSMM may have stronger prognostic impact than PEM. © 2016 The Japan Society of Hepatology.

  12. Prevalence of protein-energy malnutrition in hospital patients over 75 years of age admitted for hip fracture.

    Science.gov (United States)

    Drevet, S; Bioteau, C; Mazière, S; Couturier, P; Merloz, P; Tonetti, J; Gavazzi, G

    2014-10-01

    One percent of falls in over-75 years old cause hip fracture (HF). Protein-energy malnutrition (PEM) is associated with falls and fracture. PEM screening and perioperative nutritional management are recommended by the European Society of Parenteral and Enteral Nutrition, yet data on nutritional status in elderly HF patients are sparse. The Mini Nutritional Assessment (MNA) score is presently the most effective screening tool for PEM in over-75 years old. The principal objective of the present study was to determine the prevalence on MNA of PEM in patients aged over 75 years admitted for HF. Secondary objectives were to identify factors associated with PEM and its role as a factor of evolution. A prospective observational epidemiological study included 50 patients aged over 75 years admitted for HF in an 8-bed orthopedic surgery department with a geriatric follow-up unit. PEM was defined by MNApatients was 86.1 years (range, 77-94 years). Prevalence of PEM was 28%; a further 58% of patients were at risk for PEM. PEM was associated with elevated CIRS-G (Ppatients aged over 75 years, supporting longer hospital stay. MNA is a diagnostic gold standard, not to be replaced by albuminemia or body-mass index in this perioperative clinical situation. Given the present economic stakes relating to geriatric trauma patients' hospital stay, it is essential to prevent, diagnose and treat PEM in elderly subjects. Level IV; prospective cohort study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. Protein-Energy Malnutrition Causes Deficits in Motor Function in Adult Male Rats.

    Science.gov (United States)

    Alaverdashvili, Mariam; Li, Xue; Paterson, Phyllis G

    2015-11-01

    Adult protein-energy malnutrition (PEM) often occurs in combination with neurological disorders affecting hand use and walking ability. The independent effects of PEM on motor function are not well characterized and may be obscured by these comorbidities. Our goal was to undertake a comprehensive evaluation of sensorimotor function with the onset and progression of PEM in an adult male rat model. In Expt. 1 and Expt. 2, male Sprague-Dawley rats (14-15 wk old) were assigned ad libitum access for 4 wk to normal-protein (NP) or low-protein (LP) diets containing 12.5% and 0.5% protein, respectively. Expt. 1 assessed muscle strength, balance, and skilled walking ability on days 2, 8, and 27 by bar-holding, cylinder, and horizontal ladder walking tasks, respectively. In addition to food intake and body weight, nutritional status was determined on days 3, 9, and 28 by serum acute-phase reactant and corticosterone concentrations and liver lipids. Expt. 2 addressed the effect of an LP diet on hindlimb muscle size. PEM evolved over time in rats consuming the LP diet. Total food intake decreased by 24% compared with the NP group. On day 28, body weight and serum albumin decreased by 31% and 26%, respectively, and serum α2-macroglobulin increased by 445% (P malnutrition. This model can be used in combination with disease models of sensorimotor deficits to examine the interactions between nutritional status, other treatments, and disease progression. © 2015 American Society for Nutrition.

  14. Hematologic and bone marrow changes in children with protein-energy malnutrition.

    Science.gov (United States)

    Özkale, Murat; Sipahi, Tansu

    2014-05-01

    All systems in an organism are affected by protein-energy malnutrition (PEM), but one of the worst affected is the hematopoietic system. Today PEM remains a very serious problem in developing countries. We examined the relationships between clinical features, hematological, and bone marrow changes with severe PEM from Turkey. We evaluated 34 (11 females and 23 males) consecutive cases of severe PEM, with no underlying diseases aged 3-20 months. The clinical nutritional conditions of the patients were determined using the Wellcome-Trust PEM classification. Ten of the patients were in the Marasmic-Kwashiorkor (M-K) group, 10 were in the Kwashiorkor (KW) group, and 14 were in the Marasmic (M) group. Full blood count, protein, albumin, serum iron (SI), iron-binding capacity (TIBC), ferritin, vitamin B12, folic acid, complement-3 (C3), complement-4 (C4), and bone marrow were investigated in all groups. Anemia was detected in 97% of patients. We determined serum iron levels were low in 67.6% of the patients, TS levels were low in 76.4% of the patients and ferritin levels were low in 20.5%. The level of vitamin B12 was normal in all patients. Bone marrow analysis showed erythroid series hypoplasia in 28.5% of patients in the M group, 50% in the KW group, and 30% in the M-K group. Marrow iron was absent in 58.8% of patients. The most common hematologic change in the children with PEM was anemia and major cause of anemia was iron deficiency in this study. Patients with severe PEM have normal Vit B12 and serum folate levels. Most of the patients with severe PEM had normal cellularity with megaloblastic and dysplastic changes in bone marrow due to the inadequate and imbalanced intake of protein and energy.

  15. Protein energy malnutrition decreases immunity and increases susceptibility to influenza infection in mice.

    Science.gov (United States)

    Taylor, Andrew K; Cao, Weiping; Vora, Keyur P; De La Cruz, Juan; Shieh, Wun-Ju; Zaki, Sherif R; Katz, Jacqueline M; Sambhara, Suryaprakash; Gangappa, Shivaprakash

    2013-02-01

    Protein energy malnutrition (PEM), a common cause of secondary immune deficiency in children, is associated with an increased risk of infections. Very few studies have addressed the relevance of PEM as a risk factor for influenza. We investigated the influence of PEM on susceptibility to, and immune responses following, influenza virus infection using isocaloric diets providing either adequate protein (AP; 18%) or very low protein (VLP; 2%) in a mouse model. We found that mice maintained on the VLP diet, when compared to mice fed with the AP diet, exhibited more severe disease following influenza infection based on virus persistence, trafficking of inflammatory cell types to the lung tissue, and virus-induced mortality. Furthermore, groups of mice maintained on the VLP diet showed significantly lower virus-specific antibody response and a reduction in influenza nuclear protein-specific CD8(+) T cells compared with mice fed on the AP diet. Importantly, switching diets for the group maintained on the VLP diet to the AP diet improved virus clearance, as well as protective immunity to viral challenge. Our results highlight the impact of protein energy on immunity to influenza infection and suggest that balanced protein energy replenishment may be one strategy to boost immunity against influenza viral infections.

  16. Protein-energy malnutrition alters thermoregulatory homeostasis and the response to brain ischemia.

    Science.gov (United States)

    Smith, Shari E; Prosser-Loose, Erin J; Colbourne, Frederick; Paterson, Phyllis G

    2011-02-01

    Co-existing protein-energy malnutrition (PEM), characterized by deficits in both protein and energy status, impairs functional outcome following global ischemia and has been associated with increased reactive gliosis. Since temperature is a key determinant of brain damage following an ischemic insult, the objective was to investigate whether alterations in post-ischemic temperature regulation contribute to PEM-induced reactive gliosis following ischemia. Male Sprague-Dawley rats (190-280 g) were assigned to either control diet (18% protein) or PEM induced by feeding a low protein diet (2% protein) for 7 days prior to either global ischemia or sham surgery. There was a rapid disruption in thermoregulatory function in rats fed the low protein diet as assessed by continuous recording of core temperature with bio-electrical sensor transmitters. Both daily temperature fluctuation and mean temperature increased within the first 24 hours, and these remained significantly elevated throughout the 7 day pre-ischemic period (p protein diet rapidly impairs the ability to maintain thermoregulatory homeostasis, and the resultant PEM also diminishes the ability to thermoregulate in response to a challenge. Since temperature regulation is a key determinant of brain injury following ischemia, these findings suggest that the pathophysiology of brain injury could be altered in stroke victims with coexisting PEM.

  17. Protein energy malnutrition predicts complications in liver cirrhosis.

    Science.gov (United States)

    Huisman, Ellen J; Trip, Evelien J; Siersema, Peter D; van Hoek, Bart; van Erpecum, Karel J

    2011-11-01

    Protein energy malnutrition frequently occurs in liver cirrhosis. Hand-grip strength according to Jamar is most reliable to predict protein energy malnutrition. We aimed to determine whether protein energy malnutrition affects complication risk. In 84 cirrhotics, baseline nutritional state was determined and subsequent complications prospectively assessed. Influence of potentially relevant factors including malnutrition (by Jamar hand-grip strength) on complication rates were evaluated with univariate analysis. Effect of malnutrition was subsequently evaluated by multivariate logistic regression with adjustment for possible confounders. Underlying causes of cirrhosis were viral hepatitis in 31%, alcohol in 26%, and other in 43%. Baseline Child-Pugh (CP) class was A, B, or C in 58, 35, and 7%, respectively. Energy and protein intake decreased significantly with increasing CP class, with shift from proteins to carbohydrates. At baseline, according to Jamar hand-grip strength, malnutrition occurred in 67% (n=56). Malnutrition was associated with older age and higher CP class (CP class A 57%, B 79%, C 100%) but not with underlying disease or comorbidity. Complications occurred in 18 and 48% in well-nourished and malnourished patients, respectively, (P=0.007) during 13 ± 6 months follow-up. In multivariate analysis, malnutrition was an independent predictor of complications, after correcting for comorbidity, age, and CP score (adjusted odds ratio 4.230; 95% confidence interval 1.090-16.422; P=0.037). In univariate analysis, mortality (4 vs. 18%; P=0.1) tended to be worse in malnourished patients, but this trend was lost in multivariate analysis. Malnutrition is an independent predictor of complications in cirrhosis.

  18. Factors Associated With Protein-energy Malnutrition in Chronic Liver Disease: Analysis Using Indirect Calorimetry.

    Science.gov (United States)

    Nishikawa, Hiroki; Yoh, Kazunori; Enomoto, Hirayuki; Iwata, Yoshinori; Kishino, Kyohei; Shimono, Yoshihiro; Hasegawa, Kunihiro; Nakano, Chikage; Takata, Ryo; Nishimura, Takashi; Aizawa, Nobuhiro; Sakai, Yoshiyuki; Ikeda, Naoto; Takashima, Tomoyuki; Ishii, Akio; Iijima, Hiroko; Nishiguchi, Shuhei

    2016-01-01

    We aimed to elucidate the incidence of protein-energy malnutrition (PEM) in patients with chronic liver disease and to identify factors linked to the presence of PEM.A total of 432 patients with chronic liver disease were analyzed in the current analysis. We defined patients with serum albumin level of ≤3.5 g/dL and nonprotein respiratory quotient (npRQ) value using indirect calorimetry less than 0.85 as those with PEM. We compared between patients with PEM and those without PEM in baseline characteristics and examined factors linked to the presence of PEM using univariate and multivariate analyses.There are 216 patients with chronic hepatitis, 123 with Child-Pugh A, 80 with Child-Pugh B, and 13 with Child-Pugh C. Six patients (2.8%) had PEM in patients with chronic hepatitis, 17 (13.8%) in patients with Child-Pugh A, 42 (52.5%) in patients with Child-Pugh B, and 10 (76.9%) in patients with Child-Pugh C (P < 0.001). Multivariate analysis revealed that Child-Pugh classification (P < 0.001), age ≥64 years (P = 0.0428), aspartate aminotransferase (AST) ≥40 IU/L (P = 0.0023), and branched-chain amino acid to tyrosine ratio (BTR) ≤5.2 (P = 0.0328) were independent predictors linked to the presence of PEM. On the basis of numbers of above risk factors (age, AST, and BTR), the proportions of patients with PEM were well stratified especially in patients with early chronic hepatitis or Child-Pugh A (n = 339, P < 0.0001), while the proportions of patients with PEM tended to be well stratified in patients with Child-Pugh B or C (n = 93, P = 0.0673).Age, AST, and BTR can be useful markers for identifying PEM especially in patients with early stage of chronic liver disease.

  19. Missed opportunities in the diagnosis and management of protein energy malnutrition among children under 5 years in Wakiso district, Uganda.

    Science.gov (United States)

    Akugizibwe, Roselyne; Kasolo, Josephine; Makubuya, Duncan B; Damani, Ali M

    2013-11-30

    Protein energy malnutrition (PEM) is one of the leading causes of death among children below 5 years in Uganda. It develops after acute childhood illnesses despite children having received treatment from health facilities. This study assessed knowledge and practices of health workers in the diagnosis and management of PEM, which was used to establish missed opportunities to prevent severe acute malnutrition (SAM) in its management. This was a cross sectional descriptive study that used questionnaires and observation of health workers at Health Center IV (HCIV) in Wakiso district, Uganda. The clinical nutrition diagnosis of the children was then obtained. There were 44 health workers that assessed 225 children. Most of the health workers 32 (72.7%) had education in PEM management and over 60% of them knew the forms of PEM, clinical signs of kwashiorkor and marasmus and the factors that predispose to PEM. Health workers did not weigh 56 (24.9%) of the children, 193 (86%) children had no height taken and only 32 (14.2%) had mid upper arm circumference measured. The weight for height of 223 (99.2%) and weight for age of 109 (93%) children was not calculated. Only 38 (16.89%) were examined for edema and 40 (17.78%) for muscle wasting. Health workers diagnosed only 21 (9%) children with malnutrition, while researchers found 94 (31.9%) with malnutrition. Children who missed opportunity to have malnutrition diagnosed at the health facility were 73 (32.9%). The knowledge of health workers on PEM is adequate, but their practice is inadequate. There is missed opportunity to diagnose and manage PEM among children who present with acute illnesses at the health centers, hence missed opportunity to prevent SAM.

  20. Protein energy malnutrition increases arginase activity in monocytes and macrophages.

    Science.gov (United States)

    Corware, Karina; Yardley, Vanessa; Mack, Christopher; Schuster, Steffen; Al-Hassi, Hafid; Herath, Shanthi; Bergin, Philip; Modolell, Manuel; Munder, Markus; Müller, Ingrid; Kropf, Pascale

    2014-01-01

    Protein energy malnutrition is commonly associated with immune dysfunctions and is a major factor in susceptibility to infectious diseases. In this study, we evaluated the impact of protein energy malnutrition on the capacity of monocytes and macrophages to upregulate arginase, an enzyme associated with immunosuppression and increased pathogen replication. Our results show that monocytes and macrophages are significantly increased in the bone marrow and blood of mice fed on a protein low diet. No alteration in the capacity of bone marrow derived macrophages isolated from malnourished mice to phagocytose particles, to produce the microbicidal molecule nitric oxide and to kill intracellular Leishmania parasites was detected. However, macrophages and monocytes from malnourished mice express significantly more arginase both in vitro and in vivo. Using an experimental model of visceral leishmaniasis, we show that following protein energy malnutrition, the increased parasite burden measured in the spleen of these mice coincided with increased arginase activity and that macrophages provide a more permissive environment for parasite growth. Taken together, these results identify a novel mechanism in protein energy malnutrition that might contributes to increased susceptibility to infectious diseases by upregulating arginase activity in myeloid cells.

  1. Possible Biochemical Markers in Protein-Energy Malnutrition and ...

    African Journals Online (AJOL)

    This study was carried out to determine possible biochemical markers in children suffering from Plasmodium falciparum malaria and Protein-Energy Malnutrition in a Hospital setting in Western Kenya. Spectrophotometric assays of selected biochemical parameters namely, albumin, total proteins, glucose, glutamate ...

  2. Effects of protein-energy malnutrition on NF-kappaB signalling in murine peritoneal macrophages.

    Science.gov (United States)

    Fock, Ricardo Ambrósio; Rogero, Marcelo Macedo; Vinolo, Marco Aurélio Ramirez; Curi, Rui; Borges, Maria Carolina; Borelli, Primavera

    2010-04-01

    Protein-energy malnutrition (PEM) is an important public health problem affecting millions of people worldwide. PEM decreases resistance to infection, impairing a number of physiological processes. In unstimulated cells, NF-kappaB is kept from binding to its consensus sequence by the inhibitor I kappaB alpha, which retains NF-kappaB in the cytoplasm. Upon various signals, such as lipopolysaccharide (LPS), I kappaB alpha is rapidly degraded and NF-kappaB is induced to translocate into the nucleus, where it activates expression of various genes that participate in the inflammatory response, including those involved in the synthesis of TNF-alpha. TRAF-6 is a cytoplasmic adapter protein that links the stimulatory signal from Toll like receptor-4 to NF-kappaB. The aim of this study was to evaluate the effect of malnutrition on induction of TNF-alpha by LPS in murine peritoneal macrophages. We evaluated peritoneal cellularity, the expression of MyD88, TRAF-6, IKK, I kappaB alpha and NF-kappaB, NF-kappaB activation and TNF-alpha mRNA and protein synthesis in macrophages. Two-month-old male BALB/C mice were submitted to PEM with a low-protein diet that contained 2% protein, compared to 12% protein in the control diet. When the experimental group had lost about 20% of the original body weight, it was used in the subsequent experiments. Malnourished animals presented anemia, leucopenia and severe reduction in peritoneal cavity cellularity. TNF-alpha mRNA and protein levels of macrophages stimulated with LPS were significantly lower in malnourished animals. PEM also decreased TRAF-6 expression and NF-kappaB activation after LPS stimulation. These results led us to conclude that PEM changes NF-kB signalling pathway in macrophages to LPS stimulus.

  3. Protein-Energy Malnutrition Exacerbates Stroke-Induced Forelimb Abnormalities and Dampens Neuroinflammation.

    Science.gov (United States)

    Alaverdashvili, Mariam; Caine, Sally; Li, Xue; Hackett, Mark J; Bradley, Michael P; Nichol, Helen; Paterson, Phyllis G

    2018-02-03

    Protein-energy malnutrition (PEM) pre-existing at stroke onset is believed to worsen functional outcome, yet the underlying mechanisms are not fully understood. Since brain inflammation is an important modulator of neurological recovery after stroke, we explored the impact of PEM on neuroinflammation in the acute period in relation to stroke-initiated sensori-motor abnormalities. Adult rats were fed a low-protein (LP) or normal protein (NP) diet for 28 days before inducing photothrombotic stroke (St) in the forelimb region of the motor cortex or sham surgery; the diets continued for 3 days after the stroke. Protein-energy status was assessed by a combination of body weight, food intake, serum acute phase proteins and corticosterone, and liver lipid content. Deficits in motor function were evaluated in the horizontal ladder walking and cylinder tasks at 3 days after stroke. The glial response and brain elemental signature were investigated by immunohistochemistry and micro-X-ray fluorescence imaging, respectively. The LP-fed rats reduced food intake, resulting in PEM. Pre-existing PEM augmented stroke-induced abnormalities in forelimb placement accuracy on the ladder; LP-St rats made more errors (29 ± 8%) than the NP-St rats (15 ± 3%; P < 0.05). This was accompanied by attenuated astrogliosis in the peri-infarct area by 18% and reduced microglia activation by up to 41 and 21% in the peri-infarct area and the infarct rim, respectively (P < 0.05). The LP diet altered the cortical Zn, Ca, and Cl signatures (P < 0.05). Our data suggest that proactive treatment of pre-existing PEM could be essential for optimal post-stroke recovery.

  4. Seroprevalence rate of Poliovirus antibodies among the Healthy and Protein Energy Malnutrition children.

    Science.gov (United States)

    Yousuf, Aliya; Syed Shah, Skindar Ali; Syed Jaffery, Imtiaz Ahmed; Ahmed, Syed Azher; Khan, M A Basit; Aslam, Mohammad

    2015-01-01

    To study the association between Protein energy malnutrition and polio-specific immunoglobulin G antibodies production among children in Gadap Town Karachi, Pakistan. Comparative cross sectional survey conducted at fixed EPI center and Pediatric OPD of a tertiary care hospital Karachi. Children were selected by convenient sampling method during the period from 17 March to 17 May 2013. It was ensured that they must have received more than seven oral polio vaccine doses as eligibility criteria for the study. A total of 170 blood samples were collected and tested for the presence of polio-specific IgG antibodies using Poliomyelitis IgG ELISA Test Kit produced. Statistically significant relation was found between PEM and IgG antibodies production OR (P = 0.000). Overall Seroprevalence rate among the study population was 98.8%, PEM group 97.6% and healthy group 100%. The study demonstrated that there is a need to focus on the protein energy malnutrition among the children as an immunization strategy for the 100% seroprevalence rate in all population against polio in Pakistan.

  5. The influence of childhood protein energy malnutrition on serum ghrelin and leptin levels

    International Nuclear Information System (INIS)

    Mostafa, A.M.

    2007-01-01

    Protein-energy malnutrition (PEM) is a clinical problem caused by inadequate intake of one or more nutritional elements and remains as one of the most important health problems in developing countries. The aim of this study is to investigate the influence of PEM on ghrelin and leptin levels and to determine the relationships of ghrelin and leptin concentrations with anthropometric measurements in malnourished children. The study group consisted of 24 infants diagnosed as PEM. They were classified into marasmic group (10), kwashiorkor group (8) and marasmic kwashiorkor group (b). Ten healthy infants were enrolled as the control group. Serum ghrelin was evaluated by enzyme linked immuno absorbent assay (ELISA) while serum leptin was determined by radioimmunoassay (RIA). Patients with PEM established a significantly lower midarm circumference, skin fold thickness, (W/A) Z, (W/H) Z, BMI, total proteins, serum albumin, cholesterol and triglycerides compared with the age-matched control group. Markedly elevated mean serum ghrelin levels (448.7± 185.82, 293.83±155.02 and 354.1±90.1 vs 20.97± 8.61 pg/ml, p

  6. Relationship between protein energy malnutrition and social maturity in children aged 1-2 years

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2006-12-01

    Full Text Available Background Protein energy malnutrition (PEM affects physical, psychological, and social development. Objective To investigate the relationship between PEM and social maturity in children aged 1-2 years. Methods We carried out a cross-sectional study at Child Health Outpatient Clinic, Sanglah Hospital, betweenApril-September 2000. We included children living with their parents, with no handicap or chronically ill condition. Data were collected by using structured questionnaires. Nutritional status was determined based on WHO-NCHS standard, while social maturity was measured by Vineland social maturity scale. Results Of the 200 subjects analyzed, the mean age was 16.9 months (SD 3.8, body weight 10.2 kg (SD 1.7 and social quotient (SQ score 94.3(SD 10.6. There was a significant correlation between SQ and PEM (B-7.5, CI 95%-10.6;-4.3, p<0.001 parents' occupation (B4.9, CI 95% 2.2-7.7, P<0.001 and mothers' education (B4.2,CI 95% 1.0-7.4, P<0.001. Conclusion This study revealed that the more severe the PEM, the lower the SQ, while the better the education and occupation, the higher the SQ was.

  7. Serum hyaluronic acid predicts protein-energy malnutrition in chronic hepatitis C.

    Science.gov (United States)

    Nishikawa, Hiroki; Enomoto, Hirayuki; Yoh, Kazunori; Iwata, Yoshinori; Hasegawa, Kunihiro; Nakano, Chikage; Takata, Ryo; Kishino, Kyohei; Shimono, Yoshihiro; Sakai, Yoshiyuki; Nishimura, Takashi; Aizawa, Nobuhiro; Ikeda, Naoto; Takashima, Tomoyuki; Ishii, Akio; Iijima, Hiroko; Nishiguchi, Shuhei

    2016-06-01

    Serum hyaluronic acid (HA) is a well-established marker of fibrosis in patients with chronic liver disease (CLD). However, the relationship between serum HA level and protein-energy malnutrition (PEM) in patients with CLD is an unknown. We aimed to examine the relationship between serum HA level and PEM in patients with chronic hepatitis C (CHC) compared with the relationships of other serum markers of fibrosis. A total of 298 CHC subjects were analyzed. We defined patients with serum albumin level of ≤3.5 g/dL and nonprotein respiratory quotient <0.85 using indirect calorimetry as having PEM. We investigated the effect of serum HA level on the presence of PEM. Receiver operating characteristic curve (ROC) analysis was performed for calculating the area under the ROC (AUROC) for serum HA level, platelet count, aspartate aminotransferase (AST) to platelet ratio index, FIB-4 index, AST to alanine aminotransferase ratio, and Forns index for the presence of PEM. The median serum HA level in this study was 148.0 ng/mL (range: 9.0-6340.0 ng/mL). In terms of the degree of liver function (chronic hepatitis, Child-Pugh A, B, and C), the analyzed patients were well stratified according to serum HA level (overall significance, P < 0.0001). The median value (range) of serum HA level in patients with PEM (n = 61) was 389.0 ng/mL (43.6-6340.0 ng/mL) and that in patients without PEM (n = 237) was 103.0 ng/mL (9.0-783.0 ng/mL) (P < 0.0001). Among 6 fibrosis markers, serum HA level yielded the highest AUROC with a level of 0.849 at an optimal cut-off value of 151.0 ng/mL (sensitivity 93.4%; specificity 62.0%; P < 0.0001). In the multivariate analysis, serum HA level was found to be a significant prognostic factor related to the presence of PEM (P = 0.0001).In conclusion, serum HA level can be a useful predictor of PEM in patients with CHC.

  8. Reduction of erythroid progenitors in protein-energy malnutrition.

    Science.gov (United States)

    Borelli, Primavera; Blatt, Solange; Pereira, Juliana; de Maurino, Beatriz Beutler; Tsujita, Maristela; de Souza, Ana Cristina; Xavier, José Guilherme; Fock, Ricardo Ambrósio

    2007-02-01

    Protein-energy malnutrition is a syndrome in which anaemia together with multivitamin and mineral deficiency may be present. The pathophysiological mechanisms involved have not, however, yet been completely elucidated. The aim of the present study was to evaluate the pathophysiological processes that occur in this anaemia in animals that were submitted to protein-energy malnutrition, in particular with respect to Fe concentration and the proliferative activity of haemopoietic cells. For this, histological, histochemical, cell culture and immunophenotyping techniques were used. Two-month-old male Swiss mice were submitted to protein-energy malnutrition with a low-protein diet (20 g/kg) compared with control diet (400 g/kg). When the experimental group had attained a 20 % loss of their original body weight, the animals from both groups received, intravenously, 20 IU erythropoietin every other day for 14 d. Malnourished animals showed a decrease in red blood cells, Hb concentration and reticulocytopenia, as well as severe bone marrow and splenic atrophy. The results for serum Fe, total Fe-binding capacity, transferrin and erythropoietin in malnourished animals were no different from those of the control animals. Fe reserves in the spleen, liver and bone marrow were found to be greater in the malnourished animals. The mixed colony-forming unit assays revealed a smaller production of granulocyte-macrophage colony-forming units, erythroid burst-forming units, erythroid colony-forming units and CD45, CD117, CD119 and CD71 expression in the bone marrow and spleen cells of malnourished animals. These findings suggest that, in this protein-energy malnutrition model, anaemia is not caused by Fe deficiency or erythropoietin deficiency, but is a result of ineffective erythropoiesis.

  9. Studies on the Predisposing Factors of Protein Energy Malnutrition Among Pregnant Women in a Nigerian Community

    Directory of Open Access Journals (Sweden)

    Okwu GN

    2008-01-01

    Full Text Available Protein Energy Malnutrition (PEM continues to be a major public health problem in developing countries and affects mostly infants, young children, pregnant and lactating mothers. This study was carried on some of the factors that predispose pregnant women to PEM and hence identify groups at greater risk. A total of 1387 pregnant women (910 in the urban area and 477 in the rural areas were recruited for the study. Anthropometric indices of weight, height and Body Mass Index (BMI of the pregnant women were measured and semi structured questionnaires were used to elicit information on possible predisposing factors such as age, level of education, parity, child spacing etc. Results obtained showed that the mean weight and height of the rural pregnant women, were significantly (p<0.0001 lower than those of the urban pregnant women. The mean BMI of the rural subjects, was also significantly (p< 0.0027 lower than that of the urban subjects. Analysis of the effect of age showed that the younger age category (24 years and below had significantly (p<0.0001 lower mean BMI and higher prevalence of PEM while the effect of level of education showed significantly (p<0006 lower mean BMI and higher PEM prevalence among the less educated (no formal and primary education. Those with parity of two, one and primipara showed significantly (p<0.0175 lower mean BMI while child spacing did not have any significant effect on both mean BMI and prevalence of PEM. The implications of these findings are discussed and recommendations made on how to tackle the problem.

  10. Convergence of a diabetes mellitus, protein energy malnutrition, and TB epidemic: the neglected elderly population.

    Science.gov (United States)

    Menon, Sonia; Rossi, Rodolfo; Nshimyumukiza, Leon; Wusiman, Aibibula; Zdraveska, Natasha; Eldin, Manal Shams

    2016-07-26

    On a global scale, nearly two billion persons are infected with Mycobacterium tuberculosis. From this vast reservoir of latent tuberculosis (TB) infection, a substantial number will develop active TB during their lifetime, with some being able to transmit TB or Multi-drug- resistant (MDR) TB to others. There is clinical evidence pointing to a higher prevalence of infectious diseases including TB among individuals with Diabetes Mellitus (DM). Furthermore, ageing and diabetes mellitus may further aggravate protein-energy malnutrition (PEM), which in turn impairs T-lymphocyte mediated immunologic defenses, thereby increasing the risk of developing active TB and compromising TB treatment. This article aims to a) highlight synergistic mechanisms associated with immunosenescence, DM and PEM in relation to the development of active TB and b) identify nutritional, clinical and epidemiological research gaps. To explore the synergistic relationship between ageing, DM, tuberculosis and PEM, a comprehensive review was undertaken. The MEDLINE and the Google Scholar databases were searched for articles published from 1990 to March 2015, using different MESH keywords in various combinations. Ageing and DM act synergistically to reduce levels of interferon gamma (IFN- γ), thereby increasing susceptibility to TB, for which cell mediated immunity (CMI) plays an instrumental role. These processes can set in motion a vicious nutritional cycle which can predispose to PEM, further impairing the CMI and consequently limiting host defenses. This ultimately transforms the latent TB infection into active disease. A clinical diagnostic algorithm and clinical guidelines need to be established for this population. Given the increase in ageing population with DM and PEM, especially in resource-poor settings, these synergistic tripartite interactions must be examined if a burgeoning TB epidemic is to be averted. Implementation of a comprehensive, all-encompassing approach to curb transmission

  11. 1Protein Energy Malnutrition Impairs Homeostatic Proliferation of Memory CD8 T cells

    Science.gov (United States)

    Iyer, Smita S.; Chatraw, Janel Hart; Tan, Wendy G.; Wherry, E. John; Becker, Todd C.; Ahmed, Rafi; Kapasi, Zoher F.

    2011-01-01

    Nutrition is a critical but poorly understood determinant of immunity. There is abundant epidemiological evidence linking protein malnutrition to impaired vaccine efficacy and increased susceptibility to infections; yet, the role of dietary protein in immune memory homeostasis remains poorly understood. Here we show that protein energy malnutrition (PEM) induced in mice by low-protein (LP) feeding has a detrimental impact on CD8 memory. Relative to adequate-protein (AP) fed controls, LP feeding in lymphocytic choriomeningitis virus (LCMV) immune mice resulted in a 2-fold decrease in LCMV-specific CD8 memory T cells. Adoptive transfer of memory cells, labeled with a division tracking dye, from AP mice into naive LP or AP mice demonstrated that PEM caused profound defects in homeostatic proliferation. Remarkably, this defect occurred despite the lymphopenic environment in LP hosts. While antigen-specific memory cells in LP and AP hosts were phenotypically similar, memory cells in LP hosts were markedly less-responsive to poly(I:C)-induced acute proliferative signals. Furthermore, upon recall, memory cells in LP hosts displayed reduced proliferation and protection from challenge with LCMV-clone 13 resulting in impaired viral clearance in the liver. The findings show a metabolic requirement of dietary protein in sustaining functional CD8 memory and suggest that interventions to optimize dietary protein intake may improve vaccine efficacy in malnourished individuals. PMID:22116826

  12. Drug disposition in obesity and protein-energy malnutrition.

    Science.gov (United States)

    Boullata, Joseph I

    2010-11-01

    Clinical response to medication can differ between patients. Among the known sources of variability is an individual's nutrition status. This review defines some pharmacokinetic terms, provides relevant body size metrics and describes the physiologic influences of protein-energy malnutrition and obesity on drug disposition. Weight-based drug dosing, which presumes a healthy BMI, can be problematic in the protein-energy malnourished or obese patient. The use of total body weight, lean body weight, or an adjusted body weight depends on the drug and how it is differently handled in malnutrition or obesity. Most of the recognized influences are seen in drug distribution and drug elimination as a result of altered body composition and function. Distribution characteristics of each drug are determined by several drug-related factors (e.g. tissue affinity) in combination with body-related factors (e.g. composition). Drug elimination occurs through metabolic and excretory pathways that can also vary with body composition. The current data are limited to select drugs that have been reported in small studies or case reports. In the meantime, a rational approach to evaluate the potential influences of malnutrition and obesity can be used clinically based on available information. Antimicrobials are discussed as a useful example of this approach. Further advancement in this field would require collaboration between experts in body composition and those in drug disposition. Until more data are available, routine monitoring by the clinician of the protein-energy malnourished or obese patient receiving weight-based drug regimens is necessary.

  13. [Protein-energy malnutrition in patients with connective tissue dysplasia].

    Science.gov (United States)

    Lialiukova, E A

    2013-01-01

    In the conditions of the specialized Center of a dysplasia of a connecting tissue the assessment of an protein--energy malnutrition at 121 patients with signs of a dysplasia of a connecting tissue is carried out. High frequency of an oligotrophy at patients with a dysplasia of a connecting tissue is registered. The I degree of a gipotorofiya is taped at 26.21% of the patients, II degree--at 18.44%, the III degree--at 3.88% of patients.

  14. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.

  15. Protein-energy malnutrition induces an aberrant acute-phase response and modifies the circadian rhythm of core temperature.

    Science.gov (United States)

    Smith, Shari E; Ramos, Rafaela Andrade; Refinetti, Roberto; Farthing, Jonathan P; Paterson, Phyllis G

    2013-08-01

    Protein-energy malnutrition (PEM), present in 12%-19% of stroke patients upon hospital admission, appears to be a detrimental comorbidity factor that impairs functional outcome, but the mechanisms are not fully elucidated. Because ischemic brain injury is highly temperature-sensitive, the objectives of this study were to investigate whether PEM causes sustained changes in temperature that are associated with an inflammatory response. Activity levels were recorded as a possible explanation for the immediate elevation in temperature upon introduction to a low protein diet. Male, Sprague-Dawley rats (7 weeks old) were fed a control diet (18% protein) or a low protein diet (PEM, 2% protein) for either 7 or 28 days. Continuous core temperature recordings from bioelectrical sensor transmitters demonstrated a rapid increase in temperature amplitude, sustained over 28 days, in response to a low protein diet. Daily mean temperature rose transiently by day 2 (p = 0.01), falling to normal by day 4 (p = 0.08), after which mean temperature continually declined as malnutrition progressed. There were no alterations in activity mean (p = 0.3) or amplitude (p = 0.2) that were associated with the early rise in mean temperature. Increased serum alpha-2-macroglobulin (p protein diet had no effect on the signaling pathway of the pro-inflammatory transcription factor, NFκB, in the hippocampus. In conclusion, PEM induces an aberrant and sustained acute-phase response coupled with long-lasting effects on body temperature.

  16. Under-five protein energy malnutrition admitted at the University of Nigeria Teaching Hospital, Enugu: a 10 year retrospective review.

    Science.gov (United States)

    Ubesie, Agozie C; Ibeziako, Ngozi S; Ndiokwelu, Chika I; Uzoka, Chinyeaka M; Nwafor, Chinelo A

    2012-06-14

    To determine the prevalence, risk factors, co-morbidities and case fatality rates of Protein Energy Malnutrition (PEM) admissions at the paediatric ward of the University of Nigeria Teaching Hospital Enugu, South-east Nigeria over a 10 year period. A retrospective study using case Notes, admission and mortality registers retrieved from the Hospital's Medical Records Department. All children aged 0 to 59 months admitted into the hospital on account of PEM between 1996 and 2005. A total of 212 children with PEM were admitted during the period under review comprising of 127 (59.9%) males and 85 (40.1%) females. The most common age groups with PEM were 6 to 12 months (55.7%) and 13 to 24 months (36.8%). Marasmus (34.9%) was the most common form of PEM noted in this review. Diarrhea and malaria were the most common associated co-morbidities. Majority (64.9%) of the patients were from the lower socio-economic class. The overall case fatality rate was 40.1% which was slightly higher among males (50.9%). Mortality in those with marasmic-kwashiokor and in the unclassified group was 53.3% and 54.5% respectively. Most of the admissions and case fatality were noted in those aged 6 to 24 months which coincides with the weaning period. Marasmic-kwashiokor is associated with higher case fatality rate than other forms of PEM. We suggest strengthening of the infant feeding practices by promoting exclusive breastfeeding for the first six months of life, followed by appropriate weaning with continued breast feeding. Under-five children should be screened for PEM at the community level for early diagnosis and prompt management as a way of reducing the high mortality associated with admitted severe cases.

  17. Experimental model considerations for the study of protein-energy malnutrition co-existing with ischemic brain injury.

    Science.gov (United States)

    Prosser-Loose, Erin J; Smith, Shari E; Paterson, Phyllis G

    2011-05-01

    Protein-energy malnutrition (PEM) affects ~16% of patients at admission for stroke. We previously modeled this in a gerbil global cerebral ischemia model and found that PEM impairs functional outcome and influences mechanisms of ischemic brain injury and recovery. Since this model is no longer reliable, we investigated the utility of the rat 2-vessel occlusion (2-VO) with hypotension model of global ischemia for further study of this clinical problem. Male, Sprague-Dawley rats were exposed to either control diet (18% protein) or PEM induced by feeding a low protein diet (2% protein) for 7d prior to either global ischemia or sham surgery. PEM did not significantly alter the hippocampal CA1 neuron death (p = 0.195 by 2-factor ANOVA) or the increase in dendritic injury caused by exposure to global ischemia. Unexpectedly, however, a strong trend was evident for PEM to decrease the consistency of hippocampal damage, as shown by an increased incidence of unilateral or no hippocampal damage (p=0.069 by chi-square analysis). Although PEM caused significant changes to baseline arterial blood pH, pO(2), pCO(2), and fasting glucose (p0.269). Intra-ischemic tympanic temperature and blood pressure were strictly and equally controlled between ischemic groups. We conclude that co-existing PEM confounded the consistency of hippocampal injury in the 2-VO model. Although the mechanisms responsible were not identified, this model of brain ischemia should not be used for studying this co-morbidity factor. © 2011 Bentham Science Publishers Ltd.

  18. Protein-energy malnutrition developing after global brain ischemia induces an atypical acute-phase response and hinders expression of GAP-43.

    Science.gov (United States)

    Smith, Shari E; Figley, Sarah A; Schreyer, David J; Paterson, Phyllis G

    2014-01-01

    Protein-energy malnutrition (PEM) is a common post-stroke problem. PEM can independently induce a systemic acute-phase response, and pre-existing malnutrition can exacerbate neuroinflammation induced by brain ischemia. In contrast, the effects of PEM developing in the post-ischemic period have not been studied. Since excessive inflammation can impede brain remodeling, we investigated the effects of post-ischemic malnutrition on neuroinflammation, the acute-phase reaction, and neuroplasticity-related proteins. Male, Sprague-Dawley rats were exposed to global forebrain ischemia using the 2-vessel occlusion model or sham surgery. The sham rats were assigned to control diet (18% protein) on day 3 after surgery, whereas the rats exposed to global ischemia were assigned to either control diet or a low protein (PEM, 2% protein) diet. Post-ischemic PEM decreased growth associated protein-43, synaptophysin and synaptosomal-associated protein-25 immunofluorescence within the hippocampal CA3 mossy fiber terminals on day 21, whereas the glial response in the hippocampal CA1 and CA3 subregions was unaltered by PEM. No systemic acute-phase reaction attributable to global ischemia was detected in control diet-fed rats, as reflected by serum concentrations of alpha-2-macroglobulin, alpha-1-acid glycoprotein, haptoglobin, and albumin. Acute exposure to the PEM regimen after global brain ischemia caused an atypical acute-phase response. PEM decreased the serum concentrations of albumin and haptoglobin on day 5, with the decreases sustained to day 21. Serum alpha-2-macroglobulin concentrations were significantly higher in malnourished rats on day 21. This provides the first direct evidence that PEM developing after brain ischemia exerts wide-ranging effects on mechanisms important to stroke recovery.

  19. Protein energy malnutrition during vaccination has limited influence on vaccine efficacy but abolishes immunity if administered during Mycobacterium tuberculosis infection.

    Science.gov (United States)

    Hoang, Truc; Agger, Else Marie; Cassidy, Joseph P; Christensen, Jan P; Andersen, Peter

    2015-05-01

    Protein energy malnutrition (PEM) increases susceptibility to infectious diseases, including tuberculosis (TB), but it is not clear how PEM influences vaccine-promoted immunity to TB. We demonstrate that PEM during low-level steady-state TB infection in a mouse model results in rapid relapse of Mycobacterium tuberculosis, as well as increased pathology, in both Mycobacterium bovis BCG-vaccinated and unvaccinated animals. PEM did not change the overall numbers of CD4 T cells in BCG-vaccinated animals but resulted in an almost complete loss of antigen-specific cytokine production. Furthermore, there was a change in cytokine expression characterized by a gradual loss of multifunctional antigen-specific CD4 T cells and an increased proportion of effector cells expressing gamma interferon and tumor necrosis factor alpha (IFN-γ(+) TNF-α(+) and IFN-γ(+) cells). PEM during M. tuberculosis infection completely blocked the protection afforded by the H56-CAF01 subunit vaccine, and this was associated with a very substantial loss of the interleukin-2-positive memory CD4 T cells promoted by this vaccine. Similarly, PEM during the vaccination phase markedly reduced the H56-CAF01 vaccine response, influencing all cytokine-producing CD4 T cell subsets, with the exception of CD4 T cells positive for TNF-α only. Importantly, this impairment was reversible and resupplementation of protein during infection rescued both the vaccine-promoted T cell response and the protective effect of the vaccine against M. tuberculosis infection. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  20. The effect of serum magnesium levels and serum endothelin-1 levels on bone mineral density in protein energy malnutrition.

    Science.gov (United States)

    Ozturk, C F; Karakelleoglu, C; Orbak, Z; Yildiz, L

    2012-06-01

    An inadequate and imbalanced intake of protein and energy results in protein-energy malnutrition (PEM). It is known that bone mineral density and serum magnesium levels are low in malnourished children. However, the roles of serum magnesium and endothelin-1 (ET-1) levels in the pathophysiology of bone mineralization are obscure. Thus, the relationships between serum magnesium and ET-1 levels and the changes in bone mineral density were investigated in this study. There was a total of 32 subjects, 25 of them had PEM and seven were controls. While mean serum ET-1 levels of the children with kwashiorkor and marasmus showed no statistically significant difference, mean serum ET-1 levels of both groups were significantly higher than that of the control group. Serum magnesium levels were lower than normal value in 9 (36%) of 25 malnourished children. Malnourished children included in this study were divided into two subgroups according to their serum magnesium levels. While mean serum ET-1 levels in the group with low magnesium levels were significantly higher than that of the group with normal magnesium levels (p malnutrition. Our study suggested that lower magnesium levels and higher ET-1 levels might be important factors in changes of bone mineral density in malnutrition. We recommend that the malnourished patients, especially with hypomagnesaemia, should be treated with magnesium early.

  1. Leucine supplementation improves acquired growth hormone resistance in rats with protein-energy malnutrition.

    Science.gov (United States)

    Gao, Xuejin; Tian, Feng; Wang, Xinying; Zhao, Jie; Wan, Xiao; Zhang, Li; Wu, Chao; Li, Ning; Li, Jieshou

    2015-01-01

    Protein-energy malnutrition (PEM) can lead to growth hormone (GH) resistance. Leucine supplementation diets have been shown to increase protein synthesis in muscles. Our study aimed at investigating if long-term leucine supplementation could modulate GH-insulin-like growth factor (IGF)-1 system function and mammalian target of rapamycin (mTOR)-related signal transduction in skeletal muscles in a rat model of severe malnutrition. Male Sprague-Dawley rats (n = 50; weight, 302 ± 5 g) were divided into 5 treatment groups, including 2 control groups (a normal control group that was fed chow and ad libitum water [CON, n = 10] and a malnourished control group [MC, n = 10] that was fed a 50% chow diet). After undergoing a weight loss stage for 4 weeks, rats received either the chow diet (MC-CON, n = 10), the chow diet supplemented with low-dose leucine (MC-L, n = 10), or the chow diet supplemented with high-dose leucine (MC-H, n = 10) for 2 weeks. The muscle masses of the gastrocnemius, soleus, and extensor digitorum longus were significantly reduced in the MC group. Re-feeding increased muscle mass, especially in the MC-L and MC-H groups. In the MC group, serum IGF-1, IGF-binding protein (IGFBP)-3, and hepatic growth hormone receptor (GHR) levels were significantly decreased and phosphorylation of the downstream anabolic signaling effectors protein kinase B (Akt), mTOR, and ribosomal protein S6 kinase 1 (S6K1) were significantly lower than in other groups. However, serum IGF-1 and IGF binding protein (IGFBP)-3 concentrations and hepatic growth hormone receptor (GHR) levels were significantly higher in the MC-L and MC-H groups than in the MC-CON group, and serum IGFBP-1 levels was significantly reduced in the MC-L and MC-H groups. These changes were consistent with those observed for hepatic mRNA expression levels. Phosphorylation of the downstream anabolic signaling effectors Akt, mTOR, and S6K1 were also significantly higher in the MC-L and MC-H groups than in the MC

  2. The Influence of Early Protein Energy Malnutrition on Subsequent Behavior and Intellectual Performance.

    Science.gov (United States)

    Gupta, Sarita

    1990-01-01

    Protein-energy malnutrition in early childhood, as seen in many developing countries, influences subsequent behavior and intellectual performance. These impairments are associated with further reduction in fine motor skills and academic performance. (Author)

  3. Protein blend ingestion before allogeneic stem cell transplantation improves protein-energy malnutrition in patients with leukemia.

    Science.gov (United States)

    Ren, Guangxu; Zhang, Jianping; Li, Minghua; Yi, Suqin; Xie, Jin; Zhang, Hongru; Wang, Jing

    2017-10-01

    Severe protein-energy malnutrition (PEM) and skeletal muscle wasting are commonly observed in patients with acute leukemia. Recently, the ingestion of a soy-whey protein blend has been shown to promote muscle protein synthesis (MPS). Thus, we tested the hypothesis that the ingestion of a soy-whey blended protein (BP) may improve the PEM status and muscle mass in acute leukemia patients. In total, 24 patients from the same treatment group were randomly assigned to the natural diet plus soy-whey blended protein (BP) group and the natural diet only (ND) group. Our data showed that protein and energy intake decreased significantly (P protein) were observed in the majority (>50%) of the patients. However, 66% of the patients who ingested the BP before transplantation showed obvious increases in arm muscle area. The gripping power value (△ post-pre or △ post-baseline ) was significantly higher in the BP group than in the ND group (P protein to different extents. Notably, the average time to stem cell engraftment was significantly shorter for patients in the BP group (12.2 ± 2.0 days) than for patients in the ND group (15.1 ± 2.9 days). Collectively, our data supported that soy-whey protein can improve PEM status and muscle mass in leukemia patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. socio-economic risk factors for severe protein energy malnutrition

    African Journals Online (AJOL)

    hi-tech

    2000-09-01

    Sep 1, 2000 ... malnutrition has other adverse consequences which include severity of illness ... those with cancer or any physical or mental condition predisposing them to ..... both groups. In a similar study in Nairobi, Kenya, Waihenya.

  5. Maternal protein-energy malnutrition during early pregnancy in sheep impacts the fetal ornithine cycle to reduce fetal kidney microvascular development.

    OpenAIRE

    Dunford, L. J.; Sinclair, K. D.; Kwong, W. Y.; Sturrock, C.; Clifford, B. L.; Giles, T. C.; Gardner, D. S.

    2014-01-01

    This paper identifies a common nutritional pathway relating maternal through to fetal protein-energy malnutrition (PEM) and compromised fetal kidney development. Thirty-one twin-bearing sheep were fed either a control (n=15) or low-protein diet (n=16, 17 vs. 8.7 g crude protein/MJ metabolizable energy) from d 0 to 65 gestation (term, ?145 d). Effects on the maternal and fetal nutritional environment were characterized by sampling blood and amniotic fluid. Kidney development was characterized ...

  6. Alcoholic Liver Disease and Malnutrition

    OpenAIRE

    McClain, Craig J.; Barve, Shirish S.; Barve, Ashutosh; Marsano, Luis

    2011-01-01

    Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepat...

  7. Liver Function Status in some Nigerian Children with Protein Energy ...

    African Journals Online (AJOL)

    Objective: To ascertain functional status of the liver in Nigeria Children with Protein energy malnutrition. Materials and Methods: Liver function tests were performed on a total of 88 children with protein energy malnutrition (PEM). These were compared with 22 apparently well-nourished children who served as controls.

  8. Protein-energy malnutrition and intellectual abilities : a study of teen-age Ugandan children

    NARCIS (Netherlands)

    Hoorweg, J.C.

    1976-01-01

    This study is concerned with the relation between protein-energy malnutrition and the intellectual abilities of children in Uganda. The findings are based on the investigation of a group of 60 Ugandan boys and girls who became severely malnourished during the first 27 months of their life, resulting

  9. Dialysis Malnutrition and Malnutrition Inflammation Scores: screening tools for prediction of dialysis-related protein-energy wasting in Malaysia.

    Science.gov (United States)

    Harvinder, Gilcharan Singh; Swee, Winnie Chee Siew; Karupaiah, Tilakavati; Sahathevan, Sharmela; Chinna, Karuthan; Ahmad, Ghazali; Bavanandan, Sunita; Goh, Bak Leong

    2016-01-01

    Malnutrition is highly prevalent in Malaysian dialysis patients and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. A total of 155 haemodialysis (HD) and 90 peritoneal dialysis (PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW. MIS cut-off score of >=5 indicated presence of malnutrition in all patients. A total of 59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, pmalnutrition classification were established (score >=5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers.

  10. Maternal protein-energy malnutrition during early pregnancy in sheep impacts the fetal ornithine cycle to reduce fetal kidney microvascular development.

    Science.gov (United States)

    Dunford, Louise J; Sinclair, Kevin D; Kwong, Wing Y; Sturrock, Craig; Clifford, Bethan L; Giles, Tom C; Gardner, David S

    2014-11-01

    This paper identifies a common nutritional pathway relating maternal through to fetal protein-energy malnutrition (PEM) and compromised fetal kidney development. Thirty-one twin-bearing sheep were fed either a control (n=15) or low-protein diet (n=16, 17 vs. 8.7 g crude protein/MJ metabolizable energy) from d 0 to 65 gestation (term, ∼ 145 d). Effects on the maternal and fetal nutritional environment were characterized by sampling blood and amniotic fluid. Kidney development was characterized by histology, immunohistochemistry, vascular corrosion casts, and molecular biology. PEM had little measureable effect on maternal and fetal macronutrient balance (glucose, total protein, total amino acids, and lactate were unaffected) or on fetal growth. PEM decreased maternal and fetal urea concentration, which blunted fetal ornithine availability and affected fetal hepatic polyamine production. For the first time in a large animal model, we associated these nutritional effects with reduced micro- but not macrovascular development in the fetal kidney. Maternal PEM specifically impacts the fetal ornithine cycle, affecting cellular polyamine metabolism and microvascular development of the fetal kidney, effects that likely underpin programming of kidney development and function by a maternal low protein diet. © FASEB.

  11. Structural and functional affection of the heart in protein energy malnutrition patients on admission and after nutritional recovery.

    Science.gov (United States)

    El-Sayed, H L; Nassar, M F; Habib, N M; Elmasry, O A; Gomaa, S M

    2006-04-01

    The pathogenesis of different malnutrition diseases was suggested to affect the heart. This study was designed to detect cardiac affection in protein energy malnutrition (PEM) patients, whether clinically or by electrocardiogram (ECG) and echocardiogram, and to assess the value of the cardiac marker troponin I in patients at risk of myocardial injury with special emphasis on the effect of nutritional rehabilitation. The present study was carried out on 30 PEM infants (16 nonedematous - 14 edematous) and 10 apparently healthy age and sex-matched infants acting as the control group. All studied infants were subjected to full history taking laying stress on dietetic history, thorough clinical and anthropometric measurements. Echocardiography and ECG were also performed. Laboratory investigations were performed including complete blood count, CRP, total proteins, albumin, liver and kidney functions as well as estimation of troponin-I in blood by immulite. Following initial evaluation, all malnourished infants were subjected to nutritional rehabilitation program for approximately 8 weeks, after which the patients were re-evaluated using the same preinterventional parameters. The results of the present study demonstrated that electrical properties of myocardium assessed by ECG showed significant decrease of R wave and QTc interval in patients compared to controls with significant improvement after nutritional rehabilitation. Echocardigraphic changes showed that cardiac mass index was significantly lower in both groups of malnourished cases compared to the controls with significant increase after nutritional rehabilitation. The study showed that the parameters of left ventricular (LV) systolic function which are the ejection fraction, fractional shortening and velocity of circumferential fiber shortening were not significantly reduced in patients compared to the controls. The diastolic function also showed no significant difference in the E wave/A wave (e/a) ratio between

  12. [Height and weight growth delay and protein-energy malnutrition in children with chronic dialysis].

    Science.gov (United States)

    Perţea, L; Diaconeasa, Lavinia; Burlea, M; Munteanu, Mihaela; Brumariu, O

    2010-01-01

    Growth retardation is an important problem in children with chronic renal disease, and malnutrition is a determinative factor. The study intends to assess the relationship between protein-energy malnutrition and stature-weight retardation in children enrolled in chronic dialysis program. The study group was composed of 16 children (5 boys and 11 girls--sex ratio of 2.2) hospitalized in the IVth Nephrology Clinic at Clinical Emergency Hospital "St. Maria" Iaşi, 13 rural and 3 urban, aged between 9 and 17 years, with chronic dialysis program. This was a follow-up study during a period of 4 years (2006-2009), resulting in correlations between anthropometric paremeters, biochemical, BIA and DEXA data. The stature-weight deficiency of the 16 patients was as follows: after an average period of 61.7 months of HD and 32.7 months of PD, in children older than 12 years (mean age 15.27 years), 7 of 10 had stature-weight deficits higher than (-3DS) or (-4DS). The group with less than (-2DS) stature-weight deficits showed the same mean age of 15.2 years, the protein energy-malnutrition was present in 2 cases (33%) and was attributed to a dialysis period shorter than 13.8 months. The late diagnosis of the disease (at an average age of 13 years), the long period of chronic dialysis program (over 39.5 months on average) and the early debut of malnutrition are favoring or worsening factors of stature-weight retardation. After correlating ESG with biochemical, BIA and DEXA data, in our group were identified 4 cases of moderate malnutrition and 9 cases of severe malnutrition.

  13. Protein-energy malnutrition alters IgA responses to rotavirus vaccination and infection but does not impair vaccine efficacy in mice.

    Science.gov (United States)

    Maier, Elizabeth A; Weage, Kristina J; Guedes, Marjorie M; Denson, Lee A; McNeal, Monica M; Bernstein, David I; Moore, Sean R

    2013-12-17

    Conflicting evidence links malnutrition to the reduced efficacy of rotavirus vaccines in developing countries, where diarrhea and undernutrition remain leading causes of child deaths. Here, we adapted mouse models of rotavirus vaccination (rhesus rotavirus, RRV), rotavirus infection (EDIM), and protein-energy malnutrition (PEM) to test the hypothesis that undernutrition reduces rotavirus vaccine immunogenicity and efficacy. We randomized wild type Balb/C dams with 3-day-old pups to a control diet (CD) or an isocaloric, multideficient regional basic diet (RBD) that produces PEM. At 3 weeks of age, we weaned CD and RBD pups to their dams' diet and subrandomized weanlings to receive a single dose of either live oral rotavirus vaccine (RRV) or PBS. At 6 weeks of age, we orally challenged all groups with murine rotavirus (EDIM). Serum and stool specimens were collected before and after RRV and EDIM administration to measure viral shedding and antibody responses by ELISA. RBD pups and weanlings exhibited significant failure to thrive compared to age-matched CD mice (Pvaccination induced higher levels of serum anti-RV IgA responses in RBD vs. CD mice (PVaccination protected CD and RBD mice equally against EDIM infection, as measured by viral shedding. In unvaccinated RBD mice, EDIM shedding peaked 1 day earlier (Pvaccination (Pvaccination mitigated stool IgA responses to EDIM more in CD vs. RBD mice (Pvaccination and infection, undernutrition does not impair rotavirus vaccine efficacy nor exacerbate infection in this mouse model of protein-energy malnutrition. Alternative models are needed to elucidate host-pathogen factors undermining rotavirus vaccine effectiveness in high-risk global settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Intellectual abilities and protein-energy malnutrition : acute malnutrition VS. chronic undernutrition

    NARCIS (Netherlands)

    Hoorweg, J.C.; Stanfield, J.P.; Brozek, J.

    1979-01-01

    Three groups of Ugandan children (20 in each group) and one comparison group of 20 children were examined between 11 and 17 years of age. The children in the first three groups had suffered from energy-protein malnutrition 10 to 16 years previously when they were hospitalised at different ages

  15. Protein-energy malnutrition halts hemopoietic progenitor cells in the G0/G1 cell cycle stage, thereby altering cell production rates

    Directory of Open Access Journals (Sweden)

    P. Borelli

    2009-06-01

    Full Text Available Protein energy malnutrition (PEM is a syndrome that often results in immunodeficiency coupled with pancytopenia. Hemopoietic tissue requires a high nutrient supply and the proliferation, differentiation and maturation of cells occur in a constant and balanced manner, sensitive to the demands of specific cell lineages and dependent on the stem cell population. In the present study, we evaluated the effect of PEM on some aspects of hemopoiesis, analyzing the cell cycle of bone marrow cells and the percentage of progenitor cells in the bone marrow. Two-month-old male Swiss mice (N = 7-9 per group were submitted to PEM with a low-protein diet (4% or were fed a control diet (20% protein ad libitum. When the experimental group had lost about 20% of their original body weight after 14 days, we collected blood and bone marrow cells to determine the percentage of progenitor cells and the number of cells in each phase of the cell cycle. Animals of both groups were stimulated with 5-fluorouracil. Blood analysis, bone marrow cell composition and cell cycle evaluation was performed after 10 days. Malnourished animals presented anemia, reticulocytopenia and leukopenia. Their bone marrow was hypocellular and depleted of progenitor cells. Malnourished animals also presented more cells than normal in phases G0 and G1 of the cell cycle. Thus, we conclude that PEM leads to the depletion of progenitor hemopoietic populations and changes in cellular development. We suggest that these changes are some of the primary causes of pancytopenia in cases of PEM.

  16. Infant feeding practices and its impact on the prevalence of protein energy malnutrition infant feeding practices and its impact on the prevalence of protein energy malnutrition

    Directory of Open Access Journals (Sweden)

    S Nanda

    1995-09-01

    Full Text Available Protein-Energy-Malnulrition is an important Public Hea Ith Problem among infants and young children. Though poverty is known to be the major fac­tor but faulty feeding habits arising out of ignorance often lead to inadequate intake of essential nutrients by the infant. In order to find out the actual prevailing feeding practices and its impact on the nutritional status of infants this study conducted in one urban andtivo rural units of Varanasi district by adopting appropriate sampling procedure. In a II mothers of360 infants (120 in each study un it were interviewed regarding breastfeeding practices, dilution and nature of top milk, age of introducing supplementaryfeeding etc. It was observed that the o verall prevalence of PEM was sig­nificantly higher in bottle fed group (72.73% than spoonfed group (40.11%. Similarly the prevalence of PEM was 67.86% in late weaned group as compared to 48.38% in optimum weaned group.

  17. Protein energy malnutrition impairs homeostatic proliferation of memory CD8 T cells.

    Science.gov (United States)

    Iyer, Smita S; Chatraw, Janel Hart; Tan, Wendy G; Wherry, E John; Becker, Todd C; Ahmed, Rafi; Kapasi, Zoher F

    2012-01-01

    Nutrition is a critical but poorly understood determinant of immunity. There is abundant epidemiological evidence linking protein malnutrition to impaired vaccine efficacy and increased susceptibility to infections; yet, the role of dietary protein in immune memory homeostasis remains poorly understood. In this study, we show that protein-energy malnutrition induced in mice by low-protein (LP) feeding has a detrimental impact on CD8 memory. Relative to adequate protein (AP)-fed controls, LP feeding in lymphocytic choriomeningitis virus (LCMV)-immune mice resulted in a 2-fold decrease in LCMV-specific CD8 memory T cells. Adoptive transfer of memory cells, labeled with a division tracking dye, from AP mice into naive LP or AP mice demonstrated that protein-energy malnutrition caused profound defects in homeostatic proliferation. Remarkably, this defect occurred despite the lymphopenic environment in LP hosts. Whereas Ag-specific memory cells in LP and AP hosts were phenotypically similar, memory cells in LP hosts were markedly less responsive to polyinosinic-polycytidylic acid-induced acute proliferative signals. Furthermore, upon recall, memory cells in LP hosts displayed reduced proliferation and protection from challenge with LCMV-clone 13, resulting in impaired viral clearance in the liver. The findings show a metabolic requirement of dietary protein in sustaining functional CD8 memory and suggest that interventions to optimize dietary protein intake may improve vaccine efficacy in malnourished individuals.

  18. Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies.

    Science.gov (United States)

    van der Pols-Vijlbrief, Rachel; Wijnhoven, Hanneke A H; Schaap, Laura A; Terwee, Caroline B; Visser, Marjolein

    2014-11-01

    Protein-energy malnutrition is associated with numerous poor health outcomes, including high health care costs, mortality rates and poor physical functioning in older adults. This systematic literature review aims to identify and provide an evidence based overview of potential determinants of protein-energy malnutrition in community-dwelling older adults. A systematic search was conducted in PUBMED, EMBASE, CINAHL and COCHRANE from the earliest possible date through January 2013. Observational studies that examined determinants of protein-energy malnutrition were selected and a best evidence synthesis was performed to summarize the results. In total 28 studies were included in this review from which 122 unique potential determinants were derived. Thirty-seven determinants were examined in sufficient number of studies and were included in a best evidence synthesis. The best evidence score comprised design (cross-sectional, longitudinal) and quality of the study (high, moderate) to grade the evidence level. Strong evidence for an association with protein-energy malnutrition was found for poor appetite, and moderate evidence for edentulousness, having no diabetes, hospitalization and poor self-reported health. Strong evidence for no association was found for anxiety, chewing difficulty, few friends, living alone, feeling lonely, death of spouse, high number of diseases, heart failure and coronary failure, stroke (CVA) and the use of anti-inflammatory medications. This review shows that protein-energy malnutrition is a multifactorial problem and that different domains likely play a role in the pathway of developing protein-energy malnutrition. These results provide important knowledge for the development of targeted, multifactorial interventions that aim to prevent the development of protein-energy malnutrition in community-dwelling older adults. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Infant Feeding Practices And Its Impact On The Prevalence Of Protein Energy- Malnutrition

    Directory of Open Access Journals (Sweden)

    S Nanda

    1995-09-01

    Full Text Available Protein-Energy-Malnulrition is an important Public Hea Ith Problem among infants and young children. Though poverty is known to be the major fac­tor but faulty feeding habits arising out of ignorance often lead to inadequate intake of essential nutrients by the infant. In order to find out the actual prevailing feeding practices and its impact on the nutritional status of infants this study conducted in one urban andtivo rural units of Varanasi district by adopting appropriate sampling procedure. In a II mothers of360 infants (120 in each study un it were interviewed regarding breastfeeding practices, dilution and nature of top milk, age of introducing supplementaryfeeding etc. It was observed that the o verall prevalence of PEM was sig­nificantly higher in bottle fed group (72.73% than spoonfed group (40.11%. Similarly the prevalence of PEM was 67.86% in late weaned group as compared to 48.38% in optimum weaned group.

  20. Effect of early childhood protein-energy malnutrition on permanent dentition dental caries.

    Science.gov (United States)

    Reyes-Perez, Elisandra; Borrell, Luisa N; Katz, Ralph V; Gebrian, Bette J; Prophete, Samuel; Psoter, Walter J

    2014-01-01

    The objective of this study is to determine the effect of early childhood protein-energy malnutrition (ECPEM) on decayed, missing, filled tooth (DMFT) scores in the permanent dentition of rural Haitian adolescents aged 11-19 years (n = 1,006). We used data from a retrospective cohort that was developed from the Haitian Health Foundation database and merged records on weight-for-age covering the birth through 5-year-old period for all enrolled participants. Dental examinations and interviewer-administered structured questionnaires on demographic and socioeconomic status, and relative sugar consumption were completed in 1,058 participants aged 11-19 years. The ECPEM was defined based on weight-for-age of the subjects during their first 5 years of life that were converted to Z-scores based on the National Center for Health Statistics referent database. Descriptive statistics were calculated. DMFT was regressed on ECPEM adjusting for age, sex, current body mass index Z-score, socioeconomic status, relative sugar consumption, and number of permanent teeth present assuming a Poisson distribution. Questionable malnutrition [rate ratio (RR) = 0.72; 95 percent confidence interval (CI), 0.61-0.86] and malnutrition (RR = 0.58; 95 percent CI, 0.49-0.69) were associated with a statistically significant lower DMFT in Haitian adolescents. ECPEM status is inversely associated with DMFT in Haitian participants. Further follow-up of these same participants will be recommended to evaluate the potential caries catch-up effect. © 2013 American Association of Public Health Dentistry.

  1. An Adjuvanted A(H5N1) Subvirion Vaccine Elicits Virus-Specific Antibody Response and Improves Protection Against Lethal Influenza Viral Challenge in Mouse Model of Protein Energy Malnutrition.

    Science.gov (United States)

    Jones, Enitra N; Amoah, Samuel; Cao, Weiping; Sambhara, Suryaprakash; Gangappa, Shivaprakash

    2017-09-15

    Protein energy malnutrition (PEM) increases susceptibility to infectious diseases, including influenza infection, but no studies have addressed the potential influences of PEM on the immunogenicity and protective efficacy of avian influenza A(H5N1) vaccine. We investigated the role of PEM on vaccine-mediated protection after a lethal challenge with recombinant A(H5N1) virus using isocaloric diets providing either adequate protein (AP; 18% protein) or very low protein (VLP; 2% protein) in an established murine model of influenza vaccination. We demonstrated that mice maintained on a VLP diet succumb to lethal challenge at greater rates than mice maintained on an AP diet, despite comparable immunization regimens. Importantly, there was no virus-induced mortality in both VLP and AP groups of mice when either group was immunized with adjuvanted low-dose A(H5N1) subvirion vaccine. Our results suggest that adjuvanted vaccination in populations where PEM is endemic may be one strategy to boost vaccination-promoted immunity and improve outcomes associated with highly pathogenic A(H5N1). Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  2. Rutin (quercetin rutinoside) induced protein-energy malnutrition in chronic kidney disease, but quercetin acted beneficially.

    Science.gov (United States)

    Hsieh, Chiu-Lan; Peng, Chiung-Chi; Chen, Kuan-Chou; Peng, Robert Y

    2013-07-31

    Nutraceutically, much of the literature has indicated that an aglycon and its related glycoside would act similarly. However, controversial reports are accumulating. We hypothesize that rutin (RT) and quercetin (QT) pharmacodynamically could act differently. To confirm this, doxorubicin (DR) (8.5 mg/kg) was used to induce rat chronic kidney disease (CKD) and then treated with QT and RT (each 70 mg/kg body weight per day) for 13 weeks. QT exhibited better body weight gaining effect (420 ± 45) vs RT, 350 ± 57 g/rat (p protein-energy malnutrition". RT stimulated serum creatinine (sCr) production to reach 6.0 ± 0.9 mg/dL (p < 0.001). QT did not alter the sCr level. RT but not QT induced uremia and hypercreatininemia. DR significantly downregulated Bcl-2, but highly upregulated Bax, Bad, and cleaved caspase-3, implicating the intrinsic mitochondrial pathway. DR damaged DNA, but QT completely rescued such an effect and recovered renal amyloidosis and collagen deposition. Conclusively, RT and QT act differently, and RT is inferior to QT with respect to treating CKD.

  3. Clinical practice guidelines from the French Health High Authority: nutritional support strategy in protein-energy malnutrition in the elderly.

    Science.gov (United States)

    Raynaud-Simon, Agathe; Revel-Delhom, Christine; Hébuterne, Xavier

    2011-06-01

    These guidelines were produced at the request of the General Directorate of Health within the scope of the French Nutrition and Health Program (PNNS). They concern the management of malnutrition in elderly persons living at home, in institutional care, or in hospital. They belong to a recent series of studies published by ANAES(1) or HAS. Preceding studies concerned the "Diagnostic assessment of protein-energy malnutrition in hospitalized adults" (ANAES, September 2003) and the work conducted by the Committee for the Assessment of Devices and Health Technologies (CEPP) on "Reimbursement procedures for dietary foods for special medical purposes for nutritional supplementation and home enteral nutrition" (HAS, September 2006). The objective of these guidelines is to develop a tool for identifying and managing elderly subjects who are malnourished or at risk of malnutrition. Copyright © 2010. Published by Elsevier Ltd.

  4. Serum vitamin D status in children with protein-energy malnutrition admitted to a national referral hospital in Uganda.

    Science.gov (United States)

    Nabeta, Henry W; Kasolo, Josephine; Kiggundu, Reuben K; Kiragga, Agnes N; Kiguli, Sarah

    2015-09-07

    Vitamin D deficiency is a world-wide epidemic with recent estimates indicating that greater than 50% of the global population is at risk. In Uganda, 80% of healthy community children in a survey were found to be vitamin D insufficient. Protein-energy malnutrition is likely to be associated with vitamin D intake deficiency. The aim of this study was to determine the prevalence of vitamin D deficiency and the associated factors among children admitted with protein-energy malnutrition to the pediatrics wards of Mulago hospital in Kampala, Uganda. Consecutive sampling was done with 158 children, aged 6-24 months, enrolled in a cross sectional study. One hundred and seventeen malnourished and 41 non malnourished children were enrolled from the Acute Care unit, pediatrics in-patient wards, outpatient and immunization clinics, following informed consent obtained from the children's parents/guardians. Children with protein energy malnutrition were categorized based on anthropometric measurements of weight-for-height and weight for length compared with the recommended WHO reference Z-score. Serum 25-hydroxyvitamin D, calcium and phosphate were assayed. One hundred seventeen malnourished and 41 non malnourished children were enrolled. The majority of study participants were male, 91 (57.6%). The mean serum vitamin D levels among the malnourished was 32.5 mmol/L (±12.0 SD) and 32.2 mmol/L (10.9 SD) among the malnourished, p = 0.868. Fifteen (36.6%) of the non malnourished children and 51 (43.6%) of the malnourished had suboptimal levels, p = 0.689. Malnourished children admitted with meningitis and cerebral palsy had lower serum vitamin D levels than those with other infections. There was no statistically significant difference in vitamin D values between the malnourished and non malnourished children. Clinicians should actively screen for children for serum vitamin D levels regardless of nutritional status.

  5. Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification.

    Science.gov (United States)

    Marshall, Skye

    2016-04-01

    Methods of identifying malnutrition in the rehabilitation setting require further examination so that patient outcomes may be improved. The purpose of this narrative review was to: (1) examine the defining characteristics of malnutrition, starvation, sarcopenia and cachexia; (2) review the validity of nutrition screening tools and nutrition assessment tools in the rehabilitation setting; and (3) determine the prevalence of malnutrition in the rehabilitation setting by geographical region and method of diagnosis. A narrative review was conducted drawing upon international literature. Starvation represents one form of malnutrition. Inadequate energy and protein intake are the critical factor in the aetiology of malnutrition, which is distinct from sarcopenia and cachexia. Eight nutrition screening tools and two nutrition assessment tools have been evaluated for criterion validity in the rehabilitation setting, and consideration must be given to the resources of the facility and the patient group in order to select the appropriate tool. The prevalence of malnutrition in the rehabilitation setting ranges from 14-65% worldwide with the highest prevalence reported in rural, European and Australian settings. Malnutrition is highly prevalent in the rehabilitation setting, and consideration must be given to the patient group when determining the most appropriate method of identification so that resources may be used efficaciously and the chance of misdiagnosis minimised. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The possible role of essential fatty acids in the pathophysiology of malnutrition : a review

    NARCIS (Netherlands)

    Smit, EN; Muskiet, FAJ; Boersma, ER

    2004-01-01

    Biochemical evidence of essential fatty acid deficiency (EFAD) may exist in protein-energy malnutrition (PEM). EFAD is characterised by low 18:2omega6, often in combination with low 20:4omega6 and 22:6omega3, and high 18: 1 omega9 and 20:3omega9. Some PEM symptoms, notably skin changes, impaired

  7. Does protein energy malnutrition affect the outcome in Tunisian cirrhotic patients?

    Science.gov (United States)

    Ennaifer, Rym; Cheikh, Myriam; Romdhane, Haifa; Sabbagh, Safa; Ben Nejma, Houda; Bougassas, Wassila; Bel Hadj, Najet

    2016-02-01

    Malnutrition is commonly seen in cirrhotic patients and has been shown to adversely affect outcome. However, it remains associated with the severity of cirrhosis. Therefore, its role as an independent prognostic factor is still under debate. The aims of our study were to determine the prevalence of malnutrition in cirrhotic patients and determine whether this condition was an independent prognostic factor. We prospectively analyzed the nutritional status of 104 consecutive patients with cirrhosis Subjective global nutritional assessment (SGA) and anthropometry [dry body mass index (BMI), triceps skinfold (TSF), arm muscle circumference (AMC)] were used for the evaluation of the nutritional status. Complications of cirrhosis during follow-up and patient's survival were recorded. Global survival and survival without complications was studied by Kaplan Meier method and using Log Rank test. Prevalence of malnutrition ranged from 16.3 and 62.5% according to the method of nutritional assessment used. Survival without complications was reduced in malnourished patients. This difference was significant when assessing malnutrition by dry BMI (p=0.001). In multivariate analysis, malnutrition defined by dry BMImalnutrition was an independent predictor of complications in cirrhosis. However, it did not appear as an independent prognostic factor for global survival. These results raise again difficulties to clarify whether malnutrition influence itself the prognosis of cirrhosis or if it is only related to the severity of cirrhosis.

  8. Some factors contributing to protein-energy malnutrition in the middle belt of Nigeria.

    Science.gov (United States)

    Ighogboja, S I

    1992-10-01

    A number of risk factors leading to malnutrition were investigated among 400 mothers of malnourished children in the middle belt of Nigeria. Poverty, family instability, poor environmental sanitation, faulty weaning practices, illiteracy, ignorance, large family size and preventable infections are the main factors responsible for malnutrition. The strategies for intervention are in the area of health education emphasizing the importance of breastfeeding, family stability, responsible parenthood and small family sizes through culturally acceptable family planning methods. There is need to improve weaning methods through nutrition education, growth monitoring and food demonstration with community participation. Political will is needed to improve literacy status, farming methods and general living conditions.

  9. Honey can repairing damage of liver tissue due to protein energy malnutrition through induction of endogenous stem cells

    Directory of Open Access Journals (Sweden)

    R. Heru Prasetyo

    2017-06-01

    Full Text Available Aim: This study was to evaluate effect of honey in repairing damage of liver tissue due to energy protein malnutrition and in mobilization of endogenous stem cells. Materials and Methods: Male mice model of degenerative liver was obtained through food fasting but still have drinking water for 5 days. It caused energy protein malnutrition and damage of liver tissue. The administration of 50% (v/v honey was performed for 10 consecutive days, while the positive control group was fasted and not given honey and the negative control not fasted and without honey. Observations of regeneration the liver tissue based on histologically examination, observation of Hsp70 expression, and homing signal based on vascular endothelial growth factor-1 (VEGF-1 expression using immunohistochemistry technique. Observation on expression of CD34 and CD45 as the marker of auto mobilization of hematopoietic stem cells using flow cytometry technique. Results: There is regeneration of the liver tissue due to protein energy malnutrition, decrease of Hsp70 expression, increase of VEGF-1 expression, and high expression of CD34 and CD45. Conclusion: Honey can improve the liver tissue based on: (1 Mobilization of endogenous stem cells (CD34 and CD45; (2 Hsp70 and VEGF-1 expressions as regeneration marker of improvement, and (3 regeneration histologically of liver tissue.

  10. Honey can repairing damage of liver tissue due to protein energy malnutrition through induction of endogenous stem cells.

    Science.gov (United States)

    Prasetyo, R Heru; Hestianah, Eka Pramyrtha

    2017-06-01

    This study was to evaluate effect of honey in repairing damage of liver tissue due to energy protein malnutrition and in mobilization of endogenous stem cells. Male mice model of degenerative liver was obtained through food fasting but still have drinking water for 5 days. It caused energy protein malnutrition and damage of liver tissue. The administration of 50% (v/v) honey was performed for 10 consecutive days, while the positive control group was fasted and not given honey and the negative control not fasted and without honey. Observations of regeneration the liver tissue based on histologically examination, observation of Hsp70 expression, and homing signal based on vascular endothelial growth factor-1 (VEGF-1) expression using immunohistochemistry technique. Observation on expression of CD34 and CD45 as the marker of auto mobilization of hematopoietic stem cells using flow cytometry technique. There is regeneration of the liver tissue due to protein energy malnutrition, decrease of Hsp70 expression, increase of VEGF-1 expression, and high expression of CD34 and CD45. Honey can improve the liver tissue based on: (1) Mobilization of endogenous stem cells (CD34 and CD45); (2) Hsp70 and VEGF-1 expressions as regeneration marker of improvement, and (3) regeneration histologically of liver tissue.

  11. Protein-energy malnutrition and the home environment : a study among children in Coast Province, Kenya

    NARCIS (Netherlands)

    Peters, C.; Niemeijer, R.

    1987-01-01

    Abr. abstr.: This is an account of a study concerning the occurrence of childhood malnutrition in Kilifi District, Kenya. The socioeconomic characteristics of women with malnourished children who attended Kilifi Family Life Training Centre in the year 1984/1985 were analysed. Next, the possible

  12. Effect of a probiotic fermented milk on the thymus in Balb/c mice under non-severe protein-energy malnutrition.

    Science.gov (United States)

    Núñez, Ivanna Novotny; Galdeano, Carolina Maldonado; Carmuega, Esteban; Weill, Ricardo; de Moreno de LeBlanc, Alejandra; Perdigón, Gabriela

    2013-08-28

    Protein–energy malnutrition (PEM) causes a significant impairment of the immune system, the thymus being one of the most affected organs. It has been demonstrated that the administration of probiotic fermented milk (PFM) recovered the intestinal barrier, histological alterations and mucosal and systemic immune functions in a non-severe malnutrition model using BALB/c mice. The aim of the present study was to evaluate, in the same model of malnutrition, the effect of a PFM added to a re-nutrition diet on the recovery of the thymus, analysing histological and functional alterations caused by malnutrition. Mice were undernourished and divided into three groups according to the dietary supplement received during re-nutrition: milk, PFM or its bacterial-free supernatant (BFS). They were compared with well-nourished and malnourished mice. PFM was the most effective re-nutrition supplement to improve the histology of the thymus, decreasing cellular apoptosis in this organ and recovering the percentage of CD4þ/CD82 single-positive thymocytes. Immature doublepositive thymocytes were increased in the malnourished control (MC). The production of different cytokines in the thymus was increased in mice given PFM, compared with the mice that received other dietary supplements and MC. Mice given the BFS presented an improvement in the thymus similar to those that received milk. We demonstrated the importance of the whole PFM supplementation on the histological and functional recovery of the thymus in a non-severe PEM model.

  13. Validity of mid arm circumference to detect protein energy malnutrition among 8-11 months old infants in a rural medical college of West Bengal.

    Science.gov (United States)

    Sadhukhan, Sanjoy Kr; Chatterjee, Chitra; Shrivastava, Prabha; Sardar, Jadav Chandra; Joardar, Gautam Kr; Lahiri, Saibendu

    2010-09-01

    This institution-based cross-sectional observational validation study was conducted in the immunisation clinic of North Bengal Medical College and Hospital, Sushrutanagar. The objective was to identify the validity characteristics of mid arm circumference to detect protein energy malnutrition among 8-11 months infants and to find out a suitable cut-off value if any. Study variables were age, sex, body weight and mid arm circumference. Mid arm circumference was validated against weight for age criteria (gold standard) of malnutrition. The mean mid arm circumference of the infants was found to be almost constant with only about 2.22% change over 4 months, signifying that single cut-off point can be used to detect protein energy malnutrition. Mid arm circumference values from 13.0 to 12.5 cm were found to have the highest accuracy to detect protein energy malnutrition (about 86%). The cut-off values of 12.5 and 12.6 cm were noted to have a sensitivity and specificity of about 52% and 96% respectively, a false negativity of 48% but a false positivity of only 4%. Receiver operating characteristics curve detected 12.5(12.6) cm as the best diagnostic cut-off point which can detect more than 50% of the malnourished babies with very little false positivity/misdiagnosis (only 4%). A simple measuring tape with some reorientation of the health workers can detect the beginning of childhood malnutrition.

  14. Alcoholic Liver Disease and Malnutrition

    Science.gov (United States)

    McClain, Craig J.; Barve, Shirish S.; Barve, Ashutosh; Marsano, Luis

    2013-01-01

    Malnutrition, both protein energy malnutrition (PEM) and deficiencies in individual nutrients, is a frequent complication of alcoholic liver disease (ALD). Severity of malnutrition correlates with severity of ALD. Malnutrition also occurs in patients with cirrhosis due to etiologies other than alcohol. The mechanisms for malnutrition are multifactorial, and malnutrition frequently worsens in the hospital due to fasting for procedures and metabolic complications of liver disease, such as hepatic encephalopathy. Aggressive nutritional support is indicated in inpatients with ALD, and patients often need to be fed through an enteral feeding tube to achieve protein and calorie goals. Enteral nutritional support clearly improves nutrition status and may improve clinical outcome. Moreover, late-night snacks in outpatient cirrhotics improve nutritional status and lean body mass. Thus, with no FDA-approved therapy for ALD, careful nutritional intervention should be considered as frontline therapy. PMID:21284673

  15. Evaluating risk factors for protein-energy malnutrition in children under the age of six years: a case-control study from Iran

    Directory of Open Access Journals (Sweden)

    Sharghi A

    2011-08-01

    Full Text Available Afshan Sharghi1, Aziz Kamran2, Mohammad Faridan31Department of Community Medicine, Medical School, Ardebil University of Medical Sciences, Ardebil, 2Department of Public Health, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, 3Department of Public Health, Faculty of Health, Lorestan University of Medical Sciences, Lorestan, IranIntroduction: Protein-energy malnutrition is one of the most important public health problems in Iran. It not only accounts for more than half of child mortality but can also produce somatic and mental impairment in survivors. The main aim of this study was to identify risk factors for protein-energy malnutrition in children under 6 years of age in Namin city.Methods: This was a population-based, multicenter case-control study. Seventy-six children with malnutrition and 76 children without malnutrition were randomly recruited for case and control groups. The prevalence of risk factors in the two groups was compared. Data were gathered from a health center database and interviews with mothers and health workers. The Wilcoxon signed-rank test and logistic regression were used for data analysis.Results: Female gender, poverty, short maternal height, and use of unhygienic latrines in the home were significantly associated with childhood malnutrition (P , 0.05.Conclusion: The results of this study indicate four main factors (poverty, small maternal height, female gender, and absence of hygienic latrines in the home as underlying factors in malnutrition of children under the age of 6 years.Keywords: protein-energy malnutrition, children, risk factors, Namin

  16. STUDY OF ANEMIA AMONG PROTEIN ENERGY MALNOURISHED CHILDREN IN MYSORE

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    Nayana

    2015-02-01

    Full Text Available INTRODUCTION AND OBJECTIVES : Anemia in Protein energy malnutrition (PEM is common and its pathogenesis is multifactorial. Since the clinico - pathological patterns are reflected by their underlying etiopathogenic factors, it is important to study the associated morbidity and mortalit y and to establish their causes for an effective management. The purpose of the present study is to determine the prevalence, patterns, clinico - pathological and morphological types of anemia in protein energy malnutrition children. The objectives of the st udy are: (1 To study the clinico - pathological and morphological patterns of anemia in PEM children of age group 6 month – 5 years. (2 To assess the resultant morbidity and mortality. (3 To determine the ideal parameter for iron deficiency anemia. METHOD S: This study was conducted on 75 clinically diagnosed Protein energy malnutrition patients of age group 6 months to 5 years. Detailed clinical history elicitation and thorough clinical examination was performed. Peripheral smears of these patients were ex amined. The complete hemogram including reticulocyte count was done. The special investigations like bone marrow study, Hb electrophoresis, iron studies and stool examination were done whenever required. RESULTS: In our study, anemia in PEM affected female population more than the males of age 36 - 47 months. Most of children had Grade III PEM and Microcytic hypochromic anemia was most prevalent. Most of the children had Iron deficiency anemia. This study also indicated that Serum iron assay and TIBC are the better indicators of iron deficiency anemia in patients with PEM and it is the investigation of choice when compared to serum ferritin as it gets falsely elevated in these patients with infections confirmed by elevated CRP level. INTERPRETATION AND CONCLUS ION: Malnutrition, Infection and Anemia show a synergistic relationship. So it necessitates prompt screening and early diagnosis through proper

  17. Prevalence of Malnutrition and Effects of Maternal Age, Education ...

    African Journals Online (AJOL)

    Background: Protein Energy Malnutrition (PEM) remains a major public health problem in Nigeria to the extent that it is a significant cause of morbidity and mortality among children. Objectives: This study aims at determining the nutritional status of children aged between 6 and 59 months. Also the relationship between ...

  18. A systematic review and meta-analysis of the criterion validity of nutrition assessment tools for diagnosing protein-energy malnutrition in the older community setting (the MACRo study).

    Science.gov (United States)

    Marshall, Skye; Craven, Dana; Kelly, Jaimon; Isenring, Elizabeth

    2017-10-12

    Malnutrition is a significant barrier to healthy and independent ageing in older adults who live in their own homes, and accurate diagnosis is a key step in managing the condition. However, there has not been sufficient systematic review or pooling of existing data regarding malnutrition diagnosis in the geriatric community setting. The current paper was conducted as part of the MACRo (Malnutrition in the Ageing Community Review) Study and seeks to determine the criterion (concurrent and predictive) validity and reliability of nutrition assessment tools in making a diagnosis of protein-energy malnutrition in the general older adult community. A systematic literature review was undertaken using six electronic databases in September 2016. Studies in any language were included which measured malnutrition via a nutrition assessment tool in adults ≥65 years living in their own homes. Data relating to the predictive validity of tools were analysed via meta-analyses. GRADE was used to evaluate the body of evidence. There were 6412 records identified, of which 104 potentially eligible records were screened via full text. Eight papers were included; two which evaluated the concurrent validity of the Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA) and six which evaluated the predictive validity of the MNA. The quality of the body of evidence for the concurrent validity of both the MNA and SGA was very low. The quality of the body of evidence for the predictive validity of the MNA in detecting risk of death was moderate (RR: 1.92 [95% CI: 1.55-2.39]; P < 0.00001; n = 2013 participants; n = 4 studies; I 2 : 0%). The quality of the body of evidence for the predictive validity of the MNA in detecting risk of poor physical function was very low (SMD: 1.02 [95%CI: 0.24-1.80]; P = 0.01; n = 4046 participants; n = 3 studies; I 2 :89%). Due to the small number of studies identified and no evaluation of the predictive validity of tools other than

  19. Pathophysiological changes that affect drug disposition in protein-energy malnourished children

    Directory of Open Access Journals (Sweden)

    Oshikoya Kazeem A

    2009-12-01

    Full Text Available Abstract Protein-energy malnutrition (PEM is a major public health problem affecting a high proportion of infants and older children world-wide and accounts for a high childhood morbidity and mortality in the developing countries. The epidemiology of PEM has been extensively studied globally and management guidelines formulated by the World Health Organization (WHO. A wide spectrum of infections such as measles, malaria, acute respiratory tract infection, intestinal parasitosis, tuberculosis and HIV/AIDS may complicate PEM with two or more infections co-existing. Thus, numerous drugs may be required to treat the patients. In-spite of abundant literature on the epidemiology and management of PEM, focus on metabolism and therapeutic drug monitoring is lacking. A sound knowledge of pathophysiology of PEM and pharmacology of the drugs frequently used for their treatment is required for safe and rational treatment. In this review, we discuss the pathophysiological changes in children with PEM that may affect the disposition of drugs frequently used for their treatment. This review has established abnormal disposition of drugs in children with PEM that may require dosage modification. However, the relevance of these abnormalities to the clinical management of PEM remains inconclusive. At present, there are no good indications for drug dosage modification in PEM; but for drug safety purposes, further studies are required to accurately determine dosages of drugs frequently used for children with PEM.

  20. Malnutrition

    Science.gov (United States)

    ... fats, vitamins, and minerals - you may suffer from malnutrition. Causes of malnutrition include: Lack of specific nutrients in your diet. ... the lack of one vitamin can lead to malnutrition. An unbalanced diet Certain medical problems, such as ...

  1. FERMENTED SOYBEAN CAKE AND ALBUMIN FORMULA AS NUTRITIONAL SUPPORT PREVENTS PROTEIN ENERGY MALNUTRITION AND AKI IN STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Nanny Djaya

    2012-06-01

    Natrium and Kalium, could be corrected with appropriate nutritional support (adequate calorie, protein and mineral and therefore prevents acute kidney injury and protein energy malnutrition in elderly patients with anorexia.

  2. Malnutrition

    Science.gov (United States)

    ... because it affects brain development and other growth. Children who suffer from malnutrition may have lifelong problems. ... Talk to your provider about the risk of malnutrition. Treatment ... Lack of menstruation Lack of growth in children Rapid hair loss

  3. Protein-energy malnutrition during early gestation in sheep blunts fetal renal vascular and nephron development and compromises adult renal function.

    Science.gov (United States)

    Lloyd, Louise J; Foster, Thomas; Rhodes, Phillip; Rhind, Stewart M; Gardner, David S

    2012-01-15

    A nutritionally poor maternal diet can reduce nephron endowment and pre-empt premature expression of markers for chronic renal disease in the offspring. A mechanistic pathway from variation in maternal diet through altered fetal renal development to compromised adult kidney structure and function with adult-onset obesity has not been described. We show that maternal protein-energy malnutrition in sheep blunts nephrogenic potential in the 0.44 gestation (65 days gestation, term ∼147 days) fetus by increasing apoptosis and decreasing angiogenesis in the nephrogenic zone, effects that were more marked in male fetuses. As adults, the low-protein-exposed sheep had reduced glomerular number and microvascular rarefaction in their kidneys compensated for, respectively, by glomerular hypertrophy and increased angiogenic support. In this study, the long-term mild anatomical deficits in the kidney would have remained asymptomatic in the lean state, but when superimposed on the broad metabolic challenge that obesity represents then microalbuminuria and blunted bilateral renal function revealed a long-term physiological compromise, that is only predicted to worsen with age. In conclusion, maternal protein-energy malnutrition specifically impacts fetal kidney vascular development and prevents full functionality of the adult kidney being achieved; these residual deficits are predicted to significantly increase the expected incidence of chronic kidney disease in prenatally undernourished individuals especially when coupled with a Western obesogenic environment.

  4. Urinary metabonomics study in a rat model in response to protein-energy malnutrition by using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry.

    Science.gov (United States)

    Wu, Zeming; Li, Min; Zhao, Chunxia; Zhou, Jia; Chang, Yuwei; Li, Xiang; Gao, Peng; Lu, Xin; Li, Yousheng; Xu, Guowang

    2010-11-01

    Systematic studies were performed on the biological perturbations in metabolic phenotype responding to protein-energy malnutrition through global metabolic profiling analysis, in combination with pattern recognition. The malnutrition rat model was established through five weeks of strict diet restriction, and the metabonome data obtained from gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-MS) were integrated to approximate the comprehensive metabolic signature. Principal component analysis and orthogonal projection to latent structure analysis were used for the classification of metabolic phenotypes and discovery of differentiating metabolites. The perturbations in the urine profiles of malnourished rats were marked by higher levels of creatine, threitol, pyroglutamic acid, gluconic acid and kynurenic acid, as well as decreased levels of succinic acid, cis-aconitic acid, citric acid, isocitric acid, threonic acid, trimethylglycine, N-methylnicotinic acid and uric acid. The alterations in these metabolites were associated with perturbations in energy metabolism, carbohydrate, amino acid, and fatty acid metabolism, purine metabolism, cofactor and vitamin metabolism, in response to protein and energy malnutrition. Our findings show the integration of GC-MS and LC-MS techniques for untargeted metabolic profiling analysis was promising for nutriology.

  5. Chronic Malnutrition Among Infants of Varanasi

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    Nanda S

    1997-01-01

    Full Text Available Research question: What is the nutritional status of infants in Varanasi? Objectives: To find out the magnitude of PEM among infants of Varanasi district. Study design: Cross-sectional. Setting: Urban slum and rural areas. Participants: 360 infants. Study variables: Age, height (length, weight. Outcome variables: Protein Energy Malnutrition. Statistical analysis: Simple proportions; Chi- square test. Results: As per the height for age criteria; only 10.56% of infants were stunted (<90% of reference standard and according to Seoane Latham classification; 44.96%, 6.05% and 4.03% were suffering from acute malnutrition and nutritional dwarfing respectively (90% of reference standard as entry point

  6. Identifying reliable predictors of protein-energy malnutrition in hospitalized frail older adults. A prospective longitudinal study.

    Science.gov (United States)

    Sanson, Gianfranco; Bertocchi, Luca; Dal Bo, Eugenia; Di Pasquale, Carmen Luisa; Zanetti, Michela

    2018-03-07

    Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identify patients for malnutrition at hospital admission and effectively monitoring their food intake. The primary aim was to identify reliable predictive indicators of reduced food intake at hospital admission. The secondary aims were to assess the adequacy of daily energy and protein intake and the impact of nutrient intake on patient outcomes. Prospective observational longitudinal study. Internal Medicine Ward of an Academic Teaching University Hospital. Acute older adults who were malnourished or at risk of malnutrition (Nutritional Risk Score-2002 ≥ 3, middle-upper arm circumference energy and protein intake was monitored during the first 5 days of hospital stay by a photographic method and compared to the daily energy and protein requirement calculated by specific equations. Data on anthropometry, inflammation/malnutrition laboratory data and body composition (phase angle calculated using bioelectrical impedance analysis) were collected. Eighty-one subjects (age 81.5 ± 11.5 years) were enrolled. Mean energy intake was 669.0 ± 573.9 kcal/day, and mean protein intake was 30.7 ± 25.8 g/day. Over 60% of patients ingested ≤50% of their calculated energy and protein requirements: these patients were older (p = 0.026), had a lower middle-upper arm circumference (p = 0.022) and total arm area (p = 0.038), a higher C-reactive protein/albumin ratio and Instant Nutritional Assessment score (p protein/albumin ratio, and impaired self-feeding at admission were independently associated with critically reduced energy and protein intake. Middle

  7. Protein-energy malnutrition during early childhood and periodontal disease in the permanent dentition of Haitian adolescents aged 12-19 years: a retrospective cohort study.

    Science.gov (United States)

    Russell, Stefanie L; Psoter, Walter J; Jean-Charles, Germain; Prophte, Samuel; Gebrian, Bette

    2010-05-01

    The aim of this retrospective cohort study was to examine whether exposure to early childhood protein-energy malnutrition (ECPEM) is related to worsened periodontal status in the permanent dentition during adolescence. A trained clinician/researcher examined the periodontal status of 96 persons aged 12-19 living in rural Haiti using WHO diagnostic criteria (Community Periodontal Index, WHO 1997). Malnutrition data of the study participants had been collected during the years 1988-1993 by a nongovernmental organization. We compared those who had been malnourished in early childhood, based on z-scores for anthropomorphic data collected during the first 5 years of life, with those who had not been malnourished, regarding mean Community Periodontal Index (CPI) score, controlling for age, sex, socioeconomic status, and smoking. Overall, 57.3% of the participants demonstrated a CPI score of 3 or greater in at least one sextant. ECPEM was independently and positively related to mean CPI score, when controlling for sex and smoking. More than half of these young Haitians demonstrated CPI scores of 3 or greater, and ECPEM was related to poorer periodontal status, as measured by CPI, in the permanent dentition.

  8. Assessment of the reliability and consistency of the "malnutrition inflammation score" (MIS) in Mexican adults with chronic kidney disease for diagnosis of protein-energy wasting syndrome (PEW).

    Science.gov (United States)

    González-Ortiz, Ailema Janeth; Arce-Santander, Celene Viridiana; Vega-Vega, Olynka; Correa-Rotter, Ricardo; Espinosa-Cuevas, María de Los Angeles

    2014-10-04

    The protein-energy wasting syndrome (PEW) is a condition of malnutrition, inflammation, anorexia and wasting of body reserves resulting from inflammatory and non-inflammatory conditions in patients with chronic kidney disease (CKD).One way of assessing PEW, extensively described in the literature, is using the Malnutrition Inflammation Score (MIS). To assess the reliability and consistency of MIS for diagnosis of PEW in Mexican adults with CKD on hemodialysis (HD). Study of diagnostic tests. A sample of 45 adults with CKD on HD were analyzed during the period June-July 2014.The instrument was applied on 2 occasions; the test-retest reliability was calculated using the Intraclass Correlation Coefficient (ICC); the internal consistency of the questionnaire was analyzed using Cronbach's αcoefficient. A weighted Kappa test was used to estimate the validity of the instrument; the result was subsequently compared with the Bilbrey nutritional index (BNI). The reliability of the questionnaires, evaluated in the patient sample, was ICC=0.829.The agreement between MIS observations was considered adequate, k= 0.585 (p <0.001); when comparing it with BNI, a value of k = 0.114 was obtained (p <0.001).In order to estimate the tendency, a correlation test was performed. The r² correlation coefficient was 0.488 (P <0.001). MIS has adequate reliability and validity for diagnosing PEW in the population with chronic kidney disease on HD. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Hitos conceptuales en la historia de la desnutrición proteico-energética Conceptual landmarks in the history of protein-energy malnutrition

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    Leopoldo Vega-Franco

    1999-07-01

    Full Text Available Aunque ancestralmente los jinetes bíblicos del hambre, la peste y la guerra han cabalgado juntos por el sendero de la historia, puede ser que las consecuencias de estas calamidades -desnutrición y muerte- hayan sido secularmente vistas de manera tan natural como la vida misma. Tal vez ésta sea la razón por la que hasta el siglo XIX -y para ser preciso, hasta 1865-, se documentó la primera descripción clínica de lo que ahora se conoce como desnutrición proteico-energética. La limitada difusión de este hallazgo dio lugar a que la enfermedad fuese redescubierta y descrita exitosamente en lengua inglesa en 1933. Un año después de creadas en 1949, la Organización Mundial de la Salud (OMS y el Fondo para la Agricultura y la Alimentación (FAO tomaron la decisión de unificar los criterios de diagnóstico de esta enfermedad e impulsar su investigación. En este ensayo se destacan algunos de los hitos en la historia del conocimiento científico de esta enfermedad.Although the biblical horsemen of hunger, plague and war have proverbially ridden together, the consequences of these adversities, i.e. malnutrition and death, may have been secularly interpreted as natural as life itself. This may be the reason why the first clinical description of what is now known as protein-energy malnutrition, did not appear until the 19th century, in 1865 to be precise. The limited dissemination of this finding, originally written in Spanish, brought about a rediscovery and successful description of the disease in English in 1933. In 1949, one year after their creation, the World Health Organization (WHO and the Food and Agriculture Organization (FAO decided to unify their diagnostic criteria of malnutrition, and endorse further research. The present assay describes some of the major conceptual landmarks in the history of the scientific knowledge of this disease.

  10. Comparison of malnutrition inflammation score, anthropometry and biochemical parameters in assessing the difference in protein-energy wasting between normal weight and obese patients undergoing haemodialysis.

    Science.gov (United States)

    Alipoor, Elham; Hosseinzadeh-Attar, Mohammad Javad; Mahdavi-Mazdeh, Mitra; Yaseri, Mehdi; Zahed, Narges S

    2017-07-01

    Protein-energy wasting (PEW) is prevalent in haemodialysis. Obesity is an independent risk factor of kidney insufficiency, but it is proposed to have beneficial roles in better outcomes in the final stage of disease. Better nutritional status and body reserves are among probable mechanisms, but direct examinations are limited. The present study aimed to investigate whether obese patients have preferable nutritional status compared to normal weight patients based on malnutrition inflammation score (MIS) and other PEW parameters in haemodialysis. This case-control study investigated 52 normal weight (18.5 < body mass index (BMI) < 25 kg/m 2 ) and 48 obese (BMI≥30 kg/m 2 ) patients on regular haemodialysis. PEW was assessed based on anthropometric and biochemical factors, recent weight changes, appetite, anorexia, dietary intake and MIS. Obese patients had better MIS compared with the normal weight group (P < 0.001), although varying degrees of wasting were prevalent among this group too (75% mild and 25% moderate wasting). The obese group had less significant weight loss (4.2 vs 8%) and anorexia and better appetite. However, a considerable percentage of patients in both groups showed muscle (94.6% of normal weight and 19.5% of obese) and peripheral fat tissue (89.2% of normal weight and 31.7% of obese) losses compared to the 50th percentile. Biochemical parameters were not significantly different between groups except for triglyceride (P = 0.001), transferrin and total iron-binding capacity (P = 0.028). MIS was significantly better in obese patients; however, both groups showed degrees of wasting based on MIS and other PEW parameters. Nutritional status of obese haemodialysis patients should be monitored regularly because of high risk of PEW like other BMI categories. © 2017 Dietitians Association of Australia.

  11. Serum zinc level in children with malnutrition

    International Nuclear Information System (INIS)

    Ahmad, T.M.; Mahmood, M.T.; Baluch, G.R.; Bhatti, M.T.

    2000-01-01

    Serum zinc level amongst children with protein energy malnutrition (PEM) was evaluated in a control study conducted in the Department of Paediatrics, Allama Iqbal Medical College and Jinnah Hospital, Lahore. Twenty-five children with PEM and 25 healthy children as control from the community were screened. Mean serum zinc level was found to be 54.48 -+ 18.91 mg/dl in children with PEM while it was 72.72 -+ 8.21 mg/dl in control group (P < 0.001). No significant difference in zinc level was noted between both sexes in each group. Marasmic 16 children revealed mean serum zinc level of 57.55 -+ 18.16 mg/dl while in Kwashiorkor it was 44.57 -+ 13.66 mg/dl. Serum zinc was significantly low in Kwashiorkor than in marasmus (P < 0.001). It was also significantly low in children with acute or chronic diarrhea associated with malnutrition (44.66 -+ 16.0 mg/dl). Acute respiratory infections in these children were not associated with low serum zinc level (71.66 -+ 16.51 mg/dl). (author)

  12. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

    2012-12-17

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

  13. Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

    International Nuclear Information System (INIS)

    Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

    2012-01-01

    Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

  14. Effect of early childhood malnutrition on tooth eruption in Haitian adolescents.

    Science.gov (United States)

    Psoter, W; Gebrian, B; Prophete, S; Reid, B; Katz, R

    2008-04-01

    The objective of this retrospective cohort study was to determine the effects of early childhood protein-energy malnutrition (EC-PEM) and current nutritional status as defined by anthropomorphic measures on the exfoliation and eruption patterns of teeth among adolescents. Oral clinical examinations were conducted in 2005 using World Health Organization (WHO) diagnostic criteria on 498 11- to 13-year-old Haitians for whom early childhood malnutrition data were available. Anthropomorphic records (weight-for-age) from the Haitian Health Foundation computerized database on children from birth through 5-years old were utilized. Current heights and weights were ascertained. Both sets of data were converted to z-scores based on the National Center for Health Statistics (NCHS) referent database. Based upon these z-scores, EC-PEM and current malnutrition categories were developed for this study. The analyses separately regressed the number of primary and permanent teeth on age, gender, EC-PEM status and current nutritional status. Both a delayed exfoliation of primary teeth and a delayed eruption of permanent teeth were associated with EC-PEM and current stunting in adolescence. The observed associations were either direct and statistically significant or indirectly demonstrated by presenting evidence of confounding. The overall interpretation of the models is that malnutrition beginning in the earliest years and extending throughout childhood influences the exfoliation and eruption of teeth. These findings present evidence of an association between tooth exfoliation/eruption patterns and both EC-PEM and nutritional insufficiency (stunting) throughout childhood. This observed delay in the exfoliation of the primary dentition and in the eruption of the permanent dentition has practical significance in interpreting age-specific dental caries data from populations with different malnutrition experiences.

  15. Effect of childhood malnutrition on salivary flow and pH.

    Science.gov (United States)

    Psoter, Walter J; Spielman, Andrew L; Gebrian, Bette; St Jean, Rudolph; Katz, Ralph V

    2008-03-01

    While protein-energy malnutrition may have multiple effects on oral tissues and subsequent disease development, reports of the effect of malnutrition on the human salivary glands are sparse. A retrospective cohort study of the effect of early childhood protein-energy malnutrition (EC-PEM) and adolescent nutritional status on salivary flow and pH was conducted with rural Haitian children, ages 11-19 years (n=1017). Malnutrition strata exposure cohorts were based on 1988-1996 weight-for-age records which covered the birth through 5-year-old period for all subjects. Then, data on current anthropometrical defined nutritional status categories, stimulated and unstimulated salivary flow rates, and salivary pH were collected for the same subjects of 11-19 years old during field examinations in the summer of 2005. Multivariate analysis of variance (MANOVA) was used for the analyses. Stimulated and unstimulated salivary flow rates were reduced at statistically significant levels in subjects who had experienced severe malnutrition in their early childhood or who had continuing nutrition stress which resulted in delayed growth, as measured at ages 11-19 years. Salivary pH demonstrated little clinically meaningful variability between malnourished and nonmalnourished groups. This study is the first to report of a continuing effect on diminished salivary gland function into adolescence as a result of early childhood malnutrition (EC-PEM) and suggests that exocrine glandular systems may be compromised for extended periods following EC-PEM, which may have important implications for the body's systemic antimicrobial defences.

  16. Desnutrição energético-protéica e cárie dentária na primeira infância Protein-energy malnutrition and early childhood caries

    Directory of Open Access Journals (Sweden)

    Dijane Pereira Costa

    2010-02-01

    Full Text Available Este estudo tem por objetivo investigar a relação existente entre a desnutrição energético-protéica e a cárie dentária precoce na primeira infância. Trata-se de uma comunicação, para a qual foi realizada uma revisão da literatura, a partir de análise documental de produção bibliográfica, baseada em levantamentos de periódicos e consultas a livros. Verificou-se que a cárie precoce na infância é altamente prevalente nas comunidades de baixa renda, nas quais a desnutrição é um fator comum e de grande relevância. Estudos mostram que crianças desnutridas tendem a apresentar defeitos estruturais no esmalte do dente, como também estão predispostas a um maior risco à cárie dentária. Portanto, uma deficiência energético-protéica durante a fase de desenvolvimento dentário (odontogênese tem demonstrado uma maior suscetibilidade à cárie dentária, atraso na cronologia de erupção e defeitos estruturais do esmalte (hipoplasia de esmalte, hipofunção das glândulas salivares e mudança na composição da saliva. Estes fatores podem ser os mecanismos pelos quais a desnutrição associa-se à cárie. Em conclusão, os estudos sugerem que a deficiência energético-protéica durante a odontogênese gera atraso na cronologia de erupção e defeitos estruturais no esmalte (hipoplasia, além de poder afetar as glândulas salivares, aumentando o risco de ocorrência da doença cárie. Estudos investigando associações entre desnutrição e cárie na primeira infância são de grande relevância para ampliar o conhecimento desta doença e o desenvolvimento de ações de promoção e de prevenção desse problema de saúde pública com aplicações nas áreas de nutrição e odontologia.This study aimed to investigate the relationship between protein-energy malnutrition and early childhood caries. For this communication, a review of the literature was performed, based on documental analysis of bibliographic searches, surveys of

  17. Inequity and health. Is malnutrition really caused by poor nutrition?

    Science.gov (United States)

    Bharmal, F Y

    2000-08-01

    To look at inequities leading to malnutrition and from the wider picture to find root causes and deal with them in order to alleviate malnutrition. Literature review. The health of the population is adversely affected by the inequities in the country. Women and children being most vulnerable are worst affected. The prevalence of Protein Energy Malnutrition (P.E.M.) in children under five years of age is 51 percent. Such a magnitude of malnutrition in a country, where availability of food per capita is more than adequate, points towards the fact that the inequities within the country are at the root of the problem. Poor income is not the only predictor of malnutrition, gender, urban-rural differences in access, utilization and quality of health care also influence health. In addition, there are some underlying factors such as illiteracy, unawareness of the mother about healthy behaviors, lack of decision-making power of women, along with deep-rooted cultural values of a patriarchal system. Malnutrition is caused by a multitude of factors, some of which are biological, others are environmental, cultural or social. Education of the invisible half of the population, who actually look after the children and the family, is an important strategy to alleviate this problem.

  18. Desnutrição energético-proteica grave durante a hospitalização: aspectos fisiopatológicos e terapêuticos Protein-energy malnutrition during hospital stay: physiopathology and treatment

    Directory of Open Access Journals (Sweden)

    Adriana Martins de Lima

    2010-09-01

    Full Text Available OBJETIVOS: Apresentar a conduta para o tratamento da desnutrição energético-proteica grave e os principais aspectos fisiopatológicos da doença. FONTES DE DADOS: Tomando como base o Manual da Organização Mundial da Saúde (OMS, 1999, realizou-se uma busca por trabalhos publicados em inglês, espanhol e português sobre o tratamento hospitalar de crianças com desnutrição grave, nas bases de dados Lilacs, Medline e SciELO, publicados nos últimos dez anos, utilizando-se as palavras-chave: desnutrição, criança, hospitalização, terapia nutricional, diretrizes, OMS. SÍNTESE DE DADOS: Foram abordadas as principais características fisiopatológicas da desnutrição grave e a conduta recomendada para o tratamento. Identificaram-se as principais complicações clínico-metabólicas, como a hipotermia, a hipoglicemia, a desidratação e as infecções recorrentes, além da má absorção e a fase de estabilização ou de recuperação do desnutrido grave. A compreensão de todos esses conceitos relacionados à fisiopatologia da desnutrição energético-proteica, associada ao adequado planejamento e execução da terapia nutricional, pode reduzir o risco de morbimortalidade em crianças com idade inferior a cinco anos. CONCLUSÕES: As diretrizes da OMS devem ser implantadas levando-se em consideração a realidade de cada região e a capacitação do profissional da saúde quanto ao conhecimento da complexidade e fisiopatologia da desnutrição energético-proteica grave, para adequado diagnóstico e tratamento. O sucesso do tratamento está associado ao cuidado e à atenção ao paciente.OBJECTIVE: To identify the main physiopathological aspects of severe protein-energy malnutrition and its treatment. DATA SOURCE: Based on the World Health Organization guidelines (WHO, 1999, an electronic search for papers on hospital treatment of children with severe malnutrition was performed on Lilacs, Medline and SciELO databases. Studies in English

  19. Parallel changes in cortical neuron biochemistry and motor function in protein-energy malnourished adult rats.

    Science.gov (United States)

    Alaverdashvili, Mariam; Hackett, Mark J; Caine, Sally; Paterson, Phyllis G

    2017-04-01

    While protein-energy malnutrition in the adult has been reported to induce motor abnormalities and exaggerate motor deficits caused by stroke, it is not known if alterations in mature cortical neurons contribute to the functional deficits. Therefore, we explored if PEM in adult rats provoked changes in the biochemical profile of neurons in the forelimb and hindlimb regions of the motor cortex. Fourier transform infrared spectroscopic imaging using a synchrotron generated light source revealed for the first time altered lipid composition in neurons and subcellular domains (cytosol and nuclei) in a cortical layer and region-specific manner. This change measured by the area under the curve of the δ(CH 2 ) band may indicate modifications in membrane fluidity. These PEM-induced biochemical changes were associated with the development of abnormalities in forelimb use and posture. The findings of this study provide a mechanism by which PEM, if not treated, could exacerbate the course of various neurological disorders and diminish treatment efficacy. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Relationship between protein-energy malnutrition, vitamin A, and parasitoses in children living in Brasília Relação entre desnutrição energético-protéica, vitamina A, e parasitoses em crianças vivendo em Brasília

    Directory of Open Access Journals (Sweden)

    Maria Imaculada Muniz-Junqueira

    2002-04-01

    Full Text Available It is still controversial whether intestinal parasitic infections can influence the nutritional status of children. The relationship between protein-energy malnutrition, vitamin A and parasitic infections was evaluated in 124 children. The food intake estimated by recall method was generally low and poor. Seventy five percent of the children were infected with intestinal parasites. The mean±SD weight-for-age and height-for-age Z-score were skewed one standard deviation to the left, when compared to normal standards. An association was found between protein-energy malnutrition and Giardia lamblia, but not with Ascaris lumbricoides or Hymenolepis nana infection. Only Giardia-infected children had a decreased weight-for-age and weight-for-height Z-score. Hypovitaminosis A was a major nutritional problem, but no relationship between this deficiency and parasitic infection was found. Our data indicate that low and poor food intake were the major cause of protein-energy malnutrition among the children, and except for Giardia, this was not influenced by parasitic infections.É controverso se parasitismo intestinal interfere no estado nutricional. A relação entre desnutrição energético-protéica, vitamina A e parasitoses intestinais foi avaliada em 124 crianças. A ingestão alimentar estimada pelo método recordatório mostrou-se deficiente em quantidade e qualidade. Setenta e cinco porcento das crianças estavam parasitadas. A média±DP do Z-escore do peso-para-idade e altura-para-idade da população estudada desviou-se aproximadamente um DP para a esquerda em relação aos padrões normais. Encontrou-se associação entre desnutrição energético-protéica e parasitismo por Giardia lamblia, mas não por Ascaris lumbricoides ou Hymenolepis nana. Somente crianças infectadas por Giardia mostraram deficiência do peso-para-idade e peso-para-altura avaliado pelo Z-escore. Hipovitaminose A foi um importante problema nutricional, mas não houve

  1. Tackling the increasing problem of malnutrition in older persons

    NARCIS (Netherlands)

    Visser, Marjolein; Volkert, D.; Corish, C.; Geisler, C.; Groot, de C.P.G.M.; Cruz-Jentoft, A.J.; Lohrmann, C.; O'Connor, E.M.; Schindler, K.; Schueren, van der D.E.

    2017-01-01

    In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A

  2. Leucine supplementation in the management of protein energy ...

    African Journals Online (AJOL)

    Objective: To establish if leucine could be used as a therapeutic agent in the treatment of protein energy malnutrition. Study selection: Based on defined key words a search was carried out on Pubmed to retrieve all publications on leucine supplementation and muscle protein synthesis. Only studies that met the search ...

  3. Bone marrow and chelatable iron in patients with protein energy ...

    African Journals Online (AJOL)

    Objectives: To examine the iron status of malnourished children by comparing bone marrow iron deposits in children with protein energy malnutrition with those in well-nourished controls, and measuring chelatable urinary iron excretion in children with kwashiorkor. Design: Bone marrow iron was assessed histologicaHy in ...

  4. Institutionalized elderly people and malnutrition: research on the patients of a nursing home

    Directory of Open Access Journals (Sweden)

    Francesco Rondoni

    2013-09-01

    Full Text Available Protein-energy malnutrition (PEM is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb were examined and compared to body mass index (BMI calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05 and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05 to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%. These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the

  5. DETECTION OF MALNUTRITION IN PATIENTS UNDERGOING MAINTENANCE HAEMODIALYSIS: A QUANTITATIVE DATA ANALYSIS ON 12 PARAMETERS.

    Science.gov (United States)

    Nafzger, Sonja; Fleury, Lea-Angelica; Uehlinger, Dominik E; Plüss, Petra; Scura, Ninetta; Kurmann, Silvia

    2015-09-01

    Protein-energy-malnutrition (PEM) is common in people with end stage kidney disease (ESKD) undergoing maintenance haemodialysis (MHD) and correlates strongly with mortality. To this day, there is no gold standard for detecting PEM in patients on MHD. The aim of this study was to evaluate if Nutritional Risk Screening 2002 (NRS-2002), handgrip strength measurement, mid-upper arm muscle area (MUAMA), triceps skin fold measurement (TSF), serum albumin, normalised protein catabolic rate (nPCR), Kt/V and eKt/V, dry body weight, body mass index (BMI), age and time since start on MHD are relevant for assessing PEM in patients on MHD. The predictive value of the selected parameters on mortality and mortality or weight loss of more than 5% was assessed. Quantitative data analysis of the 12 parameters in the same patients on MHD in autumn 2009 (n = 64) and spring 2011 (n = 40) with paired statistical analysis and multivariate logistic regression analysis was performed. Paired data analysis showed significant reduction of dry body weight, BMI and nPCR. Kt/Vtot did not change, eKt/v and hand grip strength measurements were significantly higher in spring 2011. No changes were detected in TSF, serum albumin, NRS-2002 and MUAMA. Serum albumin was shown to be the only predictor of death and of the combined endpoint "death or weight loss of more than 5%". We now screen patients biannually for serum albumin, nPCR, Kt/V, handgrip measurement of the shunt-free arm, dry body weight, age and time since initiation of MHD. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  6. Knowledge of Parents of a Back-ward Community Regarding Malnutrition in Children

    Directory of Open Access Journals (Sweden)

    C P Mishra

    1987-04-01

    Full Text Available Protein energy malnutrition (PEM ia children has been considered as the most important problem in the field of preventive medicine particularly so in the developing countries (WHO, 1974. Vari­ous crash activities and nutrition program­mes in our country could not bring an appreciable change in the over-all magni­tude of the problem (ICSSR and ICMR, 1981. In order to have sustained improve­ment, parents education holds great promise Information education and com­munication (IEC is emerging as an impor­tant tool in the delivery of Primary Health Care (PHC as well as nutrition related services. For proper application of this tool it is imperative to have basal knowle­dge of parents regarding identification, causes and preventability of important nutritional disorders. The specific objec­tives of the present study were to explore-(aThe ability of parents to recog­nise marasmus, kwashiorkor, vitamin A and vitamin B deficinc es with photograph of these disorders and also on description.(bKnowledge of parents regarding causes of marasmus, kwashiorkor, vitamin A and B complex deficien­cies.(cKnowledge of parents regarding prevention of malnutrition dis­orders.The important facets and concepts of a backward community of Banda District, Uttar Pradesh as revealed by the present study may be of immense help in planning a ‘Nutrition Education pro­gramme’.

  7. Knowledge of Parents of a Back-ward Community Regarding Malnutrition in Children

    Directory of Open Access Journals (Sweden)

    C P Mishra

    1987-04-01

    Full Text Available Protein energy malnutrition (PEM ia children has been considered as the most important problem in the field of preventive medicine particularly so in the developing countries (WHO, 1974. Vari­ous crash activities and nutrition program­mes in our country could not bring an appreciable change in the over-all magni­tude of the problem (ICSSR and ICMR, 1981. In order to have sustained improve­ment, parents education holds great promise Information education and com­munication (IEC is emerging as an impor­tant tool in the delivery of Primary Health Care (PHC as well as nutrition related services. For proper application of this tool it is imperative to have basal knowle­dge of parents regarding identification, causes and preventability of important nutritional disorders. The specific objec­tives of the present study were to explore- (aThe ability of parents to recog­nise marasmus, kwashiorkor, vitamin A and vitamin B deficinc es with photograph of these disorders and also on description. (bKnowledge of parents regarding causes of marasmus, kwashiorkor, vitamin A and B complex deficien­cies. (cKnowledge of parents regarding prevention of malnutrition dis­orders. The important facets and concepts of a backward community of Banda District, Uttar Pradesh as revealed by the present study may be of immense help in planning a ‘Nutrition Education pro­gramme’.

  8. Metabolic changes in malnutrition.

    Science.gov (United States)

    Emery, P W

    2005-10-01

    This paper is concerned with malnutrition caused by inadequate intake of all the major nutrients rather than deficiency diseases relating to a single micronutrient. Three common situations are recognised: young children in third world countries with protein-energy malnutrition; adults in the same countries who are chronically adapted to subsisting on marginally inadequate diets; and patients who become malnourished as a result of chronic diseases. In all these situations infectious diseases are often also present, and this complicates the interpretation of biochemical and physiological observations. The metabolic response to starvation is primarily concerned with maintaining a supply of water-soluble substrates to supply energy to the brain. Thus there is an initial rise in metabolic rate, reflecting gluconeogenic activity. As fasting progresses, gluconeogenesis is suppressed to minimise muscle protein breakdown and ketones become the main fuel for the brain. With chronic underfeeding the basal metabolic rate per cell appears to fall, but the mechanistic basis for this is not clear. The main adaptation to chronic energy deficiency is slow growth and low adult body size, although the reduction in energy requirement achieved by this is partially offset by the preservation of the more metabolically active organs at the expense of muscle, which has a lower metabolic rate. The interaction between malnutrition and the metabolic response to trauma has been studied using an animal model. The rise in energy expenditure and urinary nitrogen excretion following surgery were significantly attenuated in malnourished rats, suggesting that malnutrition impairs the ability of the body to mobilise substrates to support inflammatory and reparative processes. However, the healing process in wounded muscle remained unimpaired in malnutrition, suggesting that this process has a high biological priority.

  9. Possible Biochemical Markers in Protein-Energy Malnutrition and ...

    African Journals Online (AJOL)

    kwena

    Plasma albumin levels showed 33% of the children to be below the normal range and 40% above normal; ... Consent: The parents or guardians of the children .... Below normal Within normal Above normal. Spoiled. Total. Number of samples.

  10. Plasma Renin Activity in Children with Protein Energy Malnutrition ...

    African Journals Online (AJOL)

    Date received: 11 October 1973. Reprint requests to Professor J. J. Jones. for analysis during each patient's last week in hospital. It was not possible ... oil, eggs, Multivite syrup, folic acid and potassium chlo- ride) and magnesium sulphate by intramuscular injection. No iron was given for the first 10 days. Intravenous trans-.

  11. Plasma Renin Activity in Children with Protein Energy Malnutrition ...

    African Journals Online (AJOL)

    Plasma renin activity was measured by bio-assay in 100 children with kwashiorkor and in 20 healthy children, and also by radio-immunoassay in another 26 children with kwashiorkor and in another 20 healthy children. Both methods showed that (compared with healthy children) renin activity was significantly increased in ...

  12. The Ongoing Evaluation of Protein-Energy Malnutrition.

    Science.gov (United States)

    Hennart, Philippe; And Others

    1984-01-01

    This report describes an approach for the evaluation of nutritional status implemented by the CEMUBAC medical mission to Zaire. Introductory remarks provide a brief, general discussion of the evaluation of individual, familial, and community nutritional status, as well as the evaluation of nutritional status and priorities. Section I focuses on…

  13. Prevalence of protein - energy malnutrition in Maiduguri, Nigeria ...

    African Journals Online (AJOL)

    children on hospital admissions to the socio economic and educational status of the parents was investigated in one hundred and twenty (70 male and 50 female) children (6 – 24months) at the paediatric wards of the University of Maiduguri Teaching Hospital and the State Specialist Hospital, Maiduguri, Nigeria. Laboratory ...

  14. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    Energy Technology Data Exchange (ETDEWEB)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P. [Laboratório de Hematologia Experimental, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP (Brazil)

    2012-09-21

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 10{sup 4} cells/mL) compared to control (69.6 ± 7.1 × 10{sup 4} cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h{sup −1}·mL{sup −1}), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h{sup −1}·mL{sup −1}, 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM.

  15. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    International Nuclear Information System (INIS)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P.

    2012-01-01

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 10 4 cells/mL) compared to control (69.6 ± 7.1 × 10 4 cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h −1 ·mL −1 ), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h −1 ·mL −1 , 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM

  16. Impairment of the hematological response and interleukin-1β production in protein-energy malnourished mice after endotoxemia with lipopolysaccharide

    Science.gov (United States)

    Fock, R.A.; Vinolo, M.A.R.; Blatt, S.L.; Borelli, P.

    2012-01-01

    The objectives of this study were to determine if protein-energy malnutrition (PEM) could affect the hematologic response to lipopolysaccharide (LPS), the interleukin-1β (IL-1β) production, leukocyte migration, and blood leukocyte expression of CD11a/CD18. Two-month-old male Swiss mice were submitted to PEM (N = 30) with a low-protein diet (14 days) containing 4% protein, compared to 20% protein in the control group (N = 30). The total cellularity of blood, bone marrow, spleen, and bronchoalveolar lavage evaluated after the LPS stimulus indicated reduced number of total cells in all compartments studied and different kinetics of migration in malnourished animals. The in vitro migration assay showed reduced capacity of migration after the LPS stimulus in malnourished animals (45.7 ± 17.2 × 104 cells/mL) compared to control (69.6 ± 7.1 × 104 cells/mL, P ≤ 0.05), but there was no difference in CD11a/CD18 expression on the surface of blood leukocytes. In addition, the production of IL-1β in vivo after the LPS stimulus (180.7 pg·h−1·mL−1), and in vitro by bone marrow and spleen cells (41.6 ± 15.0 and 8.3 ± 4.0 pg/mL) was significantly lower in malnourished animals compared to control (591.1 pg·h−1·mL−1, 67.0 ± 23.0 and 17.5 ± 8.0 pg/mL, respectively, P ≤ 0.05). The reduced expression of IL-1β, together with the lower number of leukocytes in the central and peripheral compartments, different leukocyte kinetics, and reduced leukocyte migration capacity are factors that interfere with the capacity to mount an adequate immune response, being partly responsible for the immunodeficiency observed in PEM. PMID:22983177

  17. Specificity of indexes of malnutrition when applied to apparently healthy people: the effect of age

    NARCIS (Netherlands)

    Naber, T.H.J.; Bree, de A.; Schermer, T.R.J.; Bakkeren, J.; Bör, B.; Wild, de G.; Katan, M.B.

    1997-01-01

    Protein-energy malnutrition is thought to be widespread in hospitalized patients. However, the specificity of indexes used to assess malnutrition is uncertain. We therefore assessed the rate of false-positive diagnoses of malnutrition when biochemical-anthropometric indexes were applied to healthy

  18. Nutrition and protein energy homeostasis in elderly.

    Science.gov (United States)

    Boirie, Yves; Morio, Béatrice; Caumon, Elodie; Cano, Noël J

    2014-01-01

    Protein-energy homeostasis is a major determinant of healthy aging. Inadequate nutritional intakes and physical activity, together with endocrine disturbances are associated with of sarcopenia and frailty. Guidelines from scientific societies mainly address the quantitative aspects of protein and energy nutrition in elderly. Besides these quantitative aspects of protein load, perspective strategies to promote muscle protein synthesis and prevent sarcopenia include pulse feeding, the use of fast proteins and the addition of leucine or citrulline to dietary protein. An integrated management of sarcopenia, taking into account the determinants of muscle wasting, i.e. nutrition, physical activity, anabolic factors such as androgens, vitamin D and n-3 polyunsaturated fatty acids status, needs to be tested in the prevention and treatment of sarcopenia. The importance of physical activity, specifically resistance training, is emphasized, not only in order to facilitate muscle protein anabolism but also to increase appetite and food intake in elderly people at risk of malnutrition. According to present data, healthy nutrition in elderly should respect the guidelines for protein and energy requirement, privilege a Mediterranean way of alimentation, and be associated with a regular physical activity. Further issues relate to the identification of the genetics determinants of protein energy wasting in elderly. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Hunger and Malnutrition

    Science.gov (United States)

    ... Videos for Educators Search English Español Hunger and Malnutrition KidsHealth / For Parents / Hunger and Malnutrition What's in ... to meet their needs. What Are Hunger and Malnutrition? Everyone feels hungry at times. Hunger is the ...

  20. Factors predicting malnutrition in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Moncef El M′Barki Kadiri

    2011-01-01

    Full Text Available Signs of protein-energy malnutrition are common in maintenance hemodialyis (HD patients and are associated with increased morbidity and mortality. To evaluate the nutritional status and relationship between various parameters used for assessing malnutrition, we performed a cross-sectional study in 37 HD patients treated with thrice weekly sessions for at least two weeks. Global nutritional status was evaluated by the dual-energy X-ray absorptiometry (DEXA scan. Body weight and several laboratory values, including serum albumin (Salb, serum prealbumin, bicarbonate, cholesterol, serum C-reactive protein (SCRP, and hemoglobin, were recorded. Dose of dialysis was evaluated by urea kinetic modeling. The patients were subdivided into two groups based on body mass index: group I, normal nutritional status (71% and group II, malnutrition (29%. The clinical factors associated with malnutrition included advanced age and cardio-vascular diseases (CVD, decreased fat mass (FM measured by DEXA, low Salb and prealbumin, and severe anemia. The Salb level was not only a predictor of nutritional status, but also was independently influenced by age and SCRP, which was more common in malnourished patients than in patients with normal nutritional status. Both low Kt/V and less weekly dialysis time were associated with malnutrition. The FM and lean body mass (LBM calculated by DEXA correlated with CVD and other markers of malnutrition (Salb, total cholesterol.

  1. The Influence of Early Malnutrition on Subsequent Behavioral Development. II: Classroom Behavior.

    Science.gov (United States)

    Galler, Janina R.; And Others

    The classroom behaviors of 129 Barbadian children (77 boys and 52 girls) ages 5 to 11 years, who had suffered from moderate to severe protein-energy malnutrition in the first year of life were compared with children with no history of malnutrition. Data were gathered from questionnaires administered to teachers who were unaware of the children's…

  2. Tackling the increasing problem of malnutrition in older persons

    OpenAIRE

    Visser, Marjolein; Volkert, D.; Corish, C.; Geisler, C.; Groot, de, C.P.G.M.; Cruz-Jentoft, A.J.; Lohrmann, C.; O'Connor, E.M.; Schindler, K.; Schueren, van der, D.E.

    2017-01-01

    In order to tackle the increasing problem of malnutrition (i.e. protein-energy malnutrition) in the older population, the Joint Action Malnutrition in the Elderly (MaNuEL) Knowledge Hub has been recently launched as part of the Strategic Research Agenda of the Joint Programming Initiative (JPI) A Healthy Diet for a Healthy Life (HDHL). This paper introduces this new European initiative and describes its objectives and design. The MaNuEL consortium consists of 22 research groups from seven cou...

  3. Evidence-based prevention of childhood malnutrition.

    Science.gov (United States)

    Imdad, Aamer; Sadiq, Kamran; Bhutta, Zulfiqar A

    2011-05-01

    Childhood malnutrition is prevalent in developing countries and contributes to one-third of all deaths in these countries. There have been advances in prevention of childhood malnutrition and the purpose of this article was to review the current evidence in the field. Multiple micronutrient (MMN) supplements during pregnancy reduce the incidence of maternal anemia and small for gestational-age babies. Recent evidence suggest that combined supplementation of MMNs with protein energy supplement is more effective than MMN supplementation alone. It is now recommended that HIV-infected mothers can exclusively breast-feed their infants for 6 months when the mother or infant is on effective antiretroviral therapy. Home fortification of complementary foods reduces the prevalence of anemia in infancy and combined supplementation of MMNs with lipid-based supplements improves growth in young children. Ready-to-use therapeutic foods have been successfully used to manage severe acute malnutrition in the community. Zinc supplementation is associated with a reduction in diarrhea and respiratory disease morbidity and improves linear growth. Vitamin A supplementation decreases the incidence of diarrhea and measles. Water supply, sanitation, and hygiene are important for the prevention of malnutrition because of their direct impact on infectious disease. There is clear evidence on the causes and consequences of malnutrition as well as effective interventions to prevent undernutrition. The next step is to implement these packages of interventions at large scale. A global effort is required that should entail unified and compelling advocacy among governments, lead organizations, and institutions.

  4. Minorities and Malnutrition.

    Science.gov (United States)

    Kornegay, Francis A.

    Various aspects of the relationship between minorities and malnutrition are discussed in this brief paper. Malnutrition, one of the byproducts of low economic status, is creating a crisis-proportion health problem affecting minority citizens. Malnutrition seriously affects children, older people in poverty, and chronically unemployed or…

  5. PEM fuel cell monitoring system

    Science.gov (United States)

    Meltser, Mark Alexander; Grot, Stephen Andreas

    1998-01-01

    Method and apparatus for monitoring the performance of H.sub.2 --O.sub.2 PEM fuel cells. Outputs from a cell/stack voltage monitor and a cathode exhaust gas H.sub.2 sensor are corrected for stack operating conditions, and then compared to predetermined levels of acceptability. If certain unacceptable conditions coexist, an operator is alerted and/or corrective measures are automatically undertaken.

  6. Bipolar Plates for PEM Systems

    OpenAIRE

    Lædre, Sigrid

    2016-01-01

    Summary of thesis: The Bipolar Plate (BPP) is an important component in both Proton Exchange Membrane Fuel Cells (PEMFCs) and Proton Exchange Membrane Water Electrolyzers (PEMWEs). Bipolar plate material and processing constitutes for a large fraction of the cost and weight of a PEM cell stack. The main tasks for the bipolar plates in both systems are to separate single cell in a stack, conduct current between single cells and remove heat from active areas. In addition, the BPPs distribu...

  7. Severe childhood malnutrition

    DEFF Research Database (Denmark)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

    2017-01-01

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use...... the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...

  8. High temperature PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jianlu; Xie, Zhong; Zhang, Jiujun; Tang, Yanghua; Song, Chaojie; Navessin, Titichai; Shi, Zhiqing; Song, Datong; Wang, Haijiang; Wilkinson, David P.; Liu, Zhong-Sheng; Holdcroft, Steven [Institute for Fuel Cell Innovation, National Research Council Canada, Vancouver, BC (Canada V6T 1W5)

    2006-10-06

    There are several compelling technological and commercial reasons for operating H{sub 2}/air PEM fuel cells at temperatures above 100{sup o}C. Rates of electrochemical kinetics are enhanced, water management and cooling is simplified, useful waste heat can be recovered, and lower quality reformed hydrogen may be used as the fuel. This review paper provides a concise review of high temperature PEM fuel cells (HT-PEMFCs) from the perspective of HT-specific materials, designs, and testing/diagnostics. The review describes the motivation for HT-PEMFC development, the technology gaps, and recent advances. HT-membrane development accounts for {approx}90% of the published research in the field of HT-PEMFCs. Despite this, the status of membrane development for high temperature/low humidity operation is less than satisfactory. A weakness in the development of HT-PEMFC technology is the deficiency in HT-specific fuel cell architectures, test station designs, and testing protocols, and an understanding of the underlying fundamental principles behind these areas. The development of HT-specific PEMFC designs is of key importance that may help mitigate issues of membrane dehydration and MEA degradation. (author)

  9. Malnutrition, Learning, and Behavior.

    Science.gov (United States)

    Read, Merrill S.; Felson, David

    The problems of those children who are chronically malnourished, the cultural environment of malnutrition, and the extent to which children are temporarily or permanently handicapped in learning because of malnutrition are discussed in this booklet. It also describes hunger and its effects on child development. The topics addressed are: definition…

  10. Functional recovery of older people with hip fracture: does malnutrition make a difference?

    Science.gov (United States)

    Li, Hsiao-Juan; Cheng, Huey-Shinn; Liang, Jersey; Wu, Chi-Chuan; Shyu, Yea-Ing Lotus

    2013-08-01

    To report a study of the effects of protein-energy malnutrition on the functional recovery of older people with hip fracture who participated in an interdisciplinary intervention. It is not clear whether protein-energy malnutrition is associated with worse functional outcomes or it affects the interdisciplinary intervention program on the functional recovery of older people with hip fracture. A randomized experimental design. Data were collected between 2002-2006 from older people with hip fracture (N = 162) in Taiwan. The generalized estimating equations approach was used to evaluate the effect of malnutrition on the functional recovery of older people with hip fracture. The majority of older patients with hip fracture were malnourished (48/80, 60% in the experimental group vs. 55/82, 67% in the control group) prior to hospital discharge. The results of the generalized estimating equations analysis demonstrated that subjects suffering from protein-energy malnutrition prior to hospital discharge appeared to have significantly worse performance trajectories for their activities of daily living, instrumental activities of daily living, and recovery of walking ability compared with those without protein-energy malnutrition. In addition, it was found that the intervention is more effective on the performance of activities of daily living and recovery of walking ability in malnourished patients than in non-malnourished patients. Healthcare providers should develop a nutritional assessment/management system in their interdisciplinary intervention program to improve the functional recovery of older people with hip fracture. © 2012 Blackwell Publishing Ltd.

  11. California dreaming?[PEM stacks

    Energy Technology Data Exchange (ETDEWEB)

    Crosse, J.

    2002-06-01

    Hyundai's Santa Fe FCEV will be on sale by the end of 2002. Hyundai uses PEM stacks that are manufactured by International Fuel Cells (IFC), a division of United Technologies. Santa Fe is equipped with a 65 kW electric powertrain of Enova systems and Shell's new gasoline reformer called Hydrogen Source. Eugene Jang, Senior Engineer - Fuel Cell and Materials at Hyundai stated that the compressor related losses on IFC system are below 3%. The maximum speed offered by the vehicle is estimated as 123km/hr while the petrol equivalent fuel consumption is quoted between 5.6L/100 km and 4.8L/100 km. Santa Fe is a compact vehicle offering better steering response and a pleasant drive. (author)

  12. UARS PEM Level 2 MEPS V001

    Data.gov (United States)

    National Aeronautics and Space Administration — The Particle Environment Monitor (PEM) level 2 Medium-Energy Particle Spectrometer (MEPS) daily product contains the electron and proton high-resolution spectral...

  13. Severe childhood malnutrition.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  14. Malnutrition related deaths.

    Science.gov (United States)

    Sparre-Sørensen, Maja; Kristensen, Gustav N

    2016-10-01

    Studies have shown that malnutrition increases the risk of morbidity, mortality, the length of hospital stay, and costs in the elderly population. Approximately one third of all patients admitted to geriatric wards in Denmark are malnourished according to the Danish Geriatric database. The aim of this study is to describe and examine the sudden increase in deaths due to malnutrition in the elderly population in Denmark from 1999 and, similarly, the sudden decline in malnutrition related deaths in 2007. A descriptive epidemiologic study was performed. All Danes listed in the national death registry who died from malnutrition in the period from 1994 to 2012 are included. The number of deaths from malnutrition increased significantly during the period from 1999 to 2007, especially in the age group 70 years and over. Additionally, we document a surprising similarity between the development in excess mortality from malnutrition in the five Danish regions during the same period. During the period 1999-2007 malnutrition was the direct cause of 340 extra deaths, and probably ten times more registered under other diseases. This development in excess mortality runs parallel in all five Danish regions over time. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  15. INCAP studies of malnutrition and cognitive behavior.

    Science.gov (United States)

    Engle, Patrice L; Fernández, Patricia D

    2010-03-01

    The Institute of Nutrition of Central America and Panama (INCAP) has made major contributions to the study of the effects of malnutrition on learning. This report summarizes work on the relationship of nutrition to children's learning and development from the 1960's through 1998. The Oriente Longitudinal Study examined the effects of two types of supplementation for mothers and young children on their growth and development (an energy-only drink compared with a protein-energy drink) using a quasi-experimental design. Both drinks were supplemented with micronutrients, and were offered daily. As a result of the research on malnutrition and mental development, researchers could conclude by 1993 that supplementary feeding of infants and young children resulted in significant increases cognitive development and school performance through adolescence. The research also suggested that the pathways that link malnutrition with later development are not only through the neurological system but also operate through changes in child behavior which affect the kinds of care children receive. Other research on learning and development showed that families understood the concept of intelligence, demonstrated the link between micronutrients and cognitive development, and documented the amount of wastage or repetition and drop-out that occurs in Guatemalan schools.

  16. Childhood tuberculosis and malnutrition.

    Science.gov (United States)

    Jaganath, Devan; Mupere, Ezekiel

    2012-12-15

    Despite the burden of both malnutrition and tuberculosis in children worldwide, there are few studies on the mechanisms that underlie this relationship. From available research, it appears that malnutrition is a predictor of tuberculosis disease and is associated with worse outcomes. This is supported through several lines of evidence, including the role of vitamin D receptor genotypes, malnutrition's effects on immune development, respiratory infections among malnourished children, and limited work specifically on pediatric tuberculosis and malnutrition. Nutritional supplementation has yet to suggest significant benefits on the course of tuberculosis in children. There is a critical need for research on childhood tuberculosis, specifically on how nutritional status affects the risk and progression of tuberculosis and whether nutritional supplementation improves clinical outcomes or prevents disease.

  17. [Epidemiology of malnutrition].

    Science.gov (United States)

    Imoberdorf, Reinhard; Ballmer, Peter E

    2014-03-01

    The World Health Organisation classifies malnutrition worldwide as the greatest threat to public health. An expert report of the Council of Europe clearly showed that malnutrition in hospitalised patients is a real existing problem in all European countries, including Switzerland. According to the literature, malnutrition is prevalent in 20 - 60 % of patients on hospital admission. Malnutrition increases with age and is found more and more in obese subjects. Unintentional weight loss is the main feature of disease-related malnutrition in normalweight and obese individuals. The nutritional problem in obese persons manifests itself through nutrient imbalances and micronutrient deficiency. The cause for nutritional deficiencies is a hypercaloric diet with its energy - dense, but qualitative low - value foods. Depending on the extent of obesity, certain micronutrients are to be critically evaluated. It has been proven that for instance the vitamin D and iron metabolism are pathologically impaired by the increased fatty tissue. In Switzerland, the proportion of people under 20 years has decreased from 40.7 % (1900) to 20.6 % (2011), whereas in the elderly over 64 years, an increase from 5.8 % to 17.2 % has been recorded. In the very elderly people over 80 years, the increase from 0.5 % to 4.8 % has been particularly pronounced. Because malnutrition increases with age, it will be an important issue in the future and hospitals, nursing homes and home care will be particularly affected.

  18. Protein-Energy Wasting and Mortality in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ezio Gianetta

    2011-05-01

    Full Text Available Protein-energy wasting (PEW is common in patients with chronic kidney disease (CKD and is associated with an increased death risk from cardiovascular diseases. However, while even minor renal dysfunction is an independent predictor of adverse cardiovascular prognosis, PEW becomes clinically manifest at an advanced stage, early before or during the dialytic stage. Mechanisms causing loss of muscle protein and fat are complex and not always associated with anorexia, but are linked to several abnormalities that stimulate protein degradation and/or decrease protein synthesis. In addition, data from experimental CKD indicate that uremia specifically blunts the regenerative potential in skeletal muscle, by acting on muscle stem cells. In this discussion recent findings regarding the mechanisms responsible for malnutrition and the increase in cardiovascular risk in CKD patients are discussed. During the course of CKD, the loss of kidney excretory and metabolic functions proceed together with the activation of pathways of endothelial damage, inflammation, acidosis, alterations in insulin signaling and anorexia which are likely to orchestrate net protein catabolism and the PEW syndrome.

  19. Early childhood malnutrition predicts depressive symptoms at ages 11-17.

    Science.gov (United States)

    Galler, J R; Bryce, C P; Waber, D; Hock, R S; Exner, N; Eaglesfield, D; Fitzmaurice, G; Harrison, R

    2010-07-01

    We examined the prevalence of depressive symptoms in Barbadian youth with histories of infantile malnutrition and in a healthy comparison group and the extent to which the effect of malnutrition was mediated/moderated by maternal depression. Depressive symptoms were assessed using a 20-item scale administered to youths (11-17 years of age) who had experienced an episode of protein-energy malnutrition (marasmus or kwashiorkor) during the first year of life and in a comparison group of healthy youths without a history of malnutrition. Their mothers completed the same questionnaire on the same test on three occasions when their children were 5-17 years of age at 2-5-year intervals. The prevalence of depressive symptoms was elevated among previously malnourished youth relative to healthy comparison children (p childhood malnutrition remained and were not discernibly attenuated from an unadjusted analysis. We also found significant independent effects of maternal depressive symptoms on youth depressive symptoms. Early childhood malnutrition contributed independently to depressive symptoms in youths who experienced a significant episode of malnutrition in the first year of life. This relationship was not mediated or moderated by the effects of maternal depression. Whether the later vulnerability to depression is a direct effect of the episode of malnutrition and related conditions early in life or whether it is mediated by the more proximal neurobehavioral effects of the malnutrition remains to be determined.

  20. Infant Malnutrition in High Density Urban Areas: Some Social and Psychological Factors.

    Science.gov (United States)

    Richter, L. M.; Griesel, R. D.

    The mothers of 135 hospitalized infants were interviewed regarding several social, familial, personal, and psychological conditions considered to be pertinent to the etiology of protein energy malnutrition in impoverished African urban areas. The information gathered was contrasted with similar data collected from the mothers of 296 adequately…

  1. Durability of PEM Fuel Cell Membranes

    Science.gov (United States)

    Huang, Xinyu; Reifsnider, Ken

    Durability is still a critical limiting factor for the commercialization of polymer electrolyte membrane (PEM) fuel cells, a leading energy conversion technology for powering future hydrogen fueled automobiles, backup power systems (e.g., for base transceiver station of cellular networks), portable electronic devices, etc. Ionic conducting polymer (ionomer) electrolyte membranes are the critical enabling materials for the PEM fuel cells. They are also widely used as the central functional elements in hydrogen generation (e.g., electrolyzers), membrane cell for chlor-alkali production, etc. A perfluorosulfonic acid (PFSA) polymer with the trade name Nafion® developed by DuPont™ is the most widely used PEM in chlor-alkali cells and PEM fuel cells. Similar PFSA membranes have been developed by Dow Chemical, Asahi Glass, and lately Solvay Solexis. Frequently, such membranes serve the dual function of reactant separation and selective ionic conduction between two otherwise separate compartments. For some applications, the compromise of the "separation" function via the degradation and mechanical failure of the electrolyte membrane can be the life-limiting factor; this is particularly the case for PEM in hydrogen/oxygen fuel cells.

  2. [Understanding the pathophysiology of malnutrition for better treatment].

    Science.gov (United States)

    De Bandt, J-P

    2015-09-01

    Malnutrition results from an imbalance between intake and protein-energy requirements resulting in tissue losses with adverse functional consequences. However, it would be better to speak of "states of malnutrition" rather than "malnutrition". Indeed, the mechanisms involved associate, with varying degrees, intake deficiency and increased needs with different clinical consequences. Adaptation to nutrient deficiency aims at establishing lasting saving conditions by promoting optimization of energy reserve utilization while preserving protein pool. This is achieved by reducing basal metabolism (low T3), by decreasing the secretion of anabolic factors and moderately increasing catabolic hormones. Unlike the previous process, the metabolic response to injury or stress, which will sometime induce major increase in requirements, will have as immediate purpose the defense of the organism. The body will draw sometime substantially in its protein pool to produce the glucose required for example by the immune cells. Stress response stems from both an endocrine response, and an immuno-inflammatory one with the important role of pro-inflammatory cytokines released in response to pathogens and more recently alarmins in response to endogenous stress in the inflammatory phenomena of the stress response and in the resulting malnutrition state. Treatment of these malnutrition conditions will thus differ: promoting anabolism in one case and fighting resistance to anabolism and hypercatabolism in the other. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Childhood Malnutrition and the Intestinal Microbiome Malnutrition and the microbiome

    OpenAIRE

    Kane, Anne V.; Dinh, Duy M.; Ward, Honorine D.

    2014-01-01

    Malnutrition contributes to almost half of all deaths in children under the age of 5 years, particularly those who live in resource-constrained areas. Those who survive frequently suffer from long-term sequelae including growth failure and neurodevelopmental impairment. Malnutrition is part of a vicious cycle of impaired immunity, recurrent infections and worsening malnutrition. Recently, alterations in the gut microbiome have also been strongly implicated in childhood malnutrition. It has be...

  4. PEMS. Advanced predictive emission monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Sandvig Nielsen, J.

    2010-07-15

    In the project PEMS have been developed for boilers, internal combustion engines and gas turbines. The PEMS models have been developed using two principles: The one called ''first principles'' is based on thermo-kinetic modeling of the NO{sub x}-formation by modeling conditions (like temperature, pressure and residence time) in the reaction zones. The other one is data driven using artificial neural network (ANN) and includes no physical properties and no thermo-kinetic formulation. Models of first principles have been developed for gas turbines and gas engines. Data driven models have been developed for gas turbines, gas engines and boilers. The models have been tested on data from sites located in Denmark and the Middle East. Weel and Sandvig has conducted the on-site emission measurements used for development and testing the PEMS models. For gas turbines, both the ''first principles'' and the data driven models have performed excellent considering the ability to reproduce the emission levels of NO{sub x} according to the input variables used for calibration. Data driven models for boilers and gas engines have performed excellent as well. The rather comprehensive first principle model, developed for gas engines, did not perform as well in the prediction of NO{sub x}. Possible a more complex model formulation is required for internal combustion engines. In general, both model types have been validated on data extracted from the data set used for calibration. The data for validation have been selected randomly as individual samplings, and is scattered over the entire measuring campaign. For one natural gas engine a secondary measuring campaign was conducted half a year later than the campaign used for training the data driven model. In the meantime, this engine had been through a refurbishment that included new pistons, piston rings and cylinder linings and cleaning of the cylinder heads. Despite the refurbishment, the

  5. Malaria, malnutrition, and birthweight

    DEFF Research Database (Denmark)

    Cates, Jordan E.; Unger, Holger W.; Briand, Valerie

    2017-01-01

    were identified by the Maternal Malaria and Malnutrition (M3) initiative using a convenience sampling approach and were eligible for pooling given adequate ethical approval and availability of essential variables. Study-specific adjusted effect estimates were calculated using inverse probability...... be multiplicative interaction between malaria infection at enrollment and low MUAC within studies conducted in Africa; however, this finding was not consistent on the additive scale, when accounting for multiple comparisons, or when using other definitions of malaria and malnutrition. The major limitations...... of the study included availability of only 2 cross-sectional measurements of malaria and the limited availability of ultrasound-based pregnancy dating to assess impacts on preterm birth and fetal growth in all studies.  Conclusions : Pregnant women with malnutrition and malaria infection are at increased risk...

  6. A retrospective on the LBNL PEM project

    International Nuclear Information System (INIS)

    Huber, J.S.; Moses, W.W.; Wang, G.C.; Derenzo, S.E.; Huesman, R.H.; Qi, J.; Virador, P.; Choong, W.S.; Mandelli, E.; Beuville, E.; Pedrali-Noy, M.; Krieger, B.; Meddeler, G.

    2004-01-01

    We present a retrospective on the LBNL Positron Emission Mammography (PEM) project, looking back on our design and experiences. The LBNL PEM camera utilizes detector modules that are capable of measuring depth of interaction (DOI) and places them into 4 detector banks in a rectangular geometry. In order to build this camera, we had to develop the DOI detector module, LSO etching, Lumirror-epoxy reflector for the LSO array (to achieve optimal DOI), photodiode array, custom IC, rigid-flex readout board, packaging, DOI calibration and reconstruction algorithms for the rectangular camera geometry. We will discuss the highlights (good and bad) of these developments

  7. [Cancer and Malnutrition].

    Science.gov (United States)

    Tsuzuki, Norimasa; Higashiguchi, Takashi; Ito, Akihiro; Ohara, Hiroshi; Futamura, Akihiko

    2015-07-01

    A Japanese proverb says that a balanced diet leads to a healthy body. However, the relation between healthy life and nutrition has not been established precisely and quantitatively. Cancer cachexia, which is malnutrition in cancer patients, has been studied extensively. Appropriate nutrition support can prevent the progression of malnutrition in cancer patients and advance the tolerance for anticancer therapy. In refractory cachexia (terminally cancer patients), we will judge the necessity of reduction of nutrition support, what it is called "gear-change", because the support is burden for the body. It is important to restrict the quantity of nutrition and to give medical treatment to retain bodily function in these patients.

  8. Severe Malnutrition: A Global Approach.

    Science.gov (United States)

    Pelletier, Jean-Gerard

    1993-01-01

    This report examines the immediate and underlying causes of malnutrition in the developing world. The first section discusses the effects of malnutrition on childhood development and examines the efficacy of nutritional rehabilitation. The second section addresses the medical effects of severe malnutrition, including the onset of ponderostatural…

  9. Reliability analysis and utilization of PEMs in space application

    Science.gov (United States)

    Jiang, Xiujie; Wang, Zhihua; Sun, Huixian; Chen, Xiaomin; Zhao, Tianlin; Yu, Guanghua; Zhou, Changyi

    2009-11-01

    More and more plastic encapsulated microcircuits (PEMs) are used in space missions to achieve high performance. Since PEMs are designed for use in terrestrial operating conditions, the successful usage of PEMs in space harsh environment is closely related to reliability issues, which should be considered firstly. However, there is no ready-made methodology for PEMs in space applications. This paper discusses the reliability for the usage of PEMs in space. This reliability analysis can be divided into five categories: radiation test, radiation hardness, screening test, reliability calculation and reliability assessment. One case study is also presented to illuminate the details of the process, in which a PEM part is used in a joint space program Double-Star Project between the European Space Agency (ESA) and China. The influence of environmental constrains including radiation, humidity, temperature and mechanics on the PEM part has been considered. Both Double-Star Project satellites are still running well in space now.

  10. Diarrhoea and malnutrition

    African Journals Online (AJOL)

    jenny

    diarrhoea and malnutrition, have demonstrated a detrimental effect of diarrhoea on ... Children with a low prevalence of diarrhoea (less than or equal to 5% of time with .... protein for children between the ages of 12 and 60 months. The reduction in ... significant malabsorption of protein, carbohydrates, and fat. Additionally ...

  11. Polypharmacy and malnutrition.

    Science.gov (United States)

    Zadak, Zdenek; Hyspler, Radomir; Ticha, Alena; Vlcek, Jiri

    2013-01-01

    Malnutrition and polypharmacy increase with age and polymorbidity and their relationship is based on a number of mechanisms. The occurrence of malnutrition in both in-patients and out-patients and its dependence on polymorbidity and age are well known, but the interrelation of polypharmacy and malnutrition has been far less investigated. The countries with the highest occurrence of polypharmacy in Europe include the Czech Republic and Finland, whereas the lowest prevalence of polypharmacy is found in Norway and the Netherlands. The occurrence, consequences and mutual relationship of malnutrition and polypharmacy are described. Up-to-date knowledge regarding the influence of drugs on nutritional status is summarized. The effect of polypharmacy on nutrition is suggested from the observations that problems with nutrition occur mostly in elderly patients, and that such patients are more frequently subject to polypharmacy. It is known that about 65% of hospitalized patients have a worse nutritional status than their healthy contemporaries. A worsened nutritional status may adversely influence the process of treatment.

  12. Malnutrition and Psychological Development.

    Science.gov (United States)

    Ricciuti, Henry N.

    What is the status of our present knowledge concerning the influence of malnutrition on intellectual development, learning, and behavior in children? This paper focuses primarily on an identification of some of the major issues and questions which are of concern to investigators in the field. The major concern of this review is with…

  13. Development of advanced PEM water electrolysers

    International Nuclear Information System (INIS)

    A Deschamps; C Etievant; C Puyenchet; V Fateev; S Grigoriev; A Kalinnikov; V Porembsky; P Millet

    2006-01-01

    Concerning the production of electrolytic hydrogen, the goal of present R and D is to develop advanced hydrogen generator based on proton exchange membrane (PEM) water electrolysers. PEM-based water electrolysis offers a number of advantages, such as ecological safety, high gas purity (more than 99.99% for hydrogen), the possibility of producing compressed gases (up to 200 bar) for direct pressurized storage without additional power inputs, etc. PEM electrolysers are considered as rather attractive devices to accelerate the transition to the hydrogen economy and develop a hydrogen infrastructure network (for example for the development of re-filling stations for cars, using electric power stations at night hours and renewable energy sources). The work presented here result from a cooperation between Hydrogen Energy and Plasma Technology Institute (HEPTI) of Russian Research Center (RRC) 'Kurchatov Institute', Universite Paris - Sud XI and Compagnie d'Etudes des Technologies de l'Hydrogene. This project is supported by the Commission of the European Communities within the frame of the 6. Framework Programme (GenHyPEM, STREP no 019802). (authors)

  14. Plastic Encapsulated Microcircuits (PEMs) Reliability Guide

    Science.gov (United States)

    Sandor, M.

    2000-01-01

    It is reported by some users and has been demonstrated by others via testing and qualification that the quality and reliability of plastic-encapsulated microcircuits (PEMs) manufactured today are excellent in commercial applications and closely equivalent, and in some cases superior to their hemetic counterparts.

  15. Malnutrition in a Modernising Economy: The Changing Aetiology and Epidemiology of Malnutrition in an African Kingdom, Buganda c.1940–73

    Science.gov (United States)

    Nott, John

    2016-01-01

    The ecological fecundity of the northern shore of Lake Victoria was vital to Buganda’s dominance of the interlacustrine region during the pre-colonial period. Despite this, protein-energy malnutrition was notoriously common throughout the twentieth century. This paper charts changes in nutritional illness in a relatively wealthy, food-secure area of Africa during a time of vast social, economic and medical change. In Buganda at least, it appears that both the causation and epidemiology of malnutrition moved away from the endemic societal causes described by early colonial doctors and became instead more defined by individual position within a rapidly modernising economy. PMID:26971598

  16. PORTABLE PEM FUEL CELL SYSTEM: WATER AND HEAT MANAGEMENT

    Directory of Open Access Journals (Sweden)

    SITI NAJIBAH ABD RAHMAN

    2016-07-01

    Full Text Available Portable polymer electrolyte membrane (PEM fuel cell power generator is a PEM fuel cell application that is used as an external charger to supply the demand for high energy. Different environments at various ambient temperatures and humidity levels affect the performance of PEM fuel cell power generators. Thermal and water management in portable PEM fuel cells are a critical technical barrier for the commercialization of this technology. The size and weight of the portable PEM fuel cells used for thermal and water management systems that determine the performance of portable PEM fuel cells also need to be considered. The main objective of this paper review was to determine the importance of water and thermal management systems in portable PEM fuel cells. Additionally, this review investigated heat transfer and water transport in PEM fuel cells. Given that portable PEM fuel cells with different powers require different thermal and water management systems, this review also discussed and compared management systems for low-, medium-, and high-power portable PEM fuel cells.

  17. Concurrent and predictive evaluation of malnutrition diagnostic measures in hip fracture inpatients: a diagnostic accuracy study.

    Science.gov (United States)

    Bell, J J; Bauer, J D; Capra, S; Pulle, R C

    2014-03-01

    Differences in malnutrition diagnostic measures impact malnutrition prevalence and outcomes data in hip fracture. This study investigated the concurrent and predictive validity of commonly reported malnutrition diagnostic measures in patients admitted to a metropolitan hospital acute hip fracture unit. A prospective, consecutive level II diagnostic accuracy study (n=142; 8 exclusions) including the International Classification of Disease, 10th Revision, Australian Modification (ICD10-AM) protein-energy malnutrition criteria, a body mass index (BMI) Patients were predominantly elderly (median age 83.5, range 50-100 years), female (68%), multimorbid (median five comorbidities), with 15% 4-month mortality. Malnutrition prevalence was lowest when assessed by BMI (13%), followed by MNA-SF (27%), ICD10-AM (48%), albumin (53%) and geriatrician assessment (55%). Agreement between measures was highest between ICD10-AM and geriatrician assessment (κ=0.61) followed by ICD10-AM and MNA-SF measures (κ=0.34). ICD10-AM diagnosed malnutrition was the only measure associated with 48-h mobilisation (35.0 vs 55.3%; P=0.018). Reduced likelihood of home discharge was predicted by ICD-10-AM (20.6 vs 57.1%; P=0.001) and MNA-SF (18.8 vs 47.8%; P=0.035). Bivariate analysis demonstrated ICD10-AM (relative risk (RR)1.2; 1.05-1.42) and MNA-SF (RR1.2; 1.0-1.5) predicted 4-month mortality. When adjusted for age, usual place of residency, comorbidities and time to surgery only ICD-10AM criteria predicted mortality (odds ratio 3.59; 1.10-11.77). Albumin, BMI and geriatrician assessment demonstrated limited concurrent and predictive validity. Malnutrition prevalence in hip fracture varies substantially depending on the diagnostic measure applied. ICD-10AM criteria or the MNA-SF should be considered for the diagnosis of protein-energy malnutrition in frail, multi-morbid hip fracture inpatients.

  18. Gut microbiota and malnutrition.

    Science.gov (United States)

    Million, Matthieu; Diallo, Aldiouma; Raoult, Didier

    2017-05-01

    Malnutrition is the leading cause of death worldwide in children under the age of five, and is the focus of the first World Health Organization (WHO) Millennium Development Goal. Breastfeeding, food and water security are major protective factors against malnutrition and critical factors in the maturation of healthy gut microbiota, characterized by a transient bifidobacterial bloom before a global rise in anaerobes. Early depletion in gut Bifidobacterium longum, a typical maternal probiotic, known to inhibit pathogens, represents the first step in gut microbiota alteration associated with severe acute malnutrition (SAM). Later, the absence of the Healthy Mature Anaerobic Gut Microbiota (HMAGM) leads to deficient energy harvest, vitamin biosynthesis and immune protection, and is associated with diarrhea, malabsorption and systemic invasion by microbial pathogens. A therapeutic diet and infection treatment may be unable to restore bifidobacteria and HMAGM. Besides refeeding and antibiotics, future trials including non-toxic missing microbes and nutrients necessary to restore bifidobacteria and HMAGM, including prebiotics and antioxidants, are warranted in children with severe or refractory disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. PEM fuel cells thermal and water management fundamentals

    CERN Document Server

    Wang, Yun; Cho, Sung Chan

    2014-01-01

    Polymer Electrolyte Membrane (PEM) fuel cells convert chemical energy in hydrogen into electrical energy with water as the only by-product. Thus, PEM fuel cells hold great promise to reduce both pollutant emissions and dependency on fossil fuels, especially for transportation-passenger cars, utility vehicles, and buses-and small-scale stationary and portable power generators. But one of the greatest challenges to realizing the high efficiency and zero emissions potential of PEM fuel cells technology is heat and water management. This book provides an introduction to the essential concepts for effective thermal and water management in PEM fuel cells and an assessment on the current status of fundamental research in this field. The book offers you: An overview of current energy and environmental challenges and their imperatives for the development of renewable energy resources, including discussion of the role of PEM fuel cells in addressing these issues; Reviews of basic principles pertaining to PEM fuel cel...

  20. Prevalence of malnutrition in a cohort of 509 patients with acute hip fracture: the importance of a comprehensive assessment.

    Science.gov (United States)

    Díaz de Bustamante, M; Alarcón, T; Menéndez-Colino, R; Ramírez-Martín, R; Otero, Á; González-Montalvo, J I

    2018-01-01

    Backgrounds/objectives:Malnutrition is very common in acute hip fracture (HF) patients. Studies differ widely in their findings, with reported prevalences between 31 and 88% mainly because of small sample sizes and the use of different criteria. The aim of this study was to learn the prevalence of malnutrition in a large cohort of HF patients in an comprehensive way that includes the frequency of protein-energy malnutrition, vitamin D deficiency and sarcopenia. A 1-year consecutive sample of patients admitted with fragility HF in a 1300-bed public University Hospital, who were assessed within the first 72 h of admission. Clinical, functional, cognitive and laboratory variables were included. Energy malnutrition (body mass index (BMI) malnutrition (serum total protein patients were included. The mean age was 85.6±6.9 years and 79.2% were women. Ninety-nine (20.1%) patients had a BMI patients (81.2%) had protein malnutrition. Eighty-seven (17.1%) patients had both energy and protein malnutrition. Serum vitamin D was patients. The prevalence of sarcopenia was 17.1%. Protein malnutrition and vitamin D deficiency are the rule in acute HF patients. Energy malnutrition and sarcopenia are also common. A nutritional assessment in these patients should include these aspects together.

  1. Development of coincidence processing module for PEM

    International Nuclear Information System (INIS)

    Feng Baotong; Shuai Lei; Li Ke

    2011-01-01

    For the breast cancer diagnosis and therapy, a prototype of positron emission mammography (PEM) was developed in Institute of High Energy Physics, Chinese Academy of Sciences. In this paper, the design of coincidence processing module (CPM) for this PEM was presented. Both the hardware architecture and the software logic were introduced. In this design, the CPM used the Rocket IO fast interface in FPGA and fiber technology to acquire the preprocessed data from the continuous sampling module (CSM) and then selected the valid event with the coincidence timing window method, which was performed in the FPGA on the daughter board. The CPM transmits the processed data to host computer via gigabit Ethernet. The whole system was controlled by CAN bus. The primary tests indicate that the performance of this design is good. (authors)

  2. Investigation of low glass transition temperature on COTS PEMs reliability

    Science.gov (United States)

    Sandor, M.; Agarwal, S.

    2002-01-01

    Many factors influence PEM component reliability.One of the factors that can affect PEM performance and reliability is the glass transition temperature (Tg) and the coefficient of thermal expansion (CTE) of the encapsulant or underfill. JPL/NASA is investigating how the Tg and CTE for PEMs affect device reliability under different temperature and aging conditions. Other issues with Tg are also being investigated. Some preliminary data will be presented on glass transition temperature test results conducted at JPL.

  3. Performance optimization of a PEM hydrogen-oxygen fuel cell

    OpenAIRE

    Maher A.R. Sadiq Al-Baghdadi

    2013-01-01

    The objective was to develop a semi-empirical model that would simulate the performance of proton exchange membrane (PEM) fuel cells without extensive calculations. A fuel cell mathematical module has been designed and constructed to determine the performance of a PEM fuel cell. The influence of some operating parameters on the performance of PEM fuel cell has been investigated using pure hydrogen on the anode side and oxygen on the cathode side. The present model can be used to investigate t...

  4. Infant malnutrition is associated with persisting attention deficits in middle adulthood.

    Science.gov (United States)

    Galler, Janina R; Bryce, Cyralene P; Zichlin, Miriam L; Fitzmaurice, Garrett; Eaglesfield, G David; Waber, Deborah P

    2012-04-01

    Infantile malnutrition is known to be associated with cognitive and behavioral impairment during childhood and adolescence. Data pertaining to longer-term effects on behavioral outcomes in adulthood are limited. In this study, we report associations between infantile malnutrition and attention problems in adults at midlife. Attention problems were assessed by the Conners Adult ADHD Rating Scales (CAARS) and the Conners Continuous Performance Test (CPT) in 145 Barbadian adults (aged 37-43 y) who had been followed longitudinally since childhood. Previously malnourished participants (n = 80) had experienced moderate to severe protein-energy malnutrition in the first year of life and were successfully rehabilitated thereafter. They were compared with healthy adults (n = 65) who were former classmates of the index cases and who had been matched for age, sex, and handedness in childhood. Multiple regression analyses showed persisting effects of childhood malnutrition on both the CAARS and the CPT, independent of effects of household standard of living assessed in childhood. The malnutrition effect on the CAARS ratings was independent of IQ, whereas this effect was attenuated for the CPT after adjustment for IQ. Teacher-reported attention problems in childhood predicted attention problems in adulthood, indicating continuity over the life span. Infantile malnutrition may have long-term effects on attentional processes nearly 40 y after the episode, even with excellent long-term nutritional rehabilitation and independent of socioeconomic conditions in childhood and adolescence. This finding has major public health implications for populations exposed to early childhood malnutrition.

  5. Infant Malnutrition Is Associated with Persisting Attention Deficits in Middle Adulthood123

    Science.gov (United States)

    Galler, Janina R.; Bryce, Cyralene P.; Zichlin, Miriam L.; Fitzmaurice, Garrett; Eaglesfield, G. David; Waber, Deborah P.

    2012-01-01

    Infantile malnutrition is known to be associated with cognitive and behavioral impairment during childhood and adolescence. Data pertaining to longer-term effects on behavioral outcomes in adulthood are limited. In this study, we report associations between infantile malnutrition and attention problems in adults at midlife. Attention problems were assessed by the Conners Adult ADHD Rating Scales (CAARS) and the Conners Continuous Performance Test (CPT) in 145 Barbadian adults (aged 37–43 y) who had been followed longitudinally since childhood. Previously malnourished participants (n = 80) had experienced moderate to severe protein-energy malnutrition in the first year of life and were successfully rehabilitated thereafter. They were compared with healthy adults (n = 65) who were former classmates of the index cases and who had been matched for age, sex, and handedness in childhood. Multiple regression analyses showed persisting effects of childhood malnutrition on both the CAARS and the CPT, independent of effects of household standard of living assessed in childhood. The malnutrition effect on the CAARS ratings was independent of IQ, whereas this effect was attenuated for the CPT after adjustment for IQ. Teacher-reported attention problems in childhood predicted attention problems in adulthood, indicating continuity over the life span. Infantile malnutrition may have long-term effects on attentional processes nearly 40 y after the episode, even with excellent long-term nutritional rehabilitation and independent of socioeconomic conditions in childhood and adolescence. This finding has major public health implications for populations exposed to early childhood malnutrition. PMID:22378333

  6. Determinants of protein–energy malnutrition in community-dwelling older adults: A systematic review of observational studies

    NARCIS (Netherlands)

    van der Pols-Vijlbrief, R.; Wijnhoven, H.A.H.; Schaap, L.A.; Terwee, C.B.; Visser, M.

    2014-01-01

    Protein-energy malnutrition is associated with numerous poor health outcomes, including high health care costs, mortality rates and poor physical functioning in older adults. This systematic literature review aims to identify and provide an evidence based overview of potential determinants of

  7. Parameterization of electrical equivalent circuits for pem fuel cells; Parametrierung elektrischer Aequivalentschaltbilder von PEM Brennstoffzellen

    Energy Technology Data Exchange (ETDEWEB)

    Haubrock, J.

    2007-12-13

    Fuel cells are a very promising technology for energy conversion. For optimization purpose, useful simulation tools are needs. Simulation tools should simulate the static and dynamic electrical behaviour and the models should parameterized by measurment results which should be done easily. In this dissertation, a useful model for simulating a pem fuel cell is developed. the model should parametrizes by V-I curve measurment and by current step respond. The model based on electrical equivalent circuits and it is shown, that it is possible to simulate the dynamic behaviour of a pem fuel cell stack. The simulation results are compared by measurment results. (orig.)

  8. Costs of hospital malnutrition.

    Science.gov (United States)

    Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H

    2017-10-01

    Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well

  9. GenHyPEM: A research program on PEM water electrolysis supported by the European Commission

    Energy Technology Data Exchange (ETDEWEB)

    Millet, Pierre; Dragoe, Diana [Institut de Chimie Moleculaire et des Materiaux d' Orsay, UMR CNRS no 8182, Universite Paris-Sud 11, 15 rue Georges Clemenceau, 91405 Orsay Cedex (France); Grigoriev, Serguey; Fateev, Vladimir [Hydrogen Energy and Plasma Technology, Institute of Russian Research Center, Kurchatov Institute, 1, Kurchatov sq., 123182 Moscow (Russian Federation); Etievant, Claude [Compagnie Europeenne des Technologies de l' Hydrogene (CETH), Innov' Valley Entreprise, Batiment D0, Route de Nozay, 91461 Marcoussis Cedex (France)

    2009-06-15

    GenHyPEM (Generateur d'Hydrogene par electrolyse de l'eau PEM <>) is an STREP programme (no 019802) supported by the European Commission in the course of the 6th framework research programme. This R and D project which started in October 2005, is a 2.6 MEUR research effort over three years. It gathers partners from Belgium, Germany, Romania, Federation of Russia, Armenia and France. The main goal of the project is to develop low-cost and high pressure (50 bar) PEM water electrolysers for the production of up to several Nm{sup 3} H{sub 2}/h. The purpose of this communication is to present the current status of GenHyPEM. Major results and technological achievements obtained so far in the fields of academic (electrocatalysis, polymer electrolyte) and applied (stack development and performances) research are presented. Non-noble electrocatalysts have been identified to replace platinum for the HER and stable performances have been obtained during operation at high (1 A cm{sup -2}) current density, paving the way to substantial cost reductions. Prototype electrolysers producing from 0.1 to 5 Nm{sup 3} H{sub 2}/h have been successfully developed. (author)

  10. Treating malnutrition in the community.

    Science.gov (United States)

    Dera, Merceline; Woodham, Diane

    2016-11-02

    Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.

  11. Detailed experimental characterization of a reformate fuelled PEM stack

    DEFF Research Database (Denmark)

    Korsgaard, Anders; Nielsen, Mads Pagh; Kær, Søren Knudsen

    2006-01-01

    Increasing attention is given to fuel cells for micro combined heat and power systems for local households. Currently, mainly three different types of fuel cells are commercially competitive: SOFC, low- and high-temperature PEM fuel cells. In the present paper the Low Temperature PEM technology i...

  12. The JPL Direct Methanol Liquid-feed PEM Fuel Cell

    Science.gov (United States)

    Halpert, G.; Surampudi, S.

    1994-01-01

    Recently, there has been a breakthrough in fuel cell technology in the Energy Storage Systems Group at the Jet Propulsion Laboratory with the develpment of a direct methanol, liquid-feed, solid polymer electrolyte membrane (PEM) fuel cell... The methanol liquid-feed, solid polymer electrolyte (PEM) design has numerous system level advantages over the gas-feed design. These include:...

  13. Study of a SOFC-PEM hybrid system

    International Nuclear Information System (INIS)

    Fillman, B.; Bjornbom, P.; Sylwan, C.

    2004-01-01

    'Full text:' In the present project a system study of a SOFC-PEM hybrid system is in progress. Positive synergy effects are expected when combining a SOFC system with a PEM system. By combining the advantages of each fuel cell type it is promising that the hybrid system has higher overall efficiency than a SOFC-only system or a reformer-PEM system. A SOFC stack produces electricity and a reformate gas that can be further processed to hydrogen by the shift reaction. The produced hydrogen can be used by PEM stack in order to produce further electricity. In the PEM system case the complex fuel reformer processing could be eliminated. The simulations were performed with the flowsheeting simulation software Aspen Plus. (author)

  14. GenHyPEM: an EC-supported STREP program on high pressure PEM water electrolysis

    International Nuclear Information System (INIS)

    Millet, P.

    2006-01-01

    GenHyPEM (generateur d'hydrogene PEM) is an international research project related to the electrolytic production of hydrogen from water, using proton exchange membrane (PEM) - based electrochemical generators. The specificity of this project is that all basic research efforts are devoted to the optimization of already existing electrolysers of industrial size, in order to facilitate the introduction of this technology in the industry and to propose technological solutions for the industrial and domestic production of electrolytic hydrogen. GenHyPEM is a three years long research program financially supported by the European Commission, gathering partners from academic institutions and from the industry, in order to reach three main technological objectives aimed at improving the performances of current 1000 Nliter/hour H 2 industrial PEM water electrolysers: (i) Development of alternative low-cost membrane electrode assemblies and stack components with electrochemical performances similar to those of state-of-the-art systems. The objectives are the development of nano-scaled electrocatalytic structures for reducing the amount of noble metals; the synthesis and characterization of non-noble metal catalytic compounds provided by molecular chemistry and bio-mimetic approaches; the preparation of new composite membrane materials for high current density, high pressure and high temperature operation; the development and optimization of low-cost porous titanium sheets acting as current collectors in the electrolysis stack; (ii) Development of an optimized stack structure for high current density (1 A.cm-2) and high pressure (50 bars) operation for direct pressurized storage; (iii) Development of an automated and integrated electrolysis unit allowing gas production from intermittent renewable sources of energy such as photovoltaic-solar and wind. Current status of the project as well as perspectives are described in this paper. This project, coordinated by University of

  15. PEM - fuel cell system for residential applications

    Energy Technology Data Exchange (ETDEWEB)

    Britz, P. [Viessmann Werke GmbH and Co KG, 35107 Allendorf (Germany); Zartenar, N.

    2004-12-01

    Viessmann is developing a PEM fuel cell system for residential applications. The uncharged PEM fuel cell system has a 2 kW electrical and 3 kW thermal power output. The Viessmann Fuel Processor is characterized by a steam-reformer/burner combination in which the burner supplies the required heat to the steam reformer unit and the burner exhaust gas is used to heat water. Natural gas is used as fuel, which is fed into the reforming reactor after passing an integrated desulphurisation unit. The low temperature (600 C) fuel processor is designed on the basis of steam reforming technology. For carbon monoxide removal, a single shift reactor and selective methanisation is used with noble metal catalysts on monoliths. In the shift reactor, carbon monoxide is converted into hydrogen by the water gas shift reaction. The low level of carbon monoxide at the outlet of the shift reactor is further reduced, to approximately 20 ppm, downstream in the methanisation reactor, to meet PEM fuel cell requirements. Since both catalysts work at the same temperature (240 C), there is no requirement for an additional heat exchanger in the fuel processor. Start up time is less than 30 min. In addition, Viessmann has developed a 2 kW class PEFC stack, without humidification. Reformate and dry air are fed straight to the stack. Due to the dry operation, water produced by the cell reaction rapidly diffuses through the electrolyte membrane. This was achieved by optimising the MEA, the gas flow pattern and the operating conditions. The cathode is operated by an air blower. (Abstract Copyright [2004], Wiley Periodicals, Inc.)

  16. Hydrogen production by a PEM electrolyser

    International Nuclear Information System (INIS)

    Aragón-González, G; León-Galicia, A; Camacho, J M Rivera; Uribe-Salazar, M; González-Huerta, R

    2015-01-01

    A PEM electrolyser for hydrogen production was evaluated. It was fed with water and a 400 mA, 3.5 V cc electrical power source. The electrolyser was built with two acrylic plates to form the anode and the cathode, two meshes to distribute the current, two seals, two gas diffusers and an assembly membrane-electrode. A small commercial neoprene sheet 1.7 mm thin was used to provide for the water deposit in order to avoid the machining of the structure. For the assembly of the proton interchange membrane a thin square 50 mm layer of Nafion 115 was used

  17. Controllable clock circuit design in PEM system

    International Nuclear Information System (INIS)

    Sun Yunhua; Wang Peihua; Hu Tingting; Feng Baotong; Shuai Lei; Huang Huan; Wei Shujun; Li Ke; Zhao Jingwei; Wei Long

    2011-01-01

    A high-precision synchronized clock circuit design will be presented, which can supply steady, reliable and anti-jamming clock signal for the data acquirement (DAQ) system of Positron Emission Mammography (PEM). This circuit design is based on the Single-Chip Microcomputer and high-precision clock chip, and can achieve multiple controllable clock signals. The jamming between the clock signals can be reduced greatly with the differential transmission. Meanwhile, the adoption of CAN bus control in the clock circuit can prompt the clock signals to be transmitted or masked simultaneously when needed. (authors)

  18. Controllable clock circuit design in PEM system

    International Nuclear Information System (INIS)

    Sun Yunhua; Wang Peilin; Hu Tingting; Feng Baotong; Shuai Lei; Huang Huan; Wei Shujun; Li Ke; Zhao Jingwei; Wei Long

    2010-01-01

    A high-precision synchronized clock circuit design will be presented, which can supply steady, reliable and anti-jamming clock signal for the data acquirement (DAQ) system of Positron Emission Mammography (PEM). This circuit design is based on the Single-Chip Microcomputer and high-precision clock chip, and can achieve multiple controllable clock signals. The jamming between the clock signals can be reduced greatly with the differential transmission. Meanwhile, the adoption of CAN bus control in the clock circuit can prompt the clock signals to be transmitted or masked simultaneously when needed. (authors)

  19. Bioimpedance-based identification of malnutrition using fuzzy logic

    International Nuclear Information System (INIS)

    Wieskotten, S; Isermann, R; Heinke, S; Wabel, P; Moissl, U; Becker, J; Pirlich, M; Keymling, M

    2008-01-01

    Protein-energy malnutrition reduces the quality of life, lengthens the time in hospital and dramatically increases mortality. Currently there is no simple and objective method available for assessing nutritional status and identifying malnutrition. The aim of this work is to develop a novel assistance system that supports the physician in the assessment of the nutritional status. Therefore, three subject groups were investigated: the first group consisted of 688 healthy subjects. Two additional groups consisted of 707 patients: 94 patients with primary diseases that are known to cause malnutrition, and 613 patients from a hospital admission screening. In all subjects bioimpedance spectroscopy measurements were performed, and the body composition was calculated. Additionally, in all patients the nutritional status was assessed by the subjective global assessment score. These data are used for the development and validation of the assistance system. The basic idea of the system is that nutritional status is reflected by body composition. Hence, features of the nutritional status, based on the body composition, are determined and compared with reference ranges, derived from healthy subjects' data. The differences are evaluated by a fuzzy logic system or a decision tree in order to identify malnourished patients. The novel assistance system allows the identification of malnourished patients, and it can be applied for screening and monitoring of the nutritional status of hospital patients

  20. The elephant moves into the sunlight: progress in childhood malnutrition.

    Science.gov (United States)

    Duggan, Maureen B

    2012-01-01

    Beginning with a historical summary of investigative work into protein-energy malnutrition, now termed 'severe acute malnutrition', this review ends by summarizing recent initiatives to tackle the global problem of malnutrition, specifically Scaling-Up Nutrition (SUN). In early years, macronutrient deficiency or imbalance was considered the principal cause of complex metabolic disturbances, including kwashiorkor, whereas, now, micronutrient deficiency infections, including HIV, and a background of deprivation are implicated. Different approaches to management are reviewed. The rehabilitation of individual children by protocolised-phased feeding has largely given way to community-based therapeutic feeding. Despite sporadic successes, the overall impact on morbidity and mortality has been so disappointing that the global community now plans a new initiative, viz. SUN. Its focus on the critical window of 1000 days (from conception to 2 years) is similar to the earlier focus on early childhood vulnerability which inspired the under-5 clinics and their integration into maternal and child health programmes. 'Targeted' interventions, recently more prominent than integrated community-based primary care, often undertaken by NGOs, have been effective, although sometimes imperfectly accountable. Will SUN, aiming for a broad approach, and the participation of recipient communities finally succeed in integrating nutrition into child health?

  1. Prevalence of Malnutrition and Associated Factors among ...

    African Journals Online (AJOL)

    BACKGROUND: HIV/AIDS predisposes to malnutrition. Malnutrition exacerbates HIV/AIDS progression resulting in increased morbidity and mortality. The magnitude of malnutrition in HIV/AIDS patients has not been well studied in Ethiopian setup. Our objective was to assess the prevalence of malnutrition and associated ...

  2. Neuropsychological Outcomes at Mid-Life Following Moderate to Severe Malnutrition in Infancy

    Science.gov (United States)

    Waber, Deborah P.; Bryce, Cyralene P.; Fitzmaurice, Garrett M.; Zichlin, Miriam; McGaughy, Jill; Girard, Jonathan M.; Galler, Janina R.

    2014-01-01

    Objective To compare neuropsychological profiles of adults who had experienced an episode of moderate to severe protein-energy malnutrition confined to the first year of life with that of a healthy community comparison group. Method We assessed neuropsychological functioning in a cohort of Barbadian adults, all of whom had birth weight >2500g. The previously malnourished group (N=77, Mean age = 38 years, 53% male) had been hospitalized during the first year of life for moderate to severe protein energy malnutrition and subsequently enrolled in a program providing nutrition education, home visits, and subsidized foods to 12 years of age. They also had documented, adequate nutrition throughout childhood and complete catch-up in growth by the end of adolescence. The healthy comparison group (N=59, Mean age = 38 years, 54% male) were recruited as children from the same classrooms and neighborhoods. Results Adjusted for effects of standard of living during childhood and adolescence and current intellectual ability level, there were nutrition group differences on measures of cognitive flexibility and concept formation, as well as initiation, verbal fluency, working memory, processing speed, and visuospatial integration. Behavioral and cognitive regulation were not affected. Conclusions Postnatal malnutrition confined to the first year of life is associated with neurocognitive compromise persisting into mid-life. Early malnutrition may have a specific neuropsychological signature, affecting response initiation to a somewhat greater extent than response inhibition. PMID:24635710

  3. Management of severe acute malnutrition

    African Journals Online (AJOL)

    age are attributed to undernutrition, especially in developing countries. ... General principles for inpatient management of acute malnutrition can be divided into two phases, i.e. the .... malnourished child: Perspective from developing countries.

  4. Clear-PEM, a dedicated PET camera for mammography

    CERN Document Server

    Lecoq, P

    2002-01-01

    Preliminary results suggest that Positron Emission Mammography (PEM) can offer a noninvasive method for the diagnosis of breast cancer. Metabolic images from PEM contain unique information not available from conventional morphologic imaging techniques and aid in expeditiously establishing the diagnosis of cancer. A dedicated machine seems to offer better perspectives in terms of position resolution and sensitivity. This paper describes the concept of Clear-PEM, the system presently developed by the Crystal Clear Collaboration at CERN for an evaluation of this approach. This device is based on new crystals introduced by the Crystal Clear as well as on modern data acquisition techniques developed for the large experiments in high energy physics experiments.

  5. Development of PEM fuel cell technology at international fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Wheeler, D.J.

    1996-04-01

    The PEM technology has not developed to the level of phosphoric acid fuel cells. Several factors have held the technology development back such as high membrane cost, sensitivity of PEM fuel cells to low level of carbon monoxide impurities, the requirement to maintain full humidification of the cell, and the need to pressurize the fuel cell in order to achieve the performance targets. International Fuel Cells has identified a hydrogen fueled PEM fuel cell concept that leverages recent research advances to overcome major economic and technical obstacles.

  6. The German hospital malnutrition study.

    Science.gov (United States)

    Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert

    2006-08-01

    Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.

  7. A study of Community Based Nutritional Intervention and prevention of malnutrition

    Directory of Open Access Journals (Sweden)

    Neelam Anupama Toppo

    2015-12-01

    Full Text Available Background: PEM is one of the major health and nutritional problem in India. It is not only an important cause of childhood mortality and morbidity but also leads to permanent impairment of both physical and mental growth of those who survive. Malnutrition is implicated in >50% of deaths of <5 children (5 million/yr. Improving nutrition for children is crucial in meeting two of the Millennium Development Goals. According to national family health survey-3 there is considerable variation across states with Madhya Pradesh recording the highest rate for underweight children (60.3% and Kerala among the lowest (28.8%. The great majority of cases of PEM nearly 80% are intermediate that is mild and moderate cases which frequently go unrecognized. These are the fact that made us to pick this issue in order to benefit the children of locality to some extent. Objectives: To identify under 5 year children with malnutrition, To demonstrate the method of preparing high protein mix diet and to educate mothers about adequate recommended diet as per age of children, To find out whether high protein mix improves nutritional status of identified malnourished children. Methodology: It was cross sectional and interventional study carried out in two villages of Jabalpur districts during the period of three months among 100 under five children. We had screened them and calculated weight for age (% and categorized them according to Gomez Classification that is normal, mild, moderate and severe malnutrition. Intervention was done on malnourished children then 4 follow ups at the interval of 15 days. Intervention strategies: Nutrition education and provision of High Protein Mix Diet. Result: 12% children were identified as malnourished where 7% were having mild grade malnutrition and 5% with moderate grade of malnutrition. Among male there were 14.04% children were malnourished while among female 9.3% were malnourished. After intervention 50% children were showing

  8. A study of Community Based Nutritional Intervention and prevention of malnutrition

    Directory of Open Access Journals (Sweden)

    Neelam Anupama Toppo

    2015-01-01

    Full Text Available Background: PEM is one of the major health and nutritional problem in India. It is not only an important cause of childhood mortality and morbidity but also leads to permanent impairment of both physical and mental growth of those who survive. Malnutrition is implicated in >50% of deaths of <5 children (5 million/yr. Improving nutrition for children is crucial in meeting two of the Millennium Development Goals. According to national family health survey-3 there is considerable variation across states with Madhya Pradesh recording the highest rate for underweight children (60.3% and Kerala among the lowest (28.8%. The great majority of cases of PEM nearly 80% are intermediate that is mild and moderate cases which frequently go unrecognized. These are the fact that made us to pick this issue in order to benefit the children of locality to some extent. Objectives: To identify under 5 year children with malnutrition, To demonstrate the method of preparing high protein mix diet and to educate mothers about adequate recommended diet as per age of children, To find out whether high protein mix improves nutritional status of identified malnourished children. Methodology: It was cross sectional and interventional study carried out in two villages of Jabalpur districts during the period of three months among 100 under five children. We had screened them and calculated weight for age (% and categorized them according to Gomez Classification that is normal, mild, moderate and severe malnutrition. Intervention was done on malnourished children then 4 follow ups at the interval of 15 days. Intervention strategies: Nutrition education and provision of High Protein Mix Diet. Result: 12% children were identified as malnourished where 7% were having mild grade malnutrition and 5% with moderate grade of malnutrition. Among male there were 14.04% children were malnourished while among female 9.3% were malnourished. After intervention 50% children were showing

  9. EFFECTS ON THE FETAL RAT INTESTINE OF MATERNAL MALNUTRITION AND EXPOSURE TO NITROFEN (2,4-DICHLOROPHENYL-P-NITROPHENYL ETHER)

    Science.gov (United States)

    The effects of maternal protein-energy malnutrition and exposure to nitrofen on selected aspects of intestinal morphology and function were studied in the fetal rat. Pregnant rats were fed, throughout gestation, diets containing 24% or 6% casein as the sole source of protein. Red...

  10. Novel High Temperature Membrane for PEM Fuel Cells, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The innovation proposed in this STTR program is a high temperature membrane to increase the efficiency and power density of PEM fuel cells. The NASA application is...

  11. Reconstruction of Clear-PEM data with STIR

    CERN Document Server

    Martins, M V; Rodrigues, P; Trindade, A; Oliveira, N; Correia, M; Cordeiro, H; Ferreira, N C; Varela, J; Almeida, P

    2006-01-01

    The Clear-PEM scanner is a device based on planar detectors that is currently under development within the Crystal Clear Collaboration, at CERN. The basis for 3D image reconstruction in Clear-PEM is the software for tomographic image reconstruction (STIR). STIR is an open source object-oriented library that efficiently deals with the 3D positron emission tomography data sets. This library was originally designed for the traditional cylindrical scanners. In order to make its use compatible with planar scanner data, new functionalities were introduced into the library's framework. In this work, Monte Carlo simulations of the Clear-PEM scanner acquisitions were used as input for image reconstruction with the 3D OSEM algorithm available in STIR. The results presented indicate that dual plate PEM data can be accurately reconstructed using the enhanced STIR framework.

  12. UARS Particle Environment Monitor (PEM) Level 3TP V001

    Data.gov (United States)

    National Aeronautics and Space Administration — The Particle Environment Monitor (PEM) Level 3TP data product consists of daily, 65.536 second and 2.048 interval time-ordered, vertical profiles of electron and...

  13. UARS PEM Level 2 AXIS 1 V001

    Data.gov (United States)

    National Aeronautics and Space Administration — The UARS Particle Environment Monitor (PEM) level 2 Atmosphere X-Ray Imaging Spectrometer (AXIS) unit 1 daily product contains the X-ray high-resolution spectral...

  14. UARS PEM Level 2 AXIS 2 V001

    Data.gov (United States)

    National Aeronautics and Space Administration — The UARS Particle Environment Monitor (PEM) level 2 Atmosphere X-Ray Imaging Spectrometer (AXIS) unit 2 daily product contains the X-ray high-resolution spectral...

  15. Protein, energy and phosphorus supplementation of cattle fed low ...

    African Journals Online (AJOL)

    The effect of protein, energy and phosphorus supplements, fed ..... The results of this experiment confirm the basic concepts that ... article. The lack of response or even negative reaction to energy supplements under these conditions can be ...

  16. potential for quality protein maize for reducing protein- energy

    African Journals Online (AJOL)

    ACSS

    social systems hampering QPM promotion and adoption and to identify ... affects growth and development. Protein- energy ... to purchase QPM seed leading to PEU reduction. Education ..... decision support framework “targetCSA”. Agricultural ...

  17. Hematological alterations in protein malnutrition.

    Science.gov (United States)

    Santos, Ed W; Oliveira, Dalila C; Silva, Graziela B; Tsujita, Maristela; Beltran, Jackeline O; Hastreiter, Araceli; Fock, Ricardo A; Borelli, Primavera

    2017-11-01

    Protein malnutrition is one of the most serious nutritional problems worldwide, affecting 794 million people and costing up to $3.5 trillion annually in the global economy. Protein malnutrition primarily affects children, the elderly, and hospitalized patients. Different degrees of protein deficiency lead to a broad spectrum of signs and symptoms of protein malnutrition, especially in organs in which the hematopoietic system is characterized by a high rate of protein turnover and, consequently, a high rate of protein renewal and cellular proliferation. Here, the current scientific information about protein malnutrition and its effects on the hematopoietic process is reviewed. The production of hematopoietic cells is described, with special attention given to the hematopoietic microenvironment and the development of stem cells. Advances in the study of hematopoiesis in protein malnutrition are also summarized. Studies of protein malnutrition in vitro, in animal models, and in humans demonstrate several alterations that impair hematopoiesis, such as structural changes in the extracellular matrix, the hematopoietic stem cell niche, the spleen, the thymus, and bone marrow stromal cells; changes in mesenchymal and hematopoietic stem cells; increased autophagy; G0/G1 cell-cycle arrest of progenitor hematopoietic cells; and functional alterations in leukocytes. Structural and cellular changes of the hematopoietic microenvironment in protein malnutrition contribute to bone marrow atrophy and nonestablishment of hematopoietic stem cells, resulting in impaired homeostasis and an impaired immune response. © The Author(s) 2017. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Agriculture and malnutrition in India.

    Science.gov (United States)

    Gulati, Ashok; Ganesh-Kumar, A; Shreedhar, Ganga; Nandakumar, T

    2012-03-01

    Despite the high and relatively stable overall growth of the economy, India's agriculture sector is underperforming and a vast section of the population remains undernourished. To explore the possible interplay between agricultural performance and malnutrition indicators to see whether states that perform better in agriculture record better nutritional outcomes. Correlation analysis and a simple linear regression model were used to study the relationship between agricultural performance and malnutrition among children under 5 years of age and adults from 15 to 49 years of age at 20 major states using data from the National Family Health Survey-3 for the year 2005/06 and the national accounts. Indicators of the level of agricultural performance or income have a strong and significant negative relationship with indices of undernutrition among adults and children, a result suggesting that improvement of agricultural productivity can be a powerful tool to reduce undernutrition across the vast majority of the population. In addition to agriculture, access to sanitation facilities and women's literacy were also found to be strong factors affecting malnutrition. Access to healthcare for women and child-care practices, in particular breastfeeding within 1 hour after birth, are other important determinants of malnutrition among adults and children. Malnutrition is a multidimensional problem that requires multisectoral interventions. The findings show that improving agricultural performance can have a positive impact on nutritional outcomes. However, improvements in agriculture alone cannot be effective in combating malnutrition if several other mediating factors are not in place. Interventions to improve education, health, sanitation and household infrastructure, and care and feeding practices are critical. Innovative strategies that integrate agriculture and nutrition programs stand a better chance of combating the malnutrition problem.

  19. DNA Methylation Signatures of Early Childhood Malnutrition Associated With Impairments in Attention and Cognition.

    Science.gov (United States)

    Peter, Cyril J; Fischer, Laura K; Kundakovic, Marija; Garg, Paras; Jakovcevski, Mira; Dincer, Aslihan; Amaral, Ana C; Ginns, Edward I; Galdzicka, Marzena; Bryce, Cyralene P; Ratner, Chana; Waber, Deborah P; Mokler, David; Medford, Gayle; Champagne, Frances A; Rosene, Douglas L; McGaughy, Jill A; Sharp, Andrew J; Galler, Janina R; Akbarian, Schahram

    2016-11-15

    Early childhood malnutrition affects 113 million children worldwide, impacting health and increasing vulnerability for cognitive and behavioral disorders later in life. Molecular signatures after childhood malnutrition, including the potential for intergenerational transmission, remain unexplored. We surveyed blood DNA methylomes (~483,000 individual CpG sites) in 168 subjects across two generations, including 50 generation 1 individuals hospitalized during the first year of life for moderate to severe protein-energy malnutrition, then followed up to 48 years in the Barbados Nutrition Study. Attention deficits and cognitive performance were evaluated with the Connors Adult Attention Rating Scale and Wechsler Abbreviated Scale of Intelligence. Expression of nutrition-sensitive genes was explored by quantitative reverse transcriptase polymerase chain reaction in rat prefrontal cortex. We identified 134 nutrition-sensitive, differentially methylated genomic regions, with most (87%) specific for generation 1. Multiple neuropsychiatric risk genes, including COMT, IFNG, MIR200B, SYNGAP1, and VIPR2 showed associations of specific methyl-CpGs with attention and IQ. IFNG expression was decreased in prefrontal cortex of rats showing attention deficits after developmental malnutrition. Early childhood malnutrition entails long-lasting epigenetic signatures associated with liability for attention and cognition, and limited potential for intergenerational transmission. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Predictive emission monitoring system (PEMS) for emission control in biomass fired plants; Predikterande emissionsmaetsystem (PEMS) foer emissionskontroll i biobraensleeldade foerbraenningsanlaeggningar

    Energy Technology Data Exchange (ETDEWEB)

    Harnevie, H; Sarkoezi, L; Trenkle, S

    1996-08-01

    An alternative method for estimation of NO{sub x}-emissions from biomass fired plants has been investigated. The method, `Predictive emission monitoring` (PEMS), implicates the creation of a mathematical formula. The formula expresses the relations between NO{sub x}-emissions and various operating and external parameters, such as flue gas temperature, excess combustion air and heat load. In this study the applicability of PEMS has been tested for two plants both of type travelling stokers. The most important results of the study are: PEMS is suitable for emission monitoring for some types of biomass fired plants (for example travelling stokers) even if the plant is fired with fuel with varying water content. In most cases it should be sufficient if the relation is based on oxygen level in the flue gas and plant load, with the possible addition of flue gas temperature and/or furnace temperature rate. These parameters are usually measured in any case, which means that no additional investment in instrumentation is necessary. In this study many measured parameters (for example the throttle levels) did not affect the NO{sub x}-emissions. A PEMS relation is only applicable for a specific plant and for a fixed validity range. Thus the function should be performed in such a way that it covers the limits of the operating parameters of the plant. Usage of different fuels or drift optimization can only be done within the validity range. Good combustion conditions could be necessary to receive a usable PEMS-function. Before creating the PEMS-function the combustion and the emission levels must be optimized. In plants with very fluctuating combustion, for example fixed stokers, it is possible that PEMS leads to not satisfying results. The total cost for a PEM-function can be calculated to be about 50-70% compared to a CEM during a period of a decade. 8 refs, 13 figs, 15 tabs, 8 appendices

  1. Malnutrition: A Deterrent to Human Progress

    Science.gov (United States)

    Johnson, Nancy E.; Found, R. Elaine

    1971-01-01

    Authors discuss the effects of malnutrition on retardation of mental development and intellectual capacity. Research findings on undernourished experimental animals are cited as well as studies involving children suffering the effects of malnutrition in infancy. (Editor/LF)

  2. State of malnutrition in hospitals of Ecuador

    OpenAIRE

    Sylvia Gallegos Espinosa; Marcelo Nicolalde Cifuentes; Sergio Santana Porbén

    2014-01-01

    Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between No...

  3. Malnutrition: The Wasting of Human Potential.

    Science.gov (United States)

    Taylor, Patricia S.

    The paper discusses the prevalence of malnutrition in developing countries and the United States, particularly as it relates to debilitating physical and psychological disorders. Educational, social, and political factors which influence the cycle of malnutrition are described. Research on the relationship between malnutrition and intellectual…

  4. Investigation of low glass transition temperature on COTS PEM's reliability for space applications

    Science.gov (United States)

    Sandor, M.; Agarwal, S.; Peters, D.; Cooper, M. S.

    2003-01-01

    Plastic Encapsulated Microelectronics (PEM) reliability is affected by many factors. Glass transition temperature (Tg) is one such factor. In this presentation issues relating to PEM reliability and the effect of low glass transition temperature epoxy mold compounds are presented.

  5. Method of monitoring CO concentrations in hydrogen feed to a PEM fuel cell

    Science.gov (United States)

    Grot, Stephen Andreas; Meltser, Mark Alexander; Gutowski, Stanley; Neutzler, Jay Kevin; Borup, Rodney Lynn; Weisbrod, Kirk

    2000-01-01

    The CO concentration in the H.sub.2 feed stream to a PEM fuel cell stack is monitored by measuring current and/or voltage behavior patterns from a PEM-probe communicating with the reformate feed stream. Pattern recognition software may be used to compare the current and voltage patterns from the PEM-probe to current and voltage telltale outputs determined from a reference cell similar to the PEM-probe and operated under controlled conditions over a wide range of CO concentrations in the H.sub.2 fuel stream. The PEM-probe is intermittently purged of any CO build-up on the anode catalyst (e.g., by (1) flushing the anode with air, (2) short circuiting the PEM-probe, or (3) reverse biasing the PEM-probe) to keep the PEM-probe at peak performance levels.

  6. Bipolar plates for PEM fuel cells

    Science.gov (United States)

    Middelman, E.; Kout, W.; Vogelaar, B.; Lenssen, J.; de Waal, E.

    The bipolar plates are in weight and volume the major part of the PEM fuel cell stack, and are also a significant contributor to the stack costs. The bipolar plate is therefore a key component if power density has to increase and costs must come down. Three cell plate technologies are expected to reach targeted cost price levels, all having specific advantages and drawbacks. NedStack has developed a conductive composite materials and a production process for fuel cell plates (bipolar and mono-polar). The material has a high electric and thermal conductivity, and can be processed into bipolar plates by a proprietary molding process. Process cycle time has been reduced to less than 10 s, making the material and process suitable for economical mass production. Other development work to increase material efficiency resulted in thin bipolar plates with integrated cooling channels, and integrated seals, and in two-component bipolar plates. Total thickness of the bipolar plates is now less than 3 mm, and will be reduced to 2 mm in the near future. With these thin integrated plates it is possible to increase power density up to 2 kW/l and 2 kW/kg, while at the same time reducing cost by integrating other functions and less material use.

  7. XAS Investigations of PEM Fuel Cells

    Science.gov (United States)

    Roth, Christina; Ramaker, David E.

    Polymer-electrolyte membrane (PEM) fuel cells are still far from an area-wide market launch due in part to long-term stability, reliability and cost issues. A more detailed knowledge of the underlying reaction mechanisms is expected to further their application, as it would allow for the design of tailor-made catalysts. However, this will only be possible by complementing traditional in situ studies on single-crystals in electrochemical cells with more sophisticated metal/electrolyte interfacial studies by novel spectroscopic methodologies, which can provide complementary insights into the behaviour of commercial catalysts under real fuel cell operating conditions. This review will focus on the advances of Xray absorption spectroscopy (XAS) in applied fuel cell research utilizing several examples. XAS enables both the nanoparticle morphology and the adsorbate coverage and binding site to be investigated with just one technique. The latter is possible when complementing the conventional extended X-ray absorption fine structure (EXAFS) analysis with the more novel Δμ XANES approach.

  8. Child Malnutrition and Antenatal Care

    NARCIS (Netherlands)

    N. Forero-Ramirez; L.F. Gamboa (Luis); A.S. Bedi (Arjun Singh); R.A. Sparrow (Robert)

    2014-01-01

    markdownabstract__Abstract__ Objective. To examine the effect of prenatal care (PNC) on the level and distribution of child stunting in three Andean countries—Bolivia, Colombia, and Peru—where expanding access to such care has been an explicit policy intervention to tackle child malnutrition in

  9. ORIGINAL ARTICLES

    African Journals Online (AJOL)

    The term protein-energy malnutrition (PEM) describes a spec- trum of pathological conditions ranging from kwashiorkor to marasmus. The risk factors and clinical features of these two forms of PEM may be similar, but the cardinal feature of kwash- iorkor is oedema.' Infection often precedes the development of kwashiorkor ...

  10. Performance optimization of a PEM hydrogen-oxygen fuel cell

    Energy Technology Data Exchange (ETDEWEB)

    Sadiq Al-Baghdadi, Maher A.R. [Fuel Cell Research Center, International Energy and Environment Foundation, Al-Najaf, P.O.Box 39 (Iraq)

    2013-07-01

    The objective was to develop a semi-empirical model that would simulate the performance of proton exchange membrane (PEM) fuel cells without extensive calculations. A fuel cell mathematical module has been designed and constructed to determine the performance of a PEM fuel cell. The influence of some operating parameters on the performance of PEM fuel cell has been investigated using pure hydrogen on the anode side and oxygen on the cathode side. The present model can be used to investigate the influence of process variables for design optimization of fuel cells, stacks, and complete fuel cell power system. The possible mechanisms of the parameter effects and their interrelationships are discussed. In order to assess the validity of the developed model a real PEM fuel cell system has been used to generate experimental data. The comparison shows good agreements between the modelling results and the experimental data. The model is shown a very useful for estimating the performance of PEM fuel cell stacks and optimization of fuel cell system integration and operation.

  11. Prescription-event monitoring in Japan (J-PEM).

    Science.gov (United States)

    Kubota, Kiyoshi

    2002-01-01

    In prescription-event monitoring in Japan (J-PEM), patients are identified by prescriptions in individual pharmacies where drugs are dispensed. The methodology is somewhat different to that used by the Drug Safety Research Unit in the UK, in that two questionnaires, one to the pharmacist and the other to the doctor are sent for each patient and the method of concurrent control is employed in J-PEM. In the data analysis, the list of events reported as a suspected reaction or a reason for stopping the drug is made to generate a signal. In addition, a signal may be generated for some events with the statistically significant difference of crude rates followed by the regression analysis or a follow-up study. In J-PEM, Medical Dictionary for Regulatory Activities (MedDRA) terminology is used for data entry and data analysis. Lowest level terms (LLTs) in MedDRA are used in data entry while a signal is generated using preferred terms (PTs). However, to generate a signal effectively, some PTs may be grouped as one term. In addition, if two terms are so similar, it may be instructed that one of those two terms is normally selected in data entry to avoid confusion. Many more PEM studies could be undertaken to determine if MedDRA can be used for effective signal generation, but the usefulness of MedDRA in J-PEM is still to be determined.

  12. Malnutrition, poverty and intellectual development.

    Science.gov (United States)

    Brown, J L; Pollitt, E

    1996-02-01

    New findings with important policy implications have revealed that malnutrition in childhood impairs intellectual function in more ways than was previously recognized, but also that some of the damage to the brain caused by malnutrition may be reversed. Early research indicated that malnourished animals lacked the energy to interact with their environment and, thus, performed poorly on tests of mental ability. To determine the effect of poor diet and an impoverished environment on mental development in humans, an extensive follow-up study was made of Guatemalan children who received two different nutritional supplements in a 1969-77 study. Mothers and children in two villages received a high-protein supplement (Atole), and those in two additional villages received a supplement with no protein (Fresco). Both supplements reduced mortality, but Atole villages saw a 69% reduction in infant mortality (vs. 24% in the Fresco villages). The 1988-89 follow-up of 70% of the original participants involved extensive cognitive testing and socioeconomic assessment. Atole subjects performed significantly better on the cognitive tests, and the lowest-income children did as well as their more economically advantaged (but still poor) peers. Those who received Atole exhibited an increased benefit from their years of education and grew up faster and stronger than those who received Fresco. Smaller children who appear younger than their age may receive less stimulation from adult expectations than larger children. These findings indicate that the deleterious effects of early malnutrition on intellectual development can continue into adulthood. Other research has revealed that iron supplements can improve the intellectual and motor abilities of infants. While enriched educational programs can ameliorate some of the problems associated with malnutrition, poor children rarely live where such programs are available. The best and least expensive policy would be to prevent malnutrition among

  13. Contributing Factors for Protein Calorie Malnutrition in Distsrict Mardan

    International Nuclear Information System (INIS)

    Khan, D.M.; Khan, S.A.

    2017-01-01

    Background: Protein calorie malnutrition (PCM) is a common health problem in developing countries resulting in high mortality in children under five years of age. It is also known as protein energy malnutrition. Objectives: To calculate the incidence and risk factors for Protein Calorie Malnutrition in children attending hospitals of district Mardan, Khyber Pakhtunkhwa. Study design, settings and duration: Retrospective hospital case record analysis of admitted children diagnosed as suffers of PCM and were admitted in hospitals from 2011-15 was done. Subjects and Methods: Children < 5 years fulfilling the inclusion criteria and reporting at four major hospitals of district Mardan from 2011-15 were included in the study. Data of children fulfilling the definition of PCM were further analyzed using SPSS software. Chi-square test and logistic regression model was used to determine the significance of the risk factors with the PCM disease. Results: Out of 448 children, 58.5 percent (n=262) had PCM and 41.5 percent (n=186) did not have PCM. The significant risk factors in the logistic model fitted for male children included economic status, number of living children, environmental sanitation, immunization, skin changes. Risk factors for PCM in female children were economic status, weight, height, number of living children, environmental sanitation, immunization, hair changes, time to time monitoring of the child and clean water availability. In the logistic model for both genders; the risk factors that showed significant association with PCM were economic status, weight, height, number of living children, environmental sanitation, immunization, hair changes, time to time monitoring of the child health, clean water availability and hypothermia. Conclusion: Almost 58 percent children admitted in different hospitals of district Mardan had PCM and the significant risk factors were economic status, weight, height, number of living children, environmental sanitation

  14. Device and materials modeling in PEM fuel cells

    CERN Document Server

    Promislow, Keith

    2009-01-01

    Device and Materials Modeling in PEM Fuel Cells is a specialized text that compiles the mathematical details and results of both device and materials modeling in a single volume. Proton exchange membrane (PEM) fuel cells will likely have an impact on our way of life similar to the integrated circuit. The potential applications range from the micron scale to large scale industrial production. Successful integration of PEM fuel cells into the mass market will require new materials and a deeper understanding of the balance required to maintain various operational states. This book contains articles from scientists who contribute to fuel cell models from both the materials and device perspectives. Topics such as catalyst layer performance and operation, reactor dynamics, macroscopic transport, and analytical models are covered under device modeling. Materials modeling include subjects relating to the membrane and the catalyst such as proton conduction, atomistic structural modeling, quantum molecular dynamics, an...

  15. Data acquisition electronics for positron emission mammography (PEM) detectors

    International Nuclear Information System (INIS)

    Martinez, J.D.; Sebastia, A.; Cerda, J.; Esteve, R.; Mora, F.J.; Toledo, J.F.; Benlloch, J.M.; Gimenez, N.; Gimenez, M.; Lerche, Ch. W.; Pavon, N.; Sanchez, F.

    2005-01-01

    Positron emission mammography (PEM) is an innovative technique to increase sensitivity and overcome the main drawbacks of conventional X-ray screening. However, dedicated PET imaging systems demand specific hardware solutions for data acquisition and processing that can take advantage of the reduction in the number of channels. Data acquisition issues can affect PEM scanners performance and they should be exhaustively addressed in order to exploit the increment in the event count rate. This is crucial in order to reduce both the scanning time and the total injected dose. This paper presents the electronics for our PEM camera prototype that enables us to achieve very high-count rates and perform comprehensive online processing. Results about acquisition in our detector for a typical clinical setup are studied using Monte Carlo simulation of hot lesion phantoms

  16. Home-prepared soymilk: Potential to alleviate protein-energy malnutrition in low-income rural communities in South Africa?

    Directory of Open Access Journals (Sweden)

    Sara S. Duvenage

    2013-10-01

    Full Text Available Research findings reported pronounced protein and some energy shortfalls for school-aged children and female caregivers in rural communities in Qwa-Qwa, South Africa. The household gardening project was expanded to include soy cultivation. Subsequently, a process was developed for home-preparation of soymilk to support macronutrient consumption. The limited explorative experimental approach included chemical analysis for total protein (Kjeldahl digestion, spectrophotometric determination, total carbohydrate (Anthone method and total lipid content (extraction, Gravimetric method, separation. Total energy content was calculated. All results were benchmarked against equivalents. Duplicate analysis of samples, respectively prepared from 1:2 (n = 6 and 1:4 (n = 4 volume ratios of rehydrated minced soybeans : water for cooking of soy mash, indicated statistically-significant differences for reported nutrients (p ≤ 0.05. Comparison between sourced commercial soymilk products for drinking indicated no statistical differences (p > 0.05. Although statistically-significant shortfalls were indicated for nearly all such values for home-prepared soymilk (1:4 ratio against industrial ‘SoyCow’ soymilk and values reported in the South African database for standardised nutrient composition of food (p ≤ 0.05, a much-needed contribution will be made to protein (and energy intake through consumption of the product. More efficient extraction (possibly double mincing of rehydrated soybeans and more efficient pressing of cooked soy mash should be explored, followed by an intervention study to evaluate the impact of daily consumption of home-prepared soymilk on the nutritional status of children in low-income communities. The development of recipes to promote the inclusion of undissolved fibre from the soymilk extraction process (okara in dishes prepared at household level, such as bread, is recommended. Navorsing het beduidende proteïen en minder ernstige energie te korte uitgewys by skoolkinders en vroulike versorgers in plattelandse gemeenskappe in Kwa-Kwa. Die huishoudelike tuinbouprojek is uitgebrei om soja-verbouing in te sluit en ’n proses is ontwikkel vir die tuisbereiding van sojamelk om makronutriënt inname te bevorder. Die beperkte eksperimentele benadering het chemiese analise vir totale proteïen (Kjeldahlvertering, spektro-fotometriese bepaling, totale koolhidraat (Anthonemetode en totale lipied inhoud (ekstraksie, Gravimetriese metode, skeiding ingesluit. Totale energie is bereken en alle resultate is met ekwivalente vergelyk. Duplikaatanalise van sojamelkmonsters, onderskeidelik berei van 1:2 (n = 6 en 1:4 (n = 4 volume verhoudings van gehidreerde gemaalde sojabone : water vir die kook van die sojapulp, het statisties-beduidende verskille uitgewys (p ≤ 0.05. Geen statisties-beduidende verskille is gevind in die makronutriëntwaardes van kommersiële sojamelkprodukte wat gedrink kan word nie (p > 0.05. Alhoewel statisties-beduidende tekorte vir bykans alle soortgelyke waardes van tuisbereide sojamelk (1:4 teenoor die industrieel bereide ‘SoyCow’ produk en waardes gerapporteer in die Suid Afrikaanse databasis vir gestandardiseerde nutriëntsamestelling van voedsel (p ≤ 0.05 waargeneem is, sal inname van die tuisbereide produk tog ’n belangrike bydrae tot proteïen (en energie inname kan lewer. Die effektiwiteit van ’n verbeterde nutriëntekstraksie, byvoorbeeld deur ‘n dubbel-maalproses en meer effektiewe pers van die gekookte sojapulp, moet ondersoek word. ’n Intervensiestudie om die effek van daaglikse sojamelk inname op die voedingstatus van kinders in lae-inkomste bemeenskappe te meet, word aanbeveel. Verder word aanbeveel dat resepte ontwikkel word om die onopgeloste vesel wat oorbly na die melkmaak proses (okara in huishoudelike geregte in te sluit, byvoorbeeld in die bereiding van brood.

  17. Home-prepared soymilk: Potential to alleviate protein-energy malnutrition in low-income rural communities in South Africa?

    Directory of Open Access Journals (Sweden)

    Gabriel N. Medoua

    2013-10-01

    Full Text Available Research findings reported pronounced protein and some energy shortfalls for school-aged children and female caregivers in rural communities in Qwa-Qwa, South Africa. The household gardening project was expanded to include soy cultivation. Subsequently, a process was developed for home-preparation of soymilk to support macronutrient consumption. The limited explorative experimental approach included chemical analysis for total protein (Kjeldahl digestion, spectrophotometric determination, total carbohydrate (Anthone method and total lipid content (extraction, Gravimetric method, separation. Total energy content was calculated. All results were benchmarked against equivalents. Duplicate analysis of samples, respectively prepared from 1:2 (n= 6 and 1:4 (n = 4 volume ratios of rehydrated minced soybeans : water for cooking of soy mash, indicated statistically-significant differences for reported nutrients (p ≤ 0.05. Comparison between sourced commercial soymilk products for drinking indicated no statistical differences (p > 0.05. Although statistically-significant shortfalls were indicated for nearly all such values for home-prepared soymilk (1:4 ratio against industrial ‘SoyCow’ soymilk and values reported in the South African database for standardised nutrient composition of food (p ≤ 0.05, a much-needed contribution will be made to protein (and energy intake through consumption of the product. More efficient extraction (possibly double mincing of rehydrated soybeans and more efficient pressing of cooked soy mash should be explored, followed by an intervention study to evaluate the impact of daily consumption of home-prepared soymilk on the nutritional status of children in low-income communities. The development of recipes to promote the inclusion of undissolved fibre from the soymilk extraction process (okara in dishes prepared at household level, such as bread, is recommended.

  18. Protein-energy malnutrition at mid-adulthood does not imprint long-term metabolic consequences in male rats.

    Science.gov (United States)

    Malta, Ananda; de Moura, Egberto Gaspar; Ribeiro, Tatiane Aparecida; Tófolo, Laize Peron; Abdennebi-Najar, Latifa; Vieau, Didier; Barella, Luiz Felipe; de Freitas Mathias, Paulo Cezar; Lisboa, Patrícia Cristina; de Oliveira, Júlio Cezar

    2016-06-01

    The long-term effects of the development of chronic metabolic diseases such as type 2 diabetes and obesity have been associated with nutritional insults in critical life stages. In this study, we evaluated the effect of a low-protein diet on metabolism in mid-adulthood male rats. At 90 days of age, Wistar male rats were fed a low-protein diet (4.0 %, LP group) for 30 days, whereas control rats were fed a normal-protein diet (20.5 %, NP group) throughout their lifetimes. To allow for dietary rehabilitation, from 120 to 180 days of age, the LP rats were fed a normal-protein diet. Then, we measured body composition, fat stores, glucose-insulin homeostasis and pancreatic islet function. At 120 days of age, just after low-protein diet treatment, the LP rats displayed a strong lean phenotype, hypoinsulinemia, as assessed under fasting and glucose tolerance test conditions, as well as weak pancreatic islet insulinotropic response to glucose and acetylcholine (p protein diet rehabilitation, the LP rats displayed a slight lean phenotype (p  0.05). Taken together, the present data suggest that the effects of dietary restriction as a stressor in adulthood are reversible with dietary rehabilitation, indicating that adulthood is not a sensitive or critical time window for metabolic programming.

  19. PEM Low Cost Endplates. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, Martin; Clyens, S.; Steenstrup, F.R.; Christiansen, Jens [Danish Technological Institute. Plastics Technology, Taastrup (Denmark); Yde-Andersen, S. [IRD Fuel Cell A/S, Svendborg (Denmark)

    2013-03-15

    In the project, an endplate for the PEM-type fuel cells has been developed. The initial idea was to use an injection mouldable fibre reinforced polymer to produce the endplate and thereby exploit the opportunities of greater geometrical freedom to reduce weight and material consumption. Different PPS/glass-fibre compounds were produced and tested in order to use the results to optimize the results on the computer through FEM simulations. As it turned out, it was impossible to achieve adequate stiffness for the endplates within the given geometrical limitations. At the relatively high temperatures at which the endplates operate the material simply goes to soft. Material focus shifted to fibre reinforced high strength concrete composite. Test specimens were produced and tested so the results again could be used for FEM-simulations which also accounted for the technical limitations the concrete composite has regarding casting ability. In the process, the way the endplate is mounted was also alternated to better accommodate the properties of the concrete composite. A number of endplates were cast in specially produced moulds in order to map the optimum process parameters, and a final endplate was tested at IRD Fuel Cells A/S. The field test was in many aspects successful. However, the gas sealing and the surface finish can be further improved. The weight may still be an issue for some applications, even though it is lower than the endplate currently used. This issue can be addressed in a future project. The work has resulted in a new endplate design, which makes the stack assembly simpler and with fewer components. The endplates fabrication involves low cost methods, which can be scaled up as demand of fuel cells begin to take off. (Author)

  20. Materials Challenges for Automotive PEM Fuel Cells

    Science.gov (United States)

    Gasteiger, Hubert

    2004-03-01

    Over the past few years, significant R efforts aimed at meeting the challenging cost and performance targets required for the use of Polymer Electrolyte Membrane (PEM) fuel cells in automotive applications. Besides engineering advances in bipolar plate materials and design, the optimization of membrane-electrode assemblies (MEAs) was an important enabler in reducing the cost and performance gaps towards commercial viability for the automotive market. On the one hand, platinum loadings were reduced from several mgPt/cm2MEA [1] to values of 0.5-0.6 mgPt/cm2MEA in current applications and loadings as low as 0.25 mgPt/cm2MEA have been demonstrated on the research level [2]. On the other hand, implementation of thin membranes (20-30 micrometer) [3, 4] as well as improvements in diffusion medium materials, essentially doubled the achievable power density of MEAs to ca. 0.9 W/cm2MEA (at 0.65 V) [5], thereby not only reducing the size of a PEMFC fuel cell system, but also reducing its overall materials cost (controlled to a large extent by membrane and Pt-catalyst cost). While this demonstrated a clear path towards automotive applications, a renewed focus of R efforts is now required to develop materials and fundamental materials understanding to assure long-term durability of PEM fuel cells. This presentation therefore will discuss the state-of-the-art knowledge of catalyst, catalyst-support, and membrane degradation mechanisms. In the area of Pt-catalysts, experience with phosphoric acid fuel cells (PAFCs) has shown that platinum sintering leads to long-term performance losses [6]. While this is less critical at the lower PEMFC operating temperatures (200C), very little is known about the dependence of Pt-sintering on temperature, cell voltage, and catalyst type (i.e., Pt versus Pt-alloys) and will be discussed here. Similarly, carbon-support corrosion can contribute significantly to voltage degradation in PAFCs [7], and even in the PEMFC environment more corrosion

  1. A novel analytical analysis of PEM fuel cell

    International Nuclear Information System (INIS)

    Yazdi, Mohamad Zardoshtizade; Kalbasi, Mansour

    2010-01-01

    In this study, a quasi three-dimensional model was developed for a single proton exchange membrane (PEM) fuel cell. The model was used for a half-cell which includes the cathode gas channel, gas diffusion layer (GDL), cathode catalyst layer and membrane is modeled. This model includes mass transfer in the gas channel and GDL, electrochemistry reaction in cathode catalyst layer, and charge transfer in the membrane phase. These expressions were solved by analytical methods. An agglomerate approach was used to describe cathode catalyst layer. By using analytical solution, the expressions can predict the PEM fuel cell behavior in different conditions which is the advantage of this method.

  2. PEM fuel cell modeling and simulation using Matlab

    CERN Document Server

    Spiegel, Colleen

    2011-01-01

    Although, the basic concept of a fuel cell is quite simple, creating new designs and optimizing their performance takes serious work and a mastery of several technical areas. PEM Fuel Cell Modeling and Simulation Using Matlab, provides design engineers and researchers with a valuable tool for understanding and overcoming barriers to designing and building the next generation of PEM Fuel Cells. With this book, engineers can test components and verify designs in the development phase, saving both time and money.Easy to read and understand, this book provides design and modelling tips for

  3. A multilevel analysis of individual and community effect on chronic childhood malnutrition in rural Nigeria.

    Science.gov (United States)

    Uthman, Olalekan A

    2009-04-01

    Protein energy malnutrition is the second most important cause of childhood morbidity and mortality in Nigeria after infections. The purpose of this article was to develop and test a model of childhood malnutrition that includes individual-level characteristics along with contextual characteristics defined at the community level. Multilevel logistic regression analysis. A total of 4007 children resident in 96 rural villages in Nigeria. Stunting: height-for-age that is less than the international reference value by >2 standard deviations (SDs). Independent of other factors, children born to underweight mothers were 1.32-times more likely to be stunted [adjusted odds ratio (aOR) 1.32; 95% confidence interval (CI) 1.07-1.64]. For each additional month of breastfeeding the odds of being stunted increased by 4% (aOR 1.04; 95% CI 1.03-1.06). Each SD increase in the household wealth index and maternal health-seeking behaviour index decreased the odds of being stunted by 16% (aOR 0.84; 95% CI 0.76-0.94) and 29% (aOR 0.71; 95% CI 0.60 -0.82), respectively. The study has provided evidence that both individual and community characteristics are important predictors of childhood malnutrition in rural Nigeria; and that scholars trying to understand variation in childhood malnutrition should pay attention to the characteristics of both children and place of residence.

  4. Childhood malnutrition and the intestinal microbiome.

    Science.gov (United States)

    Kane, Anne V; Dinh, Duy M; Ward, Honorine D

    2015-01-01

    Malnutrition contributes to almost half of all deaths in children under the age of 5 y, particularly those who live in resource-constrained areas. Those who survive frequently suffer from long-term sequelae including growth failure and neurodevelopmental impairment. Malnutrition is part of a vicious cycle of impaired immunity, recurrent infections, and worsening malnutrition. Recently, alterations in the gut microbiome have also been strongly implicated in childhood malnutrition. It has been suggested that malnutrition may delay the normal development of the gut microbiota in early childhood or force it toward an altered composition that lacks the required functions for healthy growth and/or increases the risk for intestinal inflammation. This review addresses our current understanding of the beneficial contributions of gut microbiota to human nutrition (and conversely the potential role of changes in that community to malnutrition), the process of acquiring an intestinal microbiome, potential influences of malnutrition on the developing microbiota, and the evidence directly linking alterations in the intestinal microbiome to childhood malnutrition. We review recent studies on the association between alterations in the intestinal microbiome and early childhood malnutrition and discuss them in the context of implications for intervention or prevention of the devastation caused by malnutrition.

  5. State of malnutrition in hospitals of Ecuador.

    Science.gov (United States)

    Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio

    2014-08-01

    Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women: 37.5%; Ages ≥ 60 years: 35.1%; Length of stay ≤ 15 days: 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Design of metallic bipolar plates for PEM fuel cells.

    Science.gov (United States)

    2012-01-01

    This project focused on the design and production of metallic bipolar plates for use in PEM fuel cells. Different metals were explored : and stainless steel was found out to be best suited to our purpose. Following the selection of metal, it was calc...

  7. Multivariable control system for dynamic PEM fuel cell model

    International Nuclear Information System (INIS)

    Tanislav, Vasile; Carcadea, Elena; Capris, Catalin; Culcer, Mihai; Raceanu, Mircea

    2010-01-01

    Full text: The main objective of this work was to develop a multivariable control system of robust type for a PEM fuel cells assembly. The system will be used in static and mobile applications for different values of power, generated by a fuel cell assembly of up to 10 kW. Intermediate steps were accomplished: a study of a multivariable control strategy for a PEM fuel cell assembly; a mathematic modeling of mass and heat transfer inside of fuel cell assembly, defining the response function to hydrogen and oxygen/air mass flow and inlet pressure changes; a testing stand for fuel cell assembly; experimental determinations of transient response for PEM fuel cell assembly, and more others. To define the multivariable control system for a PEM fuel cell assembly the parameters describing the system were established. Also, there were defined the generic mass and energy balance equations as functions of derivative of m i , in and m i , out , representing the mass going into and out from the fuel cell, while Q in is the enthalpy and Q out is the enthalpy of the unused reactant gases and heat produced by the product, Q dis is the heat dissipated to the surroundings, Q c is the heat taken away from the stack by active cooling and W el is the electricity generated. (authors)

  8. Review: Durability and degradation issues of PEM fuel cell components

    NARCIS (Netherlands)

    Bruijn, de F.A.; Dam, V.A.T.; Janssen, G.J.M.

    2008-01-01

    Besides cost reduction, durability is the most important issue to be solved before commercialisation of PEM Fuel Cells can be successful. For a fuel cell operating under constant load conditions, at a relative humidity close to 100% and at a temperature of maximum 75 °C, using optimal stack and flow

  9. ClearPEM: prototype PET device dedicated to breast imaging

    CERN Multimedia

    Joao Varela

    2009-01-01

    Clinical trials have begun in Portugal on a new breast imaging system (ClearPEM) using positron emission tomography (PET). The system, developed by a Portuguese consortium in collaboration with CERN and laboratories participating in the Crystal Clear collaboration, will detect even the smallest tumours and thus help avoid unnecessary biopsies.

  10. 400 W High Temperature PEM Fuel Cell Stack Test

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl; Kær, Søren Knudsen

    2006-01-01

    This work demonstrates the operation of a 30 cell high temperature PEM (HTPEM) fuel cell stack. This prototype stack has been developed at the Institute of Energy Technology, Aalborg University, as a proof-of-concept for a low pressure cathode air cooled HTPEM stack. The membranes used are Celtec...

  11. High Temperature PEM Fuel Cell Systems, Control and Diagnostics

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl; Kær, Søren Knudsen; Justesen, Kristian Kjær

    2015-01-01

    fuels utilizes one of the main advantages of the high temperature PEM fuel cell: robustness to fuel quality and impurities. In order for such systems to provide efficient, robust, and reliable energy, proper control strategies are needed. The complexity and nonlinearity of many of the components...

  12. Case Study: Small bowel perforation secondary to ileal tuberculosis ...

    African Journals Online (AJOL)

    intestinal tuberculosis, other common causes of ileal perforation include typhoid ... Barré syndrome are the same as those for any other critically ill patient. .... Grade II protein-energy malnutrition (PEM): An estimated body ... of > 2 litres/24 hours, current clinical practice guidelines on its ..... Recognizing malnutrition in adults:.

  13. Socio-economic factors predisposing under five-year-old children to ...

    African Journals Online (AJOL)

    Background: Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or ...

  14. Development of integrated DMFC and PEM fuel cell units. Final report; Udvikling af integrerede DMFC og PEM braendselscelle enheder. Slutrapport

    Energy Technology Data Exchange (ETDEWEB)

    Odgaard, M. (IRD Fuel Cell Technology, Svendborg (DK))

    2007-06-15

    The 36-month long project 'Development of integrated DMFC and PEM fuel cell units' has been completed. The project goal was to develop a completely new MEA concept for integrated PEM and DMFC unit cells with enhanced power density and in this way obtain a price reduction. The integrated unit cell consists of a MEA, a gas diffusion layer with flow fields completed with bipolar plates and seals. The main focus of the present project was to: 1) Develop new catalyst materials fabricated by the use of FSD (flame spray deposition method). 2) Optimisation of the state-of-the-art MEA materials and electrode structure. 3) Implementation of a model to account for the CO poisoning of PEM fuel cells. Results and progress obtained in the project established that the individual unit cell components were able to meet and follow the road map of LT-PEM FC regarding electrode catalyst loading and fulfilled the targets for Year 2006. The project has resulted in some important successes. The highlights are as follows: The project has resulted in some important successes. The highlights are as follows: 1) MEA structure knowledge acquired in the project provide a sound basis for further progress. 2) A novel method for the synthesis of electrode by using flame spray synthesis was explored. 3) Electrochemical and catalytic behaviours of catalysts activity for CH{sub 3}OH explored. 4) Implementation of a sub model to account for the CO poisoning of PEM FC has been developed. 5) Numerical study of the flow distribution in FC manifolds was developed and completed with experimental data. 6) The electrode catalyst loading targets for year 2006 achieved. 7) The DMFC MEA performance has been improved by 35%. 8) Optimisation of the MEAs fabrication process has been successfully developed. 9) A new simple flow field design has been designed. 10) A procedure for integrated seals has been developed (au)

  15. Development of Novel PEM Membrane and Multiphase CD Modeling of PEM Fuel Cell

    Energy Technology Data Exchange (ETDEWEB)

    K. J. Berry; Susanta Das

    2009-12-30

    To understand heat and water management phenomena better within an operational proton exchange membrane fuel cell's (PEMFC) conditions, a three-dimensional, two-phase computational fluid dynamic (CFD) flow model has been developed and simulated for a complete PEMFC. Both liquid and gas phases are considered in the model by taking into account the gas flow, diffusion, charge transfer, change of phase, electro-osmosis, and electrochemical reactions to understand the overall dynamic behaviors of species within an operating PEMFC. The CFD model is solved numerically under different parametric conditions in terms of water management issues in order to improve cell performance. The results obtained from the CFD two-phase flow model simulations show improvement in cell performance as well as water management under PEMFCs operational conditions as compared to the results of a single phase flow model available in the literature. The quantitative information obtained from the two-phase model simulation results helped to develop a CFD control algorithm for low temperature PEM fuel cell stacks which opens up a route in designing improvement of PEMFC for better operational efficiency and performance. To understand heat and water management phenomena better within an operational proton exchange membrane fuel cell's (PEMFC) conditions, a three-dimensional, two-phase computational fluid dynamic (CFD) flow model has been developed and simulated for a complete PEMFC. Both liquid and gas phases are considered in the model by taking into account the gas flow, diffusion, charge transfer, change of phase, electro-osmosis, and electrochemical reactions to understand the overall dynamic behaviors of species within an operating PEMFC. The CFD model is solved numerically under different parametric conditions in terms of water management issues in order to improve cell performance. The results obtained from the CFD two-phase flow model simulations show improvement in cell

  16. Use of biogas in PEM fuel cells; Einsatz von Biogas in PEM-Brennstoffzellen

    Energy Technology Data Exchange (ETDEWEB)

    Scholz, Volkhard; Schmersahl, Ralf; Ellner, Janine (comps.)

    2009-06-15

    This research project was dedicated to two problems: 1. What demands must biogas meet in order to conform to the specifications of PEM fuel cell systems and permit safe operation? 2. How must a fuel cell system be designed and operated in order to be well-adapted to the special features of biogas as opposed to natural gas? For this purpose biogas samples were taken from laboratory-scale and commercial plants and analysed by gas chromatography using various substrates and methods. By combining this with the use of a mass spectroscopy detector (GC-MS system) it was possible to perform a qualitative and quantitative analysis of sulphurious trace gases in the biogas which might cause damage to the fuel cell system. Investigations were performed on an experimental reformer using either modelled or native biogas of different compositions, the intent being to obtain information for the design of the individual process stages. The two operating parameters steam-methane ratio (or S/C ratio) and reforming temperature were varied to optimise parameter settings in terms of energy efficiency. By linking the reformer to a 500 W fuel cell it was possible confirm the suitability of the reformed biogas for use in fuel cells. [German] In diesm Forschungsvorhaben werden zwei Fragestellungen bearbeitet: 1. Welche Anforderungen ergeben sich an das Biogas, um den Spezifikationen von PEM-Brennstoffzellensystemen zu genuegen und eine sicheren Betrieb zu ermoeglichen? 2. Wie muss das Brennstoffzellensystem ausgelegt und gefuehrt werden, um den Besonderheiten von Biogas im Vergleich zu Erdgas Rechnung zu tragen? Dazu wurden Biogasproben aus Labor- und Praxisanlagen unter Beruecksichtigung unterschiedlicher Substrate und Verfahren gaschromatisch analysiert. Die Kopplung mit einem massenspektroskopischen Detektor (GC-MS System) ermoeglicht dabei die Qualifizierung und Quantifizierung der vorhandenen schwefelhaltigen Spurengase, die eine Schaedigung von Brennstoffzellenanlagen verursachen. Die

  17. Quantify and improve PEM fuel cell durability. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Grahl-Madsen, L.; Odgaard, M.; Munksgaard Nielsen, R. (IRD Fuel Cell A/S, Svendborg (Denmark)); Li, Q.; Jensen, Jens Oluf (Technical Univ. of Denmark, Dept. of Chemistry, Kgs. Lyngby (Denmark)); Andersen, Shuang Ma; Speder, J.; Skou, E. (Syddansk Univ. (SDU), Odense (Denmark))

    2010-07-01

    The aim of the present project is to systematically quantify and improve the durability of the PEM FC including the following three PEM FC variants: LT PEM FC, DMFC, and HT PEM FC. Different factors influencing dissolution properties of noble metal catalyst platinum and platinum-ruthenium alloy has been studied. The dissolution was found to increase by increasing the CV cycle upper potential limit, number of potential cycles, solution acidity, oxygen partial pressure, involvement of chloride, and temperature. Ruthenium was found to deteriorate ten (10) times faster than platinum catalyst; and carbon supported catalyst (Pt: 20%, Ru: up to 100%) deteriorate ten (10) times faster than non-supported catalyst (Pt: 2%, Ru: 30%) at the same condition. Loss of sulphonic acid groups and fluoride from perfluorinated sulfonic acid membrane was confirmed by different techniques, which locally leads to loss of acidity, and consequently enhances dissolution of noble metal catalyst. Degradation of Nafion ionomer in the electrode was enhanced by noble metal catalyst and the thermal decomposition properties has synergetic effect with carbon degradation. Hydrophobicity of GDL and electrode on GDL were found to degrade e.g. radical attack, oxidation, and physical wear out. The very top micro surface structure turned out to be responsible for wetting property after chemical ageing. Optimal catalyst and ionomer ratio is also reflected in contact angle value, which can be understood in terms of catalyst/carbon - ionomer affinity and layered structure. Long-term tested and 'virgin' LT PEM MEAs have been characterised with respect to SEM, TEM, EDS, and XRD. Both failed and well-functioning MEAs have been characterised. The Post Mortem analysis has shown and quantified degradation mechanisms like catalyst growth and carbon corrosion. Furthermore, the effect of fuel starvation was shown by pronounced Ru-catalyst band within the membrane. The catalyst coarsening observed after

  18. Nutritional evaluation of patients receiving dialysis for the management of protein-energy wasting: what is old and what is new?

    Science.gov (United States)

    Riella, Miguel C

    2013-05-01

    Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  19. Malnutrition and Risk of Structural Brain Changes Seen on Magnetic Resonance Imaging in Older Adults.

    Science.gov (United States)

    de van der Schueren, Marian A E; Lonterman-Monasch, Sabine; van der Flier, Wiesje M; Kramer, Mark H; Maier, Andrea B; Muller, Majon

    2016-12-01

    To study the associations between protein energy malnutrition, micronutrient malnutrition, brain atrophy, and cerebrovascular lesions. Cross-sectional. Geriatric outpatient clinic. Older adults (N = 475; mean age 80 ± 7). Nutritional status was assessed using the Mini Nutritional Assessment (MNA) and according to serum micronutrient levels (vitamins B1, B6, B12, D; folic acid). White matter hyperintensities (WMHs), global cortical brain atrophy, and medial temporal lobe atrophy on magnetic resonance imaging (MRI) were rated using visual rating scales. Logistic regression analyses were performed to assess associations between the three MNA categories (malnutrition (MNA = 17-23.5). Participants at risk of malnutrition (odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.01-3.71) or who were malnourished (OR = 2.80, 95% CI = 1.19-6.60) had a greater probability of having severe WMHs independent of age and sex than those with adequate nutritional status. Results remained significant after further adjustments for cognitive function, depressive symptoms, cardiovascular risk factors, history of cardiovascular disease, smoking and alcohol use, and micronutrient levels. Lower vitamin B1 (OR = 1.51, 95% CI = 1.11-2.08) and B12 (OR = 1.45, 95% CI = 1.02-2.04) levels were also related to greater risk of severe WMHs, independent of age and sex. Results remained significant after additional adjustments. MNA and vitamin levels were not associated with measures of brain atrophy. Malnutrition and lower vitamin B1 and B12 levels were independently associated with greater risk of WMHs. Underlying mechanisms need to be further clarified, and whether nutritional interventions can modify these findings also needs to be studied. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  20. Socioeconomic inequality in malnutrition in developing countries

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); A.R. Hosseinpoor (Ahmad); N. Speybroeck (Niko); T.G.M. van Ourti (Tom); J. Vega (Jeanette)

    2008-01-01

    textabstractObjective: The objectives of this study were to report on socioeconomic inequality in childhood malnutrition in the developing world, to provide evidence for an association between socioeconomic inequality and the average level of malnutrition, and to draw attention to different patterns

  1. To the limit of extreme malnutrition

    DEFF Research Database (Denmark)

    Frølich, Jacob; Buskbjerg, Camilla Viola; Støving, Rene K

    2016-01-01

    Extreme malnutrition with body mass index (BMI) as low as 10 kg/m(2) is not uncommon in anorexia nervosa, with survival enabled through complex metabolic adaptations. In contrast, outcomes from hunger strikes and famines are usually fatal after weight loss to about 40% below expected body weight...... malnutrition has not previously been reported. The present case emphasizes the importance of adherence...

  2. Malnutrition: more than the eye can see

    NARCIS (Netherlands)

    van Leth, F. C.; Koeleman, J. M.; Manya, A. S.

    2000-01-01

    To assess the magnitude of malnutrition in a hospital setting and to relate anthropometric measures to the clinical diagnosis of malnutrition. A descriptive study whereby anthropometric measures (length and weight) were taken of every child under the age of five years who was admitted to the

  3. Early Malnutrition and Central Nervous System Function

    Science.gov (United States)

    Scrimshaw, Nevin S.

    1969-01-01

    Discusses the consequences of severe malnutrition in young experimental animals. Development of the brain is permanently impaired. Studies of the effects of malnutrition on children are included. (This paper was presented at the Eighth Annual Lecture of the Merrill-Palmer Historical Library in Child Development and Family Life, October 25, 1968.)…

  4. Complications associated with malnutrition in elective surgical ...

    African Journals Online (AJOL)

    Purpose: To identify the level of malnutrition and complications observed in Malaysia. Methods: A prospective, observational study was conducted with the objectives of identifying the degree of malnutrition, complications and the need for nutritional support in elective surgical patients. Collection of data was performed in ...

  5. Malnutrition: Missed opportunities for diagnosis | Antwi | Ghana ...

    African Journals Online (AJOL)

    Introduction: Malnutrition is a serious public health problem particularly in developing countries where it is responsible for 54% of under 5s mortality. Anthropometric measurements are key tools for the assessment of nutritional status and diagnosis of malnutrition. Height and weight measurements are not routinely done in ...

  6. Protein-energy wasting syndrome in advanced chronic kidney disease: prevalence and specific clinical characteristics.

    Science.gov (United States)

    Pérez-Torres, Almudena; González Garcia, M Elena; San José-Valiente, Belén; Bajo Rubio, M Auxiliadora; Celadilla Diez, Olga; López-Sobaler, Ana M; Selgas, Rafael

    Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA). Cross-sectional study of 186 patients (101 men) with a mean age of 66.1±16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio. The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084-1.457, p=0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893-0.983, p=0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998-0.999, p=0.001) and cell mass index (OR: 0.995; 95% CI: 0.992-0.998). Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  7. Decomposition of childhood malnutrition in Cambodia.

    Science.gov (United States)

    Sunil, Thankam S; Sagna, Marguerite

    2015-10-01

    Childhood malnutrition is a major problem in developing countries, and in Cambodia, it is estimated that approximately 42% of the children are stunted, which is considered to be very high. In the present study, we examined the effects of proximate and socio-economic determinants on childhood malnutrition in Cambodia. In addition, we examined the effects of the changes in these proximate determinants on childhood malnutrition between 2000 and 2005. Our analytical approach included descriptive, logistic regression and decomposition analyses. Separate analyses are estimated for 2000 and 2005 survey. The primary component of the difference in stunting is attributable to the rates component, indicating that the decrease of stunting is due mainly to the decrease in stunting rates between 2000 and 2005. While majority of the differences in childhood malnutrition between 2000 and 2005 can be attributed to differences in the distribution of malnutrition determinants between 2000 and 2005, differences in their effects also showed some significance. © 2013 John Wiley & Sons Ltd.

  8. Experimental Characterization and Modeling of PEM Fuel Cells

    DEFF Research Database (Denmark)

    Jespersen, Jesper Lebæk

    fundamental knowledge of the transport and electrochemical processes of PEM fuel cells and to provide methods for obtaining high quality data for PEM fuel cell simulation model validation. In this thesis three different areas of experimental characterization techniques was investigated, they include: Stack...... for obtaining very detailed data of the manifold flow. Moreover, the tools complement each other well, as high quality validation data can be obtained from PIV measurements to verify CFD models. AC Impedance Spectroscopy was used to thoroughly characterize a HTPEM single cell. The measurement method...... was furthermore transferred onto a Labview platform, which signiffcantly improves the exibility and lowers the cost of using this method. This technique is expected to bea very important future tool, used both for material characterization, celldiagnostic, system optimization and as a control input parameter...

  9. Building a Predictive Capability for Decision-Making that Supports MultiPEM

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, Joshua Daniel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-11-20

    Multi-phenomenological explosion monitoring (multiPEM) is a developing science that uses multiple geophysical signatures of explosions to better identify and characterize their sources. MultiPEM researchers seek to integrate explosion signatures together to provide stronger detection, parameter estimation, or screening capabilities between different sources or processes. This talk will address forming a predictive capability for screening waveform explosion signatures to support multiPEM.

  10. Degradation mechanisms and accelerated testing in PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Borup, Rodney L [Los Alamos National Laboratory; Mukundan, Rangachary [Los Alamos National Laboratory

    2010-01-01

    The durability of PEM fuel cells is a major barrier to the commercialization of these systems for stationary and transportation power applications. Although there has been recent progress in improving durability, further improvements are needed to meet the commercialization targets. Past improvements have largely been made possible because of the fundamental understanding of the underlying degradation mechanisms. By investigating component and cell degradation modes; defining the fundamental degradation mechanisms of components and component interactions new materials can be designed to improve durability. Various factors have been shown to affect the useful life of PEM fuel cells. Other issues arise from component optimization. Operational conditions (such as impurities in either the fuel and oxidant stream), cell environment, temperature (including subfreezing exposure), pressure, current, voltage, etc.; or transient versus continuous operation, including start-up and shutdown procedures, represent other factors that can affect cell performance and durability. The need for Accelerated Stress Tests (ASTs) can be quickly understood given the target lives for fuel cell systems: 5000 hours ({approx} 7 months) for automotive, and 40,000 hrs ({approx} 4.6 years) for stationary systems. Thus testing methods that enable more rapid screening of individual components to determine their durability characteristics, such as off-line environmental testing, are needed for evaluating new component durability in a reasonable turn-around time. This allows proposed improvements in a component to be evaluated rapidly and independently, subsequently allowing rapid advancement in PEM fuel cell durability. These tests are also crucial to developers in order to make sure that they do not sacrifice durability while making improvements in costs (e.g. lower platinum group metal [PGM] loading) and performance (e.g. thinner membrane or a GDL with better water management properties). To

  11. Experimental characterization of the Clear-PEM scanner spectrometric performance

    Energy Technology Data Exchange (ETDEWEB)

    Bugalho, R; Carrico, B; Ferreira, C S; Frade, M; Ferreira, M; Moura, R; Ortigao, C; Pinheiro, J F; Rodrigues, P; Rolo, I; Silva, J C; Trindade, A; Varela, J [Laboratorio de Instrumentacao e Fisica Experimental de Particulas (LIP), Av. Elias Garcia 14-1, 1000-149 Lisboa (Portugal)], E-mail: frade@lip.pt

    2009-10-15

    In the framework of the Clear-PEM project for the construction of a high-resolution and high-specificity scanner for breast cancer imaging, a Positron Emission Mammography tomograph has been developed and installed at the Instituto Portugues de Oncologia do Porto hospital. The Clear-PEM scanner is mainly composed by two planar detector heads attached to a robotic arm, trigger/data acquisition electronics system and computing servers. The detector heads hold crystal matrices built from 2 x 2 x 20 mm{sup 3} LYSO:Ce crystals readout by Hamamatsu S8550 APD arrays. The APDs are optically coupled to both ends of the 6144 crystals in order to extract the DOI information for each detected event. Each one of 12288 APD's pixels is read and controlled by Application Specific Integrated Circuits water-cooled by an external cooling unit. The Clear-PEM frontend boards innovative design results in a unprecedented integration of the crystal matrices, APDs and ASICs, making Clear-PEM the PET scanner with the highest number of APD pixels ever integrated so far. In this paper, the scanner's main technical characteristics, calibration strategies and the first spectrometric performance evaluation in a clinical environment are presented. The first commissioning results show 99.7% active channels, which, after calibration, have inter-pixel and absolute gain distributions with dispersions of, respectively, 12.2% and 15.3%, demonstrating that despite the large number of channels, the system is uniform. The mean energy resolution at 511 keV is of 15.9%, with a 8.8% dispersion, and the mean C{sub DOI}{sup -1} is 5.9%/mm, with a 7.8% dispersion. The coincidence time resolution, at 511 keV, for a energy window between 400 and 600 keV, is 5.2 ns FWHM.

  12. Hydrogen-Oxygen PEM Regenerative Fuel Cell Energy Storage System

    Science.gov (United States)

    Bents, David J.; Scullin, Vincent J.; Chang, Bei-Jiann; Johnson, Donald W.; Garcia, Christopher P.

    2005-01-01

    An introduction to the closed cycle hydrogen-oxygen polymer electrolyte membrane (PEM) regenerative fuel cell (RFC), recently constructed at NASA Glenn Research Center, is presented. Illustrated with explanatory graphics and figures, this report outlines the engineering motivations for the RFC as a solar energy storage device, the system requirements, layout and hardware detail of the RFC unit at NASA Glenn, the construction history, and test experience accumulated to date with this unit.

  13. Clear-PEM: A dedicated PET camera for improved breast cancer detection

    International Nuclear Information System (INIS)

    Abreu, M. C.; Almeida, P.; Balau, F.; Ferreira, N. C.; Fetal, S.; Fraga, F.; Martins, M.; Matela, N.; Moura, R.; Ortigao, C.; Peralta, L.; Rato, P.; Ribeiro, R.; Rodrigues, P.; Santos, A. I.; Trindade, A.; Varela, J.

    2005-01-01

    Positron emission mammography (PEM) can offer a non-invasive method for the diagnosis of breast cancer. Metabolic images from PEM using 18 F-fluoro-deoxy-glucose, contain unique information not available from conventional morphologic imaging techniques like X-ray radiography. In this work, the concept of Clear-PEM, the system presently developed in the frame of the Crystal Clear Collaboration at CERN, is described. Clear-PEM will be a dedicated scanner, offering better perspectives in terms of position resolution and detection sensitivity. (authors)

  14. Performance and quality control of Clear-PEM detector modules

    International Nuclear Information System (INIS)

    Amaral, Pedro; Carrico, Bruno; Ferreira, Miguel; Moura, Rui; Ortigao, Catarina; Rodrigues, Pedro; Da Silva, Jose C.; Trindade, Andreia; Varela, Joao

    2007-01-01

    Clear-PEM is a dedicated PET scanner for breast and axilla cancer diagnosis, under development within the framework of the Crystal Clear Collaboration at CERN, aiming at the detection of tumors down to 2 mm in diameter. The camera consists of two planar detector heads with active dimensions 16.0x14.5 cm 2 . Each head has 96 Clear-PEM detector modules consisting of 32 LYSO:Ce pixels with dimensions 2x2x20 mm 3 packed in a 4x8 BaSO 4 reflector matrix compressed between two Hamamatsu S8550 APD arrays in a double-readout configuration for Depth-of-Interaction (DoI) determination. The modules are individually measured and characterized before being grouped into Supermodules (comprised of 24 modules). Measured properties include photo-peak position, relative gain dispersion, energy resolution, cross-talk and DoI resolution. Optical inspection of matrices was also performed with the aid of a microscope, to search for pixel misalignments and matrix defects. Modules' performance was thoroughly evaluated with a 511 keV collimated beam to exactly determine DoI resolution. In addition, a fast quality control (QC) procedure using flood irradiations from a 137 Cs source was applied systematically. The overall performance of the 24 detector modules complies with the design goals of the Clear-PEM detector, showing energy resolution around 15%, DoI resolution of about 2 mm and gain dispersion among pixels of 15%

  15. Fuel starvation. Irreversible degradation mechanisms in PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Rangel, Carmen M.; Silva, R.A.; Travassos, M.A.; Paiva, T.I.; Fernandes, V.R. [LNEG, National Laboratory for Energy and Geology, Lisboa (Portugal). UPCH Fuel Cells and Hydrogen Unit

    2010-07-01

    PEM fuel cell operates under very aggressive conditions in both anode and cathode. Failure modes and mechanism in PEM fuel cells include those related to thermal, chemical or mechanical issues that may constrain stability, power and lifetime. In this work, the case of fuel starvation is examined. The anode potential may rise to levels compatible with the oxidization of water. If water is not available, oxidation of the carbon support will accelerate catalyst sintering. Diagnostics methods used for in-situ and ex-situ analysis of PEM fuel cells are selected in order to better categorize irreversible changes of the cell. Electrochemical Impedance Spectroscopy (EIS) is found instrumental in the identification of fuel cell flooding conditions and membrane dehydration associated to mass transport limitations / reactant starvation and protonic conductivity decrease, respectively. Furthermore, it indicates that water electrolysis might happen at the anode. Cross sections of the membrane catalyst and gas diffusion layers examined by scanning electron microscopy indicate electrode thickness reduction as a result of reactions taking place during hydrogen starvation. Catalyst particles are found to migrate outwards and located on carbon backings. Membrane degradation in fuel cell environment is analyzed in terms of the mechanism for fluoride release which is considered an early predictor of membrane degradation. (orig.)

  16. Non-platinum electrocatalysts for PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.; Zhang, L.; Shi, Z.; Hui, R.; Zhang, J. [National Research Council of Canada, Vancouver, BC (Canada). Inst. For Fuel Cell Innovation

    2008-07-01

    High cost, low reliability and durability are the main barriers preventing widespread commercialization of fuel cells. In particular, the platinum (Pt)-based electrocatalysts used in proton exchange membrane (PEM) fuel cells, including direct methanol fuel cells (DMFCs) are major contributors to the high cost of PEM fuel cells. The Institute for Fuel Cell Innovation at the National Research Council of Canada has developed several new non-Pt electrocatalysts for PEM fuel cell applications. This paper presented the research results on these catalysts, including transition metal macrocycles, chalcogenides, and Ir- or Pd-based alloys. It also described catalyst structure modes via theoretical density functional theory (DFT) calculations. Research activities on these electrocatalysts was summarized in terms of catalytic activity and the oxygen reduction reaction (ORR). Typical catalysts such as cobalt(Co)-polypyrrole (PPy) and the chalcogenides show promising results in terms of catalytic activity and a 4-electron reaction mechanism. Efforts are underway to modify both catalyst structure and synthesis methods in order to further improve catalyst performance. 4 refs., 2 figs.

  17. Production of hydrogen using composite membrane in PEM water electrolysis

    Energy Technology Data Exchange (ETDEWEB)

    Santhi priya, E.L.; Mahender, C.; Mahesh, Naga; Himabindu, V. [Centre for Environment, Institute of Science and Technology, Jawaharlal Nehru Technological University Hyderabad, Kukatpally, Hyderabad-500 085, A.P (India); Anjaneyulu, Y. [Director, TLGVRC, JSU Box 18739, JSU, Jackson, MS 32917-0939 (United States)

    2012-07-01

    Electrolysis of water is the best known technology till today to produce hydrogen. The only practical way to produce hydrogen using renewable energy sources is by proton exchange membrane (PEM) water electrolysis. The most commonly used PEM membrane is Nafion. Composite membrane of TiO2 is synthesized by casting method using Nafion 5wt% solution. RuO2 is used as anode and 10 wt% Pd on activated carbon is used as cathode in the water electrolyser system. The performance of this Composite membrane is studied by varying voltage range 1.8 to 2.6V with respect to hydrogen yield and at current density 0.1, 0.2, 0.3, 0.4, and 0.5(A cm-2). This Composite membrane has been tested using in-house fabricated single cell PEM water electrolysis cell with 10cm2 active area at temperatures ranging from 30,45,65 850c and at 1 atmosphere pressure.

  18. Commercialization of proton exchange membrane (PEM) fuel cell technology

    International Nuclear Information System (INIS)

    Goel, N.; Pant, A.; Sera, G.

    1995-01-01

    The MCTTC performed a market assessment for PEM Fuel Cells for terrestrial applications for the Center for Space Power (CSP). The purpose of the market assessment was to gauge the market and commercial potential for PEM fuel cell technology. Further, the market assessment was divided into subsections of technical and market overview, competitive environment, political environment, barriers to market entry, and keys to market entry. The market assessment conducted by the MCTTC involved both secondary and primary research. The primary target markets for PEM fuel cells were transportation and utilities in the power range of 10 kW to 100 kW. The fuel cell vehicle market size was estimated under a pessimistic scenario and an optimistic scenario. The estimated size of the fuel cell vehicle market in dollar terms for the year 2005 is $17.3 billion for the pessimistic scenario and $34.7 billion for the optimistic scenario. The fundamental and applied research funded and conducted by the National Aeronautics and Space Administration (NASA) and DOE in the area of fuel cells presents an excellent opportunity to commercialize dual-use technology and enhance U.S. business competitiveness. copyright 1995 American Institute of Physics

  19. Severe acute malnutrition and infection

    Science.gov (United States)

    Jones, Kelsey D J; Berkley, James A

    2014-01-01

    Severe acute malnutrition (SAM) is associated with increased severity of common infectious diseases, and death amongst children with SAM is almost always as a result of infection. The diagnosis and management of infection are often different in malnourished versus well-nourished children. The objectives of this brief are to outline the evidence underpinning important practical questions relating to the management of infectious diseases in children with SAM and to highlight research gaps. Overall, the evidence base for many aspects covered in this brief is very poor. The brief addresses antimicrobials; antipyretics; tuberculosis; HIV; malaria; pneumonia; diarrhoea; sepsis; measles; urinary tract infection; nosocomial Infections; soil transmitted helminths; skin infections and pharmacology in the context of SAM. The brief is structured into sets of clinical questions, which we hope will maximise the relevance to contemporary practice. PMID:25475887

  20. Structured modelling and nonlinear analysis of PEM fuel cells; Strukturierte Modellierung und nichtlineare Analyse von PEM-Brennstoffzellen

    Energy Technology Data Exchange (ETDEWEB)

    Hanke-Rauschenbach, R.

    2007-10-26

    In the first part of this work a model structuring concept for electrochemical systems is presented. The application of such a concept for the structuring of a process model allows it to combine different fuel cell models to form a whole model family, regardless of their level of detail. Beyond this the concept offers the opportunity to flexibly exchange model entities on different model levels. The second part of the work deals with the nonlinear behaviour of PEM fuel cells. With the help of a simple, spatially lumped and isothermal model, bistable current-voltage characteristics of PEM fuel cells operated with low humidified feed gases are predicted and discussed in detail. The cell is found to exhibit current-voltage curves with pronounced local extrema in a parameter range that is of practical interest when operated at constant feed gas flow rates. (orig.)

  1. Effect of compressive force on PEM fuel cell performance

    Science.gov (United States)

    MacDonald, Colin Stephen

    Polymer electrolyte membrane (PEM) fuel cells possess the potential, as a zero-emission power source, to replace the internal combustion engine as the primary option for transportation applications. Though there are a number of obstacles to vast PEM fuel cell commercialization, such as high cost and limited durability, there has been significant progress in the field to achieve this goal. Experimental testing and analysis of fuel cell performance has been an important tool in this advancement. Experimental studies of the PEM fuel cell not only identify unfiltered performance response to manipulation of variables, but also aid in the advancement of fuel cell modelling, by allowing for validation of computational schemes. Compressive force used to contain a fuel cell assembly can play a significant role in how effectively the cell functions, the most obvious example being to ensure proper sealing within the cell. Compression can have a considerable impact on cell performance beyond the sealing aspects. The force can manipulate the ability to deliver reactants and the electrochemical functions of the cell, by altering the layers in the cell susceptible to this force. For these reasons an experimental study was undertaken, presented in this thesis, with specific focus placed on cell compression; in order to study its effect on reactant flow fields and performance response. The goal of the thesis was to develop a consistent and accurate general test procedure for the experimental analysis of a PEM fuel cell in order to analyse the effects of compression on performance. The factors potentially affecting cell performance, which were a function of compression, were identified as: (1) Sealing and surface contact; (2) Pressure drop across the flow channel; (3) Porosity of the GDL. Each factor was analysed independently in order to determine the individual contribution to changes in performance. An optimal degree of compression was identified for the cell configuration in

  2. Danish research and development in PEM fuel cell technology. Status for strategy follow up; Dansk forskning og udvikling inden for PEM-braendselscelleteknologi. Status for strategiopfoelgning

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-11-15

    PEM fuel cell technology shows promise as to efficient and environmental friendly production of power and heat. Furthermore, the technology can be used for production of hydrogen through electrolysis of water. In Denmark research and development focus on PEM fuel cells for low temperatures (up to c 80 deg. C) as well as for high temperatures (up to 200 deg. C). This note summarizes the present plane for research and development in PEM in Denmark, including status for development within specific areas i.e. basic research and development, process development, cell and stack development and tests, and system development. (BA)

  3. DOD Residential Proton Exchange Membrane (PEM) Fuel Cell Demonstration Program. Volume 2. Summary of Fiscal Year 2001-2003 Projects

    Science.gov (United States)

    2005-09-01

    produced many of the Beatles 1970s recordings. This facility was selected to host the UK PEM demonstration project from a selection of four potential sites...funded the Department of Defense (DOD) Residential PEM Demonstration Project to demonstrate domestically-produced, residential Proton Exchange Membrane...PEM) fuel cells at DOD Facilities. The objectives were to: (1) assess PEM fuel cells’ role in supporting sustainability at military installations

  4. Malnutrition and vaccination in developing countries

    Science.gov (United States)

    Prendergast, Andrew J.

    2015-01-01

    Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge. PMID:25964453

  5. Malnutrition in Patients with Acute Stroke

    Directory of Open Access Journals (Sweden)

    Stella D. Bouziana

    2011-01-01

    Full Text Available Stroke is a devastating event that carries a potential for long-term disability. Malnutrition is frequently observed in patients with stroke, and dysphagia contributes to malnutrition risk. During both the acute phase of stroke and rehabilitation, specific nutritional interventions in the context of a multidisciplinary team effort can enhance the recovery of neurocognitive function. Early identification and management of malnutrition with dietary modifications or specific therapeutic strategies to ensure adequate nutritional intake should receive more attention, since poor nutritional status appears to exacerbate brain damage and to contribute to adverse outcome. The main purpose of nutritional intervention should be the prevention or treatment of complications resulting from energy-protein deficit. This paper reviews the evaluation and management of malnutrition and the use of specialized nutrition support in patients with stroke. Emphasis is given to enteral tube and oral feeding and to strategies to wean from tube feeding.

  6. Child malnutrition in Tigray, Northern Ethiopia

    NARCIS (Netherlands)

    Mulugeta, A.; Hagos, F.; Kruseman, G.; Linderhof, V.G.M.; Stroecker, B.; Abraha, Z.; Yohannes, M.; Samuel, G.G.

    2010-01-01

    Objective: Estimate levels of and identify factors contributing to child malnutrition in Tigray, Northern Ethiopia. Design: Cross-sectional survey. Setting: Rural communities from four zones of Tigray. Subjects: Three hundred and eighteen under five children representing 587 randomly selected

  7. Prevalence of malnutrition among gynaecological cancer patients

    OpenAIRE

    Hölscher, Claudia

    2011-01-01

    Whereas there is a growing awareness of obesity in the population in Germany and other industrialized countries, the problem of malnutrition goes largely unnoticed among the public. Malnutrition is a common problem in gynaecological oncology patients, but only a few studies cover this topic. The present study documented the nutritional status of 274 consecutively admitted breast, ovarian and cervical carcinoma patients using five different measurement parameters. These included the SGA, the M...

  8. Fidelity in Animal Modeling: Prerequisite for a Mechanistic Research Front Relevant to the Inflammatory Incompetence of Acute Pediatric Malnutrition.

    Science.gov (United States)

    Woodward, Bill

    2016-04-11

    Inflammatory incompetence is characteristic of acute pediatric protein-energy malnutrition, but its underlying mechanisms remain obscure. Perhaps substantially because the research front lacks the driving force of a scholarly unifying hypothesis, it is adrift and research activity is declining. A body of animal-based research points to a unifying paradigm, the Tolerance Model, with some potential to offer coherence and a mechanistic impetus to the field. However, reasonable skepticism prevails regarding the relevance of animal models of acute pediatric malnutrition; consequently, the fundamental contributions of the animal-based component of this research front are largely overlooked. Design-related modifications to improve the relevance of animal modeling in this research front include, most notably, prioritizing essential features of pediatric malnutrition pathology rather than dietary minutiae specific to infants and children, selecting windows of experimental animal development that correspond to targeted stages of pediatric immunological ontogeny, and controlling for ontogeny-related confounders. In addition, important opportunities are presented by newer tools including the immunologically humanized mouse and outbred stocks exhibiting a magnitude of genetic heterogeneity comparable to that of human populations. Sound animal modeling is within our grasp to stimulate and support a mechanistic research front relevant to the immunological problems that accompany acute pediatric malnutrition.

  9. Fidelity in Animal Modeling: Prerequisite for a Mechanistic Research Front Relevant to the Inflammatory Incompetence of Acute Pediatric Malnutrition

    Science.gov (United States)

    Woodward, Bill

    2016-01-01

    Inflammatory incompetence is characteristic of acute pediatric protein-energy malnutrition, but its underlying mechanisms remain obscure. Perhaps substantially because the research front lacks the driving force of a scholarly unifying hypothesis, it is adrift and research activity is declining. A body of animal-based research points to a unifying paradigm, the Tolerance Model, with some potential to offer coherence and a mechanistic impetus to the field. However, reasonable skepticism prevails regarding the relevance of animal models of acute pediatric malnutrition; consequently, the fundamental contributions of the animal-based component of this research front are largely overlooked. Design-related modifications to improve the relevance of animal modeling in this research front include, most notably, prioritizing essential features of pediatric malnutrition pathology rather than dietary minutiae specific to infants and children, selecting windows of experimental animal development that correspond to targeted stages of pediatric immunological ontogeny, and controlling for ontogeny-related confounders. In addition, important opportunities are presented by newer tools including the immunologically humanized mouse and outbred stocks exhibiting a magnitude of genetic heterogeneity comparable to that of human populations. Sound animal modeling is within our grasp to stimulate and support a mechanistic research front relevant to the immunological problems that accompany acute pediatric malnutrition. PMID:27077845

  10. Study on modulation amplitude stabilization method for PEM based on FPGA in atomic magnetometer

    Science.gov (United States)

    Wang, Qinghua; Quan, Wei; Duan, Lihong

    2017-10-01

    Atomic magnetometer which uses atoms as sensitive elements have ultra-high precision and has wide applications in scientific researches. The photoelastic modulation method based on photoelastic modulator (PEM) is used in the atomic magnetometer to detect the small optical rotation angle of a linearly polarized light. However, the modulation amplitude of the PEM will drift due to the environmental factors, which reduces the precision and long-term stability of the atomic magnetometer. Consequently, stabilizing the PEM's modulation amplitude is essential to precision measurement. In this paper, a modulation amplitude stabilization method for PEM based on Field Programmable Gate Array (FPGA) is proposed. The designed control system contains an optical setup and an electrical part. The optical setup is used to measure the PEM's modulation amplitude. The FPGA chip, with the PID control algorithm implemented in it, is used as the electrical part's micro controller. The closed loop control method based on the photoelastic modulation detection system can directly measure the PEM's modulation amplitude in real time, without increasing the additional optical devices. In addition, the operating speed of the modulation amplitude stabilization control system can be greatly improved because of the FPGA's parallel computing feature, and the PID control algorithm ensures flexibility to meet different needs of the PEM's modulation amplitude set values. The Modelsim simulation results show the correctness of the PID control algorithm, and the long-term stability of the PEM's modulation amplitude reaches 0.35% in a 3-hour continuous measurement.

  11. Malnutrition predicting factors in hemodialysis patients.

    Science.gov (United States)

    Jahromi, Soodeh Razeghi; Hosseini, Saeed; Razeghi, Effat; Meysamie, Ali pasha; Sadrzadeh, Haleh

    2010-09-01

    Malnutrition is a predictor of increased mortality in chronic hemodialysis (HD) patients. Various factors may contribute to malnutrition in these patients including energy and protein intake, inflammation, and comorbidity. To determine the importance of these factors in malnutrition of chronic HD patients, we studied 112 chronic HD patients in two centers was evaluated with the Dialysis Malnutrition Score (DMS) and anthropometric and biochemical indices. Seventy six (67.8%) patients were classified as malnourished. According to DMS score, poor protein intake (r= -0.34, Penergy intake (r= - 0.18, Pmalnutrition in descending order of importance. Multiple regression analysis showed that only poor protein intake was the explanatory variable of anthropometric measurements decline including body mass index, triceps skin fold thick-ness, mid arm circumference, mid arm muscle circumference, fat free mass, fat mass, albumin, creatinine and transferrine. None of the mentioned factors predicted the decrease of biochemical markers. We conclude that the frequency of malnutrition is high in our population and poor protein intake is the primary contributing factor for this condition. Therefore, providing enough protein may be a simple and effective way in preventing malnutrition in these patients.

  12. Protein malnutrition induces bone marrow mesenchymal stem cells commitment to adipogenic differentiation leading to hematopoietic failure.

    Science.gov (United States)

    Cunha, Mayara Caldas Ramos; Lima, Fabiana da Silva; Vinolo, Marco Aurélio Ramirez; Hastreiter, Araceli; Curi, Rui; Borelli, Primavera; Fock, Ricardo Ambrósio

    2013-01-01

    Protein malnutrition (PM) results in pathological changes that are associated with peripheral leukopenia, bone marrow (BM) hypoplasia and alterations in the BM microenvironment leading to hematopoietic failure; however, the mechanisms involved are poorly understood. In this context, the BM mesenchymal stem cells (MSCs) are cells intimately related to the formation of the BM microenvironment, and their differentiation into adipocytes is important because adipocytes are cells that have the capability to negatively modulate hematopoiesis. Two-month-old male Balb/c mice were subjected to protein-energy malnutrition with a low-protein diet containing 2% protein, whereas control animals were fed a diet containing 12% protein. The hematopoietic parameters and the expression of CD45 and CD117 positive cells in the BM were evaluated. MSCs were isolated from BM, and their capability to produce SCF, IL-3, G-CSF and GM-CSF were analyzed. The expression of PPAR-γ and C/EBP-α as well as the expression of PPAR-γ and SREBP mRNAs were evaluated in MSCs together with their capability to differentiate into adipocytes in vitro. The malnourished animals had anemia and leukopenia as well as spleen and bone marrow hypoplasia and a reduction in the expression of CD45 and CD117 positive cells from BM. The MSCs of the malnourished mice presented an increased capability to produce SCF and reduced production of G-CSF and GM-CSF. The MSCs from the malnourished animals showed increased expression of PPAR-γ protein and PPAR-γ mRNA associated with an increased capability to differentiate into adipocytes. The alterations found in the malnourished animals allowed us to conclude that malnutrition committed MSC differentiation leading to adipocyte decision and compromised their capacity for cytokine production, contributing to an impaired hematopoietic microenvironment and inducing the bone marrow failure commonly observed in protein malnutrition states.

  13. Protein Malnutrition Induces Bone Marrow Mesenchymal Stem Cells Commitment to Adipogenic Differentiation Leading to Hematopoietic Failure

    Science.gov (United States)

    Cunha, Mayara Caldas Ramos; Lima, Fabiana da Silva; Vinolo, Marco Aurélio Ramirez; Hastreiter, Araceli; Curi, Rui; Borelli, Primavera; Fock, Ricardo Ambrósio

    2013-01-01

    Protein malnutrition (PM) results in pathological changes that are associated with peripheral leukopenia, bone marrow (BM) hypoplasia and alterations in the BM microenvironment leading to hematopoietic failure; however, the mechanisms involved are poorly understood. In this context, the BM mesenchymal stem cells (MSCs) are cells intimately related to the formation of the BM microenvironment, and their differentiation into adipocytes is important because adipocytes are cells that have the capability to negatively modulate hematopoiesis. Two-month-old male Balb/c mice were subjected to protein-energy malnutrition with a low-protein diet containing 2% protein, whereas control animals were fed a diet containing 12% protein. The hematopoietic parameters and the expression of CD45 and CD117 positive cells in the BM were evaluated. MSCs were isolated from BM, and their capability to produce SCF, IL-3, G-CSF and GM-CSF were analyzed. The expression of PPAR-γ and C/EBP-α as well as the expression of PPAR-γ and SREBP mRNAs were evaluated in MSCs together with their capability to differentiate into adipocytes in vitro. The malnourished animals had anemia and leukopenia as well as spleen and bone marrow hypoplasia and a reduction in the expression of CD45 and CD117 positive cells from BM. The MSCs of the malnourished mice presented an increased capability to produce SCF and reduced production of G-CSF and GM-CSF. The MSCs from the malnourished animals showed increased expression of PPAR-γ protein and PPAR-γ mRNA associated with an increased capability to differentiate into adipocytes. The alterations found in the malnourished animals allowed us to conclude that malnutrition committed MSC differentiation leading to adipocyte decision and compromised their capacity for cytokine production, contributing to an impaired hematopoietic microenvironment and inducing the bone marrow failure commonly observed in protein malnutrition states. PMID:23516566

  14. Development of ClearPEM-Sonic, a multimodal mammography system for PET and Ultrasound

    Science.gov (United States)

    Cucciati, G.; Auffray, E.; Bugalho, R.; Cao, L.; Di Vara, N.; Farina, F.; Felix, N.; Frisch, B.; Ghezzi, A.; Juhan, V.; Jun, D.; Lasaygues, P.; Lecoq, P.; Mensah, S.; Mundler, O.; Neves, J.; Paganoni, M.; Peter, J.; Pizzichemi, M.; Siles, P.; Silva, J. C.; Silva, R.; Tavernier, S.; Tessonnier, L.; Varela, J.

    2014-03-01

    ClearPEM-Sonic is an innovative imaging device specifically developed for breast cancer. The possibility to work in PEM-Ultrasound multimodality allows to obtain metabolic and morphological information increasing the specificity of the exam. The ClearPEM detector is developed to maximize the sensitivity and the spatial resolution as compared to Whole-Body PET scanners. It is coupled with a 3D ultrasound system, the SuperSonic Imagine Aixplorer that improves the specificity of the exam by providing a tissue elasticity map. This work describes the ClearPEM-Sonic project focusing on the technological developments it has required, the technical merits (and limits) and the first multimodal images acquired on a dedicated phantom. It finally presents selected clinical case studies that confirm the value of PEM information.

  15. Development of ClearPEM-Sonic, a multimodal mammography system for PET and Ultrasound

    International Nuclear Information System (INIS)

    Cucciati, G; Vara, N Di; Ghezzi, A; Paganoni, M; Pizzichemi, M; Auffray, E; Frisch, B; Lecoq, P; Bugalho, R; Neves, J; Cao, L; Peter, J; Farina, F; Felix, N; Juhan, V; Mundler, O; Siles, P; Jun, D; Lasaygues, P; Mensah, S

    2014-01-01

    ClearPEM-Sonic is an innovative imaging device specifically developed for breast cancer. The possibility to work in PEM-Ultrasound multimodality allows to obtain metabolic and morphological information increasing the specificity of the exam. The ClearPEM detector is developed to maximize the sensitivity and the spatial resolution as compared to Whole-Body PET scanners. It is coupled with a 3D ultrasound system, the SuperSonic Imagine Aixplorer that improves the specificity of the exam by providing a tissue elasticity map. This work describes the ClearPEM-Sonic project focusing on the technological developments it has required, the technical merits (and limits) and the first multimodal images acquired on a dedicated phantom. It finally presents selected clinical case studies that confirm the value of PEM information

  16. Characterization of PM-PEMS for in-use measurements conducted during validation testing for the PM-PEMS measurement allowance program

    Science.gov (United States)

    Khan, M. Yusuf; Johnson, Kent C.; Durbin, Thomas D.; Jung, Heejung; Cocker, David R.; Bishnu, Dipak; Giannelli, Robert

    2012-08-01

    This study provides an evaluation of the latest Particulate Matter-Portable Emissions Measurement Systems (PM-PEMS) under different environmental and in-use conditions. It characterizes four PM measurement systems based on different measurement principles. At least three different units were tested for each PM-PEMS to account for variability. These PM-PEMS were compared with a UC Riverside's mobile reference laboratory (MEL). PM measurements were made from a class 8 truck with a 2008 Cummins diesel engine with a diesel particulate filter (DPF). A bypass around the DPF was installed in the exhaust to achieve a brake specific PM (bsPM) emissions level of 25 mg hp-1h-1. PM was dominated by elemental carbon (EC) during non-regeneration conditions and by hydrated sulfate (H2SO4.6H2O) during regeneration. The photo-acoustic PM-PEMS performed best, with a linear regression slope of 0.90 and R2 of 0.88 during non-regenerative conditions. With the addition of a filter, the photo-acoustic PM-PEMS slightly over reported than the total PM mass (slope = 1.10, R2 = 0.87). Under these same non-regeneration conditions, a PM-PEMS equipped with a quartz crystal microbalance (QCM) technology performed the poorest, and had a slope of 0.22 and R2 of 0.13. Re-tests performed on upgraded QCM PM-PEMS showed a better slope (0.66), and a higher R2 of 0.25. In the case of DPF regeneration, all PM-PEMS performed poorly, with the best having a slope of 0.20 and R2 of 0.78. Particle size distributions (PSD) showed nucleation during regeneration, with a shift of particle size to smaller diameters (˜64 nm to ˜13 nm) with elevated number concentrations when compared to non-regeneration conditions.

  17. Laser Ablation Increases PEM/Catalyst Interfacial Area

    Science.gov (United States)

    Whitacre, Jay; Yalisove, Steve

    2009-01-01

    An investigational method of improving the performance of a fuel cell that contains a polymer-electrolyte membrane (PEM) is based on the concept of roughening the surface of the PEM, prior to deposition of a thin layer of catalyst, in order to increase the PEM/catalyst interfacial area and thereby increase the degree of utilization of the catalyst. The roughening is done by means of laser ablation under carefully controlled conditions. Next, the roughened membrane surface is coated with the thin layer of catalyst (which is typically platinum), then sandwiched between two electrode/catalyst structures to form a membrane/ele c t - rode assembly. The feasibility of the roughening technique was demonstrated in experiments in which proton-conducting membranes made of a perfluorosulfonic acid-based hydrophilic, protonconducting polymer were ablated by use of femtosecond laser pulses. It was found that when proper combinations of the pulse intensity, pulse-repetition rate, and number of repetitions was chosen, the initially flat, smooth membrane surfaces became roughened to such an extent as to be converted to networks of nodules interconnected by filaments (see Figure 1). In further experiments, electrochemical impedance spectroscopy (EIS) was performed on a pristine (smooth) membrane and on two laser-roughened membranes after the membranes were coated with platinum on both sides. Some preliminary EIS data were interpreted as showing that notwithstanding the potential for laser-induced damage, the bulk conductivities of the membranes were not diminished in the roughening process. Other preliminary EIS data (see Figure 2) were interpreted as signifying that the surface areas of the laser-roughened membranes were significantly greater than those of the smooth membrane. Moreover, elemental analyses showed that the sulfur-containing molecular groups necessary for proton conduction remained intact, even near the laser-roughened surfaces. These preliminary results can be taken

  18. PEM fuel cell bipolar plate material requirements for transportation applications

    Energy Technology Data Exchange (ETDEWEB)

    Borup, R.L.; Stroh, K.R.; Vanderborgh, N.E. [Los Alamos National Lab., NM (United States)] [and others

    1996-04-01

    Cost effective bipolar plates are currently under development to help make proton exchange membrane (PEM) fuel cells commercially viable. Bipolar plates separate individual cells of the fuel cell stack, and thus must supply strength, be electrically conductive, provide for thermal control of the fuel stack, be a non-porous materials separating hydrogen and oxygen feed streams, be corrosion resistant, provide gas distribution for the feed streams and meet fuel stack cost targets. Candidate materials include conductive polymers and metal plates with corrosion resistant coatings. Possible metals include aluminium, titanium, iron/stainless steel and nickel.

  19. Association of malnutrition-inflammation score, dialysis-malnutrition score and serum albumin with novel risk factors for cardiovascular diseases in hemodialysis patients.

    Science.gov (United States)

    As'habi, Atefeh; Tabibi, Hadi; Hedayati, Mehdi; Mahdavi-Mazdeh, Mitra; Nozary-Heshmati, Behnaz

    2015-02-01

    This study was designed to investigate the associations between malnutrition-inflammation score (MIS), dialysis-malnutrition score (DMS) and serum albumin with novel risk factors for cardiovascular diseases (CVD) in hemodialysis (HD) patients. In this cross-sectional study, 291 HD patients were randomly selected from among 2302 adult HD patients in Tehran HD centers. The MIS and DMS were determined during one of the dialysis sessions in these patients. In addition, 4 mL blood was obtained before dialysis and analyzed for serum albumin and novel risk factors for CVD, including C-reactive protein (CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), sE-selectin, malondialdehyde (MDA), nitric oxide (NO), endothelin-1 and lipoprotein (a) [Lp (a)]. MIS and DMS were significantly positively correlated with serum CRP (p protein-energy wasting indicators in HD patients are associated with serum CRP and sICAM-1, as two CVD risk factors.

  20. Synchrotron radiography and tomography of a PEM fuel cell; Synchrotron-Radiographie und -Tomographie einer PEM-Brennstoffzelle

    Energy Technology Data Exchange (ETDEWEB)

    Markoetter, Henning; Manke, Ingo [Helmholtzzentrum Berlin fuer Materialien und Energie, Berlin (Germany). Fachgruppe Bildgebende Verfahren; Arlt, Tobias [TU Berlin, Berlin (Germany); Banhart, John [TU Berlin, Institut fuer angewandte Materialforschung, Berlin (Germany); TU Berlin, Institut fuer Werkstoffwissenschaften und -technologien, Berlin (Germany); Riesemeier, Heinrich [Bundesanstalt fuer Materialforschung und -pruefung (BAM), Arbeitsgruppe Synchrotronstrahlanalytik (Germany); Krueger, Philipp [CONSULECTRA Unternehmensberatung GmbH, Hamburg (Germany); Haussmann, Jan; Klages, Merle [Zentrum fuer Sonnenenergie- und Wasserstoff-Forschung, Stuttgart (Germany); Scholta, Joachim [Zentrum fuer Sonnenenergie- und Wasserstoff-Forschung, Stuttgart (Germany). Fachgruppe Brennstoffzellen-Stacks

    2013-06-01

    The three dimensional water distribution and transport pathways in gas diffusion layers (GDL) of a polymer electrolyte membrane fuell cell (PEM FC) are analysed at various operating conditions. The method of quasi in-situ X-ray tomography is used for a three dimensional visualization of the water distribution and the GDL structure. Based on the results of dynamic radiographic measurements water transport pathways are located and subsequently investigated in detail by means of tomography. The combination of 2D and 3D techniques allows for an identification of 3D transport pathways through the GDl.

  1. Experimental analysis of a PEM fuel cell 15 W; Analise experimental de uma celula a combustivel PEM 15W

    Energy Technology Data Exchange (ETDEWEB)

    Miyake, Raphael Guardini; Bazzo, Edson [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil). Dept. de Engenharia Mecanica. Lab. de Combustao e Engenharia de Sistemas Termicos], e-mail: miyake@labcet.ufsc.br, e-mail: ebazzo@emc.ufsc.br

    2006-07-01

    Fuel cells have been considered a promising alternative for electric energy generation. In order to contribute with the development of this technology, a PEM fuel cell was installed and new experiments were carried out at LabCET (Laboratory of Combustion and Thermal System Engineering). Previous results have shown polarization curves identifying the need of rigorous controlling of humidification temperature of the fuel cell. In this paper, new results were carried out considering the use of a fan connected to the fuel cell and possible degradation in the electrolyte, after a relative long time operation. New polarization curves were plotted for comparison with previous results. (author)

  2. The effect of malnutrition on norovirus infection.

    Science.gov (United States)

    Hickman, Danielle; Jones, Melissa K; Zhu, Shu; Kirkpatrick, Ericka; Ostrov, David A; Wang, Xiaoyu; Ukhanova, Maria; Sun, Yijun; Mai, Volker; Salemi, Marco; Karst, Stephanie M

    2014-03-04

    Human noroviruses are the primary cause of severe childhood diarrhea in the United States, and they are of particular clinical importance in pediatric populations in the developing world. A major contributing factor to the general increased severity of infectious diseases in these regions is malnutrition-nutritional status shapes host immune responses and the composition of the host intestinal microbiota, both of which can influence the outcome of pathogenic infections. In terms of enteric norovirus infections, mucosal immunity and intestinal microbes are likely to contribute to the infection outcome in substantial ways. We probed these interactions using a murine model of malnutrition and murine norovirus infection. Our results reveal that malnutrition is associated with more severe norovirus infections as defined by weight loss, impaired control of norovirus infections, reduced antiviral antibody responses, loss of protective immunity, and enhanced viral evolution. Moreover, the microbiota is dramatically altered by malnutrition. Interestingly, murine norovirus infection also causes changes in the host microbial composition within the intestine but only in healthy mice. In fact, the infection-associated microbiota resembles the malnutrition-associated microbiota. Collectively, these findings represent an extensive characterization of a new malnutrition model of norovirus infection that will ultimately facilitate elucidation of the nutritionally regulated host parameters that predispose to more severe infections and impaired memory immune responses. In a broad sense, this model may provide insight into the reduced efficacy of oral vaccines in malnourished hosts and the potential for malnourished individuals to act as reservoirs of emergent virus strains. IMPORTANCE Malnourished children in developing countries are susceptible to more severe infections than their healthy counterparts, in particular enteric infections that cause diarrhea. In order to probe the

  3. INVESTIGATION OF PEM FUEL CELL FOR AUTOMOTIVE USE

    Directory of Open Access Journals (Sweden)

    A. K. M. Mohiuddin

    2015-11-01

    Full Text Available This paper provides a brief investigation on suitability of Proton-exchange  membrane fuel cells (PEMFCs as the source of power for transportation purposes. Hydrogen is an attractive alternative transportation fuel. It is the least polluting fuel that can be used in an internal combustion engine (ICE and it is widely available. If hydrogen is used in a fuel cell which converts the chemical energy of hydrogen into electricity, (NOx emissions are eliminated. The investigation was carried out on a  fuel cell car model by implementing polymer electrolyte membrane (PEM types of fuel cell as the source of power to propel the prototype car. This PEMFC has capability to propel the electric motor by converting chemical energy stored in hydrogen gas into useful electrical energy. PEM fuel cell alone is used as the power source for the electric motor without the aid of any other power source such as battery associated with it. Experimental investigations were carried out to investigate the characteristics of fuel cell used and the performance of the fuel cell car. Investigated papameters are the power it develops, voltage, current and speed it produces under different load conditions. KEYWORDS: fuel cell; automotive; proton exchange membrane; polymer electrolyte membrane; internal combustion engine

  4. Modeling two-phase flow in PEM fuel cell channels

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yun; Basu, Suman; Wang, Chao-Yang [Electrochemical Engine Center (ECEC), and Department of Mechanical and Nuclear Engineering, The Pennsylvania State University, University Park, PA 16802 (United States)

    2008-05-01

    This paper is concerned with the simultaneous flow of liquid water and gaseous reactants in mini-channels of a proton exchange membrane (PEM) fuel cell. Envisaging the mini-channels as structured and ordered porous media, we develop a continuum model of two-phase channel flow based on two-phase Darcy's law and the M{sup 2} formalism, which allow estimate of the parameters key to fuel cell operation such as overall pressure drop and liquid saturation profiles along the axial flow direction. Analytical solutions of liquid water saturation and species concentrations along the channel are derived to explore the dependences of these physical variables vital to cell performance on operating parameters such as flow stoichiometric ratio and relative humility. The two-phase channel model is further implemented for three-dimensional numerical simulations of two-phase, multi-component transport in a single fuel-cell channel. Three issues critical to optimizing channel design and mitigating channel flooding in PEM fuel cells are fully discussed: liquid water buildup towards the fuel cell outlet, saturation spike in the vicinity of flow cross-sectional heterogeneity, and two-phase pressure drop. Both the two-phase model and analytical solutions presented in this paper may be applicable to more general two-phase flow phenomena through mini- and micro-channels. (author)

  5. An Open-Source Toolbox for PEM Fuel Cell Simulation

    Directory of Open Access Journals (Sweden)

    Jean-Paul Kone

    2018-05-01

    Full Text Available In this paper, an open-source toolbox that can be used to accurately predict the distribution of the major physical quantities that are transported within a proton exchange membrane (PEM fuel cell is presented. The toolbox has been developed using the Open Source Field Operation and Manipulation (OpenFOAM platform, which is an open-source computational fluid dynamics (CFD code. The base case results for the distribution of velocity, pressure, chemical species, Nernst potential, current density, and temperature are as expected. The plotted polarization curve was compared to the results from a numerical model and experimental data taken from the literature. The conducted simulations have generated a significant amount of data and information about the transport processes that are involved in the operation of a PEM fuel cell. The key role played by the concentration constant in shaping the cell polarization curve has been explored. The development of the present toolbox is in line with the objectives outlined in the International Energy Agency (IEA, Paris, France Advanced Fuel Cell Annex 37 that is devoted to developing open-source computational tools to facilitate fuel cell technologies. The work therefore serves as a basis for devising additional features that are not always feasible with a commercial code.

  6. Malnutrition in elderly: social and economic determinants.

    Science.gov (United States)

    Donini, L M; Scardella, P; Piombo, L; Neri, B; Asprino, R; Proietti, A R; Carcaterra, S; Cava, E; Cataldi, S; Cucinotta, D; Di Bella, G; Barbagallo, M; Morrone, A

    2013-01-01

    Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. The aim of this study was to assess the prevalence of malnutrition in a sample of elderly people living in different settings and to identify the determinants of malnutrition. A total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three different regions in Italy. Nutritional status, depression, social, functional and cognitive status, were evaluated. According to the Mini Nutritional Assessment (MNA), a high prevalence of malnutrition was found out in both genders: 26% of F and 16.3% of M were classified as being malnourished (MNAshop, prepare and cook meals because of a low income, distance from markets or supermarkets as well as impossibility to drive the car or to use public transportation. This study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.

  7. Addressing Disease-Related Malnutrition in Healthcare

    Science.gov (United States)

    Correia, Maria Isabel; Hegazi, Refaat A.; Diaz-Pizarro Graf, José Ignacio; Gomez-Morales, Gabriel; Fuentes Gutiérrez, Catalina; Goldin, Maria Fernanda; Navas, Angela; Pinzón Espitia, Olga Lucia; Tavares, Gilmária Millere

    2015-01-01

    Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms—increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients’ clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.’s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use. PMID:25883116

  8. The dual burden of malnutrition in Colombia.

    Science.gov (United States)

    Sarmiento, Olga L; Parra, Diana C; González, Silvia A; González-Casanova, Inés; Forero, Ana Y; Garcia, Johnattan

    2014-12-01

    Almost all nutrition policies in Colombia currently focus on either undernutrition or obesity, with the predominant emphasis on undernutrition. It is crucial to assess the prevalence of the dual burden of malnutrition in Colombia to better target programs and policies. The aim was to estimate the national prevalence of the dual burden of malnutrition in Colombia at the individual and household levels in children aged malnutrition was defined as the coexistence of overweight and stunting or anemia in the same person or household. In Colombia, low to high prevalences of overweight and obesity (3.4-51.2%) coexist with moderate to high prevalences of anemia (8.1-27.5%) and stunting (13.2%). The observed prevalence of the dual burden was lower than expected. Approximately 5% of households had at least one stunted child aged malnutrition in Colombia are lower than expected. Despite the independence of the occurrence of these conditions, the fact that the dual burden coexists at the national, household, and intraindividual levels suggests that public policies should address both conditions through multiple strategies. It is imperative to evaluate the current nutrition policies to inform malnutrition prevention efforts in Colombia and to share lessons with other countries at a similar stage of nutritional transition. © 2014 American Society for Nutrition.

  9. Thermal stability control system of photo-elastic interferometer in the PEM-FTs

    Science.gov (United States)

    Zhang, M. J.; Jing, N.; Li, K. W.; Wang, Z. B.

    2018-01-01

    A drifting model for the resonant frequency and retardation amplitude of a photo-elastic modulator (PEM) in the photo-elastic modulated Fourier transform spectrometer (PEM-FTs) is presented. A multi-parameter broadband-matching driving control method is proposed to improve the thermal stability of the PEM interferometer. The automatically frequency-modulated technology of the driving signal based on digital phase-locked technology is used to track the PEM's changing resonant frequency. Simultaneously the maximum optical-path-difference of a laser's interferogram is measured to adjust the amplitude of the PEM's driving signal so that the spectral resolution is stable. In the experiment, the multi-parameter broadband-matching control method is applied to the driving control system of the PEM-FTs. Control of resonant frequency and retardation amplitude stabilizes the maximum optical-path-difference to approximately 236 μm and results in a spectral resolution of 42 cm-1. This corresponds to a relative error smaller than 2.16% (4.28 standard deviation). The experiment shows that the method can effectively stabilize the spectral resolution of the PEM-FTs.

  10. Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition.

    Science.gov (United States)

    Laur, Celia V; McNicholl, Tara; Valaitis, Renata; Keller, Heather H

    2017-05-01

    There is increasing awareness of the detrimental health impact of frailty on older adults and of the high prevalence of malnutrition in this segment of the population. Experts in these 2 arenas need to be cognizant of the overlap in constructs, diagnosis, and treatment of frailty and malnutrition. There is a lack of consensus regarding the definition of malnutrition and how it should be assessed. While there is consensus on the definition of frailty, there is no agreement on how it should be measured. Separate assessment tools exist for both malnutrition and frailty; however, there is intersection between concepts and measures. This narrative review highlights some of the intersections within these screening/assessment tools, including weight loss/decreased body mass, functional capacity, and weakness (handgrip strength). The potential for identification of a minimal set of objective measures to identify, or at least consider risk for both conditions, is proposed. Frailty and malnutrition have also been shown to result in similar negative health outcomes and consequently common treatment strategies have been studied, including oral nutritional supplements. While many of the outcomes of treatment relate to both concepts of frailty and malnutrition, research questions are typically focused on the frailty concept, leading to possible gaps or missed opportunities in understanding the effect of complementary interventions on malnutrition. A better understanding of how these conditions overlap may improve treatment strategies for frail, malnourished, older adults.

  11. Intradialytic parenteral nutrition in maintenance hemodialysis patients suffering from protein-energy wasting. Results of a multicenter, open, prospective, randomized trial.

    Science.gov (United States)

    Marsen, Tobias A; Beer, Justinus; Mann, Helmut

    2017-02-01

    Protein-energy wasting (PEW) is increasingly becoming a clinical problem in maintenance hemodialysis patients and guidelines call for nutritional interventions. Serum prealbumin (transthyretin) represents a critical nutritional marker positively correlated with patient survival and negatively correlated with morbidity. Nutritional counseling, oral supplementation as well as intradialytic parenteral nutrition (IDPN) are recommended to fight PEW, however clinical trials on their use are scarce. We conducted a prospective, multicenter, randomized, open-label, controlled, parallel-group Phase IV clinical trial in 107 maintenance hemodialysis patients suffering from PEW to assess the impact of IDPN on prealbumin and other biochemical and clinical parameters reflecting nutritional status. Patients randomized to the intervention group received standardized nutritional counseling plus IDPN three times weekly over 16 weeks followed by a treatment-free period of 12 weeks. The control group received standardized nutritional counseling only. Main trial inclusion criteria included moderate to severe malnutrition (SGA score B or C), maintenance hemodialysis therapy (3 times per week) for more than six months, and presence of two out of the following three criteria: albumin 30 mg/L at week 16 (48.7% vs. 31.8%). Prealbumin response to IDPN therapy was more prominent in patients suffering from moderate malnutrition (SGA score B) compared to patients with severe malnutrition (SGA score C). The results of this trial demonstrate for the first time that IDPN therapy, given three times weekly in a 16-week short-term intervention, results in a statistically significant and clinically relevant increase in mean serum prealbumin, a surrogate marker for outcome and survival in hemodialysis patients suffering from PEW, and is superior to nutritional counseling. Clinical trial registry:www.clinicaltrials.gov (NCT00501956). Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights

  12. Malnutrition in Very Old Hospitalized Patients: A New Etiologic Factor of Anemia?

    Science.gov (United States)

    Frangos, E; Trombetti, A; Graf, C E; Lachat, V; Samaras, N; Vischer, U M; Zekry, D; Rizzoli, R; Herrmann, F R

    2016-01-01

    Anemia and malnutrition are highly prevalent, frequently concomitant and associated with negative outcomes and mortality in the elderly. To evaluate the association between these two entities, and test the hypothesis that protein-energy deficit could be etiology of anemia. Prospective case-control study. Geriatric and Rehabilitation Hospital, Geneva University Hospitals, Switzerland. 392 patients (mean age 84.8 years old, 68.6% female). Hematological (hemoglobin (Hb)), chemical (iron work up, cyanocobalamin, folates, renal function, C-Reactive Protein (CRP)) and nutrition (albumin, prealbumin) parameters, and mini nutritional assessment short form (MNA-SF). The prevalence of anemia (defined as Hbmalnutrition according to the MNA-SF (p=0.047), with lower serum albumin (p 10). Albumin levels are strongly associated with anemia in the elderly. Screening for undernutrition should be included in anemia assessment in those patients. Further prospective studies are warranted in order to explore the effect of protein and energy supplementation on hemoglobin level.

  13. Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger.

    Science.gov (United States)

    Binagwaho, Agnès; Agbonyitor, Mawuena; Rukundo, Alphonse; Ratnayake, Niloo; Ngabo, Fidel; Kayumba, Josephine; Dowdle, Bridget; Chopyak, Elena; Smith Fawzi, Mary C

    2011-12-29

    Progress towards the first Millennium Development Goal (MDG1) to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

  14. Underdiagnosis of malnutrition in infants and young children in Rwanda: implications for attainment of the Millennium Development Goal to end poverty and hunger

    Directory of Open Access Journals (Sweden)

    Binagwaho Agnès

    2011-12-01

    Full Text Available Abstract Progress towards the first Millennium Development Goal (MDG1 to end poverty and hunger has lagged behind attainment of other MDGs due to chronic poverty and worldwide inequity in access to adequate health care, food, clean water, and sanitation. Despite ongoing challenges, Rwanda has experienced economic progress and the expansion of the national public health system during the past 20 years. However, protein-energy malnutrition in children under five is still a major concern for physicians and government officials in Rwanda. Approximately 45% of children under the age of five in Rwanda suffer from chronic malnutrition, and one in four is undernourished. For years, health facilities in Rwanda have used incorrect growth references for measuring nutritional status of children despite the adoption of new standards by the World Health Organization in 2006. Under incorrect growth references used in Rwanda, a number of children under five who were severely underweight were not identified, and therefore were not treated for malnutrition, thus potentially contributing to the under five mortality rate. Given that one in ten children suffer from malnutrition worldwide, it is imperative that all countries with a burden of malnutrition adopt the most up-to-date international standards for measuring malnutrition, and that the problem is brought to the forefront of international public health initiatives. For low income countries in the process of improving economic conditions, as Rwanda is, increasing the identification and treatment of malnutrition can promote the advancement of MDG1 as well as physical and cognitive development in children, which is imperative for advancing future economic progress.

  15. Child Malnutrition in Pakistan: Evidence from Literature

    Science.gov (United States)

    Asim, Muhammad; Nawaz, Yasir

    2018-01-01

    Pakistan has one of the highest prevalences of child malnutrition as compared to other developing countries. This narrative review was accomplished to examine the published empirical literature on children’s nutritional status in Pakistan. The objectives of this review were to know about the methodological approaches used in previous studies, to assess the overall situation of childhood malnutrition, and to identify the areas that have not yet been studied. This study was carried out to collect and synthesize the relevant data from previously published papers through different scholarly database search engines. The most relevant and current published papers between 2000–2016 were included in this study. The research papers that contain the data related to child malnutrition in Pakistan were assessed. A total of 28 articles was reviewed and almost similar methodologies were used in all of them. Most of the researchers conducted the cross sectional quantitative and descriptive studies, through structured interviews for identifying the causes of child malnutrition. Only one study used the mix method technique for acquiring data from the respondents. For the assessment of malnutrition among children, out of 28 papers, 20 used the World Health Organization (WHO) weight for age, age for height, and height for weight Z-score method. Early marriages, large family size, high fertility rates with a lack of birth spacing, low income, the lack of breast feeding, and exclusive breastfeeding were found to be the themes that repeatedly emerged in the reviewed literature. There is a dire need of qualitative and mixed method researches to understand and have an insight into the underlying factors of child malnutrition in Pakistan. PMID:29734703

  16. Child Malnutrition in Pakistan: Evidence from Literature

    Directory of Open Access Journals (Sweden)

    Muhammad Asim

    2018-05-01

    Full Text Available Pakistan has one of the highest prevalences of child malnutrition as compared to other developing countries. This narrative review was accomplished to examine the published empirical literature on children’s nutritional status in Pakistan. The objectives of this review were to know about the methodological approaches used in previous studies, to assess the overall situation of childhood malnutrition, and to identify the areas that have not yet been studied. This study was carried out to collect and synthesize the relevant data from previously published papers through different scholarly database search engines. The most relevant and current published papers between 2000–2016 were included in this study. The research papers that contain the data related to child malnutrition in Pakistan were assessed. A total of 28 articles was reviewed and almost similar methodologies were used in all of them. Most of the researchers conducted the cross sectional quantitative and descriptive studies, through structured interviews for identifying the causes of child malnutrition. Only one study used the mix method technique for acquiring data from the respondents. For the assessment of malnutrition among children, out of 28 papers, 20 used the World Health Organization (WHO weight for age, age for height, and height for weight Z-score method. Early marriages, large family size, high fertility rates with a lack of birth spacing, low income, the lack of breast feeding, and exclusive breastfeeding were found to be the themes that repeatedly emerged in the reviewed literature. There is a dire need of qualitative and mixed method researches to understand and have an insight into the underlying factors of child malnutrition in Pakistan.

  17. Factors influencing the pattern of malnutrition among acutely ill ...

    African Journals Online (AJOL)

    Factors influencing the pattern of malnutrition among acutely ill children presenting in ... height/length) measurements and z-scores calculated for the individual nutritional ... The factors associated with malnutrition included early introduction of ...

  18. Use of Bee Honey as Alternative Medicine in Protein Energy Deficiency

    OpenAIRE

    Prasetyo, R. Heru; Sandhika, Willy; Susanto, Djoni

    2013-01-01

    The protein energy deficiency cause intestinal villus atrophy and epithel mucous damage. The effect of bee honey on histostructure of intestine was studied in the experimental mice as model of proteinenergy deficiency. The use bee honey in protein-energy deficiency shown to improve intestinal villus atrophy and epithel damage. In conclusion that bee honey can use as alternative medicine in protein energydeficiency

  19. Determinants of Growth Hormone Resistance in Malnutrition

    Science.gov (United States)

    Fazeli, Pouneh K.; Klibanski, Anne

    2014-01-01

    States of under-nutrition are characterized by growth hormone resistance. Decreased total energy intake, as well as isolated protein-calorie malnutrition and isolated nutrient deficiencies result in elevated growth hormone levels and low levels of IGF-I. We review various states of malnutrition and a disease state characterized by chronic under-nutrition -- anorexia nervosa -- and discuss possible mechanisms contributing to the state of growth hormone resistance, including FGF-21 and SIRT1. We conclude by examining the hypothesis that growth hormone resistance is an adaptive response to states of under-nutrition, in order to maintain euglycemia and preserve energy. PMID:24363451

  20. Childhood Malnutrition In China: Change Of Inequality In A Decade

    OpenAIRE

    Chen, Zhuo; Eastwood, David B.; Yen, Steven T.

    2005-01-01

    A concentration index methodology to analyze the inequality in childhood malnutrition in China is outlined. Height-for-age z score is used as a measure of childhood malnutrition. Using household survey data from nine Chinese provinces, it is found that per-capita household income, household head's education, urban residence and access to a bus stop reduced malnutrition. Child's age had a nonlinear effect on the malnutrition status. Income growth and access to public transportation reduced the...

  1. Risk for malnutrition in patients prior to vascular surgery

    NARCIS (Netherlands)

    Beek, Lies Ter; Banning, Louise B D; Visser, Linda; Roodenburg, Jan L N; Krijnen, Wim P; van der Schans, Cees P; Pol, Robert A; Jager-Wittenaar, Harriët

    2017-01-01

    BACKGROUND: Malnutrition is an important risk factor for adverse post-operative outcomes. The prevalence of risk for malnutrition is unknown in patients prior to vascular surgery. We aimed to assess prevalence and associated factors of risk for malnutrition in this patient group. METHODS: Patients

  2. Malnutrition, Learning and Intellectual Development: Research and Remediation.

    Science.gov (United States)

    Ricciuti, Henry N.

    After a discussion of the problem of malnutrition and its effect on intellectual development, this paper concentrates on the study of protein-calorie malnutrition in infants and children as it occurs in postnatal and subsequent development. An overview and summary of the principal investigations on the relationship of malnutrition to intellectual…

  3. Protein-energy wasting syndrome in advanced chronic kidney disease: Prevalence and specific clinical characteristics

    Directory of Open Access Journals (Sweden)

    Almudena Pérez-Torres

    2018-03-01

    Full Text Available Introduction: Protein-energy wasting (PEW is associated with increased mortality and differs depending on the chronic kidney disease (CKD stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. Objective: To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA. Patients and methods: Cross-sectional study of 186 patients (101 men with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. Results: The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p < 0.005, while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio.The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002, percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008, total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001 and cell mass index (OR: 0.995; 95% CI: 0.992–0.998. Conclusion: Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. Resumen: Introducción: El desgaste proteico energético (DPE se asocia a mayor mortalidad y difiere dependiendo del estadio de la enfermedad renal y de la técnica de diálisis. Su prevalencia en pacientes sin di

  4. Dynamic Model of High Temperature PEM Fuel Cell Stack Temperature

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl; Kær, Søren Knudsen

    2007-01-01

    cathode air cooled 30 cell HTPEM fuel cell stack developed at the Institute of Energy Technology at Aalborg University. This fuel cell stack uses PEMEAS Celtec P-1000 membranes, runs on pure hydrogen in a dead end anode configuration with a purge valve. The cooling of the stack is managed by running......The present work involves the development of a model for predicting the dynamic temperature of a high temperature PEM (HTPEM) fuel cell stack. The model is developed to test different thermal control strategies before implementing them in the actual system. The test system consists of a prototype...... the stack at a high stoichiometric air flow. This is possible because of the PBI fuel cell membranes used, and the very low pressure drop in the stack. The model consists of a discrete thermal model dividing the stack into three parts: inlet, middle and end and predicting the temperatures in these three...

  5. High Temperature PEM Fuel Cells and Organic Fuels

    DEFF Research Database (Denmark)

    Vassiliev, Anton

    of the products. The observation of internal reforming was indirectly confirmed by electrochemical impedance spectroscopy, where the best fits were obtained when a Gerischer element describing preceding chemical reaction and diffusion was included in the equivalent circuit of a methanol/air operated cell...... evaporated liquid stream supply to either of the electrodes. A large number of MEAs with different component compositions have been prepared and tested in different conditions using the constructed setups to obtain a basic understanding of the nature of direct DME HT-PEM FC, to map the processes occurring...... inside the cells and to determine the lifetime. Additionally, comparison was made with methanol as fuel, which is the main competitor to DME in direct oxidation of organic fuels in fuel cells. For the reference, measurements have also been done with conventional hydrogen/air operation. All...

  6. Optimization Design of Bipolar Plate Flow Field in PEM Stack

    Science.gov (United States)

    Wen, Ming; He, Kanghao; Li, Peilong; Yang, Lei; Deng, Li; Jiang, Fei; Yao, Yong

    2017-12-01

    A new design of bipolar plate flow field in proton exchange membrane (PEM) stack was presented to develop a high-performance transfer efficiency of the two-phase flow. Two different flow fields were studied by using numerical simulations and the performance of the flow fields was presented. the hydrodynamic properties include pressure gap between inlet and outlet, the Reynold’s number of the two types were compared based on the Navier-Stokes equations. Computer aided optimization software was implemented in the design of experiments of the preferable flow field. The design of experiments (DOE) for the favorable concept was carried out to study the hydrodynamic properties when changing the design parameters of the bipolar plate.

  7. Model-based fault diagnosis in PEM fuel cell systems

    Energy Technology Data Exchange (ETDEWEB)

    Escobet, T; de Lira, S; Puig, V; Quevedo, J [Automatic Control Department (ESAII), Universitat Politecnica de Catalunya (UPC), Rambla Sant Nebridi 10, 08222 Terrassa (Spain); Feroldi, D; Riera, J; Serra, M [Institut de Robotica i Informatica Industrial (IRI), Consejo Superior de Investigaciones Cientificas (CSIC), Universitat Politecnica de Catalunya (UPC) Parc Tecnologic de Barcelona, Edifici U, Carrer Llorens i Artigas, 4-6, Planta 2, 08028 Barcelona (Spain)

    2009-07-01

    In this work, a model-based fault diagnosis methodology for PEM fuel cell systems is presented. The methodology is based on computing residuals, indicators that are obtained comparing measured inputs and outputs with analytical relationships, which are obtained by system modelling. The innovation of this methodology is based on the characterization of the relative residual fault sensitivity. To illustrate the results, a non-linear fuel cell simulator proposed in the literature is used, with modifications, to include a set of fault scenarios proposed in this work. Finally, it is presented the diagnosis results corresponding to these fault scenarios. It is remarkable that with this methodology it is possible to diagnose and isolate all the faults in the proposed set in contrast with other well known methodologies which use the binary signature matrix of analytical residuals and faults. (author)

  8. Studies on PEM fuel cell noble metal catalyst dissolution

    DEFF Research Database (Denmark)

    Andersen, S. M.; Grahl-Madsen, L.; Skou, E. M.

    2011-01-01

    A combination of electrochemical, spectroscopic and gravimetric methods was carried out on Proton Exchange Membrane (PEM) fuel cell electrodes with the focus on platinum and ruthenium catalysts dissolution, and the membrane degradation. In cyclic voltammetry (CV) experiments, the noble metals were...... found to dissolve in 1 M sulfuric acid solution and the dissolution increased exponentially with the upper potential limit (UPL) between 0.6 and 1.6 vs. RHE. 2-20% of the Pt (depending on the catalyst type) was found to be dissolved during the experiments. Under the same conditions, 30-100% of the Ru...... (depending on the catalyst type) was found to be dissolved. The faster dissolution of ruthenium compared to platinum in the alloy type catalysts was also confirmed by X-ray diffraction measurements. The dissolution of the carbon supported catalyst was found one order of magnitude higher than the unsupported...

  9. Transients of Water Distribution and Transport in PEM Fuel Cells

    KAUST Repository

    Hussaini, Irfan S.; Wang, Chao-Yang

    2009-01-01

    The response of polymer electrolyte membrane (PEM) fuel cells to a step change in load is investigated experimentally in this work. Voltage undershoot, a characteristic feature of transient response following a step increase in current, is due to transients of water distribution in the membrane and ionomers occurring at subsecond time scales. The use of humidified reactants as a means to control the magnitude of voltage undershoot is demonstrated. Further, the response under a step decrease in current density is explored to determine the existence of hysteresis. Under sufficiently humidified conditions, the responses under forward and reverse step changes are symmetric, but under low relative humidity conditions, voltage undershoot is twice as large as the overshoot. © 2009 The Electrochemical Society.

  10. Design and Control of High Temperature PEM Fuel Cell System

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl

    E-cient fuel cell systems have started to appear in many dierent commercial applications and large scale production facilities are already operating to supply fuel cells to support an ever growing market. Fuel cells are typically considered to replace leadacid batteries in applications where...... to conventional PEM fuel cells, that use liquid water as a proton conductor and thus operate at temperatures below 100oC. The HTPEM fuel cell membrane in focus in this work is the BASF Celtec-P polybenzimidazole (PBI) membrane that uses phosphoric acid as a proton conductor. The absence of water in the fuel cells...... enables the use of designing cathode air cooled stacks greatly simplifying the fuel cell system and lowering the parasitic losses. Furthermore, the fuel impurity tolerance is signicantly improved because of the higher temperatures, and much higher concentrations of CO can be endured without performance...

  11. A portable power system using PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Long, E. [Ball Aerospace and Technologies Corp., Boulder, CO (United States)

    1997-12-31

    Ball has developed a proof-of-concept, small, lightweight, portable power system. The power system uses a proton exchange membrane (PEM) fuel cell stack, stored hydrogen, and atmospheric oxygen as the oxidant to generate electrical power. Electronics monitor the system performance to control cooling air and oxidant flow, and automatically do corrective measures to maintain performance. With the controller monitoring the system health, the system can operate in an ambient environment from 0 C to +50 C. The paper describes system testing, including load testing, thermal and humidity testing, vibration and shock testing, field testing, destructive testing of high-pressure gas tanks, and test results on the fuel cell power system, metal hydride hydrogen storage, high-pressure hydrogen gas storage, and chemical hydride hydrogen storage.

  12. Modeling of Pem Fuel Cell Systems Including Controls and Reforming Effects for Hybrid Automotive Applications

    National Research Council Canada - National Science Library

    Boettner, Daisie

    2001-01-01

    .... This study develops models for a stand-alone Proton Exchange Membrane (PEM) fuel cell stack, a direct-hydrogen fuel cell system including auxiliaries, and a methanol reforming fuel cell system for integration into a vehicle performance simulator...

  13. Analysing Gas-Liquid Flow in PEM Electrolyser Micro-Channels (Poster)

    DEFF Research Database (Denmark)

    Lafmejani, Saeed Sadeghi; Olesen, Anders Christian; Kær, Søren Knudsen

    One means of increasing the hydrogen yield to cost ratio of a PEM water electrolyser, is to increase the operating current density. However, at high current densities (higher than 1 A/cm2), management of heat and mass transfer in the anode current collector and channel becomes crucial and can lead...... to hot spots. Management of heat and fluid flow through the micro-channels play a great role in the capability of PEM water electrolysis when working at high current densities. Despite, many studies have been done on gas-liquid flows; still there is a lack of research on gas-liquid flows in micro......-sized channels (hydraulic diameter of 1 mm) of PEM water electrolysis. Precisely controlling all the parameters that affect the gas-liquid flow in a PEM water electrolysis cell is quite challenging, hence a simplified setup is constructed consisting of only a transparent channel with a sheet of titanium felt...

  14. UARS PEM Level 2 AXIS 2 V001 (UARPE2AXIS2) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The UARS Particle Environment Monitor (PEM) level 2 Atmosphere X-Ray Imaging Spectrometer (AXIS) unit 2 daily product contains the X-ray high-resolution spectral...

  15. UARS PEM Level 2 AXIS 1 V001 (UARPE2AXIS1) at GES DISC

    Data.gov (United States)

    National Aeronautics and Space Administration — The UARS Particle Environment Monitor (PEM) level 2 Atmosphere X-Ray Imaging Spectrometer (AXIS) unit 1 daily product contains the X-ray high-resolution spectral...

  16. Research in Review. Malnutrition and Children's Development.

    Science.gov (United States)

    Stevens, Joseph H., Jr.; Baxter, Delia H.

    1981-01-01

    Indicates how various degrees of malnutrition affect children's development. Reviews research conducted in several developing countries and the United States, and describes the nutritional status of children in the United States. Implications for nutrition programs, research and policy formation are pointed out. (Author/RH)

  17. Mobilizing University Resources Against Hunger and Malnutrition.

    Science.gov (United States)

    Bell, David E.

    There are four central issues in mobilizing the resources of American universities to contribute more effectively to alleviating world hunger and malnutrition: (1) To what extent should universities' motivation be original, and to what extent related to government support?; (2) What needs to be done, beyond additional food production?; (3) What…

  18. Long term consequences of early childhood malnutrition

    NARCIS (Netherlands)

    Kinsey, B.H.; Hoddinott, J; Alderman, H.

    2006-01-01

    This paper examines the impact of pre-school malnutrition on subsequent human capital formation in rural Zimbabwe using a maternal fixed effects - instrumental variables (MFE-IV) estimator with a long term panel data set. Representations of civil war and drought shocks are used to identify

  19. Malnutrition and mealtime ambiance in nursing homes

    NARCIS (Netherlands)

    Nijs, K.A.N.D.; Graaf, de C.; Staveren, van W.A.; Groot, de C.P.G.M.

    2009-01-01

    Inadequate nutritional intake is the predominant cause of malnutrition in older persons. It is one of the most common and devastating conditions in nursing home residents. It is multifactorial and treatment or nutrition care plans should try to address the main causes. Such plans often include means

  20. Dermatosis in children with oedematous malnutrition (Kwashiorkor)

    DEFF Research Database (Denmark)

    Heilskov, S; Rytter, M; Vestergaard, Christian

    2014-01-01

    Children with oedematous malnutrition, known as kwashiorkor, may develop a characteristic skin lesion, named 'Dermatosis of Kwashiorkor' (DoK). Only a few studies have been concerned with this condition, and the reason for the development of DoK remains unexplained. This study review the existing...

  1. Socioeconomic Inequality in Malnutrition in Developing Countries

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); A.R. Hosseinpoor (Ahmad); N. Speybroeck (Niko); T.G.M. van Ourti (Tom); J. Vega (Jeanette)

    2008-01-01

    textabstractEpidemiological evidence points to a small set of primary causes of child mortality that are the main killers of children aged less than 5 years: pneumonia, diarrhoea, low birth weight, asphyxia and, in some parts of the world, HIV and malaria. Malnutrition is the underlying cause of one

  2. Protein metabolism in severe childhood malnutrition

    Science.gov (United States)

    The major clinical syndromes of severe childhood malnutrition (SCM) are marasmus (non-oedematous SCM), kwashiorkor and marasmic-kwashiorkor (oedematous SCM). Whereas treatment of marasmus is straightforward and the associated mortality is low, kwashiorkor and marasmic-kwashiorkor are difficult to tr...

  3. Factors Associated With Adolescent Malnutrition Among Nigerian ...

    African Journals Online (AJOL)

    This study determined the factors associated with malnutrition among adolescents in senior secondary schools in The Abuja Municipal area council. This was a cross-sectional study conducted among adolescents (10-19 years) in secondary schools. A multistage sampling technique was employed to select a total of 1700 ...

  4. Protein malnutrition and metronidazole induced intestinal bacterial ...

    African Journals Online (AJOL)

    This study was designed to assess the effects of protein malnutrition (PM) associated with antibiotic on growth weight, cecal bacterial overgrowth and enterobacteria translocation. Eighteen Gnotobiotic young Wistar rats (135 ± 2.35 g) were treated orally with antibiotic and submitted to dietary restriction based on maize diet ...

  5. Soil transmitted helminths infections, malnutrition and anaemia ...

    African Journals Online (AJOL)

    Soil-transmitted helminths (STHs) are a major public health problem in many developing countries. Establishment of prevalence and intensity of infections is important in designing, implementating and evaluating control programs. This study aimed at determining the prevalence and intensity of STH infections, malnutrition ...

  6. Health insurance or subsidy has universal advantage for management of hospital malnutrition unrelated to GDP.

    Science.gov (United States)

    Klek, Stanislaw; Chourdakis, Michael; Abosaleh, Dima Abdulqudos; Amestoy, Alejandra; Baik, Hyun Wook; Baptista, Gertrudis; Barazzoni, Rocco; Fukushima, Ryoji; Hartono, Josef; Jayawardena, Ranil; Garcia, Rafael Jimenez; Krznaric, Zeljko; Nyulasi, Ibolya; Parallada, Gabriela; Francisco, Eliza Mei Perez; Panisic-Sekeljic, Marina; Perman, Mario; Prins, Arina; Del Rio Requejo, Isabel Martinez; Reddy, Ravinder; Singer, Pierre; Sioson, Marianna; Ukleja, Andrew; Vartanian, Carla; Fuentes, Nicolas Velasco; Waitzberg, Dan Linetzky; Zoungrana, Steve Leonce; Galas, Aleksander

    2017-03-01

    Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings. An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN. The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019). A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.

  7. Current Knowledge on Moderate Malnutrition in Sri Lanka

    International Nuclear Information System (INIS)

    Fernando, Peter Hiram Prasantha

    2014-01-01

    forms of under nutrition; stunting, wasting and underweight. A study conducted in 2006 in the central part of the country in the estate sector 46% acutely malnourished, 43% chronically malnourished and 32.9% both acutely and chronically malnourished. Although there were differences between boys and girls those differences were not statistically significant. Another study indicated the prevalence of protein energy malnutrition, underweight and wasting in State operated foster care institutions were considerably higher than the national levels (2006). No significant associations were there in relation to the studied sociodemographic characteristics with the under nutritional status of children brought up at ‘day-care centers’ or at home groups (2009). Selected aspects of infant complementary feeding practice in a district of Sri Lanka and outcome of an intervention aimed at improving these practices (2006) Since overweight and obesity has attracted the interest of the researchers’ under-nutrition has become a topic of yesteryear. Therefore it is important to revitalize research studies on moderate malnutrition in children. (author)

  8. The malnutrition screening tool versus objective measures to detect malnutrition in hip fracture.

    Science.gov (United States)

    Bell, J J; Bauer, J D; Capra, S

    2013-12-01

    The Malnutrition Screening Tool (MST) is the most commonly used screening tool in Australia. Poor screening tool sensitivity may lead to an under-diagnosis of malnutrition, with potential patient and economic ramifications. The present study aimed to determine whether the MST or anthropometric parameters adequately detect malnutrition in patients who were admitted to a hip fracture unit. Data were analysed for a prospective convenience sample (n = 100). MST screening was independently undertaken by nursing staff and a nutrition assistant. Mid upper arm circumference (MUAC) was measured by a trained nutrition assistant. Nutritional risk [MST score ≥ 2, body mass index (BMI) malnutrition diagnosed by accredited practicing dietitians using International Classification of Diseases version 10-Australian Modification (ICD10-AM) coding criteria. Malnutrition prevalence was 37.5% using ICD10-AM criteria. Delirium, dementia or preadmission cognitive impairment was present in 65% of patients. The BMI as a nutrition risk screen was the most valid predictor of malnutrition (sensitivity 75%; specificity 93%; positive predictive value 73%; negative predictive value 84%). Nursing MST screening was the least valid (sensitivity 73%; specificity 55%; positive predictive value 50%; negative predictive value 77%). There was only fair agreement between nursing and nutrition assistant screening using the MST (κ = 0.28). In this population with a high prevalence of delirium and dementia, further investigation is warranted into the performance of nutrition screening tools and anthropometric parameters such as BMI. All tools failed to predict a considerable number of patients with malnutrition. This may result in the under-diagnosis and treatment of malnutrition, leading to case-mix funding losses. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  9. A parametric study of assembly pressure, thermal expansion, and membrane swelling in PEM fuel cells

    OpenAIRE

    Maher A.R. Sadiq Al-Baghdadi

    2016-01-01

    Proton Exchange membrane (PEM) fuel cells are still undergoing intense development, and the combination of new and optimized materials, improved product development, novel architectures, more efficient transport processes, and design optimization and integration are expected to lead to major gains in performance, efficiency, durability, reliability, manufacturability and cost-effectiveness. PEM fuel cell assembly pressure is known to cause large strains in the cell components. All components ...

  10. Steam and partial oxidation reforming options for hydrogen production from fossil fuels for PEM fuel cells

    OpenAIRE

    Yousri M.A. Welaya; Mohamed M. El Gohary; Nader R. Ammar

    2012-01-01

    Proton exchange membrane fuel cell (PEM) generates electrical power from air and from hydrogen or hydrogen rich gas mixtures. Therefore, there is an increasing interest in converting current hydrocarbon based marine fuels such as natural gas, gasoline, and diesel into hydrogen rich gases acceptable to the PEM fuel cells on board ships. Using chemical flow sheeting software, the total system efficiency has been calculated. Natural gas appears to be the best fuel for hydrogen rich gas productio...

  11. Defining malnutrition: A plea to rethink.

    Science.gov (United States)

    Soeters, P; Bozzetti, F; Cynober, L; Forbes, A; Shenkin, A; Sobotka, L

    2017-06-01

    In a recent consensus report in Clinical Nutrition the undernourished category of malnutrition was proposed to be defined and diagnosed on the basis of a low BMI or unintentional weight loss combined with low BMI or FFMI with certain cut off points. The definition was endorsed by ESPEN despite recent endorsement of a very different definition. The approach aims to assess whether nutritional intake is sufficient but is imprecise because a low BMI does not always indicate malnutrition and individuals with increasing BMI's may have decreasing FFM's. The pathophysiology of individuals, considered to be malnourished in rich countries and in areas with endemic malnutrition, results predominantly from deficient nutrition combined with infection/inflammation. Both elements jointly determine body composition and function and consequently outcome of disease, trauma or treatment. When following the consensus statement only an imprecise estimate is acquired of nutritional intake without knowing the impact of inflammation. Most importantly, functional abilities are not assessed. Consequently it will remain uncertain how well the individual can overcome stressful events, what the causes are of dysfunction, how to set priorities for treatment and how to predict the effect of nutritional support. We therefore advise to consider the pathophysiology of malnourished individuals leading to inclusion of the following elements in the definition of malnutrition: a disordered nutritional state resulting from a combination of inflammation and a negative nutrient balance, leading to changes in body composition, function and outcome. A precise diagnosis of malnutrition should be based on assessment of these elements. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  12. Energy flows modelling of a PEM electrolyzer-Photovoltaic generator-PEM fuel cell coupling dedicated to stationary applications

    International Nuclear Information System (INIS)

    Agbli, Krehi Serge

    2012-01-01

    A standalone multi-source system based on the coupling of photovoltaic energy and both a PEM electrolyzer and a PEMFC for stationary application is studied. The system gathers photovoltaic array as main energy source, ultra-capacitors and batteries packs in order to smooth respectively fast and medium dynamic by supplying the load or by absorbing photovoltaic source overproduction. Because of the necessity of fuel availability, especially for islanding application like this one, a PEM electrolyzer is integrated to the system for in situ hydrogen production. The relevance of PEMFC system powered by solar hydrogen is pointed out before examining hydrogen storage issue. Energetic and economic analyses have been performed leading to the choice of the pressurised hydrogen storage (in the bottle) rather than hydrogen storage both as liquid and within metal hydride. The main purpose being the proper management of the power flows in order to meet the energy requirement (the load) without power cut, a graphical modelling tool namely Energetic Macroscopic Representation (EMR) is used because of its analysis and control strengths. The EMR ability to describe multi-physics energetic tools is used to develop a PEM electrolyzer model. The multi-domain interaction between the electrical, the electrochemical, the thermodynamic and the fluidic domain is emphasised. Moreover, the temperature variation influence on the electrochemical parameters of the electrolyzer is taken into account by the developed EMR model. Afterwards, thanks to the modular feature of the EMR, the different models of each energetic entity of the system are performed before their assembling leading to the overall system EMR model. By using scale effect allowing extending the energetic tool power range from the experimental validation one to another one, the energetic system sizing is performed according to a household power profile. Then, by the help of the multi-level representation, the maximal control

  13. Design and construction of an electrolyte PEM test; Diseno y construccion de un electrolizador PEM de prueba

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez-Huerta, R. G.; Santillan-Aragon, G. [Instituto Politecnico Nacional, Mexico, D.F. (Mexico)]. E-mail: rosgonzalez_h@yahoo.com.mx; Solorza-Feria, O. [CINVESTAV-IPN, Mexico D.F. (Mexico)

    2009-09-15

    The use of hydrogen as a fuel is directly linked to its efficient and clean production. One of the most promising methods is water electrolysis, which coupled with a renewable energy source prevents the emission of pollutants into the atmosphere. If a proton exchange membrane (PEM) electrolysis is used, a highly pure hydrogen is produced, ready to be used in a fuel battery. Many studies and investigations in this area concentrate on finding different stable and selective electrocatalysts for the cathode reaction (production of hydrogen) and anode reaction (production of oxygen). To conduct these studies, equipment is needed to perform electrochemical studies and determine the stability and performance of different electrocatalysts. This work presents the design and construction of an a PEM electrolysis test to determine the performance of different anode electrocatalysts. Its active area is 4 cm{sup 2}, its structure is graphite and the current distribution mesh is made of stainless steel. Its performance was determined using as electrocatalysts 10% Pt/C E-tek® anodes and a 50%-50%, 25%-75% and 75%-25% combination of RuO{sub 2}-IrO{sub 2}. The authors wish to thank the ICYTDF (PICS08-37) for financial support and IPN (SIP-20090433) and architect Nestor Romero for the electrolysis machining. [Spanish] La utilizacion del hidrogeno como combustible esta ligado directamente a su produccion eficiente y limpia, uno de los metodos mas prometedores es la electrolisis del agua, ya que acoplado con una fuente de energia renovable se evita la emision de contaminantes a la atmosfera. Si se utiliza un electrolizador de membrana de intercambio protonico (Tipo PEM), el hidrogeno que se produce es de alta pureza, listo para ser utilizado en una pila de combustible. Muchos estudios e investigaciones en esta area se concentran en encontrar distintos electrocatalizadores estables y selectivos para la reaccion catodica (produccion de hidrogeno) y anodica (produccion de oxigeno). Para

  14. PEM-Scoot - Control system and analysis of operation; PEM-Scoot. Steuerung und Betriebsanalyse. Diplomarbeit 2006/07

    Energy Technology Data Exchange (ETDEWEB)

    Naegeli, M.; Kaiser, R.

    2007-07-01

    This diploma thesis presented at the Bernese University of Applied Sciences, Switzerland, describes a project concerning a new drive technology. The PEM-Scoot is a scooter with an electric drive which is powered by a fuel cell, using hydrogen and oxygen stored in two pressure cylinders. That only water is exhausted during operation is considered to be an important advantage. The work done in the project consisted on the one hand of the writing of software for the control and putting it into service and, on the other hand, of various driving tests carried out in order to optimise the control software for stand-alone handling. The planning of the project is described, as are the various components used. The software for the operation of the vehicle is described in detail. The results of driving tests are presented. The report is complemented with a comprehensive appendix.

  15. HOGEN{trademark} proton exchange membrane hydrogen generators: Commercialization of PEM electrolyzers

    Energy Technology Data Exchange (ETDEWEB)

    Smith, W.F.; Molter, T.M. [Proton Energy Systems, Inc., Rocky Hill, CT (United States)

    1997-12-31

    PROTON Energy Systems` new HOGEN series hydrogen generators are Proton Exchange Membrane (PEM) based water electrolyzers designed to generate 300 to 1000 Standard Cubic Feet Per Hour (SCFH) of high purity hydrogen at pressures up to 400 psi without the use of mechanical compressors. This paper will describe technology evolution leading to the HOGEN, identify system design performance parameters and describe the physical packaging and interfaces of HOGEN systems. PEM electrolyzers have served US and UK Navy and NASA needs for many years in a variety of diverse programs including oxygen generators for life support applications. In the late 1970`s these systems were advocated for bulk hydrogen generation through a series of DOE sponsored program activities. During the military buildup of the 1980`s commercial deployment of PEM hydrogen generators was de-emphasized as priority was given to new Navy and NASA PEM electrolysis systems. PROTON Energy Systems was founded in 1996 with the primary corporate mission of commercializing PEM hydrogen generators. These systems are specifically designed and priced to meet the needs of commercial markets and produced through manufacturing processes tailored to these applications. The HOGEN series generators are the first step along the path to full commercial deployment of PEM electrolyzer products for both industrial and consumer uses. The 300/1000 series are sized to meet the needs of the industrial gases market today and provide a design base that can transition to serve the needs of a decentralized hydrogen infrastructure tomorrow.

  16. A Frequency-Domain Adaptive Filter (FDAF) Prediction Error Method (PEM) Framework for Double-Talk-Robust Acoustic Echo Cancellation

    DEFF Research Database (Denmark)

    Gil-Cacho, Jose M.; van Waterschoot, Toon; Moonen, Marc

    2014-01-01

    to the FDAF-PEM-AFROW algorithm. We show that FDAF-PEM-AFROW is by construction related to the best linear unbiased estimate (BLUE) of the echo path. We depart from this framework to show an improvement in performance with respect to other adaptive filters minimizing the BLUE criterion, namely the PEM......In this paper, we propose a new framework to tackle the double-talk (DT) problem in acoustic echo cancellation (AEC). It is based on a frequency-domain adaptive filter (FDAF) implementation of the so-called prediction error method adaptive filtering using row operations (PEM-AFROW) leading...... regularization (VR) algorithms. The FDAF-PEM-AFROW versions significantly outperform the original versions in every simulation. In terms of computational complexity, the FDAF-PEM-AFROW versions are themselves about two orders of magnitude cheaper than the original versions....

  17. PEM-fuel cells for mobile application. Sub task: development of electrocatalysts. Final report; PEM-Brennstoffzelle fuer mobile Anwendung. Teilprojekt: Katalysatorenentwicklung. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Starz, K A

    1999-01-01

    PEM fuel cells are gaining increasing importance for use in automotive application. The goal of the research program reported here was to develop the basic technology and components for PEMFC stacks for use in transport applications. The sub-task of Degussa was to develop improved electrocatalysts for PEMFC single cells and stacks. The technical objectives of the research project were met. Electrocatalysts, characterized by a high Pt-dispersion, high surface area and excellent activity, were developed. With this material, considerable progress was made to reduce the total platinum loading of PEMFC cells and stacks to about 0,5 mgPt/cm{sup 2}. With this value, the goal of the program (<0,8 mg/cm{sup 2}) was significantly surpassed. Additionally, higher power densities of >0.4 W/cm{sup 2} were achieved at Degussa for hydrogen/air and reformate/air operation of the PEMFC. A CO-tolerant anode electrocatalyst, exhibiting a CO-tolerance of up to 100 ppm CO, enables the operation of PEMFC stacks with on-board generated methanol reformate. The performance of the new electrocatalyst materials was verified by DaimlerChrysler in a PEMFC demonstration stack at the end of the program. (orig.) [Deutsch] PEM-Brennstoffzellen gewinnen fuer die mobile Anwendung immer mehr an Bedeutung. Im Rahmen des hier beschriebenen Leitprojektes sollten die Basistechnologien fuer den Einsatz der PEM-Brennstoffzelle im mobilen Bereich (Elektrotraktion) entwickelt werden. Das Teilprojekt der Degussa befasst sich mit der Entwicklung von verbesserten Elektrokatalysatoren fuer PEM-Brennstoffzellenstacks. Die technischen Arbeitsziele des Vorhabens wurden erreicht. So konnten Elektrokatalysatoren bereitgestellt werden, die sich durch eine hohe Pt-Dispersion, eine grosse Pt-Oberflaeche sowie eine sehr gute Aktivitaet auszeichnen. Mit diesen Elektrokatalysatoren gelang es, die Platinbeladung der PEM-Elektroden (Anode und Kathode) erheblich abzusenken. Mit einer Gesamtplatinbeladung von 0,5 mg/cm{sup 2

  18. Using the caffeine breath test to study drug metabolism in protein-energy malnourished children

    OpenAIRE

    Oshikoya, Kazeem Adeola

    2014-01-01

    Malnutrition is a global health problem that affects infants and young children. It is frequently associated with infections and commonly affects children in developing countries. Malnutrition is the cellular imbalance between the supply of energy from macronutrients and micronutrients and the demand of the body for them in order to achieve normal growth, maintenance, and specific functions. Underweight (mild to moderate) and marasmus, marasmic-kwashiorkor, and kwashiorkor (severe) are the sp...

  19. An alternative approach to continuous compliance monitoring and turbine plant optimization using a PEMS (predictive emission monitoring system)

    International Nuclear Information System (INIS)

    Swanson, B.G.; Lawrence, P.

    2009-01-01

    This paper reviewed the use of a predictive emissions monitoring system (PEMS) at 3 different gas turbine facilities in the United States and highlighted the costs and benefits of using a PEMS for documenting emissions of priority pollutants and greenhouse gases (GHG). The PEMS interfaces directly to the turbine control system and represents a lower cost alternative to the traditional continuous emission monitoring system (CEMS). The PEMS can track combustion efficiency through modeling of the turbine's operation and emissions. Excess emissions can be tracked and the causes of pollution can be determined and mitigated. The PEMS installed at the 3 turbine plants must meet rigorous performance specification criteria and the sites perform ongoing quality assurance tasks such as periodic audits with portable analyzers. The PEMS is much less expensive to install, operate, and maintain compared to the standard CEMS gas analyzer. Empirical PEMS achieves very high accuracy levels and has demonstrated superior reliability over CEMS for various types of continuous process applications under existing air compliance regulations in the United States. Annual accuracy testing at the gas turbine sites have shown that the PEMS predictions are usually within 5 per cent of the reference method. PEMS can be certified as an alternative to gas analyzer based CEMS for nitrogen oxides and carbon dioxide compliance and for GHG trading purposes. 5 refs., 8 figs.

  20. [Child malnutrition, infrastructure and income in Mexico].

    Science.gov (United States)

    Ayala-Gaytán, Edgardo A; Díaz Durán-Hernández, Andrea

    2015-01-01

    Explain the variation in child malnutrition (CM), understood as low height for age (0 to 5 years old) for the period 1999-2006. State estimations of child malnutrition and several indicators of subjacent probable causes of CM were employed, such as poverty indices, state product per capita, women scholar attainment and access to health and the sewage system. Panel data regression analysis with fixed and random effects were used to analyze the data. The results indicate that the lack to access to health and sewage systems and poverty worsen CM, whereas women education helps to diminish CM. The study shows that infrastructure variables explain a significant part of the recent variation in DI across Mexican states, and that economic growth is not a sufficient condition to diminish DI.

  1. Malnutrition and disability: unexplored opportunities for collaboration

    Science.gov (United States)

    Groce, N; Challenger, E; Berman-Bieler, R; Farkas, A; Yilmaz, N; Schultink, W; Clark, D; Kaplan, C; Kerac, M

    2014-01-01

    There is increasing international interest in the links between malnutrition and disability: both are major global public health problems, both are key human rights concerns, and both are currently prominent within the global health agenda. In this review, interactions between the two fields are explored and it is argued that strengthening links would lead to important mutual benefits and synergies. At numerous points throughout the life-cycle, malnutrition can cause or contribute to an individual’s physical, sensory, intellectual or mental health disability. By working more closely together, these problems can be transformed into opportunities: nutrition services and programmes for children and adults can act as entry points to address and, in some cases, avoid or mitigate disability; disability programmes can improve nutrition for the children and adults they serve. For this to happen, however, political commitment and resources are needed, as are better data. PMID:25309998

  2. Intergovernmental Advanced Stationary PEM Fuel Cell System Demonstration Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Rich Chartrand

    2011-08-31

    A program to complete the design, construction and demonstration of a PEMFC system fuelled by Ethanol, LPG or NG for telecom applications was initiated in October 2007. Early in the program the economics for Ethanol were shown to be unfeasible and permission was given by DOE to focus on LPG only. The design and construction of a prototype unit was completed in Jun 2009 using commercially available PEM FC stack from Ballard Power Systems. During the course of testing, the high pressure drop of the stack was shown to be problematic in terms of control and stability of the reformer. Also, due to the power requirements for air compression the overall efficiency of the system was shown to be lower than a similar system using internally developed low pressure drop FC stack. In Q3 2009, the decision was made to change to the Plug power stack and a second prototype was built and tested. Overall net efficiency was shown to be 31.5% at 3 kW output. Total output of the system is 6 kW. Using the new stack hardware, material cost reduction of 63% was achieved over the previous Alpha design. During a November 2009 review meeting Plug Power proposed and was granted permission, to demonstrate the new, commercial version of Plug Power's telecom system at CERL. As this product was also being tested as part of a DOE Topic 7A program, this part of the program was transferred to the Topic 7A program. In Q32008, the scope of work of this program was expanded to include a National Grid demonstration project of a micro-CHP system using hightemperature PEM technology. The Gensys Blue system was cleared for unattended operation, grid connection, and power generation in Aug 2009 at Union College in NY state. The system continues to operate providing power and heat to Beuth House. The system is being continually evaluated and improvements to hardware and controls will be implemented as more is learned about the system's operation. The program is instrumental in improving the

  3. Malnutrition risk questionnaire combined with body composition measurement in malnutrition screening in inflammatory bowel disease.

    Science.gov (United States)

    Csontos, Ágnes Anna; Molnár, Andrea; Piri, Zsolt; Pálfi, Erzsébet; Miheller, Pál

    2017-01-01

    The purpose of malnutrition screening is to predict the probability of a worse outcome due to nutritional factors. The Malnutrition Universal Screening Tool (MUST) can be used for screening in inflammatory bowel disease (IBD); however, it does not provide details about body composition. Our aim was to assess the body composition and combine this with the MUST method to screen risk of malnutrition and sarcopenia. A total of 173 IBD outpatients were enrolled in this cross-sectional study. The MUST scale indicated 21.4% of IBD patients to be at risk of malnutrition. A risk of sarcopenia was detected in 27.7%. However, one third of these patients were not considered to be at risk by their MUST score. Furthermore, Crohn's disease (CD) patients had a strongly unfavorable fat-free mass index (FFMI) value compared to ulcerative colitis (UC) patients, and these differences were significant among men (FFMI: 18.62 ± 2.16 vs 19.85 ± 2.22, p = 0.02, in CD and UC males, respectively). As sarcopenia is a relevant prognostic factor, the MUST method should be expanded to include body composition analysis to detect more IBD patients at risk of malnutrition and sarcopenia in order to start their nutritional therapy immediately.

  4. Mineral Malnutrition Following Bariatric Surgery12

    Science.gov (United States)

    Gletsu-Miller, Nana; Wright, Breanne N.

    2013-01-01

    Moderate/severe obesity is on the rise in the United States. Weight management includes bariatric surgery, which is effective and can alleviate morbidity and mortality from obesity-associated diseases. However, many individuals are dealing with nutritional complications. Risk factors include: 1) preoperative malnutrition (e.g., vitamin D, iron); 2) decreased food intake (due to reduced hunger and increased satiety, food intolerances, frequent vomiting); 3) inadequate nutrient supplementation (due to poor compliance with multivitamin/multimineral regimen, insufficient amounts of vitamins and/or minerals in supplements); 4) nutrient malabsorption; and 5) inadequate nutritional support (due to lack of follow-up, insufficient monitoring, difficulty in recognizing symptoms of deficiency). For some nutrients (e.g., protein, vitamin B-12, vitamin D), malnutrition issues are reasonably addressed through patient education, routine monitoring, and effective treatment strategies. However, there is little attention paid to other nutrients (e.g., zinc, copper), which if left untreated may have devastating consequences (e.g., hair loss, poor immunity, anemia, defects in neuro-muscular function). This review focuses on malnutrition in essential minerals, including calcium (and vitamin D), iron, zinc, and copper, which commonly occur following popular bariatric procedures. There will be emphasis on the complexities, including confounding factors, related to screening, recognition of symptoms, and, when available, current recommendations for treatment. There is an exceptionally high risk of malnutrition in adolescents and pregnant women and their fetuses, who may be vulnerable to problems in growth and development. More research is required to inform evidence-based recommendations for improving nutritional status following bariatric surgery and optimizing weight loss, metabolic, and nutritional outcomes. PMID:24038242

  5. [Anorexia nervosa: a model of malnutrition].

    Science.gov (United States)

    Rigaud, D

    2000-11-01

    Anorexia nervosa is a typical kind of malnutrition resulting from chronic starvation. The malnutrition is related to a severe eating disorder (fear of eating and becoming fat) causing reduction of food intake. The large majority of the patients are women (95%). There are two types of anorexia nervosa with different prognosis and treatment: the restricting type and the "purging" type (with or without bulimia). In this kind of malnutrition, plasma nutritional markers are normal. The decrease in energy intake induces an adaptative decrease in energy expenditure. Body weight loss is related to a loss in fat free mass and in fat mass, although there is an increase in extracellular water. Below a body mass index of 15 kg/(m)(2), sodium and water retention require prescription of a low sodium diet. Several factors of resistance are operating in this disease, acting against body weight gain: metabolic wasting of energy expenditure (futile cycles), fear-related energy expenditure, dissimulations. Recovery is still long and difficult to obtain and requires a combined nutritional and psychotherapeutic approach.

  6. The impact of malnutrition on childhood infections.

    Science.gov (United States)

    Walson, Judd L; Berkley, James A

    2018-06-01

    Almost half of all childhood deaths worldwide occur in children with malnutrition, predominantly in sub-Saharan Africa and South Asia. This review summarizes the mechanisms by which malnutrition and serious infections interact with each other and with children's environments. It has become clear that whilst malnutrition results in increased incidence, severity and case fatality of common infections, risks continue beyond acute episodes resulting in significant postdischarge mortality. A well established concept of a 'vicious-cycle' between nutrition and infection has now evolving to encompass dysbiosis and pathogen colonization as precursors to infection; enteric dysfunction constituting malabsorption, dysregulation of nutrients and metabolism, inflammation and bacterial translocation. All of these interact with a child's diet and environment. Published trials aiming to break this cycle using antimicrobial prophylaxis or water, sanitation and hygiene interventions have not demonstrated public health benefit so far. As further trials are planned, key gaps in knowledge can be filled by applying new tools to re-examine old questions relating to immune competence during and after infection events and changes in nutritional status; and how to characterize overt and subclinical infection, intestinal permeability to bacteria and the role of antimicrobial resistance using specific biomarkers.

  7. State of malnutrition in Cuban hospitals.

    Science.gov (United States)

    Barreto Penié, Jesús

    2005-04-01

    We assessed the current state of undernutrition as observed in 1905 patients hospitalized in 12 Cuban health care institutions, as part of a Latin American, multinational survey similar in design and goals. We surveyed 1905 randomly selected patients from 12 Cuban hospitals in a two-phase study. Patients' clinical charts were audited in phase 1, the Subjective Global Assessment was used to assess patients' nutritional status in phase 2. The study was locally conducted by a properly trained team. The frequency of undernutrition in Cuban hospitals was 41.2% (95% confidence interval = 38.9 to 43.4), and 11.1% of patients were considered severely undernourished. Statistically significant (P hospital services/specialties were identified: geriatrics (56.3%), critical care (54.8%), nephrology (54.3%), internal medicine (48.6%), gastroenterology (46.5%), and cardiovascular surgery (44.8%). Malnutrition rates increased progressively with prolonged length of stay. A high malnutrition rate was observed among participating hospitals. The design and inception of policies that foster intervention programs focusing on early identification of hospital malnutrition and its timely management is suggested to decrease its deleterious effects on outcomes of health care in the participating hospitals.

  8. Cryptosporidium infection in undernourished children with HIV/AIDS ...

    African Journals Online (AJOL)

    Background: AIDS and Protein energy malnutrition (PEM) severely impair the immune system Cryptosporidium has over the last two decades emerged as a life threatening disease. The study attempts to determine the prevalence of Cryptosporidium infection in malnourished children with HIV/AIDS. Method: Blood and stool ...

  9. The Relationship between Nutritional Status and Anthropometric ...

    African Journals Online (AJOL)

    Three hundred and six (306) children of both sexes aged 1-5 years were classified into three groups: Normal, protein-energy malnutrition (PEM) and vitamin deficiency (VD). The relative importance of the various anthropometric measurements was assessed in these three categories of children through comparison of their ...

  10. Electrochemical extraction of oxygen using PEM electrolysis technology

    Directory of Open Access Journals (Sweden)

    BOULBABA ELADEB

    2012-11-01

    Full Text Available Electrochemical extraction of oxygen from air can be carried out by chemical reduction of oxygen at the cathode and simultaneous oxygen evolution by water anode oxidation. The present investigation deals with the use of an electrolysis cell of PEM technology for this purpose. A dedicated 25 cm2 cell provided with a commercial water electrolysis MEA and titanium grooved plates has been designed for continuous operation at pressures close to the ambient level. The MEA consisted of a Nafion 117 membrane sandwiched between a Pt/C cathode and a non-supported Pt-Ir anode. Oxygen partial consumption in long-term runs was evaluated by analysis of the outlet air by gas chromatography, depending on the cell voltage - or the current density - and the excess in air oxygen fed to the cathode. Runs over more 50 hours indicated the relative stability of the components used for current densities ranging from 0.1 to 0.2 A cm-2 with high efficiency of oxygen reduction. Higher current density could be envisaged with more efficient MEA’s, exhibiting lower overpotentials for oxygen evolution to avoid too significant degradation of the anode material and the membrane. Interpretation of the data has been carried out by calculation of the cathode current efficiency.

  11. The morphology of durability issues in PEM fuel cells

    International Nuclear Information System (INIS)

    Kundu, S.; Fowler, M.; Simon, L.; Grot, S.

    2004-01-01

    'Full text:' The work presented here examines durability issues in PEM fuel cell materials by examining material morphology and linking morphological features to performance. Scanning electron microscope (SEM) techniques have been able to identify a variety of features on the catalyst layer, each with their own implication to the overall performance and durability of the membrane electrode assembly (MEA). These features include cracking, delamination of the catalyst layer, catalyst clustering, electrolyte clustering, and thickness variations. Links between several of these features and catalyst dispersion conditions was also examined, showing that how the material was manufactured influences the type of morphological features present. The SEM has also been used with accelerated aging techniques to closely examine aging of the gas diffusion layer (GDL). It can be shown that over time the GDL will loose its hydrophobic character and hence become more susceptible to flooding in a fuel cell. The impact of morphological changes were determined using fuel cell models and experimental work. The ultimate aim of this work is to provide material developers with the tools and knowledge necessary to design better materials and therefore bring fuel cells closer to commercialization. (author)

  12. Experimental investigation and mathematical modeling of triode PEM fuel cells

    International Nuclear Information System (INIS)

    Martino, E.; Koilias, G.; Athanasiou, M.; Katsaounis, A.; Dimakopoulos, Y.; Tsamopoulos, J.; Vayenas, C.G.

    2017-01-01

    Highlights: •The triode fuel cell operation was tested using novel comb-type electrode designs. •Triode operation enhances the PEMFC power output by up to 500%. •Power output enhancement exceeds auxiliary power by up to 20%. •Good agreement with mathematical model based on the laws of Kirchhoff. •Proton fluxes in the membrane found via solution of the Nernst Planck equation -- Abstract: The triode operation of humidified PEM fuel cells has been investigated both with pure H 2 and with CO poisoned H 2 feed over commercial Vulcan supported Pt(30%)-Ru(15%) anodes. It was found that triode operation, which involves the use of a third, auxiliary, electrode, leads to up to 400% power output increase with the same CO poisoned H 2 gas feed. At low current densities, the power increase is accompanied by an increase in overall thermodynamic efficiency. A mathematical model, based on Kirchhoff’s laws, has been developed which is in reasonably good agreement with the experimental results. In order to gain some additional insight into the mechanism of triode operation, the model has been also extended to describe the potential distribution inside the Nafion membrane via the numerical solution of the Nernst-Planck equation. Both model and experiment have shown the critical role of minimizing the auxiliary-anode or auxiliary-cathode resistance, and this has led to improved comb-shaped anode or cathode electrode geometries.

  13. Sliding-Mode Control of PEM Fuel Cells

    CERN Document Server

    Kunusch, Cristian; Mayosky, Miguel

    2012-01-01

    Recent advances in catalysis technologies and new materials make fuel cells an economically appealing and clean energy source with massive market potential in portable devices, home power generation and the automotive industry. Among the more promising fuel-cell technologies are proton exchange membrane fuel cells (PEMFCs). Sliding-Mode Control of PEM Fuel Cells demonstrates the application of higher-order sliding-mode control to PEMFC dynamics. Fuel-cell dynamics are often highly nonlinear and the text shows the advantages of sliding modes in terms of robustness to external disturbance, modelling error and system-parametric disturbance using higher-order control to reduce chattering. Divided into two parts, the book first introduces the theory of fuel cells and sliding-mode control. It begins by contextualising PEMFCs both in terms of their development and within the hydrogen economy and today’s energy production situation as a whole. The reader is then guided through a discussion of fuel-cell operation pr...

  14. A PEM fuel cell for in situ XAS studies

    International Nuclear Information System (INIS)

    Wiltshire, Richard J.K.; King, Colin R.; Rose, Abigail; Wells, Peter P.; Hogarth, Martin P.; Thompsett, David; Russell, Andrea E.

    2005-01-01

    A miniature proton exchange membrane (PEM) fuel cell has been designed to enable in situ XAS investigations of the anode catalyst using fluorescence detection. The development of the cell is described, in particular the modifications required for elevated temperature operation and humidification of the feed gasses. The impact of the operating conditions is observed as an increase in the catalyst utilisation, which is evident in the EXAFS collected at the Pt L III and Ru K edges for a PtRu/C catalyst. The Pt component of the catalyst was found to be readily reduced by hydrogen in the fuel, while the Ru was only fully reduced under conditions of good gas flow and electrochemical contact. Under such conditions no evidence of O neighbours were found at the Ru edge. The results are interpreted in relation to the lack of surface sensitivity of the EXAFS method and indicate that the equilibrium coverage of O species on the Ru surface sites is too low to be observed using EXAFS

  15. Starved Guts: Morphologic and Functional Intestinal Changes in Malnutrition.

    Science.gov (United States)

    Attia, Suzanna; Feenstra, Marjon; Swain, Nathan; Cuesta, Melina; Bandsma, Robert H J

    2017-11-01

    Malnutrition contributes significantly to death and illness worldwide and especially to the deaths of children younger than 5 years. The relation between intestinal changes in malnutrition and morbidity and mortality has not been well characterized; however, recent research indicates that the functional and morphologic changes of the intestine secondary to malnutrition itself contribute significantly to these negative clinical outcomes and may be potent targets of intervention. The aim of this review was to summarize current knowledge of experimental and clinically observed changes in the intestine from malnutrition preclinical models and human studies. Limited clinical studies have shown villous blunting, intestinal inflammation, and changes in the intestinal microbiome of malnourished children. In addition to these findings, experimental data using various animal models of malnutrition have found evidence of increased intestinal permeability, upregulated intestinal inflammation, and loss of goblet cells. More mechanistic studies are urgently needed to improve our understanding of malnutrition-related intestinal dysfunction and to identify potential novel targets for intervention.

  16. Reforming options for hydrogen production from fossil fuels for PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Ersoz, Atilla; Olgun, Hayati [TUBITAK Marmara Research Center, Institute of Energy, Gebze, 41470 Kocaeli (Turkey); Ozdogan, Sibel [Marmara University Faculty of Engineering, Goztepe, 81040 Istanbul (Turkey)

    2006-03-09

    PEM fuel cell systems are considered as a sustainable option for the future transport sector in the future. There is great interest in converting current hydrocarbon based transportation fuels into hydrogen rich gases acceptable by PEM fuel cells on-board of vehicles. In this paper, we compare the results of our simulation studies for 100kW PEM fuel cell systems utilizing three different major reforming technologies, namely steam reforming (SREF), partial oxidation (POX) and autothermal reforming (ATR). Natural gas, gasoline and diesel are the selected hydrocarbon fuels. It is desired to investigate the effect of the selected fuel reforming options on the overall fuel cell system efficiency, which depends on the fuel processing, PEM fuel cell and auxiliary system efficiencies. The Aspen-HYSYS 3.1 code has been used for simulation purposes. Process parameters of fuel preparation steps have been determined considering the limitations set by the catalysts and hydrocarbons involved. Results indicate that fuel properties, fuel processing system and its operation parameters, and PEM fuel cell characteristics all affect the overall system efficiencies. Steam reforming appears as the most efficient fuel preparation option for all investigated fuels. Natural gas with steam reforming shows the highest fuel cell system efficiency. Good heat integration within the fuel cell system is absolutely necessary to achieve acceptable overall system efficiencies. (author)

  17. Reforming options for hydrogen production from fossil fuels for PEM fuel cells

    Science.gov (United States)

    Ersoz, Atilla; Olgun, Hayati; Ozdogan, Sibel

    PEM fuel cell systems are considered as a sustainable option for the future transport sector in the future. There is great interest in converting current hydrocarbon based transportation fuels into hydrogen rich gases acceptable by PEM fuel cells on-board of vehicles. In this paper, we compare the results of our simulation studies for 100 kW PEM fuel cell systems utilizing three different major reforming technologies, namely steam reforming (SREF), partial oxidation (POX) and autothermal reforming (ATR). Natural gas, gasoline and diesel are the selected hydrocarbon fuels. It is desired to investigate the effect of the selected fuel reforming options on the overall fuel cell system efficiency, which depends on the fuel processing, PEM fuel cell and auxiliary system efficiencies. The Aspen-HYSYS 3.1 code has been used for simulation purposes. Process parameters of fuel preparation steps have been determined considering the limitations set by the catalysts and hydrocarbons involved. Results indicate that fuel properties, fuel processing system and its operation parameters, and PEM fuel cell characteristics all affect the overall system efficiencies. Steam reforming appears as the most efficient fuel preparation option for all investigated fuels. Natural gas with steam reforming shows the highest fuel cell system efficiency. Good heat integration within the fuel cell system is absolutely necessary to achieve acceptable overall system efficiencies.

  18. The magnitude of the problem of malnutrition in Europe.

    Science.gov (United States)

    Kondrup, Jens; Sorensen, Janice M

    2009-01-01

    A review of the publications on hospital malnutrition in Europe over the last 5 years shows that the incidence and prevalence of malnutrition are still very high: 21 and 37%, respectively. The process of structured nutrition support is still far from being generally implemented, as based on the few studies available. As a result, malnutrition diagnosed on admission to hospital is still associated with adverse clinical outcome (increased length of stay and higher rates of complications). Copyright (c) 2009 S. Karger AG, Basel.

  19. Disease-related malnutrition: influence on body composition and prognosis

    OpenAIRE

    Pirlich, Matthias

    2010-01-01

    Disease-related malnutrition is a frequent clincal problem with severe medical and economic impact. This work summarizes studies on body composition analysis, risk factors, prevalence and prognostic impact of malnutrition. The diagnosis of malnutrition in patients with chronic liver disease is hampered by hyperhydration and requires body composition analysis. Using four different methods for body composition analysis (total body potassium counting, anthropometry, bioelectrical impedance analy...

  20. Effects of honey to mobilize endogenous stem cells in efforts intestinal and ovarian tissue regeneration in rats with protein energy malnutrition

    Directory of Open Access Journals (Sweden)

    R. Heru Prasetyo

    2016-05-01

    Conclusions: Expression of CD34+ and CD45+, which significantly different in treatment 2 (2. Furthermore, increase of immune response (decrease Hsp70 expression and increased PGE2 in intestinal tissue. Increased immune response causes expression of GDF-9 in ovarian tissue. Decreased of Hsp70 expression, increased PGE2 and increased GDF-9 followed the process of regeneration of the intestinal and ovarian tissue.

  1. [Identification and treatment of malnutrition in a hospital patient].

    Science.gov (United States)

    Orell-Kotikangas, Helena; Antikainen, Anne; Pihlajamäki, Jussi

    2014-01-01

    Malnutrition associated with a disease remains often undiagnosed despite of having a frequency 20 to 60% in the developed countries. Malnutrition delays the recovery from diseases and operations, and increases complications and mortality. In Europe, the costs caused by malnutrition are two times higher than those due to overweight. Good clinical nutritional therapy requires immediate identification of patients having or being at risk of malnutrition. Approximately one out of three hospital patients is a high-risk patient. Attempts should be made to start the clinical nutritional therapy for these patients as early as possible.

  2. Optimized High Temperature PEM Fuel Cell & High Pressure PEM Electrolyser for Regenerative Fuel Cell Systems in GEO Telecommunication Satellites

    Directory of Open Access Journals (Sweden)

    Farnes Jarle

    2017-01-01

    Full Text Available Next generation telecommunication satellites will demand increasingly more power. Power levels up to 50 kW are foreseen for the next decades. Battery technology that can sustain up to 50 kW for eclipse lengths of up to 72 minutes will represent a major impact on the total mass of the satellite, even with new Li-ion battery technologies. Regenerative fuel cell systems (RFCS were identified years ago as a possible alternative to rechargeable batteries. CMR Prototech has investigated this technology in a series of projects initiated by ESA focusing on both the essential fuel cell technology, demonstration of cycle performance of a RFCS, corresponding to 15 years in orbit, as well as the very important reactants storage systems. In the last two years the development has been focused towards optimising the key elements of the RFCS; the HTPEM fuel cell and the High Pressure PEM electrolyser. In these ESA activities the main target has been to optimise the design by reducing the mass and at the same time improve the performance, thus increasing the specific energy. This paper will present the latest development, including the main results, showing that significant steps have been taken to increase TRL on these key components.

  3. Compendium of NASA data base for the global tropospheric experiment's Pacific Exploratory Mission West-B (PEM West-B)

    Science.gov (United States)

    Gregory, Gerald L.; Scott, A. Donald, Jr.

    1995-01-01

    This compendium describes aircraft data that are available from NASA's Pacific Exploratory Mission West-B (PEM West-B). PEM West is a component of the International Global Atmospheric Chemistry's (IGAC) East Asia/North Pacific Regional Study (APARE) project. Objectives of PEM West are to investigate the atmospheric chemistry of ozone over the northwest Pacific -- natural budgets and the impact of anthropogenic/continental sources; and to investigate sulfur chemistry -- continental and marine sulfur sources. The PEM West program encompassed two expeditions. PEM West-A was conducted in September 1991 during which the predominance of tropospheric air was from mid-Pacific (marine) regions, but (at times) was modified by Asian outflow. PEM West-B was conducted during February 1994, a period characterized by maximum Asian outflow. Results from PEM West-A and B are public domain. PEM West-A data are summarized in NASA TM 109177 (published February 1995). Flight experiments were based at Guam, Hong Kong, and Japan. This document provides a representation of NASA DC-8 aircraft data that are available from NASA Langley's Distributed Active Archive Center (DAAC). The DAAC includes numerous other data such as meteorological and modeling products, results from surface studies, satellite observations, and sonde releases.

  4. Compendium of NASA data base for the Global Tropospheric Experiment's Pacific Exploratory Mission West-A (PEM West-A)

    Science.gov (United States)

    Gregory, G. L.; Scott, A. D., Jr.

    1995-01-01

    This compendium describes aircraft data that are available from NASA's Pacific Exploratory Mission West-A (PEM West-A). PEM West is a component of the International Global Atmospheric Chemistry's (IGAC) East Asia/North Pacific Regional Study (APARE) project. The PEM- West program encompassed two expeditions to study contrasting meteorological regimes in the Pacific. Objectives of PEM West are to investigate the atmospheric chemistry of ozone over the northwest Pacific -- natural budgets and the impact of anthropogenic sources; and to investigate sulfur chemistry -- continental versus marine sulfur sources. PEM West-A was conducted in September 1991 during which the predominance of tropospheric air is from the mid-Pacific (marine) regions, but (at times) is modified/mixed with Asian continental outflow. PEM West-B was conducted during February 1994, a period characterized by maximum continental outflow. PEM-B data (not included) will become public domain during the Summer of 1995. PEM West-A flight experiments were based at Japan, Hong Kong, and Guam. This document provides a representation of NASA DC-8 aircraft data that are available from NASA Langley's Distributed Active Archive Center (DAAC), which include numerous data such as meteorological observations, modeling products, results from surface studies, satellite observations, and sonde releases.

  5. Mothers literacy status and its association with feeding practices and PEM among 1-5 year aged children in southern part of India, Mysore

    Directory of Open Access Journals (Sweden)

    Santosh Kumar A

    2012-10-01

    Full Text Available Objective: To estimate the prevalence of PEM in children aged 1 to 5 years and to study the association of mothers educational status with feeding practices and nutritional status of children aged 1 to 5 years. Methods: A cross sectional study of 600 children of 1-5 year age group in urban slums of Mysore city was carried out with cluster random sampling method. The data was collected by using a predesigned and pretested proforma. Assessment of the nutritional status was done by clinical examination and anthropometry. WHO child growth standards, 2006 reference data were used to classify malnutrition. Results: Among 600 children examined, 285 (47.5% were males and 315 (52.5% were females. Exclusive breast feeding was given in 295 (49.2% of children. Pre lacteal feeds and top milk feeds were given in 123 (20.5% and 108 (18% of children respectively. The prevalence of underweight, stunting and wasting was observed to be 31.3%, 42.2% and 14.2% respectively. About 12.8% of mothers were illiterate and this was significantly associated with feeding practices and nutritional status of children. Conclusions: Mothers literacy status plays important role in feeding practices of their children which inturn is an important factor in determining the nutritional status of child

  6. Irisin is Associated with Urotensin II and Protein Energy Wasting in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Wan-Yu He

    2016-02-01

    Full Text Available Aims/Introduction: Irisin is a newly identified myokine which can promote energy expenditure. Urotensin II (UII is identified as the most potent mammalian vasoconstrictor to date. Previous studies showed that UII can aggravate insulin resistance while irisin alleviate insulin resistance. Through this study, it is our aim to elucidate if UII can induce insulin resistance and also have an association with the irisin level in hemodialysis (HD patients. Materials and Methods: One hundred and twenty-eight patients on maintenance hemodialysis treatment and forty healthy subjects were enrolled in this study. Blood irisin concentrations and UII concentrations were measured by ELISA and RIA respectively. The body composition was analyzed by bioelectrical impedance. Results: The serum irisin levels and UII levels were both significantly lower in HD patients in comparison to that of the healthy subjects. The serum irisin levels were lower in HD patients with protein energy wasting than those of the patients without protein energy wasting. The independent determinants of circulating Ln (irisin (the natural logarithm of irisin were UII lean body mass and patients with protein energy wasting. Conclusions: Our results are the first to provide the clinical evidence of the association among irisin, UII, and protein energy wasting. Our results hint that UII and protein energy wasting might inhibit the release or synthesis of irisin from skeletal muscles in HD patients.

  7. Thermal modeling and temperature control of a PEM fuel cell system for forklift applications

    DEFF Research Database (Denmark)

    Liso, Vincenzo; Nielsen, Mads Pagh; Kær, Søren Knudsen

    2014-01-01

    Temperature changes in PEM fuel cell stacks are considerably higher during load variations and have a negative impact as they generate thermal stresses and stack degradation. Cell hydration is also of vital importance in fuel cells and it is strongly dependent on operating temperature....... A combination of high temperature and reduced humidity increases the degradation rate. Stack thermal management and control are, thus, crucial issues in PEM fuel cell systems especially in automotive applications such as forklifts. In this paper we present a control–oriented dynamic model of a liquid–cooled PEM...... fuel cell system for studying temperature variations over fast load changes. A temperature dependent cell polarization and hydration model integrated with the compressor, humidifier and cooling system are simulated in dynamic condition. A feedback PID control was implemented for stack cooling...

  8. Phase 1 feasibility study of an integrated hydrogen PEM fuel cell system. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Luczak, F.

    1998-03-01

    Evaluated in the report is the use of hydrogen fueled proton exchange membrane (PEM) fuel cells for devices requiring less than 15 kW. Metal hydrides were specifically analyzed as a method of storing hydrogen. There is a business and technical part to the study that were developed with feedback from each other. The business potential of a small PEM product is reviewed by examining the markets, projected sales, and required investment. The major technical and cost hurdles to a product are also reviewed including: the membrane and electrode assembly (M and EA), water transport plate (WTP), and the metal hydrides. It was concluded that the best potential stationary market for hydrogen PEM fuel cell less than 15 kW is for backup power use in telecommunications applications.

  9. Corrections for the effects of accidental coincidences, Compton scatter, and object size in positron emission mammography (PEM) imaging

    Energy Technology Data Exchange (ETDEWEB)

    Raymond Raylman; Stanislaw Majewski; Randolph Wojcik; Andrew Weisenberger; Brian Kross; Vladimir Popov

    2001-06-01

    Positron emission mammography (PEM) has begun to show promise as an effective method for the detection of breast lesions. Due to its utilization of tumor-avid radiopharmaceuticals labeled with positron-emitting radionuclides, this technique may be especially useful in imaging of women with radiodense or fibrocystic breasts. While the use of these radiotracers affords PEM unique capabilities, it also introduces some limitations. Specifically, acceptance of accidental and Compton-scattered coincidence events can decrease lesion detectability. The authors studied the effect of accidental coincidence events on PEM images produced by the presence of 18F-Fluorodeoxyglucose in the organs of a subject using an anthropomorphic phantom. A delayed-coincidence technique was tested as a method for correcting PEM images for the occurrence of accidental events. Also, a Compton scatter correction algorithm designed specifically for PEM was developed and tested using a compressed breast phantom.

  10. Corrections for the effects of accidental coincidences, Compton scatter, and object size in positron emission mammography (PEM) imaging

    International Nuclear Information System (INIS)

    Raymond Raylman; Stanislaw Majewski; Randolph Wojcik; Andrew Weisenberger; Brian Kross; Vladimir Popov

    2001-01-01

    Positron emission mammography (PEM) has begun to show promise as an effective method for the detection of breast lesions. Due to its utilization of tumor-avid radiopharmaceuticals labeled with positron-emitting radionuclides, this technique may be especially useful in imaging of women with radiodense or fibrocystic breasts. While the use of these radiotracers affords PEM unique capabilities, it also introduces some limitations. Specifically, acceptance of accidental and Compton-scattered coincidence events can decrease lesion detectability. The authors studied the effect of accidental coincidence events on PEM images produced by the presence of 18F-Fluorodeoxyglucose in the organs of a subject using an anthropomorphic phantom. A delayed-coincidence technique was tested as a method for correcting PEM images for the occurrence of accidental events. Also, a Compton scatter correction algorithm designed specifically for PEM was developed and tested using a compressed breast phantom

  11. Content validity across methods of malnutrition assessment in patients with cancer is limited

    NARCIS (Netherlands)

    Sealy, Martine J.; Nijholt, Willemke; Stuiver, Martijn M.; van der Berg, Marit M.; Roodenburg, Jan L. N.; Schans, van der Cees P.; Ottery, Faith D.; Jager-Wittenaar, Harriet

    Objective: To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition. Study Design and Setting: Systematic review of studies in cancer patients that operationalized malnutrition as a variable,

  12. The Relation Between Malnutrition and the Exocrine Pancreas: A Systematic Review

    NARCIS (Netherlands)

    Bartels, Rosalie H.; van den Brink, Deborah A.; Bandsma, Robert H.; Boele van Hensbroek, Michael; Tabbers, Merit M.; Voskuijl, Wieger P.

    2018-01-01

    Objective: The relation between malnutrition and exocrine pancreatic insufficiency (EPI) has been described previously, but it is unclear if malnutrition leads to EPI or vice versa. We systematically synthesized current evidence evaluating the association between malnutrition and EPI in children.

  13. Content validity across methods of malnutrition assessment in patients with cancer is limited

    NARCIS (Netherlands)

    Sealy, Martine; Nijholt, Willemke; Stuiver, M.M.; van der Berg, M.M.; Roodenburg, Jan; Ottery, Faith D.; van der Schans, Cees; Jager, Harriët

    2016-01-01

    Objective To identify malnutrition assessment methods in cancer patients and assess their content validity based on internationally accepted definitions for malnutrition. Study Design and Setting Systematic review of studies in cancer patients that operationalized malnutrition as a variable,

  14. Advanced Materials for PEM-Based Fuel Cell Systems

    Energy Technology Data Exchange (ETDEWEB)

    James E. McGrath

    2005-10-26

    Proton exchange membrane fuel cells (PEMFCs) are quickly becoming attractive alternative energy sources for transportation, stationary power, and small electronics due to the increasing cost and environmental hazards of traditional fossil fuels. Two main classes of PEMFCs include hydrogen/air or hydrogen/oxygen fuel cells and direct methanol fuel cells (DMFCs). The current benchmark membrane for both types of PEMFCs is Nafion, a perfluorinated sulfonated copolymer made by DuPont. Nafion copolymers exhibit good thermal and chemical stability, as well as very high proton conductivity under hydrated conditions at temperatures below 80 °C. However, application of these membranes is limited due to their high methanol permeability and loss of conductivity at high temperatures and low relative humidities. These deficiencies have led to the search for improved materials for proton exchange membranes. Potential PEMs should have good thermal, hydrolytic, and oxidative stability, high proton conductivity, selective permeability, and mechanical durability over long periods of time. Poly(arylene ether)s, polyimides, polybenzimidazoles, and polyphenylenes are among the most widely investigated candidates for PEMs. Poly(arylene ether)s are a promising class of proton exchange membranes due to their excellent thermal and chemical stability and high glass transition temperatures. High proton conductivity can be achieved through post-sulfonation of poly(arylene ether) materials, but this most often results in very high water sorption or even water solubility. Our research has shown that directly polymerized poly(arylene ether) copolymers show important advantages over traditional post-sulfonated systems and also address the concerns with Nafion membranes. These properties were evaluated and correlated with morphology, structure-property relationships, and

  15. Advanced Materials for PEM-Based Fuel Cell Systems

    Energy Technology Data Exchange (ETDEWEB)

    James E. McGrath; Donald G. Baird; Michael von Spakovsky

    2005-10-26

    Proton exchange membrane fuel cells (PEMFCs) are quickly becoming attractive alternative energy sources for transportation, stationary power, and small electronics due to the increasing cost and environmental hazards of traditional fossil fuels. Two main classes of PEMFCs include hydrogen/air or hydrogen/oxygen fuel cells and direct methanol fuel cells (DMFCs). The current benchmark membrane for both types of PEMFCs is Nafion, a perfluorinated sulfonated copolymer made by DuPont. Nafion copolymers exhibit good thermal and chemical stability, as well as very high proton conductivity under hydrated conditions at temperatures below 80 degrees C. However, application of these membranes is limited due to their high methanol permeability and loss of conductivity at high temperatures and low relative humidities. These deficiencies have led to the search for improved materials for proton exchange membranes. Potential PEMs should have good thermal, hydrolytic, and oxidative stability, high proton conductivity, selective permeability, and mechanical durability over long periods of time. Poly(arylene ether)s, polyimides, polybenzimidazoles, and polyphenylenes are among the most widely investigated candidates for PEMs. Poly(arylene ether)s are a promising class of proton exchange membranes due to their excellent thermal and chemical stability and high glass transition temperatures. High proton conductivity can be achieved through post-sulfonation of poly(arylene ether) materials, but this most often results in very high water sorption or even water solubility. Our research has shown that directly polymerized poly(arylene ether) copolymers show important advantages over traditional post-sulfonated systems and also address the concerns with Nafion membranes. These properties were evaluated and correlated with morphology, structure-property relationships, and states of water in the membranes. Further improvements in properties were achieved through incorporation of inorganic

  16. Simulation study of a PEM fuel cell system fed by hydrogen produced by partial oxidation

    Energy Technology Data Exchange (ETDEWEB)

    Ozdogan, S [Marmara University, Faculty of Engineering, Istanbul (Turkey); Ersoz, A; Olgun, H [TUBITAK Marmara Research Center, Energy Systems and Environmental Research Institute, Kocaeli (Turkey)

    2003-09-01

    Within the frame of sustainable development, efficient and clean, if possible zero emission energy production technologies are of utmost importance in various sectors such as utilities, industry, households and transportation. Low-temperature fuel cell systems are suitable for powering transportation systems such as automobiles and trucks in an efficient and low-emitting manner. Proton exchange membrane (PEM) fuel cell systems constitute the most promising low temperature fuel cell option being developed globally. PEM fuel cells generate electric power from air and hydrogen or from a hydrogen rich gas via electrochemical reactions. Water and waste heat are the only by-products of PEM fuel cells. There is great interest in converting current hydrocarbon based common transportation fuels such as gasoline and diesel into hydrogen rich gases acceptable by PEM fuel cells. Hydrogen rich gases can be produced from conventional transportation fuels via various reforming technologies. Steam reforming, partial oxidation and auto-thermal reforming are the three major reforming technologies. In this paper, we discuss the results of a simulation study for a PEM fuel cell with partial oxidation. The Aspen HYSYS 3.1 code has been used for simulation purposes. Two liquid hydrocarbon fuels have been selected to investigate the effect of average molecular weights of hydrocarbons, on the fuel processing efficiency. The overall system efficiency depends on the fuel preparation and fuel cell efficiencies as well as on the heat integration within the system. It is desired to investigate the overall system efficiencies for net electrical power production at 100 kW considering bigger scale transport applications. Results indicate that fuel properties, fuel preparation system operating parameters and PEM fuel cell polarization curve characteristics all affect the overall system efficiency. (authors)

  17. Water droplet accumulation and motion in PEM (Proton Exchange Membrane) fuel cell mini-channels

    International Nuclear Information System (INIS)

    Carton, J.G.; Lawlor, V.; Olabi, A.G.; Hochenauer, C.; Zauner, G.

    2012-01-01

    Effective water management is one of the key strategies for improving low temperature PEM (Proton Exchange Membrane) fuel cell performance and durability. Phenomena such as membrane dehydration, catalyst layer flooding, mass transport and fluid flow regimes can be affected by the interaction, distribution and movement of water in flow plate channels. In this paper a literature review is completed in relation to PEM fuel cell water flooding. It is clear that droplet formation, movement and interaction with the GDL (Gas Diffusion Layer) have been studied extensively. However slug formation and droplet accumulation in the flow channels has not been analysed in detail. In this study, a CFD (Computational Fluid Dynamic) model and VOF (Volume of Fluid) method is used to simulate water droplet movement and slug formation in PEM fuel cell mini-channels. In addition, water slug visualisation is recorded in ex situ PEM fuel cell mini-channels. Observation and simulation results are discussed with relation to slug formation and the implications to PEM fuel cell performance. -- Highlights: ► Excess water in mini-channels from the collision and coalescence of droplets can directly form slugs in PEM fuel cells. ► Slugs can form at low flow rates so increasing the flow rate can reduce the size and frequency of slugs. ► One channel of a double serpentine mini-channel may become blocked due to the redistribution of airflow and pressure caused by slug formation. ► Correct GDL and mini-channel surface coatings are essential to reduce slug formation and stagnation. ► Having geometry changes (bends and steps) in the flow fields can disrupt slug movement and avoid channel blockages.

  18. PEM Water Electrolysis: Preliminary Investigations Using Neutron Radiography

    Science.gov (United States)

    de Beer, Frikkie; van der Merwe, Jan-Hendrik; Bessarabov, Dmitri

    The quasi-dynamic water distribution and performance of a proton exchange membrane (PEM) electrolyzer at both a small fuel cell's anode and cathode was observed and quantitatively measured in the in-plane imaging geometry direction(neutron beam parallel to membrane and with channels parallel to the beam) by applying the neutron radiography principle at the neutron imaging facility (NIF) of NIST, Gaithersburg, USA. The test section had 6 parallel channels with an active area of 5 cm2 and in-situ neutron radiography observation entails the liquid water content along the total length of each of the channels. The acquisition was made with a neutron cMOS-camera system with performance of 10 sec per frame to achieve a relatively good pixel dynamic range and at a pixel resolution of 10 x 10 μm2. A relatively high S/N ratio was achieved in the radiographs to observe in quasi real time the water management as well as quantification of water / gas within the channels. The water management has been observed at increased steps (0.2A/cm2) of current densities until 2V potential has been achieved. These observations were made at 2 different water flow rates, at 3 temperatures for each flow rate and repeated for both the vertical and horizontal electrolyzer orientation geometries. It is observed that there is water crossover from the anode through the membrane to the cathode. A first order quantification (neutron scattering correction not included) shows that the physical vertical and horizontal orientation of the fuel cell as well as the temperature of the system up to 80 °C has no significant influence on the percentage water (∼18%) that crossed over into the cathode. Additionally, a higher water content was observed in the Gas Diffusion Layer at the position of the channels with respect to the lands.

  19. Coolant controls of a PEM fuel cell system

    Science.gov (United States)

    Ahn, Jong-Woo; Choe, Song-Yul

    When operating the polymer electrolyte membrane (PEM) fuel cell stack, temperatures in the stack continuously change as the load current varies. The temperature directly affects the rate of chemical reactions and transport of water and reactants. Elevated temperature increases the mobility of water vapor, which reduces the ohmic over-potential in the membrane and eases removal of water produced. Adversely, the high temperature might impose thermal stress on the membrane and cathode catalyst and cause degradation. Conversely, excessive supply of coolants lowers the temperature in the stack and reduces the rate of the chemical reactions and water activity. Corresponding parasitic power dissipated at the electrical coolant pump increases and overall efficiency of the power system drops. Therefore, proper design of a control for the coolant flow plays an important role in ensuring highly reliable and efficient operations of the fuel cell system. Herein, we propose a new temperature control strategy based on a thermal circuit. The proposed thermal circuit consists of a bypass valve, a radiator with a fan, a reservoir and a coolant pump, while a blower and inlet and outlet manifolds are components of the air supply system. Classic proportional and integral (PI) controllers and a state feedback control for the thermal circuit were used in the design. In addition, the heat source term, which is dependent upon the load current, was feed-forwarded to the closed loop and the temperature effects on the air flow rate were minimized. The dynamics and performance of the designed controllers were evaluated and analyzed by computer simulations using developed dynamic fuel cell system models, where a multi-step current and an experimental current profile measured at the federal urban driving schedule (FUDS) were applied. The results show that the proposed control strategy cannot only suppress a temperature rise in the catalyst layer and prevent oxygen starvation, but also reduce the

  20. Performance of a PEM water electrolyser using a TaC-supported iridium oxide electrocatalyst

    DEFF Research Database (Denmark)

    Polonský, J.; Mazúr, P.; Paidar, M.

    2014-01-01

    by dispersing the precious metal compound onto a catalyst support. Electrocatalysts with 50, 70 and 90 wt.% of IrO2 on a TaC support were tested in a laboratory PEM water electrolyser and compared with pure IrO2. The temperature was set at 90, 110, 120 and 130 °C respectively and the cell voltage was varied......Polymer electrolyte membrane (PEM) water electrolysis is an attractive way of producing carbon-free hydrogen. One of the drawbacks of this method is the need for precious metal-based electrocatalysts. This calls for a highly efficient utilization of the precious metal, which can be obtained...

  1. Silicon carbide-silicon as a support material for oxygen evolution reaction in PEM steam electrolysers

    DEFF Research Database (Denmark)

    Nikiforov, Aleksey; Petrushina, Irina; Christensen, Erik

    cells. In the present work a commercial SiC-Si, produced by the Acheson process, with a fraction of free silicon around 20% wt. was investigated as a catalyst support for anode electrocatalyst in PEM steam electrolysers. This electrocatalyst system was characterized using several techniques such as XRD......, cyclic voltammetry, SEM, EDX and steady state electrochemical polarisation in a working PEM steam electrolyser. Several SiC-Si-IrO2 electrodes have been prepared and tested. The iridium oxide content at the electrode active layer varied from x=0.2 to x=1, corresponding to the general formula (1-x...... for phosphoric acid doped membrane steam electrolysers....

  2. Structural and Morphological Features of Acid-Bearing Polymers for PEM Fuel Cells

    DEFF Research Database (Denmark)

    Yang, Yunsong; Siu, Ana; Peckham, Timothy J.

    2008-01-01

    Chemical structure, polymer microstructure, sequence distribution, and morphology of acid-bearing polymers are important factors in the design of polymer electrolyte membranes (PEMs) for fuel cells. The roles of ion aggregation and phase separation in vinylic- and aromatic-based polymers in proton...... conductivity and water transport are described. The formation, dimensions, and connectivity of ionic pathways are consistently found to play an important role in determining the physicochemical properties of PEMs. For polymers that possess low water content, phase separation and ionic channel formation...

  3. Adaptive Process Controls and Ultrasonics for High Temperature PEM MEA Manufacture

    Energy Technology Data Exchange (ETDEWEB)

    Walczyk, Daniel F. [Rensselaer Polytechnic Inst., Troy, NY (United States)

    2015-08-26

    The purpose of this 5-year DOE-sponsored project was to address major process bottlenecks associated with fuel cell manufacturing. New technologies were developed to significantly reduce pressing cycle time for high temperature PEM membrane electrode assembly (MEA) through the use of novel, robust ultrasonic (U/S) bonding processes along with low temperature (<100°C) PEM MEAs. In addition, greater manufacturing uniformity and performance was achieved through (a) an investigation into the causes of excessive variation in ultrasonically and thermally bonded MEAs using more diagnostics applied during the entire fabrication and cell build process, and (b) development of rapid, yet simple quality control measurement techniques for use by industry.

  4. Modeling a Distributed Power Flow Controller with a PEM Fuel Cell for Power Quality Improvement

    Directory of Open Access Journals (Sweden)

    J. Chakravorty

    2018-02-01

    Full Text Available Electrical power demand is increasing at a relatively fast rate over the last years. Because of this increasing demand the power system is becoming very complex. Both electric utilities and end users of electric power are becoming increasingly concerned about power quality. This paper presents a new concept of distributed power flow controller (DPFC, which has been implemented with a proton exchange membrane (PEM fuel cell. In this paper, a PEM fuel cell has been simulated in Simulink/MATLAB and then has been used in the proposed DPFC model. The new proposed DPFC model has been tested on a IEEE 30 bus system.

  5. Discordance between bioelectrical impedance vector analysis and the new ESPEN definition of malnutrition for the diagnosis of hospital malnutrition.

    Science.gov (United States)

    Dehesa-López, Edgar; Martínez-Felix, Jesús Israel; Ruiz-Ramos, Arturo; Atilano-Carsi, Ximena

    2017-04-01

    No universally accepted diagnostic criteria for malnutrition are available to date. The aim was to assess the concordance for the diagnosis of hospital malnutrition between the bioelectrical impedance vector analysis (BIVA) and the new definition of malnutrition proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN). A total of 140 adult hospitalized patients were included. The malnutrition risk was assessed by the Nutritional Risk Screening. The ESPEN malnutrition criteria (body mass index (BMI) malnutrition was diagnosed using the BIVA method. Diagnostic concordance between the BIVA and the new ESPEN definition was assessed with the Kappa coefficient. The malnutrition prevalence was higher with the BIVA vs ESPEN definition (22.1% vs 13.6%) in the global population and was similar (12.8% vs 12.1%) in the population at risk of malnutrition. The diagnostic performance of the BIVA was acceptable, with higher sensitivity in patients with fluid overload (FO) and more specificity in euvolemic patients. Diagnostic concordance between the BIVA and the ESPEN definition was poor for the global population (kappa = 0.56) and the population at risk of malnutrition (kappa = 0.67) but was acceptable in patients with FO (kappa = 0.78). However, the discordant BIVA+/ESPEN- patients classified as false positives for BIVA showed clinical and body composition data (low FFMI, low phase angle) consistent with malnutrition. According to the clinical and bioelectrical characteristics of the discordant BIVA+/ESPEN- patients, the BIVA could perform better that the new ESPEN definition for the diagnosis of hospital malnutrition, which should be confirmed with other studies. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  6. Children with severe acute malnutrition : New diagnostic and treatment strategies

    NARCIS (Netherlands)

    Bartels, R.H.

    2018-01-01

    Forty-five percent of worldwide deaths in children under-5 years of age is directly or indirectly attributable to poor nutrition. Tackling the global problem of malnutrition and of severe acute malnutrition (SAM) in particular, to increase health, quality of life, and to reduce under-5 mortality, is

  7. factors associated with malnutrition among under- five children in ...

    African Journals Online (AJOL)

    Global Journal

    Malnutrition is a consequence of consumption of dietary nutrient either ... The aim of this study was to carry out a review of malnutrition-dependent factors among ... observed that an estimated 60 million under-five children in developing .... adults (Etim et al., 2017). .... appetite, and this may be common among terminally ill.

  8. Malnutrition among Preschool-Aged Autistic Children in Oman

    Science.gov (United States)

    Al-Farsi, Yahya M.; Al-Sharbati, Marwan M.; Waly, Mostafa I.; Al-Farsi, Omar A.; Al Shafaee, Mohammed A.; Deth, Richard C.

    2011-01-01

    To assess prevalence of malnutrition indicators among preschool children with autism spectrum disorder (ASD) a cross-sectional study was conducted among 128 Omani autistic children 3-5 years of age. Based on standardized z-scores, the overall prevalence of malnutrition was 9.2 per 100 preschool ASD children (95% CI 4.1, 11.6). The most common type…

  9. Can wheat bran mitigate malnutrition and enteric pathogens?

    Science.gov (United States)

    Child malnutrition is a complex global problem, of which lack of food is only one component. Enteric pathogens and malnutrition work in a cyclic manner to depress a child’s intestinal immunity, while decreasing nutrient absorption. This cycle leads to stunting, wasting, and death. Often malnourished...

  10. Impact of Childhood Malnutrition on Host Defense and Infection.

    Science.gov (United States)

    Ibrahim, Marwa K; Zambruni, Mara; Melby, Christopher L; Melby, Peter C

    2017-10-01

    The global impact of childhood malnutrition is staggering. The synergism between malnutrition and infection contributes substantially to childhood morbidity and mortality. Anthropometric indicators of malnutrition are associated with the increased risk and severity of infections caused by many pathogens, including viruses, bacteria, protozoa, and helminths. Since childhood malnutrition commonly involves the inadequate intake of protein and calories, with superimposed micronutrient deficiencies, the causal factors involved in impaired host defense are usually not defined. This review focuses on literature related to impaired host defense and the risk of infection in primary childhood malnutrition. Particular attention is given to longitudinal and prospective cohort human studies and studies of experimental animal models that address causal, mechanistic relationships between malnutrition and host defense. Protein and micronutrient deficiencies impact the hematopoietic and lymphoid organs and compromise both innate and adaptive immune functions. Malnutrition-related changes in intestinal microbiota contribute to growth faltering and dysregulated inflammation and immune function. Although substantial progress has been made in understanding the malnutrition-infection synergism, critical gaps in our understanding remain. We highlight the need for mechanistic studies that can lead to targeted interventions to improve host defense and reduce the morbidity and mortality of infectious diseases in this vulnerable population. Copyright © 2017 American Society for Microbiology.

  11. Senior Health: How to Prevent and Detect Malnutrition

    Science.gov (United States)

    Healthy Lifestyle Caregivers Malnutrition is a serious senior health issue. Know the warning signs and how to help an older loved one avoid ... nutrient-rich diet for an older loved one. Malnutrition in older adults can lead to various health ...

  12. Management of acute moderate and severe childhood malnutrition

    Science.gov (United States)

    Acute childhood malnutrition affects about a tenth of the world's children under 5 years of age, particularly those living in circumstances of extreme poverty in the developing world. Malnutrition is typically the result of an inadequate diet and is one of the most common diagnoses in children in he...

  13. Not by Bread Alone: Reversing the Effects of Childhood Malnutrition.

    Science.gov (United States)

    Carson, David K.; Greeley, Sharon

    1988-01-01

    Investigates three central findings in human malnutrition research: (1) behavioral changes in infants and young children are observable outcomes of malnutrition; (2) non-nutritional factors in the environment affect child development; (3) nutritional supplementation with a consistent and varied regimen of stimulation hold potential for reversing…

  14. Malnutrition and School Feeding. Bulletin, 1921, No. 37

    Science.gov (United States)

    Gebhart, John C.

    1922-01-01

    Malnutrition is a term used to indicate a general condition of less than normal physical and mental vigor. While the causes of malnutrition are many, incorrect or inadequate diet appears all too often as one of the causes. School feeding, which affords not only an opportunity, to supplement the home food supply but also to teach correct food…

  15. Assessment and Management of Severe Malnutrition in Children ...

    African Journals Online (AJOL)

    BACKGROUND: Severe malnutrition is a common cause of morbidity and mortality among children less than five years of age. The World Health Organisation (WHO) has developed two manuals for the in-patient treatment of severe malnutrition. However, these manuals are not widely distributed with the result that most ...

  16. Moderate malnutrition: do we know how to manage it?

    African Journals Online (AJOL)

    Angel_D

    There are no recent international guidelines for the management of moderate malnutrition in spite of the fact that it: ▫ Increases the risk of death from common diseases and may result in severe acute malnutrition and/or severe stunting (both life- threatening conditions). ▫ Is likely to be associated with more nutrition-.

  17. Malnutrition amidst plenty: An assessment of factors responsible for ...

    African Journals Online (AJOL)

    In spite of favourable natural and human resource capacity, malnutrition remains an important health and welfare problem in Uganda especially among children below 5 years. Western Uganda has persistently registered highest levels of childhood malnutrition despite being referred to as gthe food basketh of the country.

  18. Malnutrition among children in Southern Ethiopia: Levels and risk ...

    African Journals Online (AJOL)

    Using data collected in the Community and Family Survey of the Southern Nations Nationalities and Peoples Region, this study estimates the level of child malnutrition and identifies the factors associated with chronic malnutrition among children in the five densely populated zones of the Region. A total of 850 children aged ...

  19. The prevalence of malnutrition in children admitted to a general ...

    African Journals Online (AJOL)

    Background. The prevalence of malnutrition, an important contributor to childhood mortality, is poorly described in hospitalised South African (SA) children, many of whom are HIV-exposed or HIV-infected. Objectives. To describe the prevalence of malnutrition in infants and children <14 years of age admitted to a general ...

  20. Development of PEM fuel cell stack for small combined heat and power units; Udvikling af PEM braendselscellestak for smaa decentrale kraftvarmeanlaeg

    Energy Technology Data Exchange (ETDEWEB)

    2008-07-01

    The aim of the project was to further develop cells and stack elements in order to reach a higher yield, longer service life, lower production costs and reduced demands for the plants' help, security and SRO (control - regulation - monitoring) systems, i.e. take the PEM fuel cell core technology's yield and cost to a level that will make power generating plants based on PEM fuel cells commercial interesting for CHP production within a capacity area of a few kW. The project focused on development of materials and processes for the individual cell and stack elements, including optimization of materials and production processes for MEAs (membrane electrode assemblies) with integrated diffusion layer, development of materials and production processes for bipolar graphite plates and development of manifold end plates for casting in polymer sandwich construction. (BA)

  1. The Use of Technology in Identifying Hospital Malnutrition: Scoping Review.

    Science.gov (United States)

    Trtovac, Dino; Lee, Joon

    2018-01-19

    Malnutrition is a condition most commonly arising from the inadequate consumption of nutrients necessary to maintain physiological health and is associated with the development of cardiovascular disease, osteoporosis, and sarcopenia. Malnutrition occurring in the hospital setting is caused by insufficient monitoring, identification, and assessment efforts. Furthermore, the ability of health care workers to identify and recognize malnourished patients is suboptimal. Therefore, interventions focusing on the identification and treatment of malnutrition are valuable, as they reduce the risks and rates of malnutrition within hospitals. Technology may be a particularly useful ally in identifying malnutrition due to scalability, timeliness, and effectiveness. In an effort to explore the issue, this scoping review synthesized the availability of technological tools to detect and identify hospital malnutrition. Our objective was to conduct a scoping review of the different forms of technology used in addressing malnutrition among adults admitted to hospital to (1) identify the extent of the published literature on this topic, (2) describe key findings, and (3) identify outcomes. We designed and implemented a search strategy in 3 databases (PubMed, Scopus, and CINAHL). We completed a descriptive numerical summary and analyzed study characteristics. One reviewer independently extracted data from the databases. We retrieved and reviewed a total of 21 articles. We categorized articles by the computerized tool or app type: malnutrition assessment (n=15), food intake monitoring (n=5), or both (n=1). Within those categories, we subcategorized the different technologies as either hardware (n=4), software (n=13), or both (n=4). An additional subcategory under software was cloud-based apps (n=1). Malnutrition in the acute hospital setting was largely an unrecognized problem, owing to insufficient monitoring, identification, and initial assessments of identifying both patients who are

  2. Relationship Between the Serum Leptin and Children with Malnutrition

    International Nuclear Information System (INIS)

    Xu Jixun

    2010-01-01

    To investigate the relationship between the serum leptin and the children with malnutrition, the serum leptin levels in 50 malnourished children and 50 normal children were determined by RIA. The results showed that the serum leptin levels in children with malnutrition were significantly lower than that in control group (P<0.05). The serum leptin levels in children with malnutrition were positively correlated with body mass index values (r= 0.650, P<0.05), and positively correlated with serum albumin values (r= 0.740,P<0.05). The serum leptin levels in female children were higher than that in men children. The leptin may involve in the regulation of the body nutritional status of children. The serum leptin level may be correlated with the degree of child malnutrition and may be used as a laboratory indicator for the diagnosis of child malnutrition. (authors)

  3. In-Patient Treatment of Severe Acute Malnutrition

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov

    Severe acute malnutrition is a serious health problem among children in low-income countries. Particularly malnourished children requiring in-hospital treatment are at high risk of dying. This dissertation investigates possible reasons for this high mortality, by following a group of 120 children...... during their in-hospital treatment of severe acute malnutrition at Mwanamugimu Nutrition Unit in Kampala, Uganda. We assessed how malnutrition affected the children’s immune system, by measuring the size of their thymus gland with ultrasound. We examined characteristics of children with the serious form...... of malnutrition, Kwashiorkor, where the children develop oedema. Finally, we explored symptoms, findings or treatments given that were associated with a higher risk of death in the children. Hopefully, these findings may contribute to improving the treatment offered to children with severe acute malnutrition....

  4. Cardiac Dysfunction in a Porcine Model of Pediatric Malnutrition

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Lykke, Mikkel; Hother, Anne-Louise

    2015-01-01

    BACKGROUND: Half a million children die annually of severe acute malnutrition and cardiac dysfunction may contribute to the mortality. However, cardiac function remains poorly examined in cases of severe acute malnutrition. OBJECTIVE: To determine malnutrition-induced echocardiographic disturbances...... and longitudinal changes in plasma pro-atrial natriuretic peptide and cardiac troponin-T in a pediatric porcine model. METHODS AND RESULTS: Five-week old piglets (Duroc-x-Danish Landrace-x-Yorkshire) were fed a nutritionally inadequate maize-flour diet to induce malnutrition (MAIZE, n = 12) or a reference diet...... groups. The myocardial performance index was 86% higher in MAIZE vs AGE-REF (pMalnutrition associates with cardiac dysfunction in a pediatric porcine model by increased myocardial performance index and pro-atrial natriuretic peptide...

  5. The immune system in children with malnutrition - a systematic review

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Kolte, Lilian; Briend, André

    2014-01-01

    BACKGROUND: Malnourished children have increased risk of dying, with most deaths caused by infectious diseases. One mechanism behind this may be impaired immune function. However, this immune deficiency of malnutrition has not previously been systematically reviewed. OBJECTIVES: To review...... the scientific literature about immune function in children with malnutrition. METHODS: A systematic literature search was done in PubMed, and additional articles identified in reference lists and by correspondence with experts in the field. The inclusion criteria were studies investigating immune parameters...... in children aged 1-60 months, in relation to malnutrition, defined as wasting, underweight, stunting, or oedematous malnutrition. RESULTS: The literature search yielded 3402 articles, of which 245 met the inclusion criteria. Most were published between 1970 and 1990, and only 33 after 2003. Malnutrition...

  6. Alzheimer's Disease in the Danish Malnutrition Period 1999-2007

    DEFF Research Database (Denmark)

    Sparre-Sørensen, Maja; Kristensen, Gustav David Westergaard

    2015-01-01

    BACKGROUND: Several studies published over the last few years have shown that malnutrition is a risk factor for developing and worsening Alzheimer's disease (AD) and that a balanced diet can delay the onset of the disease. During the period from January 1999 to January 2007, a statistically...... significant increase in the number of deaths related to malnutrition was found among the elderly in Denmark. Many more may have been suffering from malnutrition, but not to such a degree that it led to their deaths. OBJECTIVE: The aim of this study is to examine whether or not the effect of the malnutrition...... from AD associated with the period when the general nutritional state among the elderly in Denmark worsened (from 1999 to 2007). CONCLUSION: The study concludes that the malnutrition period resulted in an excess death rate from Alzheimer's disease. All in all, a total of 345 extra lives were lost...

  7. PEM fuel cells with injection moulded bipolar plates of highly filled graphite compounds; PEM-Brennstoffzellen mit spritzgegossenen Bipolarplatten aus hochgefuelltem Graphit-Compound

    Energy Technology Data Exchange (ETDEWEB)

    Kreuz, Can

    2008-04-11

    This work concerns with the injection moulding of highly filled graphite compounds to bipolar plates for PEM fuel cells in a power output range between 100 - 500 Watts. A particular focus is laid on the combination of the three multidisciplinary scopes like material development, production technology and component development / design. The results of the work are specified by the process-oriented characterisation of the developed and manufactured bipolar plates as well as their application in a functioning fuel cell. (orig.)

  8. KAITAN ANTARA PREVALENSI GIZI BURUK DENGAN PDRB PER KAPITA DAN TINGKAT KEMISKINAN SERTA ESTIMASI KERUGIAN EKONOMI AKIBAT GIZI BURUK PADA BALITA DI BERBAGAI KABUPATEN/KOTA DI PULAU JAWA DAN BALI

    Directory of Open Access Journals (Sweden)

    Narita Kusumawardhani

    2012-03-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Malnutrition may decrease in human resources work capacity which is lead to regional economic lost. The study was aimed to find the relationship between severe underweight, GDRP and poverty level and to estimate economic lost due to severe Protein Energy Malnutrition (PEM among underfive children in various districs/cities at Java and Bali Islands. A descriptive study designed was implemented and a set of secondary data was used in the study. The data uses are prevalence of PEM among underfive children from 2007 Riskesdas, Gross Domestic Regional Product (GDRP, population by sex and age group, and poverty level. Data processing and analysis were conducted in Bogor, from April to July 2010. The result showed that economic lost due to PEM was highest in Bekasi Regency, West Java and lowest in Kepulauan Seribu Regency, DKI Jakarta. Higher GDRP per capita means lower severe PEM prevalence and higher poverty level means higher severe PEM prevalence. Percentage of total economic lost due to severe PEM among under five children was ranged from 0,039% GDRP - 0,177% GDRP. Key words: economic Lost, Protein Energy Malnutrition, Java and Bali Islands.

  9. Real life testing of a Hybrid PEM Fuel Cell Bus

    Science.gov (United States)

    Folkesson, Anders; Andersson, Christian; Alvfors, Per; Alaküla, Mats; Overgaard, Lars

    Fuel cells produce low quantities of local emissions, if any, and are therefore one of the most promising alternatives to internal combustion engines as the main power source in future vehicles. It is likely that urban buses will be among the first commercial applications for fuel cells in vehicles. This is due to the fact that urban buses are highly visible for the public, they contribute significantly to air pollution in urban areas, they have small limitations in weight and volume and fuelling is handled via a centralised infrastructure. Results and experiences from real life measurements of energy flows in a Scania Hybrid PEM Fuel Cell Concept Bus are presented in this paper. The tests consist of measurements during several standard duty cycles. The efficiency of the fuel cell system and of the complete vehicle are presented and discussed. The net efficiency of the fuel cell system was approximately 40% and the fuel consumption of the concept bus is between 42 and 48% lower compared to a standard Scania bus. Energy recovery by regenerative braking saves up 28% energy. Bus subsystems such as the pneumatic system for door opening, suspension and brakes, the hydraulic power steering, the 24 V grid, the water pump and the cooling fans consume approximately 7% of the energy in the fuel input or 17% of the net power output from the fuel cell system. The bus was built by a number of companies in a project partly financed by the European Commission's Joule programme. The comprehensive testing is partly financed by the Swedish programme "Den Gröna Bilen" (The Green Car). A 50 kW el fuel cell system is the power source and a high voltage battery pack works as an energy buffer and power booster. The fuel, compressed hydrogen, is stored in two high-pressure stainless steel vessels mounted on the roof of the bus. The bus has a series hybrid electric driveline with wheel hub motors with a maximum power of 100 kW. Hybrid Fuel Cell Buses have a big potential, but there are

  10. Investigation of a novel concept for hydrogen production by PEM water electrolysis integrated with multi-junction solar cells

    International Nuclear Information System (INIS)

    Ferrero, Domenico; Santarelli, Massimo

    2017-01-01

    Highlights: • A 2D model of a PEM water electrolyzer is developed and validated. • A novel system integrating PEM and multi-junction solar cells is proposed. • The model is applied to the simulation of the novel system. • The integration of PEM and MJ cells enhances the hydrogen production efficiency. - Abstract: A 2D finite element model of a high-pressure PEM water electrolyzer is developed and validated over experimental data obtained from a demonstration prototype. The model includes the electrochemical, fluidic and thermal description of the repeating unit of a PEM electrolyzer stack. The model is applied to the simulation of a novel system composed by a high-temperature, high-pressure PEM electrochemical cell coupled with a photovoltaic multi-junction solar cell installed in a solar concentrator. The thermo-electrochemical characterization of the solar-driven PEM electrolysis system is presented and the advantages of the high-temperature operation and of the direct coupling of electrolyzer and solar cell are assessed. The results show that the integration of the multi-junction cell enhances the performance of the electrolyzer and allows to achieve higher system efficiency compared to separated photovoltaic generation and hydrogen production by electrolysis.

  11. Malnutrition induces gut atrophy and increases hepatic fat infiltration: studies in a pig model of childhood malnutrition.

    Science.gov (United States)

    Lykke, Mikkel; Hother, Anne-Louise; Hansen, Christian F; Friis, Henrik; Mølgaard, Christian; Michaelsen, Kim F; Briend, André; Larsen, Torben; Sangild, Per T; Thymann, Thomas

    2013-01-01

    Childhood malnutrition is a problem in developing countries, and pathological changes in digestive organs such as the intestine and liver are poorly understood. An animal model to study the progression of severe acute malnutrition could elucidate pathological changes in the intestine and liver. We sought to characterize growth and clinical changes during malnutrition related to structural and functional indices in the intestine and liver. Newly weaned piglets were given ad libitum access to a maize flour diet (MAIZE, n=9) or a nutritionally optimized reference diet (REFERENCE, n=12) for 7 weeks. Growth, hematology and clinical biochemistry where recorded weekly. After 7 weeks, the MAIZE pigs had lower body weights than the REF pigs (8.3 kg vs. 32.4 kg, P malnutrition and are associated with temporal changes in growth and hematological and biochemical endpoints. The pig model is relevant for malnourished infants and can act as a valuable tool for understanding the pathophysiology of malnutrition.

  12. WC as a non-platinum hydrogen evolution electrocatalyst for high temperature PEM water electrolysers

    DEFF Research Database (Denmark)

    Nikiforov, Aleksey; Petrushina, Irina; Christensen, Erik

    2012-01-01

    Tungsten carbide (WC) nanopowder was tested as a non-platinum cathode electrocatalyst for polymer electrolyte membrane (PEM) water electrolysers, operating at elevated temperatures. It was prepared in thermal plasma reactor with confined plasma jet from WO3 precursor in combination with CH4...

  13. Model-supported characterization of a PEM water electrolysis cell for the effect of compression

    DEFF Research Database (Denmark)

    Frensch, Steffen Henrik; Olesen, Anders Christian; Simon Araya, Samuel

    2018-01-01

    This paper investigates the influence of the cell compression of a PEM water electrolysis cell. A small single cell is therefore electrochemically analyzed by means of polarization behavior and impedance spectroscopy throughout a range of currents (0.01 A cm−2 to 2.0 A cm−2) at two temperatures (60...

  14. Patriot Script 1.0.13 User Guide for PEM 1.3.2

    Energy Technology Data Exchange (ETDEWEB)

    Cleland, Timothy James [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Kubicek, Deborah Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Stroud, Phillip David [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Cuellar-Hengartner, Leticia [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Mathis, Mark [Descartes Labs, Inc., Los Alamos, NM (United States)

    2015-11-02

    This document provides an updated user guide for Patriot Script Version 1.0.13, for release with PEM 1.3.1 (LAUR-1422817) that adds description and instructions for the new excursion capability (see section 4.5.1).

  15. Framework for the assessment of PEMS (Portable Emissions Measurement Systems) uncertainty.

    Science.gov (United States)

    Giechaskiel, Barouch; Clairotte, Michael; Valverde-Morales, Victor; Bonnel, Pierre; Kregar, Zlatko; Franco, Vicente; Dilara, Panagiota

    2018-06-13

    European regulation 2016/427 (the first package of the so-called Real-Driving Emissions (RDE) regulation) introduced on-road testing with Portable Emissions Measurement Systems (PEMS) to complement the chassis dynamometer laboratory (Type I) test for the type approval of light-duty vehicles in the European Union since September 2017. The Not-To-Exceed (NTE) limit for a pollutant is the Type I test limit multiplied by a conformity factor that includes a margin for the additional measurement uncertainty of PEMS relative to standard laboratory equipment. The variability of measured results related to RDE trip design, vehicle operating conditions, and data evaluation remain outside of the uncertainty margin. The margins have to be reviewed annually (recital 10 of regulation 2016/646). This paper lays out the framework used for the first review of the NO x margin, which is also applicable to future margin reviews. Based on experimental data received from the stakeholders of the RDE technical working group in 2017, two NO x margin scenarios of 0.24-0.43 were calculated, accounting for different assumptions of possible zero drift behaviour of the PEMS during the tests. The reduced uncertainty margin compared to the one foreseen for 2020 (0.5) reflects the technical improvement of PEMS over the past few years. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Characterisation and Modelling of a High Temperature PEM Fuel Cell Stack using Electrochemical Impedance Spectroscopy

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl; Jespersen, Jesper Lebæk; Schaltz, Erik

    2009-01-01

    temperature PEM (HTPEM) fuel cell stack. A Labview virtual instrument has been developed to perform the signal generation and data acquisition which is needed to perform EIS. The typical output of an EIS measurement on a fuel cell, is a Nyquist plot, which shows the imaginary and real part of the impedance...

  17. Modelling membrane hydration and water balance of a pem fuel cell

    DEFF Research Database (Denmark)

    Liso, Vincenzo; Nielsen, Mads Pagh

    2015-01-01

    Polymer electrolyte membrane (PEM) fuel cells requires an appropriate hydration in order to ensure high efficiency and long durability. As water is essential for promoting proton conductivity in the membrane, it is important to control membrane water hydration to avoid flooding. In this study we...

  18. PEM fuel cell cost minimization using ``Design For Manufacture and Assembly`` techniques

    Energy Technology Data Exchange (ETDEWEB)

    Lomax, F.D. Jr.; James, B.D. [Directed Technologies, Inc., Arlington, VA (United States); Mooradian, R.P. [Ford Motor Co., Dearborn, MI (United States)

    1997-12-31

    Polymer Electrolyte Membrane (PEM) fuel cells fueled with direct hydrogen have demonstrated substantial technical potential to replace Internal Combustion Engines (ICE`s) in light duty vehicles. Such a transition to a hydrogen economy offers the potential of substantial benefits from reduced criteria and greenhouse emissions as well as reduced foreign fuel dependence. Research conducted for the Ford Motor Co. under a US Department of Energy contract suggests that hydrogen fuel, when used in a fuel cell vehicle (FCV), can achieve a cost per vehicle mile less than or equal to the gasoline cost per mile when used in an ICE vehicle. However, fuel cost parity is not sufficient to ensure overall economic success: the PEM fuel cell power system itself must be of comparable cost to the ICE. To ascertain if low cost production of PEM fuel cells is feasible, a powerful set of mechanical engineering tools collectively referred to as Design for Manufacture and Assembly (DFMA) has been applied to several representative PEM fuel cell designs. The preliminary results of this work are encouraging, as presented.

  19. Modelling of a High Temperature PEM Fuel Cell Stack using Electrochemical Impedance Spectroscopy

    DEFF Research Database (Denmark)

    Andreasen, Søren Juhl; Jespersen, Jesper Lebæk; Kær, Søren Knudsen

    2008-01-01

    This work presents the development of an equivalent circuit model of a 65 cell high temperature PEM (HTPEM) fuel cell stack using Electrochemical Impedance Spectroscopy (EIS). The HTPEM fuel cell membranes used are PBI-based and uses phosphoric acid as proton conductor. The operating temperature...

  20. A comprehensive, consistent and systematic mathematical model of PEM fuel cells

    International Nuclear Information System (INIS)

    Baschuk, J.J.; Li Xianguo

    2009-01-01

    This paper presents a comprehensive, consistent and systematic mathematical model for PEM fuel cells that can be used as the general formulation for the simulation and analysis of PEM fuel cells. As an illustration, the model is applied to an isothermal, steady state, two-dimensional PEM fuel cell. Water is assumed to be in either the gas phase or as a liquid phase in the pores of the polymer electrolyte. The model includes the transport of gas in the gas flow channels, electrode backing and catalyst layers; the transport of water and hydronium in the polymer electrolyte of the catalyst and polymer electrolyte layers; and the transport of electrical current in the solid phase. Water and ion transport in the polymer electrolyte was modeled using the generalized Stefan-Maxwell equations, based on non-equilibrium thermodynamics. Model simulations show that the bulk, convective gas velocity facilitates hydrogen transport from the gas flow channels to the anode catalyst layers, but inhibits oxygen transport. While some of the water required by the anode is supplied by the water produced in the cathode, the majority of water must be supplied by the anode gas phase, making operation with fully humidified reactants necessary. The length of the gas flow channel has a significant effect on the current production of the PEM fuel cell, with a longer channel length having a lower performance relative to a shorter channel length. This lower performance is caused by a greater variation in water content within the longer channel length

  1. CFD modelling of cooling channel geometry of PEM fuel cell for ...

    African Journals Online (AJOL)

    In this study, a numerical investigation was carried out to deter mine the impact of cooling channel geometry in combination with temperature dependent operating parameters on thermal management and overall performance of a PEM fuel cell system. The evaluation is performed using a computational fluid dynamics ...

  2. Protein-energy nutritional status and kidney disease-specific quality of life in hemodialysis patients

    NARCIS (Netherlands)

    Mazairac, A.H.A.; de Wit, G.A.; Penne, E.L.; van der Weerd, N.C.; Grooteman, M.P.C.; van den Dorpel, M.A.; Nube, M.J.; Buskens, E.; Levesque, R.; ter Wee, P.M.; Bots, M.L.; Blankestijn, P.J.

    Objective: Health-related quality of life (HRQOL) is an important outcome in dialysis care. Previous research has related protein-energy nutritional status to generic HRQOL domains, but it is still not clear as to how it relates to HRQOL domains that are unique to hemodialysis patients. Therefore,

  3. Obesity as a form of malnutrition: over-nutrition on the Uganda "malnutrition" agenda.

    Science.gov (United States)

    Ngaruiya, Christine; Hayward, Alison; Post, Lori; Mowafi, Hani

    2017-01-01

    The objectives were to highlight the burden of overweight and obesity as an additional area of importance for the malnutrition agenda in Uganda and to provide evidence-based considerations for stakeholders involved. Mirroring other Low- and Middle-Income Countries (LMICs), Uganda is experiencing a "double burden" of over-nutrition related issues - both obesity and overweight, and related non-communicable diseases (NCDs) alongside the under-nutrition that has long plagued the country. Despite the commonplace assumption that under-nutrition is the predominant form of malnutrition in Uganda, we explore recent literature that in fact, challenges this notion. While food insecurity has contributed to the under-nutrition problem, a lack of dietary diversity also has a demonstrated role in increasing over-nutrition. We cannot afford to ignore over-nutrition concomitant with stunting and wasting in the country. Increase in the burden of this less acknowledged form of malnutrition in Uganda is critical to investigate, and yet poorly understood. A move towards increased regionally targeted over-nutrition research, funding, government prioritization and advocacy is needed.

  4. Social dimension of malnutrition, notes for discussion

    Directory of Open Access Journals (Sweden)

    Edwar Manrique

    2012-10-01

    Full Text Available This article describes and constructs an argument concerning the social effects of malnutrition, by reviewing reports and articles in the nutritional situation in Colombia and the world, to finally address the nutritional status in Boyacá. The theme is developed considering nutrition as a field in influencing social, cultural, religious, historical, political and economic, that affect populations when there is no adequate scientific and social processes, to ensure access and adequate food resources due to poverty, lack of programs to ensure food security and sovereignty, high unemployment, looking mainly affected children, pregnant women and the elderly, preventing them from developing their full human potential.

  5. Dietary diversity and child malnutrition in Ghana

    Directory of Open Access Journals (Sweden)

    Raymond Boadi Frempong

    2017-05-01

    Full Text Available The health of children in Ghana has improved in recent years. However, the current prevalence rates of malnutrition remain above internationally acceptable levels. This study, therefore, revisits the determinants of child health by using Ghana’s Multiple Indicator Cluster Survey to investigate the effect of infant feeding practices on child health. We used the World Health Organization’s Infant and Young Children Feeding guidelines to measure dietary quality. The econometric analyses show that dietary diversity may cause improvement in children’s health in Ghana. This suggests that educational campaigns on proper infant feeding and complementary dieting could be an effective means of improving the health of children in Ghana.

  6. [Economic impact of chronic, acute and global malnutrition in Peru].

    Science.gov (United States)

    Alcázar, Lorena; Ocampo, Diego; Huamán-Espino, Lucio; Pablo Aparco, Juan

    2013-01-01

    To estimate the economic impact of chronic, acute and global malnutrition in Peru. This study, through an econometric model, estimated the economic impact of child malnutrition in two time horizons (incidental retrospective and prospective) during 2011, considering malnutrition-associated costs of health, education and productivity for the Peruvian economy. Information collected is a combination of data coming from the Demographic Survey of Family Health, the National Survey of Homes, the 2007 Census of Population and Housing, and public budget information, as well as estimates of risks a child is exposed to due to malnutrition during their first years of life. Nationwide it was found that in the perspective retrospective, the cost of child malnutrition in 2011 was 10,999 million soles, which was equal to 2.2% of GDP for that same year. Prospective costs nationwide, of those who by 2011 were 0 to 59 months, reached 4,505 million soles and represented 0.9% of GDP in 2011. Most cases stem from losses of productivity in both cases. Moreover, malnutrition affects much more both the Andes and jungle regions. The economic impact of child malnutrition represents a significant percentage of GDP, reason for which it is necessary to continue investing equitably in its prevention through participation with proven efficiency.

  7. Serum Leptin Is a Biomarker of Malnutrition in Decompensated Cirrhosis

    Science.gov (United States)

    Rachakonda, Vikrant; Borhani, Amir A.; Dunn, Michael A.; Andrzejewski, Margaret; Martin, Kelly; Behari, Jaideep

    2016-01-01

    Background and Aims Malnutrition is a leading cause of morbidity and mortality in cirrhosis. There is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. The aim of this study was to measure biochemical, serologic, hormonal, radiographic, and anthropometric features in a cohort of hospitalized cirrhotic patients to characterize biomarkers for identification of malnutrition. Design In this prospective observational cohort study, 52 hospitalized cirrhotic patients were classified as malnourished (42.3%) or nourished (57.7%) based on mid-arm muscle circumference malnutrition. Results Subjects with and without malnutrition differed in several key features of metabolic phenotype including wet and dry BMI, skeletal muscle index, visceral fat index and HOMA-IR. Serum leptin levels were lower and INR was higher in malnourished subjects. Serum leptin was significantly correlated with HOMA-IR, wet and dry BMI, mid-arm muscle circumference, skeletal muscle index, and visceral fat index. Logistic regression analysis revealed that INR and log-transformed leptin were independently associated with malnutrition. Conclusions Low serum leptin and elevated INR are associated with malnutrition in hospitalized patients with end-stage liver disease. PMID:27583675

  8. Estimating the costs associated with malnutrition in Dutch nursing homes.

    Science.gov (United States)

    Meijers, Judith M M; Halfens, Ruud J G; Wilson, Lisa; Schols, Jos M G A

    2012-02-01

    Malnutrition in western health care involves a tremendous burden of illness. In this study the economic implications of malnutrition in Dutch nursing homes are investigated as part of the Health and Economic Impact of Malnutrition in Europe Study from the European Nutrition for Health Alliance. A questionnaire was developed, focussing on the additional time and resources spent to execute all relevant nutritional activities in nursing home patients with at risk of malnutrition or malnourished. Results were extrapolated on national level, based on the prevalence rates gathered within the national Prevalence Measurement of Care Problems 2009. The normal nutritional costs are 319 million Euro per year. The total additional costs of managing the problem of malnutrition in Dutch nursing homes involve 279 million Euro per year and are related to extra efforts in nutritional screening, monitoring and treatment. The extra costs for managing nursing home residents at risk of malnutrition are 8000 euro per patient and 10000 euro for malnourished patients. The extra costs related to malnutrition are a considerable burden for the nursing home sector and urge for preventive measures. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  9. Carbon nanotubes as electrode substrate material for PEM fuel cells; Kohlenstoff-Nanoroehrchen als Elektrodenmaterial fuer PEM-Brennstoffzellen

    Energy Technology Data Exchange (ETDEWEB)

    Soehn, Matthias

    2010-06-21

    This thesis reports an enhanced method to deposit nanoscaled noble metal catalysts (Pt/Ru) uniformly on carbon nanotubes based on wet chemical reduction of anorganic precursors via ethylene glycol. This well-known method is widely used to deposit noble metal catalyst particles on carbon black. Unfortunately, carbon nanotubes tend to agglomerate and therefore form bundles which cannot be penetrated by the precursor. Thus, effectiveness of the substrate is reduced. The new method prevents this by suspending the CNTs in butyl acetate by means of ultrasonic dispersion leading to a homogenous distribution. Because the butyl acetate is almost unpolar, it is nearly immiscible with the water-based ethylene glycol mixture. This problem has been solved by adding liquid Nafion {sup registered} which acts as an emulsifying agent. Thus an emulsion is created by ultrasonic treatment. This results in 30 {mu}m-sized droplets of butyl acetate with a layer of CNTs and Nafion {sup registered}. The large interface to the ethylene glycol phase yields a large surface for homogenous catalyst deposition. The prepared samples showed a narrow size distribution ({+-}0.5 nm) of small noble metal particles with loading up to 50% by weight and an average particle size of 3 nm. They are investigated using XRD, SEM, TEM, TGA-MS and CV. The added Nafion {sup registered} improves catalyst utilisation by establishing a proton conductive path to the catalyst particles. Furthermore, different manufacturing techniques for the CNT electrodes are evaluated. Thin layer Membrane-Electrode-Assemblies (MEAs) are prepared by the airbrush technique. Electrode thickness, composition and structure as well as membrane thickness is varied and the MEAs are tested in a single-cell hydrogen-oxygen-fed PEM fuel cell. The cells are characterised by cyclic IV curves which are recorded over an extended period of time, showing power densities up to 770mWcm-2 at a platinum loading of 0.3mgcm-2. Additionally, the MEAs are

  10. The Prevalence of Malnutrition and Effectiveness of STRONGkids Tool in the Identification of Malnutrition Risks among Pediatric Surgical Patients

    Directory of Open Access Journals (Sweden)

    Çiğdem Ulukaya Durakbaşa

    2014-12-01

    Full Text Available Background: High prevalence of malnutrition along with the risk for the development of malnutrition in hospitalised children has been reported. However, this problem remains largely unrecognised by healthcare workers. Aims: To determine the prevalence of malnutrition and effectiveness of STRONGkids nutritional risk screening (NRS tool in the identification of malnutrition risk among pediatric surgical patients. Study Design: Cross-sectional study. Methods: A total of 494 pediatric surgical patients (median age 59 months, 75.8% males were included in this prospective study conducted over 3 months. SD-scores 60 months (13.4 vs. 6.6%, p=0.012. Chronic malnutrition was identified in 23 (4.6% of patients with no significant difference between age groups. There were 7 (1.4% children with coexistent acute and chronic malnutrition. The STRONGkids tool revealed that 35.7% of patients were either in the moderate or high risk group for malnutrition. Malnutrition, as revealed by anthropometric measurements, was more likely in the presence of gastrointestinal (26.9%, p=0.004 and inguinoscrotal/penile surgery (4.0%, p=0.031, co-morbidities affecting nutritional status (p<0.001 and inpatient admissions (p=0.014. Among patients categorized as low risk for malnutrition, there were more outpatients than inpatients (89.3 vs. 10.7%, p<0.001 and more elective surgery cases than emergency surgery cases (93.4 vs. 6.6%, p<0.001. Conclusion: Providing data on the prevalence of malnutrition and risk of malnutrition in a prospectively recruited group of hospitalised pediatric surgical patients, the data acquired in the present study emphasise the need to raise clinician’s awareness about the importance of nutritional status assessment among hospitalised pediatric patients and the benefits of identifying patients at the risk of nutritional depletion before malnutrition occurs. Our findings support the use of the STRONGkids tool among pediatric surgical patients to

  11. Nutrition and malnutrition in elderly patients

    Directory of Open Access Journals (Sweden)

    Daniela Tozzuoli

    2013-04-01

    Full Text Available Protein-energy undernutrition is a very common problem among elderly patients. It is promoted by age-related decreases in the basal metabolic rate, physiological change in body composition, progressive dysphagia, physical and/or cognitive impairments, depression, socioeconomic factors, effects of drugs on absorption and utilization of nutrients, and other factors. Several studies suggest that nutritional support can lower the risk of adverse outcomes among undernourished elderly patients. Monitoring food intake in patients with dysphagia may be useful in deciding between oral supplementation or artificial nutrition. The decision to provide nutritional support and the route to be used will depend on the clinical conditions of the patient, the severity of the dysphagia, the expected course of any underlying diseases, and several other patient-specific considerations. In geriatric patients, the main objectives of this type of therapy are usually the maintenance of function and improvement of the quality of life.

  12. Malnutrition in South Asia-A Critical Reappraisal.

    Science.gov (United States)

    Akhtar, Saeed

    2016-10-25

    Malnutrition continues to be a major public health challenge especially in South Asian developing countries. The aim of the present review is to spotlight the magnitude of the prevalence of malnutrition and its dynamics in South Asian region and to suggest potential approaches for the prevention and control of this issue of public health significance. An extensive review of literature, covering malnutrition and its determinants, health and economic consequences and pragmatic preventive strategies was performed on computer based bibliographic databases (PubMed, Google Scholar, Scopus, Medline and Sciencedirect.com ) to retrieve abstracts and full texts for India, Pakistan, Bangladesh, Sri Lanka and Nepal. All relevant titles and abstracts were examined and evaluated for malnutrition and its prevalence in South Asia. The results revealed malnutrition to be a major public health problem and a potential cause of high disease burden and mortality in South Asia. Compelling evidence suggests malnutrition to be the leading cause of stunting, wasting and underweight with drastic economic consequences among vulnerable populations. Reduced cognitive performance and low productivity have also been associated with micronutrients malnutrition. Suboptimal breastfeeding, inadequate food supply, micronutrient deficiencies, low household income, poor health care system, increased healthcare costs, illiteracy, unhygienic and substandard living, inappropriate child's care and the caregiver, food insecurity and on top of that vicious cycle of poverty, have been recognized as principal indicators for growing malnutrition prevalence in South Asia. Global organizations, local governments, program managers, NGOs, academia, industry in particular and the society at large need to take up the challenge to completely confiscate malnutrition from the region for economic prosperity and a healthier future.

  13. Malnutrition upon Hospital Admission in Geriatric Patients: Why Assess It?

    Directory of Open Access Journals (Sweden)

    Paolo Orlandoni

    2017-10-01

    Full Text Available ObjectiveTo assess the prevalence of malnutrition according to the new ESPEN definition in a population of geriatric hospital patients and to determine how malnutrition affects the length of hospital stay (LOS and hospital mortality.DesignA retrospective analysis of data gathered during nutritional screening surveys carried out three consecutive years, from 2012 to 2014, in an Italian geriatric research hospital (INRCA, Ancona was performed. On the day of the study, demographic data, data on clinical conditions and the nutritional status of newly admitted patients were collected. Patients were screened for malnutrition risk using the Malnutrition Universal Screening Tool (MUST. Subsequently, malnutrition was diagnosed, for subjects at high risk, following the criteria suggested by the European Association for Clinical Nutrition and Metabolism [body mass index (BMI < 18.5 kg/m2 or different combinations of unintentional weight loss over time and BMI values]. Sensitivity, specificity, positive and negative predictive value of MUST compared to ESPEN criteria were assessed. The characteristics of patients with a diagnosis of malnutrition were compared to those of non-malnourished patients. The impact of malnutrition on LOS and hospital mortality was investigated through logistic and linear regression models.SettingThe study was performed in an Italian geriatric research hospital (INRCA, Ancona.SubjectsTwo hundred eighty-four newly hospitalized geriatric patients from acute care wards (mean age 82.8 ± 8.7 years, who gave their written consent to participate in the study, were enrolled.ResultsAccording to the MUST, high risk of malnutrition at hospitalization was found in 28.2% of patients. Malnutrition was diagnosed in 24.6% of subjects. The malnutrition was an independent predictor of both the LOS and hospital mortality. The multivariate analyses—linear and logistic regression—were performed considering different potential

  14. Determining the prevalence of malnutrition in hospitalized paediatric patients.

    Science.gov (United States)

    Marino, L V; Goddard, E; Workman, L

    2006-09-01

    To determine the prevalence of malnutrition in hospitalised paediatric patients at Red Cross War Memorial Children's Hospital. A 1-day cross-sectional survey was completed in all medical and surgical wards and some specialist outpatient clinics. A total of 227 children participated in the study. Thirty-five per cent of patients were moderately malnourished (malnutrition seen, a nutrition risk-screening tool, identifying risk factors for malnutrition such as food access and vulnerability, should be developed. The tool should be used to assess nutrition status and risk during the course of hospitalisation, in addition to planning appropriate nutrition care plan interventions for discharge.

  15. Effect of balanced protein energy supplementation during pregnancy on birth outcomes

    Directory of Open Access Journals (Sweden)

    Bhutta Zulfiqar A

    2011-04-01

    Full Text Available Abstract Background The nutritional status of the mother prior to and during pregnancy plays a vital role in fetal growth and development, and maternal undernourishment may lead to adverse perinatal outcomes including intrauterine growth restriction (IUGR. Several macronutrient interventions had been proposed for adequate protein and energy supplementation during pregnancy. The objective of this paper was to review the effect of balanced protein energy supplementation during pregnancy on birth outcomes. This paper is a part of a series of reviews undertaken for getting estimates of effectiveness of an intervention for input to Lives Saved Tool (LiST model. Methods A literature search was conducted on PubMed, Cochrane Library and WHO regional data bases to identify randomized trials (RCTs and quasi RCTs that evaluated the impact of balanced protein energy supplementation in pregnancy. Balanced protein energy supplementation was defined as nutritional supplementation during pregnancy in which proteins provided less than 25% of the total energy content. Those studies were excluded in which the main intervention was dietary advice to pregnant women for increase in protein energy intake, high protein supplementation (i.e. supplementation in which protein provides at least 25% of total energy content, isocaloric protein supplementation (where protein replaces an equal quantity of non-protein energy content, or low energy diet to pregnant women who are either overweight or who exhibit high weight gain earlier in gestation. The primary outcomes were incidence of small for gestational age (SGA birth, mean birth weight and neonatal mortality. Quality of evidence was evaluated according to the Child Health Epidemiology Reference group (CHERG adaptation of Grading of Recommendations Assessment, Development and Evaluation (GRADE criteria. Results The final number of studies included in our review was eleven comprising of both RCTs and quasi-RCTs. Our meta

  16. Final Report - MEA and Stack Durability for PEM Fuel Cells

    Energy Technology Data Exchange (ETDEWEB)

    Yandrasits, Michael A.

    2008-02-15

    Proton exchange membrane fuel cells are expected to change the landscape of power generation over the next ten years. For this to be realized one of the most significant challenges to be met for stationary systems is lifetime, where 40,000 hours of operation with less than 10% decay is desired. This project conducted fundamental studies on the durability of membrane electrode assemblies (MEAs) and fuel cell stack systems with the expectation that knowledge gained from this project will be applied toward the design and manufacture of MEAs and stack systems to meet DOE’s 2010 stationary fuel cell stack systems targets. The focus of this project was PEM fuel cell durability – understanding the issues that limit MEA and fuel cell system lifetime, developing mitigation strategies to address the lifetime issues and demonstration of the effectiveness of the mitigation strategies by system testing. To that end, several discoveries were made that contributed to the fundamental understanding of MEA degradation mechanisms. (1) The classically held belief that membrane degradation is solely due to end-group “unzipping” is incorrect; there are other functional groups present in the ionomer that are susceptible to chemical attack. (2) The rate of membrane degradation can be greatly slowed or possibly eliminated through the use of additives that scavenge peroxide or peroxyl radicals. (3) Characterization of GDL using dry gases is incorrect due to the fact that fuel cells operate utilizing humidified gases. The proper characterization method involves using wet gas streams and measuring capillary pressure as demonstrated in this project. (4) Not all Platinum on carbon catalysts are created equally – the major factor impacting catalyst durability is the type of carbon used as the support. (5) System operating conditions have a significant impact of lifetime – the lifetime was increased by an order of magnitude by changing the load profile while all other variables remain

  17. Salt Effects on Surface Structures of Polyelectrolyte Multilayers (PEMs) Investigated by Vibrational Sum Frequency Generation (SFG) Spectroscopy.

    Science.gov (United States)

    Ge, Aimin; Matsusaki, Michiya; Qiao, Lin; Akashi, Mitsuru; Ye, Shen

    2016-04-26

    Sum frequency generation (SFG) vibrational spectroscopy was employed to investigate the surface structures of polyelectrolyte multilayers (PEMs) constructed by sequentially alternating adsorption of poly(diallyldimethylammonium chloride) (PDDA) and poly(styrenesulfonate) (PSS). It was found that the surface structures and surface charge density of the as-deposited PEMs of PDDA/PSS significantly depend on the concentration of sodium chloride (NaCl) present in the polyelectrolyte solutions. Furthermore, it was found that the surface structure of the as-deposited PEMs is in a metastable state and will reach the equilibrium state by diffusion of the polyelectrolyte chain after an aging process, resulting in a polyelectrolyte mixture on the PEM surfaces.

  18. A multi-phase, multi-component PEM fuel cell model. Paper no. IGEC-1-051

    International Nuclear Information System (INIS)

    Baschuk, J.J.; Li, X.

    2005-01-01

    'Full text:' Mathematical modeling is an important tool for PEM fuel cell commercialization. Mathematical models can illustrate the effect of the different processes on the overall performance of a PEM fuel cell; thus, mathematical models can be used to as a design tool to find optimal designs and operating conditions. A general formulation for a comprehensive fuel cell model, based on the conservation principle and volume-averaging, is presented. The model formulation includes the electro-chemical reactions, proton migration, and the mass transport of the gaseous reactants and liquid water. Additionally, the model formulation can be applied to all regions of the PEM fuel cell: the bipolar plates, gas flow channels, electrode backing, catalyst, and polymer electrolyte layers. Numerical results, showing the effect of water flooding on PEM fuel cell performance, are presented. (author)

  19. A matching decomposition of the rural-urban difference in malnutrition in Malawi

    OpenAIRE

    Mussa, Richard

    2014-01-01

    Background: Child malnutrition remains widespread in many developing countries. Malnutrition during infancy may substantially increase vulnerability to infection and disease, and the risk of premature death. Malnutrition in children may also lead to permanent effects and to their having diminished health capital later in life as adults. These negative consequences of child malnutrition entail that the reduction of child malnutrition is vital for the social-economic development of countries. U...

  20. Child malnutrition and mortality in Swaziland: Situation analysis of ...

    African Journals Online (AJOL)

    Child malnutrition and mortality in Swaziland: Situation analysis of the immediate, ... African Journal of Food, Agriculture, Nutrition and Development ... care of children and women, insufficient health services and unhealthy environment), and ...

  1. Factors contributing to malnutrition in patients with Parkinson's disease.

    Science.gov (United States)

    Kim, Sung R; Chung, Sun J; Yoo, Sung-Hee

    2016-04-01

    Our objective in this study was to evaluate the nutritional status and to identify clinical, psychosocial, and nutritional factors contributing to malnutrition in Korean patients with Parkinson's disease. We used a descriptive, cross-sectional study design. Of 102 enrolled patients, 26 (25.5%) were malnourished and 27 (26.5%) were at risk of malnutrition based on Mini-Nutritional Assessment scores. Malnutrition was related to activity of daily living score, Hoehn and Yahr stage, duration of levodopa therapy, Beck Depression Inventory and Spielberger's Anxiety Inventory scores, body weight, body weight at onset of Parkinson's disease, and body mass index. On multiple logistic regression analysis, anxiety score, duration of levodopa therapy, body weight at onset of Parkinson's disease, and loss of body weight were significant factors predicting malnutrition in Parkinson's disease patients. Therefore, nutritional assessment, including psychological evaluation, is required for Parkinson's disease patients to facilitate interdisciplinary nutritional intervention for malnourished patients. © 2014 John Wiley & Sons Australia, Ltd.

  2. Malnutrition and associated factors among adults starting on ...

    African Journals Online (AJOL)

    user

    This calls for routine nutritional assessment at CTCs prior to initiation of ART so as to ... exacerbates reduced food intake through hyperpyrexia, anorexia and thus leading to malnutrition. (WHO, 2003). ... adults and 6,000 children monthly.

  3. Hospital Admissions for Malnutrition and Dehydration in Patients With Dementia.

    Science.gov (United States)

    Marshall, Katherine A; Burson, Rosanne; Gall, Kristyn; Saunders, Mitzi M

    2016-01-01

    Dehydration and malnutrition are commonly experienced by patients with dementia and can result in hospitalizations and decreased quality of life. The purpose of this study was to explore and describe retrospectively, the incidence and correlations of variables that may precede hospitalizations for dehydration/malnutrition in the community-dwelling patient with dementia. Data from the Outcome and Assessment Information Set (OASIS) Start of Care (SOC) on 44 patients served by a Michigan home care agency were retrieved for analysis. This study did not reveal any single or collection of variables that would predict risk for hospitalization for dehydration/malnutrition. With the lack of specific predictors of hospitalization related to dehydration and malnutrition, clinicians need to place high priority on risk-lowering strategies and preventive education for patients, family, and caregivers.

  4. VOLUME OVERLOAD IS ASSOCIATED WITH MALNUTRITION IN PERITONEAL DIALYSIS

    Directory of Open Access Journals (Sweden)

    Jin Joo Cha

    2012-06-01

    Volume overload is associated with malnutrition and seems to be an independent predictor of mortality in PD population. Further study should evaluate the effects of intervention of volume control in PD patients.

  5. Estimation of zinc levels among children with malnutrition at ...

    African Journals Online (AJOL)

    ABEOLUGBENGAS

    cognitive function, behavioral problems, memory impairment, growth retardation, increased incidence of diarrhoea and ... 0% using WHO reference value for children below the age of 5 years. .... classification of malnutrition:<-1 to <-3 Z scores.

  6. Early Childhood Education: The Biological Bases: Malnutrition and Behavioral Development

    Science.gov (United States)

    Read, Merrill S.

    1972-01-01

    Malnutrition, contrasted with hunger, is defined as a state of impaired functional ability or development resulting from an inadequate supply of essential nutrients or calories to meet long-term biologic needs. (Author/MB)

  7. Treatment outcome of children with severe acute malnutrition ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

    3Liverpool School of Tropical Medicine, Pembroke place, L3 5QA, Liverpool, UK. Brief communication ... malnutrition admitted to therapeutic feeding centers in. Southern .... checked by trained supervisors and higher professionals including ...

  8. Poverty Mapping Project: Global Subnational Prevalence of Child Malnutrition

    Data.gov (United States)

    National Aeronautics and Space Administration — The Global Subnational Prevalence of Child Malnutrition dataset consists of estimates of the percentage of children with weight-for-age z-scores that are more than...

  9. association between early life malnutrition and the size of lumbar ...

    African Journals Online (AJOL)

    Objective: To determine the relationship between early life malnutrition and the development of lumbar ... incriminate such predictors as poverty, aridity and human development which can be reduced ..... relationship with early childhood caries.

  10. Food Insecurity, Malnutrition and Crude Oil Spillage in a Rural ...

    African Journals Online (AJOL)

    , external control group study design, with a semi-structured questionnaire and anthropometry as the study tools. The study ... Keywords: Pipeline oil spill, household food security, malnutrition, rural community, Nigeria. Nigerian Journal of ...

  11. Food insecurity and malnutrition in Chinese elementary school students.

    Science.gov (United States)

    Shen, Xiuhua; Gao, Xiang; Tang, Wenjing; Mao, Xuanxia; Huang, Jingyan; Cai, Wei

    2015-09-28

    It has been shown that food insecurity is associated with poor diet quality and unfavourable health outcomes. However, little is known about the potential effects of food insecurity on the overall malnutrition status among children. In this study, we investigated the prevalence of food insecurity among 1583 elementary school students, aged 6-14 years, living in Chinese rural areas and examined its association with four malnutrition signs, including rickets sequelae, anaemia, stunting and wasting. Information on food security was collected via questionnaires. Rickets sequelae were assessed by an experienced paediatrician during the interview. Anaemia was determined by the WHO Hb thresholds adjusted by the local altitude. Weight and height were measured during the interview. Stunting and wasting were then evaluated according to WHO child growth standards (2007). We examined the association between food insecurity and the number of malnutrition signs (total number = 4), and the likelihood of having severe malnutrition (presence of 3+ signs), after adjusting for potential confounders, such as age, social-economic status and dietary intakes. During the previous 12 months, the overall prevalence of food insecurity was 6.1% in the entire studied population and 16.3% in participants with severe malnutrition. Participants with food insecurity had a slightly higher number of malnutrition signs (1.14 v. 0.96; P=0.043) relative to those who were food secure, after adjusting for potential confounders. Food insecurity was also associated with increased likelihood of having severe malnutrition (adjusted OR 3.08; 95% CI 1.47, 6.46; P=0.003). In conclusion, food insecurity is significantly associated with malnutrition among Chinese children in this community.

  12. Risk factors associated with malnutrition in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Roberta Flores Marquezini FRAGAS

    2016-06-01

    Full Text Available ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.

  13. The relationship between mother-child in marasmus type malnutrition

    Directory of Open Access Journals (Sweden)

    Claudia Inés Restrepo Vásquez

    2012-07-01

    Full Text Available This reflection aims to describe some theoretical reflections about the features that appear in the mother / son / food relational dynamic. It presents the research projects that are so far on the relationship between malnutrition and psychological aspects that accompany it. The chosen method in order to select the literature used the following search criteria: papers published between 2001 and 2011. It was used word-phrases: (Malnutrition, (marasmus, (marasmus type malnutrition and psychological and (mother / child relationship and malnutrition. As search facilities: Electronic databases (Ebsco, Medline, PubMed, SciELO, Embase. Priority was given to research work at national and local levels. Only those works which explicitly use the concept of malnutrition / stagnation / mother son bond were considerate. Also it was identified the most prominent authors in the field, and it was conducted exchanges with specialists on the field. Results show that so far there is no recent work related to this specific subject, except the work done by the doctor and psychoanalyst Rene Spitz in 1945. Conclusions: In this absence of research papers and given the particular phenomenon of marasmus type malnutrition, unacceptable as a problem that affects children’s mental health; there is the urge to create investigative actions that favor the construction of new intervention mechanisms for this complex reality. © Revista Colombiana de Ciencias Sociales.

  14. Malnutrition in the UK: policies to address the problem.

    Science.gov (United States)

    Elia, M; Russell, C A; Stratton, R J

    2010-11-01

    In 2007, the estimated cost of disease-related malnutrition in the UK was in excess of £13×109. At any point in time, only about 2% of over 3 million individuals at risk of malnutrition were in hospital, 5% in care homes and the remainder in the community (2-3% in sheltered housing). Some government statistics (England) grossly underestimated the prevalence of malnutrition on admission and discharge from hospital (1000-3000 annually between 1998 and 2008), which is less than 1% of the prevalence (about 3 million in 2007-2008) established by national surveys using criteria based on the 'Malnutrition Universal Screening Tool' ('MUST'). The incidence of malnutrition-related deaths in hospitals, according to government statistics (242 deaths in England in 2007), was also policies have reduced the number of hospital and care home beds and encouraged care closer to home. Such policies have raised issues about education and training of the homecare workforce, including 6 million insufficiently supported informal carers (10% of the population), the commissioning process, and difficulties in implementing nutritional policies in a widely distributed population. The four devolved nations in the UK (England, Scotland, Northern Ireland and Wales) have developed their own healthcare polices to deal with malnutrition. These generally aim to span across all care settings and various government departments in a co-ordinated manner, but their effectiveness remains to be properly evaluated.

  15. The Rise and Fall of Protein Malnutrition in Global Health.

    Science.gov (United States)

    Semba, Richard D

    2016-01-01

    From the 1950s to the mid-1970s, United Nations (UN) agencies were focused on protein malnutrition as the major worldwide nutritional problem. The goal of this review is to examine this era of protein malnutrition, the reasons for its demise, and the aftermath. The UN Protein Advisory Group was established in 1955. International conferences were largely concerned about protein malnutrition in children. By the early 1970s, UN agencies were ringing the alarm about a 'protein gap'. In The Lancet in 1974, Donald McLaren branded these efforts as 'The Great Protein Fiasco', declaring that the 'protein gap' was a fallacy. The following year, John Waterlow, the scientist who led most of the efforts on protein malnutrition, admitted that a 'protein gap' did not exist and that young children in developing countries only needed sufficient energy intake. The emphasis on protein malnutrition waned. It is recently apparent that quality protein and essential amino acids are missing in the diet and may have adverse consequences for child growth and the reduction of child stunting. Key Messages: It may be time to re-include protein and return protein malnutrition in the global health agenda using a balanced approach that includes all protective nutrients. © 2016 S. Karger AG, Basel.

  16. Experimental validation of modelling tools for a PEM fuel cell; Validation experimentale d'outils de modelisation d'une pile a combustible de type PEM

    Energy Technology Data Exchange (ETDEWEB)

    Boillot, M.

    2005-10-15

    In this work, a global view of the phenomena occurring in a PEM fuel cell is given. An original methodology was developed in order to determine the main parameters: thermodynamics, kinetics and transport phenomena. The gas flow in bipolar plates was characterised using experimental determination of residence time distributions and numerical simulations. Kinetics of both electrochemical reactions were analysed feeding the cell by diluted gases. In this part, the diffusion of reactants in the membrane electrodes assembly was taken into account. Finally, the relationship between humidity and electrical performance was investigated and the ohmic resistance of the cell was estimated. (author)

  17. Immunosuppressive mechanisms in protein-calorie malnutrition

    International Nuclear Information System (INIS)

    Redmond, H.P.; Shou, J.; Kelly, C.J.; Schreiber, S.; Miller, E.; Leon, P.; Daly, J.M.

    1991-01-01

    Protein-calorie malnutrition (PCM) induces immunosuppression leading to increased mortality rates. Impaired macrophage respiratory burst activity (superoxide anion [O2-] generation) occurs in PCM, but cellular mechanisms are unclear. The major pathway resulting in O2- production involves inositol lipid-dependent signal transduction. This study examined the effect of mild versus severe PCM on macrophage O2- generating signal transduction pathways specific for responses to Candida albicans. Mice (CFW/Swiss Webster: n = 300) were randomized to either control or low protein diets for 3 or 8 weeks. Peritoneal macrophages were harvested for O2- production, mannose-fucose receptor (MFR) expression, membrane phospholipid analysis, arachidonic acid (AA) content, prostaglandin E2 (PGE2) production, and protein kinase C levels. O2- release was impaired in both mild and severe PCM. MFR expression was also decreased at these time points. Inositol lipid content was significantly lower at the 8-week time point only, although PGE2 and AA were significantly higher in the low protein diet group at 3 weeks. Protein kinase C levels were unchanged by PCM. Thus, mild PCM significantly increases macrophage-PGE2 production secondary to increased AA phospholipid content, with subsequent inhibition of O2- and MFR expression. Severe PCM inhibits macrophage (O2-) through depletion of critical membrane phospholipid components with subsequent impairment in signal transduction

  18. Influence from sea water constituents on the efficiency of water electrolysis by PEM-cells

    DEFF Research Database (Denmark)

    Agersted, Karsten; Bentzen, Janet Jonna; Yde-Andersen, S.

    Among the sea-water specific impurities tested, magnesium has the most profound effect on PEM-cell degradation. Significant amounts of the cation was retrieved in the NAFION®-membrane structure after testing. Degradation was seen from a magnesium concentration as low as 3 10-7 mol/l, and increasing...... with concentration it led to a 86% increase of the area specific resistance at a concentration of 3 10-5 mol/l; equivalent to a conductivity of ~5 μS/cm. Other species (Cl-, Na+, SO4 2- ) seems to affect, though slowly, the performance negatively. If PEM will be used for electrolysis it seems therefore necessary...... to purify the feed water to ~1 μS/cm or even further while particularly focusing on the concentrations of polyvalent cations. e.g. magnesium....

  19. Modeling and experimental validation of water mass balance in a PEM fuel cell stack

    DEFF Research Database (Denmark)

    Liso, Vincenzo; Araya, Samuel Simon; Olesen, Anders Christian

    2016-01-01

    Polymer electrolyte membrane (PEM) fuel cells require good hydration in order to deliver high performance and ensure long life operation. Water is essential for proton conductivity in the membrane which increases by nearly six orders of magnitude from dry to fully hydrated. Adequate water...... management in PEM fuel cell is crucial in order to avoid an imbalance between water production and water removal from the fuel cell. In the present study, a novel mathematical zero-dimensional model has been formulated for the water mass balance and hydration of a polymer electrolyte membrane. This model...... is validated against experimental data. In the results it is shown that the fuel cell water balance calculated by this model shows better fit with experimental data-points compared with model where only steady state operation were considered. We conclude that this discrepancy is due a different rate of water...

  20. Analysis of the Coupling Behavior of PEM Fuel Cells and DC-DC Converters

    Directory of Open Access Journals (Sweden)

    Achim Kienle

    2009-03-01

    Full Text Available The connection between PEM fuel cells and common DC-DC converters is examined. The analysis is model-based and done for boost, buck and buck-boost converters. In a first step, the effect of the converter ripples upon the PEM fuel cell is shown. They introduce oscillations in the fuel cell. Their appearance is explained, discussed and possibilities for their suppression are given. After that, the overall behaviors of the coupled fuel cell-converter systems are analyzed. It is shown, that neither stationary multiplicities nor oscillations can be introduced by the couplings and therefore separate control approaches for both the PEMFC and the DC-DC converters are applicable.

  1. A computational model of a PEM fuel cell with finite vapor absorption rate

    Energy Technology Data Exchange (ETDEWEB)

    Vorobev, A.; Zikanov, O.; Shamim, T. [Department of Mechanical Engineering, University of Michigan-Dearborn, 48128-1491 Dearborn, MI (United States)

    2007-03-30

    The paper presents a new computational model of non-steady operation of a PEM fuel cell. The model is based on the macroscopic hydrodynamic approach and assumptions of low humidity operation and one-dimensionality of transport processes. Its novelty and advantage in comparison with similar existing models is that it takes into account the finite-time equilibration between vapor and membrane-phase liquid water within the catalyst layers. The phenomenon is described using an additional parameter with the physical meaning of the typical reciprocal time of the equilibration. A computational parametric study is conducted to identify the effect of the finite-time equilibration on steady-state and transient operation of a PEM fuel cell. (author)

  2. Optimization of a thermoelectric generator subsystem for high temperature PEM fuel cell exhaust heat recovery

    DEFF Research Database (Denmark)

    Gao, Xin; Andreasen, Søren Juhl; Kær, Søren Knudsen

    2014-01-01

    In previous work, a thermoelectric (TE) exhaust heat recovery subsystem for a high temperature polymer electrolyte membrane (HT-PEM) fuel cell stack was developed and modeled. Numerical simulations were conducted and have identified an optimized subsystem configuration and 4 types of compact heat...... modules are now connected into branches. The procedures of designing and optimizing this TE exhaust heat recovery subsystem are drawn out. The contribution of TE exhaust heat recovery to the HT-PEM fuel cell power system is preliminarily concluded. Its feasibility is also discussed....... exchangers with superior performance for further analysis. In this work, the on-design performances of the 4 heat exchangers are more thoroughly assessed on their corresponding optimized subsystem configurations. Afterward, their off-design performances are compared on the whole working range of the fuel...

  3. Development of a 400 W High Temperature PEM Fuel Cell Power Pack

    DEFF Research Database (Denmark)

    Schaltz, Erik; Jespersen, Jesper Lebæk; Rasmussen, Peter Omand

    2006-01-01

    reformer design because CO removal is not needed. A fuel like methanol would be a preferable choice for reforming when using HTPEM fuel cells because of its high energy density and low reforming temperatures. The thermal integration and use of HTPEM fuel cells with methanol reformers show promising results......When using pressurized hydrogen to fuel a fuel cell, much space is needed for fuel storage. This is undesirable especially with mobile or portable fuel cell systems, where refuelling also often is inconvenient. Using a reformed liquid carbonhydrate can reduce this fuel volume considerably. Nafion...... based low temperature PEM (LTPEM) fuel cells are very intolerant to reformate gas because of the presence of CO. PBI based high temperature PEM (HTPEM) fuel cells can operate stable at much higher CO concentrations. This makes the HTPEM very suitable for applications using a reformer, and could simplify...

  4. Simulation results of a veto counter for the ClearPEM

    CERN Document Server

    Trummer, J; Lecoq, P

    2009-01-01

    The Crystal Clear Collaboration (CCC) has built a prototype of a novel positron emission tomograph dedicated to functional breast imaging, the ClearPEM. The ClearPEM uses the common radio pharmaceutical FDG for imaging cancer. As FDG is a rather non-specific radio tracer, it accumulates not only in cancer cells but in all cells with a high energy consumption, such as the heart and liver. This fact poses a problem especially in breast imaging, where the vicinity of the heart and other organs to the breast leads to a high background noise level in the scanner. In this work, a veto counter to reduce the background is described. Different configurations and their effectiveness were studied using the GATE simulation package.

  5. Numerical Simulations and Diagnostic Studies of Meteorological Conditions During PEM-Tropics B

    Science.gov (United States)

    Fuelberg, Henry E.

    2001-01-01

    Provides a final report on the work accomplished by several meteorological scientists under a NASA grant in conjunction with the DC-8 component of Pacific Exploratory Mission (PEM)-Tropics B. The responsibilities of the principal investigator included collaboration with the Science Team on flight planning, presentation of forecasts, and the preparation of map discussions for each flight. In a published manuscript, the principal investigator summarized the meteorological conditions during PEM-TB which included mean flow patterns, subtropical anticyclones, the South Pacific Convergence Zone (SPCZ), and the Intertropical Convergence Zone (ITCZ). Methodologies used included streamlines, ten day backward trajectories, thermodynamic soundings, and satellite imagery. Other interests included air sampling for the purpose of determining pollution levels.

  6. Bi-polarized translation of ascidian maternal mRNA determinant pem-1 associated with regulators of the translation machinery on cortical Endoplasmic Reticulum (cER).

    Science.gov (United States)

    Paix, Alexandre; Le Nguyen, Phuong Ngan; Sardet, Christian

    2011-09-01

    Polarized cortical mRNA determinants such as maternal macho-1 and pem-1 in ascidians, like budding yeast mating factor ASH1 reside on the cER-mRNA domain a subdomain of cortical Endoplasmic Reticulum(ER) and are translated in its vicinity. Using high resolution imaging and isolated cortical fragments prepared from eggs and embryos we now find that macho-1 and pem-1 RNAs co-localize with phospho-protein regulators of translation initiation (MnK/4EBP/S6K). Translation of cortical pem-1 RNA follows its bi-polarized relocalization. About 10 min after fertilization or artificial activation with a calcium ionophore, PEM1 protein is detected in the vegetal cortex in the vicinity of pem-1 RNA. About 40 min after fertilization-when pem-1 RNA and P-MnK move to the posterior pole-PEM1 protein remains in place forming a network of cortical patches anchored at the level of the zygote plasma membrane before disappearing. Cortical PEM1 protein is detected again at the 4 cell stage in the posterior centrosome attracting body (CAB) region where the cER-mRNA domain harboring pem-1/P-MnK/P-4EBP/P-S6K is concentrated. Bi-polarized PEM1 protein signals are not detected when pem-1 morpholinos are injected into eggs or zygotes or when MnK is inhibited. We propose that localized translation of the pem-1 RNA determinant is triggered by the fertilization/calcium wave and that the process is controlled by phospho-protein regulators of translation initiation co-localized with the RNA determinant on a sub-domain of the cortical Endoplasmic Reticulum. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Development of Low Temperature Catalysts for an Integrated Ammonia PEM Fuel Cell

    OpenAIRE

    Hill, Alfred

    2014-01-01

    It is proposed that an integrated ammonia-PEM fuel cell could unlock the potential of ammonia to act as a high capacity chemical hydrogen storage vector and enable renewable energy to be delivered eectively to road transport applications. Catalysts are developed for low temperature ammonia decomposition with activity from 450 K (ruthenium and cesium on graphitised carbon nanotubes). Results strongly suggest that the cesium is present on the surface and close proximity to ruthenium nanoparticl...

  8. Long-term stability of the Clear-PEM detector modules

    International Nuclear Information System (INIS)

    Amaral, Pedro; Bruyndonckx, Peter; Carrico, Bruno; Ferreira, Miguel; Luyten, Joan; Moura, Rui; Ortigao, Catarina; Rodrigues, Pedro; Silva, Jose C. da; Trindade, Andreia; Varela, Joao

    2007-01-01

    Experimental evaluation of the imaging system Clear-PEM for positron emission mammography, under development within the framework of the crystal clear collaboration at CERN, is presented in terms of its long-term stability. The detector modules and experimental setup are described. Time evolution results of signal yield, energy resolution, depth-of-interaction and inter-channel crosstalk for a reference detector module are reported

  9. Fuzzy Logic Based Control of Power of PEM Fuel Cell System for Residential Application

    Directory of Open Access Journals (Sweden)

    Khaled MAMMAR

    2009-07-01

    Full Text Available This paper presents a dynamic model of Fuel cell system for residential power generation. The models proposed include a fuel cell stack model, reformer model and DC/AC inverter model. Furthermore a fuzzy logic (FLC controller is used to control active power of PEM fuel cell system. The controller modifies the hydrogen flow feedback from the terminal load. Simulation results confirmed the high performance capability of the fuzzy logic controller to control power generation.

  10. Optimal Control of a PEM Fuel Cell for the Inputs Minimization

    Directory of Open Access Journals (Sweden)

    José de Jesús Rubio

    2014-01-01

    Full Text Available The trajectory tracking problem of a proton exchange membrane (PEM fuel cell is considered. To solve this problem, an optimal controller is proposed. The optimal technique has the objective that the system states should reach the desired trajectories while the inputs are minimized. The proposed controller uses the Hamilton-Jacobi-Bellman method where its Riccati equation is considered as an adaptive function. The effectiveness of the proposed technique is verified by two simulations.

  11. Development of an angled Si-PM-based detector unit for positron emission mammography (PEM) system

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Kouhei, E-mail: nakanishi.kouhei@c.mbox.nagoya-u.ac.jp; Yamamoto, Seiichi

    2016-11-21

    Positron emission mammography (PEM) systems have higher sensitivity than clinical whole body PET systems because they have a smaller ring diameter. However, the spatial resolution of PEM systems is not high enough to detect early stage breast cancer. To solve this problem, we developed a silicon photomultiplier (Si-PM) based detector unit for the development of a PEM system. Since a Si-PM's channel is small, Si-PM can resolve small scintillator pixels to improve the spatial resolution. Also Si-PM based detectors have inherently high timing resolution and are able to reduce the random coincidence events by reducing the time window. We used 1.5×1.9×15 mm LGSO scintillation pixels and arranged them in an 8×24 matrix to form scintillator blocks. Four scintillator blocks were optically coupled to Si-PM arrays with an angled light guide to form a detector unit. Since the light guide has angles of 5.625°, we can arrange 64 scintillator blocks in a nearly circular shape (a regular 64-sided polygon) using 16 detector units. We clearly resolved the pixels of the scintillator blocks in a 2-dimensional position histogram where the averages of the peak-to-valley ratios (P/Vs) were 3.7±0.3 and 5.7±0.8 in the transverse and axial directions, respectively. The average energy resolution was 14.2±2.1% full-width at half-maximum (FWHM). By including the temperature dependent gain control electronics, the photo-peak channel shifts were controlled within ±1.5% with the temperature from 23 °C to 28 °C. With these results, in addition to the potential high timing performance of Si-PM based detectors, our developed detector unit is promising for the development of a high-resolution PEM system.

  12. Simulation study of a proton exchange membrane (PEM) fuel cell system with autothermal reforming

    Energy Technology Data Exchange (ETDEWEB)

    Ersoz, Atilla [TUBITAK Marmara Research Centre, Energy Systems and Environmental Research Institute, 41470 Gebze, Kocaeli (Turkey); Olgun, Hayati [TUBITAK Marmara Research Centre, Energy Systems and Environmental Research Institute, 41470 Gebze, Kocaeli (Turkey); Ozdogan, Sibel [Marmara University, Faculty of Engineering, Department of Mechanical Engineering, 81040 Goztepe, Istanbul (Turkey)

    2006-08-15

    This paper presents the results of a study for a 100 kW net electrical power PEM fuel cell system. The major system components are an autothermal reformer, high and low temperature shift reactors, a preferential oxidation reactor, a PEM fuel cell, a combustor and an expander. Intensive heat integration within the PEM fuel cell system has been necessary to achieve acceptable net electrical efficiency levels. The calculations comprise the auxiliary equipment such as pumps, compressors, heaters, coolers, heat exchangers and pipes. The process simulation package 'ASPEN-HYSYS 3.1' has been used along with conventional calculations. The operation conditions of the autothermal reformer have been studied in detail to determine the values, which lead to the production of a hydrogen rich gas mixture with CO concentration at ppm level. The operation parameters of the other reactors have been determined considering the limitations implied by the catalysts involved. A gasoline type hydrocarbon fuel has been studied as the source for hydrogen production. The chemical composition of the hydrocarbon fuel affects the favorable operation conditions of autothermal reforming and the following fuel purification steps. Thermal efficiencies have been calculated for all of the major system components for selected operation conditions. The fuel cell stack efficiency has been calculated as a function of the number of cells (500-1250 cells). Efficiencies of all of the major system components along with auxiliary unit efficiencies determine the net electrical efficiency of the PEM fuel cell system. The obtained net electrical efficiency levels are between 30 (500 cells) and 37% (1250 cells). Hence, they are comparable with or higher than those of the conventional gasoline based internal combustion engine systems, in terms of the mechanical power efficiency.

  13. Simulation study of a proton exchange membrane (PEM) fuel cell system with autothermal reforming

    International Nuclear Information System (INIS)

    Ersoz, Atilla; Olgun, Hayati; Ozdogan, Sibel

    2006-01-01

    This paper presents the results of a study for a 100 kW net electrical power PEM fuel cell system. The major system components are an autothermal reformer, high and low temperature shift reactors, a preferential oxidation reactor, a PEM fuel cell, a combustor and an expander. Intensive heat integration within the PEM fuel cell system has been necessary to achieve acceptable net electrical efficiency levels. The calculations comprise the auxiliary equipment such as pumps, compressors, heaters, coolers, heat exchangers and pipes. The process simulation package 'ASPEN-HYSYS 3.1' has been used along with conventional calculations. The operation conditions of the autothermal reformer have been studied in detail to determine the values, which lead to the production of a hydrogen rich gas mixture with CO concentration at ppm level. The operation parameters of the other reactors have been determined considering the limitations implied by the catalysts involved. A gasoline type hydrocarbon fuel has been studied as the source for hydrogen production. The chemical composition of the hydrocarbon fuel affects the favorable operation conditions of autothermal reforming and the following fuel purification steps. Thermal efficiencies have been calculated for all of the major system components for selected operation conditions. The fuel cell stack efficiency has been calculated as a function of the number of cells (500-1250 cells). Efficiencies of all of the major system components along with auxiliary unit efficiencies determine the net electrical efficiency of the PEM fuel cell system. The obtained net electrical efficiency levels are between 30 (500 cells) and 37% (1250 cells). Hence, they are comparable with or higher than those of the conventional gasoline based internal combustion engine systems, in terms of the mechanical power efficiency

  14. An efficient mathematical model for air-breathing PEM fuel cells

    International Nuclear Information System (INIS)

    Ismail, M.S.; Ingham, D.B.; Hughes, K.J.; Ma, L.; Pourkashanian, M.

    2014-01-01

    Graphical abstract: The effects of the ambient humidity on the performance of air-breathing PEM fuel cells become more pronounced as the ambient temperature increases. The polarisation curves have been generated using the in-house developed MATLAB® application, Polarisation Curve Generator, which is available in the supplementary data. - Highlights: • An efficient mathematical model has been developed for an air-breathing PEM fuel cell. • The fuel cell performance is significantly over-predicted if the Joule and entropic heats are neglected. • The fuel cell performance is highly sensitive to the state of water at the thermodynamic equilibrium. • The cell potential dictates the favourable ambient conditions for the fuel cell. - Abstract: A simple and efficient mathematical model for air-breathing proton exchange membrane (PEM) fuel cells has been built. One of the major objectives of this study is to investigate the effects of the Joule and entropic heat sources, which are often neglected, on the performance of air-breathing PEM fuel cells. It is found that the fuel cell performance is significantly over-predicted if one or both of these heat sources is not incorporated into the model. Also, it is found that the performance of the fuel cell is highly sensitive to the state of the water at the thermodynamic equilibrium magnitude as both the entropic heat and the Nernst potential considerably increase if water is assumed to be produced in liquid form rather than in vapour form. Further, the heat of condensation is shown to be small and therefore, under single-phase modelling, has a negligible effect on the performance of the fuel cell. Finally, the favourable ambient conditions depend on the operating cell potential. At intermediate cell potentials, a mild ambient temperature and low humidity are favoured to maintain high membrane conductivity and mitigate water flooding. At low cell potentials, low ambient temperature and high humidity are favoured to

  15. Development of integrated system to operational control and monitoring for PEM fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Mauricio Stelita; Ferreira, Valdemar Stelita [NovoCell Sistemas de Energia S.A., Santa Barbara D' Oeste, SP (Brazil)], Email: mauricio.ferreira@novocell.ind.br

    2010-07-01

    The demonstration of fuel cells prototype in some applications such as in stationary systems and vehicles has been increased, but higher costs and lack of criteria for system longevity still prevent their mass production. Acting directly on this aspect, Novocell has proposed to develop innovative processes and materials to manufacture at scale and with competitive cost for these systems. Thus, this paper presents solutions that enable its production line of PEM fuel cells. (author)

  16. Process for recycling components of a PEM fuel cell membrane electrode assembly

    Science.gov (United States)

    Shore, Lawrence [Edison, NJ

    2012-02-28

    The membrane electrode assembly (MEA) of a PEM fuel cell can be recycled by contacting the MEA with a lower alkyl alcohol solvent which separates the membrane from the anode and cathode layers of the assembly. The resulting solution containing both the polymer membrane and supported noble metal catalysts can be heated under mild conditions to disperse the polymer membrane as particles and the supported noble metal catalysts and polymer membrane particles separated by known filtration means.

  17. The effect of material properties on the performance of a new geometry PEM fuel cell

    Energy Technology Data Exchange (ETDEWEB)

    Khazaee, Iman [Islamic Azad University, Department of Mechanical Engineering, Torbat-e-jam Branch, Torbat-e-jam (Iran, Islamic Republic of); Ghazikhani, Mohsen [Ferdowsi University of Mashhad, Department of Mechanical Engineering, Faculty of Engineering, Mashhad (Iran, Islamic Republic of)

    2012-05-15

    In this paper a computational dynamics model for duct-shaped geometry proton exchange membrane (PEM) fuel cell was used to investigate the effect of changing gas diffusion layer and membrane properties on the performances, current density and gas concentration. The proposed model is a full cell model, which includes all the parts of the PEM fuel cell, flow channels, gas diffusion electrodes, catalyst layers and the membrane. Coupled transport and electrochemical kinetics equations are solved in a single domain; therefore no interfacial boundary condition is required at the internal boundaries between cell components. This computational fluid dynamics code is used as the direct problem solver, which is used to simulate the 2-dimensional mass, momentum and species transport phenomena as well as the electron- and proton-transfer process taking place in a PEMFC that cannot be investigated experimentally. The results show that by increasing the thickness and decreasing the porosity of GDL the performance of the cell enhances that it is different with planner PEM fuel cell. Also the results show that by increasing the thermal conductivity of the GDL and membrane, the overall cell performance increases. (orig.)

  18. Characterization and quality control of avalanche photodiode arrays for the Clear-PEM detector modules

    International Nuclear Information System (INIS)

    Abreu, Conceicao; Amaral, Pedro; Carrico, Bruno; Ferreira, Miguel; Luyten, Joan; Moura, Rui; Ortigao, Catarina; Rato, Pedro; Varela, Joao

    2007-01-01

    Clear-PEM is a Positron Emission Mammography (PEM) prototype being developed in the framework of the Crystal Clear Collaboration at CERN. This device is a dedicated PET camera for mammography, based on LYSO:Ce scintillator crystals, Avalanche PhotoDiodes (APD) and a fast, low-noise electronics readout system, designed to examine both the breast and the axillary lymph node areas, and aiming at the detection of tumors down to 2 mm in diameter. The prototype has two planar detector heads, each composed of 96 detector modules. The Clear-PEM detector module is composed of a matrix of 32 identical 2x2x20 mm 3 LYSO:Ce crystals read at both ends by Hamamatsu S8550 APD arrays (4x8) for Depth-of-Interaction (DoI) capability. The APD arrays were characterized by the measurement of gain and dark current as a function of bias voltage, under controlled temperature conditions. Two independent setups were used. The full set of 398 APD arrays followed a well-defined quality control (QC) protocol, aiming at the rejection of arrays not complying within defined specifications. From a total of 398 arrays, only 2 (0.5%) were rejected, reassuring the trust in these detectors for prototype assembly and future developments

  19. Using the PAW/PEM monitoring systems to support operations at Point Lepreau

    International Nuclear Information System (INIS)

    MacDonald, S.; McIntyre, M.; Dai, H.

    1997-01-01

    The plant data logger was brought on-line at the Point Lepreau Generating Station (PLGS) in 1992 in order to record information from instruments throughout the plant. Using the System Engineers Data Extraction (SEDE) utility, current plant data is at the fingertips of anyone with a network connection. System engineers can monitor the performance of their systems at any time and take pro-active measures to avoid problems with performance, as well as monitor behaviour during tests and plant upsets. Nuclear Safety personnel gather data for use in simulation and analysis validation, as well as to ensure that plant parameters are kept within the safe operating envelope. The PLGS operational safety group embarked on a project to develop a data management system. The project and the monitoring process has come to be known as the Plant Analysis Workbench (PAW). When the need for complex monitoring of safety system signals was identified, this led to a similar project called the Plant Expert Monitor (PEM). In this paper we present an overview of the functionality of both PAW and PEM, outlining in particular the expert system architecture in PEM and giving an example of its day-to-day use

  20. Steam and partial oxidation reforming options for hydrogen production from fossil fuels for PEM fuel cells

    Directory of Open Access Journals (Sweden)

    Yousri M.A. Welaya

    2012-06-01

    Full Text Available Proton exchange membrane fuel cell (PEM generates electrical power from air and from hydrogen or hydrogen rich gas mixtures. Therefore, there is an increasing interest in converting current hydrocarbon based marine fuels such as natural gas, gasoline, and diesel into hydrogen rich gases acceptable to the PEM fuel cells on board ships. Using chemical flow sheeting software, the total system efficiency has been calculated. Natural gas appears to be the best fuel for hydrogen rich gas production due to its favorable composition of lower molecular weight compounds. This paper presents a study for a 250 kW net electrical power PEM fuel cell system utilizing a partial oxidation in one case study and steam reformers in the second. This study has shown that steam-reforming process is the most competitive fuel processing option in terms of fuel processing efficiency. Partial oxidation process has proved to posses the lowest fuel processing efficiency. Among the options studied, the highest fuel processing efficiency is achieved with natural gas steam reforming system.