Value of the modified Patient-Generated Subjective Global Assessment in indicating the need for nutrition intervention and predicting overall survival in patients with malignant tumors in at least two organs.

BACKGROUND: Although the Patient-Generated Subjective Global Assessment (PG-SGA) is a reference standard used to assess a patient's nutrition status, it is cumbersome to administer. The aim of the present study was to estimate the value of a simpler and easier-to-use modified PG-SGA (mPG-SGA) to evaluate the nutrition status and need for intervention in patients with malignant tumors present in at least two organs. METHODS: A total of 591 patients (343 male and 248 female) were included from the INSCOC study. A Pearson correlation analysis was conducted to assess the correlation between the mPG-SGA and nutrition-related factors, with the optimal cut-off defined by a receiver operating characteristic curve (ROC). The consistency between the mPG-SGA and PG-SGA was compared in a concordance analysis. A survival analysis was used to determine the effects of nutritional intervention among different nutrition status groups. Univariable and multivariable Cox analyses were applied to evaluate the association of the mPG-SGA with the all-cause mortality. RESULTS: The mPG-SGA showed a negative association with nutrition-related factors. Individuals with an mPG-SGA ≥ 5 (rounded from 4.5) were considered to need nutritional intervention. Among the malnourished patients (mPG-SGA ≥ 5), the overall survival (OS) of those who received nutrition intervention was significantly higher than that of patients who did not. However, the OS was not significantly different in the better-nourished patients (mPG-SGA < 5). CONCLUSION: Our findings support that the mPG-SGA is a feasible tool that can be used to guide nutritional interventions and predict the survival of patients with malignant tumors affecting at least two organs.

Prediction and Health Risk Assessment of Copper, Lead, Cadmium, Chromium, and Nickel in Tieguanyin Tea: A Case Study from Fujian, China.

Heavy metal is widespread in food and the environment due to multiple origins, raising concerns over their persistent potential health risks. Contamination of multiple heavy metals in tea leaves is frequently reported. However, the dietary exposure risk that heavy metals in Tieguanyin tea (a famous type of oolong tea,) pose to different subpopulations has not been explored. In this study, contaminations of five heavy metals (Cu, Pb, Cr, Cd, and Ni) of concern in Tieguanyin tea were monitored, then the related health risk was assessed for six different subpopulations based on tea brewing experiments and a previous consumption survey. Results show that the mean levels found were as follows: 8.18 mg/kg (Cu), 0.84 mg/kg (Pb), 0.51 mg/kg (Cr), 0.04 mg/kg (Cd), and 1.90 mg/kg (Ni), respectively, and their transfer rates during tea brewing varied within 10.2-70.4%. All estimated daily intakes of individual targeted elements via Tieguanying tea consumption were far below their corresponding tolerable limits. The adjusted hazard index value ranged from 1.1 × 10-2 to 1.7 × 10-2, indicating that exposure to these five elements via drinking Tieguanyin tea would not pose significant non-cancer risks for six subpopulations under the current consumption habit. In addition, the carcinogenic risks associated with heavy metals (Pb, Cd, and Cr) were acceptable because no total cancer risk values exceeded the 10-4 threshold. However, in order to improve consumer protection, we still suggest that considerable attention should be paid to Pb, Ni, and Cd because of their high concentration in infusion, high extraction rate, and major carcinogenic risk contribution, respectively.

De novo Creation and Assessment of a Prognostic Fat-Age-Inflammation Index "FAIN" in Patients With Cancer: A Multicenter Cohort Study.

Background and Aims: Malnutrition is highly prevalent and is related to multiple impaired clinical outcomes in cancer patients. This study aimed to de novo create an objective, nutrition-related index specially for prognostic purposes in oncology populations. Methods: We performed a multicenter cohort study including 14,134 cancer patients. The prognostic impact for each baseline characteristic was estimated by calculating Harrell's C-index. The optimal parameters reflecting the nutritional and inflammatory impact on patients' overall survival were selected to develop the fat-age-inflammation (FAIN) index. The associations of the FAIN with the nutritional status, physical performance, quality of life, short-term outcomes and mortality of patients were comprehensively evaluated. Independent external validation was performed to further assess the prognostic value of the FAIN. Results: The study enrolled 7,468 men and 6,666 women with a median age of 57 years and a median follow-up of 42 months. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)]. There were significant associations of the FAIN with the nutritional status, physical performance, quality of life and short-term outcomes. The FAIN also showed better discrimination performance than the Nutritional Risk Index, the Prognostic Nutritional Index and the Controlling Nutritional Status index (all P < 0.05). In multivariable-adjusted models, the FAIN was independently associated with a reduced death hazard both as a continuous variable (HR = 0.57, 95%CI = 0.47-0.68) and per one standard deviation (HR = 0.83, 95%CI = 0.78-0.88). External validation in a multicenter lung cancer cohort (n = 227) further confirmed the prognostic value of the FAIN. Conclusions: This study created and assessed the prognostic FAIN index, which might act as a feasible option to monitor the nutritional status and help develop intervention strategies to optimize the survival outcomes of cancer patients.

Health risk assessment of 42 pesticide residues in Tieguanyin tea from Fujian, China.

The objective of this study was to evaluate the residues of 42 pesticides subject to public concern in Tieguanyin tea produced in Fujian, China. The presence of 42 pesticide residues in 90 Tieguanyin tea samples were determined. A total of 17 pesticides were detected. At least one pesticide residue was detected in 65 samples (72.2%). The detected pesticides imidacloprid, tolfenpyrad, bifenthrin, acetamiprid were found in 55.6%, 33.3%, 18.9% and 16.7% of samples, respectively. Pesticide residues in Tieguanyin tea varied significantly over the seasons and across the production regions. Based on data obtained, the health risks associated with long-term exposure to those pesticides were assessed and risks of detected pesticides were ranked. The hazard quotients (HQs) among the detected pesticides range from 5 × 10-8 for fenpropathrin to 3 × 10-4 for imidacloprid. The results demonstrated that despite a high occurrence of pesticide residues in Tieguanyin tea, residue levels observed could not be considered as a serious public health problem. The risk ranking scheme showed dicofol and thiacloprid were considered to pose a medium-risk. The suggestions for 17 detected pesticides used in Tieguanyin tea plantation were made, including those already banned from use in China (dicofol and methomyl), recommended for diminished use (thiacloprid and chlorpyrifos), and permitted use with considering the pre-harvest interval (13 other pesticides).

Perchlorate contamination of tea leaves and a corresponding probabilistic dietary risk assessment using Monte Carlo simulation.

Perchlorate is known as a thyroid disrupter. Its contamination in various tea samples was monitored, and 286 samples belonging to four types of tea leaves were analysed. The detection rate of perchlorate in tea was 99.3%. The mean concentration in different tea types decreased in order from green tea, oolong tea, white tea to black tea. A probabilistic approach was performed to evaluate the dietary exposure of perchlorate for six different subpopulations. The daily intakes (EDIs) for consumers over the age of 41 were higher than that of other subpopulations. The hazard quotient for six groups was lower than 1 even at the extreme percentile (P99). It indicates that the risk of dietary exposure to perchlorate from tea consumption for Fujian people is acceptable without considering other foodstuffs. However, the high occurrence of perchlorate in tea samples suggested that the actual source of this contaminant should be further investigated.

Occurrence of pesticides in white tea and a corresponding risk exposure assessment for the different residents in Fujian, China.

White tea has been of increasing public interest worldwide owing to its health benefits. Based on 2 years of surveillance, the long-term and cumulative chronic exposure risks of pesticide residues through white tea drinking were assessed for different subpopulations in Fujian, China. Twenty-five different pesticides were found, and 74.8% of samples contained at least one pesticide residue. The most frequently detected pesticide was bifenthrin with detection rates of 61.6%. Risk assessment was performed using both the deterministic approach and semiprobabilistic model under the best-case and the worst-case scenarios. The results demonstrated that the dietary risks were extremely low for six different subpopulations in which the risks for adults over the age of 41 were relatively higher. The risk ranking scheme indicated that isocarbophos and triazophos were considered to be of medium risk. The different use suggestions for the 25 positive pesticides are proposed to further minimize the exposure risk to consumer health. PRACTICAL APPLICATION: Tea is the second most popular nonalcoholic beverage throughout the world. Pesticides are used to improve the yield of tea. Pesticide residues in tea could be one of the exposure pathways for consumers. Monitoring residual levels and assessing the health risk assessment in tea are thus in an urge.

Dietary risk assessment of pesticide residues on Tremella fuciformis Berk (snow fungus) from Fujian Province of China.

To assess the dietary exposure risks of pesticide residues in snow fungus for the general population and young children, 91 snow fungus samples were collected from major production areas in Fujian Province, China and the presence of 44 pesticides was determined. A total of thirteen pesticides were detected; 65.9% of the samples contained one or more pesticide residues. The most frequently found pesticide was carbofuran, followed by acetamiprid and then imidacloprid. Data obtained were used for chronic, acute, and chronic cumulative dietary exposure risk assessments. The chronic hazard quotient (cHQ) was extremely low for both the general population and young children. The %ADI values of cumulative dietary exposures to organophosphorus pesticides and carbamates ranged from 0.53% to 1.49%, and did not exceed their corresponding ADIs. However, the acute dietary risks from all 13 pesticides, especially carbofuran and methamidophos, were of concern due to the relatively high acute hazard quotient. The risk ranking scheme showed that carbofuran could pose a high risk to snow fungus consumers. Finally, suggestions are made about the potential use in snow fungus cultivation of the pesticides with detected residues.