Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 3...Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.展开更多
The construction of the new tunnel under the existing railway will break the original stress balance in the engineering area, resulting in the secondary redistribution of surrounding rock stress. The large amount of e...The construction of the new tunnel under the existing railway will break the original stress balance in the engineering area, resulting in the secondary redistribution of surrounding rock stress. The large amount of excavation unloading of the soil below is also easy to induce the uneven settlement deformation of the existing structure above, affecting the safety of driving. Based on the shield tunnel project between Caoqiao Station and Lize Business District Station of Beijing Metro, this paper restores the construction site by constructing the finite element numerical model of the project area, calculates and analyzes the deformation and stress of the existing railway structure before and after the construction of the tunnel, and determines the safety impact of the new structure on the existing railway. The results show that the shield tunnel undercrossing construction will cause the “concave” settlement of the railway subgrade above. Under the condition of grouting reinforcement, the “concave” settlement curve is slower and the distribution range is wider. With the advancement of the construction step, the settlement deformation of the subgrade gradually increases. When the tunnel approaches and passes directly below the subgrade, the settlement deformation curve of the subgrade changes from slow to steep. After the tunnel passes away, the curve changes from steep to slow, and the deformation of the subgrade reaches the maximum after the tunnel is connected. Under the grouting condition, the maximum settlement deformation of the subgrade is 2.08 mm, which is about 45% of the settlement deformation of the subgrade under the non-grouting condition. The ground grouting reinforcement can effectively control the subgrade settlement, and the field monitoring verifies the rationality of the calculation results. After the tunnel passes underneath, the most unfavorable section of the existing railway frame bridge is located at the top plate of the structure, and the maximum crack width is 0.178 mm. After grouting reinforcement, the stress environment of the structure is improved, the crack width generated by the structure is smaller, the reinforcement area required for calculation is less, and the structural safety meets the requirements.展开更多
文摘Background: Severe acute malnutrition (SAM) is one of the major public health problems associated with increased mortality in under-five children. In low-income countries, renal dysfunction (RD) contributes to about 34% mortality in under-five children with severe acute malnutrition. This study aimed to determine the impacts of severe acute malnutrition on the kidney among the admitted under-five children. Methods: In this prospective longitudinal observational study, a total of 190 children aged 6 to 59 months were enrolled from Iringa and Dodoma tertiary hospitals. Socio-demographic, clinical and laboratory data were collected using a structured questionnaire. Estimated Glomerular Filtration Rate (eGFR) and urine albumin creatinine ratio (uACR) were used to determine RD. Data analysis was done using SPSS version 26 and statistical significance was assumed for factors with p-value Results: Out of 190 children with severe acute malnutrition, 36 (19%) had renal dysfunction. Factors associated with RD in malnourished children were the history of local herbs used within one week (AOR = 5.85, 95% CI [1.41, 24.319], p = 0.0152), Acute watery diarrhea with severe dehydration (AOR = 2.15, 95% CI [1.033, 4.711], p = 0.0166), and positive urine leukocytes (AOR = 19.91, 95% CI [4.09, 96.989], p = 0.0002). At three months of follow up, out of 36 children with RD, 20 (55.56%) attained full recovery, while 4 (11.11%) developed chronic kidney disease (CKD). Children with RD had prolonged hospital stays for more than 14 days with a mean 12.25 ± 5.00 days compared to those with no RD with a mean 6.29 ± 1.68 days (p Conclusion: Renal dysfunction is common among children with severe acute malnutrition. It is associated with prolonged hospital stays and increased mortality. Further studies which can determine the burden of RD in children with severe acute malnutrition as compared to those with no severe acute malnutrition are needed.
文摘The construction of the new tunnel under the existing railway will break the original stress balance in the engineering area, resulting in the secondary redistribution of surrounding rock stress. The large amount of excavation unloading of the soil below is also easy to induce the uneven settlement deformation of the existing structure above, affecting the safety of driving. Based on the shield tunnel project between Caoqiao Station and Lize Business District Station of Beijing Metro, this paper restores the construction site by constructing the finite element numerical model of the project area, calculates and analyzes the deformation and stress of the existing railway structure before and after the construction of the tunnel, and determines the safety impact of the new structure on the existing railway. The results show that the shield tunnel undercrossing construction will cause the “concave” settlement of the railway subgrade above. Under the condition of grouting reinforcement, the “concave” settlement curve is slower and the distribution range is wider. With the advancement of the construction step, the settlement deformation of the subgrade gradually increases. When the tunnel approaches and passes directly below the subgrade, the settlement deformation curve of the subgrade changes from slow to steep. After the tunnel passes away, the curve changes from steep to slow, and the deformation of the subgrade reaches the maximum after the tunnel is connected. Under the grouting condition, the maximum settlement deformation of the subgrade is 2.08 mm, which is about 45% of the settlement deformation of the subgrade under the non-grouting condition. The ground grouting reinforcement can effectively control the subgrade settlement, and the field monitoring verifies the rationality of the calculation results. After the tunnel passes underneath, the most unfavorable section of the existing railway frame bridge is located at the top plate of the structure, and the maximum crack width is 0.178 mm. After grouting reinforcement, the stress environment of the structure is improved, the crack width generated by the structure is smaller, the reinforcement area required for calculation is less, and the structural safety meets the requirements.
