Food systems, nutrition, health and the environment

Nutritionists are classically concerned with the associations between nutrients and diets and nutrition and health outcomes. Understanding these associations is important. Insufficient and poor quality food, especially during pregnancy and in early childhood is a major contributor to the high burden of undernutrition: globally, 159 million children younger than 5 years are stunted (too short for their age), 50 million children globally are wasted (dangerously thin), and more than 3 million children die every year from causes associated with undernutrition. Simultaneously, nutrition-related chronic diseases such as obesity, diabetes, cardiovascular disease, and some forms of cancer are major contributors to the global burden of disease. Ambitious goals have been set by the international community to eliminate malnutrition in all its forms, and 2016 saw the start of a UN Decade of Action on Nutrition designed to reinvigorate national and international efforts for nutrition

Sensor fault detection and isolation for a class of uncertain nonlinear system using sliding mode observers

Quick and timely fault detection is of great importance in control systems reliability. Undetected faulty sensors could result in irreparable damages. Although fault detection and isolation (FDI) methods in control systems have received much attention in the last decade, these techniques have not been applied for some classes of nonlinear systems yet. This paper deals with the issues of sensor fault detection and isolation for a class of Lipschitz uncertain nonlinear system. By introducing a coordinate transformation matrix for states and output, the original system is first divided into two subsystems. The first subsystem is affected by uncertainty and disturbance. The second subsystem just has sensor faults. The nonlinear term is separated to linear and pure nonlinear parts. For fault detection, two sliding mode observers (SMO) are designed for the two subsystems. The stability condition is obtained based on the Lyapunov approach. The necessary matrices and parameters are obtained by solving the linear matrix inequality (LMI) problem. Furthermore, two sliding mode observers are designed for fault isolation. Finally, the effectiveness of the proposed approach is illustrated by simulation examples

Interpersonal behavior in anticipation of pain:a naturalistic study of behavioral mimicry prior to surgery

Abstract. Introduction:. Social relationships facilitate coping with pain, but research suggests that it may be difficult to galvanize social support during an episode of acute pain. Objectives:. The current research examined whether social connections are optimized in the anticipation of pain by observing patients' mimicry of an interaction partner prior to surgery. We hypothesized that when controlling for their current experience of pain, patients' anticipation of pain would be associated with greater mimicry of an interaction partner. Methods:. Sixty-five patients were interviewed in the waiting room of a maxillofacial surgery unit prior to the removal of an impacted wisdom tooth. Patients' spontaneous mimicry of an interviewer was observed. Patients then rated the quality and intensity of their anticipated pain, as well as the intensity of their current pain and their affective distress. Results:. Anticipated pain, current pain, and affective distress were positively correlated. Current pain was associated with less frequent mimicry of an interaction partner. The zero-order correlation between anticipated pain and mimicry did not reach conventional levels of significance; however, when controlling for current pain, anticipated pain predicted more frequent mimicry of an interaction partner. The relationship between anticipated pain and mimicry was not explained by affective distress. Conclusion:. This is the first study to demonstrate that anticipated and current pain relate to behavioral mimicry in divergent ways. Further research is needed to investigate whether the current pattern of results generalizes to other interpersonal behaviors that facilitate social bonds

Upper Gastrointestinal Bleeding as Delayed Presentation of Traumatic Diaphragmatic Hernia: a Case Report

Introduction: Traumatic diaphragmatic hernia (TDH) is one of the critical complications resulting from penetrating chest trauma. The rate of undiagnosed TDH equivocates 12-60%. The significant part of complications happens 1-4 years after the primary damage. Here, we report a case of delayed TDH presented with upper gastrointestinal bleeding (GIB) as an excuse to discuss this issue. Case presentation: The patient was a 35-year-old man, admitted with objection of abdominal pain. A nasogastric tube was inserted and fixed that resulted in drainage of about 500cc dark blood. He was candidate for emergent endoscopy due to upper GIB. During resuscitation measures, he suddenly developed respiratory distress that could not be justified by upper GIB alone. Therefore, bedside sonography discovered some soft tissue apart from lung tissue in the left hemithorax. After performing diagnostic measures, with diagnosis of diaphragmatic herniation and strangulation he underwent emergent surgery. Conclusion: Small diaphragmatic lesions, which usually result from stab wounds, may develop into larger injuries if left untreated and they might lead to a diaphragmatic hernia with a potential risk of early or late complications and mortality. One of the rare complications is GIB, which should be considered in a patient with past history of trauma and presentation of GIB

Upper Gastrointestinal Bleeding as Delayed Presentation of Traumatic Diaphragmatic Hernia: a Case Report

Introduction: Traumatic diaphragmatic hernia (TDH) is one of the critical complications resulting from penetrating chest trauma. The rate of undiagnosed TDH equivocates 12-60%. The significant part of complications happens 1-4 years after the primary damage. Here, we report a case of delayed TDH presented with upper gastrointestinal bleeding (GIB) as an excuse to discuss this issue. Case presentation: The patient was a 35-year-old man, admitted with objection of abdominal pain. A nasogastric tube was inserted and fixed that resulted in drainage of about 500cc dark blood. He was candidate for emergent endoscopy due to upper GIB. During resuscitation measures, he suddenly developed respiratory distress that could not be justified by upper GIB alone. Therefore, bedside sonography discovered some soft tissue apart from lung tissue in the left hemithorax. After performing diagnostic measures, with diagnosis of diaphragmatic herniation and strangulation he underwent emergent surgery. Conclusion: Small diaphragmatic lesions, which usually result from stab wounds, may develop into larger injuries if left untreated and they might lead to a diaphragmatic hernia with a potential risk of early or late complications and mortality. One of the rare complications is GIB, which should be considered in a patient with past history of trauma and presentation of GIB

Mandibular trauma treatment: a comparison of two protocols

Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study. Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 – 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center. Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons’ experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible

The Cost of Leaving the Emergency Department without Notice; a Cross-sectional Study

Introduction: Leaving the hospital without notice is among the problems that can inflict financial and non-financial burdens on the health care system of a country. Objective: The present study was carried out with the aim of evaluating the prevalence of leaving without notice cases in the emergency department (ED) of one of the major teaching hospitals of Tehran affiliated with Shahid Beheshti University of Medical Sciences and calculating the direct costs resulting from it. Methods: This study was a retrospective cross-sectional one carried out during 1 year from 2016 to 2017 in one of the teaching hospitals of Tehran affiliated with Shahid Beheshti University of Medical Sciences. Sampling was performed via census method and the study population consisted of the profiles of all the patients who had left the hospital without notice or checking out after being admitted to the hospital. To gather the required data for this study, a checklist consisting of questions regarding sex, age, insurance coverage, and the amount of money they owed the hospital was used. Statistical analysis was performed using the software IBM Statistics for Windows v22 and P-value<0.05 was considered significant. Results: Out of the total of 39946 patients visiting the ED of the studied hospital during 1 year, 1692 (4.2%) had left the hospital without checking out. Below 30 years age range was the most common age range with 46.9% (794 patients) and 72.9% of the patients leaving without notice were men. Based on the findings obtained, male patients without insurance coverage had attempted to leave the hospital without notice more than others (p<0.001). The total cost inflicted by leaving without notice throughout the studied year was 1,755,286,279 Rials, which is equal to 0.0059 of the total annual income of the ED. Conclusion: Throughout the year this study was performed, a total of 1.2% of all the visitors of the ED of a hospital affiliated with Shahid Beheshti University of Medical Sciences left the hospital without notice or checking out, which inflicted a considerable cost on the ED