Thesis (M. Sc. (Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

This thesis focuses on design a new layout of production hall in engineering company PSP Pohony Inc. The company is engaged in manufacturing od industrial gearboxes, clutch and brakes. Based on the analysis of material flow values and spaghetti diagram of current status of the company, is designed a new structure of individual workplaces so as to optimalization material flow in manufacturing and to reduction production time.

La malnutrition à l’admission en réanimation pédiatrique est fréquente et associée à une augmentation de la morbi-mortalité. Néanmoins, la plupart des études, limitées à une évaluation statique du statut nutritionnel, ne permettent pas une analyse fine de l’impact de la malnutrition. Une approche systémique associerait en plus d’une évaluation nutritionnelle statique, une analyse dynamique dans le temps, une analyse de la composition corporelle et une analyse physiopathologique et étiologique. Cette approche globale a été appliquée dans 4 études prospectives observationnelles, incluant des enfants sévèrement agressés de plus de 36 semaines d’âge corrigé. Il en ressort que la dénutrition globale à l’admission est fréquente (23,7%) et que la cassure des courbes de croissance avant l’admission est associée à une augmentation de la durée de séjour de 3 jours. L’enfant sévèrement agressé présente à l’admission des taux plasmatiques abaissés de 6 micronutriments impliqués dans le stress oxydant (Sélénium, Zinc, Cuivre, Vitamines C, E et bêta-carotène), proportionnellement au nombre de défaillances d’organe. La dénutrition globale et la fonte musculaire acquises en cours de séjour sont des phénomènes fréquents, précoces et importants, associés à une durée de séjour prolongée. Les changements métaboliques liés à l’agression sévère conduisent à une dénutrition. Ces processus adaptatifs sont parfois dépassés et la dénutrition pourra à son tour aggraver le pronostic. La bonne compréhension de la physiopathologie sous-jacente et un suivi systémique et systématique du statut nutritionnel sont les éléments indispensables à l’évaluation des stratégies nutritionnelles / Malnutrition at pediatric Intensive care unit (PICU) admission is frequent and associated with impaired outcomes. However, most studies have focused solely on a static definition. A holistic approach would improve the description of malnutrition: this would include both a static and dynamic assessment of nutritional status, together with body composition assessment and with malnutrition classified based on its patho-physiology and etiology. This holistic assessment of malnutrition has been applied and examined in four observational studies which included critically ill children older than 36 gestational weeks (corrected age). These found that malnutrition was frequent at PICU admission (27.3%) and faltering growth prior to PICU admission was associated with an increased length of PICU stay (+3 days). Critically ill children present at admission with decreased plasma levels of 6 micro-nutrients (Selenium, Copper, Zinc, Vitamin C, E and beta-carotene) involved in anti-oxidative stress pathways. Nutritional status deterioration during PICU stay, and associated muscle mass loss occurred frequently and were intense. This early phenomenon was associated with extended length of PICU stay. A profound critical illness related metabolic shift leads to malnutrition as an adaptive process. However, malnutrition may also negatively impact on outcomes in this setting. These studies have led to a clearer understanding of the underlying patho-physiology. This, combined with a more systematic and holistic nutritional assessment, will enable implementation and assessment of nutritional strategies aiming to improve the functional outcome of critically ill children

Faible masse musculaire a été peu étudiée chez les patients avant le stade terminal de la maladie rénale chronique (MRC). Nous avons évalué la masse musculaire à partir de la créatininurie des 24h pour étudier ses déterminants, son évolution avec le déclin de la fonction rénale ainsi que ses liens avec les risques de progression vers l’insuffisance rénale terminale traitée (IRTT) et de décès avant IRTT. Dans la cohorte NephroTest incluant 1429 patients avec une MRC stades 1 à 4, le débit de filtration glomérulaire a été mesuré par la clairance du 51Cr-EDTA (DFGm) et estimé par l’équation CKD EPI (DFGe). La créatininurie moyenne à l’inclusion diminuait de 15.3±3.1 à 12.1±3.3 mmol/24 chez les hommes et de 9.6±1.9 à 7.6±2.5 chez les femmes, pour une baisse du DFGm de ≥ 60 à < 15 mL/min/1.73 m2. Être plus âgé, avoir un diabète, un faible IMC ou un niveau faible de protéinurie et d’apports protidiques était associé à un niveau faible de créatininurie. Un déclin annuel du DFGm de 5 mL/min/1.73 m2 était lié à une baisse de créatininurie, indépendamment de ces déterminants. Au cours d’un suivi médian de 3.6 ans, 229 patients ont développé une IRTT, et 113 sont décédés avant IRTT. Après ajustement sur les facteurs de confusion, le hasard ratio (HR) était de 1.6 (0.88-2.9) pour le risque de décès et de 0.60 (0.39-0.91) pour le risque d’IRTT, dans le 1er vs 4ème quartile de créatininurie. La baisse de la créatininurie apparait précocement dans la MRC et est liée au décès avant dialyse. La diminution du risque d’IRTT pourrait s’expliquer par un démarrage plus tardif de la dialyse en raison d’une surestimation du DFGm par le DFGe chez les patients avec une faible créatininurie. / Mainly described in patients on dialysis, muscle wasting has received little attention in early stage chronic kidney disease (CKD). We used 24-hour creatininuria to assess determinants of low muscle mass and its putative associations with CKD outcomes, using data from the NephroTest cohort, including 1429 non-dialysis patients with CKD stages 1 to 5. Kidney function was assessed with both measured (mGFR, by 51Cr-EDTA renal clearance) and estimated glomerular filtration rate (eGFR, by CKD-EPI equation). End-stage renal disease (ESRD) and pre-ESRD death were the main studied outcomes. The mean baseline creatininuria decreased from 15.3±3.1 to 12.1±3.3 mmol/24 h in men and from 9.6±1.9 to 7.6±2.5 in women, when mGFR fell from ≥ 60 to < 15 mL/min/1.73 m2. Other determinants of low creatininuria were an older age, diabetes, a lower body mass index, a lower level of proteinuria or protein intake. A fast annual decline in mGFR of 5 mL/min/1.73 m2 was linked with a 2-fold decrease in creatininuria, independent of changes in protein intake and other determinants of muscle mass. Over a median follow-up of 3.6 years, 229 patients developed ESRD and 113 patients died before ESRD. After adjustment for confounders, patients with low muscle mass showed a significantly higher risk for pre-ESRD death (HR 1.6, 95% CI 0.88-2.9), but a lower risk for ESRD (HR 0.60, 95% CI 0.39-0.91). The latter was reversed (HR 1.5, 95% CI 1.01-2.4) when mGFR was replaced by eGFR. Decrease in 24-hour creatininuria may appear early in CKD patients, is related to pre-ESRD death. The lower risk for ESRD may reflect later dialysis start due to overestimation of true GFR by eGFR in patients with low muscle mass.

A growing body of evidence supports the observation that marine disease outbreaks, especially those caused by opportunistic pathogens, are increasing in frequency and severity. One genus of such pathogens, Labyrinthula, has been identified as the causative agent of seagrass wasting disease, an epidemic that has historically plagued seagrass beds around the world. It is suspected that pathogenicity is intimately linked to the ability of the host to initiate defense responses, but a lack of compelling evidence prevents any meaningful application of preliminary observations. This body of work investigated the roles of host genotype, host immune status, and environmental stressors in dictating the susceptibility of Thalassia testudinum (turtlegrass) to seagrass wasting disease, through two investigational studies. The first, a lab-based study, addressed the deficit in empirical methods through the development of techniques that measured: 1) Labyrinthula loading in host tissue through a novel qPCR-based assay and 2) immune status in the seagrass host via four immune biomarker assays, measuring peroxidase (POX), exochitinase (EXOC), polyphenol oxidase (PPO), and lysozyme (LYS) activity. These methods were used to analyze turtlegrass individuals exposed to 1) abiotic stressors alone or 2) abiotic stressors followed by pathogen-challenge, in a controlled laboratory setting. The qPCR assay successfully quantified pathogen loading in seagrass tissue with high specificity. All four biomarkers were constitutively active in host tissue, but expression was largely unaffected by the chosen abiotic stressors. There were significant positive relationships between pathogen loading and two of the four biomarkers (POX and EXOC), regardless of abiotic stress treatment. Finally, despite the widely variable response among individuals, regardless of treatment, we identify a potential trade-off mediated immune response in T. testudinum, when faced with pathogen invasion. The second investigation was a field study conducted in Florida Bay, a shallow, subtropical estuary characterized by many spatiotemporally unique basins, where T. testudinum dominates. Samples collected from 15 representative sites were analyzed using the methods developed in the first study as well as historical monitoring databases, in an effort to identify ecologically significant trends that existed in patterns between: 1) pathogen loading and immune status; 2) pathogen loading and geographic site; 3) pathogen loading and morphometric characteristics; 4) pathogen loading and water quality data; 5) immune status and geographic site; 6) immune status and morphometric characteristics; and 7) immune status and water quality data. The results revealed that both pathogen loading and immune status varied as a function of location in Florida Bay. Furthermore, based on the trends observed among and between sites with regards to pathogen loading, immune status, leaf morphology and water quality, a mechanism in which all four of these parameter sets interact is proposed as a potential explanation for the differences observed in Labyrinthula prevalence and severity within the bay. The results of both investigations address whether wasting disease susceptibility is driven primarily by variability in the environment or in the host species, and provide valuable insight regarding the extent to which seagrasses possess the capacity for resilience against marine pathogens.

Lean production determine the appropriate way to better workplace organization based on the elimination of various types of wasting, which only increase costs without adding customer value. It isn't important only implementation of lean production methods, but especially maintenance of lean principles and creating an atmosphere of continuous improvement. Lean production is the philosophy, which must be accepted by all em-ployees inside every company. It is the way to successful business in the 21st century. This thesis deals with the application of lean production in the selected company. The practical part describes the selected company, its history and manufacturing program. The next part is focused on description of the production center and its production layout. The result of this thesis is creating the product layout plan depending on the material flow and additional proposals for improvement.

Critical care has undergone several developments in the recent years leading to improved survival. However, acquired muscle weakness in the intensive care unit (ICU) is an important complication that affects severely ill patients and can prolong their ICU stay. Critical illness myopathy (CIM) is the progressive decline in the function and mass of the limb muscles in response to exposure to the ICU condition, while ventilator-induced diaphragm dysfunction (VIDD) is the time dependent decrease in the diaphragm function after the initiation of mechanical ventilation. Since the complete underlying mechanisms for CIM and VIDD are not completely understood, there is a compelling need for research on the mechanisms of CIM and VIDD to develop intervention strategies targeting these mechanisms. The aim of this thesis was to investigate the effects of several intervention strategies and rehabilitation programs on muscle wasting associated with ICU condition. Moreover, muscle specific differences in response to exposure to the ICU condition and different interventions was investigated. Hence, a rodent ICU model was used to address the mechanistic and therapeutic aspects of CIM and VIDD. The effects of heat shock protein 72 co-inducer (HSP72), BGP-15, on diaphragm and soleus for rats exposed to different durations of ICU condition was investigated. We showed that 5 and 10 days treatment with BGP-15 improved diaphragm fiber and myosin function, protected myosin from posttranslational modification, induced HSP72 and improved mitochondrial function. Moreover, BGP-15 treatment for 5 days improved soleus muscle fibers function, improved mitochondrial structure and reduced the levels of some ubiquitin ligases. In addition to BGP-15 treatment, passive mechanical loading of the limb muscles was investigated during exposure to the ICU condition. We showed that mitochondrial dynamics and mitophagy gene expression was affected by Mechanical silencing while mechanical loading counteracted these effects. Our investigation for other pathways that can be involved in muscle wasting associated with ICU condition showed that the Janus kinase 2/ Signal transducer and activator of transcription 3 (JAK2/STAT3) pathway is differentially activated in plantaris, intercostals and diaphragm. However, further studies are required with JAK2/STAT3 inhibitors to fully examine the role of this pathway in the pathogenesis of CIM and VIDD prior to translation to clinical research.

Introduction: Sodium chloride supplementation in saltwasting congenital adrenal hyperplasia (CAH) is generally recommended in infants, but its implementation in routine care is very heterogeneous. Objective: To evaluate oral sodium chloride supplementation, growth, and hydrocortisone and fludrocortisone dose in infants with salt-wasting CAH due to 21-hydroxylase in 311 infants from the AQUAPE CAH database. Results: Of 358 patients with classic CAH born between 1999 and 2015, 311 patients had salt-wasting CAH (133 females, 178 males). Of these, 86 patients (27.7%) received oral sodium chloride supplementation in a mean dose of 0.9 ± 1.4 mmol/kg/day (excluding nutritional sodium content) during the first year of life. 225 patients (72.3%) were not treated with sodium chloride. The percentage of sodium chloride-supplemented patients rose from 15.2% in children born 1999–2004 to 37.5% in children born 2011–2015. Sodium chloride-supplemented and -unsupplemented infants did not significantly differ in hydrocortisone and fludrocortisone dose, target height-corrected height-SDS, and BMI-SDS during the first 2 years of life. Conclusion: In the AQUAPE CAH database, approximately one-third of infants with salt-wasting CAH receive sodium chloride supplementation. Sodium chloride supplementation is performed more frequently in recent years. However, salt supplementation had no influence on growth, daily fludrocortisone and hydrocortisone dose, and frequency of adrenal crisis.

The diploma thesis is focused on proposal of workplace modification according to the lean manufacturing methodology (DMAIC). The target is to minimize the wasting and to increase the production efficiency based on LEAN tools implementation. The theoretical part of the thesis defines the basic terms, such as primarily lean production, DMAIC, wasting. In the practical part there is at problem analysis using the DMAIC method, then the proposal for improvement is solved, that contains reduction of wasting, process of the project, timetable, costs and implantation of the solution, finally there is evaluated the benefit.

The main goal of this diploma thesis is new lay – out of organizational structure of assembly lines, which is leading to the material flow shortening and elimination of problems with factionalism of industrial process. In this thesis is introduce the company, where is proposed new organizational structure of assembly lines, together with description of deficiencies current organization. The good know ledges of assembly process and technology is important for the right modification. According theoretic findings it was proposed new organizational structure of assembly lines and the cost saving was calculated