Search

Simple Summary: Despite the promising evidence of the Royal Marsden Hospital (RMH) score as a readily available prognostic biomarker in patients with cancer, the wide scale implementation in clinical practice as well as the true benefit in clinical decision-making is lacking. Therefore, we systematically reviewed the available evidence on the association between the RMH score and prognosis in patients with cancer. This comprehensive meta-analysis, encompassing over a hundred thousand patients, revealed a negative association between a higher RMH score and survival in cancer patients. The available evidence demonstrates that the RMH score is not only a selective biomarker for patients enrolled in clinical trials, but also a useful prognostic biomarker in a real-world setting. Future research should aim to validate and refine this score, ensuring its optimal application in clinical practice and decision-making. Background: Cancer remains a leading cause of death globally, necessitating the identification of prognostic biomarkers to guide treatment decisions. The Royal Marsden Hospital (RMH) score, based on readily available blood tests and clinical features, has emerged as a prognostic tool, although its performance across variable clinical scenarios is not thoroughly delineated. Therefore, we aimed to systematically assess the association between RMH score and survival in cancer patients. Methods: We conducted a systematic literature search across Pubmed, Scopus, and Web of Science databases for studies published up to 15 February 2024. We performed a meta-analysis with the generic inverse variance method with a random-effects model and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Nineteen studies encompassing 127,230 patients were included. A higher RMH score was significantly associated with worse overall survival (OS) (HR: 2.09, 95% CI: 1.87–2.33, p < 0.001) and progression-free survival (PFS) (HR: 1.80, 95% CI: 1.48–2.18, p < 0.001). This association was consistent across various subgroups, including study population (clinical trial vs. real-world cohort), geographic region, and tumor type. Conclusion: This meta-analysis, including over a hundred thousand patients, demonstrates a negative association between a higher RMH score and survival in cancer patients. The RMH score holds promise as a readily available prognostic tool across diverse cancer types and clinical settings. Future research should focus on validating and refining this score to aid clinical decision-making. [ABSTRACT FROM AUTHOR]

Simple Summary: Immune checkpoint inhibitors have become widely used against malignant tumors. The neutrophil-to-lymphocyte ratio, an index focusing on immune cells, has been reported as a marker to predict the efficacy and side effects of anti-tumor drugs. In the present study, we found that the neutrophil-to-lymphocyte ratio shows an altered predictability of anti-tumor efficacy and side effects due to changes in nutritional status. Patients with carcinoma in situ are prone to changes in nutritional status depending on the progression of the cancer and the age of the patient. We believe that the results of this study are important findings in predicting the course of treatment for cancer patients. The neutrophil -to-lymphocyte ratio (NLR) is useful for predicting the effectiveness of treatment with immune checkpoint inhibitors (ICIs) and immune-related adverse events (irAEs). Because a growing body of evidence has recently shown that the number of lymphocytes that comprise NLR fluctuates according to nutritional status, this study examined whether the usefulness of NLR varies in ICI treatment due to changes in nutritional status. A retrospective analysis was performed on 1234 patients who received ICI treatment for malignant tumors at our hospital. Progression-free survival (PFS) was significantly prolonged in patients with NLR < 4. Multivariate analysis revealed that the factors associated with the occurrence of irAE were NLR < 4 and the use of ipilimumab. However, when limited to cases with serum albumin levels <3.8 g/dL, lymphocyte counts significantly decreased, and the associations between NLR and PFS and between NLR and irAE occurrence disappeared. In contrast, when limited to the cases with serum albumin levels ≥3.8 g/dL, the associations remained, with significantly prolonged PFS and significantly increased irAE occurrence at NLR < 4. NLR may be a good predictive tool for PFS and irAE occurrence during ICI treatment when a good nutritional status is maintained. [ABSTRACT FROM AUTHOR]

The published data on the vitamin status of patients with phenylketonuria (PKU) is contradictory; therefore, this systematic review and meta-analysis evaluated the vitamin status of PKU patients. A comprehensive search of multiple databases (PubMed, Web of Sciences, Cochrane, and Scopus) was finished in March 2024. The included studies compared vitamin levels between individuals diagnosed with early-treated PKU and healthy controls while excluding pregnant and lactating women, untreated PKU or hyperphenylalaninemia cases, control groups receiving vitamin supplementation, PKU patients receiving tetrahydrobiopterin or pegvaliase, and conference abstracts. The risk of bias in the included studies was assessed by the Newcastle–Ottawa scale. The effect sizes were expressed as standardised mean differences. The calculation of effect sizes with 95% CI using fixed-effects models and random-effects models was performed. A p-value < 0.05 was considered statistically significant. The study protocol was registered in the PROSPERO database (CRD42024519589). Out of the initially identified 11,086 articles, 24 met the criteria. The total number of participants comprised 770 individuals with PKU and 2387 healthy controls. The meta-analyses of cross-sectional and case–control studies were conducted for vitamin B12, D, A, E, B6 and folate levels. PKU patients demonstrated significantly higher folate levels (random-effects model, SMD: 1.378, 95% CI: 0.436, 2.320, p = 0.004) and 1,25-dihydroxyvitamin D concentrations (random-effects model, SMD: 2.059, 95% CI: 0.250, 3.868, p = 0.026) compared to the controls. There were no significant differences in vitamin A, E, B6, B12 or 25-dihydroxyvitamin D levels. The main limitations of the evidence include a limited number of studies and their heterogeneity and variability in patients' compliance. Our findings suggest that individuals with PKU under nutritional guidance can achieve a vitamin status comparable to that of healthy subjects. Our study provides valuable insights into the nutritional status of PKU patients, but further research is required to confirm these findings and explore additional factors influencing vitamin status in PKU. [ABSTRACT FROM AUTHOR]

Background: Nutritional deficiencies are frequently observed in patients with head and neck cancer (HNC) undergoing radiation therapy. microRNAs (miRNAs) were found to play an important role in the development of metabolic disorders throughout regulation of genes involved in inflammatory responses. This study aimed to explore the correlation between pre-treatment miR-5682 expression and parameters reflecting nutritional deficits in laryngeal cancer (LC) patients subjected to radiotherapy (RT). Methods: Expression of miR-5682 was analyzed in plasma samples of 56 male LC individuals. Nutritional status of LC patients was assessed using anthropometric and laboratory parameters, bioelectrical impedance analysis (BIA) and clinical questionnaires. Results: A high expression of miR-5682 was associated with significantly lower values of BMI, fat mass, fat-free mass and plasma albumin at selected periods of RT course. miR-5682 allowed us to distinguish between patients classified with both SGA-C and low albumin level from other LC patients with 100% sensitivity and 69.6% specificity (AUC = 0.820; p < 0.0001). Higher expression of studied miRNA was significantly associated with shorter median overall survival (OS) in LC patients (HR = 2.26; p = 0.008). Conclusions: analysis of miR-5682 expression demonstrates a potential clinical utility in selection of LC patients suffering from nutritional deficiencies developing as a consequence of RT-based therapy. [ABSTRACT FROM AUTHOR]

Statistical genetic models of genotype-by-environment (G×E) interaction can be divided into two general classes, one on G×E interaction in response to dichotomous environments (e.g., sex, disease-affection status, or presence/absence of an exposure) and the other in response to continuous environments (e.g., physical activity, nutritional measurements, or continuous socioeconomic measures). Here we develop a novel model to jointly account for dichotomous and continuous environments. We develop the model in terms of a joint genotype-by-sex (for the dichotomous environment) and genotype-by-social determinants of health (SDoH; for the continuous environment). Using this model, we show how a depression variable, as measured by the Beck Depression Inventory-II survey instrument, is not only underlain by genetic effects (as has been reported elsewhere) but is also significantly determined by joint G×Sex and G×SDoH interaction effects. This model has numerous applications leading to potentially transformative research on the genetic and environmental determinants underlying complex diseases. [ABSTRACT FROM AUTHOR]

Simple Summary: Significant progress has been made in the surgical treatment of stomach cancer. A shift towards less invasive techniques is evident, and new methods continue to evolve. Laparoscopic surgery is widely adopted and its indications have steadily expanded, while robot-assisted surgery is being introduced in clinical practice. Function-preserving surgery, which retains the stomach's capacity and digestive function, has now been established as a valid option for early-stage tumors. Currently, more limited procedures are being explored, such as sentinel node navigation surgery, which seeks to target only the specific lymph nodes most likely to be affected. The goal of these efforts is to reduce postoperative complications, accelerate recovery, minimize the impact on nutritional status, and preserve the quality of life of patients following surgery. This review aims to provide an up-to-date overview of the current state of surgical treatment for stomach cancer, addressing established practices, emerging trends, and future directions. Significant progress has been made in the surgical management of gastric cancer over the years, and previous discrepancies in surgical practice between different parts of the world have gradually lessened. A transition from the earlier period of progressively more extensive surgery to the current trend of a more tailored and evidence-based approach is clear. Prophylactic resection of adjacent anatomical structures or neighboring organs and extensive lymph node dissections that were once assumed to increase the chances of long-term survival are now performed selectively. Laparoscopic gastrectomy has been widely adopted and its indications have steadily expanded, from early cancers located in the distal part of the stomach, to locally advanced tumors where total gastrectomy is required. In parallel, function-preserving surgery has also evolved and now constitutes a valid option for early gastric cancer. Pylorus-preserving and proximal gastrectomy have improved the postoperative quality of life of patients, and sentinel node navigation surgery is being explored as the next step in the process of further refining the minimally invasive concept. Moreover, innovative techniques such as indocyanine green fluorescence imaging and robot-assisted gastrectomy are being introduced in clinical practice. These technologies hold promise for enhancing surgical precision, ultimately improving the oncological and functional outcomes. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most common cancers worldwide, at the same time being one of the most prevalent causes of women's death. Many factors such as alcohol, weight fluctuations, or hormonal replacement therapy can potentially contribute to breast cancer development and progression. Another important factor in breast cancer onset includes micronutrient status. In this narrative review, we analyzed 23 micronutrients and their possible influence on breast cancer onset and progression. Further, the aim of this study was to investigate the impact of micronutrient status on the prevention of breast cancer and its possible influence on various therapeutic pathways. We researched meta-analyses, systemic and narrative reviews, retrospective studies, as well as original studies on human and animal models. The results of these studies indicate a possible correlation between the different levels of micronutrients and a decreased risk of breast cancer as well as a better survival rate. However, further studies are necessary to establish adequate doses of supplementation of the chosen micronutrients and the exact mechanisms of micronutrient impact on breast cancer therapy. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is a condition in which the pathological cumulation of fat with coexisting inflammation and damage of hepatic cells leads to progressive dysfunctions of the liver. Except for the commonly well-known major causes of NAFLD such as obesity, dyslipidemia, insulin resistance, or diabetes, an unbalanced diet and imbalanced nutritional status should also be taken into consideration. In this narrative review, we summarized the current knowledge regarding the micro- and macronutrient status of patients suffering from NAFLD considering various diets and supplementation of chosen supplements. We aimed to summarize the knowledge indicating which nutritional impairments may be associated with the onset and progression of NAFLD at the same time evaluating the potential therapy targets that could facilitate the healing process. Except for the above-mentioned objectives, one of the most important aspects of this review was to highlight the possible strategies for taking care of NAFLD patients taking into account the challenges and opportunities associated with the micronutrient status of the patients. The current research indicates that a supplementation of chosen vitamins (e.g., vitamin A, B complex, C, or D) as well as chosen elements such as zinc may alleviate the symptoms of NAFLD. However, there is still a lack of sufficient data regarding healthy ranges of dosages; thus, further research is of high importance in this matter. [ABSTRACT FROM AUTHOR]

Due to the high mortality rate in Western countries, pancreatic cancer is considered one of the big killers, leaving patients and their families with little hope upon diagnosis. Although surgical and drug therapies are critical for cancer patients to improve life expectancy and alleviation of suffering, nutrition plays a key role in improving cancer treatment outcomes. This narrative review, conducted as part of the activities of the Italian Society of Human Nutrition (SINU) working group in oncology, focuses on the prevalence of vitamin malnutrition among pancreatic cancer patients. The results of the literature search show that pancreatic cancer patients are at a heightened risk of water-soluble vitamin deficiencies, particularly of vitamins B1, B3, and B6. Additionally, they also face an increased risk of deficiency of fat-soluble vitamins. Among these vitamins, the potential role of vitamin D in pancreatic cancer has garnered the most attention, with its plasma levels being identified as a significant factor in patient survival. Investigating vitamin nutritional status could provide valuable insights for incorporating nutritional approaches into the prevention and treatment of pancreatic cancer, thereby reducing the exacerbation of symptoms associated with the diagnosis. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate age-specific variations in the blood levels of micronutrients, homocysteine, and CoQ10, along with physical activity (PA) patterns, among 123 Austrian adult bankers in operational and frontline roles (mean age: 43 years; 50% female). Methods: Blood analysis was conducted to assess micronutrients and the serum concentrations of homocysteine and CoQ10. The micronutrient values in whole blood were compared to sex-specific reference ranges and categorized as below, within, or above them. The Global Physical Activity Questionnaire was utilized to assess PA patterns. Participants were classified as young adults (18–34 years), middle-aged adults (35–49 years), and older adults (50–64 years). Results: Significant age-based differences were found in participants' mean homocysteine levels (p = 0.039) and homocysteine categories (p = 0.034), indicating an increasing prevalence of hyperhomocysteinemia with age. No significant difference between age categories was observed for sex, BMI, diet types, PA levels, sedentary behavior, and CoQ10 (p > 0.05). There was no significant age-based difference in the blood concentrations of most minerals and vitamins (p > 0.05), except for magnesium among females (p = 0.008) and copper among males (p = 0.042). Conclusion: The findings offer initial evidence of the age-related differences in the health status of adult bankers, providing insights for customized approaches to occupational health that support the importance of metabolic health and overall well-being across adulthood. [ABSTRACT FROM AUTHOR]

General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with SMIs (schizophrenia, bipolar disorder, or major depression) were recruited from Bahrain. The participants completed the 50-item Dietary Intake Evaluation Questionnaire for Serious Mental Illness (DIETQ-SMI) FFQ and a 3-day food record (FR). The validity of the FFQ was assessed by comparing nutrient intake to FR intake using correlation and reliability statistics. The DIETQ-SMI demonstrated a good ranking validity compared to the FR based on correlation coefficients (rho 0.33 to 0.92) for energy and macro- and micronutrients. The FFQ had high internal consistency (McDonald's omega = 0.84; Cronbach's alpha = 0.91) and test–retest reliability (ICC > 0.90). The FFQ tended to estimate higher absolute intakes than the FR but adequately ranked the intakes. The FFQ value was correlated with the FR for all the items (p < 0.001). The DIETQ-SMI is a valid and reliable FFQ for ranking dietary intake in individuals with an SMI. It can help assess nutritional status and, subsequently, guide interventions in high-risk psychiatric populations. [ABSTRACT FROM AUTHOR]

Soil salinity affects nutrient uptake by cotton. The cotton bud stage is a very important period in the process of cotton planting and directly affects the yield of cotton. The nutritional status of the bud stage directly affects the reflectance spectra of cotton canopy leaves. Therefore, it is of great significance to nondestructively monitor the nutritional status of the cotton bud stage on salinized soil via spectroscopic techniques and perform corresponding management measures to improve cotton yield. In this study, potted plants with different nitrogen application rates were set up to obtain the reflection spectral curves of cotton bud stage leaves, analyze their spectral characteristics under different nitrogen application rates, and establish spectral estimation models of chlorophyll density. The results are as follows: in the continuum removal spectrum of the cotton bud stage, the lowest point of the absorption valley near 500 nm shifted to the shortwave direction with an increasing nitrogen application rate. The mean reflectance between 765 and 880 nm was significantly different between nitrogen-stressed and nitrogen-unstressed cotton. The average reflectance of the near-infrared band, the absorption valley depths near 500 nm and 675 nm, the first derivative of the 710 nm reflectance, and the second derivatives of the 690 nm and 730 nm reflectance increased with increasing nitrogen application and chlorophyll density, and significant correlations were observed with the chlorophyll density. These parameters were modeled using support vector regression (SVR) and artificial neural network (ANN) methods, two commonly used algorithms in the field of machine learning. The determination coefficients of the three chlorophyll samples via the ANN models were 0.92, 0.77, and 0.94 for the modeling set and 0.77, 0.69, and 0.77 for the verification set. The ratio of quartile to root-mean-square error (RPIQ) of the ANN model was greater than 2.2, and the ratio of the standard error of the measured value to the standard error of the predicted (SEL/SEP) was close to 1, indicating that the chlorophyll density estimation models built based on the ANN algorithm had robust prediction ability. Our model could accurately estimate the leaf chlorophyll density in the cotton bud stage. [ABSTRACT FROM AUTHOR]

Simple Summary: We studied whether the female body size of strepsipteran parasites of Xenos oxyodontes is affected by the following four factors: season, host body size, multiparasitism, and reproductive conditions of the host wasp. The cephalothorax width of female parasites did not change throughout the seasons but was strongly affected by host body size, number of parasites per host wasp, and reproductive conditions of host wasps. Our results suggested that female parasites with larger body sizes have greater potential for reproduction. Parasite growth in hosts depends on their hosts' nutritional status. This study examined whether the body size of the strepsipteran parasite Xenos oxyodontes, which parasitizes the eusocial wasp Vespa analis, is affected by several key factors, including host body size. We collected V. analis using bait traps for three years in Niigata, Japan, and evaluated the number of male and female X. oxyodontes parasites throughout the seasons. A total of 185 female parasites were collected, and their cephalothorax widths were measured. The widths of female parasites did not statistically vary among seasons and were positively correlated with the head widths of female host wasps but negatively correlated with the number of parasites per host wasp. In addition, we examined whether the reproductive conditions of post-hibernation solitary queens affected the cephalothorax width of female parasites. The widths of the female parasites were greater when the queens had less-developed ovaries. These results suggested that nutrient availability by female parasites depends on the host wasp and competition with conspecific individuals. [ABSTRACT FROM AUTHOR]

Simple Summary: The carbohydrate source is a nutritional aspect critical for the basic behaviors of mosquitoes, such as flying and mating. For the maintenance of a colony of mosquitoes, it is important to choose a good source of carbohydrates that increases mosquito fitness. In this study, we found that a 15% honey solution increased mosquito longevity in comparison with a 10% sugar solution, probably due to the nutritional value of honey. Accordingly, a carbohydrate source based on a 15% honey solution could be a better choice for maintenance of Anopheles darlingi and Anopheles deaneorum in the lab-rearing context. The maintenance of a highly productive colony of anopheline mosquitoes requires standardized methods in order to obtain a sufficient number of homogeneous individuals for malaria research. In this context, nutritional status may affect survival, fecundity, and the capacity to support pathogen development. Here we assess the effects of carbohydrate sources on fecundity, survival, and susceptibility to Plasmodium vivax infection in colonies of Anopheles darlingi and Anopheles deaneorum mosquitoes. Newly emerged females from each species were fed either 10% sugar or 15% honey solutions until the end of each experiment. The type of carbohydrate meal did not impact any entomological parameters for An. deaneorum, except for survival. For both species, honey meal significantly increased median survival post-emergence by three to four days, probably due to its nutritional value. For An. darlingi fed with honey, a higher mean frequency in stage 5 was observed at 48 h post-blood-meal, which could indicate a delay in the digestion process. However, no effects on fecundity parameters were observed. Regarding susceptibility, An. darlingi fed with sugar exhibited a low intensity of sporozoites, although any negative effects of sucrose on sporozoites invasions in the salivary glands are unknown. Based on the increase in mosquito survival, a carbohydrate source composed of 15% honey solution could be better for maintaining An. darlingi and An. deaneorum in the lab-rearing context. [ABSTRACT FROM AUTHOR]

Simple Summary: Aside from a decreased quality of life, patients with esophagogastric tumors often suffer from difficulties with eating that impact nutritional status. Both the presence of cancer and the impacted nutritional status can also reduce muscle mass. All of this can impact treatment decisions: a patient with low muscle mass and low caloric impact might have a lower tolerance for chemotherapy or other treatment courses. However, treating physicians do not always have immediate access to current data on muscle mass and nutritional status. If there was a correlation between quality of life and these parameters, this might allow for the estimation of real-time muscle mass and suggest further controlled studies. (1) Background: Health-related quality of life (HRQoL) gains importance as novel treatment options for individuals with esophagogastric tumors to improve long-term survival. Impaired HRQoL has been shown to be a predictor of overall survival. Sarcopenia is a known prognostic factor for postoperative complications. As the regular control of sarcopenia through CT scans might not always be possible and HRQoL and nutritional scores are easier to obtain, this study aimed to assess the relationship between nutritional scores, HRQoL and skeletal muscle mass in patients undergoing chemotherapy for cancers of the upper gastrointestinal tract. (2) Methods: Eighty patients presenting with tumors of the upper GI tract were included and asked to fill out the standardized HRQoL questionnaire, EORTC's QLQ-C30. Nutritional status was assessed using the MNA, MUST and NRS 2002 scores. Sarcopenia was determined semi-automatically based on the skeletal muscle index at the L3 vertebrae level in staging CT scans. (3) Results: In chemo-naïve patients, HRQoL summary scores correlated significantly with nutritional scores and SMI. SMI and HRQoL prior to neoadjuvant therapy correlated significantly with SMI after treatment. (4) Conclusions: HRQoL is a helpful tool for assessing patients' overall constitution. The correlation of HRQoL summary scores and SMI might allow for a rough assessment of skeletal muscle status through HRQoL assessment in chemo-naïve patients. [ABSTRACT FROM AUTHOR]

Simple Summary: A low prognostic nutritional index (PNI) is linked to poor survival in patients with nasopharyngeal carcinoma (NPC), but existing research primarily examines the pre- or post-treatment PNI at single timepoints. Our study employs joint modeling to investigate the relationship between longitudinal PNI data from routine visits and overall survival. This approach addresses biases inherent in traditional time-varying covariate Cox models. Our findings indicate that decreased PNI levels during follow-up correlate with a reduced overall survival. Specifically, a post-treatment PNI below 38.1 markedly increases the risk of 90-day mortality. This emphasizes the importance of routine longitudinal PNI data in predicting survival outcomes for patients with NPC, offering a comprehensive perspective compared to isolated timepoint measurements. Background: a low PNI in patients with NPC is linked to poor survival, but prior studies have focused on single-timepoint measurements. Our study aims to employ joint modeling to analyze longitudinal PNI data from each routine visit, exploring its relationship with overall survival. Methods: In this retrospective study using data from the Chang Gung Research Database (2007–2019), we enrolled patients with NPC undergoing curative treatment. We analyzed the correlation between patient characteristics, including the PNI, and overall survival. A joint model combining a longitudinal sub-model with a time-to-event sub-model was used to further evaluate the prognostic value of longitudinal PNI. Results: A total of 2332 patient were enrolled for the analysis. Separate survival analyses showed that longitudinal PNI was an independent indicator of a reduced mortality risk (adjusted HR 0.813; 95% CI, 0.805 to 0.821). Joint modeling confirmed longitudinal PNI as a consistent predictor of survival (HR 0.864; 95% CI, 0.850 to 0.879). An ROC analysis revealed that a PNI below 38.1 significantly increased the risk of 90-day mortality, with 90.0% sensitivity and 89.6% specificity. Conclusions: Longitudinal PNI data independently predicted the overall survival in patients with NPC, significantly forecasting 90-day survival outcomes. We recommend routine PNI assessments during each clinic visit for these patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Recent observations have led to an expansion of the role of neoadjuvant treatment (NAT) as a component of a multidisciplinary approach to the treatment of pancreatic ductal adenocarcinoma (PDAC). However, some issues related to this treatment remain unclear, including (1) the appropriate indications for NAT (as opposed to up-front surgery); (2) predictors of response to NAT; (3) the effect of the response to NAT on the efficacy of postoperative adjuvant chemotherapy (AC); and (4) the establishment of an adjuvant treatment policy based on post-neoadjuvant therapy/surgery histopathological findings. In this article, we discuss these issues based on a review of the literature and the authors' own experience of NAT using gemcitabine plus S-1. In addition to established evidence of the efficacy of adjuvant chemotherapy (AC) for pancreatic ductal adenocarcinoma (PDAC), evidence of the effects of neoadjuvant treatments (NATs), including chemotherapy and chemoradiotherapy, has also been accumulating. Recent results from prospective studies and meta-analyses suggest that NATs may be beneficial not only for borderline resectable PDAC, but also for resectable PDAC, by increasing the likelihood of successful R0 resection, decreasing the likelihood of the development of lymph node metastasis, and improving recurrence-free and overall survival. In addition, response to NAT may be informative for predicting the clinical course after preoperative NAT followed by surgery; in this way, the postoperative treatment strategy can be revised based on the effect of NAT and the post-neoadjuvant therapy/surgery histopathological findings. On the other hand, the response to NAT and AC is also influenced by the tumor biology and the patient's immune/nutritional status; therefore, planning of the treatment strategy and meticulous management of NAT, surgery, and AC is required on a patient-by-patient basis. Our experience of using gemcitabine plus S-1 showed that this NAT regimen achieved tumor shrinkage and decreased the levels of tumor markers but failed to provide a survival benefit. Our results also suggested that response/adverse events to NAT may be predictive of the efficacy of AC, as well as survival outcomes. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is an underdiagnosed condition that negatively affects the clinical outcomes of patients, being associated with an increased risk of adverse events, increased hospital stay, and higher mortality. Therefore, nutritional assessment is a required and necessary process in patient care. The objective of this study was to identify the factors associated with nutritional risk by applying the Malnutrition Universal Screening Tool (MUST) scale in a population of critically ill patients. Methods: This was an observational, analytical, and retrospective study. Sociodemographic, clinical, hematological, and biochemical variables and their relationship with nutritional risk and mortality were analyzed. Results: Of 630 patients, the leading cause of admission was pathologies of the circulatory and respiratory system (50%); 28.4% were at high nutritional risk; and mortality was 11.6% and associated with nutritional risk, hemoglobin, and plasma urea nitrogen. Conclusions: The presence of gastrointestinal symptoms and the type of nutritional support received during hospitalization could increase the likelihood of presenting a medium/high nutritional risk, while polycythemia reduced this probability. An associative model was found to determine nutritional risk with an adequate specificity and diagnostic validity index. [ABSTRACT FROM AUTHOR]

Inflammation can be triggered by a variety of factors, including pathogens, damaged cells, and toxic compounds. It is a biological response of the immune system, which can be successfully assessed in clinical practice using some molecular substances. Because adiponectin, a hormone released by adipose tissue, influences the development of inflammation, its evaluation as a potential measure of inflammation in clinical practice is justified. In the present contribution, statistical comparison of adiponectin concentration and selected molecular substances recognized in clinical practice as measures of inflammation were utilized to demonstrate whether adipose tissue hormones, as exemplified by adiponectin, have the potential to act as a measure of rapidly changing inflammation when monitoring older hospitalized patients in the course of bacterial infection. The study showed no statistically significant differences in adiponectin levels depending on the rapidly changing inflammatory response in its early stage. Interestingly, the concentration of adiponectin is statistically significantly higher in malnourished patients than in people with normal nutritional levels, assessed based on the MNA. According to the results obtained, adiponectin is not an effective measure of acute inflammation in clinical practice. However, it may serve as a biomarker of malnutrition in senile individuals. [ABSTRACT FROM AUTHOR]

The management of hyperparathyroidism (intact parathyroid hormone (iPTH) serum levels > 585 pg/mL), frequently focuses on the appropriate control of mineral and bone markers, with the decrease in serum and dietary phosphorus as two of the targets. We aimed to investigate the association between iPTH, serum phosphorus levels and dietary intake. This was a cross-sectional, multicenter, observational study with 561 patients on hemodialysis treatment. Clinical parameters, body composition and dietary intake were assessed. For the analysis, patients were divided into three groups: (a) iPTH < 130, (b) iPTH between 130 and 585 and (c) iPTH > 585 pg/mL. The association between PTH, serum phosphorus and dietary intake was analyzed using linear regression models. In the whole sample, 23.2% of patients presented an iPTH > 585 pg/mL. Patients with higher iPTH levels were those with longer HD vintage and lower ages, higher serum phosphorus, serum calcium, Ca/P product, albumin and caffeine intake, and a lower dietary intake of phosphorus, fiber, riboflavin and folate. Higher serum phosphorus predicted higher iPTH levels, even in the adjusted model. However, lower dietary phosphorus and fiber intake were predictors of higher iPTH levels, including in the adjusted model. Our results bring new data to the relationship between dietary intake and iPTH values. Despite higher serum phosphorus being observed in patients with HPTH, an opposite association was noted regarding dietary phosphate and fiber. [ABSTRACT FROM AUTHOR]

Simple Summary: Under field conditions, interactions occur between animals, parasites and the environment. Usually, only 30% of goats (over a dispersed distribution) display high gastrointestinal nematode (GIN) burdens. Hence, focusing on individual infection would allow better management of the impact of GINs. As acclaimed evolutionary biologist and natural historian S.J. Gould (1941–2002) once emphasized: "The Median Isn't the Message". The relationship between individual and herd GIN infection levels, nutritional and productive performance and anemia parameters in a tropical farm context were evaluated. Fifty-four female goats browsing the tropical forest (supplemented with balanced feed and chopped grass) were used. Measurements were obtained every 15 days (six samplings during the study); likewise, in each sampling time, the fecal samples were obtained in the morning [AM] and afternoon [PM] to assess the GIN burdens (eggs per gram of feces). The individual AM and PM values were similar and highly correlated at each sampling time. The nutritional and productive status fluctuated over time, although the median GIN burden of the flock was relatively constant. Nevertheless, the individual GIN burden differed when assessed at 30 d intervals; thus, these sampling points can be considered independent. Higher GIN burdens were associated with low body condition and low hematocrit. Moreover, the marked fluctuation of live weight should warn that nutrition is highly dynamic and could have a more important effect than GIN burden on the performance of goats under farm conditions in the tropics. We evaluated the relationship between individual and herd GIN infection level, nutrition, production performance and anemia parameters in a tropical farm context. Fifty-four female goats were monitored to assess their body condition score (BCS, nutritional status indicator), live weight (LW) and LW gain (LWG, both used as production level indicators), FAMACHA© and hematocrit (HT, both used as anemia indicators). Goats browsed for 4 h in a tropical forest and received balanced feed and chopped grass. The eggs per gram of feces (EPG) indicated the GIN burden, with fecal samples obtained at 7:00 (AM) and 15:00 h (PM.) from each goat at six sampling points during the study. The variables and their relationship with GIN burdens were analyzed using Kruskall–Wallis, ANOVA and Friedman tests and Spearman correlations. The fecal samples obtained in the AM and PM can be equally representative of parasitic burdens (similar and highly correlated). However, the EPG of individual goats from periods of 30 days apart can be considered independent. The BCS and LWG varied between sampling times (p < 0.05), whereas EPG, LW and HT did not (p > 0.05). The GIN burden was negatively correlated with HT and BCS (−0.21, p = 0.01 for each one). The individual pattern of infection demonstrates the true impact of GINs on their hosts. Additionally, feeding and nutritional status may present important variations influencing the performance of the goats more than the impact of GINs under the farm conditions of the present study. However, GIN infection contributed to the variation in goat health and productivity in this tropical farm. [ABSTRACT FROM AUTHOR]

Simple Summary: The diamondback moth, Plutella xylostella (L.), is an important migratory insect pest worldwide. In this study, the effects of environmental parameters, age, nutritional supplementation and sex on the wingbeat frequency of the insect adult were measured in the laboratory, and the results showed that nutritional status, sex and ambient temperature modulate the wingbeat frequency of the moth. These findings can be helpful for further understanding flight biology of the insect as well as to improve the accuracy using insect radar facility to directly identify migrating moths based on species difference of wingbeat frequency. The diamondback moth, Plutella xylostella L. (Lepidoptera: Plutellidae), is a cosmopolitan horticultural pest that is undergoing a fast, climate-driven range expansion. Its wide geographic distribution, pest status, and high incidence of insecticide resistance are directly tied to long-distance migration. Wingbeat frequency (WBF) is a key aspect of P. xylostella migratory behavior, but has received limited scientific attention. Here, we investigated the effects of environmental parameters, age, adult nutrition, and sex on P. xylostella WBF. Across experimental regimes, WBF ranged from 31.39 Hz to 78.87 Hz. Over a 10–35 °C range, the WBF of both male and female moths increased with temperature up to 62.96 Hz. Though male WBF was unaffected by humidity, females exhibited the highest WBF at 15% relative humidity (RH). WBF was unaffected by adult age, but adult nutrition exerted important impacts. Specifically, the WBF of moths fed honey water (54.66 Hz) was higher than that of water-fed individuals (49.42 Hz). Lastly, males consistently exhibited a higher WBF than females. By uncovering the biological and (nutritional) ecological determinants of diamondback moth flight, our work provides invaluable guidance to radar-based monitoring, migration forecasting, and the targeted deployment of preventative mitigation tactics. [ABSTRACT FROM AUTHOR]

Simple Summary: The increasing presence or contamination of various everyday-life products (including foodstuffs) by graphene oxides and silver nanoparticles (GOs and AgNPs, respectively) raises a risk of their possibly deleterious effects on digestive functions and, consequently, nutrient and energy intake by an organism. The study addresses this issue by considering various NP concentrations and exposure times. The scarcity of relevant data makes such studies necessary for the reliable assessment of NP effects. This study on a model insect species—adult house crickets—revealed a changed profile of digestive enzymes' activities in the gut, mainly when a high content of NPs was present in the food: stimulated digestion of carbohydrates and lipids but inhibited digestion of proteins. These changes were more pronounced in AgNP-treated than in GO-treated insects and increased with exposure time. Disturbed digestion led to decreased food consumption with exposure time in AgNP-treated crickets. Food assimilation was also affected—the cumulative food assimilation (CFA) was higher and lower compared with the control in crickets exposed to the lowest and moderate concentrations of AgNPs, respectively. These findings confirmed weak or no effects of low amounts of NPs in food and revealed that their higher concentrations may adversely influence digestive processes and resulting nutrient and energy intakes, particularly during prolonged exposure of an organism. The advancement of nanotechnology poses a real risk of insect exposure to nanoparticles (NPs) that can enter the digestive system through contaminated food or nanopesticides. This study examines whether the exposure of model insect species—Acheta domesticus—to increasing graphene oxide (GO) and silver nanoparticle (AgNP) concentrations (2, 20, and 200 ppm and 4, 40, and 400 ppm, respectively) could change its digestive functions: enzymes' activities, food consumption, and assimilation. We noticed more pronounced alterations following exposure to AgNPs than to GO. They included increased activity of α-amylase, α-glucosidase, and lipase but inhibited protease activity. Prolonged exposure to higher concentrations of AgNPs resulted in a significantly decreased food consumption and changed assimilation compared with the control in adult crickets. A increase in body weight was observed in the insects from the Ag4 group and a decrease in body weight or no effects were observed in crickets from the Ag40 and Ag400 groups (i.e., 4, 40, or 400 ppm of AgNPs, respectively), suggesting that even a moderate disturbance in nutrient and energy availability may affect the body weight of an organism and its overall condition. This study underscores the intricate interplay between NPs and digestive enzymes, emphasizing the need for further investigation to comprehend the underlying mechanisms and consequences of these interactions. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses. [ABSTRACT FROM AUTHOR]

Simple Summary: Individual differences exist in the tolerability of surgical intervention among elderly patients, and it is necessary for appropriate treatment planning. The aim of our retrospective study was to investigate the efficacy of markers of preoperative inflammatory and nutritional status and identified perioperative high-risk elderly patients with gastric cancer. We analyzed whether preoperative inflammatory nutritional markers of 571 gastric cancer patients (<65 years old; n = 192, ≥65 years old; n = 379) can predict postoperative short-term and long-term outcomes. Preoperative high C-reactive albumin ratio (CAR) was not only associated with the occurrence of postoperative complications but also with poor prognosis in elderly gastric cancer patients. However, these trends were not observed among younger patients. The importance of these findings is that CAR has the potential to be used as a simple tool to predict short- and long-term postoperative outcomes that reflect the nutritional inflammatory status of the elde. Individualized preoperative assessment of the general condition of elderly patients with gastric cancer is necessary for appropriate surgical treatment planning. This study investigated the efficacy of preoperative markers that could be easily calculated from preoperative peripheral blood to predict the short- and long-term postoperative outcomes of gastrectomy. In total, 571 patients who underwent R0 surgical resection for gastric cancer were enrolled. In the elderly patient group (≥65 years old), univariate analyses revealed that the incidence of postoperative complications was associated with poor performance status (p = 0.012), more comorbidities (p = 0.020), high C-reactive protein to albumin ratio (CAR, p = 0.003), total gastrectomy (p = 0.003), open approach (p = 0.034), blood transfusion (p = 0.002), and advanced cancer (p = 0.003). Multivariate analysis showed that a high CAR was associated with a high incidence of postoperative complications (p = 0.046). High CAR was also associated with poor OS (p = 0.015) and RFS (p = 0.035). However, these trends were not observed among younger patients (<65 years old). Preoperative CAR may play a significant role in predicting short- and long-term surgical outcomes, particularly in elderly patients with gastric cancer. [ABSTRACT FROM AUTHOR]

Malnutrition is prevalent in patients with chronic kidney disease (CKD), especially those on hemodialysis. Recently, our group described that a new oral nutritional supplement (ONS), specifically designed for malnourished (or at risk) hemodialysis patients with a "similar to the Mediterranean diet" pattern, improved caloric-protein intake, nutritional status and biomarkers of inflammation and oxidation. Our aim in this study was to evaluate whether the new ONS, associated with probiotics or not, may produce changes in miRNA's expression and its target genes in malnourished hemodialysis patients, compared to individualized diet recommendations. We performed a randomized, multicenter, parallel-group trial in malnourished hemodialysis patients with three groups (1: control (C) individualized diet (n = 11); 2: oral nutritional supplement (ONS) + placebo (ONS-PL) (n = 10); and 3: ONS + probiotics (ONS-PR) (n = 10)); the trial was open regarding the intake of ONS or individualized diet recommendations but double-blinded for the intake of probiotics. MiRNAs and gene expression levels were analyzed by RT-qPCR at baseline and after 3 and 6 months. We observed that the expression of miR-29a and miR-29b increased significantly in patients with ONS-PR at 3 months in comparison with baseline, stabilizing at the sixth month. Moreover, we observed differences between studied groups, where miR-29b expression levels were elevated in patients receiving ONS-PR compared to the control group in the third month. Regarding the gene expression levels, we observed a decrease in the ONS-PR group compared to the control group in the third month for RUNX2 and TNFα. TGFB1 expression was decreased in the ONS-PR group compared to baseline in the third month. PTEN gene expression was significantly elevated in the ONS-PR group at 3 months in comparison with baseline. LEPTIN expression was significantly increased in the ONS-PL group at the 3-month intervention compared to baseline. The new oral nutritional supplement associated with probiotics increases the expression levels of miR-29a and miR-29b after 3 months of intervention, modifying the expression of target genes with anti-inflammatory and anti-fibrotic actions. This study highlights the potential benefit of this oral nutritional supplement, especially associated with probiotics, in malnourished patients with chronic renal disease on hemodialysis. [ABSTRACT FROM AUTHOR]

Simple Summary: Cachexia and malnutrition are characteristic of oncology patients, including those with head and neck cancer (HNSCC). Fifty-six patients diagnosed with HNSCC (study group) were included in the study, and seventy patients constituted the control group. We used standardized questionnaires to assess nutritional status and cachexia. In our study, we evaluated whether ghrelin, titin, and irisin can be a useful diagnostic marker, a prognostic marker of cancer development in these patients, and whether the levels of these proteins depend on the nutritional status of the patients. We used molecular biology methods to evaluate the concentration of the selected proteins. The results indicate that the levels of ghrelin, titin, and irisin correlate well with the nutritional and cachexia status of patients with HNSCC. Until now, to our best knowledge, this is the first study assessing the changes in concentrations of these proteins in this type of cancer. The goal of this paper was the evaluation of the changes in the expression profile of irisin, ghrelin, and titin in the carcinoma tissue and in the blood of patients with head and neck squamous cell carcinoma (HNSCC), including determining the profile of their expression in relation to patient nutrition. The study included 56 patients with diagnosed squamous cell carcinoma of HNSCC in the T3 and T4 stages of the disease. Healthy control tissue specimens were collected from an area 10 mm outside the histologically negative margin. In turn, the blood and serum from the control group came from healthy volunteers treated for non-oncologic reasons (n = 70). The molecular analysis allowed us to determine the profile of irisin, ghrelin, and titin methylation, evaluate their expression on the level of mRNA (quantitative Reverse Transcription Polymerase Chain Reaction; qRT-PCR) and protein (Enzyme-Linked Immunosorbent Assay Reaction; ELISA) in the carcinoma tissue and the margin of healthy tissue, as well as in serum of patients in the study and control groups. At the start of our observations, a Body Mass Index (BMI) < 18.5 was noted in 42 of the patients, while six months after the treatment a BMI < 18.5 was noted in 29 patients. We also noted a decrease in the expression of irisin, ghrelin, and titin both on the level of mRNA and protein, as well as a potential regulation of their expression via DNA methylation. There is no convincing evidence that the proteins assayed in the present work are specific with regard to HNSSC. [ABSTRACT FROM AUTHOR]

Simple Summary: After minimal-invasive resection esophagectomy for cancer, patients experience significant impairments to nutritional supply and quality of life. The meticulous monitoring of vitamin status and potentially treatable nutritional intake is therefore mandatory. Minimal-invasive resection of the esophagus for esophageal cancer has led to a relevant decrease in postoperative morbidity. Postoperatively, patients still suffer from surgical and adjuvant therapy-related symptoms impairing nutrition and quality of life. The aim of this study was to evaluate the nutritional status and associated symptoms six months after esophagectomy. Patients who attended follow-up examination six months after minimal-invasive esophagectomy were included. Blood and fecal tests, quality of life surveys (QLQ-C30 and QLQ-OG25) and nutritional risk screening (NRS) were performed. Twenty-four patients participated. The mean weight loss was 11 kg. A significant decrease in vitamin B12 (737 to 467 pg/mL; p = 0.033), ferritin (302 to 126 ng/mL; p = 0.012) and haptoglobin (227 to 152 mg/dL; p = 0.025) was found. In total, 47% of the patients had an impaired pancreatic function (fecal elastase < 500 µg/g). Physical (72 to 58; p = 0.034) and social functioning (67 to 40; p = 0.022) was significantly diminished, while self-reported global health status remained stable (52 to 54). The number of patients screened and found to be in need of nutritional support according to NRS score decreased slightly (59% to 52%). After MIE, patients should be meticulously monitored for nutritional status after surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Bile acids (BAs) improve antioxidant properties and lipid metabolism, but their effects on dairy cattle remain to be elucidated. The study results revealed that total antioxidant capacity and levels of superoxide dismutase and glutathione peroxidase were significantly higher in dairy cows supplemented with 18 g of BAs than in control cows. In conclusion, BAs can improve the antioxidant performance of dairy cows. This experiment investigated the effects of different levels of bile acid (BA) additives in diets on the lactation performance, serum antioxidant metabolites, and serum biochemical indices of 60 multiparous mid-lactation dairy cows. The cows were randomized to receive one of the four homogeneous treatments, with the BA preparation supplemented at 0, 6, 12, and 18 g/head/d. The experiment lasted for 14 weeks. The first 2 weeks were the pre-feeding period. The milk yield and composition data were recorded weekly, and the dry matter intake and antioxidative blood index were analyzed on the 6th, 10th, and 14th weeks of the study. On the 84th day of the experiment, the experimental group exhibited significantly higher levels of total protein and albumin, by 57.5% and 55.6%, respectively, compared to the control group (p < 0.05). On both the 28th and 84th days of the trial, the experimental group showed a markedly higher lipase content compared to the control group, by 26.5% and 25.2%, respectively (p < 0.05). Furthermore, the experimental group displayed notably elevated levels of superoxide dismutase, glutathione peroxidase, and total antioxidant capacity, surpassing the control group by 17.4%, 21.6%, and 8.7%, respectively. In conclusion, BA additives improve the serum antioxidant indices of dairy cows, thereby enhancing the performance of these cows. [ABSTRACT FROM AUTHOR]

Simple Summary: Due to several factors including persistent drought conditions and the increased occurrence and severity of fire on rangeland, there is an increased need for the use of alternative forages to meet the nutrient requirements of ruminants raised in extensive grazing systems. However, information on the nutritive value of alternative forages like Eragrostis teff as influenced by harvest maturity, and the best supplementation strategies that complement and improve utilization of those forages, is still lacking. Therefore, the present study evaluated the effects of harvest maturity of teff hay (early- compared to late-heading stage of maturity) and supplemental energy sources (corn grain compared to beet pulp at 0.5% of body weight) on nutrient intake and digestibility and nitrogen utilization in beef heifers. Delaying the harvest of teff hay resulted in a decrease in nutrient supply, which was not attenuated by feeding either supplemental corn grain or beet pulp. Nitrogen retention was also negative regardless of harvest maturity, and this potentially indicates that there might be a need to provide both energy and protein supplements to improve nutrient supply and, thus, growth performance when feeding teff hay to beef cattle. The phenological stage of maturity of grasses and supplementation program can impact forage utilization in grazing beef cattle. However, the potential interaction between harvest maturity of Eragrostis tef (teff) hay and energy supplement source was yet to be fully evaluated. Therefore, our objective was to determine the effects of harvest maturity of teff hay and supplemental energy sources on nutrient intake, apparent total-tract nutrient digestion, nitrogen (N) utilization, and ruminal fermentation characteristics in beef heifers. A split-plot design with teff hay harvest maturity as the whole plot and supplemental energy source as the subplot was administered in a three-period (21 d), three × three Latin square design. Six crossbred beef heifers (804 ± 53.6 kg of body weight; BW) were allocated to two harvest maturities (early- (EH]) or late-heading (LH)) and to two supplemental energy sources (no supplement (CON), or rolled corn grain or beet pulp pellet fed at 0.5% of BW). Data were analyzed using SAS. There was no harvest maturity × energy supplement interaction. Although harvest maturity had no impact on total dry matter intake (DMI), crude protein (CP) intake was greater (p < 0.01) for EH than LH heifers. Total intakes of dry (DM) and organic matter (OM) were also greater (p < 0.01) for supplemented than CON heifers, whereas acid detergent fiber (ADF) intake was greater for beet pulp heifers compared to heifers fed the CON diet and supplemental corn grain. Harvest maturity had no impact on ruminal pH. However, mean ruminal pH was lower (p = 0.04), duration pH < 6.2, and molar proportions of butyrate and branched-chain fatty acids were greater (p ≤ 0.049) for heifers fed corn grain compared to CON and beet pulp diets. Heifers fed EH hay had greater (p ≤ 0.02) apparent total-tract DM, OM, CP, NDF, and ADF digestibility than heifers fed LH hay. Although there was no supplemental energy effect on microbial nitrogen (N) flow, it was greater (p < 0.01) for EH than LH heifers. Apparent N retention, which did not differ, was negative across all diets. In summary, delaying the harvest of teff hay from the EH to LH stage of maturity compromised nutrient supply, which was not attenuated by feeding supplemental corn grain and beet pulp at 0.5% of diet DM. Because N retention was negative across harvest maturity, there might be a need to provide both energy and protein supplements to improve growth performance when feeding teff hay to beef cattle. [ABSTRACT FROM AUTHOR]

Simple Summary: Millions of people suffer from malnutrition worldwide, and not enough or suboptimal nutrients also constitute a major challenge for many other species. Here, we investigated the effects of undernutrition on phenotypes associated with the aging processes utilizing Drosophila melanogaster as a model species. We fed flies with either a balanced and nutritious diet or restricted diets with nutritional deficiencies. We found that flies fed on poor diets weighed less, had shortened lives, and were less active and more sensitive to environmental stress compared to flies fed on more nutritious diets. Interestingly, these negative impacts of undernutrition were much more severe in males than in females. We conclude that the period of life spent in good health conditions, i.e., healthspan, can be markedly reduced by nutritional stress and that female flies are better able to cope with an insufficient diet, possibly because of a larger innate fat deposit compared to males. Insufficient intake of essential nutrients, malnutrition is a major issue for millions of people and has a strong impact on the distribution and abundance of species in nature. In this study, we investigated the effect of malnutrition on several fitness components in the vinegar fly Drosophila melanogaster. Four diets with different nutritional values, including three diluted diets of an optimal nutritional balanced diet, were used as feed sources. The effect of malnutrition on fitness components linked to healthspan, the period of life spent in good health conditions, was evaluated by quantifying the flies' lifespan, locomotor activity, heat stress tolerance, lipid content, and dry weight. The results showed that malnutrition had severe negative impact, such as reduced lifespan, locomotor activity, heat stress tolerance, fat content, and dry weight. The negative phenotypic effects were highly sex-dependent, with males being more negatively impacted by malnutrition compared to females. These findings highlight important detrimental and sex-specific effects of malnutrition not only on lifespan but also on traits related to healthspan. [ABSTRACT FROM AUTHOR]

Simple Summary: The mature Kiko wethers performed satisfactorily in woodlands, whereas the performance of young and growing animals was suboptimal, and they required supplementation. However, information is scant on supplementation strategies for nursing does and their kids stocked in woodlands. This study aimed to evaluate the supplementation strategies and assess the associated performance of nursing Kiko does and kids and the nutritional status of does as reflected in their feces when stocked in woodlands. Two supplementation strategies were evaluated: (1) supplemental grazing in adjacent silvopasture plots for 3–4 h/day and (2) supplementation with corn at the rate of 0.5% of their metabolic body weight and free-choice hay. Nursing Kiko does raised in woodlands with supplemental grazing showed a better FAMACHA score and browsing activities at a greater height compared to their counterpart does supplemented with hay and corn. The fecal nitrogen concentration was higher in does with supplemental grazing compared to those supplemented with hay and corn. The supplemental grazing was found to be a better option than supplementing with hay and corn for nursing Kiko does raised in woodlands. The influence of different supplement types on the performance and nutrient dynamics of goats stocked in woodlands is not known. The objective of this study was to evaluate the effect of supplement type on the performance and the concentration of fecal nutrients of nursing does and the performance of kids raised in woodlands. One group of goats (SG, 9 does; 18 kids) was allowed supplemental grazing in adjacent silvopasture plots for 3–4 h daily and another group (SF, 8 does; 15 kids) was supplemented with corn (0.5% of metabolic weight) and ad libitum hay. Vegetation samples were collected and analyzed for productivity and quality (crude protein, CP; acid detergent fiber, ADF; neutral detergent fiber, NDF). The quality of the hay (N, ADF, NDF) and fecal samples (N, P, Ca) was analyzed. The animals' live weight, FAMACHA score, and body condition score were collected. The browsing height for does consuming woodland vegetation was measured. Data were analyzed using the GLM procedure, Mixed procedure, and MEANS procedure in SAS 9.4. SG does showed better FAMACHA scores vs. SF does (p < 0.05). Fecal N and ADF were greater (p < 0.0001) in SG does vs. SF does. The findings showed a better performance and greater concentration of fecal nutrients in SG does vs. SF does, suggesting grazing quality pastures is a better option than using feedstuffs to supplement nursing does in woodland. [ABSTRACT FROM AUTHOR]

The Prognostic Nutritional Index (PNI) is widely recognized as a screening tool for nutrition. We retrospectively examined the impact of PNI in patients with chronic liver disease (CLD, n = 319, median age = 71 years, 153 hepatocellular carcinoma (HCC) patients) as an observational study. Factors associated with PNI < 40 were also examined. The PNI correlated well with the albumin–bilirubin (ALBI) score and ALBI grade. The 1-year cumulative overall survival rates in patients with PNI ≥ 40 (n = 225) and PNI < 40 (n = 94) were 93.2% and 65.5%, respectively (p < 0.0001). In patients with (p < 0.0001) and without (p < 0.0001) HCC, similar tendencies were found. In the multivariate analysis, hemoglobin (p = 0.00178), the presence of HCC (p = 0.0426), and ALBI score (p < 0.0001) were independent factors linked to PNI < 40. Receiver operating characteristic (ROC) curve analysis based on survival for the PNI yielded an area under the ROC curve of 0.79, with sensitivity of 0.80, specificity of 0.70, and an optimal cutoff point of 42.35. In conclusion, PNI can be a predictor of nutritional status in CLD patients. A PNI of <40 can be useful in predicting the prognosis of patients with CLD. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer-related fatigue (CRF) is the most common and distressing symptom in cancer survivors, severely affecting their quality of life. However, clinicians and patients are not well recognized for its importance and lack timely screening and assessment. With the rapid development of artificial intelligence and personalized care, early screening and assessment of CRF using machine learning to construct risk prediction models may contribute to this. Therefore, we redefined the predictors of CRF based on the predisposing, precipitating, and perpetuating (3P) model to develop a valid basis for the feature selection of future prediction models, intending to provide a more accurate and personalized plan for the clinical diagnosis and management of CRF. Cancer-related fatigue (CRF) is a widespread symptom with high prevalence in cancer patients, seriously affecting their quality of life. In the context of precision care, constructing machine learning-based prediction models for early screening and assessment of CRF is beneficial to this situation. To further understand the predictors of CRF for model construction, we conducted a comprehensive search in PubMed, Web of Science, Embase, and Scopus databases, combining CRF with predictor-related terms. A total of 27 papers met the inclusion criteria. We evaluated the above studies into three subgroups following the predisposing, precipitating, and perpetuating (3P) factor model. (1) Predisposing factors—baseline fatigue, demographic characteristics, clinical characteristics, psychosocial traits and physical symptoms. (2) Precipitating factors—type and stage of chemotherapy, inflammatory factors, laboratory indicators and metabolic changes. (3) Perpetuating factors—a low level of physical activity and poorer nutritional status. Future research should prioritize large-scale prospective studies with emerging technologies to identify accurate predictors of CRF. The assessment and management of CRF should also focus on the above factors, especially the controllable precipitating factors, to improve the quality of life of cancer survivors. [ABSTRACT FROM AUTHOR]

Simple Summary: This study group has previously published and documented that multimodal prehabilitation (enhanced optimization of physical function and adjustment of modifiable medical issues) before major bladder surgery is feasible and leads to a positive change in patients' fitness and functional status from a short-term perspective after surgery. However, long-term follow-ups after prehabilitation have not yet been published. Thus, this study aims to evaluate 1-year results on the efficacy of physical prehabilitation on functional capacity and nutritional recovery to inform the bladder cancer community of the potential of prehabilitation. The results show that prehabilitation in major bladder cancer surgery can significantly improve physical function and support the maintenance of nutritional status one year after major bladder cancer surgery. The results promote the gradual recognition that early restoration of physical function is vital to a full recovery. Multimodal prehabilitation is the process of enhancing physiological, nutritional, and psychological resilience to increase patients' functional capacity before major cancer surgery and aims to empower the patient to withstand the pending stress of major surgery and ultimately to improve long-term outcomes. The effect of physical prehabilitation to counteract the physical decline in surgical cancer patients has been documented; however, long-term results have not yet been published. This follow-up study aims to evaluate 1-year results on the efficacy of physical prehabilitation after bladder cancer surgery. The efficacy of prehabilitation was measured over the course of 1 year in 107 patients randomized to (1) pre- and rehabilitation or (2) standard care divided by n = 50 in the intervention (I) and n = 57 in the standard group (S). Physical function was measured by muscle leg power, and nutritional status was expressed with handgrip strength. Prehabilitation in major bladder cancer surgery can significantly improve physical function with 19.8 Watt/kg (p = 0.04), lean body mass (p = 0.047) and body cell mass (p = 0.03), and regained nutritional status one year after surgery. The results demonstrate that the restoration of physical function is vital to a full recovery. [ABSTRACT FROM AUTHOR]

About 30–40% of the general population in the United Kingdom (UK) has been reported to have vitamin D deficiency during winter months, representing a public health risk. The aim of this study was to assess the dietary intake of vitamin D in university students at De Montfort University (DMU, UK). Nutrient intake data were collected from 111 (20.45 yrs old; 78 female) DMU students (41 Asian, 41 African and 27 European; 2 unclassified). The dietary intake of vitamin D was slightly higher in male participants (4.287 vs. 3.853 µg/day; p-value = 0.196), which could be attributed to the generally higher intake of food products rich in this vitamin, specifically cereals (436.165 vs. 308.750 g/day; p-value = 0.002), meat (271.553 vs. 193.063 g/day; p-value = 0.016) and bacon (4.911 vs. 1.551 g/day; p-value = 0.024), intakes of which were significantly higher in males. The dietary intakes of vitamin D recorded are lower than the amount of 10 µg/day recommended by the UK's National Health Service. Intake did not show statistical differences according to ethnic background (Asian (3.708) < African (4.109) < European (4.199); all in µg/day), which might reflect poor and similar dietary habit/choices when students transition from home to university regardless of ethnic background. Our results suggest some prevalence of hypovitaminosis D in DMU students which should be tackled to prevent diseases related to vitamin D deficiency. [ABSTRACT FROM AUTHOR]

This literature overview describes the potential benefits associated with the integration of precision nutrition and artificial intelligence (AI). PubMed was searched up to June 2023 to identify clinical studies that focused on AI dietary apps used in precision nutrition. The search yielded a total of 198 results, out of which 7 clinical studies were deemed relevant and included in this analysis. These studies examined the applications of AI mobile apps in various areas, including regulating nutrient intake, aiding in weight loss, enhancing dietary treatments for chronic diseases, and predicting metabolic parameters, such as glucose levels in individuals with diabetes. Despite some limitations, the findings indicate that these apps demonstrated a satisfactory level of accuracy in accomplishing their intended tasks. The advantages and limitations of utilizing AI-based tools for nutritional support are then discussed. In conclusion, the integration of precision nutrition and AI presents transformative opportunities for personalized health. By harnessing the computational power of AI, researchers and healthcare practitioners can unlock the potential of large-scale data analysis for tailored dietary interventions. [ABSTRACT FROM AUTHOR]

The current treatment for the autoimmune disease of hypothyroidism (AIDH) is based on pharmacotherapy with levothyroxine. A non-pharmacological supplementary element of therapy could be the implementation of an individualized balanced diet and probiotics. Lactiplantibacillus plantarum 299v (Lp299v), with its anti-inflammatory effects, may also support the therapy. However, the number of studies on personalized dietary interventions with probiotics in AIDH is limited, and no clear conclusions can be drawn from the results so far. Therefore, this trial will analyze the effect of Lp299v supplementation in conjunction with nutrition education on the quality of life and nutritional status of patients with Hashimoto's. Methods: This double-blind, 12-week intervention study will include 100 female patients with AIDH. They will be divided into two groups: (1) individual personalized nutrition education + Lp299v and (2) individual personalized nutrition education + placebo. Before and after the education intervention, selected elements in the diet, eating behavior, quality of life, nutritional status (anthropometric parameters, body composition), blood pressure, and anti-TPO (antibodies against thyroid peroxidase) titer will be assessed. Hypothesis: It is expected that this study will provide deeper knowledge on the validity of using proper nutritional principles and Lp299v in AIDH. Specifically, the impact on the subjective assessment of the quality of life, selected elements in the diet, and the state of nutrition and health will be assessed. [ABSTRACT FROM AUTHOR]

Simple Summary: A critical environmental factor that affects the growth and development of insect herbivores is food quality, and insect herbivores require the correct blend and balance of different nutrients in order to meet their physiological demands. For the first time, we investigated the nutritional regulation of the oriental armyworm, Mythimna separata (walker), and the association between insect performance (i.e., developmental time, insect mass, and reproductive response) and nutrients. Caterpillars had different intake targets for two macronutrients, proteins and carbohydrates, at two larval stages, and food consumption and nutrient intake were closely correlated with the content of protein and carbohydrate, respectively. Interestingly, we also found that the trade-off between nutritional regulation and fecundity, a phenomenon often seen in this migrating species, may be attributed to food quality and, subsequently, physiological preparation. These results help us better understand the behavior of this economically important pest in the field. In nature, plants can contain variable nutrients depending upon the species, tissue, and developmental stage. Insect herbivores may regulate their nutrient intake behaviorally and physio- logically when encountering different foods. This study examined the nutritional regulation of the oriental armyworm, Mythimna separata, for the first time. In one experiment, we allowed the cater-pillars to choose between two nutritionally balanced but complementary diets. The caterpillars did not randomly consume the paired foods, but instead chose between the nutritionally balanced but complementary diets. This intake behavior was found to change with their developmental stages. Furthermore, the nutrient concentrations in food significantly impacted the insect's performance. In the other experiment, caterpillars were given one of eleven diets that reflected the different nutrient conditions in the field. The results showed that proteins were significantly associated with developmental time and fecundity. For example, by consuming protein-biased food, the caterpillars developed faster and produced more eggs. In contrast, carbohydrates were more strongly linked to lipid accumulation, and caterpillars accumulated more lipids when consuming the carbohydrate-biased food. Moreover, the caterpillars were also found to actively regulate their intake of proteins and carbohydrates based on food quality and to physiologically prepare for subsequent life stages. These findings enhance our understanding of how M. separata feeds and responds to different nutritional environments in the field, which could have implications for managing insect herbivores in agricultural settings. [ABSTRACT FROM AUTHOR]

Simple Summary: Supportive care is an essential component of excellent cancer care. It refers to the optimization of outcomes through supportive practices such as infection prevention, nutritional improvements, survivorship, early integration of palliative care, and addressing the psychological effects of cancer therapy. This perspective highlights the future directions and efforts necessary to advance supportive care in order to improve outcomes, survival, and quality of life for pediatric cancer patients. Herein, the authors summarize critical accomplishments and highlight important opportunities to expand research in this field to ensure optimal outcomes for children with cancer and survivors of childhood cancer. The optimization of outcomes for pediatric cancer patients relies on the successful advancement of supportive care to ease the treatment burden and mitigate the long-term impacts of cancer therapy. Advancing pediatric supportive care requires research prioritization as well as the development and implementation of innovations. Like the prevailing theme throughout pediatric oncology, there is a clear need for personalized or precision approaches that are consistent, evidence-based, and guided by clinical practice guidelines. By incorporating technology and datasets, we can address questions which may not be feasible to explore in clinical trials. Now is the time to listen to patients' voices by using patient-reported outcomes (PROs) to ensure that their contributions and experiences inform clinical care plans. Furthermore, while the extrapolation of knowledge and approaches from adult populations may suffice in the absence of pediatric-specific evidence, there is a critical need to specifically understand and implement elements of general and developmental pediatrics like growth, nutrition, development, and physical activity into care. Increased research funding for pediatric supportive care is critical to address resource availability, equity, and disparities across the globe. Our patients deserve to enjoy healthy, productive lives with optimized and enriched supportive care that spans the spectrum from diagnosis to survivorship. [ABSTRACT FROM AUTHOR]

Malnutrition is a tangible complication of cirrhosis with portal hypertension with a prevalence of up to 50%. In particular, sarcopenia and myosteatosis, defined as the alteration in muscle quantity and quality, have a negative impact on the main complications of liver disease and are associated with higher mortality in patients with cirrhosis. Recently, alterations in adipose tissue have also been described in cirrhotic patients and they seem to influence the course of liver disease. Several pieces of evidence indicate that a transjugular intrahepatic portosystemic shunt (TIPS), placed for the treatment of refractory portal hypertension, can lead to a modification of body composition consisting in the improvement of the skeletal muscle index, myosteatosis, and an increase in subcutaneous fat. These modifications of the nutritional status, even more pronounced in sarcopenic patients before TIPS, have been associated with an amelioration of cognitive impairment after TIPS as well as with an increase in the survival rate. The aim of this paper is to provide an overview of the effects of TIPS placement on nutritional status in cirrhosis focusing on its pathophysiological mechanisms and its relationship with liver-related outcomes. [ABSTRACT FROM AUTHOR]

Simple Summary: More than 60% of biliary tract cancer patients receive curative surgical resection. Nethereless, there is an absence of useful tools to predict prognosis before operation. Serum albumin and neutrophil-to-lymphocyte ratios are easily determined. Serum albumin is a marker of nutrition status and is correlated with prognosis in many cancer treatments. A neutrophil-to-lymphocyte ratio is a novel parameter widely used in most medical fields because it is a reliable marker of the immune response to different stimuli. Our study demonstrates that combined albumin and neutrophil scores, including nutritional and inflammatory indices, could predict operative survival in resectable biliary tract cancer patients. Background: The mainstay treatment of biliary tract cancer is complete tumor resection. Prior to surgery, risk stratification may help to predict and plan treatment approaches. In this study, we investigated the possibility of combining serum albumin concentrations and neutrophil-to-lymphocyte ratios (NLR) to create a score as ANS to predict the prognoses of biliary tract cancer before surgery. Methods: This study retrospectively collected serum albumin concentration, neutrophil, and lymphocyte data measured in biliary tract cancer patients slated to receive complete tumor resections within two weeks before surgery. From January 2013 to December 2019, 268 biliary tract cancer patients who had received tumor resections at our hospital were categorized into 3 ANS groups: ANS = 0 (high albumin and low NLR), ANS = 1 (low albumin or high NLR), and ANS = 2 (low albumin and high NLR). Results: Five-year survival rates were 70.1%, 47.6%, and 30.8% in the ANS = 0, 1, and 2 groups, respectively. The median overall survival time for the ANS = 0 group could not be determined by the end of the study, while those for ANS = 1 and ANS = 2 groups were 54.90 months and 16.62 months, respectively. The results of our multivariate analysis revealed that ANS could be used as an independent predictor of overall and recurrent-free survival. A high ANS was also correlated with other poor prognostic factors. Conclusions: The ANS devised for this study can be used to predict postoperative survival in patients with BTC and to guide treatment strategies. [ABSTRACT FROM AUTHOR]

This paper presents a procedure for the comparison of two technologies developed to classify peach trees according to their nutritional status. The first technology uses the leaf SPAD-502 meter value to characterize tree classes as indicated by agronomist experts: sound, intermediate, and strong chlorosis trees. It is used as a reference for the second technology, which uses a combination of two multispectral indexes computed from reflectance hyperspectral images. Specifically, R_NDVI = (R800 − R670)/(R800 + R670) and HyperSPAD = (R940/R650) are computed for each leaf pixel. An automated methodology is proposed that sets two optical thresholds (three hyperspectral categories) in view of the outliers according to a normal distribution, together with an iterative optimization of the bounding that determines the best assignment of trees to one of the three SPAD_502 levels of nutritional status, as required for practical agronomical purposes such as fertilization. The Chi 2 distribution is used to confirm the similarity of both nutritional classifications. These results encourage the use of on-board multispectral cameras to monitor the nutritional status of trees and to establish a more efficient fertilization strategy where inputs are applied according to individual status, with the consequent reduction in losses of fertilizers such as nitrogen to the atmosphere, soil, and water resulting from over-application. [ABSTRACT FROM AUTHOR]

(1) Background: Kidney transplantation is widely recognized as the most effective method of treating end-stage renal disease. Immunosuppressive therapy plays a pivotal role in the treatment of kidney transplant patients, encompassing all patients (except identical twins), and is administered from organ transplantation until the end of its function. The aim of this systematic review is to identify the evidence of the association between immunosuppressive therapy and nutritional status of patients following kidney transplantation. (2) Methods: This protocol has been designed in line with Preferred Items for Systematic Reviews (PRISMA-P). Our search encompasses several databases, including MEDLINE (via PubMed), EMBASE (Elsevier), Scopus and Web of Science. We intend to include observational studies (cross-sectional, case-control, and cohort designs), randomized controlled trials (RCTs), as well as completed and ongoing non-randomized study designs. We will confine our search to studies published in English within the past decade (from inception to 17 February 2023). Qualitative studies, case studies, and conference reports will be excluded. The selection process will be done in Covidence by two independent reviewers. Data extraction will be conducted using a standardized MS Excel template version 16.0. Quality assessment of included studies will be performed using the Cochrane Risk of Bias tool for randomized trials (RoB2), or the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Risk-of-bias plots will be generated using the web application Robvis. Relevant data that have been extracted from eligible studies will be presented in a narrative synthesis. We expect the studies to be too heterogeneous to perform subgroup analyses. (3) Conclusion: This systematic review will offer insights into the evidence regarding association between immunosuppressive therapy and nutritional status of adult patients (18 years of age or older) within the initial year following kidney transplantation. To our knowledge, there is no systematic review addressing that question. [ABSTRACT FROM AUTHOR]

Background: Neurological disease patients present an increased risk of developing pressure ulcers. The primary aim of this study is to evaluate the incidence and prevalence of pressure ulcers and their impact on length of stay and functional recovery. Methods: A retrospective study was conducted in a neurorehabilitation unit over a seven-year period. Data collected include demographic data, length of stay, functional evaluation, risk of pressure ulcers development, nutritional status, and skin. Pressure ulcers were classified according to the European Pressure Ulcer Advisory Panel System. Results: Data from 816 patients were analyzed. On admission, the authors found 236 pressure ulcers in 131 patients (about 16%), divided into stage I (25%), stage II (50%), and stage III–IV (25%). The most common sites were the heel (36%) and sacrum (29%). Among the risk factors for the development of pressure ulcers, malnutrition played a significant role, with approximately 76% of patients with pressure ulcers having mild to moderate malnutrition. Conclusion: The presence of pressure ulcers seems to have a negative impact on the functional recovery of patients, as shown by the outcome scales and the average length of stay: 51 days versus 36 days (p < 0.01). [ABSTRACT FROM AUTHOR]

Simple Summary: Systemic inflammatory markers are useful methods to predict the prognosis of colorectal cancer patients after surgeries. The Naples prognostic score is a useful predictive scoring system that reflects a patient's inflammatory and nutritional status. In this study, the postoperative Naples prognostic score showed high accuracy in predicting survival after curative resection in stage II–III colorectal cancer patients compared with preoperative inflammatory markers. Background: The Naples prognostic score (NPS) is a scoring system that reflects a patient's systemic inflammatory and nutritional status. This study aimed to evaluate whether postoperative NPS is effective in assessing the prognosis of stage II–III colorectal cancer (CRC) patients compared with preoperative NPS. Methods: Between 2005 and 2012, a total of 164 patients diagnosed with stage II–III CRC, who underwent curative resection followed by adjuvant chemotherapy, were divided into two groups: Group 0–1 (NPS = 0–2) and Group 2 (NPS = 3 or 4). Preoperative NPS was calculated based on the results before surgeries, and postoperative NPS was assessed using the results obtained before adjuvant chemotherapy. Results: The overall survival of Group 0–1 was higher than that of Group 2 in both pre- and postoperative NPS assessments. According to the ROC curve analysis, the Area Under the Curve (AUC) ratio for postoperative NPS was 0.64, compared with 0.57 for preoperative NPS, 0.52 for the preoperative neutrophil–lymphocyte ratio (p = 0.032), and 0.51 for the preoperative platelet–lymphocyte ratio (p = 0.027). Conclusions: Postoperative NPS is effective in predicting the prognosis of stage II–III CRC patients who underwent curative resection followed by adjuvant chemotherapy. The use of NPS could be beneficial in evaluating the prognosis of CRC patients after surgeries. [ABSTRACT FROM AUTHOR]

Simple Summary: To choose the appropriate treatment for patients with upper tract urothelial carcinoma (UTUC), proper diagnosis and risk assessment of the disease is mandatory. This study reviews some of the diagnostic tools, and the patient- and disease-related prognostic factors that affect the outcome. Predictive tools designed by these factors help determine which patients should undergo radical nephroureterectomy. Other tools help post-operative decisions regarding the use of chemotherapy and planning follow-up sessions. The available pre-operative predictive tools and post-operative nomograms are discussed. A revision of the current classification of patients to low- and high-risk groups is recommended, to expand the number of patients benefiting from kidney-sparing surgeries. Diagnosis and risk stratification are cornerstones of therapeutic decisions in the management of patients with upper tract urothelial carcinoma (UTUC). Diagnostic modalities provide data that can be integrated, to provide nomograms and stratification tools to predict survival and adverse outcomes. This study reviews cytology, ureterorenoscopy and the novel tools and techniques used with it (including photodynamic diagnosis, narrow-band imaging, optical coherence tomography, and confocal laser endomicroscopy), and biopsy. Imaging modalities and novel biomarkers are discussed in another article. Patient- and tumor-related prognostic factors, their association with survival indices, and their roles in different scores and predictive tools are discussed. Patient-related factors include age, sex, ethnicity, tobacco consumption, surgical delay, sarcopenia, nutritional status, and several blood-based markers. Tumor-related prognosticators comprise stage, grade, presentation, location, multifocality, size, lymphovascular invasion, surgical margins, lymph node status, mutational landscape, architecture, histologic variants, and tumor-stroma ratio. The accuracy and validation of pre-operative predictive tools, which incorporate various prognosticators to predict the risk of muscle-invasive or non-organ confined disease, and help to decide on the surgery type (radical nephroureterectomy, or kidney-sparing procedures) are also investigated. Post-operative nomograms, which help decide on adjuvant chemotherapy and plan follow-up are explored. Finally, a revision of the current stratification of UTUC patients is endorsed. [ABSTRACT FROM AUTHOR]

Older people's health is strongly determined by their lifestyle, and its deterioration is a cause for concern and calls for effective efforts to slow down the process. The aim of the study was to determine the relationship between diet quality and other non-food lifestyle elements. The data were collected in 2017 through a cross-sectional survey among 271 Polish elder citizens. A K-means cluster analysis was applied to separate homogeneous groups by lifestyle components (without diet) and a logistic regression was used to analyze the relationships between identified clusters and sociodemographic characteristics, nutritional knowledge and diet quality. Three homogenous clusters were identified, i.e., individuals with moderate physical activity and recommended sleep duration (pro-healthy), with low physical activity (low PA), and with short sleep (short sleep). Gender, age, education, place of residence, BMI, and health-promoting diet index (pHDI) did not differentiate adherence to clusters. The probability of being in the pro-healthy cluster increased with nutritional knowledge and declaring the same or better health status compared to peers, while it decreased when above-average financial status was reported. The obtained results importantly extend the previous findings by showing that the individual elements of lifestyle should be also perceived in the context of others. Further research focused on lifestyle as a whole might considerably support the implementation of multifaceted lifestyle interventions. [ABSTRACT FROM AUTHOR]

Microbiome dysbiosis is increasingly being recognized as implicated in immune-mediated disorders including multiple sclerosis (MS). The microbiome is modulated by genetic and environmental factors including lifestyle, diet, and drug intake. This study aimed to characterize the MS-associated gut microbiome in the Israeli populations and to identify associations with demographic, dietary, and clinical features. The microbiota from 57 treatment-naive patients with MS (PwMS) and 43 age- and gender-matched healthy controls (HCs) was sequenced and abundance compared. Associations between differential microbes with demographic or clinical characteristics, as well as diet and nutrient intake, were assessed. While there was no difference in α- or β-diversity of the microbiome, we identified 40 microbes from different taxonomic levels that differ in abundance between PwMS and HCs, including Barnesiella, Collinsella, Egerthella, Mitsuokella, Olsenella Romboutsia, and Succinivibrio, all enhanced in PwMS, while several members of Lacnospira were reduced. Additional MS-differential microbes specific to ethnicity were identified. Several MS-specific microbial patterns were associated with gender, vitamin D level, Mediterranean diet, nutrient intake, or disability status. Thus, PwMS have altered microbiota composition, with distinctive patterns related to geographic locations and population. Microbiome dysbiosis seem to be implicated in disease progression, gender-related differences, and vitamin D-mediated immunological effects recognized in MS. Dietary interventions may be beneficial in restoring a "healthy microbiota" as part of applying comprehensive personalized therapeutic strategies for PwMS. [ABSTRACT FROM AUTHOR]

The presence of sarcopenia has been associated with the worst outcome of Crohn's disease (CD). At present, no studies have evaluated the impact of ustekinumab (UST) in terms of its effects on body composition. The aim of this prospective study was to evaluate whether UST treatment could modify the parameters of body composition as assessed by bioelectrical impedance assay (BIA) in patients with CD. We prospectively enrolled consecutive patients with CD treated with UST, evaluating the therapeutic outcome at week 48 in terms of clinical remission and mucosal healing. BIA was performed at baseline and at week 48, assessing body cellular mass, total body water, phase angle, and body mass index. Out of 44 patients enrolled, 26 (59%) were in clinical remission and 22 (50%) achieved mucosal healing at the end of follow up. No significant differences were observed at baseline in all the BIA parameters between responders and non-responders. Phase angle increased over time in responders, while this was not observed in non-responders (test for the interaction between time and outcome, p-value = 0.009 and 0.007 for clinical remission and mucosal healing, respectively). The same differential increase was observed for body cellular mass (test for the interaction between time and outcome, p-value = 0.03 and 0.05 for clinical remission and mucosal healing, respectively). Total body water and BMI increased homogenously over time regardless of the outcomes (tests for the association with time, p-values of 0.01). To conclude, responsiveness to UST therapy seems to be associated with body composition modifications in patients with CD. In particular, the increase in phase angle in responders suggests that a significant improvement of nutritional status occurred in these patients. [ABSTRACT FROM AUTHOR]