Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Novel hamacher aggregation operators based on complex T-spherical fuzzy numbers for cleaner production evaluation in gold mines

Cleaner production (CP) is defined as a preventive approach to managing the environmental effect of business processes and products. CP is also related to the use of less but more efficient energy and materials and the substitution of products harmful to the environment/health with less dangerous ones. The Hamacher Aggregation (HA) operator is an easy technique that permits several comparison declarations to be prepared while yet securing an overall confidence coefficient is sustained. The major benefit of HA operator based on Hamacher t-norm and Hamacher t-conorm is that they provide a lot of specific aggregation operators due to their parameters included in the mathematical form of HA operator. Another hand, the conception of complex T-spherical fuzzy (CTSF) strategy is a novel and original technique that exists with a well-known theme and advantages in the circumstance of fuzzy set theory. The key influence of this hypothesis is to evaluate the conception of Hamacher operational laws and their influential results. Moreover, the theory of CTSF Hamacher weighted averaging (CTSFHWA) and CTSF Hamacher weighted geometric (CTSFHWG) operators and described their influential properties with several strong results. Moreover, a strategic decision-making technique is evaluated in the existence of the deliberated operators for CTSF settings. Finally, to check the stability and accurateness of the invented operators, we assessed the comparative analysis and geometrical shape of the presented works with the help of many numerical illustrations