Development of a behaviour pattern-based testing approach for coupled socioeconomic and environmental models.

Understanding the interactions between human and environmental systems is key to sustainable environmental management. Dynamically Coupled Socioeconomic system dynamics models integrated with physically-based Environmental Models (DCSEMs) are promising tools to appropriately capture the non-linear relationships between complex socioeconomic and biophysical systems, thereby supporting sustainable environmental management. However, existing approaches for testing integrated models are commonly based on the point-to-point analysis of model outputs, which is not suitable for DCSEMs that are behaviour pattern oriented. Consequently, the lack of well-defined behaviour pattern-based approaches has limited the adaptability of DCSEMs. To address this gap, this study proposes a novel behaviour pattern-based model testing approach that includes global sensitivity analysis (GSA), auto-calibration algorithms, and evaluation to assess behaviour pattern similarities between model outputs and real-world trends. The proposed approach is demonstrated through a real-world case study, in which an existing DCSEM is calibrated and evaluated to simulate water table depth in the Rechna Doab region of Pakistan. Compared to the conventional numerical point approach, the proposed approach is better suited for DCSEMs, as it replicates observed system behaviour patterns (as opposed to observed point values) over time. Furthermore, the outcomes of the Theil inequality statistical analysis and parameter distribution analysis provide evidence that the suggested approach is effective in testing and improving the performance of the DCSEM by capturing the spatial heterogeneity within the study area. The proposed behaviour-pattern testing procedure is a useful approach for model testing in data-limited, spatially-distributed DCSEMs.

Nutritional problems in children with neuromotor disabilities: an Italian case series.

BACKGROUND AND AIMS: Several neuromotor disorders share exclusive, although often overlooked, nutritional problems. The objective of this study is therefore to delineate the frequency of malnutrition, evaluate the effectiveness of nutritional care, and identify issues needing to be possibly strengthened when caring for these patients into a general pediatrics department. PATIENTS AND METHODS: The study included 30 patients, 21 males and 9 females, aged between 2 and 15 years, affected by cerebral palsy, epileptic encephalopathy, and severe psychomotor developmental delay.Nutritional status was assessed by a dietary questionnaire administered to parents to investigate feeding difficulties; 3 days food diary to quantify daily calorie intake; anthropometrical (weight, height/length, body mass index percentiles, plicometry, specific body segments measurement) and blood (blood count, serum iron, albumin, transferrin, calcium, phosphorus) parameters. RESULTS: More than 44% individuals of the study population was at risk of malnutrition, according to feeding difficulties, progressive depletion of weight, reduced daily calorie intake, reduced albumin and transferrin levels. This occurred despite a massive caregivers commitment, as documented by almost universal parental constant assistance during their long-duration meals. CONCLUSIONS: Our results individuate the nutritional aspect being still a problem in the care of children with severe neuromotor disability.

Fatty liver disease and hypertransaminasemia hiding the association of clinically silent Duchenne muscular dystrophy and hereditary fructose intolerance.

We report a case with the association of well self-compensated hereditary fructose intolerance and still poorly symptomatic Duchenne type muscular dystrophy. This case illustrates the problems of a correct diagnosis in sub-clinical patients presenting with "cryptogenic" hypertransaminasemia.