Bioelectricity from Anaerobic Co-Digestion of Organic Solid Wastes and Sewage Sludge Using Microbial Fuel Cells (MFCs)

Recently microbial fuel cells (MFCs) have been considered as an alternative power generation technique by utilizing organic wastes. In this study, an experiment was carried out to generate bioelectricity from co-digestion of organic waste (kitchen waste) and sewage sludge as a waste management option using microbial fuel cell (MFC) in anaerobic process. A total of five samples with different sludge-waste ratio were used with zinc (Zn) and cupper (Cu) as cell electrodes for the test. The trends of voltage generation were different for each sample in cells such as 350 mV, 263 mV, 416 mV maximum voltage were measured from sample I, II and III respectively. It was observed that the MFC with sewage sludge showed the higher values (around 960 mV) of voltages with time whereas 918 mV obtained with organic waste. Precisely comparing cases with varying the organic waste and sewage sludge ratio helps to find the best bioelectricity generation option. Using MFCs can be appeared as the solution of electricity scarcity along the world as an efficient and eco-friendly manner as well as organic solid waste and sewage sludge management.

Enhancing bioelectricity generation in microbial fuel cells and biophotovoltaics using nanomaterials

Microbial fuel cells and biophotovoltaics represent promising technologies for green bioelectricity generation.However,these devices suffer from low durability and efficiency that stem from their reliance on living organisms to act as catalysts.Such limitations can be overcome with augmented capabilities enabled by nanotechnology.This review presents an overview of the different nanomaterials used to enhance bioelectricity generation through improved light harvesting,extracellular electron transfer,and anode performance.The implementation of nanomaterials in whole-cell energy devices holds promise in developing bioelectrical devices that are suitable for industry.

Chemico-biological conversion of carbon dioxide

The unabated carbon dioxide(CO_(2))emission into the atmosphere has exacerbated global climate change,resulting in extreme weather events,biodiversity loss,and an intensified greenhouse effect.To address these challenges and work toward carbon(C)neutrality and reduced CO_(2)emissions,the capture and utilization of CO_(2)have become imperative in both scientific research and industry.One cutting-edge approach to achieving efficient catalytic performance involves integrating green bioconversion and chemical conversion.This innovative strategy offers several advantages,including environmental friendliness,high efficiency,and multi-selectivity.This study provides a comprehensive review of existing technical routes for carbon sequestration(CS)and introduces two novel CS pathways:the electrochemicalbiological hybrid and artificial photosynthesis systems.It also thoroughly examines the synthesis of valuable Cnproducts from the two CS systems employing different catalysts and biocatalysts.As both systems heavily rely on electron transfer,direct and mediated electron transfer has been discussed and summarized in detail.Additionally,this study explores the conditions suitable for different catalysts and assesses the strengths and weaknesses of biocatalysts.We also explored the biocompatibility of the electrode materials and developed novel materials.These materials were specifically engineered to combine with enzymes or microbial cells to solve the biocompatibility problem,while improving the electron transfer efficiency of both.Furthermore,this review summarizes the relevant systems developed in recent years for manufacturing different products,along with their respective production efficiencies,providing a solid database for development in this direction.The novel chemical-biological combination proposed herein holds great promise for the future conversion of CO_(2)into advanced organic compounds.Additionally,it offers exciting prospects for utilizing CO_(2)in synthesizing a wide range of industrial products.Ultimately,the present study provides a unique perspective for achieving the vital goals of“peak shaving”and C-neutrality,contributing significantly to our collective efforts to combat climate change and its associated challenges.

Prevalence and outcome of sarcopenia in non-alcoholic fatty liver disease

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)includes a spectrum of conditions,progressing from mild steatosis to advanced fibrosis.Sarcopenia,characterized by decreased muscle strength and mass,shares common pathophysiological traits with NAFLD.An association exists between sarcopenia and increased NAFLD prevalence.However,data on the prevalence of sarcopenia in NAFLD and its impact on the outcomes of NAFLD remain inconsistent.AIM To analyze the prevalence and outcomes of sarcopenia in patients with NAFLD.METHODS We conducted a comprehensive search for relevant studies in MEDLINE,Embase,and Scopus from their inception to June 2023.We included studies that focused on patients with NAFLD,reported the prevalence of sarcopenia as the primary outcome,and examined secondary outcomes,such as liver fibrosis and other adverse events.We also used the Newcastle-Ottawa scale for quality assessment.RESULTS Of the 29 studies included,the prevalence of sarcopenia in NAFLD varied widely(1.6%to 63.0%),with 20 studies reporting a prevalence of more than 10.0%.Substantial heterogeneity was noted in the measurement modalities for sarcopenia.Sarcopenia was associated with a higher risk of advanced fibrosis(odd ratio:1.97,95%confidence interval:1.44-2.70).Increased odds were consistently observed in fibrosis assessment through biopsy,NAFLD fibrosis score/body mass index,aspartate aminotransferase to alanine aminotransferase ratio,diabetes(BARD)score,and transient elastography,whereas the fibrosis-4 score showed no such association.Sarcopenia in NAFLD was associated with a higher risk of steatohepatitis,insulin resistance,cardiovascular risks,and mortality.CONCLUSION This systematic review highlights the critical need for standardized diagnostic criteria and measurement methods for sarcopenia in NAFLD patients.The variability in study designs and assessment methods for sarcopenia and liver fibrosis may account for the inconsistent findings.This review demonstrates the multidimensional impact of sarcopenia on NAFLD,indicating its importance beyond liver-related events to include cardiovascular risks,mortality,and metabolic complications.

Association of Breastfeeding Duration with Body Composition in Children Aged 3–5 Years

Objective This study aimed to assess the relationship between the body composition of children aged 3–5 years and breastfeeding status and duration.Methods The study was conducted using data from the National Nutrition and Health Systematic Survey for children 0–17 years of age in China(CNHSC),a nationwide cross-sectional study.Breastfeeding information and potential confounders were collected using standardized questionnaires administered through face-to-face interviews.The body composition of preschool children was measured using bioelectrical impedance analysis.A multivariate linear regression model was used to assess the relationship between breastfeeding duration and body composition after adjusting for potential confounders.Results In total,2,008 participants were included in the study.Of these,89.2%were ever breastfed and the median duration of breastfeeding was 12 months(IQR 7–15 months).Among children aged 3 years,the height-for-age Z-score(HAZ)for the ever breastfed group was lower than that for never breastfed group(0.12 vs.0.42,P=0.043).In addition,the weight-for-age Z-score(WAZ)of the ever breastfed group was lower than that of the never breastfed group(0.31 vs.0.65,P=0.026),and the WAZ was lower in children aged 4 years who breastfed between 12 and 23 months than in those who never breastfed.Compared to the formula-fed children,the fat-free mass of breastfed infants was higher for children aged 3 years(12.84 kg vs.12.52 kg,P=0.015)and lower for those aged 4 years(14.31 kg vs.14.64 kg,P=0.048),but no difference was detected for children aged 5 years(16.40 kg vs.16.42 kg,P=0.910)after adjusting for potential confounders.No significant difference was detected in the weight-for-height Z-score(WHZ),body mass index(BMI)-for-age Z-score(BAZ),fat-free mass index,and body fat indicators in the ever breastfed and never breastfed groups and among various breastfeeding duration groups for children aged 3–5 years.Conclusion No obvious associations were detected between breastfeeding duration,BMI,and fat mass indicators.Future prospective studies should explore the relationship between breastfeeding status and fat-free mass.

A Time-Varying Parameter Estimation Method for Physiological Models Based on Physical Information Neural Networks

In the establishment of differential equations,the determination of time-varying parameters is a difficult problem,especially for equations related to life activities.Thus,we propose a new framework named BioE-PINN based on a physical information neural network that successfully obtains the time-varying parameters of differential equations.In the proposed framework,the learnable factors and scale parameters are used to implement adaptive activation functions,and hard constraints and loss function weights are skillfully added to the neural network output to speed up the training convergence and improve the accuracy of physical information neural networks.In this paper,taking the electrophysiological differential equation as an example,the characteristic parameters of ion channel and pump kinetics are determined using BioE-PINN.The results demonstrate that the numerical solution of the differential equation is calculated by the parameters predicted by BioE-PINN,the RootMean Square Error(RMSE)is between 0.01 and 0.3,and the Pearson coefficient is above 0.87,which verifies the effectiveness and accuracy of BioE-PINN.Moreover,realmeasuredmembrane potential data in animals and plants are employed to determine the parameters of the electrophysiological equations,with RMSE 0.02-0.2 and Pearson coefficient above 0.85.In conclusion,this framework can be applied not only for differential equation parameter determination of physiological processes but also the prediction of time-varying parameters of equations in other fields.

Suppression of transmembrane sodium currents on the freshly isolated hippocampal neuron cell with continuous infrared light

Physiotherapeutic effects of infrared lasers have been proved in clinic.These infrared-based regulations of the bioelectrical activities can roughly be classied into enhancement and suppression of action potential(AP),which are described by sodium(Na)and potassium(K)transmembrane current equations,named as Hodgkin and Huxley(HH)-model.The enhancement effect is able to evoke or strengthen the AP when infrared light is applied.Its corresponding mechanism is commonly ascribed to the changes of the cell membrane capacitance,which is transiently increased in response to the infrared radiation.The distinctive feature of the suppression effect is to inhibit or reduce the AP by the designed protocols of infrared radiation.However,its mechanism presents more complexity than that in enhancement cases.HH-model describes how the Na current determines the initial phase of AP.So,the enhancement and suppression of AP can be also ascribed to the regulations of the corresponding Na currents.Here,a continuous infrared light at the wavelength of 980 nm(CIS-980)was employed to stimulate a freshly isolated hippocampal neuron in vitro and a suppression effect on the Na currents of the neuron cell was observed.Both Na and K currents,which are named as whole cell currents,were simultaneously recorded with the cell membrane capacitance current by using a patch clamp combined with infrared irradiation.The results demonstrated that the CIS-980 was able to reversibly increase the capacitance currents,completely suppressed Na currents,but little changed K currents,which forms the steady outward whole cell currents and plays a major role on the AP repolarization.A conrmation experiment was designed and carried out by synchronizing tens of milliseconds of infrared stimulation on the same kinds of hippocampal neuron cells.After the blocked K channel,a reduction of Na current amplitude was still recorded.This proved that infrared suppression of Na current was irrelevant to K channel.A membrane capacitance mediation process was preliminarily proposed to explain the Na channel suppression process.

生物电阻抗法在慢性肾脏病儿童营养评估中的应用

目的：探讨生物电阻抗原理（bioelectrical impedance analysis, BIA）在评价慢性肾脏病儿童营养方面的临床应用价值。方法选取2009年至2011年期间就诊于北京儿童医院肾脏内科的单中心慢性肾脏病（chronic kid-ney disease, CKD）患儿57例（CKD组），同时选择健康儿童54例作为正常对照组。利用生物电阻抗原理对儿童进行人体成分（主要包括蛋白质、脂肪含量的测定）的评估及比较。结果 CKD组蛋白质相对含量为（14.72±2.44）%，正常对照组为（18.10±3.91）%，两组间差异有统计学意义（t=2.61，P=0.000）；CKD组脂肪相对含量为（24.31±12.52）%，显著高于正常对照组的（16.1±17.34）%，差异有统计学意义（t=3.89，P=0.000）；CKD1~2期患儿蛋白质相对含量为（34.57±7.39）%，CKD3~5期患儿含量为（41.08±5.53）%，两者比较差异有统计学意义（t=3.749，P=0.000）；CKD1~2期患儿相对脂肪含量为（28.73±12.50）%，CKD3~5期患儿含量为（16.13±7.52）%，其差异有统计学意义（t=-4.745，P=0.000）。 CKD组中47例（82.45%）处于营养成分失衡状态；在身高别体重提示营养状况良好的32例CKD患儿中25例（78.12%）存在营养成分不均衡。结论 CKD患儿存在蛋白质、脂肪等人体成分不均衡状态，个体化、针对性的营养管理对CKD患儿的营养状况改善有一定帮助。生物电阻抗原理对于评价CKD患儿营养状况有一定的临床应用价值。

Unveiling the morphogenetic code:A new path at the intersection of physical energies and chemical signaling

In this editorial,we discuss the remarkable role of physical energies in the control of cell signaling networks and in the specification of the architectural plan of both somatic and stem cells.In particular,we focus on the biological relevance of bioelectricity in the pattern control that orchestrates both developmental and regenerative pathways.To this end,the narrative starts from the dawn of the first studies on animal electricity,reconsidering the pioneer work of Harold Saxton Burr in the light of the current achievements.We finally discuss the most recent evidence showing that bioelectric signaling is an essential component of the informational processes that control pattern specification during embryogenesis,regeneration,or even malignant transformation.We conclude that there is now mounting evidence for the existence of a Morphogenetic Code,and that deciphering this code may lead to unprecedented opportunities for the development of novel paradigms of cure in regenerative and precision medicine.

Evaluation of the Effect of Agricultural Management on Energy Yield and Greenhouse Gas Emission Reduction of Bioenergy Production Chains

The role of energy crops in reducing fossil energy use and greenhouse gas emission is much debated. To improve decision making on the use of crops for producing bioenergy, a tool (Energy Crop Simulation Model or E-CROP) has been developed to calculate 1) sustainable crop dry matter yield levels as function of agricultural inputs, and 2) gross and net energy yield and greenhouse gas emission reduction, covering the entire bioenergy production chain from sowing to distribution of bioenergy. E-CROP can be applied to a wide range of crops, soils, climatic conditions, management choices, and conversion technologies. This paper describes E-CROP and focuses on its application on four arable crops, as cultivated on two contrasting sites in the Netherlands (potato and sugar beet for bioethanol, winter oilseed rape for biodiesel and silage maize for bioelectricity) and on the effect of crop management (viz. irrigation and nitrogen fertilisation). In all situations, gross energy output exceeded total energy input. Calculated for an average situation, net energy yield ranged from 45 to 140 GJ.ha-1. Lowering irrigation and/or fertilisation input levels generally resulted in a reduction of net energy yields. The net reduction of greenhouse gas emissions in the average situation ranged from 0.60 to 6.5 t CO2-eq.ha-1. In general, N2O emission from nitrogen fertiliser caused large variations in the net reduction of greenhouse gas emission, which even became negative in some situations. Lowering nitrogen fertilisation to levels that are suboptimal for net energy yields enhanced the net reduction in greenhouse gas emission, implicating that both goals cannot be optimised simultaneously. Agricultural knowledge is important for optimising the outputs of bioenergy production chains.

Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis

AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.

Nutritional evaluation in cirrhosis: Emphasis on the phase angle

Protein-calorie malnutrition(PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and nonanthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis(BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle(PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients' overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.

Measurement of body composition as a surrogate evaluation of energy balance in obese patients

In clinical practice obesity is primarily diagnosed through the body mass index. In order to characterize patients affected by obesity the use of traditional anthropometric measures appears misleading. Beyond the body mass index, there are overwhelming evidences towards the relevance of a more detailed description of the individual phenotype by characterizing the main body componentsas free-fat mass, muscle mass, and fat mass. Among the numerous techniques actually available, bioelectrical impedance analysis seems to be the most suitable in a clinical setting because it is simple, inexpensive, noninvasive, and highly reproducible. To date, there is no consensus concerning the use of one preferred equation for the resting energy expenditure in overweight and/or obese population. Energy restriction alone is an effective strategy to achieve an early and significant weight loss, however it results in a reduction of both fat and lean mass therefore promoting or aggravating an unfavourable body composition(as sarcobesity) in terms of mortality and comorbidities. Therefore the implementation of daily levels of physical activity should be simultaneously promoted. The major role of muscle mass in the energy balance has been recently established by the rising prevalence of the combination of two condition as sarcopenia and obesity. Physical exercise stimulates energy expenditure, thereby directly improving energy balance, and also promotes adaptations such as fiber type, mitochondrial biogenesis, improvement of insulin resistance, and release of myokines, which may influence different tissues, including muscle.

NOVEL DESIGN OF A BIOELECTRIC AMPLIFIER WITH MINIMIZED MAGNITUDE AND PHASE ERRORS

A new design of a bioelectric amplifier that has better parameters than conventional designs is presented. The design allows the construction of bioelectric amplifier with improved parameters in terms of common-mode rejection ratio and phase and magnitude errors. The voltage gain is easily adapted to a wide range of biomedical applications. The experimental and simulation results of the designed bioelectric amplifier are also included.

Novel Bioelectric Mechanisms and Functional Significance of Peripheral and Central Entrainment by Respiration

The human organism is a complex biological system with emergent properties that arise from the unified functional interactions among its diverse components. When studying the brain and body in light of modern biological systems approaches, one must analyze them in a holistic manner, putting aside reductionist models in order to understand how certain properties manifest from complex system interactions. The respiratory system is capable of continuously adapting to changes in the internal and external environment, making it one of the most integrated of physiological processes. We propose an additional respiratory process: respiration-derived electrical currents during inspiration that spread throughout the entire body maintaining homeostasis through entraining oscillatory activity, modulating cognitive processes, and modulating the autonomic nervous system. If these currents are indeed created in part from redox reactions occurring on a massive scale, then we assert they are a major aspect of an embodied cognitive framework. We propose that this potentially major source of organism integrity has been overlooked, and its application to medicine could drastically change how we understand human physiology, the autonomic nervous system, and the therapeutic treatment of various clinical disorders.

Screening of Total Organophosphate Pesticides in Agricultural Products with a Cellular Biosensor

Organophosphates belong to the most important pesticides used in agricultural practice worldwide. Although their analytical determinations are quite feasible with various conventional methods, there is a lack of efficient screening methods, which will facilitate the rapid, high-throughput detection of organophosphates in different food commodities. This study presents the construction of a rapid and sensitive cellular biosensor test based on the measurement of changes of the cell membrane potential of immobilized cells, according to the working principle of the Bioelectric Recognition Assay (BERA). Two different cell types were used, derived either by animal (neuroblastoma) or plant cells (tobacco protoplasts). The sensor was applied for the detection of a mixture of two organophosphate pesticides, diazinon and chlorpyrifos in two different substrates (tomato, orange). The pesticides in the samples inhibited the activity of cell membrane-bound acetylcholinesterase (AChE), thus causing a measurable membrane depolarization in the presence of achetylcholine (Ach). Based on the observed patterns of response, we demonstrate that the sensor can be used for the qualitative and, in some concentrations, quantitative detection of organophosphates in different substrates with satisfactory reproducibility and sensitivity, with a limit of detection at least equal to the official Limit of Detection (LOQ). The assay is rapid with a total duration of 3 min at a competitive cost. The sensitivity of the biosensor can be further increased either by incorporating more AChE-bearing cells per test reaction unit or by using cells engineered with more potent AChE isoforms. Standardization of cultured cell parameters, such as age of the cells and subculture history prior to cell immobilization, combined with use of planar electrodes, can further increase the reproducibility of the novel test.

Combining the Patient-Generated Subjective Global Assessment (PGSGA) and Objective Nutrition Assessment Parameters Better Predicts Malnutrition in Elderly Patients with Colorectal Cancer

Background Malnutrition is common in colorectal cancer(CRC)patients,especially in elderly patients.The Patient-Generated Subjective Global Assessment(PG-SGA)is a widely used tool developed to detect malnutrition.The aim of this study was to compare the value of the PG-SGA and objective nutrition assessment parameters,in order to identify a better predictive index for malnutrition in elderly patients with CRC.Methods A total of 131 elderly patients(age≥60 years)with CRC were included and were evaluated for their individual nutritional status using the PG-SGA.Anthropometric and serological indicators were also assayed within 48 h of admission to the hospital.Body composition analysis was implemented by bioelectrical impedance analysis(BIA)instrument.The Chi-squared test,univariate and multivariate logistic regression analysis,or Spearman’s rank correlation analysis were used to determine the differences among the above indices and parameters with regard to predicting malnutrition.Results According to the PG-SGA score,the incidence of total malnutrition in elderly patients with CRC was 80.92%(PG-SGA score≥2),which increased with age.It was found that 28%of the patients with PG-SGA classification A(PG-SGA score 0-1)had a low fat-free mass index(FFMI).Compared with those with PG-SGA A,patients with PG-SGA C PG-SGA score≥9)showed an increased neutrophil to lymphocyte ratio(NLR)and an increased platelet and lymphocyte ratio(PLR)(median=1.78 VS.2.35,P=0.015 and median=108.8 VS.141.6,P=0.001,respectively).In terms of objective nutrition assessment parameters,severely malnourished CRC patients had significantly lower values of serum albumin(ALB),and retinol conjugated protein(RBP)than those who were well-nourished[(38.35±4.84)g/L VS.(40.56±3.44)g/L,P=0.039 and(30.31±15.83)mg/L VS.(39.01±11.95)mg/L,P=0.033,respectively].The Spearman’s rank correlation analysis showed that the PG-SGA findings had positive correlations with the NLR and PLR;while it had negative correlations with the FFMI,body mass index(BMI),ALB,prealbumin,and RBP.Conclusions In clinical practice,a comprehensive nutritional diagnosis,including the PG-SGA score and these objective indicators,can avoid the underdiagnosis of malnutrition,and is more suitable to detect malnutrition(as well as its causes)in elderly patients with CRC.

Bioelectrical Impedance Phase Angle as a Predictors of Mortality in Patients with Lung Cancer:a Prospective Study

Objective Bioelectrical impedance analysis(BIA)is used to measure a patient's body composition.The phase angle(PA),the major parameter in BIA,is one of the most sensitive indicators of malnutrition.The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients.Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital.Anthropometric measurements,hematological values,the nutritional risk screening(NRS 2002)score,patient generated-subjective global assessment(PG-SGA)score,Karnofsky performance status(KPS)scale,European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ C-30)score,and BIA were investigated within 48 hours after admission to the hospital.A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA.A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival(OS)and PA.Results The mean age for all patients was 63 years old(42 females and 124 males).The median PA was 5.5°(4.70°,6.23°).The PA was positively associated with the body mass index,hand grip strength,mid-arm circumference,mid-arm muscle circumference,albumin,prealbumin,C-reactive protein,red blood cells,hemoglobin and KPS score.The PG-SGA scores,QLQ-C30 score,and NRS2002 score showed a significant negative association with the PA.According to a multivariate analysis,the PA(HR=0.47;95%CI:0.27-0.81)was independent predictor of the lung cancer patients'long-term OS.Patients with a higher PA(≥5°)had better overall survival(median=426 days)compared to those with a lower PA(<5°)(median=96 days)based on the one-year follow-up data(P<0.0001).Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.

Low Phase Angle Predicts Poor Survival in Patients with Hepatocellular Carcinoma:A Retrospective Study

Background The phase angle(PA)is an indicator of nutritional status derived from bioelectrical impedance analysis(BIA).Studies have shown that the PA is one of several factors related to the survival of cancer patients.However,the correlation between the PA and prognosis in patients with hepatocellular carcinoma(HCC)has not been reported.This study aimed to explore the relationship between the PA,nutrition-related indicators,and patient prognosis.Methods The data from 248 HCC patients who underwent BIA between January 2015 and December 2019 at the First Hospital of Jilin University were retrospectively analyzed.Patients were divided into two groups according to the median PA value,then the nutrition-related indicators and overall survival(OS)were compared between the two groups.The correlations between the PA and laboratory test nutrition-related indicators and the results of a body composition analysis were determined using Pearson correlation analysis.Independent predictors of the patient prognosis were identified using univariate and multivariate analyses.Results The median OS in the high and low PA groups were 70 and 54.6 months,respectively(P=0.004).The Pearson correlation analysis revealed that the PA was associated with both laboratory test nutrition-related indicators and the results of a body composition analysis.The multivariable Cox regression analysis identified the PA as an independent risk factor affecting the prognosis of patients with Barcelona Clinic Liver Cancer stage A or B.Conclusion The PA is a good biomarker for the nutritional status.We found that the PA was associated with the prognosis in patients with HCC,with a low PA indicating a poor nutritional status and worse prognosis.

Bioelectrical impedance analysis-guided fluid management promotes primary fascial closure after open abdomen:a randomized controlled trial

Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)patients.Bioelectrical impedance analysis(BIA)is a promising tool for monitoring fluid status and FO.Therefore,we sought to investigate the efficacy of BIA-directed fluid resuscitation among OA patients.Methods:A pragmatic,prospective,randomized,observer-blind,single-center trial was performed for all trauma patients requiring OA between January 2013 and December 2017 to a national referral center.A total of 140 postinjury OA patients were randomly assigned in a 1:1 ratio to receive either a BIA-directed fluid resuscitation(defined as BIA)protocol that included fluid administration with monitoring of hemodynamic parameters and different degrees of interventions to achieve a negative fluid balance targeting the hydration level(HL)measured by BIA or a traditional fluid resuscitation(TRD)in which clinicians determined the fluid resuscitation regimen according to traditional parameters during 30 d of intensive care unit(ICU)management.The primary outcome was the 30-day primary fascial closure(PFC)rate.The secondary outcomes included the time to PFC,postoperative 7-day cumulative fluid balance(CFB)and adverse events within 30 d after OA.The Kaplan–Meier method and the log-rank test were utilized for PFC after OA.A generalized linear regression model for the time to PFC and CFB was built.Results:A total of 134 patients completed the trial(BIA,n=66;TRD,n=68).The BIA patients were significantly more likely to achieve PFC than the TRD patients(83.33%vs.55.88%,P<0.001).In the BIA group,the time to PFC occurred earlier than that of the TRD group by an average of 3.66 d(P<0.001).Additionally,the BIA group showed a lower postoperative 7-day CFB by an average of 6632.80 ml(P<0.001)and fewer complications.Conclusions:Among postinjury OA patients in the ICU,the use of BIA-guided fluid resuscitation resulted in a higher PFC rate and fewer severe complications than the traditional fluid resuscitation strategy.