Rapid Deterioration Research Articles

Challenges and pitfalls of youth-onset type 2 diabetes

The incidence and prevalence of youth-onset type 2 diabetes mellitus (T2DM) are increasing. The rise in frequency and severity of childhood obesity, inclination to sedentary lifestyle, and epigenetic risks related to prenatal hyperglycemia exposure are important drivers of the youth-onset T2DM epidemic and might as well be responsible for the early onset of diabetes complications. Indeed, youth-onset T2DM has a more extreme metabolic phenotype than adult-onset T2DM, with greater insulin resistance and more rapid deterioration of beta cell function. Therefore, intermediate complications such as microalbuminuria develop in late childhood or early adulthood, while end-stage complications develop in mid-life. Due to the lack of efficacy and safety data, several drugs available for the treatment of adults with T2DM have not been approved in youth, reducing the pharmacological treatment options. In this mini review, we will try to address the present challenges and pitfalls related to youth-onset T2DM and summarize the available interventions to mitigate the risk of microvascular and macrovascular complications.

Chemical short-range disorder in lithium oxide cathodes.

Ordered layered structures serve as essential components in lithium (Li)-ion cathodes1-3. However, on charging, the inherently delicate Li-deficient frameworks become vulnerable to lattice strain and structural and/or chemo-mechanical degradation, resulting in rapid capacity deterioration and thus short battery life2,4. Here we report an approach that addresses these issues using the integration of chemical short-range disorder (CSRD) into oxide cathodes, which involves the localized distribution of elements in a crystalline lattice over spatial dimensions, spanning a few nearest-neighbour spacings. This is guided by fundamental principles of structural chemistry and achieved through an improved ceramic synthesis process. To demonstrate its viability, we showcase how the introduction of CSRD substantially affects the crystal structure of layered Li cobalt oxide cathodes. This is manifested in the transition metal environment and its interactions with oxygen, effectively preventing detrimental sliding of crystal slabs and structural deterioration during Li removal. Meanwhile, it affects the electronic structure, leading to improved electronic conductivity. These attributes are highly beneficial for Li-ion storage capabilities, markedly improving cycle life and rate capability. Moreover, we find that CSRD can be introduced in additional layered oxide materials through improved chemical co-doping, further illustrating its potential to enhance structural and electrochemical stability. These findings open up new avenues for the design of oxide cathodes, offering insights into the effects of CSRD on the crystal and electronic structure of advanced functional materials.

Flash heating process for efficient meat preservation

Maintaining food safety and quality is critical for public health and food security. Conventional food preservation methods, such as pasteurization and dehydration, often change the overall organoleptic quality of the food products. Herein, we demonstrate a method that affects only a thin surface layer of the food, using beef as a model. In this method, Joule heating is generated by applying high electric power to a carbon substrate in <1 s, which causes a transient increase of the substrate temperature to > ~2000 K. The beef surface in direct contact with the heating substrate is subjected to ultra-high temperature flash heating, leading to the formation of a microbe-inactivated, dehydrated layer of ~100 µm in thickness. Aerobic mesophilic bacteria, Enterobacteriaceae, yeast and mold on the treated samples are inactivated to a level below the detection limit and remained low during room temperature storage of 5 days. Meanwhile, the product quality, including visual appearance, texture, and nutrient level of the beef, remains mostly unchanged. In contrast, microorganisms grow rapidly on the untreated control samples, along with a rapid deterioration of the meat quality. This method might serve as a promising preservation technology for securing food safety and quality.

A Rare Case Report of an Acquired Aorto-Pulmonary Artery Fistula after Bentall Procedure: Multimodality Imaging Approach may be the Key?

Abstract Background The acquired communication between the aorta and the pulmonary artery is a rare and potentially life-threatening condition. Its diagnosis is challenging and may require a multimodality imaging approach. Case Summary A 67-year-old Caucasian man, admitted for acute respiratory failure unresponsive to medical therapy and non-invasive ventilation, was diagnosed with an aorto-pulmonary fistula (APF) complicating a pseudoaneurysm of the aortic root. This condition developed after Bentall cardiac surgery, which entailed the use of a straight Dacron aortic graft coupled with a mechanical prosthesis. A multimodal imaging approach, combining echocardiography and computed tomography angiography, was diagnostic and supported the development of a surgical treatment strategy. The patient underwent successful surgical closure of the APF and correction of the aortic pseudoaneurysm. Discussion Aorto-pulmonary fistula can result in rapid clinical deterioration if left untreated. The combination of echocardiography and computed tomography angiography techniques allowed for the diagnosis and surgical correction of the APF.

The influence of drying and storage conditions on the volatilome and cannabinoid content of Cannabis sativa L. inflorescences.

The increasing interest in hemp and cannabis poses new questions about the influence of drying and storage conditions on the overall aroma and cannabinoids profile of these products. Cannabis inflorescences are subjected to drying shortly after harvest and then to storage in different containers. These steps may cause a process of rapid deterioration with consequent changes in precious secondary metabolite content, negatively impacting on the product quality and potency. In this context, in this work, the investigation of the effects of freeze vs tray drying and three storage conditions on the preservation of cannabis compounds has been performed. A multi-trait approach, combining both solid-phase microextraction (SPME) two-dimensional gas chromatography coupled to mass spectrometry (SPME-GC × GC-MS) and high-performance liquid chromatography (HPLC), is presented for the first time. This approach has permitted to obtain the detailed characterisation of the whole cannabis matrix in terms of volatile compounds and cannabinoids. Moreover, multivariate statistical analyses were performed on the obtained data, helping to show that freeze drying conditions is useful to preserve cannabinoid content, preventing decarboxylation of acid cannabinoids, but leads to a loss of volatile compounds which are responsible for the cannabis aroma. Furthermore, among storage conditions, storage in glass bottle seems more beneficial for the retention of the initial VOC profile compared to open to air dry tray and closed high-density polyethylene box. However, the glass bottle storage condition causes formation of neutral cannabinoids at the expenses of the highly priced acid forms. This work will contribute to help define optimal storage conditions useful to produce highly valuable and high-quality products.

An Innovative Layer-by-Layer Edible Coating to Regulate Oxidative Stress and Ascorbate–Glutathione Cycle in Fresh-Cut Melon

Fresh-cut fruits, renowned for their convenience and nutritional value, are susceptible to rapid deterioration, compromising their quality and shelf life. In this study, a sustainable and environmentally friendly edible coating was developed based on sodium alginate (SA; 1% w/v), cedar mucilage (CM; 4% w/v), and calcium chloride (2% w/v), applied using a layer-by-layer technique to preserve the quality and prolong the shelf life of fresh-cut melon. Fruits were cut into cubes coated or uncoated by dipping and subsequently packaged in a polyethylene terephthalate container and stored for 15 days at 4 °C. Physicochemical traits and qualitative features such as polyphenol, flavonoid, carotenoid, ascorbic acid content, as well as antioxidant activity, were assessed. Furthermore, the enzymatic antioxidant system and the ascorbate–glutathione cycle were investigated. The coating reduced weight loss and enhanced polyphenol, flavonoid, and ascorbic acid content and antioxidant activity during cold storage. Edible coating (SA + CM) represents a valid tool to extend the postharvest life, improve the storability, and enhance the physicochemical and qualitative traits of fresh-cut melon. Further research is required to optimize coating formulations and application techniques to maximize their effectiveness and commercial viability in the food industry.

Metabolism effects of static magnetic field‐assisted freezing on shrimp (Penaeus vannamei)

SummaryShrimp undergo rapid deterioration after death, primarily due to enzyme activity and microbial growth, with freezing serving as its primary preservation method. In this study, shrimp underwent both conventional freezing (CF) and magnetic field‐assisted freezing (MF), and the shrimp meat's metabolites were scrutinised via metabonomic analysis techniques. The results demonstrate that MF treatment effectively preserved umami components like glutamic acid (log2(FC) = 0.37) and inosinic acid (1.02) while inhibiting the accumulation of spoilage‐related metabolites such as inosine (HxR) (−2.51), hypoxanthine (Hx) (−1.43) and uric acid (UA) (−1.24). Moreover, specific compounds, including 3‐methylhistidine, 1,6‐bisphosphate, phosphatidylcholine (PC), phosphatidylethanolamine (PE), HxR, Hx and UA were recognised as potential biomarkers throughout the freezing process. This research offers crucial insights into the intricate molecular mechanisms behind magnetic field‐assisted freezing.

Management of an Iatrogenic Pulmonary Artery Rupture via Balloon Tamponade.

Pulmonary artery rupture is a rare complication of right heart catheterization characterized by a rapid clinical deterioration and high mortality rate. We present the case of an 89-year-old woman with severe symptomatic aortic stenosis who underwent cardiac catheterization prior to aortic valve replacement. The patient had acute cardiopulmonary deterioration due to pulmonary artery rupture at the time of right heart catheterization, that was successfully sealed by balloon tamponade.

Cu-doped Sb-Zn alloy anodes tailored by novel pulse electrodeposition achieving robust sodium storage

Sodium-ion batteries (SIBs) have garnered significant attention as cost-efficient and expandable energy conversion devices. Nonetheless, their further utilization is impeded by the rapid deterioration in the capacity of anode materials during cycling. Herein, we have successfully introduced both active (Zn) and non-active (Cu) metal components into Sb by fabricating Cu-doped Sb-Zn (SZC-N) anodes through a template-free novel pulse potential electrodeposition (NPPED) approach. The introduction of Cu demonstrated a crucial role in directing the formation of the uniform structure. On the other hand, active “Zn” increases overall capacity and serves as a cushion against the volume expansion of Sb. Notably, the SZC-N exhibits enhanced charge diffusion while maintaining the structural integrity of the electrode, making it a promising choice for SIBs. Interestingly, the SZC-N electrode demonstrated remarkable cycling and rate performance, manifesting an excellent reversible capacity of 380.9 mAh·g−1 after 250 cycles, with an outstanding capacity retention of 80 % when operated at 1 C. Furthermore, it achieved a noteworthy capacity of 454.1 mAh·g−1 at a high current density of 10 C. In contrast, both the SZC-R and SZ-C anodes only yielded 52.9 and 3.9 mAh·g−1 (after 250 cycles), moreover, delivering inferior rate performance. The increased cyclic performance of the SZC-N electrode can be ascribed to the presence of a Cu network, which facilitates charge transport and promotes the stabilization of the electrode structure. The findings suggest that binder-free anode materials produced through the NPPED method present a promising opportunity for SIBs.

Long-Term Outcome After Discontinuation of CGRP-Targeting Therapy for Migraine.

Calcitonin gene-related peptide (CGRP)-targeting agents are potential candidates for disease-modifying migraine drugs. However, most studies on CGRP-targeting agents have assessed efficacy outcomes rather than long-term effects after discontinuation. This review aimed to synthesize and scrutinize the latest clinical data on the outcomes after the discontinuation of CGRP-targeting therapy in patients with episodic and chronic migraine, with a particular focus on chronic migraine. Real-world studies involving patients with migraine have reported consistent findings of worsened headache frequency and quality of life after the discontinuation of CGRP monoclonal antibodies (CGRP mAbs). Although many patients maintain improvements for up to 4months after discontinuation compared to baseline (before starting CGRP mAbs), no studies have evaluated the effects of stopping treatment for > 5months, which is the five-half-life of CGRP mAbs. Several studies have suggested that patients treated with CGRP receptor mAbs experience more rapid deterioration than those treated with CGRP ligand mAbs after discontinuing CGRP mAbs. The results of real-world studies suggest that for many patients with migraine, the benefits of CGRP mAbs diminish months after discontinuation. Therefore, anti-CGRP therapies may not be considered disease-modifying. However, the comprehensive assessment of the disease-modifying potential of these drugs requires studies with extended treatment and cessation durations.

Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature.

Glioblastoma is the most common primary malignant brain tumor. While preliminary data point to the positive effects of rehabilitation for patients with glioblastoma, there are unique challenges for clinicians working with this population, including limited life expectancy and/or rapid neurological deterioration. The aim of this article is to review the literature on rehabilitation of adults with glioblastoma, including the feasibility of interventions, their effectiveness, as well as the current clinical practice. The reviewed literature suggests that rehabilitation has been found beneficial for improving the functional prognosis and quality of life of adults with glioblastoma and is desired by patients. We summarize the qualitative evidence regarding healthcare professionals' and patients' perspectives on the use of supportive care services. We conclude there is a need for the design of effective rehabilitation programs for patients with glioblastoma, as well as for the development of glioblastoma-specific clinical guidelines for rehabilitation practitioners.

Delayed presentation of Wilkie’s syndrome after scoliotic curve correction surgery: a case report

BackgroundSuperior mesenteric artery (SMA) syndrome, also known as Wilkie’s syndrome, is a rare but serious complication following scoliosis correction surgery. It occurs as a result of mechanical compression of third part of duodenum between the SMA and aorta. This condition occurs most commonly in significantly underweight patients with deformities, and usually during the first week following spinal deformity corrective surgeries. The angle between the abdominal aorta and the SMA gets reduced following spinal lengthening during deformity correction surgery causing compression of third part of duodenum resulting in development of SMA syndrome.Case presentation.We present a case of 17-year-old male with congenital scoliosis with a 70-degree scoliotic curve who underwent spinal deformity correction surgery with posterior instrumented fusion. Post-operative course was uneventful and the patient was discharged after suture removal on post-operative day 15. The patient presented after 21-days of symptom onset on post-operative-day 51, with a 3 week history of post-prandial vomiting, abdominal pain and distension which resulted in rapid weight loss of 11 kg. A CT-angiogram showed obstruction at third part of duodenum. After reviewing clinical and radiological profile of the patient, a diagnosis of SMA syndrome was made. Conservative management was tried, but due to rapid deterioration of patient condition and symptoms of complete intestinal obstruction, the patient was treated surgically by gastro-jejunostomy and side-to-side jejuno-jejunostomy, which improved his condition.ConclusionSMA syndrome can occur much later than previously reported cases and with potentially life-threatening symptoms following scoliosis correction. Having a high index of suspicion, early recognition of condition and institution of appropriate treatment are essential to prevent occurrence of severe complications including risk of intestinal perforation and mortality. This case highlights management of delayed onset of SMA syndrome, with presentation further delayed after symptom onset, as is common in developing parts of the world, due to limited availability and accessibility of resources, and low socio-economic status of large segments of the population.

Effect of pectinase produced by Bacillus velezensis W17-6 on methanol content and overall quality of kiwifruit wine

Kiwifruit, a climacteric-fruit susceptible to rapid deterioration, attains considerable value upon transformation into kiwifruit wine, thereby increasing its added value. However, a noteworthy challenge arises from its high pectin content, which negatively affects byproduct quality, necessitating pectinase treatment during processing. Commercial pectinases exhibit heightened pectin esterase activity, giving rise to safety apprehensions due to augmented methanol content during kiwifruit pectin hydrolysis. In this study, Bacillus velezensis W17-6 was screened for its high pectinase activity coupled with low pectin esterase activity. The resultant crude pectinase named PBV was acquired through fed-batch-fermentation and partial purification. Subsequently, PBV was deployed in the fermentation of Xuxiang kiwifruit wine, and its impact on overall quality was assessed through diverse analyses. The results indicated that Xuxiang kiwifruit wine with PBV treatment outperformed counterparts treated with commercial pectinases. PBV treatment not only yielded superior clarity (83.75% ± 0.47%) and juice yield (81.60% ± 0.47%) but also increased the total flavonoids content in Xuxiang kiwifruit wine by 1.2 times compared to commercial pectinase. Notably, the methanol content of PBV-treated Xuxiang kiwifruit wine was significantly lower at 36.13 ± 1.83 mg/L than that of wines treated with two commercial pectinases. PBV-treated kiwifruit wine also exhibited elevated concentrations of volatile compounds such as phenethyl alcohol, ethyl undecanoate, lauric aldehyde, isobutyric acid, and myrcene. Impressively, PBV-treated kiwifruit wine surpassed other wines in both electronic and artificial sensory analyses. In summary, PBV exhibits substantial potential in the production of low-methanol, high-quality kiwifruit wine, enhancing the flavor and nutritional value while minimizing methanol production and improving the safety profile.

A comparison of native vaginal and ligament surgery for cure of pelvic organ prolapse and overactive bladder.

The key messages from the Shkarupa et al. native cardinal/uterosacral ligament (CL/USL) study, was that, in premenopausal women, ligament repair alone is sufficient for cure of pelvic organ prolapse (POP) and urgency, achieving cure rates of 85.7% for POP and 81.6% for urgency at 12 months. However, in postmenopausal women, the cure rates were 20.5% for POP and 33.3% for urge at 12 months. The Lancet Prospect Trial recorded 21% for native vaginal repair at 12 months. The poor POP cure rate in the Prospect Trial, and the rapid deterioration in the post-menopausal CL/USL repair group, can be explained by known biomechanics. The vagina has little structural strength. Ligaments, with a much higher breaking strain, are the main structural support of pelvic organs. Yet, even native ligament repair reported very low cure rates at 12 months. The poor results in postmenopausal women with native ligament repair can be explained by collagen breakdown after the menopause, as collagen is the key structural component of ligaments. An important question posed in the ligament repair study was, "What happens to women cured by ligament repair after the menopause when the collagen leaches out of the ligaments?". One recommendation was that collagen creating tapes be routinely applied in prolapse surgery and OAB, at least in postmenopausal women. The recommendation for routine collagen-creating ligament repair methods, especially in older women, are supported by high 5-year surgical cure rates in 70-year-old Japanese women, 91.2% for POP, at 12 months, falling to 79.0 at 60 months, using collagen creating Tissue Fixation System (TFS) minislings.

Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach.

Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.

RNA splicing modulates the postharvest physiological deterioration of cassava storage root.

Rapid postharvest physiological deterioration (PPD) of cassava (Manihot esculenta Crantz) storage roots is a major constraint that limits the potential of this plant as a food and industrial crop. Extensive studies have been performed to explore the regulatory mechanisms underlying the PPD processes in cassava to understand their molecular and physiological responses. However, the exceptional functional versatility of alternative splicing (AS) remains to be explored during the PPD process in cassava. Here, we identified several aberrantly spliced genes during the early PPD stage. An in-depth analysis of AS revealed that the abscisic acid (ABA) biosynthesis pathway might serve as an additional molecular layer in attenuating the onset of PPD. Exogenous ABA application alleviated PPD symptoms through maintaining ROS generation and scavenging. Interestingly, the intron retention transcript of MeABA1 (ABA DEFICIENT 1) was highly correlated with PPD symptoms in cassava storage roots. RNA yeast three-hybrid and RNA immunoprecipitation assays showed that the serine/arginine-rich protein MeSCL33 (SC35-like splicing factor 33) binds to the precursor mRNA of MeABA1. Importantly, overexpressing MeSCL33 in cassava conferred improved PPD resistance by manipulating the AS and expression levels of MeABA1 and then modulating the endogenous ABA levels in cassava storage roots. Our results uncovered the pivotal role of the ABA biosynthesis pathway and RNA splicing in regulating cassava PPD resistance and proposed the essential roles of MeSCL33 for conferring PPD resistance, broadening our understanding of SR proteins in cassava development and stress responses.

Understanding rapid oral health deterioration and its associated factors among older adults: A scoping review

Understanding rapid oral health deterioration and its associated factors among older adults: A scoping review

Comparative Performance of Different Fertilizer Recommendation Methods on Growth and Yield of Rice (Oryza sativa) in Old Brahmaputra Floodplain Soils

Improving rice productivity is the challenge for the farmer due to rapid soil health deterioration in intensive agricultural system. Therefore, the present study was conducted to evaluate comparative performance of different nutrient management practices in rice production in Bangladesh. The experiment was laid out in a randomized complete block design with three replications. There      were six treatments namely, T1 (Control-no fertilizer), T2 (Farmer’s Practice), T3 (Fertilizer Recommendation Guide-2018), T4 (BAU Soil Testing Kit), T5 (Soil Test Basis) and T6 (Rice Crop Manager). The results revealed that all the treatments showed better performances over control (T1). Treatment T4 (BAU Soil Testing Kit) produced the highest value of plant height (90.18 cm), panicle length (24.90), filled grains panicle-1 (122.60) and 1000-grain weight (26.67g) while T5 (Soil Test Basis) produced maximum effective tillers hill-1 (12.80). The highest grain yield (6.29 t ha-1) and straw yield (7.73 t ha-1) were recorded in treatment T4 (BAU Soil Testing Kit). Treatment T4 (BAU Soil Testing Kit) also showed the highest grain yield increase (61.49%) and straw yield increase (90.49%) over control. The highest total N, P and K uptake (108.84 kg ha-1, 24.54 kg ha-1 and 128.17 kg ha-1) were obtained in the treatment T4 (BAU Soil Testing Kit). Control treatment T1 (No fertilizers) showed minimum performances in all the cases compared to other treatments. The overall result demonstrated that the application of fertilizers following BAU Soil Testing Kit method of fertilizer application system is a better option for rice production.

Atypical anti-glomerular basement membrane disease with membranous hyperplasia: diagnostic challenges and treatment variability

This case report presents a detailed analysis of a 31-year-old male patient who presented with a complex array of clinical symptoms, including proteinuria, hematuria, edema, and kidney insufficiency. Despite undergoing multiple tests, the results for anti-glomerular basement membrane antibodies yielded negative findings. Subsequently, kidney biopsy pathology revealed a distinct diagnosis of atypical anti-glomerular basement membrane (anti-GBM) disease with membrane hyperplasia. Treatment was initiated with a comprehensive approach involving high doses of corticosteroids therapy and cyclophosphamide (CTX). However, contrary to expectations, the patient’s kidney function exhibited rapid deterioration following this therapeutic regimen. The culmination of these complications necessitated a pivotal transition to maintenance hemodialysis. This case underscores the intricate challenges associated with diagnosing and managing rare and atypical presentations of kidney disorders. The negative anti-GBM antibody results and subsequent identification of atypical anti-GBM nephropathy highlight the need for tailored diagnostic strategies to discern subtle nuances within complex clinical scenarios. Additionally, the unexpected response to the treatment regimen emphasizes the potential variability in individual patient responses, underlining the necessity for vigilant monitoring and adaptable treatment strategies. This case report contributes to the evolving understanding of atypical kidney pathologies and the complexities involved in their management.

Predictors of nutritional recovery time in children aged 6-59months with severe acute malnutrition in Sofala Province, Mozambique: survival analysis approach.

Malnutrition is a public health problem that affects physical and psychosocial well-being. It manifests as a rapid deterioration in nutritional status and bilateral edema due to inadequate food intake or illness. This study is a retrospective cohort of 1208 children with severe acute malnutrition (SAM) in Sofala Province from 2018 to 2022. It includes hospitalized children aged 6-59months with SAM and related complications. The dependent variable is recovery, and the independent variables include age, sex of the child, vomiting, dehydration, hypoglycemia, nutritional edema and anthropometry. Survival curves were plotted using the Kaplan-Meier method, and bivariable and multivariable Cox regression analyses were performed. The crude analysis revealed significant factors for nutritional recovery in children with SAM, including age, weight, height, malaria, diarrhea and dehydration. Children under 24months had a 28% lower likelihood of recovery. Weight below 6.16kg decreased the likelihood by 2%, and height above 71.1cm decreased it by 20%. Conversely, malaria, diarrhea and dehydration increased the likelihood of recovery. However, after adjustment, only diarrhea remained a significant predictor of nutritional recovery. This study found that diarrhea is a predictor of nutritional recovery in children with SAM.