Integrating Blockchain and Internet of Things Platforms: An Empirical Study on Immunization Cold Chain

The adoption of Blockchain technology introduces the possibility to decentralize cold chain systems. This adaptation enhances them to be more efficient, accessible, verifiable, and data security. Additionally, the Internet of Things (IoT) concept is considered as an added-value to various application domains. Cargo tracking and cold chain are a few to name. However, the security of the IoT transactions and integrated devices remains one of the key challenges to the IoT application’s success. Consequently, Blockchain technology and its consensus protocols have been used to solve many information security problems. In this paper, we discuss the advantages of integrating Blockchain technology into IoT platform to improve security and provide an overview of existing literature on integrating Blockchain and IoT platforms. Then, we present the immunization cold chain solution as a use-case that could be applied to any critical goods based on integrating Hyperledger fabric platform and IoT platform.

Wildfires Assessed by Remote Sense Images and Burned Land Monitoring

The tools described in this paper enable the location of burned areas where took place the annihilation of natural habitats and establishes a baseline for major changes in forest ecosystems during recovery. Moreover, the result allows the follow up of the surface fuel loading, allowing the evaluation and guidance of restoration measures to remote areas by phased time planning. This case study implements the evaluation of burned areas that suffered successive wildfires in Portugal mainland during the summer of 2017, killing more than 60 people. The goal is to show that this evaluation can be done with remote sense data free of charges in a simple laptop, with open-source software, describing the not-so-simple methodology step by step, to make it accessible for local workers in the areas attained, where the availability of information is essential for the immediate planning of mitigation measures, such as restoring road access, allocate funds for the recovery of human dwellings and assess further needs for restoration of the ecological system. Wildfires also devastate forest ecosystems having a direct impact on vegetation cover and killing or driving away the animal population, besides loss of all crops in rural areas that are essential as local resources. The economic interests are also attained, as the pinewood burned becomes useless for the noblest applications, so its value decreases, and resin extraction ends for several years.

A Timed and Colored Petri Nets for Modeling and Verifying Cloud System Elasticity

Elasticity is the essential property of cloud computing. As the name suggests, it constitutes the ability of a cloud system to adjust resource provisioning in relation to fluctuating workloads. There are two types of elasticity operations, vertical and horizontal. In this work, we are interested in horizontal scaling, which is ensured by two mechanisms; scaling in and scaling out. Following the sizing of the system, we can adopt scaling in the event of over-supply and scaling out in the event of under-supply. In this paper, we propose a formal model, based on temporized and colored Petri nets (TdCPNs), for the modeling of the duplication and the removal of a virtual machine from a server. This model is based on formal Petri Nets (PNs) modeling language. The proposed models are edited, verified, and simulated with two examples implemented in colored Petri nets (CPNs)tools, which is a modeling tool for colored and timed PNs.

Auditory Brainstem Response in Wave VI for the Detection of Learning Disabilities

The use of brain stem auditory evoked potential (BAEP) is a common way to study the hearing function of people, a way to learn the functionality of a part of the brain neuronal groups that intervene in the learning process by studying the behaviour of wave VI. The latest advances in neuroscience have revealed the existence of different brain activity in the learning process that can be highlighted through the use of innocuous, low-cost and easy-access techniques such as, among others, the BAEP that can help us to detect early possible neurodevelopmental difficulties for their subsequent assessment and cure. To date and the authors best knowledge, only the latency data obtained, observing the first to V waves and mainly in the left ear, were taken into account. This work shows that it is essential to consider both ears; with these latest data, it has been possible to diagnose more precisely some cases than with the previous data had been diagnosed as “normal”despite showing signs of some alteration that motivated the new consultation to the specialist.

Effectiveness and Performance of Spatial Communication within Composite Interior Space: The Wayfinding System in the Saudi National Museum as a Case Study

The wayfinding system affects the course of a museum journey for visitors, both directly and indirectly. The design aspects of this system play an important role, making it an effective communication system within the museum space. However, translating the concepts that pertain to its design, and which are based on integration and connectivity in museum space design, such as intelligibility, lacks customization in the form of specific design considerations with reference to the most important approaches. These approaches link the organizational and practical aspects to the semiotic and semantic aspects related to the space syntax by targeting the visual and perceived consistency of visitors. In this context, the present study aims to identify how to apply the concept of intelligibility by employing integration and connectivity to design a wayfinding system in museums as a kind of composite interior space. Using the available plans and images to extrapolate the considerations used to design the wayfinding system in the Saudi National Museum as a case study, a descriptive analytical method was used to understand the basic organizational and Morphological principles of the museum space through the main aspects of space design (the Morphological and the pragmatic). The study’s methodology is based on the description and analysis of the basic organizational and Morphological principles of the museum space at the level of the major Morphological and Pragmatic design layers (based on available pictures and diagrams) and inductive method about applied level of intelligibility in spatial layout in the Hall of Islam and Arabia at the National Museum Saudi Arabia within the framework of a case study through the levels of verification of the properties of the concepts of connectivity and integration. The results indicated that the application of the characteristics of intelligibility is weak on both Pragmatic and Morphological levels. Based on the concept of connective and integration, we conclude the following: (1) High level of reflection of the properties of connectivity on the pragmatic level, (2) Weak level of reflection of the properties of Connectivity at the morphological level (3) Weakness in the level of reflection of the properties of integration in the space sample as a result of a weakness in the application at the morphological and pragmatic level. The study’s findings will assist designers, professionals, and researchers in the field of museum design in understanding the significance of the wayfinding system by delving into it through museum spaces by highlighting the most essential aspects using a clear analytical method.

The Impact of COVID-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. To conduct the study, retrospective data of patients presenting acutely to the urology department were collected between January 13 to March 22, 2020 (pre-lockdown period) and March 23 to May 31, 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Included in the study were 1092 patients. The results show that an overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. The results of the study concluded that the admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

A Practical Construction Technique to Enhance the Performance of Rock Bolts in Tunnels

In Swedish tunnel construction, a critical issue that has been repeatedly acknowledged is corrosion and, consequently, failure of the rock bolts in rock support systems. The defective installation of rock bolts results in the formation of cavities in the cement mortar that is regularly used to fill the area under the dome plates. These voids allow for water-ingress to the rock bolt assembly, which results in corrosion of rock bolt components and eventually failure. In addition, the current installation technique consists of several manual steps with intense labor works that are usually done in uncomfortable and exhausting conditions, e.g., under the roof of the tunnels. Such intense tasks also lead to a considerable waste of materials and execution errors. Moreover, adequate quality control of the execution is hardly possible with the current technique. To overcome these issues, a non-shrinking/expansive cement-based mortar filled in the paper packaging has been developed in this study which properly fills the area under the dome plates without or with the least remaining cavities, ultimately that diminishes the potential of corrosion. This article summarizes the development process and the experimental evaluation of this technique for the installation of rock bolts. In the development process, the cementitious mortar was first developed using specific cement and shrinkage reducing/expansive additives. The mechanical and flow properties of the mortar were then evaluated using compressive strength, density, and slump flow measurement methods. In addition, isothermal calorimetry and shrinkage/expansion measurements were used to elucidate the hydration and durability attributes of the mortar. After obtaining the desired properties in both fresh and hardened conditions, the developed dry mortar was filled in specific permeable paper packaging and then submerged in water bath for specific intervals before the installation. The tests were enhanced progressively by optimizing different parameters such as shape and size of the packaging, characteristics of the paper used, immersion time in water and even some minor characteristics of the mortar. Finally, the developed prototype was tested in a lab-scale rock bolt assembly with various angles to analyze the efficiency of the method in real life scenario. The results showed that the new technique improves the performance of the rock bolts by reducing the material wastage, improving environmental performance, facilitating and accelerating the labor works, and finally enhancing the durability of the whole system. Accordingly, this approach provides an efficient alternative for the traditional way of tunnel bolt installation with considerable advantages for the Swedish tunneling industry.

Disparities versus Similarities: WHO GPPQCL and ISO/IEC 17025:2017 International Standards for Quality Management Systems in Pharmaceutical Laboratories

Medicines regulatory authorities expect pharmaceutical companies and contract research organizations to seek ways to certify that their laboratory control measurements are reliable. Establishing and maintaining laboratory quality standards are essential in ensuring the accuracy of test results. ‘ISO/IEC 17025:2017’ and ‘WHO Good Practices for Pharmaceutical Quality Control Laboratories (GPPQCL)’ are two quality standards commonly employed in developing laboratory quality systems. A review was conducted on the two standards to elaborate on areas on convergence and divergence. The goal was to understand how differences in each standard's requirements may influence laboratories' choices as to which document is easier to adopt for quality systems. A qualitative review method compared similar items in the two standards while mapping out areas where there were specific differences in the requirements of the two documents. The review also provided a detailed description of the clauses and parts covering management and technical requirements in these laboratory standards. The review showed that both documents share requirements for over ten critical areas covering objectives, infrastructure, management systems, and laboratory processes. There were, however, differences in standard expectations where GPPQCL emphasizes system procedures for planning and future budgets that will ensure continuity. Conversely, ISO 17025 was more focused on the risk management approach to establish laboratory quality systems. Elements in the two documents form common standard requirements to assure the validity of laboratory test results that promote mutual recognition. The ISO standard currently has more global patronage than GPPQCL.

Investigating the Geopolymerization Process of Aluminosilicates and Its Impact on the Compressive Strength of the Produced Geopolymers

This paper investigates multiple factors that impact the formation of geopolymers and their compressive strength to be utilized in construction as an environmentally-friendly material. Bentonite and Kaolinite were thermally calcinated at 750 °C to obtain Metabentonite and Metakaolinite with higher reactivity. Both source materials were activated using a solution of sodium hydroxide (NaOH). Thereafter, samples were cured at different temperatures. The samples were analyzed chemically using a host of spectroscopic techniques. The bulk density and compressive strength of the produced geopolymer pastes were studied. Findings indicate that the ratio of NaOH solution to source material affects the compressive strength, being optimal at 0.54. Moreover, controlled heat curing was proven effective to improve compressive strength. The existence of characteristic Fourier Transform Infrared Spectroscopy (FTIR) peaks at approximately 1020 cm-1 and 460 cm-1 which correspond to the asymmetric stretching vibration of Si-O-T and bending vibration of Si-O-Si, hence, confirming the formation of the target geopolymer.

The Evaluation of New Generation Cardiovascular Risk Markers in Childhood Obesity

Obesity, as excessive fat accumulation in the body, is a global health problem. The prevalence of obesity and its complications increase due to easy access to high-energy food and decreased physical activity. Cardiovascular diseases (CVDs) constitute a significant part of obesity-related morbidity and mortality. Since the effects of obesity on cardiovascular system may start during childhood without clinical findings, elucidating the mechanisms of cardiovascular changes associated with childhood obesity became more important. In this study, we aimed to investigate some biochemical parameters which may be involved in obesity-related pathologic processes of CVDs. One hundred and seventy-seven children were included in the study, and they were divided into four groups based upon WHO criteria and presence of the metabolic syndrome (MetS): children with normal-BMI, obesity, morbid obesity, and MetS. High-sensitive cardiac troponin T (hs-cTnT), cardiac myosin binding protein C (cMyBP-C), trimethylamine N-oxide (TMAO), soluble tumor necrosis factor-like weak inducer (sTWEAK), chromogranin A (CgA), multimerin-2 levels, and other biochemical parameters were measured in serum samples. Anthropometric measurements and clinical findings of the children were recorded. Statistical analyses were performed. Children with normal-BMI had significantly higher CgA levels than children with obesity, morbid obesity, and MetS (p < 0.05). Cardiac MyBP-C levels of children with MetS were significantly higher than of children with normal-BMI and OB children (p < 0.05). There was no significant difference in hs-cTnT, sTWEAK, TMAO and multimerin-2 between the groups (p>0.05). These results suggested that cMyBP-C and CgA molecules may be involved in the pathogenesis of obesity-related CVDs.

Microstructure and Texture Evolution of Cryo Rolled and Annealed Ductile TaNbHfZrTi Refractory High Entropy Alloy

The microstructure and texture evolution of cryo rolled and annealed ductile TaHfNbZrTi refractory high entropy alloy was investigated. To obtain that, the alloy is severely cryo rolled and subsequently annealed for the recrystallization process. The cryo rolled – 90% shows the presence of very fine grains and microstructural heterogeneity. The cryo rolled samples are annealed at a temperature ranging from 800°C to 1400°C, the partial recrystallization is observed at 800°C annealed condition, and at higher annealing temperatures the complete recrystallization process is noticed. The development of ND fiber texture is observed after the annealing.

Combination of Tensile Strength and Elongation of Reverse Rolled TaNbHfZrTi Refractory High Entropy Alloy

The refractory high entropy alloys are potential materials for high-temperature applications because of their ability to retain high strength up to 1600°C. However, their practical applications were limited due to poor elongation at room temperature. Therefore, decreasing the average valence electron concentrations (VEC) is an effective design strategy to improve the intrinsic ductility of refractory high entropy alloys. In this work, the high-entropy alloy TaNbHfZrTi was processed at room temperature by each step reverse rolling up to a 90% reduction in thickness. Subsequently, the reverse rolled 90% samples were utilized for annealing treatment at 800°C and 1000°C for 1 h to understand phase stability, microstructure, texture, and mechanical properties. The reverse rolled 90% condition contains body-centered cubic (BCC) single-phase; upon annealing at 800 °C, the formation of secondary phase BCC-2 prevailed. The partial recrystallization and complete recrystallization microstructures were developed for annealed at 800°C and 1000°C, respectively. The reverse rolled condition and 1000°C annealed temperature exhibit extraordinary room temperature tensile properties with high ultimate tensile strength (UTS) without compromising loss of ductility called “strength-ductility” trade-off. The reverse-rolled 90% and annealing treatment carried out at temperature about 1000°C for 1 h consist of UTS 1430 MPa and 1556 MPa with an appreciable amount of 21% and 20% elongation, respectively. The development of hierarchical microstructure prevailed for the annealed 1000°C which led to the simultaneous increase in tensile strength and elongation.

Empirical Analysis of Velocity Behavior for Collaborative Robots in Transient Contact Cases

In this paper, a suitable measurement setup is presented to conduct force and pressure measurements for transient contact cases at the example of lathe machine tending. Empirical measurements were executed on a selected collaborative robot’s behavior regarding allowable operating speeds under consideration of sensor- and workpiece-specific factors. Comparisons between the theoretic calculations proposed in ISO/TS 15066 and the practical measurement results reveal a basis for future research. With the created database, preliminary risk assessment and economic assessment procedures of collaborative machine tending cells can be facilitated.

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.

Separation of Composites for Recycling: Measurement of Electrostatic Charge of Carbon and Glass Fiber Particles

Composite waste from manufacturing can consist of different fiber materials, including blends of different fiber. Commercially, the recycling of composite waste is currently limited to carbon fiber waste and recycling glass fiber waste is currently not economically viable due to the low cost of virgin glass fiber and the reduced mechanical properties of the recovered fibers. For this reason, the recycling of hybrid fiber materials, where carbon fiber is blended with glass fibers, cannot be processed economically. Therefore, a separation method is required to remove the glass fiber materials during the recycling process. An electrostatic separation method is chosen for this work because of the significant difference between carbon and glass fiber electrical properties. In this study, an experimental rig has been developed to measure the electrostatic charge achievable as the materials are passed through a tube. A range of particle lengths (80-100 µm, 6 mm and 12 mm), surface state conditions (0%SA, 2%SA and 6%SA), and several tube wall materials have been studied. A polytetrafluoroethylene (PTFE) tube and recycled fiber without sizing agent were identified as the most suitable parameters for the electrical separation method. It was also found that shorter fiber lengths helped to encourage particle flow and attain higher charge values. These findings can be used to develop a separation process to enable the cost-effective recycling of hybrid fiber composite waste. 

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.

Effect of Type of Pile and Its Installation Method on Pile Bearing Capacity by Physical Modeling in Frustum Confining Vessel

Various factors such as the method of installation, the pile type, the pile material and the pile shape, can affect the final bearing capacity of a pile executed in the soil; among them, the method of installation is of special importance. The physical modeling is among the best options in the laboratory study of the piles behavior. Therefore, the current paper first presents and reviews the frustum confining vessel (FCV) as a suitable tool for physical modeling of deep foundations. Then, by describing the loading tests of two open-ended and closed-end steel piles, each of which has been performed in two methods, “with displacement" and "without displacement", the effect of end conditions and installation method on the final bearing capacity of the pile is investigated. The soil used in the current paper is silty sand of Firuzkuh, Iran. The results of the experiments show that in general the without displacement installation method has a larger bearing capacity in both piles, and in a specific method of installation the closed ended pile shows a slightly higher bearing capacity.

An E-Maintenance IoT Sensor Node Designed for Fleets of Diverse Heavy-Duty Vehicles

E-maintenance is a relatively recent concept, generally referring to maintenance management by monitoring assets over the Internet. One of the key links in the chain of an e-maintenance system is data acquisition and transmission. Specifically for the case of a fleet of heavy-duty vehicles, where the main challenge is the diversity of the vehicles and vehicle-embedded self-diagnostic/reporting technologies, the design of the data acquisition and transmission unit is a demanding task. This is clear if one takes into account that a heavy-vehicles fleet assortment may range from vehicles with only a limited number of analog sensors monitored by dashboard light indicators and gauges to vehicles with plethora of sensors monitored by a vehicle computer producing digital reporting. The present work proposes an adaptable internet of things (IoT) sensor node that is capable of addressing this challenge. The proposed sensor node architecture is based on the increasingly popular single-board computer – expansion boards approach. In the proposed solution, the expansion boards undertake the tasks of position identification, cellular connectivity, connectivity to the vehicle computer, and connectivity to analog and digital sensors by means of a specially targeted design of expansion board. Specifically, the latter offers a number of adaptability features to cope with the diverse sensor types employed in different vehicles. In standard mode, the IoT sensor node communicates to the data center through cellular network, transmitting all digital/digitized sensor data, IoT device identity and position. Moreover, the proposed IoT sensor node offers connectivity, through WiFi and an appropriate application, to smart phones or tablets allowing the registration of additional vehicle- and driver-specific information and these data are also forwarded to the data center. All control and communication tasks of the IoT sensor node are performed by dedicated firmware.

A 3D Numerical Environmental Modeling Approach for Assessing Transport of Spilled Oil in Porous Beach Conditions under a Meso-Scale Tank Design

Shorelines are vulnerable to significant environmental impacts from oil spills. Stranded oil can cause potential short- to long-term detrimental effects along beaches that include injuries to ecosystem, socio-economic and cultural resources. In this study, a three-dimensional (3D) numerical modeling approach is developed to evaluate the fate and transport of spilled oil for hypothetical oiled shoreline cases under various combinations of beach geomorphology and environmental conditions. The developed model estimates the spatial and temporal distribution of spilled oil for the various test conditions, using the finite volume method and considering the physical transport (dispersion and advection), sinks, and sorption processes. The model includes a user-friendly interface for data input on variables such as beach properties, environmental conditions, and physical-chemical properties of spilled oil. An experimental meso-scale tank design was used to test the developed model for dissolved petroleum hydrocarbon within shorelines. The simulated results for effects of different sediment substrates, oil types, and shoreline features for the transport of spilled oil are comparable to that obtained with a commercially available model. Results show that the properties of substrates and the oil removal by shoreline effects have significant impacts on oil transport in the beach area. Sensitivity analysis, through the application of the one-step-at-a-time method (OAT), for the 3D model identified hydraulic conductivity as the most sensitive parameter. The 3D numerical model allows users to examine the behavior of oil on and within beaches, assess potential environmental impacts, and provide technical support for decisions related to shoreline clean-up operations.

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.