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Özcan B, Güner M, Ceylan S, Öztürk Y, Girgin S, Okyar Baş A, Koca M, Balcı C, Doğu BB, Cankurtaran M, Yıldırım T, Halil MG. Calf circumference predicts sarcopenia in maintenance hemodialysis. Nutr Clin Pract 2024; 39:193-201. [PMID: 37933421 DOI: 10.1002/ncp.11089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/28/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Early recognition of sarcopenia in hemodialysis (HD) patients will be of great importance in preventing adverse outcomes and improving the quality of life in these patients. The main goal of this study was to evaluate the diagnostic accuracy of calf circumference (CC) measurement in detecting sarcopenia among CKD patients undergoing maintenance HD. METHODS This cross-sectional study included 52 patients (53 ± 17 years) who were currently in a maintenance HD. Muscle strength was evaluated using handgrip strength, and smooth muscle mass index (SMI) was assessed through bioelectrical impedance analysis, and CC was measured at the widest part of the calf with the foot pressed against a hard surface. RESULTS Out of the total patient population, sarcopenia was identified in 32.7% (n = 17). The two groups were comparable in terms of age, weight, and height, but the median body mass index of sarcopenic group was statistically lower than nonsarcopenic group (21.6 kg/m2 [18.9-24.6] vs 24.7 kg/m2 [21.4-27.3]. The sarcopenic group had a substantially smaller CC than the nonsarcopenic group (30.0 cm [26.5-32.0] vs 31.5 cm [30.3-34.8], P = 0.013; respectively). In the regression analysis, CC was found to be independently associated with post-HD SMI (P < 0.001; odds ratio, 1.938; and 95% CI, 1.020-2.856). CC was positively but weakly correlated with handgrip strength, however strong and significant correlation was found between CC and SMI (r = 0.277, P = 0.047 and r = 0.733, P < 0.001; respectively). A CC of 31 cm or less predicted confirmed sarcopenia in HD patients (area under the curve = 0.709, P = 0.006, specificity = 0.556, sensitivity = 0.765). CONCLUSIONS Low muscle mass and potentially low muscle strength in HD patients can be accurately identified through the use of CC measurements. Specifically, a CC measurement below 31 cm has found to be a useful indicator to identify individuals on maintenance HD.
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Affiliation(s)
- Berşan Özcan
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Merve Güner
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Serdar Ceylan
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Öztürk
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sinem Girgin
- Department of Internal Medicine, Division of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Arzu Okyar Baş
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koca
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cafer Balcı
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Balam Doğu
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tolga Yıldırım
- Department of Internal Medicine, Division of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Gülhan Halil
- Department of Internal Medicine, Division of Geriatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Sato R, Sawaya Y, Ishizaka M, Shiba T, Hirose T, Yin L, Urano T. Association between decreased neck circumference and impaired activities of daily living among older adults in long-term care. Geriatr Gerontol Int 2023; 23:906-911. [PMID: 37861100 DOI: 10.1111/ggi.14704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023]
Abstract
AIM Assessment interventions for the decline of activities of daily living (ADLs) in older adults are crucial, as ADL decline increases hospitalization duration and mortality risk. Decreased neck circumference may result in various physical dysfunctions, including malnutrition. However, the association between neck circumference and ADLs has not been fully clarified. This study aimed to determine the association between decreased neck circumference and ADLs in older adults requiring long-term care. METHODS The study included 152 older adults deemed to require support or care under Japan's long-term care insurance system. Neck circumference was measured just below the thyroid cartilage with a measuring tape. The Barthel index was used to evaluate ADLs, and skeletal muscle mass and nutritional status were assessed by bioelectrical impedance analysis instruments. A multivariate analysis was conducted to investigate the association between neck circumference and ADLs. RESULTS Neck circumference demonstrated a significant inverse correlation with age and a significant positive correlation with body mass index, skeletal muscle mass index, phase angle, and Barthel index. In the multivariate analysis, ADLs was significantly associated with neck circumference (odds ratio [OR] = 0.51, P = 0.002) and phase angle (OR = 0.04, P < 0.001). CONCLUSIONS Neck circumference is associated with age, skeletal muscle mass, and nutritional status. Furthermore, a decrease in neck circumference is suggested as an independent risk factor for ADL decline in older adults requiring long-term care. Geriatr Gerontol Int 2023; 23: 906-911.
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Affiliation(s)
- Ryo Sato
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Yohei Sawaya
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Takahiro Shiba
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tamaki Hirose
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Tochigi, Japan
| | - Lu Yin
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
| | - Tomohiko Urano
- Department of Day Rehabilitation, Nishinasuno General Home Care Center, Care Facility for the Elderly "Maronie-en", Tochigi, Japan
- Department of Geriatric Medicine, School of Medicine, International University of Health and Welfare, Chiba, Japan
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3
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Sánchez-Rodríguez D, De Meester D, Minon L, Claessens M, Gümüs N, Lieten S, Benoit F, Surquin M, Marco E. Association between Malnutrition Assessed by the Global Leadership Initiative on Malnutrition Criteria and Mortality in Older People: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5320. [PMID: 37047936 PMCID: PMC10094645 DOI: 10.3390/ijerph20075320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/06/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) criteria were introduced in 2018 for the diagnosis of malnutrition in adults. This review was aimed at gathering the evidence about the association between malnutrition according to the GLIM criteria and mortality in older people, an emerging and clinically meaningful topic in the implementation of the GLIM criteria in geriatric healthcare settings. This scoping review considered meta-analyses, systematic reviews, cohort studies, and cross-sectional studies published in PubMed, Scopus, and the Cochrane Database for Systematic Reviews from the development of the GLIM criteria in 2018 to January 2023. Seventeen articles (15 cohort and 2 cross-sectional studies) were included. The association between GLIM criteria and mortality had been assessed in hospitalized (11 over the 17 articles) and community-dwelling older populations, and those in nursing homes. The review found a strong association between malnutrition according to GLIM criteria and mortality in hospitalized (1.2-fold to 7-fold higher mortality) and community-dwelling older people (1.6-fold to 4-fold higher mortality). These findings highlight the prognostic value of the GLIM criteria and support strategies towards the implementation of malnutrition evaluation according to the GLIM, in order to optimize comprehensive geriatric assessment and provide older people with the highest quality of nutritional care. Studies in nursing home populations were very scarce and may be urgently required.
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Affiliation(s)
- Dolores Sánchez-Rodríguez
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Dr. Aiguader, 88, 08003 Barcelona, Spain
- Geriatric Department, Centre Fòrum-Hospital del Mar, Parc de Salut Mar, Llull, 410, 08029 Barcelona, Spain
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium
| | - Dorien De Meester
- Department of Geriatrics, Onze Lieve Vrouw Ziekehuis (OLV) Aalst, Moorselbaan 164, 9300 Aalst, Belgium
| | - Léa Minon
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
| | - Marie Claessens
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
| | - Neslian Gümüs
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
| | - Siddhartha Lieten
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, Jette, 1090 Brussels, Belgium
| | - Florence Benoit
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
| | - Murielle Surquin
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, Place A. Van Gehuchten 4, 1020 Brussels, Belgium
| | - Ester Marco
- Rehabilitation Research Group, Hospital del Mar Medical Research Institute (IMIM), Dr. Aiguader, 88, 08003 Barcelona, Spain
- Physical Medicine and Rehabilitation Department, Hospital del Mar-Hospital de L’Esperança, Parc de Salut Mar, Pg. Marítim de la Barceloneta, 25-29, 08003 Barcelona, Spain
- School of Medicine, Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain
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4
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Dent E, Wright ORL, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet 2023; 401:951-966. [PMID: 36716756 DOI: 10.1016/s0140-6736(22)02612-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/15/2022] [Accepted: 12/01/2022] [Indexed: 01/29/2023]
Abstract
Malnutrition is a highly prevalent condition in older adults, and poses a substantial burden on health, social, and aged-care systems. Older adults are vulnerable to malnutrition due to age-related physiological decline, reduced access to nutritious food, and comorbidity. Clinical guidelines recommend routine screening for malnutrition in all older adults, together with nutritional assessment and individually tailored nutritional support for older adults with a positive screening test. Nutritional support includes offering individualised nutritional advice and counselling; oral nutritional supplements; fortified foods; and enteral or parenteral nutrition as required. However, in clinical practice, the incorporation of nutritional guidelines is inadequate and low-value care is commonplace. This Review discusses the current evidence on identification and treatment of malnutrition in older adults, identifies gaps between evidence and practice in clinical care, and offers practical strategies to translate evidence-based knowledge into improved nutritional care. We also provide an overview of the prevalence, causes, and risk factors of malnutrition in older adults across health-care settings.
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Affiliation(s)
- Elsa Dent
- Research Centre for Public Health, Equity & Human Flourishing, Torrens University Australia, Adelaide, SA, Australia.
| | - Olivia R L Wright
- School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Jean Woo
- Department of Medicine and Therapeutics and Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong Special Administrative Region, China
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science and Department of General Practice, Location VU University Medical Center, Amsterdam UMC, Amsterdam, Netherlands; Amsterdam Public Health research institute and Ageing & Later Life Research Program, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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5
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Sato R, Sawaya Y, Shiba T, Hirose T, Ishizaka M, Urano T. Indicators predicting the development and improvement of sarcopenia in older adults requiring long-term care. J Phys Ther Sci 2023; 35:242-246. [PMID: 36866017 PMCID: PMC9974322 DOI: 10.1589/jpts.35.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/14/2022] [Indexed: 03/04/2023] Open
Abstract
[Purpose] This study aimed to identify factors associated with sarcopenia development and improvement among older adults requiring long-term care. [Participants and Methods] This prospective observational study included 118 older adults requiring long-term care in a single facility. Sarcopenia was assessed according to the 2019 diagnostic criteria of the Asian Working Group for Sarcopenia at baseline and after 6 months. Nutritional status was measured using calf circumference and the Mini Nutritional Assessment-Short Form to examine the association between sarcopenia onset and improvement. [Results] Risk of malnutrition and lower calf circumference at baseline were significantly associated with sarcopenia development. The study also showed that a non-risk of malnutrition, higher calf circumference, and higher skeletal muscle mass index were significantly associated with improved sarcopenia. [Conclusion] The Mini Nutritional Assessment-Short Form and calf circumference were able to predict sarcopenia development and improvement in older adults requiring long-term care.
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Affiliation(s)
- Ryo Sato
- Division of Physical Therapy, Doctoral Program in Health
Sciences, Graduate School of Health and Welfare Sciences, International University of
Health and Welfare, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day
Rehabilitation, Care Facility for the Elderly “Maronie-en”, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences,
International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Department of Geriatric Medicine, School of Medicine,
International University of Health and Welfare: 4-3 Kozunomori, Narita-shi, Chiba
286-8686, Japan,Corresponding author. Tomohiko Urano (E-mail: )
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6
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Song M, Zhang Q, Liu T, Tang M, Zhang X, Ruan G, Zhang X, Zhang K, Ge Y, Yang M, Li W, Cong M, Wang K, Song C, Shi H. Efficacy of Global Leadership Initiative on Malnutrition as potential cachexia screening tool for patients with solid cancer. Nutr J 2022; 21:73. [PMID: 36476477 PMCID: PMC9727850 DOI: 10.1186/s12937-022-00829-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Cachexia has a very high prevalence in patients with cancer, and lacks effective screening tools yet. Global Leadership Initiative on Malnutrition (GLIM) is a novel malnutrition assessment tool, with increased important roles in malnutrition diagnosis for patients with cancer. However, whether GLIM can be used as an effective screening tool remains unknown. METHODS We performed a multicenter cohort study including 8,478 solid tumor patients from 40 clinical centers throughout China. Cachexia was diagnosed based on the 2011 international cancer cachexia consensus. The receiver operating characteristic curves (ROC) and decision curve analysis (DCA) were developed to determine the efficacy and clinical net benefit of GLIM and Patient-Generated Subjective Global Assessment (PG-SGA) in the detection of cancer cachexia, respectively. RESULTS According to the consensus guidelines, 1,441 (17.0%) cancer patients were diagnosed with cachexia among 8,478 patients in the present study. The sensitivity of one-step GLIM and two-step GLIM for detecting cachexia were 100 and 88.8%, respectively, while that of PG-SGA was 86.2%. The accuracies of one-step GLIM and two-step GLIM reached 67.4 and 91.3%, which were higher than that of PG-SGA (63.1%). The area under the curves (AUCs) of one-step GLIM (0.835) and two-step GLIM (0.910) were higher than PG-SGA (0.778) in patients with cancer. The DCA also revealed that two-step GLIM had better clinical effect than PG-SGA between 20-50% threshold probabilities. CONCLUSION GLIM could be used as an effective tool in screening cancer cachexia, two-step GLIM criteria show more accurate while one-step GLIM criteria is more sensitive. TRIAL REGISTRATION ChiCTR1800020329.
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Affiliation(s)
- Mengmeng Song
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Qi Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Tong Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Meng Tang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Xi Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Guotian Ruan
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Xiaowei Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Kangping Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Yizhong Ge
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China ,grid.417384.d0000 0004 1764 2632The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Ming Yang
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
| | - Wei Li
- grid.430605.40000 0004 1758 4110Cancer Center of the First Hospital of Jilin University, Changchun, Jilin, 130021 China
| | - Minghua Cong
- grid.506261.60000 0001 0706 7839Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kunhua Wang
- grid.440773.30000 0000 9342 2456Yunnan University, Kunming, 650091 China
| | - Chunhua Song
- grid.207374.50000 0001 2189 3846Department of Epidemiology and Statistics, Henan Key Laboratory of Tumor Epidemiology College of Public Health, Zhengzhou University, Zhengzhou, 450001 Henan China
| | - Hanping Shi
- grid.24696.3f0000 0004 0369 153XDepartment of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, No.10 Tieyi Road Haidian Dist, Beijing, 100038 China ,Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China ,Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
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7
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Dawed A, Mekonnen TC, Genetu M, Tadesse SE, Dewau R, Muche A, Zerga AA, Ayele FY, Gill TK. Comparing the validity of anthropometric measurements in identifying malnutrition status of older age people in Borena district, North Central Ethiopia: a cross_sectional study. BMC Geriatr 2022; 22:776. [PMID: 36192694 PMCID: PMC9528122 DOI: 10.1186/s12877-022-03467-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malnutrition among older age people is becoming significantly higher in spite of improvements in the health care system. Life expectancy of Ethiopian elders is increasing; but reliable and valid tools for screening and diagnosis of malnutrition in this subgroup are limited. This study aimed to assess the validity of anthropometric measurements: Mid Upper Arm Circumference (MUAC), Body Mass Index (BMI), and Calf Circumference (CC) in detecting malnutrition status of older age people in Ethiopia. Methods A community based cross-sectional study was conducted in Borena District from January to March, 2020. A total of 421 participants aged were systematically included in the study. To test reliability and validity of the measurements,Cronbach’s α coefficient and Pearson’s correlations were used, respectively. The full Mini-Nutritional Assessment (MNA) tool was used to diagnosis malnutrition. Overall accuracy, sensitivity and specificity of BMI, MUAC and CC were estimated using Receiver Operating Characteristic curves. The Youden Index was used to determine the best cut-off point. Results The reliability of BMI, MUAC and CC by Cronbach’s alpha was found 0.847. Significant positive correlations between MNA, BMI(r = 0.56, p < 0.01); MNA, MUAC(r = 0.43, p < 0.01; and MNA, CC(r = 0.52, p < 0.01) revealed. The area under the curve (AUC) of BMI, MUAC and CC were found: 0.98(95% CI, 0.96–0.99, p < 0.001), 0.94(95% CI, 0.89–0.98, p < 0.001) and 0.96(95% CI, 0.94–0.98, p < 0.001) indicating the overall accuracy respectively. The sensitivity and specificity of BMI, MUAC and CC using established cut off points were found: 90%, 96%; 78%, 94% and 84%, 95% respectively. However, using the Youden index the best cut-off point, the sensitivity and specificity of MUAC and CC were 88%, 86%; 92% and 89% respectively and adjusted for age and sex. Conclusions The current study demonstrated that BMI was a reliable and valid method to identify the malnutrition status of older age people. A MUAC value of 19 cm and CC of 30 cm were simple and efficient cut-off points for the determination of malnutrition in the older age people. A future study is needed to validate the validity of BMI, MUAC and CC against biochemical tests as gold standard. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03467-9.
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Affiliation(s)
- Abdu Dawed
- Dessie Comprehensive Specialized Hospital, Dessie, North Eastern, Ethiopia
| | - Tefera Chane Mekonnen
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| | - Muluken Genetu
- Department of Health Service Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Sisay Eshete Tadesse
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Reta Dewau
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Amare Muche
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Aregash Abebayehu Zerga
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Human Nutrition and Dietetics Department, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tiffany K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, the University of Adelaide, Adelaide, South Australia, Australia
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8
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Karim KMR, Tasnim T, Shams SD, Zaher MA, Mamun S. Mini Nutritional Assessment and physical function of older people in residential aged care facility, Bangladesh. Nutr Health 2021; 28:443-452. [PMID: 34250851 DOI: 10.1177/02601060211030119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Malnutrition may decrease physical function and exacerbate health conditions and thus have a negative effect on health-related quality of life of older people. AIM The study was aimed at evaluating the extent of malnutrition, physical function and other associated risk factors for the older persons (>65 years) living in the residential aged care facilities in Bangladesh. METHODS A cross-sectional study was performed with a sample of 200 older people in various residential aged care facilities in Dhaka, Bangladesh. Nutritional status was evaluated using the Mini Nutritional Assessment. A structured questionnaire was used to assess the socioeconomic condition, dietary diversity, functional ability and other related risk factors for malnutrition. RESULTS According to the Mini Nutritional Assessment, 33.5% of participants living in residential aged care facilities were malnourished and 52.5% were at risk of malnutrition. Dietary diversity score differs significantly (p<0.001) among malnourished (3.78 ± 0.45), at risk of malnutrition (4.46 ± 0.98) and well-nourished (4.75 ± 1.11) groups. Twenty-five percent of the study participants reported limitations in mobility and 26.5% reported limitations in activities of daily living. Females were more vulnerable in terms of malnutrition and physical function than males. Mini Nutritional Assessment score is significantly correlated (p<0.05) with several risk factors for malnutrition such as body mass index, education level, meal, protein consumption, dietary diversity score, weight loss, reduced food intake, mobility and activities of daily living of the older people. CONCLUSIONS The study reaffirms that a high rate of malnutrition and risk of malnutrition is prevalent among aged care residents, who need special attention and may benefit from individualized nutrition interventions.
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Affiliation(s)
| | - Tasmia Tasnim
- Department of Nutrition and Food Engineering, 130058Daffodil International University, Bangladesh
| | - Sabrin Deeba Shams
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
| | | | - Sumaiya Mamun
- Institute of Nutrition and Food Science, 95324University of Dhaka, Bangladesh
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Malafarina V, Serra Rexach JA, Masanés F, Cervera-Díaz MC, Lample Lacasa L, Ollero Ortigas A, Cruz-Jentoft AJ. Results of High-Protein, High-Calorie Oral Nutritional Supplementation in Malnourished Older People in Nursing Homes: An Observational, Multicenter, Prospective, Pragmatic Study (PROT-e-GER). J Am Med Dir Assoc 2021; 22:1919-1926.e5. [PMID: 33819452 DOI: 10.1016/j.jamda.2021.02.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To assess if the impact of oral nutritional supplements (ONS) on nutritional and functional status in malnourished older persons living in nursing homes shown by clinical trials are also found outside a trial setting. DESIGN Observational, multicenter, prospective, pragmatic study. SETTING AND PARTICIPANTS This study was carried out in 38 nursing homes throughout Spain. Nursing home physicians recruited consecutive residents, older than 65 years, with a diagnosis of malnutrition, when a clinical decision to start ONS had been taken after unsuccessful initial management with dietary interventions. INTERVENTION The participants received daily 2 bottles of an energy-rich, high-protein commercial ONS for 3 months. MEASURES Primary outcomes were changes in nutritional status [body weight, body mass index (BMI), and Mini Nutritional Assessment-Short Form (MNA-SF)]; secondary outcomes were functional changes [Functional Ambulation Classification, Barthel index, handgrip strength, and Short Physical Performance Battery (SPPB)], as well as safety and adherence after 12 weeks of follow-up. RESULTS A total of 282 residents (median age 86 years, 67% women) were included, and 244 (86.5%) completed the follow-up. At baseline, 77.3% of the participants were malnourished (BMI 19.7 kg/m2, interquartile range 18.3-21.8). After 12 weeks of follow-up, participants experienced significant increases in body weight (2.6 ± 3.1 kg, 5.2 ± 5.9%), BMI (1.0 ± 1.2 kg/m2) and MNA-SF (4.0 ± 2.5 points). There were also significant improvements in functional status measured by the Barthel index, handgrip strength, SPPB, and gait speed. Good adherence was registered in 94.6% of the participants. No relevant side effects were found. CONCLUSIONS AND IMPLICATIONS Improvements in nutritional and functional status can be found when using a high-protein, high-calorie ONS in older undernourished people living in nursing homes.
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Affiliation(s)
- Vincenzo Malafarina
- Department of Nutrition, Food Science, and Physiology, School of Pharmacy and Nutrition, Universidad de Navarra, Pamplona, Spain; Department of Geriatrics, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - José A Serra Rexach
- Departamento de Geriatría, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense, CIBERFES, Madrid, Spain
| | - Ferrán Masanés
- Departamento de Medicina Interna, Hospital Clinic, Barcelona, Spain
| | - Ma Carmen Cervera-Díaz
- Unidad de Geriatría, Hospital Clínico Universitario, Valladolid, Spain; Asociación Casa de Beneficencia, Valladolid, Spain
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10
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Guigoz Y, Vellas B. Nutritional Assessment in Older Adults : MNA® 25 years of a Screening Tool and a Reference Standard for Care and Research; What Next? J Nutr Health Aging 2021; 25:528-583. [PMID: 33786572 DOI: 10.1007/s12603-021-1601-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A tool to assess nutritional status in older persons was really needed. It took 5 years to design the MNA® (Mini Nutrition Assessment) tool, complete the first validations studies both in Europe and in the U.S. and to publish it. After the full MNA®, the MNA® short form and the self-MNA® have been validated. As well as Chinese and other national MNA® forms. Now more than 2000 clinical research have used the MNA® all over the world from community care to hospital. At least 22 Expert groups included the MNA® in new clinical practice guidelines, national or international registries. The MNA® is presently included in almost all geriatric and nutrition textbook and part of the teaching program for medicine and other health care professional worldwide. The urgent need is to target the frail older adults more likely to have weight loss and poor appetite and to prevent frailty and weight loss in the robust. We present in this paper the review of 25 years of clinical research and practice using the MNA® worldwide.
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Affiliation(s)
- Y Guigoz
- Yves Guigoz, Chemin du Raidillon, CH-1066 Epalinges, Switzerland.
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11
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Sanchez-Rodriguez D, Locquet M, Bruyère O, Lengelé L, Cavalier E, Reginster JY, Beaudart C. Prediction of 5-year mortality risk by malnutrition according to the GLIM format using seven pragmatic approaches to define the criterion of loss of muscle mass. Clin Nutr 2020; 40:2188-2199. [PMID: 33069510 DOI: 10.1016/j.clnu.2020.09.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To assess the association between baseline malnutrition according to the GLIM format, using seven pragmatic approaches to define the criterion of loss of muscle mass, with mortality in the SarcoPhAge (Sarcopenia and Physical Impairment with advancing Age) study during a 5-year follow-up. Secondarily, to calculate diagnostic performance indicators, concordance, and feasibility of these 7 pragmatic approaches compared to the original GLIM criteria. METHODS Post-hoc analysis of the SarcoPhAge cohort, which included 534 community-dwelling volunteers ≥65-year-old, followed-up from 2013 to 2019. Baseline malnutrition was defined by GLIM criteria and 7 approaches: 1) Omission of a reduced muscle mass as a criterion; 2) Substitution for handgrip strength, 3) Calf-circumference, 4) Mid-arm circumference, 5) Goodman's grid, 6) Ishii's score chart, and 7) Yu's formula. The association between malnutrition (according to GLIM criteria and the 7 approaches) and mortality was assessed by Cox-regressions. Sensitivity, Specificity, Positive (PPV), Negative (NPV) predictive values, area under the curve (AUC), Cohen-kappa coefficient, and TELOS-feasibility score were calculated. RESULTS Data to calculate GLIM criteria were available for 373 subjects (73.07 ± 5.96 years, 56% women). Prevalence of malnutrition with GLIM criteria was 24.4% (ranged from 13.9% to 20.9% with the 7 approaches). GLIM criteria showed a HR = 3.38 (1.89-6.09) to predict mortality during the 5-year follow-up, which ranged from HR = 2.72 (1.51-4.91) to 3.94 (2.14-7.24) with the 7 approaches. All 7 approaches were feasible (TELOS ≥ 3), showed sensitivity ≥ 65%, specificity ≥ 95.4%, PPV ≥ 85%, NPV ≥ 88%, AUC ≥ 0.7 and had almost-perfect/strong concordance (k ≥ 0.7) with the original GLIM criteria. CONCLUSIONS GLIM criteria and the 7 approaches predicted three-to four-fold mortality, all ensured an accurate diagnosis, and were feasible in clinical settings.
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Affiliation(s)
- Dolores Sanchez-Rodriguez
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Geriatrics Department, Rehabilitation Research Group, Hospital Del Mar Medical, Research Institute (IMIM), Universitat Pompeu Fabra, Barcelona, Spain.
| | - Médéa Locquet
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Laetitia Lengelé
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU - Sart Tilman, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Charlotte Beaudart
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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12
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Improving nutrition research through better methodology: Study protocols now accepted in Clinical Nutrition ESPEN. Clin Nutr ESPEN 2020; 38:1-2. [PMID: 32690143 DOI: 10.1016/j.clnesp.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 06/10/2020] [Indexed: 11/20/2022]
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13
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Yin L, Lin X, Li N, Zhang M, He X, Liu J, Kang J, Chen X, Wang C, Wang X, Liang T, Liu X, Deng L, Li W, Song C, Cui J, Shi H, Xu H. Evaluation of the Global Leadership Initiative on Malnutrition Criteria Using Different Muscle Mass Indices for Diagnosing Malnutrition and Predicting Survival in Lung Cancer Patients. JPEN J Parenter Enteral Nutr 2020; 45:607-617. [PMID: 32386328 DOI: 10.1002/jpen.1873] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/21/2020] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Liangyu Yin
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xin Lin
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Na Li
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Mengyuan Zhang
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xiumei He
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Jie Liu
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Jun Kang
- Department of Respiratory and Critical Medicine, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
| | - Xiao Chen
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Chang Wang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Xu Wang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Tingting Liang
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Xiangliang Liu
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Li Deng
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Wei Li
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Chunhua Song
- Department of Epidemiology, College of Public Health Zhengzhou University Zhengzhou Henan China
| | - Jiuwei Cui
- Cancer Center of the First Hospital of Jilin University Changchun Jilin China
| | - Hanping Shi
- Department of Gastrointestinal Surgery Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing China
| | - Hongxia Xu
- Department of Clinical Nutrition, Daping Hospital Army Medical University (Third Military Medical University) Chongqing China
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14
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Taking a step toward implementation of Global Leadership Initiative on Malnutrition (GLIM) criteria in geriatric rehabilitation. Eur Geriatr Med 2020; 11:349-352. [DOI: 10.1007/s41999-020-00325-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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