Assessment of risk factors associated with drug-resistant tuberculosis in pulmonary tuberculosis patients.

INTRODUCTION: Tuberculosis remains a global health problem worldwide and the risk progression of Tuberculosis to Drug Resistant Tuberculosis is influenced by various factors. These include immunocompromised status, past history of tuberculosis, life style and nutritional level. Hence, identifying the population at risk of multidrug-resistant tuberculosis is essential and may help in developing appropriate case-finding strategies. Therefore, the present study was designed to study the contributing risk-factors associated with Drug resistant Tuberculosis. MATERIALS AND METHODS: In this prospective observational study, we assessed 189 Pulmonary tuberculosis diagnosed patients during the period of 2 years at government recognized tertiary care centers. Data was collected from all these patients checked to investigate risk factors associated with Drug resistant tuberculosis development by multivariant analysis. RESULTS: Of the 189 participants, 36 were diagnosed with drug resistant tuberculosis and 153 with drug sensitive tuberculosis. Factors associated with drug resistant tuberculosis include low-weight (OR 8.50; p = 0.0008430991), low-BMI (p = 0.0000527166), lower economic status (OR-2.1351; p = 0.048608696) and tobacco (OR-4.5192; p = 0.0023003189) were found clinically and statistically significant in development of drug resistant tuberculosis. Binary logistic regression was performed to ascertain the effects of various statistically significant factors. Drug resistant tuberculosis patients were 7.77 times more likely to be tobacco users than drug sensitive tuberculosis. CONCLUSIONS: Our study suggests that, there is a compelling and urgent need for increasing public awareness, initiating better nutrition and food programs, regular screening, and better management & control of MDR-TB.

Combined early palliative care for non-small-cell lung cancer patients: a randomized controlled trial in Chongqing, China.

Purpose: More effective approaches are needed to improve the prognosis of non-small-cell lung cancer (NSCLC) patients. Thus, we used the E-warm model to assess how early integration of interdisciplinary palliative care was related to the quality of life (QoL), psychological functioning, pain management, and nutrition factors of NSCLC patients. Methods: This randomized controlled trial enrolled 280 newly diagnosed NSCLC patients, which were randomly divided (1:1) into combined early palliative care (CEPC) and standard oncological care (SC) groups. At baseline and after 24 weeks, the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, Hospital Anxiety and Depression Scale (HADS), and the Patient Health Questionnaire-9 (PHQ-9) were used to assess QoL and psychological function, respectively. The Numerical Rating Scale (NRS) and Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess cancer patients' pain and nutrition levels. The primary outcome was overall survival (OS). Secondary outcomes comprised changes in the QoL, psychological functioning, pain, and nutrition state. The intention-to-treat method was applied for analysis. This study was registered at www.chictr.org.cn (ChiCTR2200062617). Results: Of the 140 patients enrolled in the CEPC and SC groups, 102 and 82 completed the research. The CEPC group presented higher QoL than the SC group (p < 0.05). Additionally, fewer patients presented depressive symptoms in the CEPC group than in the SC group (p < 0.05), as well as better nutritional status (p = 0.007) and pain management (p = 0.003). Compared to the SC group, CEPC patients had significantly longer OS (20.4 vs. 24.6 months, p = 0.042; HR: 0.19; 95% CI: 0.04-0.85, p = 0.029). Conclusion: With combined early palliative care, NSCLC patients lived longer, had better QoL, were psychologically stable, were in less pain, and were more nutritionally satisfied.

Dietary Nutritional Level Affects Intestinal Microbiota and Health of Goats.

The intestine is a complex micro-ecosystem, and its stability determines the health of animals. Different dietary nutritional levels affect the intestinal microbiota and health. In this study, the nutritional levels of energy and protein in the diet of goats were changed, and the body weight was measured every 15 days. In the late feeding period, 16 S rRNA sequencing technology was used to detect the content of microorganisms. A meteorological chromatograph was used to detect volatile fatty acids in the cecum and colon of goats. In the feeding stage, reducing the nutritional level of the diet significantly reduced the weight of the lamb (p < 0.05). In the cecum, the abundance of potentially harmful bacteria, such as Sphingomonas, Marvinbryantia, and Eisenbergiella, were significantly enriched in goats fed with the standard nutritional level diets (p < 0.05). Additionally, the contents of acetate (p = 0.037) and total VFAs (p = 0.041) increased. In the colon, the abundance of SCFAs-producing bacteria, such as Ruminococcaceae, Christensenellaceae, and Papillibacter, decreased as the nutritional level in the diet increased (p < 0.05). In conclusion, the increase in nutritional level could affect the growth performance and composition of intestinal microbiota.

Healthy lifestyles and physical fitness are associated with abdominal obesity among Latin-American and Spanish preschool children: A cross-cultural study.

BACKGROUND: Identifying environmental factors that influence health in children are necessary to develop preventive strategies. OBJECTIVE: To determine the association between the lifestyles of children (i.e., Mediterranean diet (MD), physical activity (PA), fitness and screen time (ST) with abdominal obesity (AO) of preschoolers from three Spanish-speaking countries (Chile, Colombia and Spain) with different socioeconomic levels and Human Development Index (HDI) indicators. MATERIAL AND METHODS: This cross-sectional study included 982 schoolchildren (aged 4-6 years; 56.8% girls) from Chile (n = 409), Colombia (n = 281), and Spain (n = 292). Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), adherence to the MD, PA, ST and physical fitness were evaluated. RESULTS: Spanish preschoolers reported a lower WtHR (p < 0.001), greater physical fitness (Z-score) (p < 0.001) and higher adherence to the MD (p < 0.001) than their Chilean and Colombian peers. In addition, Colombian preschoolers had a better lifestyle (PA + ST) than their Chilean and Spanish peers (p < 0.001). Chilean preschoolers reported a higher prevalence of AO than the Spanish preschoolers (65% vs. 51.9%; p = 0.001). CONCLUSION: Lifestyle had a significant association with AO among Spanish-speaking preschool children, with physical fitness especially being a relevant factor regardless of the country of origin. The findings of the current study may support the development of public guidelines focusing on healthy lifestyles in children to create effective plans that contribute to the early treatment of AO in preschool children.

The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia.

OBJECTIVE: The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren. RESEARCH METHODS & PROCEDURES: This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used. RESULTS: Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence. CONCLUSION: AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).

The Role of Mealtimes in Fostering Language Development and Aligning Home and School Learning: Protocol for a Multi-Method Study of Preschool Children in Rural Kenya and Zambia.

BACKGROUND: The association between school and home is fundamental to sustainable education: parents' understanding of the school's priorities and teachers' understanding of their pupils' home environment are both vital for children to remain in school and succeed academically. The relationship between parents and teachers is closest in preschool settings, providing a valuable opportunity to build bridges between home and school. In this protocol paper, we outline our planned methods for identifying beneficial home and school behaviors. OBJECTIVE: Our project aims to identify culture-specific structures and behaviors in home and school settings, which influence the quantity and quality of child-directed speech and identify positive experiences that can help improve children's linguistic development and nutrition. METHODS: Using a mixed methods approach and focusing on early language learning, nutrition, and responsive caregiving, we will video-record and analyze mealtime language and eating behaviors at home and in school, targeting 80 preschool children and their families in rural Kenya and Zambia. In addition, we will assess children's language skills through audio recordings and use questionnaire-based interviews to collect extensive sociodemographic and dietary data. RESULTS: Between the start of our project in January 2020 and the end of December 2021, we had collected complete sets of sociodemographic, observational, and food recall data for 40 children in Kenya and 16 children in Zambia. By the end of May 2022, we had started data collection for an additional 24 children in Zambia and transcribed and coded approximately 85% of the data. By the end of September, 2022, we plan to complete data collection, transcription, and coding for the entire sample of 80 children across both countries. From September 2022 onwards, we will focus on analyzing our language data, and we hope to have results ready for publication in early 2023. By relating children's language outcomes and nutritional intake to the observed mealtime behaviors, we hope to identify practices that increase the quantity and quality of child-directed speech and improve children's nutritional intake. CONCLUSIONS: Good nutrition and the promotion of language learning are key issues in early childhood development. By using a cross-cultural approach, combining a variety of methods, and working closely with stakeholders and policy makers throughout the project, we hope to find and share best practices for improving children's linguistic outcomes and nutrition and lay the foundation for the development of practitioner networks and parent outreach programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36925.

Association between the Sociodemographic Characteristics of Parents with Health-Related and Lifestyle Markers of Children in Three Different Spanish-Speaking Countries: An Inter-Continental Study at OECD Country Level.

The purpose of this cross-cultural study was to determine the association between the sociodemographic background of a child's parents (i.e., their socioeconomic level, marital status, and educational level) with the child's lifestyle (i.e., Mediterranean diet (MD), physical activity (PA) and screen time (ST)), and health markers. Material: This cross-sectional study included 1273 children, from Chile (n = 496), Colombia (n = 340), and Spain (n = 437). The sociodemographic information together with the lifestyle and health markers of the children were measured. There was an inverse association between a low or medium-low socioeconomic level for the parents of Chilean children and handgrip strength (ß -0.61, p < 0.001); meanwhile, for Spanish children, an inverse association between a low or medium-low socioeconomic level and PA after school (ß -0.58, p = 0.016), lifestyle (ß -0.74, p = 0.015), and with MD adherence (ß -0.86, p = 0.004) was found. The risk (i.e., by odd ratios (OR)) of being divorced/separated parents marital status showed an inverse association with abdominal obesity (OR 0.21, p = 0.045) in Spanish children; however, the parent's marital status and a low educational level were risk factors for the suffering of a low nutritional level in Colombian children (OR 2.02, p = 0.048; OR 2.49, p < 0.001, respectively). On the other hand, a low educational level for parents reported for Chilean children had a positive association with ST of ≥4 h per day (OR 1.82, p = 0.020). In conclusion, in Spanish-speaking children, the lifestyle and health markers of the children are affected by the sociodemographic background of their parents; however, these effects could be moderated by the socio-cultural and economic status of their countries as members of the OCDE; therefore, it is essential to develop policies that decrease these gaps, so that children who are under-resourced can reach their full potential.

The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia.

OBJECTIVE: The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren. RESEARCH METHODS & PROCEDURES: This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used. RESULTS: Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence. CONCLUSION: AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).

Exploration of n-6 and n-3 Polyunsaturated Fatty Acids Metabolites Associated with Nutritional Levels in Patients with Severe Stable Chronic Obstructive Pulmonary Disease.

Background and Objective: Severe chronic obstructive pulmonary disease (COPD) is the terminal stage of the disease characterized by declined lung function, malnutrition, and poor prognosis. Such patients cannot tolerate long-time sports rehabilitation owing to dyspnea and fail to achieve the desired therapeutic effect; therefore, increasing nutritional support will be an important strategy for them. The present study applied metabolomics technology to evaluate the correlation between serum concentrations of polyunsaturated fatty acid (PUFA) metabolites, nutritional status, and lung function in patients with COPD to provide a theoretical basis for accurate nutritional support. Materials and Methods: We enrolled 82 patients with stable severe COPD in our hospital. The general characteristics including height, weight, and lung function were recorded. Metabolomics was used to detect the concentrations of serum metabolites of n-3 and n-6 at baseline and at 24 and 52 weeks after enrollment. The correlations between nutrition level and pulmonary function and clinical indicators were evaluated. Results: The concentrations of n-3 and n-6 increased over time along with the progression of COPD. Body mass index (BMI) and percent of ideal body weight (IBW%) decreased with disease development, and BMI was found to be significantly correlated with FEV1% predicted and FEV1/FVC. Serum levels of n-6 metabolites such as linoleic acid (LA), γ-linoleic acid (GLA), and arachidonic acid (ARA) (all P < 0.01) and the n-3 metabolites such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (all P < 0.05) showed significant correlations with BMI and were closely correlated with FEV1% predicted and FEV1/FVC of lung function (all P< 0.05). Conclusion: This study demonstrates that malnutrition in patients with severe COPD is progressive and is positively correlated with n-3 and n-6 polyunsaturated fatty acids and lung function.

Highly nutritious diet resists Salmonella Typhimurium infections by improving intestinal microbiota and morphology in broiler chickens.

Salmonella Typhimurium (S. Typhimurium) infection in broiler chickens threatens public health and livestock production. In this study, we explored the effects of highly nutritious (crude protein 21.8%, metabolizable energy 3.16 Mcal/kg) and lowly nutritious (crude protein 18.1%, metabolizable energy 2.98 Mcal/kg) diets on S. Typhimurium infection by altering the intestinal morphology and environment in broiler chickens. The highly nutritious diet significantly increased the body weight gain and reduced feed conversion ratio on day 1 to 21 (P < 0.01). The highly nutritious diets promoted the intestinal villus height, crypt depth, and their ratio to improve the intestinal epithelial maturation (P < 0.05). Highly nutritious diets significantly increased the expression of claudin-1, occludin, and NF-κB genes in the intestinal epithelium on the days of 14 and 21 (P < 0.05). S. Typhimurium activated the expression of TLR4, MyD88, and NF-κB genes to cause an inflammatory response. The S. Typhimurium can increase the activity of myeloperoxidase, which cause an inflammatory response. The S. Typhimurium significantly reduced the diversity indexes of the ileal microbiota (P < 0.05), increased the abundance of Cyanobacteria which can synthesize toxins. The highly nutritious diet group challenged with S. Typhimurium can increase the abundance of Lactobacillus in the ileum, which lead to improved intestinal health (P < 0.05). It is concluded that increasing the nutritional level of dietary is beneficial to improve the resistance to S. Typhimurium infection by altering the intestinal bacterial community.

Diet and Skin Aging-From the Perspective of Food Nutrition.

We regularly face primary challenges in deciding what to eat to maintain young and healthy skin, defining a healthy diet and the role of diet in aging. The topic that currently attracts maximum attention is ways to maintain healthy skin and delay skin aging. Skin is the primary barrier that protects the body from external aggressions. Skin aging is a complex biological process, categorized as chronological aging and photo-aging, and is affected by internal factors and external factors. With the rapid breakthrough of medicine in prolonging human life and the rapid deterioration of environmental conditions, it has become urgent to find safe and effective methods to treat skin aging. For diet, as the main way for the body to obtain energy and nutrients, people have gradually realized its importance to the skin. Therefore, in this review, we discuss the skin structure, aging manifestations, and possible mechanisms, summarize the research progress, challenges, possible directions of diet management, and effects of foodborne antioxidants on skin aging from the perspective of food and nutrition.

Risk factors of pressure injury in patients with advanced cancer / 中国基层医药

Objective:To investigate the risk factors of pressure injury in patients with advanced cancer.Methods:100 patients with advanced malignant tumors who received treatment in The First People's Hospital of Huzhou from January to December 2019 were included in this study. After filling in data registration form, all patients received the first pressure injury risk assessment to assess their skin conditions within 2 hours after admission. At the same time, Karnofsky Performance Scale (KPS), Braden Scale score, serum albumin and hemoglobin levels were determined and assessed. Logistic multiple regression was used to analyze the correlation between various factors and stress injury.Results:Among the 100 patients, five patients had pressure injury. The incidence of hospital-acquired pressure injury was 5.00%. These five patients, consisting of three males (60.0%) and two females (40.00%), were aged 38-89 years. One (20%) patient had stage I pressure injury, three (60%) patients had type II pressure injury, and one (20.00%) patient had non staged injury. Pressure injury was compared between patients at different ages, with different Braden Scale scores, serum albumin and hemoglobin levels, KPS scores ( χ2 = 7.916, 34.657, 5.432, 18.034, 38.922, all P < 0.05). The incidence of pressure injury in patients aged ≥ 70 years with low serum albumin level, low hemoglobin level, KPS score ≤ 30 points, Braden Scale score ≤ 16 points was significantly higher than that in patients aged < 70 years with high serum albumin level, high hemoglobin level, KPS score > 30 points, Braden Scale score > 16 points ( χ2 = 18.034, 5.432, 7.916, 38.922, 34.657, all P < 0.05). Taking pressure injury as the dependent variable and a single factor as the independent variable, correlation analysis results revealed that low serum albumin level, low hemoglobin level, age ≥ 70 years, KPS score ≤ 30 points, Braden Scale score ≤ 16 points were independent risk factors for pressure injury in advanced cancer. Conclusion:KFS score, Braden scale score, serum albumin and hemoglobin levels are closely related to the occurrence of pressure injury in patients with advanced cancer. They are independent risk factors for pressure injury in patients with advanced cancer.

The social and psychological health of children is associated with Mediterranean diet adherence items, cardiorespiratory fitness, and lifestyle / La salud social y psicológica de los niños está asociada a los ítems de la adherencia a la dieta mediterránea, la capacidad cardiorrespiratoria y el estilo de vida

Background: Mediterranean diet (MD) adherence, physical activity (PA) patterns, and physical fitness are associated with physical, social, and psychological health in children. Objective: the purpose of this study was to determine the association of items of MD adherence, fitness components, and lifestyle with psychological and social health in Chilean schoolchildren. Material and methods: this cross-sectional study included 615 schoolchildren, both girls (n = 271, 11.7 ± 1.00 years old) and boys (n = 344, 11.8 ± 1.1 years old). Anthropometric parameters, fitness components, lifestyle, health-related quality of life (HRQoL), and self-esteem were measured. Results: HRQoL showed an association with cardiorespiratory fitness (β: 0.12, p < 0.001) and PA (β: 0.32, p = 0.023). Self-esteem was inversely associated with screen time (β: -1.35, p < 0.001). Moreover, social health presented a positive association with PA after school (β: 0.06, p = 0.037). In relation to MD adherence items, HRQoL was linked to the items “Takes a fruit or fruit juice every day” (β: 1.93, p = 0.004) and “Consumes fresh or cooked vegetables > 1 time/day” (β: 1.12, p = 0.018). Self-esteem was associated to “Consumes a dairy product > 1 time/day” (β: 3.30, p = 0.030). Social health was inversely related to “Eats at a fast food restaurant ≥ 1 time/week” (β: -0.26, p = 0.003) and positively to “Consumes pasta or rice almost every day” (β: 0.35, p = 0.049). Conclusion: MD adherence items, fitness, and lifestyle were linked to psychological and social health, therefore it is necessary to develop preventive strategies for schoolchildren to change in a positive way these modifiable lifestyle behaviors. (AU)

Antecedentes: la adherencia a la dieta mediterránea (DM), los patrones de actividad física (AF) y la condición física están asociados a la salud física, social y psicológica de los niños. Objetivo: el propósito de este estudio fue determinar la asociación entre ítems de adherencia a la DM, componentes de la condición física y el estilo de vida con la salud psicológica y social de los escolares chilenos. Material y métodos: este estudio transversal incluyó a 615 escolares, niñas (n = 271, 11,7 ± 1,00 años) y niños (n = 344, 11,8 ± 1,1 años). Se midieron parámetros antropométricos, componentes de la condición física, estilo de vida, calidad de vida relacionada con la salud (CVRS) y autoestima. Resultados: la CVRS mostró asociación con la capacidad cardiorrespiratoria (β: 0,12, p < 0,001) y la PA (β: 0,32, p = 0,023). La autoestima, por su parte, se relacionó de manera inversa con el tiempo frente a la pantalla (β: -1,35, p < 0,001). Además, la salud social presentó una asociación positiva con la AF después de la escuela (β: 0,06, p = 0,037). En relación a los ítems de adherencia a la DM, la CVRS se vinculó a los ítems “Toma una fruta o jugo de fruta todos los días” (β: 1,93, p = 0,004) y “Consume verduras frescas o cocidas > 1 vez/día” (β: 1,12, p = 0,018). La autoestima se asoció a “Consume un producto lácteo > 1 vez/día” (β: 3,30, p = 0,030). La salud social se vinculó inversamente con “Come en un restaurante de comida rápida ≥ 1 vez/semana” (β: -0,26, p = 0,003) y positivamente con “Consume pasta o arroz casi todos los días” (β: 0,35, p = 0,049). Conclusión: los ítems de adherencia a la DM, la condición física y el estilo de vida se relacionaron con la salud psicológica y social de los escolares, por lo que es necesario desarrollar estrategias preventivas para modificar de manera positiva estas conductas de estilo de vida modificables. (AU)

THE ANALYSIS OF THE CONSTITUTION OF DIETS AND NUTRITIONAL STATUS OF INHABITANTS IN DANDONG / 营养学报

This paper collected and analysed the materials concernig constitution and the nutritional level of the diets of inhabitants in Dandong city from 1959 to 1985. The results showed 1) Nutrients level of the diets increased with years and became rational. Intakes of energy and protein were over 110% and 97.1% of the RDA:the protein provided 10.5%, fat 30% and carbohydrate 58% of total energy intake; and 13.2% of protein originated from animal sources. 2) The weight of new-borns and children was less than that in developed countries. 3) The weight of children at age 8 and 14 increased 0.11 (boy), 0.06 (girl) and 0.33, 0.2lkg respectively. The height of the boys increased 0.37, 0.51 cm and the girls 0.28, 0.30 cm respectively. The increased rate is quicker. 4) At the age 0-7, the incidence of the des-eases caused by malnutrition declined yearly but incidence of rickets dropped down less. This may concern less sunning and less VD of the diets.