Nutrition Support Practices of Hematopoietic Stem Cell Transplantation Centers in China's Mainland

Summary:It has been identified that malnutrition can influence the immune system and time of engraftment,and it's also associated with increased incidence of complications,prolonged length of hospital stays,and transplant mortality and morbidity in patients undergoing hematopoietic stem cell transplantation(HSCT),so dynamic nutrition care is highly important.The aim of this study was to better understand the differences between clinical nutrition practices and international recommendations as well as possible barriers to the use of nutrition support in HSCT patients.An evidence-based nutrition support pathway was constructed through a systematic literature review to identify evidence and recommendations relating to the relevant issues.Then,a questionnaire consisting of 28 questions that focused on the 4 topics,namely,assessment and screening for malnutrition,nutrition support interventions,nutrition support in gastrointestinal graft-ver5U5・host disease(GVHD)and neutropenic diet was developed by the study authors and used for data collection.Responses of 18 HSCT centers from 17 provinces were received.General assessment for malnutrition was performed at 72%(13/18)centers.Parenteral nutrition(PN)was given as the first option to HSCT patients in the majority of centers,despite the fact that current guidelines recommend enteral nutrition(EN)over PN.As many as 72%(13/18)of the centers considered a neutropenic diet in the management of HSCT patients,but only one center had a formal neutropenic diet protocol in place for transplant recipients.Criteria for initiating nutrition support in patients with gastrointestinal GVHD were heterogeneous among the centers,and PN was the most widely used technique.The survey results revealed significant heterogeneity with regard to nutrition support practices among the centers,as well as between the practices and the guidelines.Standard nutrition support guidelines or protocols for nutrition support practices were absent in most of the centers.

Assessment of soil erosion in the Irga watershed on the eastern edge of the Chota Nagpur Plateau,India

Human activities to improve the quality of life have accelerated the natural rate of soil erosion.In turn,these natural disasters have taken a great impact on humans.Human activities,particularly the conversion of vegetated land into agricultural land and built-up area,stand out as primary contributors to soil erosion.The present study investigated the risk of soil erosion in the Irga watershed located on the eastern fringe of the Chota Nagpur Plateau in Jharkhand,India,which is dominated by sandy loam and sandy clay loam soil with low soil organic carbon(SOC)content.The study used the Revised Universal Soil Loss Equation(RUSLE)and Geographical Information System(GIS)technique to determine the rate of soil erosion.The five parameters(rainfall-runoff erosivity(R)factor,soil erodibility(K)factor,slope length and steepness(LS)factor,cover-management(C)factor,and support practice(P)factor)of the RUSLE were applied to present a more accurate distribution characteristic of soil erosion in the Irga watershed.The result shows that the R factor is positively correlated with rainfall and follows the same distribution pattern as the rainfall.The K factor values in the northern part of the study area are relatively low,while they are relatively high in the southern part.The mean value of the LS factor is 2.74,which is low due to the flat terrain of the Irga watershed.There is a negative linear correlation between Normalized Difference Vegetation Index(NDVI)and the C factor,and the high values of the C factor are observed in places with low NDVI.The mean value of the P factor is 0.210,with a range from 0.000 to 1.000.After calculating all parameters,we obtained the average soil erosion rate of 1.43 t/(hm^(2)•a),with the highest rate reaching as high as 32.71 t/(hm^(2)•a).Therefore,the study area faces a low risk of soil erosion.However,preventative measures are essential to avoid future damage to productive and constructive activities caused by soil erosion.This study also identifies the spatial distribution of soil erosion rate,which will help policy-makers to implement targeted soil erosion control measures.