Experimental Formula Research Articles

Similar to Those Who Are Breastfed, Infants Fed a Formula Containing 2′-Fucosyllactose Have Lower Inflammatory Cytokines in a Randomized Controlled Trial

Background: Evidence suggests that human milk oligosaccharides (HMOs) provide multiple benefits to infants, including prebiotic effects, gut maturation, antimicrobial activities, and immune modulation. Clinical intervention studies with HMOs are required to confirm these benefits in infants.Objective: Our objective was to investigate the effects of feeding formulas supplemented with the HMO 2′-fucosyllactose (2′-FL) on biomarkers of immune function in healthy term infants.Methods: We performed a substudy nested within a randomized, double-blind, controlled growth and tolerance study in healthy singleton infants (birth weight ≥2490 g) who were enrolled by 5 d of life and exclusively formula-fed (n = 317) or breastfed (n = 107) from enrollment to 4 mo of age. Formula-fed infants were randomly assigned to receive 1 of 3 formulas, all containing 2.4 g total oligosaccharides/L [control: galacto-oligosaccharides (GOS) only; experimental formulas: GOS + 0.2 or 1.0 g 2′-FL/L], and compared with a breastfed reference group. For this substudy, blood samples were drawn from infants at 6 wk of age (n = 31–42/group). Peripheral blood mononuclear cells (PBMCs) were isolated for cellular phenotyping and stimulated ex vivo with phytohemagglutinin for proliferation and cell cycle progression or respiratory syncytial virus (RSV). Cytokine concentrations were measured in plasma and in ex vivo–stimulated culture supernatants.Results: Breastfed infants and infants fed either of the experimental formulas with 2′-FL were not different but had 29–83% lower concentrations of plasma inflammatory cytokines than did infants fed the control formula [interleukin (IL) receptor antagonist (IL-1ra), IL-1α, IL-1β, IL-6, and tumor necrosis factor α (TNF-α)] (P ≤ 0.05). In ex vivo RSV–stimulated PBMC cultures, breastfed infants were not different than either of the groups fed formula with 2′-FL, but they had lower concentrations of TNF-α (31%) and interferon γ (IFN-γ 54%) (P ≤ 0.05) and tended to have lower IL-1ra (25%) and IL-6 (38%) (unadjusted P ≤ 0.05) and IL-1β (30%) (unadjusted P = 0.06) than did infants fed the control formula.Conclusions: Our data indicate that infants fed formula supplemented with 2′-FL exhibit lower plasma and ex vivo inflammatory cytokine profiles, similar to those of a breastfed reference group. This trial was registered at clinicaltrials.gov as NCT01808105.

An approach for the numerical prediction of the compressible supercavitating flows over ultrahigh-speed underwater object

Purpose Ultrahigh-speed projectile running in water with the velocity close to the speed of sound usually causes large supercavity. The computation of such transonic cavitating flows is usually difficult, thus high-speed model reflecting the compressibility of both the liquid and the vapor phases should be introduced to model such flow. The purpose of this paper is to achieve a model within an in-house developed solver to simulate the ultrahigh-speed subsonic supercavitating flows. Design/methodology/approach An improved TAIT equation adjusted by local temperature is adopted as the equation of state (EOS) for the liquid phase, and the Peng-Robinson EOS is used for the vapor phase. An all-speed variable coupling algorithm is used to unify the computations and regulate the convergence at arbitrary Mach number. The ultrahigh-speed (Ma=0.7) supercavitating flows around circular disk are investigated in contrast with the case of low subsonic (Ma=0.007) flow. Findings The characteristic physical variables are reasonably predicted, and the cavity profiles are compared to be close to the experimental empirical formula. An important conclusion in the compressible cavitating flow theory is verified by the numerical result that, at any specific cavitation number the cavity’s size and the drag coefficient both increase along with the rise of Mach number. On the contrary, it is found as well that the cavity’s slenderness ratio decreases when Mach number goes up. It indicates that the compressibility has different influences on the length and the radius of the supercavity. Originality/value A high-speed model reflecting the compressibility of both the liquid and the vapor phases was suggested to model the ultrahigh-speed supercavitating flows around underwater projectiles.

Assessment of total efficiency in adiabatic engines

The paper presents influence of ceramic coating in all surfaces of the combustion chamber of SI four-stroke engine on working parameters mainly on heat balance and total efficiency. Three cases of engine were considered: standard without ceramic coating, fully adiabatic combustion chamber and engine with different thickness of ceramic coating. Consideration of adiabatic or semi-adiabatic engine was connected with mathematical modelling of heat transfer from the cylinder gas to the cooling medium. This model takes into account changeable convection coefficient based on the experimental formulas of Woschni, heat conductivity of multi-layer walls and also small effect of radiation in SI engines. The simulation model was elaborated with full heat transfer to the cooling medium and unsteady gas flow in the engine intake and exhaust systems. The computer program taking into account 0D model of engine processes in the cylinder and 1D model of gas flow was elaborated for determination of many basic engine thermodynamic parameters for Suzuki DR-Z400S 400 cc SI engine. The paper presents calculation results of influence of the ceramic coating thickness on indicated pressure, specific fuel consumption, cooling and exhaust heat losses. Next it were presented comparisons of effective power, heat losses in the cooling and exhaust systems, total efficiency in function of engine rotational speed and also comparison of temperature inside the cylinder for standard, semi-adiabatic and full adiabatic engine. On the basis of the achieved results it was found higher total efficiency of adiabatic engines at 2500 rpm from 27% for standard engine to 37% for full adiabatic engine.

Modeling for Shell-Side Heat Transfer Coefficient and Pressure Drop of Helical Baffle Heat Exchangers

This study has suitably modified the existing heat transfer and pressure drop correction factors of the modified Bell–Delaware method used for heat exchangers with segmental baffles, taking into consideration the helical baffle geometry. These correction factors are presented in parametric formulas based on the Taborek presented procedure for segmental baffles. These formulas are functions of the geometrical and physical parameters of discontinuous helical baffles. In addition, the parametric formulas are presented graphically based on the Stehlik method. The correction design method proposed by Stehlik for the helical baffle is presented in detail and a theoretical model for shell-side heat transfer and pressure drop is developed. In general, the results show that the present model matches more closely with the graphically proposed correction factors of Stehlik. In order to calculate the shell-side heat transfer coefficient and pressure drop using the present method, a computational code has been developed by the authors. In addition, in order to examine the validity, the results of the code for a case study are compared with the results obtained from EXPRESS software and experimental formulas presented by Zhang. The results of comparison show that the proposed method is accurate and can be used by designers confidently.

Experiment Study on Efficient Flank Milling of Ti6AL4V Thin-walled Components

Flank milling is a method of line contact machining and also is an important method in machining aerospace structures components, turbine blades and so on. In this paper, flank milling of Ti6AL4V is conducted with carbide tools on CNC machining center. First, acquired cutting force signals are analyzed in time domain and frequency domain based on Matlab software to obtain the distribution of cutting force energy. Second, the flank milling force experimental formulas are established by means of regression analysis. Finally, the influence of cutting parameters such as feed per tooth, the axial depth of cut, cutting width and cutting speed on cutting force is studied. The curves between cutting parameters and cutting force are obtained by analyzing the flank milling experiment. This research has certain guiding significance in selecting cutting parameters for flank machining Ti6AL4V.

Stochastic equations for continuum and determination of hydraulic drag coefficients for smooth flat plate and smooth round tube with taking into account intensity and scale of turbulent flow

The stochastic equations of continuum are used for determining the hydraulic drag coefficients. As a result, the formulas for the hydraulic drag coefficients dependent on the turbulence intensity and scale instead of only on the Reynolds number are proposed for the classic flows of an incompressible fluid along a smooth flat plate and a round smooth tube. It is shown that the new expressions for the classical drag coefficients, which depend only on the Reynolds number, should be obtained from these new general formulas if to use the well-known experimental data for the initial turbulence. It is found that the limitations of classical empirical and semiempirical formulas for the hydraulic drag coefficients and their deviation from the experimental data depend on different parameters of initial fluctuations in the flow for different experiments in a wide range of Reynolds numbers. On the basis of these new dependencies, it is possible to explain that the differences between the experimental results for the fixed Reynolds number are caused by the difference in the values of flow fluctuations for each experiment instead of only due to the systematic error in the processing of experiments. Accordingly, the obtained general dependencies for the smooth flat plate and the smooth round tube can serve as the basis for clarifying the results of experiments and the experimental formulas, which used for continuum flows in different devices.

Effects of DTAC on the warmth retention of down fiber based on response surface method

The warmth retention of down is improved through grafting DTAC (dodecyl trimethyl ammonium chloride) onto the natural fiber. The effect of DTAC concentration (A), temperature (B), and time (C) on the warmth retention was studied using the response surface method to obtain the optimal experimental formula and models. The optimum process conditions are A: 17.1 %, B: 38.91 °C, C: 61.37 min and the predicted warmth retention rate is 80.4 %. Verified by experiments, the actual result is 80.34 %, and the fitting degree is 99.92 %. The results show that the warmth retention rate of the treated down increased by 5.98 % compared to raw down. The filling power significantly increased by 21.85 %, and the graft modification had no effect on the turbidity of the down. No obvious changes were detected using SEM. This explains that the DTAC was successfully grafted onto the down fiber and the modification did not damage the down.

NEW APPROACH FOR SEGMENTATION AND EXTRACTION OF SINGLE TREE FROM POINT CLOUDS DATA AND AERIAL IMAGES

Abstract. This paper addresses a new approach for reconstructing a 3D model from single trees via Airborne Laser Scanners (ALS) data and aerial images. The approach detects and extracts single tree from ALS data and aerial images. The existing approaches are able to provide bulk segmentation from a group of trees; however, some methods focused on detection and extraction of a particular tree from ALS and images. Segmentation of a single tree within a group of trees is mostly a mission impossible since the detection of boundary lines between the trees is a tedious job and basically it is not feasible. In this approach an experimental formula based on the height of the trees was developed and applied in order to define the boundary lines between the trees. As a result, each single tree was segmented and extracted and later a 3D model was created. Extracted trees from this approach have a unique identification and attribute. The output has application in various fields of science and engineering such as forestry, urban planning, and agriculture. For example in forestry, the result can be used for study in ecologically diverse, biodiversity and ecosystem.

NEW APPROACH FOR SEGMENTATION AND EXTRACTION OF SINGLE TREE FROM POINT CLOUDS DATA AND AERIAL IMAGES

This paper addresses a new approach for reconstructing a 3D model from single trees via Airborne Laser Scanners (ALS) data and aerial images. The approach detects and extracts single tree from ALS data and aerial images. The existing approaches are able to provide bulk segmentation from a group of trees; however, some methods focused on detection and extraction of a particular tree from ALS and images. Segmentation of a single tree within a group of trees is mostly a mission impossible since the detection of boundary lines between the trees is a tedious job and basically it is not feasible. In this approach an experimental formula based on the height of the trees was developed and applied in order to define the boundary lines between the trees. As a result, each single tree was segmented and extracted and later a 3D model was created. Extracted trees from this approach have a unique identification and attribute. The output has application in various fields of science and engineering such as forestry, urban planning, and agriculture. For example in forestry, the result can be used for study in ecologically diverse, biodiversity and ecosystem.

Analysis of the structure of a mathematical model of a piston engine cycle

The paper analyzes the structure of the mathematical model of a piston engine cycle and proposes a modified version of it, allowing determination of the optimum pressure p in the cylinder. For the analysis the authors used published results of other authors’ studies of work processes for piston engines, working on liquid fuels, and gave recommendations on usage of models for calculation and development of engines. In the considered mathematical model there are used cycle equations of: thermodynamic processes, energy balance, mass conservation, state and known empirical relationships. It is shown that four factors have major impact on changes of pressures p: current volume of the cylinder V; mass of the working body at gas exchange M; supply of heat released during combustion Qx and heat exchange with walls of intracylinder space Qw. The authors analyzed the influence of each of these factors on the change of pressure in a piston engine cylinder. Defining contribution of each of these factors on the pressure change of the working body in the cylinder will purposefully improve processes in a piston engine, providing not only environmental but also efficiency performance. Although the mathematical model is presented in quasi-stationary formulation, it provides the desired results in design studies, especially in fine-tuning engine to the required performance. When calculating the cycle the most important is accuracy of determination of the start of visible combustion (the beginning of heat supply to the working body by the crank angle φf), as well as determination of mixture ignition time delay (MID) τi. Position of the point by crankshaft angle φf relative to the TDC significantly affects indicator performance and cycle efficiency. Angle φf is an adjustment parameter, so its accepted value is included in the original data for calculation of the cycle. The complexity of considering of influence of various factors on the duration of mixture ignition delay led to a wide variety of empirical or semi-empirical formulas for calculation of MID τi, which significantly complicates their selection for a particular model. The analysis made for the structure, conditions and methods for the preparation of formulas for determination of τi (analyzed 19 semi-empirical and experimental formulas of various authors). The heat involved in the heat exchange between the working body and the walls of intracylinder space is calculated by the formula of Newton-Richman. Increments of pressure and temperature in the pipes are calculated in the exhaust and intake pipes. The described model of piston engine cycle was implemented in a package of piston engines and calculation softwares used in scientific research and educational process.

Hydraulic conductivity prediction based on grain-size distribution using M5 model tree

ABSTRACTThe hydraulic conductivity, Ks, is one of the most important hydraulic properties which controls the water and solute movement into the soil. It is measured on soil specimens in the laboratory. On the other hand, sometimes it is obtained by tests carried out in the field by a number of researchers. Therefore, several experimental formulas have developed to predict it. Recently, soft computing tools have been used to evaluate the hydraulic conductivity. However, these tools are not as transparent as empirical formulas. In this study, another soft computing approach, i.e. model trees, have been used for predicting the hydraulic conductivity. The main advantage of model trees is that, unlike the other data learning tools, they are easier to use and represent understandable mathematical rules more clearly. In this paper, a new formula that includes some parameters is derived to estimate the hydraulic conductivity. To develop the new formulas, experimental data sets of hydraulic conductivity were used. A comparison is made between the estimated hydraulic conductivity by this new formula and formulas given by other’s researches.

OPTIMIZATION OF ETHANOL-WATER COMPOSITION AS EXTRACTION SOLVENT IN PRODUCING SAMBUNG NYAWA (Gynura procumbens (Lour.) Merr.) LEAVES DRY EXTRACT

Sambung Nyawa leaves ( Gynura procumbens (Lour.) Merr has been widely used as herbal medicine which requires a quality improvement of the dry extract for industrial production. Extraction solvent optimization is one key factor which determines the quality. This research aims was to find out the optimal ethanol-water composition as extraction solvent by using Simplex Lattice Design (SLD) method of which the total phenolics, total flavonoids and DPPH radical scavenging activity were used as quality parameters. Dried leaves as raw materials were pulverized and screened at Mesh 60, macerated (1:5) with ethanol-water compositition as 1:0; 0.7:0.3; and 0.5:0.5 v/v, shaked for 24 h, filtered. The procedure was repeated twice. Filtrates were collected of which lactose were added (1:2)w/w and spray dried at 100C for 30 min. Dried extracts yielded were evaluated the quality by using SLD method of which the total phenolics, total flavonoids as well as DPPH radical scavenging activity were used as parameters. Optimal SLD response was revealed at the ethanol:water composition of 0.66:0.34 – 0.75:0.25 v/v (Rtotal>0.9). No significant difference of the above mentioned parameters between the values resulted from the experiment and SLD formula. Correlation analyses of total phenolics and total flavonoids towards DPPH-radical scavenging activity were found as 95.29% and 1.25%, respectively.

Single Tree Vegetation Depth Estimation Tool for Satellite Services Link Design

Attenuation caused by tree shadowing is an important factor for describing the propagation channel of satellite services. Thus, vegetation effects should be determined by experimental studies or empirical formula- tions. In this study, tree types in the Black Sea Region of Turkey are classified based on their geometrical shapes into four groups such as conic, ellipsoid, spherical and hemispherical. The variations of the vegetation depth according to different tree shapes are calculated with ray tracing method. It is shown that different geometrical shapes have different vegetation depths even if they have same foliage volume for different elevation angles. The proposed method is validated with the related literature in terms of average single tree attenuation. On the other hand, in order to decrease system requirements (speed, memory usage etc.) of ray tracing method, an artificial neural network is proposed as an alternative. A graphical user interface is created for the above processes in MATLAB environment named vegetation depth estimation tool (VdET).

Experimental Validation of Surface Coverage Model for Li-Air Battery

The Lithium-air battery has captured so much interest and been considered as a promising candidate for the future renewable energy sources because of its high specific energy density comparable to gasoline. But unfortunately, the maximum amount of the lithium metal utilized is limited because of the tunnel blockage and surface coverage inside cathode, which are caused by insoluble lithium composite generated at cathode. In other words, the total energy capacity is restricted by the cathode under adequate lithium. So if we can fully understand how the deposits work on the cathode, we are supposed to develop a better cathode, which can hold more products per unit volume, with immensely higher energy capacity per unit cathode volume. This paper describes a surface coverage model and two relative dominating effects, electrode passivation and transport resistance. By using the electron conservation combined with experimental formula from previous works, we could investigate how much the insoluble there is and the coverage coefficient used to evaluate what degree deposits damage the effectivity of cathode to. We could use the coverage coefficient to describe the effective surface area under different stage of precipitation. We may go further to obtain the oxygen profile by taking the oxygen transport equation into account. Then we have a chance to use the above model to formulate the loss of effective voltage and total energy capacity. We could eventually split the voltage loss into 2 pieces, one caused by electrode passivation and another caused by oxygen transport resistance. We can compare them to find out which one is the prime force to kill the battery, or that they cooperate together. We can also know how much deposits the cathode can be filled with before exhausted. Then the total energy capacity is ready to come out by integrating the voltage along the time under constant current. By looking into the integral, there are actually three parts, which are the capacity without considering voltage loss effect, and two capacity losses solely considering the voltage loss from the electrode passivation or oxygen transport resistance respectively. If we compare these different part, we could have a knowledge of whether the capacity loss is immense enough to be cared about, or which kind of loss costs more. To validate our model, we will also perform the experiments by using our sandwich cell to get the discharging curve, which will be used to validate our model by comparing the voltage loss and energy capacity loss. The sandwich cell structure from bottom to top is: bottom frame, aluminum foil, lithium metal, separator, rubble sealing ring, top frame with air window and electrolyte pool on top, and cathode. The whole cell is assembled by using screws. We could get open circuit voltage and discharging curves under different current. The data will be used to validate and improve our model mentioned above.

Polyaluminocarbosilane as precursor for aluminum-containing SiC fiber from oxygen-free sources

Aluminum-containing silicon carbide (SiC) fiber, such as Tyranno SA fiber, is the typical 3rd generation SiC fiber. Polyaluminocarbosilane (PACS) is the precursor of Al-containing SiC fiber. PACS was synthesized via elimination of HCl during the reaction between dimethyaluminium chloride ((CH3)2AlCl) and polycarbosilane (PCS) in this work. Composition and structure of the as-synthesized PACS were characterized by elemental analysis, FT IR, GPC, and TG, respectively. The results showed that, the yield of the reaction was 72.5% and the reaction degree of Si–H bonds was 16.5%. The obtained PACS had melting point of about 218.8°C, experimental formula as SiC2.003Al0.023O0.048H3.713, number average molecular weight Mn of 1859, weight average molecular weight Mw of 4895, polydispersity index (Mw/Mn) of 2.632. The molecular structure of PACS was similar to that of PCS. Four stages could be divided during pyrolysis process of PACS according to TG spectrum. The ceramic yield was found to be around 67.3% at 1000°C in N2 atmosphere. The PACS precursor is melt spinnable into flexible and uniform green fibers with the diameter about 12.6μm.

Analytical calculations for impurity seeded partially detached divertor conditions

A simple analytical formula for the impurity seeded partially detached divertor operational point has been developed using 1D modelling. The inclusion of charge exchange momentum loss terms improves the 1D modelling for ASDEX Upgrade conditions and its extrapolation to larger devices. The investigations are concentrated around a partially detached divertor working point of low heat flux and an electron temperature around 2.5 eV at the target which are required to maintain low sputtering rates at a tungsten target plate. An experimental formula for the onset of detachment by nitrogen seeding in ASDEX Upgrade is well reproduced, and predictions are given for N, Ne and Ar seeding for variable device size. Moderate deviations from a linear size dependence of the detachment threshold are seen in the modelling caused by upstream radiation at longer field line lengths. The presented formula allows the prediction of the neutral gas or seed impurity pressure which is required to achieve partial detachment for a given in devices with a closed divertor similar to the geometry in ASDEX Upgrade.

Discussion on size effect of footing in ultimate bearing capacity of sandy soil using rigid plastic finite element method

Currently, many formulas are used to calculate the ultimate bearing capacity. However, these formulas have disadvantages when being applied in practice since they can only be applied for calculating simple footing shapes and uniform grounds. Most formulas do not take into account the size effect of the footing on the ultimate bearing capacity, except for the formula by the Architectural Institute of Japan. The advantage of using the finite element method (FEM) is its applicability to non-uniform grounds, for example, multi-layered and improved grounds, and to complicated footing shapes under three-dimensional conditions. FEM greatly improves the accuracy in estimating the ultimate bearing capacity. The objective of this study is to propose a rigid plastic constitutive equation using the non-linear shear strength property against the confining pressure. The constitutive equation was built based on experiments for the non-linear shear strength property against the confining pressure reported by Tatsuoka and other researchers. The results from tests on Toyoura sand and various other kinds of sand indicated that, although the internal friction angle differs among sandy soils, the normalized internal friction angle decreases with an increase in the normalized first stress invariant for various sands despite dispersion in the data. This property always holds irrespective of the reference value of the confining pressure in the normalization of the internal friction angle. The applicability of the proposed rigid plastic equation was proved by comparing it to the ultimate bearing capacity formula by the Architectural Institute of Japan, which is an experimental formula that takes into account the size effect of the footing. The results of rigid plastic finite element method (RPFEM) with the proposed constitutive equation were found to be similar to those obtained with the Architectural Institute of Japan’s formula. It is clear that RPFEM, with the use of the non-linear shear strength against the confining pressure, provides good estimations of the ultimate bearing capacity of the footing by taking account of the size effect of the footing.

Characterizing Texture, Color and Sensory Attributes of Cookies Made with Jerusalem Artichoke (Helianthus tuberosus L.) Flour Using a Mixture Design and Browning Reaction Kinetics

Abstract Effect of interactions between Jerusalem artichoke flour (JF), wheat flour (WF) and sugar (S) on the texture properties of cookies was investigated. JF was the most influential component on the dough and cookies, possibly due to inulin in JF. To develop an optimum formulation using mixture design, the constraint values for the quality indices were: hardness (12 N), adhesiveness (10 mJ), and cohesiveness (0.27) of dough, and maximum force of cookie (73 N). Optimum values of WF, JF and S in the mixture were found to be 151.89 g, 55.33 g and 87.78 g, respectively, with a desirability of 0.943. Two experimental cookie formulas, similar to the optimal formula, were tested for their sensory properties and resulted in highly acceptable scores. As baking time increased, the browning and antioxidant activity of all cookies increased; however, the browning and antioxidant activity of samples containing JF was significantly higher than the others.

Use of the Spent Bleaching Earth from Palm Oil Industry in Non Fired Wall Tiles

ABSTRACT : Currently, abundant wastes from the palm oil refining process have been generated which are hard to handle. Spent Bleaching Earth (SBE) is the solid waste from this process and leads the cost of elimination to the company. This study aims to utilize the SBE as the alternative material in the non-fired wall tiles. The main raw materials used in non-fired wall tiles consist of laterite soil, fluvial sand, and Portland cement. The experimental formulas have been conducted and divided into 3 groups by varying the percentage of the SBE in main raw materials. The specimens of material mixture have been produced by uniaxial pressing at 100 bars, dimensions in 50x100x8 mm. These specimens are sprayed with water and cured in the air for 7 days. After that, bending strength and water absorption test of these specimens has been performed. It can be concluded that the best formula with the percentage of laterite soil, fluvial sand, Portland cement, and SBE are 60.94%, 13.125%, 22.5%, and 3.435%, respectively. Its bending strength and %water absorption are 0.68 MPa and 5.64%. Material costs of specimen are approximately $0.00276 USD /100g. Furthermore, the comparison of curing period between 7 days and 30 days has been performed. The 30 days of curing period can improve the bending strength of the specimen, but there is no effect on water absorption.

Cost-effectiveness of a disease-specific oral nutritional support for pressure ulcer healing

The Oligo Element Sore Trial has shown that supplementation with a disease-specific nutritional formula enriched with arginine, zinc, and antioxidants improves pressure ulcer (PU) healing in malnourished patients compared to an isocaloric-isonitrogenous support. However, the use of such a nutritional formula needs to be supported also by a cost-effectiveness evaluation. This economic evaluation - from a local healthcare system perspective - was conducted alongside a multicenter, randomized, controlled trial following a piggy-back approach. The primary efficacy endpoint was the percentage of change in PU area at 8 weeks. The cost analysis focused on: the difference in direct medical costs of local PU care between groups and incremental cost-effectiveness ratio (ICER) of nutritional therapy related to significant study endpoints (percentage of change in PU area and ≥40% reduction in PU area at 8 weeks). Although the experimental formula was more expensive (mean difference: 39.4 Euros; P<0.001), its use resulted in money saving with respect to both non-nutritional PU care activities (difference,-113.7 Euros; P=0.001) and costs of local PU care (difference,-74.3 Euros; P=0.013). Therefore, given its efficacy it proved to be a cost-effective intervention. The robustness of these results was confirmed by the sensitivity analyses. The use of a disease-specific oral nutritional formula not only results in better healing of PUs, but also reduces the costs of local PU care from a local healthcare system perspective.