Rapid assessment of malnutrition based on GLIM diagnosis in Crohn’s disease

Background and aimsMalnutrition is strongly linked to adverse outcomes in patients with Crohn’s disease (CD). In this study, our objective was to validate the Global Leadership Initiative on Malnutrition (GLIM) criteria and develop a fast and accurate diagnostic approach for identifying malnutrition in CD patients.MethodsThis study assessed 177 CD patients from four general hospitals. The efficacy of the GLIM criteria for the diagnosis of CD malnutrition was compared. By analyzing the independent factors, a nomogram model was derived and internally validated to predict the diagnosis of malnutrition in patients with CD. Model performance was assessed using discrimination and calibration, decision curves, and net benefit analyses.ResultsCompared with the SGA criteria, the GLIM criteria was consistent in sensitivity (88.89%) and specificity (78.43%) [AUC = 0.84; 95% Confidence Interval (CI): 0.77–0.89]. The Harvey-Bradshaw index(HBI) score (OR: 1.58; 95% CI: 1.15–2.18), body mass index (OR: 0.41; 95% CI: 0.27–0.64), and mid-upper arm circumference (OR: 0.68; 95% CI: 0.47–0.9) were independent factors associated with malnutrition. The nomogram was developed based on these indicators showing good discrimination in malnutrition diagnosis (AUC = 0.953; 95% CI: 0.922–0.984), with agreement after calibration curve and decision curve analysis.ConclusionThe GLIM criteria are appropriate for diagnosing malnutrition in CD patients. The HBI score may be used to diagnose malnutrition in patients with CD and become a possible selection for the GLIM etiologic criteria of inflammation. The HBM nomogram could be a simple, rapid, and efficient method for diagnosing malnutrition in CD patients

Core-shell gold-nickel nanostructures as highly selective and stable nonenzymatic glucose sensor for fermentation process

Non-enzymatic electrodes based on noble metals have excellent selectivity and high sensitivity in glucose detection but no such shortcomings as easy to be affected by pH, temperature, and toxic chemicals. Herein, spherical gold-nickel nanoparticles with a core-shell construction (Au@Ni) are prepared by oleylamine reduction of their metal precursors. At an appropriate Au/Ni ratio, the core-shell Au@Ni nanoparticles as a sensor for glucose detection combine the high electrocatalytic activity, good selectivity and biological compatibility of Au with the remarkable tolerance of Ni for chlorine ions (Cl-) and poisoning intermediates in catalytic oxidation of glucose. This electrode exhibits a low operating voltage of 0.10 V vs. SCE for glucose oxidation, leading to higher selectivity compared with other Auand Ni-based sensors. The linear range for the glucose detection is from 0.5 mmol L-1 to 10 mmol L-1 with a rapid response time of ca. 3 s, good stability, sensitivity estimated to be 23.17 mu A cm(-2) mM(-1), and a detection limit of 0.0157 mM. The sensor displays high anti-toxicity, and is not easily poisoned by the adsorption of Cl- in solution

KECA Similarity-Based Monitoring and Diagnosis of Faults in Multi-Phase Batch Processes

Multiple phases with phase to phase transitions are important characteristics of many batch processes. The linear characteristics between phases are taken into consideration in the traditional algorithms while nonlinearities are neglected, which can lead to inaccuracy and inefficiency in monitoring. The focus of this paper is nonlinear multi-phase batch processes. A similarity metric is defined based on kernel entropy component analysis (KECA). A KECA similarity-based method is proposed for phase division and fault monitoring. First, nonlinear characteristics can be extracted in feature space via performing KECA on each preprocessed time-slice data matrix. Then phase division is achieved with the similarity variation of the extracted feature information. Then, a series of KECA models and slide-KECA models are established for steady and transitions phases respectively, which can reflect the diversity of transitional characteristics objectively and preferably deal with the stage-transition monitoring problem in multistage batch processes. Next, in order to overcome the problem that the traditional contribution plot cannot be applied to the kernel mapping space, a nonlinear contribution plot diagnosis algorithm is proposed, which is easier, more intuitive and implementable compared with the traditional one. Finally, simulations are performed on penicillin fermentation and industrial application. Specifically, the proposed method detects the abnormal agitation power and the abnormal substrate supply at 47 h and 86 h, respectively. Compared with traditional methods, it has better real-time performance and higher efficiency. Results demonstrate the ability of the proposed method to detect faults accurately and effectively in practice

Differential Metabolomic Analysis of Liver Tissues from Rat Models of Parenteral Nutrition-Associated Liver Disease

Parenteral nutrition (PN) is a life-saving therapy for patients with intestinal failure, but parenteral nutrition-associated liver disease (PNALD) limits its long-term use. The present study is aimed at determining which pathways are altered most notably in a rat model of PNALD. We randomly assigned male Sprague-Dawley (SD) rats into two different groups, whereby they received either enteral nutrition (EN) or PN. Liver tissues were harvested from all rats 7 days later for metabolomic profiling. The composition of primary conjugated bile acids was altered, the synthesis of polyunsaturated fatty acids was reduced, the conversion of pyruvate to acetyl-CoA was blocked, and the synthesis of phosphatidylcholine was inhibited in rats with PNALD. Riboflavin, which is involved in the electron transfer process in the mitochondrial electron transport chain, was remarkably decreased in PNALD rats. A deficiency of polyunsaturated fatty acids, riboflavin, choline, and taurine might be involved in the progression of PNALD. The implications of these findings for the field of medicine are that supplementation with polyunsaturated fatty acids, riboflavin, choline, and taurine might have potential as therapeutic strategies for PNALD and also shed light on the mechanisms of PNALD

Long-Term Outcome in Gastric Cancer Patients with Different Body Composition Score Assessed via Computed Tomography

Background The purpose of this study was to assess the body composition score (BCS) impact on 3-year survival after radical gastrectomy in patients with gastric cancer. Methods This retrospective study included patients with gastric cancer from September 2015 to June 2017. The patients were divided into three groups: BCS0 (having normal skeletal muscle or adipose mass), BCS1 (having low skeletal muscle mass only), and BCS2 (having low skeletal muscle and adipose mass) according to their third lumbar vertebra skeletal muscle index and fat index calculated using abdominal computed tomography. The clinicopathological indicators, postoperative complications, 3-year over survival (OS) rate after radical gastrectomy, and cause of death among the three groups were compared. Results A total of 187 patients were enrolled in the study, in which 102 patients (54.6%) had BCS0, 76 (40.6%) had BCS1 and 9 (4.8%) had BCS2. There was no significant difference in postoperative complications among the groups. 3-year OS was significantly shortened with each 1-score increase in BCS (Log-rank p < 0.001). Multivariate Cox regression analyses showed that no neoadjuvant chemotherapy, tumor stage III, BCS1, and BCS2 were independent prognostic factors for 3-year OS after radical gastrectomy. The main cause of death was cancer-related. Conclusion We demonstrated that BCS1 and BCS2 were strongly associated with poor 3-year survival for patients with gastric cancer who underwent radical gastrectomy, suggesting that special attention may be required for nutritional support while determining therapeutic strategies

Partial Enteral Nutrition Preserves Elements of Gut Barrier Function, Including Innate Immunity, Intestinal Alkaline Phosphatase (IAP) Level, and Intestinal Microbiota in Mice

Lack of enteral nutrition (EN) during parenteral nutrition (PN) leads to higher incidence of infection because of gut barrier dysfunction. However, the effects of partial EN on intestina linnate immunity, intestinal alkaline phosphatase (IAP) and microbiota remain unclear. The mice were randomized into six groups to receive either standard chow or isocaloric and isonitrogenous nutritional support with variable partial EN to PN ratios. Five days later, the mice were sacrificed and tissue samples were collected. Bacterial translocation, the levels of lysozyme, mucin 2 (MUC2), and IAP were analyzed. The composition of intestinal microbiota was analyzed by 16S rRNA pyrosequencing. Compared with chow, total parenteral nutrition (TPN) resulted in a dysfunctional mucosal barrier, as evidenced by increased bacterial translocation (p &lt; 0.05), loss of lysozyme, MUC2, and IAP, and changes in the gut microbiota (p &lt; 0.001). Administration of 20% EN supplemented with PN significantly increased the concentrations of lysozyme, MUC2, IAP, and the mRNA levels of lysozyme and MUC2 (p &lt; 0.001). The percentages of Bacteroidetes and Tenericutes were significantly lower in the 20% EN group than in the TPN group (p &lt; 0.001). These changes were accompanied by maintained barrier function in bacterial culture (p &lt; 0.05). Supplementation of PN with 20% EN preserves gut barrier function, by way of maintaining innate immunity, IAP and intestinal microbiota

N-3 Polyunsaturated Fatty Acids Improve Liver Lipid Oxidation-Related Enzyme Levels and Increased the Peroxisome Proliferator-Activated Receptor α Expression Level in Mice Subjected to Hemorrhagic Shock/Resuscitation

Appropriate metabolic interventions after hemorrhagic shock/resuscitation injury have not yet been identified. We aimed to examine the effects of fish oil on lipid metabolic intervention after hemorrhagic shock/resuscitation. Firstly, 48 C57BL/6 mice were assigned to six groups (n = 8 per group). The sham group did not undergo surgery, while mice in the remaining groups were sacrificed 1–5 days after hemorrhagic shock/resuscitation. In the second part, mice were treated with saline or fish oil (n = 8 per group) five days after injury. We determined serum triglyceride levels and liver tissues were collected and prepared for qRT-PCR or Western blot analysis. We found that triglyceride levels were increased five days after hemorrhagic shock/resuscitation, but decreased after addition of fish oil. After injury, the protein and gene expression of carnitine palmitoyltransferase 1A, fatty acid transport protein 1, and peroxisome proliferator-activated receptor-α decreased significantly in liver tissue. In contrast, after treatment with fish oil, the expression levels of these targets increased compared with those in the saline group. The present results suggest n-3 polyunsaturated fatty acids could improve lipid oxidation-related enzymes in liver subjected to hemorrhagic shock/resuscitation. This function is possibly accomplished through activating the peroxisome proliferator-activated receptor-α pathway