Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees...Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees of inflammation and disease severity,ranging from self-limiting mild AP to devastating and fatal severe AP.Many factors contribute to malnutrition in AP,especially abnormal metabolism and catabolism related to inflammation.The concept of“pancreatic rest”is not evidence-based.There is however,emerging evidence that supports the use of oral or enteral nutrition to improve nutrition status and to reduce local and systemic inflammation,complications,and death.In mild disease,patients are generally able to initiate solid oral diet and do not require specialized nutrition care such as enteral or parenteral nutrition.In contrast,nutrition interventions are imperative in moderately severe and severe AP.The current article aims to review the latest evidence and suggest practical nutrition interventions in patients with AP,including nutrition requirements,routes of nutrition treatment,types of formula,and the role of nutritional supplements,such as glutamine,probiotics,omega-3 fatty acids,and antioxidants.展开更多
Breast cancer patients face different nutritional problems at each stage. However, the nutrition of breast cancer patients has not been taken seriously. As a result, some patients cannot tolerate treatment due to poor...Breast cancer patients face different nutritional problems at each stage. However, the nutrition of breast cancer patients has not been taken seriously. As a result, some patients cannot tolerate treatment due to poor nutrition, thus affecting the prognosis. This study aims to introduce a typical case to explore the whole-course</span><span style="font-family:""> </span><span style="font-family:Verdana;">(started at admission and ended 5 years after surgery)</span><span style="font-family:""> </span><span style="font-family:Verdana;">and Multidisciplinary Teams (MDTs)</span><span style="font-family:""> </span><span style="font-family:Verdana;">(comprising physician, primary nurse, case manager, nutrition liaison and nutrition specialist nurse)</span><span style="font-family:""> </span><span style="font-family:Verdana;">nutritional management mode of breast cancer patients. The patient successfully completed the scheduled treatment by implementing the whole-course and multidisciplinary nutrition management. The mode can prospectively and dynamically estimate the changes </span><span style="font-family:Verdana;">in</span><span style="font-family:Verdana;"> patients’ nutritional status, and provide timely nutritional intervention to promote patient outcomes.展开更多
BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modi...BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.展开更多
BACKGROUND Glucose imbalance is common in total parenteral nutrition(TPN).Hypoglycemia seems to be less frequent than hyperglycemia,but it influences the clinical outcome to a greater extent.Therefore,it should be eff...BACKGROUND Glucose imbalance is common in total parenteral nutrition(TPN).Hypoglycemia seems to be less frequent than hyperglycemia,but it influences the clinical outcome to a greater extent.Therefore,it should be effectively prevented and treated.However,there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury.CASE SUMMARY We present three patients with liver cell injury who developed severe hypo-glycemia during or after TPN infusion.The causes of severe hypoglycemia and glucose-raising strategies were discussed.According to the physiological charac-teristics of the hepatocellular injury,the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases.We simultaneously reduced the dose of insulin and fat emulsion,and increased the dose of glucose in TPN.The blood glucose level was restored to normal range and clinical symptoms were eliminated.CONCLUSION When hypoglycemia occurs during or after TPN in patients with hepatocellular injury,physicians need to simultaneously reduce insulin and fat emulsion,and increase glucose,and correct severe hypoglycemia in time to reduce its adverse consequences.展开更多
Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or ...Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.展开更多
Globally,type 2 diabetes mellitus(T2DM)is one of the most common metabolic disorders.T2DM physiopathology is influenced by complex interrelationships between genetic,metabolic and lifestyle factors(including diet),whi...Globally,type 2 diabetes mellitus(T2DM)is one of the most common metabolic disorders.T2DM physiopathology is influenced by complex interrelationships between genetic,metabolic and lifestyle factors(including diet),which differ between populations and geographic regions.In fact,excessive consumptions of high fat/high sugar foods generally increase the risk of developing T2DM,whereas habitual intakes of plant-based healthy diets usually exert a protective effect.Moreover,genomic studies have allowed the characterization of sequence DNA variants across the human genome,some of which may affect gene expression and protein functions relevant for glucose homeostasis.This comprehensive literature review covers the impact of gene-diet interactions on T2DM susceptibility and disease progression,some of which have demonstrated a value as biomarkers of personal responses to certain nutritional interventions.Also,novel genotype-based dietary strategies have been developed for improving T2DM control in comparison to general lifestyle recommendations.Furthermore,progresses in other omics areas(epigenomics,metagenomics,proteomics,and metabolomics)are improving current understanding of genetic insights in T2DM clinical outcomes.Although more investigation is still needed,the analysis of the genetic make-up may help to decipher new paradigms in the pathophysiology of T2DM as well as offer further opportunities to personalize the screening,prevention,diagnosis,management,and prognosis of T2DM through precision nutrition.展开更多
Over the past few decades,genetic selection and refined nutritional management have extensively been used to increase the growth rate and lean meat production of livestock.However,the rapid growth rates of modern bree...Over the past few decades,genetic selection and refined nutritional management have extensively been used to increase the growth rate and lean meat production of livestock.However,the rapid growth rates of modern breeds are often accompanied by a reduction in intramuscular fat deposition and increased occurrences of muscle abnor‑malities,impairing meat quality and processing functionality.Early stages of animal development set the long‑term growth trajectory of offspring.However,due to the seasonal reproductive cycles of ruminant livestock,gestational nutrient deficiencies caused by seasonal variations,frequent droughts,and unfavorable geological locations nega‑tively affect fetal development and their subsequent production efficiency and meat quality.Therefore,enrolling live‑stock in nutritional intervention strategies during gestation is effective for improving the body composition and meat quality of the offspring at harvest.These crucial early developmental stages include embryonic,fetal,and postnatal stages,which have stage‑specific effects on subsequent offspring development,body composition,and meat quality.This review summarizes contemporary research in the embryonic,fetal,and neonatal development,and the impacts of maternal nutrition on the early development and programming effects on the long‑term growth performance of livestock.Understanding the developmental and metabolic characteristics of skeletal muscle,adipose,and fibrotic tissues will facilitate the development of stage‑specific nutritional management strategies to optimize production efficiency and meat quality.展开更多
This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descr...This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.展开更多
The call for agri-food system transformation is urgent in many global development agendas(UN 2023).Food systems have contributed to economic prosperity and feeding the world,but they are also associated with numerous ...The call for agri-food system transformation is urgent in many global development agendas(UN 2023).Food systems have contributed to economic prosperity and feeding the world,but they are also associated with numerous challenges,including climate change,continued hunger,poor diets and malnutrition,and increasing disparities(Webb et al.2020;Fanzo et al.2021).展开更多
The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumer...The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.展开更多
BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplan...BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.展开更多
This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demogra...This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.展开更多
Yellow mealworm larvae(YML;Tenebrio molitor) are considered as a valuable insect species for animal feed due to their high nutritional values and ability to grow under different substrates and rearing conditions. Adva...Yellow mealworm larvae(YML;Tenebrio molitor) are considered as a valuable insect species for animal feed due to their high nutritional values and ability to grow under different substrates and rearing conditions. Advances in the understanding of entomophagy and animal nutrition over the past decades have propelled research areas toward testing multiple aspects of YML to exploit them better as animal feed sources. This review aims to summarize various approaches that could be exploited to maximize the nutritional values of YML as an animal feed ingredient. In addition, YML has the potential to be used as an antimicrobial or bioactive agent to improve animal health and immune function in production animals. The dynamics of the nutritional profile of YML can be influenced by multiple factors and should be taken into account when attempting to optimize the nutrient contents of YML as an animal feed ingredient. Specifically, the use of novel land-based and aquatic feeding resources, probiotics, and the exploitation of larval gut microbiomes as novel strategies can assist to maximize the nutritional potential of YML. Selection of relevant feed supplies, optimization of ambient conditions, the introduction of novel genetic selection procedures, and implementation of effective post-harvest processing may be required in the future to commercialize mealworm production. Furthermore, the use of appropriate agricultural practices and technological improvements within the mealworm production sector should be aimed at achieving both economic and environmental sustainability. The issues highlighted in this review could pave the way for future approaches to improve the nutritional value of YML.展开更多
Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in deve...Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.展开更多
The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycle...The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycles,little is known about the impact of Rural Dibao on child nutrition outcomes.Using China Family Panel Studies(CFPS),this paper examines the effects of Rural Dibao on child nutrition outcomes and investigates potential pathways and heterogeneous effects.We exploit propensity score matching and difference-in-differences techniques to evaluate the effects of the Rural Dibao program on child nutrition outcomes.Our results suggest that Rural Dibao significantly impacts the nutrition outcomes of children up to 15 years of age.Specifically,our results suggest that Rural Dibao improves child height-to-age z-scores by 1.05 standard deviations and lowers the probability of stunting by 11.9 percentage points.Additional analyses suggest that increased protein intake is the main pathway through which Rural Dibao participation contributes to better nutrition outcomes.We also find that the effect of the program is more pronounced among girls,children who are non-left-behind or live with highly educated mothers,and those from low-income families and poor areas.Our findings suggest that Rural Dibao participation helps improve child nutrition outcomes through improving diet quality.展开更多
This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivot...This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivotal role in neurodegenerative diseases like Parkinson's disease,encompassing diverse components such as the gut microbiota,immune system,metabolism,and neural pathways.The gut microbiome,profoundly influenced by dietary factors,emerges as a key player.Nutrition during the first 1000 days of life shapes the gut microbiota composition,influencing immune responses and impacting both child development and adult health.High-fat,high-sugar diets can disrupt this delicate balance,contributing to inflammation and immune dysfunction.Exploring nutritional strategies,the Mediterranean diet's anti-inflammatory and antioxidant properties show promise in reducing Parkinson's disease risk.Microbiome-targeted dietary approaches and the ketogenic diet hold the potential in improving brain disorders.Beyond nutrition,emerging research uncovers potential interactions between steroid hormones,nutrition,and Parkinson's disease.Progesterone,with its anti-inflammatory properties and presence in the nervous system,offers a novel option for Parkinson's disease therapy.Its ability to enhance neuroprotection within the enteric nervous system presents exciting prospects.The review addresses the hypothesis thatα-synuclein aggregates originate from the gut and may enter the brain via the vagus nerve.Gastrointestinal symptoms preceding motor symptoms support this hypothesis.Dysfunctional gut-brain signaling during gut dysbiosis contributes to inflammation and neurotransmitter imbalances,emphasizing the potential of microbiota-based interventions.In summary,this review uncovers the complex web of interactions between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the gut-brain axis framework.Understanding these connections not only offers novel therapeutic insights but also illuminates the origins of neurodegenerative diseases such as Parkinson's disease.展开更多
Capsicum is a nutritious vegetable and its cultivation in farms is getting popular in Bangladesh. Although many efforts have lain to explore better yielding and nutritionally rich cultivars with suitable modern cultiv...Capsicum is a nutritious vegetable and its cultivation in farms is getting popular in Bangladesh. Although many efforts have lain to explore better yielding and nutritionally rich cultivars with suitable modern cultivation techniques but still have to find the desired outcome. Thus, it’s necessary to conduct further research to identify the high-yielding and nutritious capsicum cultivars in Bangladesh. An experiment was conducted from July 2021 to June 2022 at the Bangladesh Institute of Research and Training on Applied Nutrition (BIRTAN) research field with three cultivars of capsicum: B<sub>0</sub> = California Wonder, B<sub>1</sub> = BARI Misti Morich-1 and B<sub>2</sub> = BARI Misti Morich-2 and three mulching: T<sub>0</sub> = No mulching, T<sub>1</sub> = Water hyacinth, T<sub>2</sub> = Poly Mulching in randomized complete block design with three replications to identify better quality capsicum cultivar and suitable mulching material. Among cultivars the BARI Misti Morich-2 (B<sub>2</sub>) showed increased agronomic parameters like number of branches and effective branches per plant, leaves length and width, consequently yield and yield contributing traits were also enhanced like fruits per plant, fruit length, fruit diameter and yield per plant (25.97%, 4.54%, 3.64% and 21.43%, respectively). Poly Mulching (T<sub>2</sub>) increased agronomic traits, yield traits and yield (0.61 kg) than BARI Misti Morich-1 (T<sub>1</sub>). The combined effect of B<sub>2</sub>T<sub>2</sub> increased the number of branches per plant, effective branches per plant, leaves length and breadth by 40%, 90%, 15.57% and 26.22%, respectively, hence resulting in an increased yield of 20%. BARI Misti Morich-2 cultivar showed an increase in Fe, Zn and Vitamin-C content of 26.24% and 23.10%, 8.82% and 5.14%, and 6.03% and 5.74% than B0 and B1 cultivars, respectively. Therefore, BARI Misti Morich-2 exhibited the improved agronomic, yield and nutritional traits of capsicum under poly mulching among other cultivars in Bangladesh.展开更多
In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughp...In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.展开更多
Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Consid...Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.展开更多
BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortali...BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain high.Several indexes have been proposed in the past few years in order to estimate the survival of patients undergoing gastrectomy.The preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been developed.The aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative intent.AIM To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction adenocarcinoma.METHODS A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI value.The PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic review.The review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic review.The patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual study.The 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included studies,patients with high preoperative PNI showed statistically significant better OS than the low PNI groups.In multivariate analyses,low PNI was repeatedly recognised as an independent prognostic factor for poor survival.CONCLUSION According to the present study,low preoperative PNI seems to be an indicator of poor OS of patients undergoing gastrectomy for gastric or gastroesophageal cancer.展开更多
文摘Acute pancreatitis(AP)is a common gastrointestinal disease and the leading cause of hospital admission and healthcare burden among gastrointestinal disorders in many countries.Patients can present with varying degrees of inflammation and disease severity,ranging from self-limiting mild AP to devastating and fatal severe AP.Many factors contribute to malnutrition in AP,especially abnormal metabolism and catabolism related to inflammation.The concept of“pancreatic rest”is not evidence-based.There is however,emerging evidence that supports the use of oral or enteral nutrition to improve nutrition status and to reduce local and systemic inflammation,complications,and death.In mild disease,patients are generally able to initiate solid oral diet and do not require specialized nutrition care such as enteral or parenteral nutrition.In contrast,nutrition interventions are imperative in moderately severe and severe AP.The current article aims to review the latest evidence and suggest practical nutrition interventions in patients with AP,including nutrition requirements,routes of nutrition treatment,types of formula,and the role of nutritional supplements,such as glutamine,probiotics,omega-3 fatty acids,and antioxidants.
文摘Breast cancer patients face different nutritional problems at each stage. However, the nutrition of breast cancer patients has not been taken seriously. As a result, some patients cannot tolerate treatment due to poor nutrition, thus affecting the prognosis. This study aims to introduce a typical case to explore the whole-course</span><span style="font-family:""> </span><span style="font-family:Verdana;">(started at admission and ended 5 years after surgery)</span><span style="font-family:""> </span><span style="font-family:Verdana;">and Multidisciplinary Teams (MDTs)</span><span style="font-family:""> </span><span style="font-family:Verdana;">(comprising physician, primary nurse, case manager, nutrition liaison and nutrition specialist nurse)</span><span style="font-family:""> </span><span style="font-family:Verdana;">nutritional management mode of breast cancer patients. The patient successfully completed the scheduled treatment by implementing the whole-course and multidisciplinary nutrition management. The mode can prospectively and dynamically estimate the changes </span><span style="font-family:Verdana;">in</span><span style="font-family:Verdana;"> patients’ nutritional status, and provide timely nutritional intervention to promote patient outcomes.
基金Supported by Research Project of Zhejiang Provincial Department of Education,No.Y202045115.
文摘BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.
文摘BACKGROUND Glucose imbalance is common in total parenteral nutrition(TPN).Hypoglycemia seems to be less frequent than hyperglycemia,but it influences the clinical outcome to a greater extent.Therefore,it should be effectively prevented and treated.However,there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury.CASE SUMMARY We present three patients with liver cell injury who developed severe hypo-glycemia during or after TPN infusion.The causes of severe hypoglycemia and glucose-raising strategies were discussed.According to the physiological charac-teristics of the hepatocellular injury,the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases.We simultaneously reduced the dose of insulin and fat emulsion,and increased the dose of glucose in TPN.The blood glucose level was restored to normal range and clinical symptoms were eliminated.CONCLUSION When hypoglycemia occurs during or after TPN in patients with hepatocellular injury,physicians need to simultaneously reduce insulin and fat emulsion,and increase glucose,and correct severe hypoglycemia in time to reduce its adverse consequences.
文摘Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition.
文摘Globally,type 2 diabetes mellitus(T2DM)is one of the most common metabolic disorders.T2DM physiopathology is influenced by complex interrelationships between genetic,metabolic and lifestyle factors(including diet),which differ between populations and geographic regions.In fact,excessive consumptions of high fat/high sugar foods generally increase the risk of developing T2DM,whereas habitual intakes of plant-based healthy diets usually exert a protective effect.Moreover,genomic studies have allowed the characterization of sequence DNA variants across the human genome,some of which may affect gene expression and protein functions relevant for glucose homeostasis.This comprehensive literature review covers the impact of gene-diet interactions on T2DM susceptibility and disease progression,some of which have demonstrated a value as biomarkers of personal responses to certain nutritional interventions.Also,novel genotype-based dietary strategies have been developed for improving T2DM control in comparison to general lifestyle recommendations.Furthermore,progresses in other omics areas(epigenomics,metagenomics,proteomics,and metabolomics)are improving current understanding of genetic insights in T2DM clinical outcomes.Although more investigation is still needed,the analysis of the genetic make-up may help to decipher new paradigms in the pathophysiology of T2DM as well as offer further opportunities to personalize the screening,prevention,diagnosis,management,and prognosis of T2DM through precision nutrition.
基金supported by the Agriculture and Food Research Initiative Competitive Grants(No.2015-67015-23219 and 2016-68006-24634)from the USDA National Institute of Food and Agriculture.
文摘Over the past few decades,genetic selection and refined nutritional management have extensively been used to increase the growth rate and lean meat production of livestock.However,the rapid growth rates of modern breeds are often accompanied by a reduction in intramuscular fat deposition and increased occurrences of muscle abnor‑malities,impairing meat quality and processing functionality.Early stages of animal development set the long‑term growth trajectory of offspring.However,due to the seasonal reproductive cycles of ruminant livestock,gestational nutrient deficiencies caused by seasonal variations,frequent droughts,and unfavorable geological locations nega‑tively affect fetal development and their subsequent production efficiency and meat quality.Therefore,enrolling live‑stock in nutritional intervention strategies during gestation is effective for improving the body composition and meat quality of the offspring at harvest.These crucial early developmental stages include embryonic,fetal,and postnatal stages,which have stage‑specific effects on subsequent offspring development,body composition,and meat quality.This review summarizes contemporary research in the embryonic,fetal,and neonatal development,and the impacts of maternal nutrition on the early development and programming effects on the long‑term growth performance of livestock.Understanding the developmental and metabolic characteristics of skeletal muscle,adipose,and fibrotic tissues will facilitate the development of stage‑specific nutritional management strategies to optimize production efficiency and meat quality.
文摘This study determined the nutritional status of households in North western region of Cameroon using weighed food intake. Twenty–two rural and 106 urban households were randomly selected for weighed food intake Descriptive and inferential statistics were used to analyze collected data and significance at p < 0.05 accepted. Corn fufu with huckleberry was the most frequently consumed meal with little or no animal-source protein. Protein and B group vitamins intake of respondents in both communities were below the FAO/WHO recommended values while energy, iron, and vitamins A and C were in excess for most age groups. Adolescents 10 - 19 years and adults 20 years and above failed to meet at least 85% of RNI for calcium.
文摘The call for agri-food system transformation is urgent in many global development agendas(UN 2023).Food systems have contributed to economic prosperity and feeding the world,but they are also associated with numerous challenges,including climate change,continued hunger,poor diets and malnutrition,and increasing disparities(Webb et al.2020;Fanzo et al.2021).
文摘The Nutri-Score is a 5-color front-of-pack nutrition label designed to provide consumers with an easily understandable guideline to the healthiness of food products.The impact that the Nutri-Score may have on consumers'choices is unclear since different experimental paradigms have found vastly different effect sizes.In the present study,we have investigated how student participants change a hypothetical personal 1-daydietary plan after a learning phase during which they learn about the Nutri-Scores of the available food items.Participants were instructed to compose a healthy diet plan in order that the question of whether the NutriScore would improve their ability to compose a healthy dietary plan could be investigated,independent of the question of whether they would apply this knowledge in their ordinary lives.We found a substantial(Cohen's d=0.86)positive impact on nutritional quality(as measured by the Nutrient Profiling System score of the Food Standards Agency)and a medium-sized(Cohen's d=0.43)reduction of energy content.Energy content reduction was larger for participants who had initially composed plans with higher energy content.The results suggest that the Nutri-Score has the potential to guide consumers to healthier food choices.It remains unclear,however,whether this potential will be reflected in real-life dietary choices.
基金Supported by The Self-Funded Research Project of the Health Commission of Guangxi Zhuang Autonomous Region,No.Z-A20230045.
文摘BACKGROUND The nutritional status is closely related to the prognosis of liver transplant re-cipients,but few studies have reported the role of preoperative objective nutri-tional indices in predicting liver transplant outcomes.AIM To compare the predictive value of various preoperative objective nutritional indicators for determining 30-d mortality and complications following liver transplantation(LT).METHODS A retrospective analysis was conducted on 162 recipients who underwent LT at our institution from December 2019 to June 2022.RESULTS This study identified several independent risk factors associated with 30-d mor-tality,including blood loss,the prognostic nutritional index(PNI),the nutritional risk index(NRI),and the control nutritional status.The 30-d mortality rate was 8.6%.Blood loss,the NRI,and the PNI were found to be independent risk factors for the occurrence of severe postoperative complications.The NRI achieved the highest prediction values for 30-d mortality[area under the curve(AUC)=0.861,P<0.001]and severe complications(AUC=0.643,P=0.011).Compared to those in the high NRI group,the low patients in the NRI group had lower preoperative body mass index and prealbumin and albumin levels,as well as higher alanine aminotransferase and total bilirubin levels,Model for End-stage Liver Disease scores and prothrombin time(P<0.05).Furthermore,the group with a low NRI exhibited significantly greater incidences of intraabdominal bleeding,primary graft nonfunction,and mortality.CONCLUSION The NRI has good predictive value for 30-d mortality and severe complications following LT.The NRI could be an effective tool for transplant surgeons to evaluate perioperative nutritional risk and develop relevant nutritional therapy.
基金This work was supported by the National Natural Science Foundation of China(71861147003 and 71925009).
文摘This paper examines the nutrition impacts of using non-solid cooking fuel on under-five children in developing countries.We draw on data from more than 1.12 million children in 62 developing countries from the Demographic and Health Surveys(DHS).Results from both fixed effects(FE)and instrumental variable(IV)estimates show that using non-solid cooking fuel significantly improves the nutrition outcomes of under-five children.Compared with their peers from households mainly using solid fuel,children from households mainly using non-solid fuel exhibit a lower probability of experiencing stunting(by 5.9 percentage points)and being underweight(by 1.2 percentage points).Our further investigation provides evidence for several underlying mechanisms,such as improved indoor air quality,induced reduction in children’s respiratory symptoms,benefits on maternal health,and reduction in maternal time spent on fuel collection or cooking.Heterogenous analyses suggest that the nutrition benefits of using non-solid cooking fuel are more prominent among boys,children above three years old,and those from households of lower socioeconomic status,rural areas,and Southeast Asia.
基金supported by research grants from Regionalt Forskningsfond (RFF) Trondelag (In FeedProject number: 309859),where Nord University is the project leading institution,and Gullimunn AS and Mære Landbruksskole are project partnerssupported by the CEER project (Project number: 2021/10345) funded by the Norwegian Agency for International Cooperation and Quality Enhancement in Higher Education (HK-dir) under the Norwegian Partnership Program for Global Academic Cooperation (NORPART ) with support from the Norwegian Ministry of Education and Research (MER)。
文摘Yellow mealworm larvae(YML;Tenebrio molitor) are considered as a valuable insect species for animal feed due to their high nutritional values and ability to grow under different substrates and rearing conditions. Advances in the understanding of entomophagy and animal nutrition over the past decades have propelled research areas toward testing multiple aspects of YML to exploit them better as animal feed sources. This review aims to summarize various approaches that could be exploited to maximize the nutritional values of YML as an animal feed ingredient. In addition, YML has the potential to be used as an antimicrobial or bioactive agent to improve animal health and immune function in production animals. The dynamics of the nutritional profile of YML can be influenced by multiple factors and should be taken into account when attempting to optimize the nutrient contents of YML as an animal feed ingredient. Specifically, the use of novel land-based and aquatic feeding resources, probiotics, and the exploitation of larval gut microbiomes as novel strategies can assist to maximize the nutritional potential of YML. Selection of relevant feed supplies, optimization of ambient conditions, the introduction of novel genetic selection procedures, and implementation of effective post-harvest processing may be required in the future to commercialize mealworm production. Furthermore, the use of appropriate agricultural practices and technological improvements within the mealworm production sector should be aimed at achieving both economic and environmental sustainability. The issues highlighted in this review could pave the way for future approaches to improve the nutritional value of YML.
文摘Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.
基金The authors are grateful for support from the National Social Science Fund of China(21AJL015).
文摘The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycles,little is known about the impact of Rural Dibao on child nutrition outcomes.Using China Family Panel Studies(CFPS),this paper examines the effects of Rural Dibao on child nutrition outcomes and investigates potential pathways and heterogeneous effects.We exploit propensity score matching and difference-in-differences techniques to evaluate the effects of the Rural Dibao program on child nutrition outcomes.Our results suggest that Rural Dibao significantly impacts the nutrition outcomes of children up to 15 years of age.Specifically,our results suggest that Rural Dibao improves child height-to-age z-scores by 1.05 standard deviations and lowers the probability of stunting by 11.9 percentage points.Additional analyses suggest that increased protein intake is the main pathway through which Rural Dibao participation contributes to better nutrition outcomes.We also find that the effect of the program is more pronounced among girls,children who are non-left-behind or live with highly educated mothers,and those from low-income families and poor areas.Our findings suggest that Rural Dibao participation helps improve child nutrition outcomes through improving diet quality.
文摘This comprehensive review explores the intricate relationship between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the context of the gut-brain axis.The gut-brain axis plays a pivotal role in neurodegenerative diseases like Parkinson's disease,encompassing diverse components such as the gut microbiota,immune system,metabolism,and neural pathways.The gut microbiome,profoundly influenced by dietary factors,emerges as a key player.Nutrition during the first 1000 days of life shapes the gut microbiota composition,influencing immune responses and impacting both child development and adult health.High-fat,high-sugar diets can disrupt this delicate balance,contributing to inflammation and immune dysfunction.Exploring nutritional strategies,the Mediterranean diet's anti-inflammatory and antioxidant properties show promise in reducing Parkinson's disease risk.Microbiome-targeted dietary approaches and the ketogenic diet hold the potential in improving brain disorders.Beyond nutrition,emerging research uncovers potential interactions between steroid hormones,nutrition,and Parkinson's disease.Progesterone,with its anti-inflammatory properties and presence in the nervous system,offers a novel option for Parkinson's disease therapy.Its ability to enhance neuroprotection within the enteric nervous system presents exciting prospects.The review addresses the hypothesis thatα-synuclein aggregates originate from the gut and may enter the brain via the vagus nerve.Gastrointestinal symptoms preceding motor symptoms support this hypothesis.Dysfunctional gut-brain signaling during gut dysbiosis contributes to inflammation and neurotransmitter imbalances,emphasizing the potential of microbiota-based interventions.In summary,this review uncovers the complex web of interactions between nutrition,the gut microbiome,steroid hormones,and Parkinson's disease within the gut-brain axis framework.Understanding these connections not only offers novel therapeutic insights but also illuminates the origins of neurodegenerative diseases such as Parkinson's disease.
文摘Capsicum is a nutritious vegetable and its cultivation in farms is getting popular in Bangladesh. Although many efforts have lain to explore better yielding and nutritionally rich cultivars with suitable modern cultivation techniques but still have to find the desired outcome. Thus, it’s necessary to conduct further research to identify the high-yielding and nutritious capsicum cultivars in Bangladesh. An experiment was conducted from July 2021 to June 2022 at the Bangladesh Institute of Research and Training on Applied Nutrition (BIRTAN) research field with three cultivars of capsicum: B<sub>0</sub> = California Wonder, B<sub>1</sub> = BARI Misti Morich-1 and B<sub>2</sub> = BARI Misti Morich-2 and three mulching: T<sub>0</sub> = No mulching, T<sub>1</sub> = Water hyacinth, T<sub>2</sub> = Poly Mulching in randomized complete block design with three replications to identify better quality capsicum cultivar and suitable mulching material. Among cultivars the BARI Misti Morich-2 (B<sub>2</sub>) showed increased agronomic parameters like number of branches and effective branches per plant, leaves length and width, consequently yield and yield contributing traits were also enhanced like fruits per plant, fruit length, fruit diameter and yield per plant (25.97%, 4.54%, 3.64% and 21.43%, respectively). Poly Mulching (T<sub>2</sub>) increased agronomic traits, yield traits and yield (0.61 kg) than BARI Misti Morich-1 (T<sub>1</sub>). The combined effect of B<sub>2</sub>T<sub>2</sub> increased the number of branches per plant, effective branches per plant, leaves length and breadth by 40%, 90%, 15.57% and 26.22%, respectively, hence resulting in an increased yield of 20%. BARI Misti Morich-2 cultivar showed an increase in Fe, Zn and Vitamin-C content of 26.24% and 23.10%, 8.82% and 5.14%, and 6.03% and 5.74% than B0 and B1 cultivars, respectively. Therefore, BARI Misti Morich-2 exhibited the improved agronomic, yield and nutritional traits of capsicum under poly mulching among other cultivars in Bangladesh.
基金supported by the Shenzhen Science and Technology Program under Grants KCXST20221021111404010,JSGG20220831103400002,JSGGKQTD20221101115655027,JCYJ 20210324094609027the National KeyR&DProgram of China under Grant 2021YFB2700900+1 种基金the National Natural Science Foundation of China under Grants 62371239,62376074,72301083the Jiangsu Specially-Appointed Professor Program 2021.
文摘In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA.
文摘Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.
文摘BACKGROUND Gastric cancer is the third most common cause of cancer related death worldwide.Surgery with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain high.Several indexes have been proposed in the past few years in order to estimate the survival of patients undergoing gastrectomy.The preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been developed.The aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative intent.AIM To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction adenocarcinoma.METHODS A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI value.The PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic review.The review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic review.The patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual study.The 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included studies,patients with high preoperative PNI showed statistically significant better OS than the low PNI groups.In multivariate analyses,low PNI was repeatedly recognised as an independent prognostic factor for poor survival.CONCLUSION According to the present study,low preoperative PNI seems to be an indicator of poor OS of patients undergoing gastrectomy for gastric or gastroesophageal cancer.
