Nutritional Index Research Articles

Fatty acid composition of two small fish in the Gyda River (Kara Sea Basin, Northwestern Siberia, Russia)

The fatty acid composition of the flesh of rainbow smelt (RS, Osmerus mordax) and ruffe (RF, Gymnocephalus cernuus), two small fish species inhabiting the Gyda River (Siberia, Russia), was assayed using a gas-liquid chromatographic method with an ionization detection system and high efficiency capillary columns. RS was found to be richer in the total fatty acid content than RF (21.5 vs. 7.07 mg g–1). The proportion of saturated fatty acids (SFA) was similar in the fish studied (29.2 % in RS and 29.6 % in RF) whereas the flesh of RS contained a higher proportion of monounsaturated fatty acids, MUFA (42.2 vs. 13.9 %), and a lower proportion of polyunsaturated fatty acids, PUFA (28.6 vs. 56.5 %) than RF. RS is rich in essential n-3 PUFAs (2610 and 2390 μg g–1 for docosahexaenoic and eicosapentaenoic acids, respectively). In RF, the atherogenic index (0.39) and thrombogenic (0.20) index were lower than in RS (0.59 and 0.27, respectively). The fatty acid profile of RS in the study area differed from that reported for the flesh of this species from a Canadian estuary probably due to substantial differences in the diet of RS in these habitats. A comparison among fish species from the Gyda River indicated that in terms of nutrition indices, RS has the highest similarity with the muksun Coregonus muksun while RF is closely related to the northern pike Esox lucius. Based on the results from this study, both RF and RS can be recommended for human consumption. In particular, RS may be used as a replacement for muksun, an overfished species, in the traditional diet of indigenous peoples in northwestern Siberia.

Conventional and machine-learning based risk score for patients with early-stage hepatocellular carcinoma.

The performance of machine-learning (ML) in predicting the outcomes of patients with hepatocellular carcinoma (HCC) remains uncertain. We aimed to develop risk scores using conventional methods and ML to categorize early-stage HCC patients into distinct prognostic groups. The study retrospectively enrolled 1411 consecutive treatment-naïve patients with the Barcelona Clinic Liver Cancer (BCLC) stage 0 to A HCC from 2012 to 2021. The patients were randomly divided into a training cohort (n=988) and validation cohort (n=423). Two risk scores (CATS-IF and CATS-INF) were developed to predict overall survival (OS) in the training cohort using the conventional methods (Cox proportional hazards model) and ML-based methods (LASSO Cox regression), respectively. They were then validated and compared in the validation cohort. In the training cohort, factors for the CATS-IF score were selected by the conventional method, including age, curative treatment, single large HCC, serum creatinine and alpha-fetoprotein levels, fibrosis-4 score, lymphocyte-to-monocyte ratio, and albumin bilirubin grade. The CATS-INF score, determined by ML-based methods, included the above factors and two additional ones (aspartate aminotransferase and prognostic nutritional index). In the validation cohort, both CATS-IF score and CATS-INF score outperformed other modern prognostic scores in predicting OS, with the CATS-INF score having the lowest Akaike information criterion value. A calibration plot exhibited good correlation between predicted and observed outcomes for both scores. Both the conventional Cox-based CATS-IF score and ML-based CATS-INF score effectively stratified patients with early-stage HCC into distinct prognostic groups, with the CATS-INF score showing slightly superior performance.

Ultra‐Processed Food, Depletion, and Social Reproduction: A Conceptual Intervention

AbstractWhat we eat and how we think about food and nutrition are undergoing a momentous change, driven by the rise of ultra‐processed food. There is a growing body of evidence linking the consumption of ultra‐processed food to poor health outcomes. However, the health depleting effects of ultra‐processed food go beyond changes in discrete indicators of nutrition and health. Processes of depletion entail social, economic, and political relations. This paper aims to emphasise the importance of a social science research agenda on ultra‐processed food by establishing the conceptual connections between ultra‐processed food and depletion using a social reproduction approach. To do this, it draws on the notion of depletion through social reproduction elaborated by Shirin Rai, Catherine Hoskyns and Dania Thomas, which provided inspiration to unpack the totality of social reproduction and consider specific resources needed for social reproduction. Such an approach reveals that ultra‐processed food is both an input for social reproduction, through consumption, and a form of social reproduction work, when food work and the associated (health) care work are considered. On this basis, the paper identifies four conceptual dimensions to explore whether and to what extent the expansion of ultra‐processed food can cause depletion and the key methodological principles to use this conceptual approach in empirical research.

Effect of Sequential Early Enteral Nutrition on Postoperative Rehabilitation and Complications in Gastric Cancer Patients

Objective: To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery. Methods: A total of 139 gastric cancer patients, treated between October 2021 and October 2023, were randomly selected and divided into two groups: Group A (68 cases, receiving early enteral nutrition) and Group B (71 cases, receiving sequential early enteral nutrition), using computer randomization. The effects of the interventions on both groups were compared. Results: Seven days post-operation, the levels of nutritional indicators in Group B were significantly higher than those in Group A (P < 0.05). Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation (P < 0.05). The postoperative complication rate in Group B was 4.23%, significantly lower than that in Group A, which was 16.18% (χ2 = 5.477, P = 0.019). Conclusion: The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers, along with enhanced immunity, effectively reducing postoperative complications.

Analysis of the influence of educational level on the nutritional status and lifestyle habits of the young Spanish population.

This study aims to analyze some nutrition and health habits of young people and the impact of educational attainment on health. An observational, descriptive, and cross-sectional study was carried out using surveys. Using non-probabilistic snowball sampling, a previously validated questionnaire was disseminated through networks, collecting a sample of 9,681 people between 18 and 30 years old. Comparative analyses between groups were obtained by clustering and the corresponding statistical tests. The results showed how young people with higher education generally have a lower BMI, a higher healthy nutrition index, less frequent consumption of sugary drinks, and less smoking than their peers with basic education. These healthier habits are reflected in the higher self-perceived health status of the higher-educated group. While for all the educational levels analyzed, the minutes of physical activity practice are above the 150 min recommended by the WHO. Our findings suggest that young people's education level is of fundamental importance for health, particularly for nutritional habits. In general, the lifestyle habits of the young Spanish population are healthy, but there is a need for improvement in those aspects related to nutrition and food.

Gram-Negative Bloodstream Infections in Healthcare: The Relationship Between Antibiotic Resistance, Mortality, and Novel Serological Biomarker.

Bloodstream infections caused by Gram-negative bacteria are highly mortal. In this study, we aimed to investigate the relationship between antimicrobial resistance profile and novel serologicalbiomarkers and mortality in bloodstream infections (BSIs) caused by Gram-negative bacteria in intensive care units (ICUs). 366 Patients diagnosed with healthcare-associated Gram-negative bloodstream infectionin the ICUs of our hospital between February 2015 and December 2021 were included in the study. Demographic variables (age, gender, comorbidities), causative microorganisms and antimicrobial susceptibilities, time to first positive blood culture after hospitalization, length of stay in hospital, surgical procedures, laboratory data (hemograms, C-reactive protein (CRP) levels, albumin), and survival data were collected.Novel serological biomarkers were calculated. Mortality in Gram-negative bloodstream infection was found to be associated with age and novel serological biomarkers, but not with carbapenems and colistin minimum inhibitory concentration (MIC) values. Mortality rates increased with age (p˂0.001). Patients who died had higher C-reactive protein/albumin ratio (CAR) (p<0.001) and neutrophil/lymphocyte ratio (NLR) (p=0.009) and lower prognostic nutritional index (PNI) (p<0.001). The study emphasizes that resistance to colistin and carbapenems is not associated with mortality in BSIs caused by Gram-negative bacteria. Novel serological biomarkers may be useful in predicting mortality. These results support the need for further studies to elucidate the true impact of infections caused by resistant bacteria.

The impact of preoperative nutritional status on postoperative outcomes: an insight from Geriatric Nutritional Risk Index in elderly pancreaticoduodenectomy patients

BackgroundMalnutrition is not uncommon among the elderly undergoing pancreatoduodenectomy (PD) and is related to increased complications. Previous studies have shown that the Geriatric Nutritional Risk Index (GNRI) predicts outcomes in various populations. Nevertheless, the research exploring the correlation between GNRI and postoperative outcomes in PD is scarce. This study aimed to investigate the preoperative malnutrition, as measured by GNRI, on outcomes in elderly patients undergoing PD.Materials and MethodsThis retrospective analysis enrolled 144 elderly patients underwent PD for periampullary tumors from November 2016 to December 2021. Patients were stratified based on the GNRI value: high/moderate nutrition risk (GNRI ≤ 92, N = 54), low nutrition risk (92 < GNRI ≤ 98, N = 35), and no nutrition risk (GNRI > 98, N = 55). Perioperative outcomes and postoperative surgical complications were compared between these groups. Univariate and multivariate analyses were performed on major postoperative complications and prolonged postoperative length of stay (PLOS).ResultsPatients in the high/moderate risk group were significantly older, with lower BMI (P = 0.012), higher mortality rate (11.1%, P = 0.024), longer PLOS (P < 0.001), and higher incidence of over grade IIIB complications (37.0%, P = 0.001), Univariate and multivariate analyses showed the high/moderate risk GNRI group (OR 3.61, P = 0.032), increased age (OR 1.11, P = 0.014) and operative time over 8 h (OR 3.04, P = 0.027) were significantly associated with increased major postoperative complications. The high/moderate risk GNRI group was also a significant predictor for prolonged PLOS (OR 3.91, P = 0.002).ConclusionsPreoperative GNRI has the potential to be a predictive tool for identifying high-risk elderly patients and monitoring nutritional status preoperatively to improve postoperative surgical outcomes following PD.

Construction of artificial neural network (ANN) based on predictive value of prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) in patients with cervical squamous cell carcinoma.

To explore the analytical worth of prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR) in patients with cervical squamous cell carcinoma. The clinical data of 539 patients with cervical cancer in the Affiliated Tumor Hospital of Nantong University from December 2007 to October 2016 were analyzed retrospectively. The ROC is used to select the best cutoff values of PNI and NLR, which are 48.95 and 2.4046. Cox regression analysis was used for univariate and multivariate analysis. Survival differences were assessed by Kaplan-Meier (KM) survival method. Finally, a 3-layer artificial neural network (ANN) model is established. In cervical squamous cell carcinoma, the KM survival curve showed that the overall survival (OS) rate of high-level PNI group was significantly higher than that of low-level PNI group (P < .001), while the OS rate of low-level NLR group was significantly higher than that of high-level NLR group (P = .002). In non-squamous cell carcinoma, there was no significant difference in OS between the 2 groups (P > .005). According to Cox multivariate analysis, preliminary diagnosed PNI and NLR were independent prognostic factors of cervical squamous cell carcinoma (P < .001, P = .008), and pathological type and International Federation of Gynecology and Obstetrics (FIGO) stage also had a certain impact on tumor progression (P = .042, P = .048). The increase of PNI and the decrease of NLR will help patients with cervical squamous cell carcinoma live longer. ANN showed that PNI and NLR were of great importance in predicting survival. Preoperative PNI and NLR are independent predictors of cervical squamous cell carcinoma patients related to clinicopathological features, and have particular value in judging prognosis.

Determining if the prognostic nutritional index can predict outcomes in community acquired bacterial pneumonia

BackgroundThe Prognostic Nutritional Index (PNI) uses albumin levels and total lymphocyte count to predict the relationship between immune-nutritional state and prognosis in a variety of diseases, however it has not been studied in community acquired bacterial pneumonia (CABP). We conducted a historical cohort study to determine if there was an association between PNI and clinical outcomes in patients with CABP. MethodsWe reviewed 204 adult patients with confirmed CABP, and calculated admission PNI and Neutrophil-to-Lymphocyte Ratio (NLR). A comparative analysis was performed to determine the association of these values, as well as other risk factors, with the primary outcomes of 30-day readmissions and death. ResultsOf the 204 patients, 56.9% (116) were male, 48% (98) were black/African American and the mean age was 63.2 ± 16.1 years. The NLR was neither associated with death nor 30-day readmission. The mean PNI in those who survived was 34.7 ± 4.5, compared to 30.1 ± 6.5, in those who died, p < 0.001. From multivariable analysis after controlling for the Charlson score and age, every one-unit increase in the PNI decreased the risk of death by 13.6%. The PNI was not associated with readmissions. ConclusionsThese findings suggest that poor immune and nutritional states, as reflected by PNI, both contribute to mortality, with a significant negative correlation between PNI and death in CABP. PNI was predictive of mortality in this patient cohort; NLR was not. Monitoring of albumin and lymphocyte count in CABP can provide a means for prevention and early intervention.

Burden of undernutrition among under-five Bengali children and its determinants: Findings from Demographic and Health Surveys of Bangladesh and India.

Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals.

GLIM criteria for definition of malnutrition in peritoneal dialysis: a new aspect of nutritional assessment

Background: The aim of our study was to evaluate the effectiveness of Global Leadership Initiative on Malnutrition (GLIM) criteria in assessing malnutrition within the peritoneal dialysis (PD) population.Methods: We conducted a retrospective analysis involving 1057 PD patients across multiple institutions, characterized by an age of 56.1 ± 14.4 years, 464 (43.9%) female, and a median follow-up of 45 (25, 68) months. Malnutrition was diagnosed according to GLIM criteria. The endpoint event was overall mortality. The survival rate and hazard ratio (HR) of death between malnutrition and well-nourished were analyzed in all patients and various subgroups. Receiver operator characteristic curve and integrated discrimination improvement (IDI) were used to distinguish the efficacy of the nutritional tools prediction model.Results: According to the GLIM criteria, the prevalence of malnutrition among the study population was 34.9%. The adjusted HR of overall mortality was 2.91 (2.39 − 3.54, p < 0.001) for malnutrition versus well-nourished. In sensitivity analyses, the HR remained robust except the cardiovascular disease subgroup. The area under the curve of GLIM predicting 5-year mortality was 0.65 (0.62–0.68, p < 0.001). As a complex model for forecast the long-term mortality, the performance of adjusted factors combined with GLIM was poorer than combined malnutrition inflammation score (MIS) (IDI >0, p < 0.001), but fitter than combined geriatric nutritional risk index (GNRI) (IDI <0, p < 0.001).Conclusions: The GLIM criteria provide a viable tool for nutritional assessment in patients with PD, and malnutrition defined according to the GLIM can predict prognosis with an acceptable performance.

Association between Socioecological Status, Nutrient Intake, and Cancer Screening Behaviors in Adults Aged 40 and Over: Insights from the Eighth Korea National Health and Nutrition Examination Survey (KNHANES, 2019).

Cancer screening is pivotal for early detection and improved survival rates. While socio-ecological factors are known to influence screening uptake, the role of lifestyle, dietary habits, and general health in shaping these decisions remains underexplored. Utilizing the 2019 Korea National Health and Nutrition Examination Survey (KNHANES), this study examined the myriad of factors impacting cancer screening utilization. Data from 274,872 adults aged 40 years or older were scrutinized, highlighting demographics, income, lifestyle behaviors, health-related variables, nutrient intake, and dietary quality. A combination of descriptive statistics and logistic regression helped us ascertain influential determinants. Higher educational attainment and income quartiles were positively correlated with cancer screening rates. Regular walkers, those engaged in moderate physical activity, and individuals with a previous cancer diagnosis were more likely to get screened. High-risk drinkers and smokers were less inclined towards screening. Dietary habits also influenced screening decisions. Notably, participants with healthier eating behaviors, indicated by factors such as regular breakfasts and fewer meals out, were more likely to undergo screening. Additionally, nutrient intake analysis revealed that those who had undergone screening consumed greater quantities of most nutrients, bar a few exceptions. For individuals aged 50-64, nutritional assessment indicators highlighted a higher mean adequacy ratio (MAR) and index of nutritional quality (INQ) value among those who participated in screening, suggesting better nutritional quality. This study elucidates the complex socio-ecological and nutritional landscape influencing cancer screening decisions. The results underscore the importance of a holistic approach, emphasizing lifestyle, dietary habits, and socio-economic considerations. It provides a roadmap for policymakers to craft more inclusive screening programs, ensuring equal access and promoting early detection.

Modeling the effect of fertilizers on cotton yields and cotton fiber quality on saline soils in so uthern Kazakhstan

Yntymak st.,26, Kazakhstan Cotton in Kazakhstan is one of the strategically important crops and is cultivated in the extreme south of the republic in the Turkestan region, in the northernmost cotton-growing zone on the globe. The aridity of the climate, the shortage of irrigation water and the growing threat of the risk of increasing saline lands in cotton plantations, on the one hand, and the insufficient and unjustified use of minerals, on the other, are the main limiting factors in cotton production. On the industrial plantations of the peasant farm "Sabyr", v. Atakent, Maktaaral district, Turkestan region, field experiments were carried out on serozems of slightly and moderately salinity in 2022. In experiments on two salinity backgrounds, 9 identical treatments of fertilizers with different doses and ratios of nitrogen, phosphorus and potassium were studied. During the phases of budding, flowering and fruit formation of cotton, biometric studies and selection of plant samples were carried out to study photosynthetic and yield indicators depending on fertilizers on 2 salinity backgrounds. The effect and interaction of fertilizers and the amount of salts in the soil on the formation of leaves in various phases of cotton development isquite accurately described (R2 = 0,957-0,972) by regression equations. At the same time, the effect of single action of nitrogen and potassium fertilizers was negative, and that of phosphorus fertilizers was positive. During the growing season, double combinations of all the studied factors, with the exception of nitrogen and potassium, had a negative effect on the dynamics of accumulation of cotton plant biomass. The gross cotton yield is 86% determined by the complex total influence of nitrogen, phosphorus and potassium fertilizers and the degree of soil salinity. At the same time, the unilateral effect of nitrogen and potassium fertilizers and soil salinity on cotton yield was negative, and that of phosphorus fertilizer was positive. There is a high correlation between potassium nutrition and fiber quality indicators (r = 0,38-0,62). Changes in fiber quality indicators generally had a strong relationship with the amount of salts in the topsoil (r = 0,51-0,61).

Relationship between prognostic nutritional index and post-stroke cognitive impairment

ABSTRACT Background The Prognostic Nutritional Index (PNI) has been described as a useful screening tool for patient prognosis in several diseases. As a potential diagnostic index, it has attracted the interest of many physicians. However, the correlation between the PNI and post-stroke cognitive impairment (PSCI) remains unclear. Methods A total of 285 patients with acute ischemic stroke were included. PNI was assessed as serum albumin (g/L) + 5× lymphocyte count (109/L) and was dichotomized according to the prespecified cut-off points 48.43 for the high and low groups. PSCI was defined as Mini-Mental State Examination (MMSE) < 27 at the 6–10 months follow-up. Multiple logistic regression and linear regression analyses were performed to examine the association between PNI and cognitive outcomes. Results A low PNI was independently associated with PSCI after adjusting for age, sex, education, National Institutes of Health Stroke Scale (NIHSS), deep white matter hyperintensity (DWMH), and stroke history (odds ratio [OR]: 2.158; 95% confidence interval [CI]: 1.205–3.863). The PNI scores were significantly associated with MMSE and attention domain (β = 0.113, p = 0.006; β = 0.109, p = 0.041, respectively). The PNI improved the model’s discrimination when added to the model with other clinical risk factors. Conclusions A low PNI was independently associated with the occurrence of PSCI and the PNI scores were specifically associated with the scores of global cognition and attention domain. It can be a promising and straightforward screening indicator to identify the person with impaired immune-nutritional status at higher risk of PSCI.

Indices of Nutrition Status of Kidney and Pancreas Transplant Candidates

Nutritional assessment is used to implement early nutritional interventions and reduce complications associated with malnutrition, which plays a crucial role in improving postoperative outcomes for patients undergoing pancreas and/or kidney transplantation. ObjectiveThe aim of this study was to analyze the nutritional status (NS) in patients eligible for kidney transplantation (KTx) and simultaneous kidney-pancreas transplantation (SPKTx). MethodsWe analyzed the database of hospitalized patients from 2020 to 2023 to identify preoperative parameters of NS in patients eligible for KTx and SPKTx. A total of 59 patients participated in the study, all of whom were candidates for KTx-23 or SPKTx-36. The study population consisted of 35 women (W) and 24 men (M), with an overall mean age of 44.8 ± 10.2 years (43.5 ± 10.2 years for W and 46.2 ± 10.9 years for M). Both groups included patients on hemodialysis (n = 34) and peritoneal dialysis (n = 12), and patients in the predialysis period (pre-emptive, n = 13). The examined parameters included Onodera's prognostic nutritional index (PNIO), the nutritional risk index (NRI), proper body mass calculated using the Lorenz formula, and the neutrophil-to-lymphocyte ratio (NLR). All patients were assessed according to the NRS 2002 scale. ResultsAnalysis of the obtained results revealed that the NLR was only one differentiating parameter between Ktx and SPKtx group. Multivariate analysis adjusted for patients’ age and gender, comparing quantitative NS indicators was performed. Albumin serum concentration was not dependent on patients’ group (KTx/SPKTx) neither age nor gender P = .382. BMI was dependent on patients’ age and gender, but not a group (KTx/SPKTx) P = .008. PNIO, NRI, and NRL were not dependent on patients’ group (KTx/SPKTx) neither age nor gender. ConclusionsAdditional effort should be devoted to the development of a proper nutrition plan for SPKTx a especially in peritoneal dialysis patients. Toward patients on the waiting list, the regular assessment of nutritional status should be performed which is not a rule in dialysis centers. SPKTx candidates in the perioperative period should receive proper nutrition taking into account their caloric and protein needs.

Letter to the Editor on "Association between nutritional indices and mortality after hip fracture: a systematic review and meta-analysis".

Letter to the Editor on "Association between nutritional indices and mortality after hip fracture: a systematic review and meta-analysis".

Value of nutritional indices in predicting survival free from pump replacement and driveline infections in centrifugal left ventricular assist devices

ObjectiveThere is a paucity of data assessing the impact of nutritional status on outcomes in patients supported with the HeartMate 3 (HM3) left ventricular assist device (LVAD). MethodsPatients ≥18 years of age who underwent HM3 LVAD implantation between 2015 and 2020 were identified from a single tertiary care center. The primary outcome assessed was death or device replacement. A secondary outcome of driveline infection was also evaluated. Kaplan-Meier survival analysis and a multivariate Cox-proportional hazards model were used to identify predictors of outcome. ResultsOf the 289 patients identified, 94 (33%) experienced a primary outcome and 96 (33%) a secondary outcome during a median follow-up time of 2.3 years. Independent predictors of the primary outcome included peripheral vascular disease (hazard ratio [HR], 3.40; 95% confidence interval [CI], 1.66-6.97, P < .01), diabetes mellitus (HR, 0.46; 95% CI, 0.27-0.80, P < .01), body mass index ≥40 kg/m2 (HR, 2.63 per 1 kg/m2 increase; 95% CI, 1.22-5.70, P < .05), preoperative creatinine level (HR, 1.86 per 1 mg/dL increase; 95% CI, 1.31-2.65, P < .01), and preoperative prognostic nutritional index (PNI) score (HR, 0.88 per 1-point increase; 95% CI, 0.81-0.96, P < .01). Independent predictors of driveline infection included age at the time of implantation (HR, 0.97; 95% CI, 0.96-0.99, P < .01) and diabetes mellitus (HR, 1.79; 95% CI, 1.17-2.73, P < .01). ConclusionsPreoperative PNI scores may independently predict mortality and the need for device replacement in patients with HM3 LVAD. Routine use of the PNI score during preoperative evaluation and, when possible, supplementation to PNI >33, may be of value in this population.

Status of Child Nutrition in India: A Comparative Study of Assam and West Bengal

Undernutrition represents a distressing health issue among children in developing countries. It has been recognized as a significant factor contributing to child mortality worldwide, with approximately half of child deaths attributed to it. Despite India initiating the largest number of anti-malnutrition programs and boasting one of the fastest-growing economies globally, the situation regarding child malnutrition remains dire compared to other developing nations. Thus, utilizing data from the National Family Health Survey (NFHS) fifth and fourth rounds, this study aims to evaluate the nutritional status of children under 5 in Assam and West Bengal. The findings of the study reveal that West Bengal slightly outperforms Assam across all nutritional indicators. The prevalence rates of stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age) are higher in both states, with noticeable increases over time as evidenced by various NFHS rounds. Furthermore, significant regional disparities exist within both states. While Assam exhibits significant results for wasting and underweight, West Bengal only displays significance for underweight. Despite robust economic growth in both states, they lag behind the Indian average concerning child nutrition.

IJCM_21A: How do under-five children belonging to scheduled tribes compare with the non- tribal children: a secondary data analysis using the Comprehensive National Nutritional Survey (CNNS) 2016-18.

Background: Scheduled tribes (ST) constitute 8.6% of India’s population. Disproportionate burden of undernutrition is found among these socially disadvantaged population. objectives: To compare the nutritional status of under-5 ST children with children belonging to other castes (non-tribal) using data from Comprehensive National Nutritional Survey (CNNS) 2016-18. Methodology: We selected relevant demographic and anthropometric variables from the CNNS dataset and dichotomized it into non-tribal and tribal. World Health Organization (WHO) Anthro software was used to calculate the z-scores; weight-for-height (WHZ), weight-for-age (WAZ), height-for-age (HAZ). We estimated the proportion of wasting, underweight and stunting in these two sets of children. The mean z-scores between non-tribal and tribal children and that between girls and boys within these subsets were tested using student t-test. Results: Valid heights were available in 28,568 non-tribal and 7155 tribal children and the corresponding weights were available in 28144 and 6956 children respectively. The mean (SD) HAZ, an indicator of long-term nutrition, was -1.12 (1.58) in non-tribal children and -1.21 (1.71) in tribal children (p:&lt;0.001) Prevalence of stunting in tribal children (31.6%; 95%CI: 30.6, 32.7) was higher than that in non-tribal (27.1%; 95%CI: 26.6, 27.6). Due to poor heights, wasting was less in tribal children (12.8%; 95%CI: 12, 13.6) compared to the non-tribal (14.5%; 95%CI: 14.1, 15). The non- tribal girls had better mean (SD) WHZ, -0.75 (1.3) and WAZ, -1.17 (1.26) than boys (p=0.01, 0.045 respectively). The heights between the boys and girls were comparable in the non-tribal subset whereas, it was better in tribal girls; mean HAZ being -1.15 (SD:1.69) in girls and -1.27, (SD:1.72) in boys (p&lt;0.0029). Conclusion: The under-5 tribal children were significantly shorter than their non-tribal counterparts. Long term nutrition as depicted by heights was similar in boys and girls in non-tribal subset but tribal girls performed better than the boys.

Associations of postoperative outcomes with geriatric nutritional risk index after conventional and robotic-assisted total knee arthroplasty: a randomized controlled trial.

The association between postoperative outcomes of robotic-assisted total knee arthroplasty (RA-TKA) and nutrition status among elderly adults remained unclear. The authors aimed to evaluate these associations and provide a nutrition status reference for the surgical technique selection of TKA. In the present study, the authors used data from a multicenter, prospective, randomized controlled project, which recruited patients underwent TKA therapy. A total of 88 elderly adults (age ≥65 years old) were included in this study. Their preoperative and postoperative demographic data and radiographic parameters were collected. Clinical outcomes, including postoperative hip-knee-ankle (HKA) angle deviation, knee society score (KSS), 10cm visual analog scale, and so on, were observed and compared between the RA-TKA group and the conventional TKA group. Logistic regression was performed to adjust several covariates. In addition, according to the results of restricted cubic splines analyses, all participants were categorized into two groups with GNRI≤100 and GNRI >100 for further subgroup analyses. Our results showed despite having a lower postoperative HKA angle deviation, the RA-TKA group had a similar postoperative KSS score compared with the conventional TKA group in elderly adults. Among elderly patients with GNRI>100, RA-TKA group achieved significantly more accurate alignment (HKA deviation, P =0.039), but did not obtain more advanced postoperative KSS scores because of the compensatory effect of good nutrition status. However, among elderly patients with GNRI≤100, RA-TKA group had significantly higher postoperative KSS scores compared to the conventional TKA group ( P =0.025) and this association were not altered after adjustment for other covariates. Considering the clinical outcomes of conventional TKA may be more susceptible to the impact of nutrition status, elderly patients with GNRI≤100 seem to be an applicable population for RA-TKA, which is more stable and would gain significantly more clinical benefits compared with conventional TKA.