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Objective: Globally, approximately 2.2 billion people suffer from visual impairments or blindness. Dietary patterns are closely associated with the prevalence of multiple ocular diseases. This study aimed to explore the association between Composite Dietary Antioxidant Index (CDAI) and ocular disorders. Methods: The data were derived from 1706 subjects aged 40 years and older who participated in the 2005–2008 National Health and Nutrition Examination Survey (NHANES), which utilized undersampling techniques. Trained staff interviewed participants to gather information about their dietary habits using the 24-h diet recall method. The CDAI, incorporating six antioxidants, was then computed using a validated method. Eye diseases were diagnosed through a combination of examinations and questionnaires. Multinomial logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. Results: After adjusting for potential confounders, higher CDAI quartiles (Q4) were significantly associated with reduced odds of diabetic retinopathy (OR: 0.55, P = 0.041), cataracts (OR: 0.37, P < 0.001), glaucoma (OR: 0.48, P = 0.003), and macular degeneration (OR: 0.19, P < 0.001). Carotenoids showed a significant negative correlation with ocular diseases, diabetic retinopathy (OR: 0.57, P < 0.001), cataracts (OR: 0.75, P = 0.014), glaucoma (OR: 0.59, P < 0.001) and macular degeneration (OR: 0.55, P < 0.001). Compared to the lowest quartile (Q1), higher quartiles (Q4) of zinc intake were associated with lower odds of DR (OR: 0.32, P < 0.001) and glaucoma (OR: 0.73, P = 0.001). Similarly, Q4 of vitamin C intake were associated with lower odds of cataracts (OR: 0.70, P = 0.001) and glaucoma (OR: 0.71, P = 0.003) compared to the Q1. Conclusion: Higher CDAI scores are correlated with a decreased odds of ocular diseases, suggesting that an antioxidant-rich dietary pattern may be associated with better ocular health. Understanding these correlations could contribute to the development of preventive strategies and intervention measures for ocular diseases. [ABSTRACT FROM AUTHOR]

This study aims to monitor and identify adverse events (AEs) associated with cetuximab, a drug used to treat various late-stage (metastatic) tumors, to improve patient safety and guide drug use. This study retrospectively analyzed the cases reported in the FDA adverse event reporting system (FAERS) related to the application of cetuximab from 2013 Q1 to 2022 Q4. Disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), and the empirical Bayesian geometric mean (EBGM) algorithms, were employed to quantify the signals of cetuximab-associated AEs. A total of 8364225 reports were contained in the FAERS database, of which 5186 reports of cetuximab were identified as 'primary suspected (PS)' AEs. The application of cetuximab resulted in AEs in 22 system organ classes (SOCs), which preserved 176 significant disproportionality preferred terms (PTs) through the computation of four algorithms. The main SOCs (Skin and subcutaneous tissue disorders, investigations, metabolism and nutrition disorders, and blood and lymphatic system disorders) accounted for 58.63%. Some AEs were not on the drug label: speech disorder, intervertebral discitis, glomerulonephritis rapidly progressive and disseminated intravascular coagulation. This study identified new signals of adverse drug reactions (ADRs) other than those mentioned in the specification associated with cetuximab, providing valuable insights into the relationship between ADRs and cetuximab use. The findings highlight the importance of continuous surveillance to detect and manage AEs effectively, ultimately improving patient safety during treatment with cetuximab. [ABSTRACT FROM AUTHOR]

A self-reported electronic questionnaire to advocate for a consensus definition of nutrition impact symptoms (NISs) was conducted in a diverse group of international healthcare providers. The questionnaire had 2 components: the definition of NISs and the relevance of each symptom as a NIS. Agreement on the tentative definition and 24 symptoms were evaluated using a seven-point Likert scale. For the factor validity and internal consistency of symptoms, an exploratory factor analysis was employed, and Cronbach's alpha coefficients (Cronbach's α) were calculated in each domain. A total of 66 healthcare providers responded. Regarding the tentative definition of NISs, the percentages of the number of participants with agree and strongly agree were 40.9% and 42.4%. Three conceptual groups were extracted as follows: 1) symptoms that interfere with patients' ability to ingest or digest nutrients, 2) symptoms that compromise patients' desire to eat and take nutrients, and 3) symptoms that indirectly compromise patients' food and nutrient intake. The values of Cronbach's α were 0.91, 0.92, and 0.87. We proposed a new definition – NISs are symptoms that compromise patients' desire or ability to eat, interfering with their nutritional needs and increasing the risk for malnutrition, loss of lean body mass, and impaired QOL. [ABSTRACT FROM AUTHOR]

Background/Objectives: The dietary changes experienced by residents in long-term care facilities (LTCFs) following an earthquake are poorly understood. This study aimed to examine variations in nutritional status among residents of an Integrated Facility for Medical and Long-term Care (IFMLC), a particular type of Japanese LTCF, after the 2024 Noto Peninsula Earthquake. Methods: This descriptive study was conducted at the single IFMLC. A total of 115 residents living at the facility on 1 January 2024, at the time of the earthquake, were recruited for the study. The focus was the body weight and skeletal muscle mass changes observed before and after the earthquake. The observation period lasted for three months following the earthquake. Results: Water outage persisted for over a month, making dishwashing impossible and leading to an extended reliance on disposable dishes with limited capacity. This situation consequently reduced the variety and volume of meal options and overall energy intake meals. Residents' body weight significantly decreased 3 months after the earthquake, and the prevalence of weight loss and skeletal muscle mass loss was particularly high in residents with normal swallowing function. To address nutritional deficiencies post-earthquake, the registered dietitian enhanced energy sufficiency through food fortification, oral nutritional supplements, and pre-prepared ready-to-hang liquid formulas. Conclusions: To prevent further weight and skeletal muscle mass reduction among IFMLC residents, providing ample water, and a disaster manual that can be used even with limited resources is essential. Furthermore, preparing for disasters by stockpiling foods and implementing strategies to enhance energy sufficiency is crucial. [ABSTRACT FROM AUTHOR]

Background/Objective: Research shows that obesity has risen among rehabilitation patients. Despite this, nutrition care in subacute rehabilitation wards focuses primarily on preventing and treating protein-energy malnutrition. The continued provision of energy-dense meals during lengthy rehabilitation admissions may present a risk of overnutrition for some patients, which can adversely affect functional outcomes. However, overnutrition is not routinely monitored in practice. This study summarizes the initial findings of a multi-site investigation of overnutrition incidence across five rehabilitation wards to scope the need for future research. Methods: A retrospective audit was conducted, including all inpatients admitted over 3 months to the study wards with a complete dataset (total sample n = 199). Data were collected from the medical record and menu management system to determine overnutrition, defined as an average daily energy intake equal to or greater than 1000 kJ above estimated requirements and weight gain of equal to or greater than 1 kg over the admission. Results: The incidence of overnutrition in the total sample was 12.1%. Of those patients deemed at low risk of malnutrition (n = 124), 19.4% developed overnutrition during their rehabilitation admission. Those who developed overnutrition during their admission gained an average of 2.9 kg, with a mean excess energy intake of 2456 kJ/day above estimated requirements. They also consumed a high intake of discretionary items (mean of 3156 kJ/day). Conclusions: The findings suggest that further research is needed to investigate the etiology and impact of the overlooked problem of overnutrition in subacute rehabilitation settings. Future investigation is essential to ensure that the planning and delivery of subacute dietetic and food services meet the nutrition needs of patients in longer-stay inpatient settings. [ABSTRACT FROM AUTHOR]

The nutrition transition in sub‐Saharan Africa has led to increased consumption of ultra‐processed foods in infancy, especially sweet foods. This has heightened the risk for nutrition‐related non‐communicable diseases, including dental caries and overweight/obesity, and promotes poor food choices later in life. The present study used a cross‐sectional design to investigate the consumption frequency of ultra‐processed foods and beverages among urban 6‐ to 36‐month‐olds attending four selected health facilities in Kampala using a standardised questionnaire and 24‐h diet recall record. The primary outcome was the consumption of at least one ultra‐processed food or beverage (UPFB) the previous day, and frequency of UPFB consumption of the week before was the secondary outcome. Four hundred and ten caregiver–child pairs were randomly recruited, 94% of caregivers being mothers with a mean age of 30.7 (±5.3) years. Fifty‐nine per cent of mothers and 73% of fathers had attained a college education. The median age of children was 18 months and 51% were female. Most children (57%) consumed at least one UPFB the previous day. In the week before, 69% had consumed UPFB frequently (4–7 days) which was significantly positively associated with maternal education (odds ratio [OR] = 2.85, 95% confidence interval [CI]: 1.02–7.96, p = 0.045) and child's age ([OR = 2.87, 95% CI: 1.62–5.08, p < 0.001], [OR = 3.68, 95% CI: 1.88–7.20, p < 0.001]). In conclusion, the dietary habits of the surveyed Ugandan population were unhealthy, characterised by the frequent consumption of UPFB with added sugar. There is an urgent need to re‐enforce existing Ugandan food regulation guidelines and policies and to build strong nutritional education programmes to enhance health‐promoting environments in early childhood. Key messages: The frequent consumption of ultra‐processed food or beverage (UPFB) in a Ugandan urban population during the complementary feeding period is an indication of an established nutrition transition.The frequent consumption of UPFB is characterised by a high sugar content and sweetened diet and therefore the potentially has health detriments in young children.There is an urgent need to promote traditional diets and minimally processed foods for complementary feeding and introduce policies that discourage consumption of UPFB in early childhood. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a prevalent disease that poses a significant threat to global public health. Digestive dysfunction, as a common complication, is of particular importance to understand its pathogenesis, diagnostic criteria, and relevant treatment strategies. TBI can affect digestive function through inflammatory immune responses, the enteric nervous system, and hormonal levels. Furthermore, TBI can also impact neurologic recovery through bidirectional communication along the brain-gut axis. Therefore, this article aims to summarize the underlying mechanisms and further explore individualized feeding strategies, therapeutic approaches, long-term prognosis for TBI patients, as well as recent advancements in related technologies. Further understanding of the pathogenesis of digestive system dysfunction after TBI on the basis of the interaction of gut-brain axis is conducive to more future therapies to treat TBI and improve the long-term prognosis of patients through improving digestive function, and achieve good clinical efficacy. [ABSTRACT FROM AUTHOR]

Context Teprotumumab, which targets the insulin-like growth factor-1 receptor, is the only drug approved by the US Food and Drug Administration (FDA) for the treatment of thyroid eye disease (TED). Objective This study aimed to identify potential safety signals of teprotumumab by analyzing postmarketing safety data from the FDA Adverse Event Reporting System (FAERS) database in 2023. Methods The case/noncase approach was used to estimate the reporting odds ratio (ROR) and information component (IC) with relevant 95% CI for adverse events (AEs) that numbered 3 or more. Results A total of 2158 cases were included in the analysis. Main safety signals identified were ear and labyrinth disorders, reproductive system and breast disorders, metabolism and nutrition disorders, and gastrointestinal disorders. Specifically, autophony (ROR [95% CI] = 4188.34 [1403.29-12500.8]), eyelid retraction (ROR [95% CI] = 2094.17 [850.69-5155.29]), permanent deafness (ROR [95% CI] = 1552.35 [789.07-3053.98]), bilateral deafness (ROR [95% CI] = 73.12 [41.14-129.97]), inflammatory bowel disease (ROR [95% CI] = 23.26 [13.46-40.19]), hyperglycemic hyperosmolar nonketotic syndrome (ROR [95% CI] = 17.75 [5.70-55.28]), and amenorrhea (ROR [95% CI] = 47.98 [36.22-63.54]) showed significant safety signals with teprotumumab. Conclusion This study identified ear and labyrinth disorders, and reproductive system and breast disorders, as specific safety signals of teprotumumab. Clinicians and pharmacists should be vigilant regarding these AEs. However, available data are currently insufficient, and further pharmacovigilance and surveillance are needed to fully understand this issue. [ABSTRACT FROM AUTHOR]

Objective: To investigate which fluoroquinolone is safer when combined with bedaquiline for tuberculosis treatment by using the FDA Adverse Event Reporting System (FAERS) database. Methods: We selected data from the first quarter (Q1) of 2013 to the second quarter (Q4) of 2024 from the FDA FAERS database for disproportionality analysis. Signal detection was conducted using the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM). Results: This study analyzed 12, 303, 879 reports from the FAERS database, including 722 reports related to the combination of bedaquiline and levofloxacin (with 2,723 adverse events) and 573 reports related to the combination of bedaquiline and moxifloxacin (with 2,233 adverse events). For the bedaquiline-levofloxacin regimen, these reports were categorized into 100 preferred terms (PTs) and 24 System Organ Classification (SOCs). The three most common SOCs were hepatobiliary disorders (n = 128, ROR 5.79, PRR 5.56, IC 2.48, EBGM 5.56), blood and lymphatic system disorders (n = 217, ROR 5.04, PRR 4.72, IC 2.24, EBGM 4.71), and metabolism and nutrition disorders (n = 185, ROR 3.44, PRR 3.27, IC 1.71, EBGM 3.27). In terms of PTs, the three strongest signals were portal fibrosis (ROR 330.64), hepatitis C RNA increased (ROR 301.24), and toxic optic neuropathy (ROR 238.11). Reports of prolonged QT interval on ECG (125 cases) and anemia (130 cases) were significantly more frequent than other PTs. For the bedaquiline-moxifloxacin regimen, these reports were categorized into 85 preferred terms (PTs) and 24 System Organ Classification (SOCs). The three most common SOCs were hepatobiliary disorders (n = 141, ROR 7.9, PRR 7.47, IC 2.9, EBGM 7.46), ear and labyrinth disorders (n = 40, ROR 4.03, PRR 3.97, IC 1.99, EBGM 3.97), and cardiac disorders (n = 141, ROR 3.08, PRR 2.95, IC 1.56, EBGM 2.95). The three strongest PT signals were chronic pyelonephritis (ROR 563.29), bronchopleural fistula (ROR 314.86), and toxic neuropathy (ROR 187.11). Prolonged QT interval on ECG (152 cases) remained the most frequently reported PT. In both treatment regimens, individuals under 45 years of age experienced a higher frequency and variety of AEs, indicating the need for enhanced monitoring. For those over 45, particular attention should be given to ECG changes, especially in men. Finally, some PTs with extremely high signal strength, such as chronic pyelonephritis (ROR 563.29), hepatitis C RNA increased (ROR 301.24), and bronchopleural fistula (ROR 301.24), may represent rare adverse events associated with the combination of bedaquiline-fluoroquinolone. Conclusion: Our study suggests that the safety profile of bedaquiline combined with moxifloxacin does not appear superior to that of bedaquiline combined with levofloxacin in terms of cardiac, hepatic, and neurological effects. Therefore, in the BPaLM regimen, considering the substitution of moxifloxacin with levofloxacin may be worthwhile if their efficacy is proven to be similar. Increased monitoring may be required for individuals under 45 years of age and male MDR-TB patients. [ABSTRACT FROM AUTHOR]

Introduction: Enfortumab vedotin (EV) and Erdafitinib are effective therapeutic drugs for bladder cancer patients following post-chemotherapy and immunotherapy. This study assessed adverse drug reactions (ADRs) from both drugs, comparing their safety profiles to guide clinical use. Methods: A retrospective descriptive analysis was conducted on ADR reports for EV and Erdafitinib from the World Health Organization (WHO)-VigiAccess database. Data on patient demographics, system organ classes (SOCs), global patient regions, symptoms, and ADRs frequencies were analyzed and compared. Results: As of 2024, 3,438 ADR reports were identified (2,257 for EV and 1,181 for Erdafitinib). The number of adverse reaction reports for EV is significantly higher than that for Erdafitinib. Among them, the SOC with the most adverse signals is gastrointestinal disorders, with the top five reports being nausea, gastrointestinal disorders, dry mouth, abdominal pain, and diarrhea. The top five reported adverse events (AEs) for EV are as follows: skin and subcutaneous tissue disorders (20.70%), general disorders and administration site conditions (14.23%), nervous system disorders (11.12%), gastrointestinal disorders (7.78%), and metabolism and nutrition disorders (6.47%). In contrast, the top five AEs for Erdafitinib are: general disorders and administration site conditions (25.36%), skin and subcutaneous tissue disorders (10.94%), gastrointestinal disorders (10.19%), eye disorders (9.21%), and injury poisoning and procedural complications (7.31%). Conclusion: Our study identified and compared potential and novel ADRs between EV and Erdafitinib, providing key insights into their safety profiles and highlighting the need for personalized treatment strategies based on individual patient risk factors. [ABSTRACT FROM AUTHOR]

Aims: This study investigated the current status of intrinsic capacity and self-management abilities and analyzed the factors influencing the self-management abilities of older adults experiencing intrinsic capacity decline. Methods: We included a sample of 382 older adults, with an average age of 72.92 ± 6.81 years, exhibiting intrinsic capacity decline in 38 communities in China. Questionnaires were administered using the sociodemographic questionnaire, the intrinsic capacity questionnaire, the social support scale, the self-rated health item, the eHealth literacy scale, and the self-management ability scale. The data were analyzed using descriptive statistics, Pearson correlation coefficients, and linear regression analysis. Results: In this study, 43.5% of older people had impairments in three of the five dimensions of intrinsic capacity, the most significant proportion. The self-management ability score of older adults experiencing intrinsic capacity decline was 67.05 ± 12.53 out of 100. There were significant associations between age, perceived social support, and intrinsic ability composite score with self-management abilities (Age: β = −0.263; p < 0.001; social support: β = 0.291; p < 0.001; intrinsic capacity composite score: β = 0.179; p < 0.001). Higher levels of self-management ability were associated with more effective maintenance of psychological capacity, regardless of the type of older adults experiencing IC decline (all p < 0.05). For example, among older adults experiencing cognitive decline, maintaining psychological function was positively associated with self-management abilities (β = 0.294; p < 0.01). Conclusion: The highest prevalence of concurrent impairments across three dimensions of intrinsic capacity was observed among older adults experiencing diminished intrinsic capacity. Fostering self-management abilities through social support and mental health interventions may benefit people experiencing intrinsic capacity decline. [ABSTRACT FROM AUTHOR]

Introduction: Across multiple studies, the most common serious adverse event groups that Small Cell Lung Cancer (SCLC) patients experience, whilst undergoing chemotherapy treatment, are: Blood and Lymphatic Disorders, Infections and Infestations together with Metabolism and Nutrition Disorders. The majority of the research that investigates the relationship between adverse events and SCLC patients, focuses on specific adverse events such as neutropenia and thrombocytopenia. Aim: This study aims to utilise machine learning in order to identify those patients who are at risk of developing common serious adverse event groups, as well as their specific adverse event classification grade. Methods: Data from five clinical trial studies were analysed and 12 analysis groups were formed based on the serious adverse event group and grade. Results: The best test runs for each of the models were able to produce an area under the curve (AUC) score of at least 0.714. The best model was the Blood and Lymphatic Disorder group, SAE grade 0 vs. grade 3 (best AUC = 1, sensitivity rate = 0.84, specificity rate = 0.96). Conclusion: The top features that contributed to this prediction were total bilirubin, alkaline phosphatase, and age. Future work should investigate the relationship between these features and common SAE groups. [ABSTRACT FROM AUTHOR]

Objective: Hypertension is a leading global risk factor for disability and death. Irbesartan, a potent angiotensin II receptor blocker, requires continuous safety monitoring. We conducted a disproportionality analysis of irbesartan-related adverse drug events (ADEs) using the FDA's FAERS and Japan's JADER databases. Methods: We extracted irbesartan-related ADE reports from FAERS (Q1 2004 to Q1 2024) and JADER (Q2 2008 to Q4 2023). We used Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM) for signal detection. Sensitivity analyses were conducted to exclude comorbid medications, and subgroup analyses by age and gender were performed to explore ADE occurrence in specific populations. Th time to onset (TTO) of ADEs was assessed using Weibull distribution test and Kaplan-Meier curves. Results: A total of 5,816 (FAERS) and 366 (JADER) reports were analyzed, with irbesartan-related preferred terms (PTs) involving 27 System Organ Classes (SOCs) in FAERS and 22 in JADER. Three SOCs met detection thresholds in both databases: "metabolism and nutrition disorders," "cardiac disorders," and "renal and urinary disorders." We identified 219 positive signals in FAERS and 20 in JADER, including known signals like hyperkalemia, hypotension, and acute kidney injury. Notably, newly identified signals such as acute pancreatitis (n = 50, ROR: 7.76 [5.88–10.25]) and rhabdomyolysis (n = 50, ROR: 7.76 [5.88–10.25]) in FAERS and respiratory failure (n = 7, ROR: 6.76 [3.20–14.26]) in JADER could have significant clinical implications, as they may lead to severe outcomes if not recognized and managed promptly. Subgroup analyses revealed both similarities and differences in signal detection across gender and age groups. Sensitivity analyses, excluding concomitant medications, confirmed the persistence of key positive signals, including hyperkalemia, angioedema, acute pancreatitis, and agranulocytosis. ADEs mainly occurred within 1 month (34.14%) and after 1 year (32.32%) after dosing, with a median onset of 107 days. Conclusion: This study provides valuable real-world evidence on the safety profile of irbesartan. The identification of new safety signals underscores the necessity of updating drug labels, particularly for assessing and managing high-risk patients. Additionally, the TTO analysis emphasizes the importance of sustained vigilance for adverse events over time. In conclusion, our findings contribute to a more comprehensive understanding of irbesartan's safety, aiding healthcare professionals in optimizing its use in clinical practice. [ABSTRACT FROM AUTHOR]

Background/Objectives: Pasireotide (PAS) is a somatostatin receptor ligand (SRL) used to treat acromegaly, a chronic condition caused by excess growth hormone. While it offers significant benefits as a second-line treatment for uncontrolled acromegaly, its use raises major concerns due to hyperglycemic side effects and gastrointestinal issues, the latter being similar to those seen with first-generation SRLs. The aim of this study is to evaluate the real-world evidence on adverse drug reactions (ADRs) reported for PAS in the EudraVigilance database, in comparison to other established drug-based therapies for acromegaly. Methods: A descriptive analysis and a disproportionality analysis were conducted. Results: The fewest individual case safety reports (ICSRs) and adverse drug reactions (ADRs) were reported for PAS, with 698 (4%) ICSRs and 1,647 (4%) ADRs, which is even lower than for pegvisomant (PEG), which had 1765 (11%) ICSRs and 4842 (10%) ADRs. Both PAS and lanreotide (LAN) exhibited the lowest proportion of cases classified as serious. Among the total reported ADRs, those categorized as "Metabolic and nutrition disorders" were most frequent and severe for PAS (PAS—17.5% vs. OCT—4.6%, LAN—4.5%, and PEG—2.7%). Additionally, PAS demonstrated a higher likelihood of reporting endocrine disorders, which were frequently classified as serious, as well as stones affecting the hepatobiliary system compared to other drugs. Conclusions: Although PAS had the fewest ICSRs and ADRs, and less frequent serious ADRs, it had more reports frequently classified as serious in the "Metabolism and Nutrition Disorders" category (including events such as elevated blood glucose levels or diabetes) and "Endocrine Disorders" category compared to other SRLs and PEG. Furthermore, there was a higher likelihood of reporting hepatobiliary stones with PAS compared to OCT and PEG. This highlights the importance of adequately monitoring glycemic control and the biliary tract through ultrasound at the initiation and during follow-up of PAS therapy. Improved monitoring and reporting of these ADRs could enhance care for patients with acromegaly. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of the causes of, and risk factors for, obesity in people with learning disabilities • To acknowledge the importance of nutrition as a key controllable factor in preventing long-term conditions • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Obesity is a major global concern and is more common among people with learning disabilities than in the general population. If unmanaged, obesity can lead or contribute to various long-term health conditions, such as type 2 diabetes, cardiovascular disease and cancer. People with learning disabilities often rely on support staff, families and carers to meet their individual nutritional needs, but care teams and families may lack adequate knowledge of public health recommendations about healthy diet and optimal nutrition. More needs to be done to enhance the diet, and subsequently improve the health outcomes, of people with learning disabilities. This article provides an overview of obesity in people with learning disabilities, including contributing factors, associated health conditions and nutritional considerations. It also details recommendations for nurses to promote a healthy diet and support positive dietary behaviour change in this population. [ABSTRACT FROM AUTHOR]

Background: Nutrition plays a pivotal role in the prevention and treatment of endocrine disorders. The aim of this study was to provide a window in order to display the 25-year activities of Endocrinology & Metabolism Research Institute (EMRI), and the gaps and future plans in the field of nutrition and endocrine disorders. Methods: To collect papers affiliated to the EMRI in field of nutrition from the inception to December 1st 2019, the electronic databases including PubMed/Medline, Web of Science, and Scopus were searched. Publications in English and Persian languages were included. Scientific Landscapes (VOS viewer) software version 1.6.13 was used to provide bibliometric maps. Results: Of 4082 studies identified in the initial search, 319 relevant papers were included. They contributed systematic review and meta-analysis/review (n = 76), clinical trials (n = 58), cross-sectional (n = 171), case-control studies (n = 11), and animal studies (n = 3). Accordingly, most nutrition studies were dedicated to the level of evidence III (cross-sectional studies: 53.60%) followed by systematic review studies (23.82%) with the level of evidence I. There was also an increasing trend in the nutrition studies through years, with a peak in 2019. Conclusion: An increasing trend in the publications related to nutrition science is observed at EMRI. However, nutrition research and publications can grow further through expanding collaborations with other fields related to endocrine. Given nutritional assessments in national projects and focusing on the identification of preventive nutritional strategies, considering the situations of our society can be helpful to make nutritional findings more practical. [ABSTRACT FROM AUTHOR]

Background: Behavioral and psychological symptoms of dementia (BPSD), as neuropsychiatric manifestations within dementia, constitute core features of dementia. However, there remains a gap in understanding the recognition of BPSD in China. Our current study was to explore the clinical awareness and treatment approaches for BPSD in China, focusing especially on the perspectives of neurologists and psychiatrists. Methods: A multicenter national survey was designed and a semi-structured questionnaire was distributed to healthcare professionals including doctors and nurses across all provinces of China. The questionnaire incorporated either closed (yes/no) and multiple-choice questions. The questions centered on the following areas: the perceived global frequency and relevance of BPSD; the assessment tools employed for evaluating BPSD; pharmacological approaches for addressing psychosis, apathy, agitation, aggression, depression, anxiety, sleep, and nutrition disorders; drug-related side effects; non-pharmacological treatment strategies. The anonymity of questionnaire responses was maintained to encourage participants to candidly express their viewpoints. Results: The majorities of respondents recognized the importance of BPSD. There were apparent differences in the perception of BPSD between neurologists and psychiatrists, encompassing variances in symptoms recognition, diagnostic approaches, and treatment strategies. A notable high percentage of neurology (27.8%) and psychiatry staff (23.6%) would not choose non-pharmacological interventions. Meanwhile, antipsychotics was overused in China. For aggression and agitation, more than half of neurologist and psychiatrist preferred antipsychotics. For psychosis, more than 80% of doctors chose antipsychotics. Nearly one-third of the medical staff expressed a preference for traditional Chinese medicine including ginkgo biloba extract. Conclusion: In summary, this study in China has shed light on the features related to perception, recognition, management, treatment options, and observed side effects associated with BPSD. Our findings have the potential to significantly enhance the understanding of BPSD characteristics among medical practitioners and offering valuable insights into improved management and treatment strategies of neuropsychic symptoms of dementia in China. [ABSTRACT FROM AUTHOR]

Gastroenterologists encounter many nutrition-related disorders in their practice, yet the nutritional needs of patients with chronic gastrointestinal (GI) and liver disease are largely unaddressed by treating physicians, due to suboptimal nutrition education. To address this gap, we developed and piloted a culinary medicine course for a GI fellowship training program. The objective of this study is to describe the development, implementation, and acceptability of the course. A registered dietitian, a chef instructor, and a gastroenterology clinical professor trained in culinary medicine developed the four-class tailored curriculum and delivered the classes remotely. Each class had a theme related to commonly encountered GI disorders and included hands-on meal preparation, a nutrition lecture, and a patient case study discussion. Post-course feedback surveys were disseminated. Twenty-three GI physicians enrolled in the course and the attendance rates in classes 1-4 were 83%, 65%, 61%, and 48%, respectively. Among 15 completed feedback surveys, 80% reported that the class contents were either moderately or extremely useful and all endorsed the curriculum for other gastroenterologists. Future studies of culinary medicine programs tailored to medical specialties should identify strategies to maintain engagement and assess the impact on nutrition knowledge, competencies, and translation of these new skills to clinical practice.

Background: The double burden of malnutrition (DBM), which involves both undernutrition and overweight/obesity, has become a significant global health concern. Significant research gaps exist in understanding the prevalence and trends of DBM among mother–child pairs in South and Southeast Asia, as existing studies frequently concentrate on single countries or specific populations. Therefore, the objective of this study is to estimate the prevalence and trends of DBM by utilising the most updated nationally representative data from four selected countries in these regions. Methods: We analyzed cross-sectional, nationally representative secondary data from the Demographic and Health Survey, conducted from 2004 to 2022. The survey included households with at least one mother–child pair for Bangladesh, Cambodia, Nepal, and Timor-Leste. Using survey weights, we calculated the weighted prevalence of household level DBM, underweight children (< 5 years old), and overweight mothers ( B M I ≥ 23 k g / m 2 ) for each country. Using chi-square tests, we investigated associations between DBM prevalence and factors such as wealth index, place of residence, and child sex. We assessed socioeconomic disparities using odds ratios obtained from a multivariable logistic regression model. Results: The prevalence of DBM at household level in Bangladesh rose from 4 in 2004 to 13.8% in 2018, with underweight children decreasing from 47.6 to 21.5% and overweight or obese mothers increasing from 11.6 to 42.3%. We observed similar trends in Cambodia (DBM prevalence: 7.4% in 2005 to 14.3% in 2022; underweight child: 28.3% in 2005 to 16.5% in 2022; overweight/obese mother: 18.6% in 2005 to 48.8% in 2022), Nepal (DBM prevalence: 5.6% in 2006 to 12.3% in 2022; underweight child: 38.6% in 2006 to 19% in 2022; overweight/obese mother: 14.4% in 2006 to 48.7% in 2022), and Timor-Leste (DBM prevalence: 9.4% in 2009 to 15.8% in 2016; underweight child: 44.1% in 2009 to 40.8% in 2016). In all four nations, households with a higher socioeconomic level (richest) consistently had a higher likelihood of developing DBM (odds ratio > 1) compared to households with a lower socioeconomic status (poorest). Furthermore, mother–child pairs living in rural regions had a lower likelihood of developing DBM compared to urban settings. Conclusion: DBM is on the rise in households across South and South-east Asian nations, particularly in urban areas and among richest households. Despite several improvements in reducing underweight prevalence, persistent undernutrition remains a significant challenge in the region. Simultaneously, the rising prevalence of obesity is a growing concern. Future research should prioritise identifying country-specific risk factors of DBM and understanding factors contributing to the high prevalence of maternal overweight. [ABSTRACT FROM AUTHOR]

\nBackground:: Growth assessments are a pillar of public health surveillance, individual health screening, and clinical care. Normal growth is defined differently for individuals versus populations. The World Health Organization (WHO) growth standards were developed to describe the pattern of growth in healthy children without socioeconomic limitations whose mothers planned to breastfeed. The growth standards’ cut-off points of ±2 standard deviations (z-scores) were defined for population assessments, based on attained size, to describe stunting and wasting at the lower end and overweight at the higher end. In a healthy population, one would expect 2.3% of the population to be above and below these cut-points. Higher child mortality rates associated with higher rates of stunting and wasting noted in observational studies validated these WHO cut-offs. There are knowledge gaps influencing the accuracy and effectiveness of growth assessments in individual children, posing challenges for health care providers. Summary:: The principles of assessing normal growth in children and preterm infants are reviewed, along with pitfalls to be avoided. Growth is determined by genetics and modified by the interplay with nutritional, environmental, socioeconomic, and possibly intergenerational factors. This complexity is reflected at both the population and individual level. However, normal growth in an individual has unique-specific factors so requires a comprehensive assessment. Normal growth for an individual child could be defined as the progression of changes in anthropometric measurements to achieve the individual’s genetic potential. A misdiagnosis of growth faltering can occur if infants and children are asses with one-time rather than serial measures, and if age is not corrected for prematurity. Health care provider sensitivity and cognizance when communicating about a child’s size is important for parental reassurance and avoiding stigma and unnecessary pressures or restrictions around feeding. Children grow in a variety of patterns and have a variety of heights and weights. A child’s height is influenced by the family genetics as well as well as the amount and type of foods they eat, illnesses and by how much they move around. Health care providers must consider all the factors that can affect child growth in order to determine if the pattern over time is normal for the child. As there are many things that affect child growth, it may not always be straightforward to decide whether an individual child has a growth problem. Normal growth is defined differently for individuals versus populations. Some healthy children (2.3%) will measure below and above the WHO definition of healthy growth, but their sizes are appropriate for those children. This paper discusses how to define normal growth and what is considered short stature, a low weight for height, and overweight for a population and how to avoid misclassifying children as underweight, short, or overweight. Labelling a child by these categories can create stigma and lead to unnecessary diet changes. It is important for health care providers to communicate the principles of growth clearly and help prevent unnecessary worry for parents and stigmatization for children. [ABSTRACT FROM AUTHOR]

Background/Objectives: Major depressive disorder is a significant public health concern linked to factors such as a low-quality diet, a sedentary lifestyle, and poor sleep quality, all of which contribute to its development; nevertheless, the existing literature lacks a comprehensive framework to effectively integrate these interrelated influences. Methods: To address this gap, we conducted a questionnaire-based study involving 411 individuals aged 18 to 74 and employed a weighted complex network model to clarify the associations among nutritional factors, physical activity levels, psychological parameters, and sleep profiles and depression. In addition to constructing networks that encompass distinct subgroups based on general context, sex differences (female vs. male), and four age categories, our network was designed with a clearly defined target: the score from the Beck Depression Inventory. Results: In all networks studied, psychological parameters (e.g., tension, depression, hostility, fatigue, confusion, and total mood disturbance) emerged as the most influential nodes in relation to the targeted node (Eigenvector centrality of approximately 0.30). Additionally, sleep quality was identified as the next most relevant parameter for the general network (Eigenvector = 0.25), while nutritional factors—particularly carbohydrates—demonstrated greater prestige within the male network (Eigenvector = 0.06). Nutritional parameters had a stronger influence on depressive symptoms among individuals aged 29–39 years (Eigenvectors = 0.09, 0.09, and 0.14 for energy, carbohydrates, and fat, respectively). Conclusions: This novel approach allowed for a clearer visualization of how the studied parameters impact depressive symptoms, revealing significant differences when certain aspects are examined independently across distinct groups. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy, preservation of laryngeal function, and safety differences between PD-1 inhibitors combined with chemotherapy, and targeted therapy combined with chemotherapy in LA HPSCC patients. Methods: This was a retrospective analysis of patients with LA HPSCC treated at Beijing Tongren Hospital, Capital Medical University from October, 2020 to March, 2024. A total of 110 eligible patients were included, 56 in the PD-1 inhibitors combined with chemotherapy group (Group A), and 54 in the targeted therapy combined with chemotherapy group (Group B). Relevant clinical data were collected, and the clinical efficacy, preservation of laryngeal function, complete response (CR) rate, pathological complete response (pCR) rate, major pathological response (MPR), and treatment-related adverse events (TRAEs) of the two groups were analyzed and compared. Results: In both groups A and B, the objective response rate (ORR) and disease control rate (DCR) were similar with no significant differences, but the pCR rate in Group A was much higher than that in Group B, at 37.5% and 7.4%, respectively (p<0.001). The rate of primary tumor downstaging in group A was much higher than that in group B (76.8% vs. 38.9%) as well (p<0.0001). In addition, the 1y-OS rate in group A was 95.7%, compared to 87.0% in group B (p=0.106, HR=0.34; 95% CI: 0.114-1.013), and the 1y-PFS rate was 89.4% in group A compared to 85.2% in group B (p=0.399, HR=0.675; 95% CI: 0.275-1.659). Furthermore, the larynx function preservation rate was significantly higher in group A at 85.7%, compared to that of group B at only 66.7% (p=0.019). There were no deaths due to TRAEs in either group, and there was no significant difference in the incidence of grade 3-4 TRAEs between the two groups either (p=0.77). The main TRAEs in Group A were metabolism and nutrition disorders (52/56, 92.9%) and, in Group B were blood and lymphatic system disorders (40/54, 74.1%). Conclusions: PD-1 inhibitors combined with chemotherapy showed better short-term efficacy compared to targeted therapy. Additionally, a trend toward improved long-term survival was observed with PD-1 inhibitors but not with targeted therapy. Results for both groups indicate that neoadjuvant therapy is both safe and manageable. [ABSTRACT FROM AUTHOR]

While previous studies have identified a relationship between dietary intake and the risk of non-alcoholic fatty liver disease (NAFLD), the influence of overall nutritional status on NAFLD development has not been thoroughly investigated. This study sought to explore the association between different nutritional status indicators and NAFLD among the older adults. Nutritional status was evaluated using controlling nutritional status (CONUT), prognostic nutritional index (PNI) and nutritional risk index (GNRI), while NAFLD was identified based on a controlled attenuation parameter ≥ 285 dB/m, measured using transient elastography. The analysis included multivariate regression, receiver operating characteristic analysis, eXtreme Gradient Boosting and subgroup analysis to investigate the relationships between nutritional status indices and NAFLD. The study enrolled 1409 participants for the main analysis, with an NAFLD prevalence of 44·7 %. After accounting for potential confounders, a positive association between PNI and NAFLD was observed. Participants in the third and fourth quartiles of PNI showed increased odds of NAFLD compared with the lowest quartile (Q3: OR = 1·45, 95 % CI (1·03, 2·05); Q4: OR = 2·27, 95 % CI (1·59, 3·24)). Similarly, higher GNRI quartiles were significantly associated with greater odds of NAFLD (Q4 v. Q1: aOR = 1·84; 95 % CI (1·28, 2·65)). Conversely, higher CONUT values were linked to a reduced prevalence of NAFLD (OR = 0·65, 95 % CI (0·48, 0·87)). This study highlights that suboptimal nutritional status, indicating overnutrition as evaluated by PNI, GNRI and CONUT, is positively linked with the risk of NAFLD in individuals aged 50 years and above. [ABSTRACT FROM AUTHOR]

Shifts in socioeconomic factors, healthcare access, lifestyle and infrastructure facilities have resulted in increased body mass index (BMI) of populations in developing countries. These shifts result in a large increase in overweight and obese individuals, with a corresponding decline in the number of those who are underweight. Although this nutritional transition among women in Bangladesh is evident, studies elucidating such change are scarce. This study aimed to explain how socioeconomic, healthcare access and infrastructural shifts contributed to the nutritional transition among women of childbearing age in Bangladesh between 2004 and 2018. Repeated cross-sectional study of respondents who participated in the latest five rounds of Bangladesh Demographic Health Surveys (BDHS) from 2004 to 2017–18. Applying counterfactual decomposition techniques to data from the latest five rounds of BDHS, this study examined how variations in observed nutrition-related determinants, and returns to them across rounds, contributed to the nutritional transition among women of childbearing age. Shifts in nutritional outcomes were primarily attributed to gains in partner's education, improved access to healthcare, a decline in breastfeeding practice and the number of births. Wealth accumulation, contraception and improved sanitation facilities appeared as secondary contributing factors. Additionally, this study identified that the BMI gap widened between the lower and the upper quantile of the distribution over the study period. Addressing the rise in BMI and the prevalence of overnutrition is imperative for the future health of the population in Bangladesh. Considering the study findings and existing national nutrition policies and programmes, it is evident that targeted policy interventions, programmatic approaches and multisectoral collaborations are essential. [ABSTRACT FROM AUTHOR]

Food as medicine (FAM) interventions have been associated with improved health outcomes. However, there is limited FAM evidence in food retail settings. The objective was to evaluate the feasibility of a registered dietitian nutritionist–led FAM program that aims to detect changes in participants' nutrition problems and related nutrition and health outcomes, as documented by the Nutrition Care Process framework. The study was a descriptive feasibility nutrition intervention cohort analysis. A convenience sample of online food shoppers were enrolled in collaboration with a food retail chain (n = 39 participants completed the intervention and were included in primary analyses). Participants received nutrition care for 6 months either in person or via telehealth. The FAM intervention included tailored nutrition care that integrated software-generated meal plans and food shopping lists to support online food shopping. Progress of nutrition problems and diet quality (assessed via the Picture your Plate survey) were measured. Measurements included changes in anthropometric and biochemical parameters, blood pressure, and quality of life (assessed via the Centers for Disease Control and Prevention's Health Related Quality of Life-14 survey). Mann-Whitney U test, Pearson's χ2, and Wilcoxon signed-rank tests were used to detect differences. The most prevalent nutrition problems demonstrated improvement rates as follows: excessive energy intake, 81% (n = 21 of 26); excessive carbohydrate intake, 88% (n = 7 of 8); and obesity, 100% (n = 5 of 5). Exposure to the FAM intervention improved dietary quality, quality of life, body weight, waist circumference, and systolic pressure. FAM interventions can be carried out by in-store registered dietitian nutritionists in the supermarket setting. This feasibility study highlighted the need and opportunity for larger studies in which registered dietitian nutritionist–led FAM interventions, in collaboration with food retailers, may improve people's nutrition and health. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition in children and adolescents is a global issue particularly in low‐ and middle‐income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence. Methods: A school based, cross‐sectional survey was conducted in Karachi, Pakistan. Total 660, 11‐ to 12‐year‐old preadolescents were selected from a middle‐class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self‐Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol. Results: Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co‐occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co‐occurring malnutrition on the internalizing problems. Conclusion: Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co‐occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues. [ABSTRACT FROM AUTHOR]

Sleep disorders significantly impact the quality of life for many individuals, which remain largely unrecognized. It is widely believed that dietary nutrient intake plays a crucial role in promoting healthy sleep patterns. However, there is lack of research focusing on cancer survivors. This study utilized the National Health and Nutrition Examination Survey (NHANES) database to investigate the correlation between dietary nutrient intake and sleep disorders in cancer survivors. Analyzing data from 2882 cancer survivors in NHANES spanning from 2005 to 2018. Dietary nutrient intake was evaluated through two 24-h dietary recalls. Weighted multivariable logistic regression model was employed to further applied to explore the association between dietary fiber intake and sleep disorders while controlling for relevant confounding factors. Additionally, the nonlinear and dose–response relationships were explored using restricted cubic spline (RCS) regression along with smooth curve fitting and threshold effect analysis. Stratified analysis and interaction analysis were conducted to assess the consistency of the results. Univariable and multivariable analysis demonstrated that dietary fiber intake showed negative correlation with sleep disorders (P < 0.05). Treating dietary fiber intake as continuous variable. After accounting for all covariates, the study reaffirmed the protective role of dietary fiber (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.98–0.99, P = 0.044). Analysis of dietary fiber intake in quartiles further supported this trend (P < 0.001). Interestingly, further investigations indicated that dietary fiber intake was not associated with sleep apnea, insomnia, restless legs syndrome, or other types of sleep disorders (P > 0.05). Notably, no statistically significant interactions were observed in all subgroup analyses except poverty income ratio (PIR) (P for interaction < 0.05), indicating that the protective effect of dietary fiber on sleep disorders was more pronounced in individuals with PIR ≥ 2.5. Our results suggest that adequate dietary fiber intake may be beneficial dietary strategy to reduce sleep disorders in cancer survivors. [ABSTRACT FROM AUTHOR]

The accelerating pace of population aging in Asia poses significant challenges for health care and economies. As life expectancy increases and chronic diseases become more prevalent, understanding and addressing the healthcare needs of older adults is crucial. This review examines the key health issues affecting older adults in Asia, including nutritional status, mobility limitations, frailty, sarcopenia, mental, and cognitive health concerns. The authors conducted a mini-review of research on the health challenges faced by older adults in the region, drawing from a wide range of sources, including indexed and nonindexed journals and databases. The review highlights that aging in Asia is accompanied by a sharp rise in physical and mental health problems. While life expectancy in Asia has increased, many older adults experience declining physical and mental health, burdened by inadequate nutrition, frailty, and sarcopenia. Mental health issues, exacerbated by social isolation and limited access to services, are particularly prevalent in this population. The rapid pace of aging in Asia, coupled with the increased vulnerability of older adults and the lack of comprehensive national aging policies, highlight the region's unpreparedness to address the challenges faced by older adults. This demands urgent actions. To ensure healthy aging, Asia must prioritize a comprehensive national policy that addresses physical and mental health, economic security, productive work, and social engagement. Investing early in the health of older adults, promoting healthy lifestyles, accessible and older adults' friendly infrastructure, and integrated, holistic health care can reap long-term benefits, reducing healthcare burdens and improving quality of life. [ABSTRACT FROM AUTHOR]

There is significant communication and interdependence among the gut, the microbiome, and the brain during development. Diseases, such as necrotizing enterocolitis (NEC), highlight how injury to the immature gastrointestinal tract leads to long-term neurological consequences, due to vulnerabilities of the brain in the early stages of life. A better understanding of the developing gut–microbiota–brain axis is needed to both prevent and treat the devastating consequences of these disease processes. The gut–microbiota–brain axis is a bidirectional communication pathway that includes metabolic, nervous, endocrine, and immune components. In this review, we discuss gut development, microbiome colonization and maturation, and the interactions that influence neurodevelopment in the context of NEC. We describe the components of the gut–brain axis and how the microbiome is an integral member of this relationship. Finally, we explore how derangements within the microbiome and gut–microbiota–brain axis affect the normal development and function of the other systems and long-term neurodevelopmental consequences for patients. [ABSTRACT FROM AUTHOR]

Background Automated frailty screening tools like the Hospital Frailty Risk Score (HFRS) are primarily validated for care consumption outcomes. We assessed the predictive ability of the HFRS regarding care consumption outcomes, frailty domain impairments and mortality among older adults with cancer, using the Geriatric 8 (G8) screening tool as a clinical benchmark. Methods This retrospective, linkage-based study included patients aged ≥70 years with solid tumor, enrolled in the Elderly Cancer Patients (ELCAPA) multicentre cohort study (2016–2020) and hospitalized in acute care within the Greater Paris University Hospitals. HFRS scores, which encompass hospital-acquired problems and frailty-related syndromes, were calculated using data from the index admission and the preceding 6 months. A multidomain geriatric assessment (GA), including cognition, nutrition, mood, functional status, mobility, comorbidities, polypharmacy, incontinence, and social environment, was conducted at ELCAPA inclusion, with computation of the G8 score. Logistic and Cox regressions measured associations between the G8, HFRS, altered GA domains, length of stay exceeding 10 days, 30-day readmission, and mortality. Results Among 587 patients included (median age 82 years, metastatic cancer 47.0%), 237 (40.4%) were at increased frailty risk by the HFRS (HFRS>5) and 261 (47.5%) by the G8 (G8≤10). Both HFRS and G8 were significantly associated with cognitive and functional impairments, incontinence, comorbidities, prolonged length of stay, and 30-day mortality. The G8 was associated with polypharmacy, nutritional and mood impairment. Discussion Although showing significant associations with short-term care consumption, the HFRS could not identify polypharmacy, nutritional, mood and social environment impairments and showed low discriminatory ability across all GA domains. [ABSTRACT FROM AUTHOR]

Excessive exercise fostered an obsession with weight and appearance, potentially leading to unhealthy eating patterns. The purpose of this study was to demonstrate that individuals who exercised compulsively or participated in high-performance sports experienced significant pressure to meet certain physical standards and followed extreme diets, which contributed to the development of eating disorders. A bibliographic review was conducted using the Prisma method, selecting 23 out of 225 relevant studies from databases including PubMed, Google Scholar, ProQuest, Mendeley, Medline, Web of Science, Scopus, and Zotero. The findings affirmed that physical hyperactivity constituted a high-risk factor for the development of eating disorders, and strict dietary regimens compromised the nutrition of young athletes. A key element in their recovery was the nutritional approach of gradual food reintroduction in small quantities until patients achieved full recovery. The study concluded by noting that a balanced relationship between nutrition and physical activity, coupled with the healthcare team's commitment to patients, would prevent the increase of such cases. [ABSTRACT FROM AUTHOR]

Introduction: Celiac disease is an autoimmune condition that affects approximately 1% of the population worldwide. Although its main impact often concerns the small intestine, resulting in villous atrophy and nutrient malabsorption, it can also cause systemic manifestations, particularly when undiagnosed or left untreated. Method: Attention is directed to the possible psychological, psychiatric, and organic brain manifestations of celiac disease. Specific topics related to the influence and risk of such manifestations with respect to celiac disease are defined and discussed. Overall, eighteen main topics are considered, sifted from over 500 references. Results: The most often studied topics were found to be the effect on quality of life, organic brain dysfunction and ataxia, epilepsy, Down syndrome, generalized psychological disorders, eating dysfunction, depression, and schizophrenia. For most every topic, although many studies report a connection to celiac disease, there are often one or more contrary studies and opinions. A bibliographic analysis of the cited articles was also done. There has been a sharp increase in interest in this research since 1990. Recently published articles tend to receive more referencing, up to as many as 15 citations per year, suggesting an increasing impact of the topics. The number of manuscript pages per article has also tended to increase, up to as many as 12 pages. The impact factor of the publishing journal has remained level over the years. Conclusion: This compendium may be useful in developing a consensus regarding psychological, psychiatric, and organic brain manifestations that can occur in celiac disease and for determining the best direction for ongoing research focus. [ABSTRACT FROM AUTHOR]

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Audience and Type of Curriculum: This is a review curriculum utilizing multiple methods of education to enhance the skills of generalist healthcare providers in low- and middle-income countries (LMICs) in the identification and stabilization of pediatric respiratory emergencies. Our audience of implementation was Belizean generalist providers (nurses and physicians). Length of Curriculum: 8-10 hours Introduction: Early recognition and stabilization of critical pediatric patients can improve outcomes. Compared with resource-rich systems, many low-resource settings (i.e., LMICs) rely on generalists to provide most pediatric acute care. We created a curriculum for general practitioners comprising multiple educational modules focused on identifying and stabilizing pediatric emergencies. Our aim was to develop an educational framework to update and teach generalists on the recommendations and techniques of optimally evaluating and managing pediatric nutritional and gastrointestinal emergencies: bowel obstructions, gastroenteritis, and malnutrition. Educational Goals: The aim of this curriculum is to increase learners' proficiency in identifying and stabilizing acutely ill pediatric patients with gastrointestinal medical or surgical disease or complications of malnutrition. This module focuses on the diagnosis and management of gastroenteritis, acute bowel obstruction, and deficiencies of feeding and nutrition. The target audience for this curriculum is generalist physicians and nurses in limited-resource settings. Educational Methods: The educational strategies used in this curriculum include didactic lectures, medical simulation, and small-group sessions. Research Methods: We evaluated written pretests before and posttests after intervention and retested participants four months later to evaluate for knowledge retention. Participants provided qualitative feedback on the module. Results: We taught 21 providers. Eleven providers completed the pretest/posttest and eight completed the retest. The mean test scores improved from 8.3 ± 1.7 in the pretest to 12.2 ± 2.6 in the posttest (mean difference: 1.4, p = 0.027). The mean test score at pretest was 8.3 ± 2.3, which increased to 10.8 ± 3.0 at retest (mean difference: 2.5, p = 0.060). Seven (71.4%) and four (28.5%) participants found the course "extremely useful" and "very useful," respectively (n = 11). Discussion: This curriculum may be an effective and welcome training tool for Belizean generalist providers. There was a statistically significant improvement in the test performance but not in retesting, possibly due to our small sample size and high attrition rate. Evaluation of other modules in this curriculum, application of this curriculum in other locations, and measuring clinical practice interventions will be included in future investigations. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) involves social communication difficulties and repetitive behaviors, and it has a growing prevalence worldwide. Symptoms include cognitive impairments, gastrointestinal (GI) issues, feeding difficulties, and psychological problems. A significant concern in ASD is food selectivity, leading to nutrient deficiencies. Common GI issues in ASD, such as constipation and irritable bowel syndrome, stem from abnormal gut flora and immune system dysregulation. Sensory sensitivities and behavioral challenges exacerbate these problems, correlating with neurological symptom severity. Children with ASD also exhibit higher oxidative stress due to low antioxidant levels like glutathione. Therapeutic diets, including ketogenic, high-antioxidant, gluten-free and casein-free, and probiotic-rich diets, show potential in managing ASD symptoms like behavior, communication, GI issues, and oxidative stress, though the evidence is limited. Various studies have focused on different populations, but there is increasing concern about the impact among children. This review aims to highlight the food preferences of the ASD population, analyze the effect of the physicochemical and nutritional properties of foods on the selectivity in its consumption, GI problems, and antioxidant deficiencies in individuals with ASD, and evaluate the effectiveness of therapeutic diets, including diets rich in antioxidants, gluten-free and casein-free, ketogenic and essential fatty acids, and probiotic-rich diets in managing these challenges. [ABSTRACT FROM AUTHOR]

According to the DSM-5, neurodevelopmental disorders represent a group of heterogeneous conditions, with onset during the developmental period, characterized by an alteration of communication and social skills, learning, adaptive behavior, executive functions, and psychomotor skills. These deficits determine an impairment of personal, social, scholastic, or occupational functioning. Neurodevelopmental disorders are characterized by an increased incidence and a multifactorial etiology, including genetic and environmental components. Data largely explain the role of genetic and environmental factors, also through epigenetic modifications such as DNA methylation and miRNA. Despite genetic factors, nutritional factors also play a significant role in the pathophysiology of these disorders, both in the prenatal and postnatal period, underscoring that the control of modifiable factors could decrease the incidence of neurodevelopmental disorders. The preventive role of nutrition is widely studied as regards many chronic diseases, such as diabetes, hypertension, and cancer, but actually we also know the effects of nutrition on embryonic brain development and the influence of prenatal and preconceptional nutrition in predisposition to various pathologies. These factors are not limited only to a correct caloric intake and a good BMI, but rather to an adequate and balanced intake of macro and micronutrients, the type of diet, and other elements such as exposure to heavy metals. This review represents an analysis of the literature as regards the physiopathological mechanisms by which food influences our state of health, especially in the age of development (from birth to adolescence), through prenatal and preconceptional changes, underlying how controlling these nutritional factors should improve mothers' nutritional state to significantly reduce the risk of neurodevelopmental disorders in offspring. We searched key words such as "maternal nutrition and neurodevelopmental disorders" on Pubmed and Google Scholar, selecting the main reviews and excluding individual cases. Therefore, nutrigenetics and nutrigenomics teach us the importance of personalized nutrition for good health. So future perspectives may include well-established reference values in order to determine the correct nutritional intake of mothers through food and integration. [ABSTRACT FROM AUTHOR]

Background: Oropharyngeal cancer (OPC) survivorship is a nursing priority because patients are living longer while significant short-term and long-term treatment complications that require nursing care are increasing. Hospital readmission is costly and reflects the quality of care patients receive. Objectives: This secondary analysis aimed to determine the prevalence of treatment complications resulting in hospital admissions among persons with OPC and examine the relationship between treatment complications resulting in hospital admission among persons with OPC and all other persons with head and neck cancer. Methods: Using the National Inpatient Survey 2008-2019 database, we identified persons with relevant head and neck cancer diagnoses using specific International Classification of Disease ICD-9 and ICD-10 codes. Complications were operationalized by diagnosis-related codes; persons with codes for major elective surgery were excluded as our focus was posttreatment symptoms requiring hospitalization. Descriptive statistics were used to characterize persons with OPC hospitalized between 2008 and 2019. Binary logistic regression was used to assess complications using crude comparisons. The Elixhauser Comorbidity Index was used for controlling for comorbidities. Results: The final analysis samples included 751,533: 164,770 persons with OPC and 586,763 with other head and cancers. Themost prevalent diagnoses observed in those with OPC were esophagitis, nutrition disorder, hematological disorder, and renal failure; the least common diagnoses were sepsis, respiratory tract infection, and pneumonia. Binary regression revealed that persons with OPC experienced significantly more esophagitis, nutrition disorders, hematological disorders, and renal failure compared to persons with other head and neck cancers. Discussion: Treatment of survivors of OPC requires more intensive monitoring for early symptoms associated with treatment, including esophagitis, nutrition disorders, bleeding disorders, and renal failure, than persons with other head and neck cancers. Monitoring laboratory values and clinical manifestations of these conditions is imperative. Nurses may encounter persons with OPC in emergency departments, outpatient radiology, or inpatient general medicine floors to manage swallowing difficulties, dehydration, malnutrition, and bleeding. Delayed or ineffective treatment of these conditions contributes to readmission, financial burden, and impairment of patient's quality of life. Future research should investigate the relationship between targeted treatment for expected complications and readmission rates in persons with OPC. [ABSTRACT FROM AUTHOR]

Eating disorders are serious health issues among young people that contribute to increased morbidity rates. The prevalence and severity of eating disorders among Latvian youth aged 18–24 and their relationship with the Healthy Eating Index, dietary habits, and BMI were analyzed in the present study. At the beginning of the study, 190 respondents participated by completing the SCOFF questionnaire, from which the sample group was selected based on the criterion of SCOFF ≥ 2. For the next stage of the study, the responses of 74 participants who completed the EDE-Q-6 questionnaire and the Canadian Food Intake Screener were analyzed. The symptoms of eating disorders were identified in 38.9% of the respondents (SCOFF ≥ 2). The global score of the EDE-Q-6 was 2.00 ± 1.81 where subscales such as body shape concerns (2.93 ± 1.44) and weight concerns (2.68 ± 1.36) were the most important factors that young people paid attention to. The severity of eating disorders was 3.20 for males and 2.62 for females, where a score of 4 and above is classified as an eating disorder. Participants with eating disorder symptoms had a higher BMI, with females having a BMI of 22.5 (normal weight) and 25.5 for males (overweight). The study sample had a poor diet, as the Healthy Eating Index was 8.7 with a maximum score of 24. Weak negative correlations were found between eating disorder severity and eating habits. The issue of eating disorders is topical among young people in Latvia, which requires solutions such as the inclusion of educational programs on healthy nutrition and eating disorders, and psychological support for young people. [ABSTRACT FROM AUTHOR]

Introduction The War-Related Illness and Injury Study Center at the VA New Jersey Health Care System (WRIISC-VANJ) serves as one of the three tertiary referral centers for combat deployed Veterans of all eras with medically unexplained or difficult-to-diagnose conditions that may be related to deployment-related exposures. Many of the Veterans seen at the WRIISC experience chronic multisymptom illness (CMI), also known as Gulf War Illness (GWI). Given the complexity and interconnectedness of symptoms, Veterans with GWI are often unlikely to produce meaningful results when addressing single symptoms. Further, Veterans with GWI often have co-morbid cognitive and behavioral health conditions (e.g. TBI, PTSD, Depression), which further compromise their self-efficacy in following treatment recommendations. Thus, the WRIISC-NJ, in collaboration with Wellness Solutions Group, developed a virtual Functional Medicine-based Interdisciplinary and Integrative Intervention to improve the health of Veterans by assisting them in implementing lifestyle changes. Methods The 6-month telehealth program included functional medicine assessments, nutrition and adaptive exercise coaching, mindfulness meditation and yoga, guest health lectures, character strength coaching, and targeted nutritional supplements. Aspects of the program were tailored to the unique clinical needs of each Veteran. Participants completed baseline and 6 month follow-up assessments of physical and emotional symptoms and overall functioning. Follow-up scores were compared with baseline data. Results The program was well received by Veterans with attendance across all offered sessions ranging from 70 to 100%. Further, at the end of the clinical pilot program, improvements were demonstrated in physical and mental health symptoms, intentional weight loss/gain, functional movement, and sleep quality. Conclusions These preliminary results demonstrate the possibility of creating positive health outcomes across multiple health indicators in medically complex combat-deployed Veterans. Our early success and participant enthusiasm for this clinical pilot program also illustrate an opportunity to provide individualized, innovative solutions for the evaluation and treatment of Veterans with GWI. [ABSTRACT FROM AUTHOR]

Nutrition problems are still a concern for the Indonesian government to be resolved immediately, one of which is the problem of stunting., Bojonegoro Regency's stunting prevalence rate is 23.9 percent, making Bojonegoro the district with the 13th highest stunting prevalence of 38 districts and cities in East Java. The prevalence of stunting which is still quite high can affect Indonesia's development performance because stunting has an impact on children's health status so that children become vulnerable to illness and has an impact on children's intelligence and quality of life, so handling it is still a government priority. The innovation of the KELANTING program (Stunting Caring Grandmother Class) is present by involving academics who act as references for solving problems based on research results (based on research) in the field of midwifery and nursing. So that it is able to increase the understanding of the community, especially grandmother caregivers, so that they are able to carry out care appropriately and get used to it. children to consume foods with balanced contents. The Klanting Program is carried out with Local Food Education and Diversification in Sidobandung Village, Balen District, Bojonegoro Regency " as a pilot project for community- based stunting prevention efforts. This activity is carried out by involving 25 grandmothers who care for toddlers by carrying out outreach and education. After the Klanting activity was carried out, there was an increase in the understanding and knowledge of grandmother caregivers regarding parenting styles and food diversification to prevent stunting, namely 72% of grandmother caregivers after the clanting activity had good knowledge, compared to previously only 28%. This shows that there is an increase in the percentage of understanding and knowledge of grandmothers who care for toddlers about parenting patterns of grandmothers and local food diversification in order to increase toddlers' interest in eating food diversity and the use of local food which can prevent stunting in toddlers. [ABSTRACT FROM AUTHOR]

Stunting, a consequence of chronic malnutrition, particularly affects children aged 0-24 months, impacting child mortality and development. This review aims to explore stunting prevention interventions in this age group, focusing on caregiving during the first 1000 days of life. A systematic search yielded 18 relevant studies published between 2019 and 2023, diverse in location and intervention approaches. Interventions varied from supplementation to community and healthcare programs. Integrating nutrition education with maternal support proved crucial. The review stresses the need for sustainable, context-specific approaches tailored to local contexts. Recommendations include integrating nutrition education into healthcare and community interventions. Continuous evaluation is vital. This review offers insights into stunting prevention, aiding evidence-based strategies globally. Future research should explore caregiving complexities and intervention sustainability. Nursing practitioners are key in implementing holistic approaches to stunting prevention and improving child health outcomes. [ABSTRACT FROM AUTHOR]

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Wasting remains a significant nutritional challenge in Indonesia. Despite a reduction in its prevalence from 10.2% in 2018 to 7.1% in 2021, the rate still falls short of the national target of 7%. This study aims to examine the relationship between health services and family income on the incidence of wasting in toddlers aged 0-59 months in the Polombangkeng Utara sub-district, Takalar district. The research employed a quantitative approach with a cross-sectional study design. The population in this study consisted of toddlers aged 0-59 months in the North Polombangkeng sub-district, with a sample size of 146 toddlers. A probability sampling technique was used. The analysis was conducted using the chi-square test. The results of the chi-square test show that household food security is not related to the incidence of wasting, with a p-value of 0.590 (>0.05). Similarly, there is no relationship between growth monitoring and the incidence of wasting, with a p-value of 0.240 (>0.05), and no relationship between the completeness of immunization status and the incidence of wasting, with a p-value of 0.776 (>0.05). However, family income does show a relationship to the incidence of wasting, with a p-value of 0.032 (

Background Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are highly efficacious at preventing severe disease in the general population, current data are lacking regarding vaccine efficacy (VE) for individuals with mild immunocompromising conditions. Methods A post hoc, cross-protocol analysis of participant-level data from the blinded phase of four randomized, placebo-controlled, coronavirus disease 2019 (COVID-19) vaccine phase 3 trials (Moderna, AstraZeneca, Janssen, and Novavax) was performed. We defined a "tempered immune system" (TIS) variable via a consensus panel based on medical history and medications to determine VE against symptomatic and severe COVID-19 cases in TIS participants versus non-TIS individuals starting at 14 days after completion of the primary series through the blinded phase for each of the 4 trials. An analysis of participants living with well-controlled human immunodeficiency virus was conducted using the same methods. Results A total of 3852/30 351 (12.7%) Moderna participants, 3088/29 868 (10.3%) Novavax participants, 3549/32 380 (11.0%) AstraZeneca participants, and 5047/43 788 (11.5%) Janssen participants were identified as having a TIS. Most TIS conditions (73.9%) were due to metabolism and nutritional disorders. Vaccination (vs placebo) significantly reduced the likelihood of symptomatic and severe COVID-19 for all participants for each trial. VE was not significantly different for TIS participants versus non-TIS for either symptomatic or severe COVID-19 for each trial, nor was VE significantly different in the symptomatic endpoint for participants with human immunodeficiency virus. Conclusions For individuals with mildly immunocompromising conditions, there is no evidence of differences in VE against symptomatic or severe COVID-19 compared with those with non-TIS in the 4 COVID-19 vaccine randomized controlled efficacy trials. [ABSTRACT FROM AUTHOR]

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have attracted much attention because of their significant hypoglycemic and weight-loss effects. Previous preparations can only be subcutaneously injected. Oral administration of GLP-1RAs semaglutide helps to broaden treatment options, but its safety in the real world still needs to be observed. This study is based on FDA adverse event reporting system (FAERS) database to mine adverse drug events (ADE) of oral semaglutide, and provide references for the clinical safe use of this drug. Methods: To analyze the signal quality of oral semaglutide, which is a drug used in the FAERS database from the third quarter of 2019 to the third quarter of 2023, we collected ADE data and performed data mining by using disproportionate analysis. Then, we standardized the data and used a variety of signal-quantification techniques, including reported odds ratio (ROR), proportional reporting ratio (PRR), Bayesian belief propagation neural network (BCPNN), and multiple empirical Bayesian gamma Poisson contractions (MGPS), for further analysis. Results: We screened 2398 reports on the use of semaglutide tablets, involving a total of 5653 ADE. These reports were mainly submitted by consumers, and the reporting country was mainly the United States. A total of 23 system organ classes (SOC) and 93 preferred terms (PT) were mined for the signals of semaglutide tablets. The three most common SOC were gastrointestinal disorders, general disorders and administration site conditions, and investigations. At the PT level, metabolism and nutrition disorders exhibit the highest number of signals, with the top three being thyroid cyst, acute cholecystitis, and ketosis. Gastrointestinal disorders rank second, primarily involving eructation, pancreatitis, impaired gastric emptying, and regurgitation. In addition, vith nerve paralysis occurs and the signal intensity is high. Conclusions: Our study provides a deeper and broader understanding of the safety of oral semaglutide. The results of the ROR, PRR, BCPNN, and MGPS algorithms exhibit high consistency, with metabolism and nutrition-related disorders having the highest number of signals. The conclusions align with the technical specifications of the product. Notably, other unexpected effects are reported, including acute cholecystitis, paralysis of the abducens nerve, and positional vertigo. [ABSTRACT FROM AUTHOR]

Purpose: Maternal and postnatal overnutrition has been linked to an increased risk of cardiometabolic diseases in offspring. This study investigated the impact of adult-onset voluntary wheel running to counteract cardiometabolic risks in female offspring exposed to a life-long high-fat, high-sucrose (HFHS) diet. Methods: Dams were fed either an HFHS or a low-fat, low-sucrose (LFLS) diet starting from 8 wk before pregnancy and continuing throughout gestation and lactation. Offspring followed their mothers' diets. At 15 wk of age, they were divided into sedentary (Sed) or voluntary wheel running (Ex) groups, resulting in four groups: LFLS/Sed (n = 10), LFLS/Ex (n = 5), HFHS/Sed (n = 6), HFHS/Ex (n = 5). Cardiac function was assessed at 25 wk, with tissue collection at 26 wk for mitochondrial respiratory function and protein analysis. Data were analyzed using two-way ANOVA. Results: Although maternal HFHS diet did not affect the offspring's body weight at weaning, continuous HFHS feeding postweaning resulted in increased body weight and adiposity, irrespective of the exercise regimen. HFHS/Sed offspring showed increased left ventricular wall thickness and elevated expression of enzymes involved in fatty acid transport (CD36, FABP3), lipogenesis (DGAT), glucose transport (GLUT4), oxidative stress (protein carbonyls, nitrotyrosine), and early senescence markers (p16, p21). Their cardiac mitochondria displayed lower oxidative phosphorylation (OXPHOS) efficiency and reduced expression of OXPHOS complexes and fatty acid metabolism enzymes (ACSL5, CPT1B). However, HFHS/Ex offspringmitigated these effects, aligning more with LFLS/Sed offspring. Conclusions: Adult-onset voluntary wheel running effectively counteracts the detrimental cardiac effects of a lifelong HFHS diet, improving mitochondrial efficiency, reducing oxidative stress, and preventing early senescence. This underscores the significant role of physical activity in mitigating diet-induced cardiometabolic risks. [ABSTRACT FROM AUTHOR]

Aging is a multifaceted process impacting cells, tissues, organs, and organ systems of the body. Like other systems, aging affects both the adaptive and the innate components of the immune system, a phenomenon known as immunosenescence. The deregulation of the immune system puts elderly individuals at higher risk of infection, lower response to vaccines, and increased incidence of cancer. In the Western world, overnutrition has increased the incidence of obesity (linked with chronic inflammation) which increases the risk of metabolic syndrome, cardiovascular disease, and cancer. Aging is also associated with inflammaging a sterile chronic inflammation that predisposes individuals to age‐associated disease. Genetic manipulation of the nutrient‐sensing pathway, fasting, and calorie restriction (CR) has been shown to increase the lifespan of model organisms. As well in humans, fasting and CR have also been shown to improve different health parameters. Yet the direct effect of fasting and CR on the aging immune system needs to be further explored. Identifying the effect of fasting and CR on the immune system and how it modulates different parameters of immunosenescence could be important in designing pharmacological or nutritional interventions that slow or revert immunosenescence and strengthen the immune system of elderly individuals. Furthermore, clinical intervention can also be planned, by incorporating fasting or CR with medication, chemotherapy, and vaccination regimes. This review discusses age‐associated changes in the immune system and how these changes are modified by fasting and CR which add information on interventions that promote healthy aging and longevity in the growing aging population. [ABSTRACT FROM AUTHOR]

Background/Objectives: Duchenne muscular dystrophy (DMD) is the most prevalent progressive muscular dystrophy, and the guidelines recommend the regular assessment of respiratory muscle function. This study aimed to assess the relationship between maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and sniff nasal inspiratory pressure (SNIP) measurements and upright-supine spirometry parameters in children with DMD, the predictability of upright–supine spirometry in terms of diaphragm involvement, and the impact of nutrition on muscle strength. Methods: This prospective cross-sectional study examined patients with DMD by comparing upright and supine FVC, MIP, MEP, and SNIP measurements. The effects of the ambulatory status, kyphoscoliosis, chest deformity, and low BMI on respiratory parameters were investigated. Results: Forty-four patients were included in the study. The mean patient age was 10.8 ± 2.9 years. Twenty-five patients were ambulatory. A significant decrease in FVC, FEV1, and FEF25–75 values was detected in the supine position in both ambulatory and non-ambulatory patients (p < 0.05). All patients had low MIP, MEP, and SNIP measurements (less than 60 cm H2O). MIP, MEP, and SNIP values were significantly lower in patients with a low BMI than in those without (p < 0.05). Conclusions: To accurately assess respiratory muscle strength, supine FVC should be combined with upright FVC, MIP, MEP, and SNIP measurements. It is crucial to regularly screen patients for nutrition, as this can significantly affect respiratory muscle function during pulmonology follow-up. [ABSTRACT FROM AUTHOR]

Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are employed extensively in the management of type 2 diabetes and obesity. However, there is a paucity of real-world data on their safety and tolerability for metabolic and nutritional adverse events in large sample populations. This study aimed to analyse the metabolic and nutritional safety signatures of different GLP-1 RAs by exploring the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). Methods: AEs data were extracted from the FDA Adverse Event Reporting System database for each GLP-1 RA from the time of its launch until the second quarter of 2023. The reported odds ratio (ROR), proportional reporting ratio (PRR), Empirical Bayesian Geometric Mean and Bayesian Confidence Propagation Neural Network were employed to identify AE signals. Results: A system organ class of metabolism and nutrition disorders was employed to filter AE reports, resulting in the identification of 10,450 reports for exenatide, 2,860 reports for liraglutide, 240 reports for albiglutide, 4,847 reports for dulaglutide, 2,905 reports for semaglutide, 1,089 reports for tirzepatide, and 13 reports for lixisenatide. Semaglutide (ROR, 3.34; 95%CI, 3.22), liraglutide (ROR, 2.78; 95%CI, 2.69), and exenatide (ROR, 2.15; 95%CI, 2.11) were associated with metabolism and nutrition disorders. The number of AE signals detected were as follows: albiglutide (n = 1), lixisenatide (n = 2), tirzepatide (n = 11), exenatide (n = 12), liraglutide (n = 16), semaglutide (n = 20), dulaglutide (n = 22). Dehydration was the most frequent AE contributing to serious outcomes for liraglutide (n = 318, 23.93%), dulaglutide (n = 434, 20.90%), semaglutide (n = 370, 25.10%) and tirzepatide (n = 70, 32.86%). The time to onset (TTO) of AE was statistically different between exenatide and the other GLP-1 RAs (p < 0.001), and the Weibull parameters for dehydration for liraglutide, dulaglutide, and semaglutide analyses all showed an early failure-type profile. Conclusion: Our study suggests that exenatide, liraglutide, and semaglutide are more susceptible to metabolic and nutritional AEs than other GLP-1 RAs. Liraglutide, dulaglutide, semaglutide, and tirzepaptide's potential to induce dehydration, necessitates special attention. Despite certain deficiencies, GLP-1 RAs have considerable potential for the treatment of eating disorders. [ABSTRACT FROM AUTHOR]