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Microplastics (MPs) contamination in marine organisms is a significant threat to seafood consumers worldwide. This study is the first to investigate the abundance of MPs in the commercial bivalves from six sites along Thailand's coastline, the daily exposure of bivalve consumers to MPs, and potential associated health risks. The microplastic occurrence varied from 69 % to 93 % in four bivalve species while the average abundance of MPs was 1.87 ± 0.86 items/individual or 0.46 ± 0.43 items/g ww. Benthic bivalves (cockles and clams) contained more MPs than their pelagic counterparts (mussels and oysters). Small blue microfibers (<500 µm) were the most abundant. The most common polymers were natural based polymers (cotton and rayon) and polyethylene terephthalate (PET). The daily microplastic exposure for consumers was 0.52 items/person. Although the risk of microplastic contamination is low, we recommend investigation into the transfer of MPs within the food web, notably as it may pose significant human health concerns.

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Uncontrolled human activity and nature are causing the deterioration of Saint Martin Island, Bangladesh's only tropical island, necessitating sustainable land use strategies and ecological practices. Therefore, the present study measures the land use/cover transition from 1974 to 2021, predicts 2032 and 2042, and constructs the spatiotemporal features of the Landscape Ecological Risk Index based on land use changes. The study utilized Maximum Likelihood Classification (MLC) on Landsat images from 1974, 1988, 2001, 2013, and Sentinel 2B in 2021, achieving ≥ 80% accuracy. The MLP-MC approach was also used to predict 2032 and 2042 LULC change patterns. The eco-risk index was developed using landscape disturbance and vulnerability indices, Bayesian Kriging interpolation, and spatial autocorrelations to indicate spatial clustering. The research found that settlements increased from 2.06 to 28.62 ha between 1974 and 2021 and would cover 41.22 ha in 2042, causing considerable losses in agricultural areas, waterbodies, sand, coral reefs, and vegetation. The area under study showed a more uniform and homogenous environment as Shannon's diversity and evenness scores decreased. The ecological risk of Saint Martin Island increased from 4.31 to 31.05 ha between 1974 and 2042 due to natural and human factors like erosion, tidal bores, population growth, coral mining, habitat destruction, and intensive agricultural practices and tourism, primarily in Nazrul Para, Galachipa, and Western Dakhin Para. The findings will benefit St. Martin Island stakeholders and policymakers by providing insights into current and potential landscape changes and land eco-management.

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BACKGROUND: The role of the geriatric nutritional risk index (GNRI) as a prognostic factor in intensive care unit (ICU) patients with acute kidney injury (AKI) remains uncertain. OBJECTIVES: The aim of this study was to investigate the impact of the GNRI on mortality outcomes in critically ill patients with AKI. METHODS: For this retrospective study, we included 12,058 patients who were diagnosed with AKI based on ICD-9 codes from the eICU Collaborative Research Database. Based on the values of GNRI, nutrition-related risks were categorized into four groups: major risk (GNRI < 82), moderate risk (82 ≤ GNRI < 92), low risk (92 ≤ GNRI < 98), and no risk (GNRI ≥ 98). Multivariate analysis was used to evaluate the relationship between GNRI and outcomes. RESULTS: Patients with higher nutrition-related risk tended to be older, female, had lower blood pressure, lower body mass index, and more comorbidities. Multivariate analysis showed GNRI scores were associated with in-hospital mortality. (Major risk vs. No risk: OR, 95% CI: 1.90, 1.54-2.33, P < 0.001, P for trend < 0.001). Moreover, increased nutrition-related risk was negatively associated with the length of hospital stay (Coefficient: -0.033; P < 0.001) and the length of ICU stay (Coefficient: -0.108; P < 0.001). The association between GNRI scores and the risks of in-hospital mortality was consistent in all subgroups. CONCLUSIONS: GNRI serves as a significant nutrition assessment tool that is pivotal to predicting the prognosis of critically ill patients with AKI.

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Heatwaves pose a serious threat and are projected to amplify with changing climate and social demographics. A comprehensive understanding of heatwave exposure to the communities is imperative for the development of effective strategies and mitigation plans. This study explores spatiotemporal characterization of heatwaves across the historically vulnerable communities in Mississippi, United States. We derive multiple heatwave metrics including frequency, duration, and magnitude based on temperature data for urban-specific daytime, nighttime, and day-night combined conditions. Our analysis depicts a rising heatwave trend across all counties, with the most extreme shifts observed in prolonged day-night events lacking overnight relief. We integrate physical heatwave hazards with a socioeconomic vulnerability index to develop an integrated urban heatwave risk index. Integrated metric identifies the counties in northwest Mississippi as heat-prone areas, exhibiting an urgent need to prioritize heat resilience and adaptive strategies in these regions. The compounding urban heatwave and vulnerability risks in these communities highlights an environmental justice imperative to implement equitable policies that protect disadvantaged populations. Although this study is focused on Mississippi, our framework is scalable and can be employed to urban regions globally. This study provides a solid foundation for developing timely heatwave preparedness and mitigation to avert preventable heat-related tragedies as extremes intensify with climate change.

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BACKGROUND: Cognitive impairment is highly prevalent among patients with chronic kidney disease, who face an increased risk of cognitive decline. The aim of this study was to investigate the relationship between the Geriatric Nutritional Risk Index (GNRI) and cognitive function in older individuals, both with and without chronic kidney disease (CKD). METHODS: In this study, we analyzed data from 2728 participants in the 2011-2014 National Health and Nutrition Examination Survey (NHANES). Cognitive function was measured using the Consortium to Establish a Registry for the Alzheimer's Disease Word Learning subtest (CERAD W-L), the animal fluency test (AFT), the digit symbol substitution test (DSST), and the global cognitive z-score. The GNRI, representing whole-body nutritional status, was calculated based on serum albumin, body weight, and ideal body weight. We employed weighted multiple linear regression analyses and subgroup analyses to assess the independent association of GNRI with cognitive function in CKD and non-CKD populations. Smoothing techniques were used to fit curves, and interaction tests were used to assess the robustness and specificity of the findings. RESULTS: Our analyses revealed a significant positive association between higher GNRI levels and cognitive function in the older US population (for global z-score: ß = 0.01; 95% confidence interval [CI] = 0.00, 0.01). This association remained consistent across various subgroup analyses, including those for different gender groups, age groups, smoking statuses, diabetes statuses, hypertension statuses, individuals with a BMI below 25, individuals who consumed alcohol, and non-Hispanic white individuals. Smoothed curve-fitting analyses indicated that the GNRI was linearly related to cognitive function. No statistically significant interactions were detected among these variables. CONCLUSION: Our findings emphasize the positive association between GNRI and cognitive health in individuals with or without CKD, especially when combined with other risk factors. Consequently, enhancing the nutritional status of the elderly may serve as a viable strategy to thwart the onset of cognitive decline.

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INTRODUCTION: Stress-induced hyperglycemia (SIH) and malnutrition are common in trauma patients and are linked to worse outcomes. This study examined the influence of nutritional status, determined by the Geriatric Nutritional Risk Index (GNRI), on the incidence of SIH in trauma patients. METHODS: A retrospective analysis was conducted on adult trauma patients admitted to a Level I trauma center from 1 January 2009 to December 31, 2021. Patients were categorized into four groups: SIH, diabetic hyperglycemia (DH), diabetic normoglycemia (DN), and non-diabetic normoglycemia (NDN). Nutritional status was assessed using GNRI: high risk (GNRI < 82), moderate risk (82 ≤ GNRI < 92), low risk (92 ≤ GNRI ≤ 98), and no risk (GNRI > 98). Incidence of SIH and outcomes were analyzed across GNRI groups. RESULTS: SIH was associated with higher mortality across all GNRI groups compared to NDN, with the highest rate (45.7%) in the high-risk group. Mortality decreased as GNRI increased in all glucose groups. NDN patients had the lowest mortality rates across GNRI groups. There was no correlation between GNRI and SIH incidence (p = 0.259). CONCLUSION: SIH significantly influenced mortality across all nutritional status groups, with the highest impact in malnourished patients. Although malnutrition did not affect SIH incidence, both SIH and poor nutritional status independently contributed to worse trauma outcomes. Targeted management of hyperglycemia and nutritional deficiencies is crucial for improving survival.

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OBJECTIVES: To review current evidence on using the geriatric nutritional risk index (GNRI) in predicting postoperative delirium (POD) in elderly patients. METHODS: The literature search was performed in core databases to include all the cohort studies on the association between GNRI and risk of POD for further meta-analysis. RESULTS: A total of 6 studies with 4242 patients underwent this meta-analysis, which showed that the risk of POD was higher in patients with moderate and high GNRI than the ones with low GNRI (odds ratio [OR]=2.04, 95% confidence interval [CI] [1.58, 2.64], p<0.001), and moderate and high GNRI significantly increased the risk of POD in patients of 60 to 75 years or above [OR=1.98, 95%CI (1.49, 2.62), p<0.001; OR=2.79, 95%CI (1.38, 5.64), p=0.004, respectively]. CONCLUSION: Therefore, moderate and high GNRI increased the risk of POD in elderly patients.

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Background: Nutritional problems are considered one of the main complications of hemodialysis, and the geriatric nutritional risk index (GNRI) is a new instrument for assessing geriatric nutritional status. The present study sought to evaluate the relationship between the GNRI and quality of life (QOL) among elderly hemodialysis patients. Methods: In the present analytical cross-sectional study, 110 hemodialysis individuals were selected by applying a simple random sampling method, among whom 57 and 53 were males and females, respectively (mean: 70.3±6.93 years). Demographic characteristics, GNRI, and QOL status were determined. The data were analyzed using SPSS 20 software and descriptive statistics, Pearson's correlation, ANOVA, independent sample t-tests, and multiple linear regression analysis. Results: The mean GNRI and mean total QOL were respectively obtained 93.903±11.067 and 20.95 ± 4.89. Among females, a significant direct relationship was observed between GNRI and total QOL (P = 0.010, r = 0.352), autonomy (P = 0.004, r = 0.389), and pleasure (P = 0.015, r = 0.333), while GNRI was not directly and significantly related to QOL in males (P = 0.161, r = 0.188). Conclusion: Due to the presence of a significant association between Geriatric GNRI and QOL among elderly hemodialysis patients, particularly among females, highlighting the importance of addressing nutritional status in optimizing well-being.

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The evaluation of metal contamination, ecological risk, bioavailability, and the environmental dredging depth in sediments of two Colombian riverine systems impacted by artisanal and small-scale gold mining (ASGM) and agricultural activities, was conducted following dredging processes. Results indicated significant contamination by Cd and Pb before dredging, based on the contamination factor (CF) and the geoaccumulation index (Igeo). Additionally, Cu and Hg were found to cause adverse biological effects according to sediment quality guidelines. Post-dredging, surface sediments exhibited a moderate ecological risk index (RI, 150-300), primarily due to increased contamination by Hg, Pb, and Cd. To mitigate this ecological risk (RI < 150), the environmental dredging depth needed to exceed 20 cm for all metals. On average, the bioavailable fraction increased 2.3 times within two months after dredging. However, the low environmental risk (%F1 = 1-10) calculated using risk assessment codes (RAC) indicates a potential risk due to metals entering the water column and bioaccumulating in organisms. These findings provide insights into the dynamics of metals and the impact of dredging activities on sediments in the Colombian Caribbean coast affected by various anthropogenic activities. The research underscores the importance of integrating sustainable practices in mining and agriculture to protect the ecological integrity of these riverine systems.

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Background: Globally, non-small cell lung cancer (NSCLC) is a leading factor in cancer-related mortality. Additionally, the Geriatric Nutritional Risk Index (GNRI) has been assessed as a predictive and prognostic indicator in various types of carcinomas. Our study aims to assess the prognostic importance of GNRI computed at diagnosis in NSCLC patients receiving immune checkpoint inhibitors (ICIs). Methods: The study evaluated 148 patients who underwent immunotherapy for NSCLC from January 1, 2018, through December 31, 2021, retrospectively. Patients combined with other malignant tumors or severe comorbidities were excluded from the study. The receiver operating characteristic (ROC) curve was employed in regulating the ideal cutoff worth of GNRI. Survival outcomes were evaluated through Kaplan-Meier analysis. Following this, both univariate and multivariate analyses were conducted utilizing Cox regression analysis to identify any potential factors that may influence the survival outcomes. Results: The cutoff point for GNRI was 108.15 [area under the curve (AUC) =0.575, P=0.048]. Further analysis using the Kaplan-Meier method demonstrated that individuals in the high GNRI group had significantly longer progression-free survival (PFS) and overall survival (OS) compared to those in the low GNRI group (P=0.02, P=0.01). The further stratified study showed that GNRI had greater predictive value in tumor node metastasis (TNM) stage II-III and elderly (age ≥65 years) NSCLC patients undergoing ICI therapy. The multivariate Cox regression analysis indicated that GNRI [hazard ratio (HR): 0.536, P=0.03], obesity (HR: 16.283, P<0.001), and surgical history (HR: 0.305, P<0.001) were associated with poorer survival rates. Conclusions: Among patients undergoing ICI therapy for NSCLC, GNRI is an effective independent prognostic indicator, and a high GNRI at diagnosis is substantially related with longer PFS and OS. The incorporation of GNRI in pre-treatment evaluations within clinical settings is beneficial.

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BACKGROUND: Post-hepatectomy liver failure (PHLF) is the most common postoperative complication and the leading cause of death after hepatectomy. The albumin-bilirubin (ALBI) score and nutritional risk index (NRI) have been shown to assess end-stage liver disease and predict PHLF and patient survival. We hypothesized that the ALBI score and NRI interact in the prediction of PHLF. AIM: To analyze the interaction between the ALBI score and NRI in PHLF in patients with hepatocellular carcinoma. METHODS: This retrospective study included 186 patients who underwent hepatectomy for hepatocellular carcinoma at the Affiliated Hospital of Youjiang Medical University for Nationalities between January 2020 and July 2023. Data on patient characteristics and laboratory indices were collected from their medical records. Univariate and multivariate logistic regression were performed to determine the interaction effect between the ALBI score and NRI in PHLF. RESULTS: Of the 186 patients included in the study, PHLF occurred in 44 (23.66%). After adjusting for confounders, multivariate logistic regression identified ALBI grade 2/3 [odds ratio (OR) = 73.713, 95% confidence interval (CI): 9.175-592.199] and NRI > 97.5 (OR = 58.990, 95%CI: 7.337-474.297) as risk factors for PHLF. No multiplicative interaction was observed between the ALBI score and NRI (OR = 0.357, 95%CI: 0.022-5.889). However, the risk of PHLF in patients with ALBI grade 2/3 and NRI < 97.5 was 101 times greater than that in patients with ALBI grade 1 and NRI ≥ 97.5 (95%CI: 56.445-523.839), indicating a significant additive interaction between the ALBI score and NRI in PHLF. CONCLUSION: Both the ALBI score and NRI were risk factors for PHLF, and there was an additive interaction between the ALBI score and NRI in PHLF.

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Background: The Geriatric Nutritional Risk Index (GNRI) is a straightforward and objective tool for nutritional screening in older patients and has been demonstrated to possess prognostic predictive value in several diseases. Nonetheless, there is a lack of research on the nutritional risk associated with brain abscess in the older. This study aimed to evaluate the prevalence of nutritional risk among these patients by GNRI and to investigate its potential prognostic value for clinical outcomes. Materials and methods: From August 2019 to April 2023, 100 older patients diagnosed with brain abscess were enrolled in this single-center prospective cohort study, which evaluated the prognostic value of the Geriatric Nutritional Risk Index (GNRI) in elderly brain abscess patients. Data collected included demographic, and clinical characteristics at admission and calculated the GNRI, and the Glasgow Outcome Scale (GOS) score 6 months post-discharge. A GOS score of 5 was considered indicative of a good recovery, whereas scores ranging from 1 to 4 were classified as poor recovery. Results: The results revealed that 48% of older brain abscess patients were at risk of malnutrition according to the GNRI. These patients had significantly higher post-admission C-reactive protein (CRP) levels (p = 0.017), more comorbidities (p < 0.001), and higher age-adjusted Charlson Comorbidity Index (aCCI) scores (p < 0.001) compared to those without nutritional risk. Spearman correlation analysis showed that GNRI scores were negatively correlated with CRP levels, comorbidities, and aCCI scores, and positively correlated with Glasgow Outcome Scale (GOS) scores (Spearman's ρ = 0.624, p < 0.001). Multivariate logistic regression revealed that lower GNRI values were linked to reduced GOS levels (OR = 0.826, 95% CI: 0.775-0.880). ROC analysis determined a GNRI threshold of 97.50 for predicting poor recovery, with 90.57% sensitivity and 87.23% specificity. Conclusion: The older brain abscess patients exhibited a high malnutrition risk. GNRI showed an important predictive value for recovery in older patients, which could be helpful in clinical intervention and rehabilitation.

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INTRODUCTION: The geriatric nutritional risk index (GNRI) can easily identify malnutrition-associated morbidity and mortality. We investigated the association between preoperative GNRI and 30-d mortality in geriatric burn patients who underwent surgery. METHODS: The study involved geriatric burn patients (aged ≥ 65 y) who underwent burn surgery between 2012 and 2022. The GNRI was computed using the following formula: 1.489 × serum albumin concentration (mg/L) + 41.7 × patient body weight/ideal body weight. Patients were dichotomized into the high GNRI (≥ 82) and low GNRI (< 82) groups. GNRI was evaluated as an independent predictor of 30-d postoperative mortality. The study also evaluated the association between GNRI and sepsis, the need for continuous renal replacement therapy (CRRT), major adverse cardiac events (MACE), and pneumonia. RESULTS: Out of 270 patients, 128 (47.4%) had low GNRI (< 82). Multivariate Cox regression analysis revealed that low GNRI was significantly associated with 30-d postoperative mortality (hazard ratio: 1.874, 95% confidence interval [CI]: 1.146-3.066, P = 0.001). Kaplan-Meier analysis revealed that the 30-day mortality rate differed significantly between the low and high GNRI groups (log-rank test, P < 0.001). The 30-d postoperative mortality (hazard ratio: 2.677, 95% CI: 1.536-4.667, P < 0.001) and the incidence of sepsis (odds ratio [OR]: 2.137, 95% CI: 1.307-3.494, P = 0.004), need for CRRT (OR: 1.919, 95% CI: 1.101-3.344, P = 0.025), MACE (OR: 1.680, 95% CI: 1.018-2.773, P = 0.043), and pneumonia (OR: 1.678, 95% CI: 1.019-2.764, P = 0.044), were significantly higher in the low GNRI group than in the high GNRI group. CONCLUSIONS: Preoperative low GNRI was associated with increased 30-d postoperative mortality, sepsis, need for CRRT, MACE, and pneumonia in geriatric burn patients.

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BACKGROUND AND OBJECTIVES: Malnutrition is associated with a higher risk of osteoporosis. We aim to assess the relationship between serum albumin with geriatric nutritional risk index and osteopenia in Chinese elderly men. METHODS AND STUDY DESIGN: This is a nested case-control study from a prospective cohort enrolled 1109 individuals who were followed for seven years. Demographic data, medical history, signs and symptoms, and laboratory parameters were collected and analysed. Nutritional status and Geriatric Nutritional Risk Index (GNRI) were assessed. The nutrition-related indexes predictive value for osteopenia development was analyzed through multivariate Cox regression analysis and by creating a receiver operating characteristic curve (ROC), calculating the area under the curve (AUC). Kaplan-Meier (K-M) method was further used to find the nutritional status level in the elderly men. RESULTS: The ALB and GNRI correlated with the risk of osteopenia in Chinese elderly men. After adjusting for all covariates, people with higher ALB level (HR: 0.821; 95% CI: 0.790-0.852) and higher GNRI score (HR: 0.889; 95% CI: 0.869-0.908) had a smaller risk of osteopenia. ROC analysis showed that the AUC for ALB was 0.729 (p<0.05) and for the GNRI score was 0.731 (p<0.05). K-M curve indicated a significant difference in ALB level (p<0.001) and GNRI score (p<0.001) in the respective subgroups. CONCLUSIONS: This study found that lower ALB level and lower GNRI score are associated with a higher prevalence of osteopenia among elderly men in China.

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Objective: To investigate the associations between the geriatric nutritional risk index (GNRI) with cognitive functions among U.S. older adults. (Patients were classified into two nutrition risk groups based on the GNRI). Methods: Our analysis utilized data from the cross-sectional National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2014. Cognitive function was measured using CERAD test, AFT and DSST. Composite z-scores were obtained by summing test-specific z-scores of the above three cognitive tests and were used to assess the global cognitive function. We employed weighted logistic regression models to evaluate the associations between GNRI and nutritional status (low and high GNRI) with cognitive function among older participants. The non-linear relationship was described using fitted smoothed curves and threshold effect analyses. Subgroup analysis and interaction tests were also conducted. Results: This study included 2,592 older participants aged 60 years and older. After adjusting for confounding variables, the GNRI was positively associated with AFT (ß = 0.05, 95% CI 0.005-0.096, p-value = 0.0285), DSST (ß = 0.192, 95% CI 0.078-0.305, p-value = 0.0010) and the composite z-scores (ß = 0.027, 95% CI 0.010-0.044, p-value = 0.0024). The results also showed that the high-GNRI group was significantly associated with AFT (ß = 0.922, 95% CI 0.166-1.677, p-value = 0.0169), DSST (ß = 2.791, 95% CI 0.884-4.698, p-value = 0.0042) and composite z-scores (ß = 0.405, 95% CI 0.115-0.695, p-value = 0.0062) likewise had significant positive correlations, using the low-GNRI group as a reference. In addition, inflection points with CERAD and composite z-scores were found at GNRI of 108.016, and 105.371, respectively. Specifically, on the left side of the inflection point GNRI levels were positively correlated with CERAD and composite z-scores (CERAD ß = 0.087, 95% CI 0.024-0.150, p-value = 0.0070; composite z-scores ß = 0.065, 95% CI 0.040-0.091, p-value <0.0001), while on the right side of the inflection point were significantly negatively associated (CERAD ß = -0.295, 95% CI -0.529 to -0.062, p-value = 0.0133, composite z-scores ß = -0.050, 95% CI -0.091 to -0.008, p-value = 0.0184). Conclusion: Lower GNRI was associated with poorer performance in several cognitive domains. Additionally, there was a non-linear positive association between GNRI and cognitive function in normal nutritional states, for excessive GNRI may cause cognitive decline.

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In recent years, the growing importance of fish species obtained through aquaculture, coupled with a decline in wild-caught fish, has raised concerns about the potential accumulation of pollutants in these fish. This work aimed to analyze the amounts of elements in trout cultured mainly between Sinop and Samsun shores at the south of the Black Sea and marketed in Sinop fish markets. The comparison of these values with national and internationally accepted regulations was conducted, and evaluation of health risks for consumers was performed. Oncorhynchus mykiss samples were bought in April, May, and June of 2022 and 2023. The heavy metal concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS). Fish tissues were wet digested in Teflon vessels. The outcomes were contrasted with established regulatory limits for heavy metals in fish. Fortunately, the metal concentrations detected in the fillets were found to be below the permissible levels set by regulations, indicating that the fish were not significantly contaminated. Furthermore, the estimated daily intake (EDI) and target hazard quotient (THQ) values, which are utilized to evaluate the possible health risks connected with heavy metal exposure, were calculated. It was reassuring to find that both EDI and THQ values were below the acceptable thresholds, suggesting that the consumption of O. mykiss is not likely to pose a threat to human health. To preserve seafood safety and safeguard public health, however, constant monitoring of fish metal levels is necessary.

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Microplastic (MP) environmental contamination has been widely studied in Mexico. However, the evaluation of the associated risk to MPs in environmental compartments is scarce. Therefore, this study addresses this issue using diverse indicators such as the Pollution Load Index (PLI), the Polymer Risk Index (PRI), and the Potential Ecological Risk Index (PERI). The results of a meta-analysis revealed high MP contamination levels in most of the studied compartments, which included marine and estuarine waters, beach sand, freshwater, sediments, and biota. Regarding the risk assessment indicators, PLIs indicated low (56%), dangerous (22%), moderate (12%), and high (10%) levels across compartments. Meanwhile, PRIs displayed concerning values, with 36%, 35%, 20%, and 9% exhibiting dangerous, high, moderate, and low levels, respectively. Thus, high PRI values emphasized the significant rise in MP pollution, largely attributed to high-hazard polymer compositions. Otherwise, PERIs showed low (56%), very dangerous (29%), moderate (6%), high (5%), and dangerous (4%) levels. Thus, the ecological risk in Mexico is widespread and mainly linked to MP abundance, polymer type, environmental matrix, and characteristics of organisms. This study represents the first attempt at MP ecological risk assessment in Mexico, providing crucial insights for developing mitigation strategies to address concerns about MP contamination.

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PURPOSE: Systemic inflammation and nutrition are vital for tumor progression. This study aimed to identify prognostic inflammation nutrition markers and develop a predictive nomogram for gallbladder cancer (GBC). METHODS: A total of 123 patients with GBC who underwent surgical resection at the First Affiliated Hospital of Soochow University and Suzhou Kowloon Hospital were included in our study. The final prognostic variables were identified using univariate and multivariate analyses. A nomogram model was then established, and the consistency index (C-index), calibration curves, and Kaplan-Meier analysis were performed to evaluate the accuracy and discrimination of the nomogram. The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) suggested that our nomogram had better predictive ability and clinical feasibility than a published model. RESULTS: The cox regression analysis showed that carcinoembryonic antigen (CEA) > 4.580, albumin-bilirubin (ALBI) > -2.091, geriatric nutritional risk index (GNRI) < 90.83, T3-T4, and N2 are independent prognostic factors. A predictive nomogram was constructed with a C-index of 0.793. In the calibration curves, the nomogram-predicted 1-, 3-, and 5-year survival matched well with the actual survival. Kaplan-Meier analysis showed that the high-risk group had worse survival than the low-risk group (P < 0.001). Finally, our nomogram achieved better 1-, 3- and 5-year AUCs than an established model (0.871, 0.844, and 0.781 vs. 0.753, 0.750, and 0.693). DCA also confirmed that our model outperformed the established model. CONCLUSIONS: In conclusion, our study revealed that CEA > 4.580, GNRI < 90.83, ALBI > -2.091, T3-T4 stage, and N2 were related to clinical outcomes of patients with GBC after surgical resection. The constructed nomogram has superior predictive ability and clinical practicality.

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INTRODUCTION: Malnutrition is common in older atrial fibrillation (AF) patients and results in poor clinical outcomes. The Geriatric Nutritional Risk Index (GNRI) is a straightforward method for evaluating nutritional health. However, its prognostic value in AF patients is unclear. This research focused on examining the correlation between GNRI and overall mortality in Chinese individuals with AF. METHODS: We performed a multicenter retrospective study at four Chinese hospitals involving patients diagnosed with AF between January 2019 and August 2023. Using GNRI, nutritional status was evaluated, classifying patients into three categories. Multivariable logistic regression and restricted cubic spline analysis assess the relationship between GNRI and mortality, with exploratory subgroup analyses investigating potential effect modifiers. RESULTS: The study included 4,878 AF patients with a median follow-up of 19 months. The mean age was 71 (63-78), and the mean GNRI was 102 (95-108). Malnutrition was identified in 1,776 patients (36.41%). During the study, 419 (8.59%) deaths occurred. After controlling for confounders, moderate to severe malnutrition was linked to an increased risk of all-cause mortality compared to no malnutrition (odds ratio 1.50; 95% CI, 1.17-1.94). The relationship between GNRI and mortality risk was approximately linear, with consistent associations across subgroups. CONCLUSION: Malnutrition, as assessed by GNRI, is prevalent among Chinese AF patients and is independently linked to higher all-cause mortality risk.