Search

Emily White,1 Mohamed Mutalib1,2 1Department of Paediatric Gastroenterology, Evelina London Children’ Hospital, London, UK; 2Faculty of Life Sciences and Medicine, King’s College London, London, UKCorrespondence: Mohamed Mutalib, Department of Paediatric Gastroenterology, Evelina London Children’ Hospital, London, SE1 7EH, UK, Email Mohamed.mutalib@gstt.nhs.ukAbstract: Pediatric neurodisability describes functional limitations in children with varied severity and complexity often attributed to brain or neuromuscular abnormalities. The life expectancy of children with neurodisability is improving, but many will require significant medical support. The gastrointestinal tract is usually affected in children with neurodisability and can lead to a wide range of symptoms. In gastrointestinal (GI) dystonia, a newly coined term, feeding will trigger a distressing dystonia and symptoms can improve with cessation of feed. Parenteral nutrition (PN) is often viewed as a viable option in severe GI dystonia or when enteral feeding does not support sufficient nutrition. The use of PN in children with severe neurodisability is complex. It involves an intricate interplay between medical, psychological and ethical factors. In the absence of a universally agreed guidance on the use of PN in this cohort, paediatricians should maintain the individual need of the child at the centre of the decision-making process and work closely with families and other healthcare professionals before initiating or withholding PN in children with severe neurodisability. In this article, we discuss the complex and multifaceted approach to the use of PN in children with severe neurodisability and aimed to explore the medical, psychological and ethical aspect dilemmas facing clinicians looking after children with declining gut function who may require PN support.Keywords: pediatric, neurodisability, parenteral nutrition, medical ethics

Functional constipation (FC) is a common condition in childhood in the United Kingdom and worldwide. Various radiological approaches have been established for diagnostic purposes. The radiopaque marker study (ROMS) is universally accepted and used to assess colonic transit time (CTT) in children with FC. Despite being widely used, there is a lack of standardization with various technical protocols, reproducibility of different populations, the purpose for using investigation, variance in the number of markers used, the amount of study days and calculations, the need to empty the colon before performing the test, and whether to perform on medication or off, or the use of specific diets. As part of the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) motility working group (MWG), we decided to explore further into the evidence, in order to provide guidance regarding the use of ROMS in dealing with FC in the pediatric population. [ABSTRACT FROM AUTHOR]

Assessing nutritional status in older people is essential to screen for malnutrition and identify the individuals requiring nutritional intervention for a better quality of life and longer life expectancy. This review aimed to investigate malnutrition and the role of nutritional assessment tools among older people in Malaysia. We systematically reviewed the publications from 2000 to 2019 using PubMed/MEDLINE and Scopus databases, recovering 15 original articles published until January 2022. This systematic review was conducted from May to September 2022. Two reviewers were involved in the process of the selection of articles and data extraction. Only research papers on malnutrition among older people in institutionalized settings in Malaysia were included. Four articles related to malnutrition in older people in old folk homes in Malaysia were included in this review. The tools with the most significant evidence were Mini Nutritional Assessment (MNA) and Nutritional Health Checklist (NHC) in residential care for the elderly. It was found that the incidence of malnutrition among the elderly in old folk homes in Malaysia ranged from 12.3% to 17.4%. Meanwhile, 40.4% to 57.7% of the population are documented to be at risk of malnutrition. NA and DETERMINE NHC were found to be most suitable for use in residential care due to their high sensitivity and specificity. A subsequent study is proposed to build and implement a scoring system to rate screening tools based on the validity, suitability, and practicability of the tools to help with malnutrition screening research and clinical practice in Malaysia and internationally. [ABSTRACT FROM AUTHOR]

This paper presents the development, calibration and mechanism control of lab scale Motorised Adjustable Vertical Platform (MAVeP) mobility prototype. MAVeP has been developed and equipped with mecanum wheels to allow an omnidirectional movement. The omnidirectionality, or the ability to move in any direction, without altering the direction of the MAVeP's body, makes this type of driving useful, especially in narrow and confined areas such as inside satellite assembly, integration and test centre (AITC). Since MAVeP has been delivered at AITC and high accuracy and repeatability movement are crucial during the application, a robot prototype representing MAVeP mobility has been designed and developed. The mechanical and electrical design, including all processes and components, are selected and explained in detail. The development of the robot prototype, its parameters and calibration are also discussed. The DC motor control for separate wheels of the MAVeP mobility prototype using PID controller and the calibrations to synchronous the four wheels' rotation are also discussed in this paper. The experimental result shows that the robot prototype is established and ready to be used in research. [ABSTRACT FROM AUTHOR]

This paper proposes the PSO-FOPID controller, which is a Fractional Order Proportional-Integral-Derivative (FOPID) controller tuned using particle swarm optimization with spreading factor algorithm for height position control of a scissor mechanism platform. The tuning process of five control gains in the FOPID controller is technically challenging to achieve high position accuracy. In this study, this problem is addressed through the offline tuning method by using particle swarm optimization with the spreading factor algorithm to reduce the complexity in tuning the control gains. From the experimental study, it is found that the proposed controller can eliminate the steady-state error under the two input references with approximately 1.5% and 0.9% reductions of the overshoot and undershoot in the height position response as compared to its promising performances in simulations. It is envisaged that the PSOFOPID controller can be useful in designing effective height position control of a non-linear platform.