Automatic Classification of the Stand-to-Sit Phase in the TUG Test Using Machine Learning

Over the past several years, researchers have shown a great interest in assessing the mobility of elderly people to measure their functional status. Usually, such an assessment is done by conducting tests that require the subject to walk a certain distance, turn around, and finally sit back down. Consequently, this study aims to provide an at home monitoring system to assess the patient’s status continuously. Thus, we proposed a technique to automatically detect when a subject sits down while walking at home. In this study, we utilized a Doppler radar system to capture the motion of the subjects. More than 20 features were extracted from the radar signals out of which 11 were chosen based on their Intraclass Correlation Coefficient (ICC > 0.75). Accordingly, the sequential floating forward selection wrapper was applied to further narrow down the final feature vector. Finally, five features were introduced to the Linear Discriminant Analysis classifier and an accuracy of 93.75% was achieved as well as a precision and recall of 95% and 90% respectively.

Design and Construction of an Impulse Current Generator for Lightning Strike Experiments

There has been a rising trend in using impulse current generators to investigate the lightning strike protection of materials including aluminum and composites in structures such as wind turbine blade and aircraft body. The focus of this research is to present an impulse current generator built in the High Voltage Lab at Mississippi State University. The generator is capable of producing component A and D of the natural lightning discharges in accordance with the Society of Automotive Engineers (SAE) standard, which is widely used in the aerospace industry. The generator can supply lightning impulse energy up to 400 kJ with the capability of producing impulse currents with magnitudes greater than 200 kA. The electrical circuit and physical components of an improved impulse current generator are described and several lightning strike waveforms with different amplitudes is presented for comparing with the standard waveform. The results of this study contribute to the fundamental understanding the functionality of the impulse current generators and present an impulse current generator developed at the High Voltage Lab of Mississippi State University.

Comparative Study of Affricate Initial Consonants in Chinese and Slovak

The purpose of the comparative study of the affricate consonants in Chinese and Slovak is to increase the awareness of the main distinguishing features between these two languages taking into consideration this particular group of consonants. We determine the main difficulties of the Slovak learners in the process of acquiring correct pronunciation of affricate initial consonants in Chinese based on the understanding of the distinguishing features of Chinese and Slovak affricates in combination with the experimental measuring of voice onset time (VOT) values. The software tool Praat is used for the analysis of the recorded language samples. The language samples contain recordings of a Chinese native speaker and Slovak students of Chinese with different language proficiency levels. Based on the results of the analysis in Praat, we identify erroneous pronunciation and provide clarification of its cause.

Cirrhosis Mortality Prediction as Classification Using Frequent Subgraph Mining

In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Comparison of Deep Convolutional Neural Networks Models for Plant Disease Identification

Identification of plant diseases has been performed using machine learning and deep learning models on the datasets containing images of healthy and diseased plant leaves. The current study carries out an evaluation of some of the deep learning models based on convolutional neural network architectures for identification of plant diseases. For this purpose, the publicly available New Plant Diseases Dataset, an augmented version of PlantVillage dataset, available on Kaggle platform, containing 87,900 images has been used. The dataset contained images of 26 diseases of 14 different plants and images of 12 healthy plants. The CNN models selected for the study presented in this paper are AlexNet, ZFNet, VGGNet (four models), GoogLeNet, and ResNet (three models). The selected models are trained using PyTorch, an open-source machine learning library, on Google Colaboratory. A comparative study has been carried out to analyze the high degree of accuracy achieved using these models. The highest test accuracy and F1-score of 99.59% and 0.996, respectively, were achieved by using GoogLeNet with Mini-batch momentum based gradient descent learning algorithm.

A Commercial Building Plug Load Management System That Uses Internet of Things Technology to Automatically Identify Plugged-In Devices and Their Locations

Plug and process loads (PPLs) account for a large portion of U.S. commercial building energy use. There is a huge potential to reduce whole building consumption by targeting PPLs for energy savings measures or implementing some form of plug load management (PLM). Despite this potential, there has yet to be a widely adopted commercial PLM technology. This paper describes the Automatic Type and Location Identification System (ATLIS), a PLM system framework with automatic and dynamic load detection (ADLD). ADLD gives PLM systems the ability to automatically identify devices as they are plugged into the outlets of a building. The ATLIS framework takes advantage of smart, connected devices to identify device locations in a building, meter and control their power, and communicate this information to a central database. ATLIS includes five primary capabilities: location identification, communication, control, energy metering, and data storage. A laboratory proof of concept (PoC) demonstrated all but the energy metering capability, and these capabilities were validated using a series of system tests. The PoC was able to identify when a device was plugged into an outlet and the location of the device in the building. When a device was moved, the PoC’s dashboard and database were automatically updated with the new location. The PoC implemented controls to devices from the system dashboard so that devices maintained correct schedules regardless of where they were plugged in within the building. ATLIS’s primary technology application is improved PLM, but other applications include asset management, energy audits, and interoperability for grid-interactive efficient buildings. An ATLIS-based system could also be used to direct power to critical devices, such as ventilators, during a brownout or blackout. Such a framework is an opportunity to make PLM more widespread and reduce the amount of energy consumed by PPLs in current and future commercial buildings.

Performance Evaluation of Minimum Quantity Lubrication on EN3 Mild Steel Turning

Lubrication, cooling and chip removal are the desired functions of any cutting fluid. Conventional or flood lubrication requires high volume flow rate and cost associated with this is higher. In addition, flood lubrication possesses health risks to machine operator. To avoid these consequences, dry machining and minimum quantity are two alternatives. Dry machining cannot be a suited alternative as it can generate greater heat and poor surface finish. Here, turning work is carried out on a Lathe machine using EN3 Mild steel. Variable cutting speeds and depth of cuts are provided and corresponding temperatures and surface roughness values were recorded. Experimental results are analyzed by Minitab software. Regression analysis, main effect plot, and interaction plot conclusion are drawn by using ANOVA. There is a 95.83% reduction in the use of cutting fluid. MQL gives a 9.88% reduction in tool temperature, this will improve tool life. MQL produced a 17.64% improved surface finish. MQL appears to be an economical and environmentally compatible lubrication technique for sustainable manufacturing.

Software Product Quality Evaluation Model with Multiple Criteria Decision Making Analysis

This paper presents a software product quality evaluation model based on the ISO/IEC 25010 quality model. The evaluation characteristics and sub characteristics were identified from the ISO/IEC 25010 quality model. The multidimensional structure of the quality model is based on characteristics such as functional suitability, performance efficiency, compatibility, usability, reliability, security, maintainability, and portability, and associated sub characteristics. Random numbers are generated to establish the decision maker’s importance weights for each sub characteristics. Also, random numbers are generated to establish the decision matrix of the decision maker’s final scores for each software product against each sub characteristics. Thus, objective criteria importance weights and index scores for datasets were obtained from the random numbers. In the proposed model, five different software product quality evaluation datasets under three different weight vectors were applied to multiple criteria decision analysis method, preference analysis for reference ideal solution (PARIS) for comparison, and sensitivity analysis procedure. This study contributes to provide a better understanding of the application of MCDMA methods and ISO/IEC 25010 quality model guidelines in software product quality evaluation process.

Sustainable Balanced Scorecard for Kaizen Evaluation: Comparative Study between Egypt and Japan

Continuous improvement activities are becoming a key organizational success factor; those improvement activities include but are not limited to kaizen, six sigma, lean production, and continuous improvement projects. Kaizen is a Japanese philosophy of continuous improvement by making small incremental changes to improve an organization’s performance, reduce costs, reduce delay time, reduce waste in production, etc. This research aims at proposing a measuring system for kaizen activities from a sustainable balanced scorecard perspective. A survey was developed and disseminated among kaizen experts in both Egypt and Japan with the purpose of allocating key performance indicators for both kaizen process (critical success factors) and result (kaizen benefits) into the five sustainable balanced scorecard perspectives. This research contributes to the extant literature by presenting a kaizen measurement of both kaizen process and results that will illuminate the benefits of using kaizen. Also, the presented measurement can help in the sustainability of kaizen implementation across various sectors and industries. Thus, grasping the full benefits of kaizen implementation will contribute to the spread of kaizen understanding and practice. Also, this research provides insights on the social and cultural differences that would influence the kaizen success. Determining the combination of the proper kaizen measures could be used by any industry, whether service or manufacturing for better kaizen activities measurement. The comparison between Japanese implementation of kaizen, as the pioneers of continuous improvement, and Egyptian implementation will help recommending better practices of kaizen in Egypt and contributing to the 2030 sustainable development goals. The study results reveal that there is no significant difference in allocating kaizen benefits between Egypt and Japan. However, with regard to the critical success factors some differences appeared reflecting the social differences and understanding between both countries, a single integrated measurement was reached between the Egyptian and Japanese allocation highlighting the Japanese experts’ opinion as the ultimate criterion for selection.

Evaluation of Iranian Standard for Assessment of Liquefaction Potential of Cohesionless Soils Based on Standard Penetration Test

In-situ testing is preferred to evaluate the liquefaction potential in cohesionless soils due to high disturbance during sampling. Although new in-situ methods with high accuracy have been developed, standard penetration test, the simplest and the oldest in-situ test, is still used due to the profusion of the recorded data. This paper reviews the Iranian standard of evaluating liquefaction potential in soils (codes 525) and compares the liquefaction assessment methods based on standard penetration test (SPT) results on cohesionless soil in this standard with the international standards. To this, methods for assessing liquefaction potential are compared with what is presented in standard 525. It is found that although the procedure used in Iranian standard of evaluating the potential of liquefaction has not been updated according to the new findings, it is a conservative procedure.

Method for Tuning Level Control Loops Based on Internal Model Control and Closed Loop Step Test Data

This paper describes a two-stage methodology derived from IMC (Internal Model Control) for tuning a PID (Proportional-Integral-Derivative) controller for levels or other integrating processes in an industrial environment. Focus is ease of use and implementation speed which are critical for an industrial application. Tuning can be done with minimum effort and without the need of time-consuming open-loop step tests on the plant. The first stage of the method applies to levels only: the vessel residence time is calculated from equipment dimensions and used to derive a set of preliminary PI (Proportional-Integral) settings with IMC. The second stage, re-tuning in closed-loop, applies to levels as well as other integrating processes: a tuning correction mechanism has been developed based on a series of closed-loop simulations with model errors. The tuning correction is done from a simple closed-loop step test and application of a generic correlation between observed overshoot and integral time correction. A spin-off of the method is that an estimate of the vessel residence time (levels) or open-loop process gain (other integrating process) is obtained from the closed-loop data.

Optimization of Hemp Fiber Reinforced Concrete for Mix Design Method

The purpose of this study is to evaluate the incorporation of hemp fibers (HF) in concrete. Hemp fiber reinforced concrete (HFRC) is becoming more popular as an alternative for regular mix designs. This study was done to evaluate the compressive strength of HFRC regarding mix procedure. HF were obtained from the manufacturer and hand processed to ensure uniformity in width and length. The fibers were added to concrete as both wet and dry mix to investigate and optimize the mix design process. Results indicated that the dry mix had a compressive strength of 1157 psi compared to the wet mix of 985 psi. This dry mix compressive strength was within range of the standard mix compressive strength of 1533 psi. The statistical analysis revealed that the mix design process needs further optimization and uniformity concerning the addition of HF. Regression analysis revealed that the standard mix design had a coefficient of 0.9 as compared to the dry mix of 0.375 indicating a variation in the mixing process. While completing the dry mix, the addition of plain HF caused them to intertwine creating lumps and inconsistency. However, during the wet mixing process, combining water and HF before incorporation allows the fibers to uniformly disperse within the mix hence the regression analysis indicated a better coefficient of 0.55. This study concludes that HRFC is a viable alternative to regular mixes however more research surrounding its characteristics needs to be conducted.

Incorporating Lexical-Semantic Knowledge into Convolutional Neural Network Framework for Pediatric Disease Diagnosis

The utilization of electronic medical record (EMR) data to establish the disease diagnosis model has become an important research content of biomedical informatics. Deep learning can automatically extract features from the massive data, which brings about breakthroughs in the study of EMR data. The challenge is that deep learning lacks semantic knowledge, which leads to impracticability in medical science. This research proposes a method of incorporating lexical-semantic knowledge from abundant entities into a convolutional neural network (CNN) framework for pediatric disease diagnosis. Firstly, medical terms are vectorized into Lexical Semantic Vectors (LSV), which are concatenated with the embedded word vectors of word2vec to enrich the feature representation. Secondly, the semantic distribution of medical terms serves as Semantic Decision Guide (SDG) for the optimization of deep learning models. The study evaluates the performance of LSV-SDG-CNN model on four kinds of Chinese EMR datasets. Additionally, CNN, LSV-CNN, and SDG-CNN are designed as baseline models for comparison. The experimental results show that LSV-SDG-CNN model outperforms baseline models on four kinds of Chinese EMR datasets. The best configuration of the model yielded an F1 score of 86.20%. The results clearly demonstrate that CNN has been effectively guided and optimized by lexical-semantic knowledge, and LSV-SDG-CNN model improves the disease classification accuracy with a clear margin.

Physicochemical and Thermal Characterization of Starch from Three Different Plantain Cultivars in Puerto Rico

Plantain contains starch as the main component and represents a relevant source of this carbohydrate. Starches from different cultivars of plantain and bananas have been studied for industrialization purposes due to their morphological and thermal characteristics and their influence in food products. This study aimed to characterize the physical, chemical, and thermal properties of starch from three different plantain cultivated in Puerto Rico: Maricongo, Maiden and FHIA 20. Amylose and amylopectin content, color, granular size, morphology, and thermal properties were determined. According to the amylose content in starches, FHIA 20 presented lowest content of the three cultivars studied. In terms of color, Maiden and FHIA 20 starches exhibited significantly higher whiteness indexes compared to Maricongo starch. Starches of the three cultivars had an elongated-ovoid morphology, with a smooth surface and a non-porous appearance. Regardless of similarities in their morphology, FHIA 20 exhibited a lower aspect ratio since its granules tended to be more elongated. Comparison of the thermal properties of starches showed that initial starch gelatinization temperature was similar among cultivars. However, FHIA 20 starch presented a noticeably higher final gelatinization temperature (87.95°C) and transition enthalpy than Maricongo (79.69°C) and Maiden (77.40°C). Despite similarities, starches from plantain cultivars showed differences in their composition and thermal behavior. This represents an opportunity to diversify plantain starch use in food-related applications.

Technical, Environmental, and Financial Assessment for the Optimal Sizing of a Run-of-River Small Hydropower Project: A Case Study in Colombia

Run-of-river (RoR) hydropower projects represent a viable, clean, and cost-effective alternative to dam-based plants and provide decentralized power production. However, RoR schemes’ cost-effectiveness depends on the proper selection of site and design flow, which is a challenging task because it requires multivariate analysis. In this respect, this study presents the development of an investment decision support tool for assessing the optimal size of an RoR scheme considering the technical, environmental, and cost constraints. The net present value (NPV) from a project perspective is used as an objective function for supporting the investment decision. The tool has been tested by applying it to an actual RoR project recently proposed in Colombia. The obtained results show that the optimum point in financial terms does not match the flow that maximizes energy generation from exploiting the river's available flow. For the case study, the flow that maximizes energy corresponds to a value of 5.1 m3/s. In comparison, an amount of 2.1 m3/s maximizes the investors NPV. Finally, a sensitivity analysis is performed to determine the NPV as a function of the debt rate changes and the electricity prices and the CapEx. Even for the worst-case scenario, the optimal size represents a positive business case with an NPV of 2.2 USD million and an internal rate of return (IRR) 1.5 times higher than the discount rate. 

Effect of Non-Metallic Inclusion from the Continuous Casting Process on the Multi-Stage Forging Process and the Tensile Strength of the Bolt: A Case Study

The paper presents the influence of non-metallic inclusions on the multi-stage forging process and the mechanical properties of the dodecagon socket bolt used in the automotive industry. The detected metallurgical defect was so large that it directly influenced the mechanical properties of the bolt and resulted in failure to meet the requirements of the mechanical property class. In order to assess the defect, an X-ray examination and metallographic examination of the defective bolt were performed, showing exogenous non-metallic inclusion. The size of the defect on the cross section was 0.531 mm in width and 1.523 mm in length; the defect was continuous along the entire axis of the bolt. In analysis, a finite element method (FEM) simulation of the multi-stage forging process was designed, taking into account a non-metallic inclusion parallel to the sample axis, reflecting the studied case. The process of defect propagation due to material upset in the head area was analyzed. The final forging stage in shaping the dodecagonal socket and filling the flange area was particularly studied. The effect of the defect was observed to significantly reduce the effective cross-section as a result of the expansion of the defect perpendicular to the axis of the bolt. The mechanical properties of products with and without the defect were analyzed. In the first step, the hardness test confirmed that the required value for the mechanical class 8.8 of both bolt types was obtained. In the second step, the bolts were subjected to a static tensile test. The bolts without the defect gave a positive result, while all 10 bolts with the defect gave a negative result, achieving a tensile strength below the requirements. Tensile strength tests were confirmed by metallographic tests and FEM simulation with perpendicular inclusion spread in the area of the head. The bolts were damaged directly under the bolt head, which is inconsistent with the requirements of ISO 898-1. It has been shown that non-metallic inclusions with orientation in accordance with the axis of the bolt can directly cause loss of functionality and these defects should be detected even before assembling in the machine element.

Verification of Space System Dynamics Using the MATLAB Identification Toolbox in Space Qualification Test

This article presents an approach with regards to the Functional Testing of Space System (SS) that could be a space vehicle (spacecraft-S/C) and/or its equipment and components – S/C subsystems. This test should finalize the Space Qualification Tests (SQT) campaign. It could be considered as a generic test and used for a wide class of SS that, from the point of view of System Dynamics and Control Theory, may be described by the ordinary differential equations. The suggested methodology is based on using semi-natural experiment laboratory stand that does not require complicated, precise and expensive technological control-verification equipment. However, it allows for testing totally assembled system during Assembling, Integration and Testing (AIT) activities at the final phase of SQT, involving system hardware (HW) and software (SW). The test physically activates system input (sensors) and output (actuators) and requires recording their outputs in real time. The data are then inserted in a laboratory computer, where it is post-experiment processed by the MATLAB/Simulink Identification Toolbox. It allows for estimating the system dynamics in the form of estimation of its differential equation coefficients through the verification experimental test and comparing them with expected mathematical model, prematurely verified by mathematical simulation during the design process. Mathematical simulation results presented in the article show that this approach could be applicable and helpful in SQT practice. Further semi-natural experiments should specify detail requirements for the test laboratory equipment and test-procedures.

Farming Production in Brazil: Innovation and Land-Sparing Effect

Innovation and technology can be determinant factors to ensure agricultural and sustainable growth, as well as productivity gains. Technical change has contributed considerably to supply agricultural expansion in Brazil. This agricultural growth could be achieved by incorporating more land or capital. If capital is the main source of agricultural growth, it is possible to increase production per unit of land. The objective of this paper is to estimate: 1) total factor productivity (TFP), which is measured in terms of the rate of output per unit of input; and 2) the land-saving effect (LSE) that is the amount of land required in the case that yield rate is constant over time. According to this study, from 1990 to 2019, it appears that 87% of Brazilian agriculture product growth comes from the gains of productivity; the remaining 13% comes from input growth. In the same period, the total LSE was roughly 400 Mha, which corresponds to 47% of the national territory. These effects reflect the greater efficiency of using productive factors, whose technical change has allowed an increase in the agricultural production based on productivity gains.

Associations among Fetuin A, Cortisol and Thyroid Hormones in Children with Morbid Obesity and Metabolic Syndrome

Obesity is a disease with an ever-increasing prevalence throughout the world. The metabolic network associated with obesity is very complicated. In metabolic syndrome (MetS), it becomes even more difficult to understand. Within this context, hormones, cytokines, and many others participate in this complex matrix. The collaboration among all of these parameters is a matter of great wonder. Cortisol, as a stress hormone, is closely associated with obesity. Thyroid hormones are involved in the regulation of energy as well as glucose metabolism with all of its associates. Fetuin A has been known for years; however, the involvement of this parameter in obesity discussions is rather new. Recently, it has been defined as one of the new generation markers of obesity. In this study, the aim was to introduce complex interactions among all to be able to make clear comparisons, at least for a part of this complicated matter. Morbid obese (MO) children participated in the study. Two groups with 46 MO children and 43 with MetS were constituted. All children included in the study were above 99th age- and sex-adjusted body mass index (BMI) percentiles according to World Health Organization criteria. Forty-three morbid obese children in the second group also had MetS components. Informed consent forms were filled by the parents of the participants. The institutional ethics committee has given approval for the study protocol. Data as well as the findings of the study were evaluated from a statistical point of view. Two groups were matched for their age and gender compositions. Significantly higher body mass index (BMI), waist circumference, thyrotropin, and insulin values were observed in the MetS group. Triiodothyronine concentrations did not differ between the groups. Elevated levels for thyroxin, cortisol, and fetuin-A were detected in the MetS group compared to the first group (p > 0.05). In MO MetS- group, cortisol was correlated with thyroxin and fetuin-A (p < 0.05). In the MO MetS+ group, none of these correlations were present. Instead, a correlation between cortisol and thyrotropin was found (p < 0.05). In conclusion, findings have shown that cortisol was the key player in severely obese children. The association of this hormone with the participants of thyroid hormone metabolism was quite important. The lack of association with fetuin A in the morbid obese MetS+ group has suggested the possible interference of MetS components in the behavior of this new generation obesity marker. The most remarkable finding of the study was the unique correlation between cortisol and thyrotropin in the morbid obese MetS+ group, suggesting that thyrotropin may serve as a target along with cortisol in the morbid obese MetS+ group. This association may deserve specific attention during the development of remedies against MetS in the pediatric population.

Relationship between Hepatokines and Insulin Resistance in Childhood Obesity

Childhood obesity is an important clinical problem, because it may lead to chronic diseases during the adulthood period of the individual. Obesity is a metabolic disease associated with low-grade inflammation. The liver occurs at the center of metabolic pathways. Adropin, fibroblast growth factor-21 (FGF-21) and fetuin A are hepatokines. Due to the immense participation of the liver in glucose metabolism, these liver derived factors may be associated with insulin resistance (IR), which is a phenomenon discussed within the scope of obesity problems. The aim of this study is to determine the concentrations of adropin, FGF-21 and fetuin A in childhood obesity, to point out possible differences between the obesity groups and to investigate possible associations among these three hepatokines in obese and morbid obese children. A total of 132 children were included in the study. Two obese groups were constituted. The groups were matched in terms of mean±SD values of ages. Body mass index values of the obese and morbid obese groups were 25.0±3.5 kg/m2 and 29.8±5.7 kg/m2, respectively. Anthropometric measurements including waist circumference, hip circumference, head circumference, and neck circumference were recorded. Informed consent forms were taken from the parents of the participants and the Ethics Committee of the institution approved the study protocol. Blood samples were obtained after an overnight fasting. Routine biochemical tests including glucose- and lipid-related parameters were performed. Concentrations of the hepatokines (adropin, FGF-21, fetuin A) were determined by enzyme-linked immunosorbent assay. Insulin resistance indices such as homeostasis model assessment for IR (HOMA-IR), alanine transaminase-to aspartate transaminase ratio (ALT/AST), diagnostic obesity notation model assessment laboratory index, diagnostic obesity notation model assessment metabolic syndrome index as well as obesity indices such as diagnostic obesity notation model assessment-II index, and fat mass index were calculated using the previously derived formulas. Statistical evaluation of the study data as well as findings of the study were performed by SPSS for Windows. Statistical difference was accepted significant when p < 0.05. Statistically significant differences were found for insulin, triglyceride, high density lipoprotein cholesterol levels of the groups. A significant increase was observed for FGF-21 concentrations in the morbid obese group. Higher adropin and fetuin A concentrations were observed in the same group in comparison with the values detected in the obese group (p > 0.05). There was no statistically significant difference between the ALT/AST values of the groups. In all of the remaining IR and obesity indices, significantly increased values were calculated for morbid obese children. Significant correlations were detected between HOMA-IR and each of the hepatokines. The highest one was the association with fetuin A (r = 0.373, p = 0.001). In conclusion, increased levels observed in adropin, FGF-21 and fetuin A have shown that these hepatokines possess increasing potential going from the obese to morbid obese state. Out of the correlations found with IR index, the most affected hepatokine was fetuin A, the parameter possibly used as the indicator of the advanced obesity stage.