Association of bioimpedance analysis parameters trajectories with clinical outcomes in neurocritical patients.

Background and objective: Neurocritical patients often experience uncontrolled high catabolic metabolism state during the acuta phase of the disease. The complex interactions of neuroendocrine, inflammation, and immune system lead to massive protein breakdown and changes in body composition. Bioelectrical impedance analysis (BIA) evaluates the content and proportions of body components based on the principles of bioelectricity. Its parameters reflect the overall health status of the body and the integrity of cellular structure and function, playing an important role in assessing the disease status and predicting prognosis of such patients. This study explored the association of BIA parameters trajectories with clinical outcomes in neurocritical patients. Methods: This study prospectively collected BIA parameters of 127 neurocritical patients in the Department of Neurology admitted to the NICU for the first 1-7 days. All these patients were adults (≥18 years old) experiencing their first onset of illness and were in the acute phase of the disease. The group-based trajectory modeling (GBTM), which aims to identify individuals following similar developmental trajectories, was used to identify potential subgroups of individuals based on BIA parameters. The short-term prognosis of patients in each trajectory group with variations in phase angle (PA) and extracellular water/total body water (ECW/TBW) over time was differentially analyzed, and the logistic regression model was used to analyze the relationship between potential trajectory groups of PA and ECW/TBW and the short-term prognosis of neurocritical patients. The outcome was Glasgow Outcome Scale (GOS) score at discharge. Results: Four PA trajectories and four ECW/TBW trajectories were detected respectively in neurocritical patients. Among them, compared with the other latent subgroups, the "Low PA rapidly decreasing subgroup" and the "High ECW/TBW slowly rising subgroup" had higher incidences of adverse outcomes at discharge (GOS:1-3), in-hospital mortality, and length of neurology intensive care unit stay (all P < 0.05). After correcting for potential confounders, compared with the "Low PA rapidly decreasing subgroup", the risk of adverse outcome (GOS:1-3) was lower in the other three PA trajectories, with OR values of 0.0003, 0.0004, and 0.003 respectively (all P < 0.05). Compared with the "High ECW/TBW slowly rising subgroup", the risk of adverse outcome (GOS:1-3) was lower in the other three ECW/TBW trajectories, with OR values of 0.013, 0.035 and 0.038 respectively (all P < 0.05). Conclusion: Latent PA trajectories and latent ECW/TBW trajectories during 1-7 days after admission were associated with the clinical outcomes of neurocritical patients. The risk of adverse outcomes was highest in the "Low PA rapidly decreasing subgroup" and the "High ECW/TBW slowly rising subgroup". These results reflected the overall health status and nutritional condition of neurocritical patients at the onset of the disease, and demonstrated the dynamic change process in body composition caused by the inflammatory response during the acute phase of the disease. This provided a reference basis for the observation and prognostic evaluation of such patients.

A 3 MHz Low-Error Adaptive Howland Current Source for High-Frequency Bioimpedance Applications.

Bioimpedance is a diagnostic sensing method used in medical applications, ranging from body composition assessment to detecting skin cancer. Commonly, discrete-component (and at times integrated) circuit variants of the Howland Current Source (HCS) topology are employed for injection of an AC current. Ideally, its amplitude should remain within 1% of its nominal value across a frequency range, and that nominal value should be programmable. However, the method's applicability and accuracy are hindered due to the current amplitude diminishing at frequencies above 100 kHz, with very few designs accomplishing 1 MHz, and only at a single nominal amplitude. This paper presents the design and implementation of an adaptive current source for bioimpedance applications employing automatic gain control (AGC). The "Adaptive Howland Current Source" (AHCS) was experimentally tested, and the results indicate that the design can achieve less than 1% amplitude error for both 1 mA and 100 µA currents for bandwidths up to 3 MHz. Simulations also indicate that the system can be designed to achieve up to 19% noise reduction relative to the most common HCS design. AHCS addresses the need for high bandwidth AC current sources in bioimpedance spectroscopy, offering automatic output current compensation without constant recalibration. The novel structure of AHCS proves crucial in applications requiring higher ß-dispersion frequencies exceeding 1 MHz, where greater penetration depths and better cell status assessment can be achieved, e.g., in the detection of skin or breast cancer.

Evaluation of North Sea saturation procedures through divers monitoring.

BACKGROUND: Saturation diving is a standard method of intervention for commercial diving during offshore operations. Current saturation procedures achieve a high level of safety with regards to decompression sickness but still put the divers under multiple stressors: 1) Environmental stress (long confinement, heat/cold, dense gases, high oxygen levels), 2) Work stress (muscular fatigue, psychological pressure, breathing equipment, etc.), 3) venous gas emboli associated with decompression, 4) Inflammation related to oxidative stress and microparticles. We present the results of a saturation divers monitoring campaign performed in the North Sea Danish sector, on the Tyra field, during 2022. The study was supported by TotalEnergies, the field operator, and performed by Boskalis Subsea Services, the diving contractor, onboard the diving support vessel Boka Atlantis. The objective was twofold: document the level of diving stress during saturation operations in the Danish sector, and compare the performances of two saturation procedures, the Boskalis and the NORSOK procedures. MATERIALS AND METHODS: Fourteen divers volunteered for the study. The monitoring package include weight and temperature measurements, psychomotor tests (objective evaluation) and questionnaires (subjective evaluation), Doppler bubble detection and bioimpedance. The results were presented in a radar diagram that provides a general view of the situation. RESULTS: The data were analysed along 3 dimensions: work and environmental, desaturation bubbles, oxidative stress and inflammation. The results showed little or no variations from the reference values. No bubbles were detected after excursion dives and the final decompression, except for two divers with a grade 1 after arriving at surface. No statistical difference could be found between the Boskalis and the NORSOK saturation procedures. CONCLUSIONS: At a depth of 40-50 msw corresponding to the Danish sector, the two saturation procedures monitored induce no or little stress to the divers. The divers know how to manage their diet, equilibrate their hydration and pace their effort. Data available on divers' post saturation period show a recovery over the 24-48 hours following the end of the decompression. Further research should focus on diving deeper than 100 msw where a greater stress can be anticipated.

Bioimpedance as an alternative tool for subjective, visual scoring of a prevalent ham quality defect.

The detection of meat quality defects can involve both subjective and objective methods. PSE-like meat is linked to a common pork defect and can be caused by rapid post-mortem damage of muscle fibers. This damage can again be linked to various factors, such as a low ultimate pH or a higher slaughter weight. PSE-like defects are characterized by discoloration, structural damage, and excessive moisture loss. However, the lack of suitable instrument-based methods makes the detection of PSE-like defects difficult, and subjective methods typically suffer from poorer reproducibility. The objective of this study was to establish how subjective visual evaluation correlates with electrical impedance spectroscopy and with traditional quality parameters. To do so, visual scoring was performed together with measurements of bioimpedance, color, and pH in two ham muscles (Adductor, Semimembranosus) for 136 animals 24-hours post-mortem. When comparing with visual scoring, Pearson correlation analysis shows the strongest correlation for bioimpedance (Py , r = -0.46, R2 = 21%), followed by pHu (r = 0.44, R2 = 19%). When using all five quality measures, i.e., Py , pHu, and CIELAB L * a * b *, the multivariate regression model had a prediction error of 0.76 for the visual scores. This was close to the error describing the subjective bias of visual scoring, more specifically the prediction error between the two observers (0.85). In all, Py showed the strongest correlation among instrument-based quality tests and alone may be used for predicting pork ham structural defects, i.e., as an instrument-based alternative for subjective, visual scoring. However, an instrument that combines Py with pH and/or L*a*b* would improve the prediction of PSE-like quality defects.

Bioimpedance analysis for identifying new indicators of exercise-induced muscle damage.

A noninvasive, immediate, and convenient method for assessing muscle tissue status during exercise-induced muscle damage (EIMD) has not been established. This study was designed to assess and determine parameters suitable for measuring EIMD after eccentric exercise, using multi-frequency bioimpedance analysis (BIA). Thirty-five young male participants performed dumbbell exercises with their left arm, and their BIA parameters were measured at various time points up to 168 h post exercise using a multi-frequency BIA device. At all-time points, intra and extracellular water content was greater in the left arm than in the right arm, whereas the impedance, reactance, resistance, and phase angle were lower in the left arm than in the right arm. Established EIMD indices, such as maximal isometric voluntary contraction, were measured and used in correlational analyses. Only reactance was correlated with biomarkers, indicating muscle damage (r = - 0.56 to - 0.49). Furthermore, reactance was found to correlate well with indirect indicators of EIMD, suggesting that it may be a suitable marker for evaluating EIMD. However, the relationship with the limited evaluation indices employed in this study is constrained. Future studies should investigate the correlation between reactance and direct damage indicators, such as structural damage, observed in biopsies.

Cell growth monitoring in a tetrapolar electrode configuration.

There are various methods for cell growth monitoring. However, most of these methods have drawbacks, such as being invasive, not providing real-time results, or being costly. In this study, we present an alternate method of cell growth monitoring, which is low-cost, non-invasive, real-time, and uses Electrical Impedance Spectro-scopy (EIS). In this work, commercially available culture plates were fitted with custom tetrapolar electrodes, and mouse cells were cultured on them. The variation of culture media impedance, resulting from cell growth, proliferation and other metabolic activities, was recorded over a period of seven days. The results demonstrated an initial increase in impedance corresponding with the cell growth phase, followed by a decrease during the cell death (apoptosis) phase, as confirmed by microscope images. Overall, the results show that our method to monitor cell growth using tetrapolar electrodes is promising and can be further refined for related applications.

Timing of Breast Cancer Related Lymphedema Development Over 3 Years: Observations from a Large, Prospective Randomized Screening Trial Comparing Bioimpedance Spectroscopy (BIS) Versus Tape Measure.

BACKGROUND: The PREVENT randomized control trial monitored progression to chronic breast cancer-related lymphedema (cBCRL) following intervention for subclinical breast cancer-related lymphedema (sBCRL) assessed by bioimpedance spectroscopy (BIS) versus tape-measure (TM). This multi-institutional trial demonstrated a 92% risk reduction of developing cBCRL. This secondary analysis reviews the timing of sBCRL and cBCRL following breast cancer (BC) treatment. PATIENTS AND METHODS: Women at risk of cBCRL (n = 919) were screened regularly up to 36 months after BC treatment using either BIS or TM. Following diagnosis of sBCRL, patients underwent a 4-week compression sleeve intervention. The time in months from BC treatment to detection was reviewed at 3-month intervals. RESULTS: In total 209 patients developed sBCRL (BIS: n = 89, TM: n = 120) and were eligible for intervention. 30 progressed to cBCRL postintervention (BIS: 7, TM: 23). More than half of patients had measurements consistent with sBCRL within 9 months of BC treatment. Patients continued to have initial detections of sBCRL, regardless of screening method, with rates remaining consistent in years two and three (p > 0.242) post surgery. Additionally, 39 patients progressed to cBCRL without developing sBCRL or receiving intervention across the 3-year period. CONCLUSIONS: The timing of sBCRL detection demonstrates that patients continue to be at risk years after treatment and may continue to progress to cBCRL years after surgery. Early detection of sBCRL allows for early intervention decreasing the likelihood of progression to cBCRL. Patients should continue to be monitored for a minimum of 3 years following completion of cancer treatment. Specifically, careful targeted monitoring over the initial 9-month period is important.

[Bioimpedance analysis of body composition and rest energy expenditure in highly trained cross-country skiers].

The body composition monitoring using bioimpedance analysis (BIA) is important in assessing the functional state of athletes in sports. Based on changes of body composition, it is possible to optimize the actual dietary intake, as well as successfully organize the training process. The purpose of this research was to conduct a comparative assessment of BIA parameters and rest energy expenditure (REE) in highly trained cross-country skiers and young non-athletes. Material and methods. The members of the national cross-country skiing team from the Komi Republic and Russian Federation (n=30; age - 22.3±2.7 years) were examined. Practically healthy medical students served as a control group for the present study (n=40; age - 20.2±2.4 years). The participants successively passed the following study steps: assessment of the body composition by BIA (ACCUNIQ BC380), REE determination by indirect non-fasting calorimetry and calculation technique. Results. The parameters of total body water, fat-free mass, lean tissue and body cell mass were higher in contrast to the fat mass percentage in the athletes (р<0.001). The calculated REE was lower than measured REE among all the participants. At the same time, the REE calculated by the Ketch-McArdle formula significantly differed between the groups, while no differences were found between the REE calculated by the Harris-Benedict prediction equation. The measured REE were significantly higher by 16% (p<0.001) i n athletes compared to those in the control group. Conclusion. The body composition of athletes was distinguished by a significantly higher amounts of total body water, fat-free mass, skeletal muscle, active cell mass, and lower percentage of fat mass compared to healthy untrained individuals. The results obtained among athletes coincided with the idea that the magnitude of REE is determined by the mass of metabolically active tissues and to a lesser extent depends on the fat mass. BIA results can be used to monitor athletes' body composition during the training process.

Axillary Reverse Mapping Aids in Reducing the Rates of Breast Cancer-Related Lymphedema in Underserved Ethnically Diverse Population.

BACKGROUND: Breast cancer-related lymphedema (BCRL) poses a significant risk following sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND), particularly affecting ethnic minorities, with a twofold increased risk. Axillary reverse mapping (ARM), a novel technique, shows potential in reducing BCRL rates, yet its utility in ethnic minorities lacks sufficient exploration. Therefore, our study aims to investigate the utility and outcomes of ARM on BCRL in an ethnic diverse group. METHODS: A retrospective chart review of ARM patients from January 2019 to July 2022 was conducted, monitoring patients over 24 months at 3-month intervals using SOZO® scores, with comparisons with preoperative baselines. RESULTS: Of the 212 patients, 83% belonged to ethnic minorities. SLNB was performed in 83%, ALND in 17%, and 62.3% underwent radiation therapy. Positive lymph nodes were found in 31.6%, with 22.2% exhibiting blue nodes and 25.9% exhibiting blue lymphatics. Of identified blue nodes, 70.2% were excised, including 51.5% crossover nodes. Lymphedema occurred in 3 patients, resulting in a BCRL rate of 1.4%. Compared with an historical BCRL incidence of 40.4% following ALND in ethnic minorities, our study reported a significantly lower rate of 8% (p < 0.001). CONCLUSION: The ARM procedure can significantly lower BCRL in ethnic minority groups. The combination of ARM and bioimpedance spectroscopy led to a remarkably low BCRL rate of 1.4%. Notably, none of the patients in our study developed an axillary recurrence at 24-month follow-up. Nevertheless, future studies with larger sample sizes are warranted to better understand the utility of the ARM technique in this population.

Mediterranean ketogenic diet accounts for reduced pain frequency and intensity in patients with chronic migraine: A pilot study.

BACKGROUND: An increasing amount of evidence suggests that migraine is a response to cerebral energy deficiencies or oxidative stress levels that exceed antioxidant capacity. Current pharmacological options are inadequate in treating patients with chronic migraine, and a growing interest focuses on nutritional approaches as non-pharmacological treatments. The ketogenic diet, mimicking fasting that leads to an elevation of ketone bodies, is a therapeutic intervention targeting cerebral metabolism that has recently shown great promise in the prevention of migraines. Moreover, Mediterranean elements like vegetables, nuts, herbs, spices, and olive oil that are sources of anti-inflammatory elements (omega-3 fatty acids, polyphenols, vitamins, essential minerals, and probiotics) may create a positive brain environment by reducing imbalance in the gut microbiome. METHODS: On the basis of these indications, a combined Mediterranean-ketogenic diet was administered to chronic migraine patients for 4 (T1) and 8 weeks (T2), and anthropometric estimations were collected at T1 and T2 while biochemical parameters at only T2. RESULTS: A significant reduction (p < 0.01) in migraine frequency and intensity was detected as early as 4 weeks of dietary intervention, which was associated with a reduced fat mass (p < 0.001) as well as Homa index (p < 0.05) and insulin levels (p < 0.01) after 8 weeks. CONCLUSION: Overall, Mediterranean-ketogenic diet may be considered an effective non-pharmacological intervention for migraine, with positive outcomes on body composition.

The association between the change in severity score from baseline and the outcomes of critically ill patients was enhanced by integration of bioimpedance analysis parameters.

The study of the outcomes of critically ill patients has been a hard stuff in the field of intensive care. To explore the relationship between changes of severity scores, bioelectrical impedance analysis (BIA) and outcomes of critically ill patients, we enrolled patients (n = 206) admitted to intensive care unit (ICU) in Jinling Hospital from 2018 to 2021 with records of BIA on the days 1- and 3- ICU. Collected BIA and clinical data including simplified acute physiology score II (SAPS II) and sequential organ failure assessment. According to the baseline and change of severity scores or phase angle (PA) values, the patients were divided into: G-G, baseline good status, 3rd day unchanged; G-B, baseline good status, 3rd day deteriorated; B-G, baseline bad status, 3rd day improved; and B-B, baseline bad status, 3rd day unchanged. According to PA, the mortality of group G-G was 8.6%, and it was greater than 50% in group B-B for severity scores. The new score combining PA and severity scores established. Multivariate logistic regression analysis revealed that PA-SAPS II score was the only independent factor for 90-day mortality (P < 0.05). A linear correlation was found between mortality and PA-SAPS II score (prediction equation: Y ( % ) = 16.97 × X - 9.67 , R2 = 0.96, P < 0.05).

Development of a Tetherless Bioimpedance Device That Uses Morphologic Changes to Predict Blood Flow Restrictions Mimicking Peripheral Artery Disease Progression.

A tetherless multi-targeted bioimpedance device was designed, modeled, built, and tested for measuring arterial pulse and, using morphological analysis, its potential for monitoring blood flow restrictions that mimic Peripheral Artery Disease (PAD) was assessed across multiple peripheral arteries. Specifically, we first developed a small form factor, tetherless, bioimpedance device, based on high-frequency structure simulator (HFSS) simulations. After designing and building the device we then tested it in vivo on human subjects on multiple arteries and found that we did not need to modify the gain on the device compared to the bench top system. Further, it was found that changes in the morphology of the bioimpedance signal over time, depicted through the ratio of the first and second harmonic in the signal frequency, could be used to predict blood flow restrictions that mimic peripheral artery disease (PAD). The HFSS simulations helped guide the modulation frequency selection and the placement of the bioimpedance electrodes. We built the device and compared it to two commercially available bioimpedance devices and it was shown to demonstrate a distinct advantage in its multi-target capability, enabling more accurate pulse measurements from different arteries without the need for tuning the circuit for each artery. Comparing the ratio of the 1st and 2nd harmonics as a function of the blood flow restriction, the two commercial devices showed a maximum error across arteries of between 22% and 27% depending on the measurement location, whereas our system consistently displayed a stable value of just below 4%. With this system, there is the potential for comprehensive and personalized medical examinations for PAD at the point of care (POC).

Machine learning-enhanced gesture recognition through impedance signal analysis.

Gesture recognition is a crucial aspect in the advancement of virtual reality, healthcare, and human-computer interaction, and requires innovative methodologies to meet the increasing demands for precision. This paper presents a novel approach that combines Impedance Signal Spectrum Analysis (ISSA) with machine learning to improve gesture recognition precision. A diverse dataset that included participants from various demographic backgrounds (five individuals) who were each executing a range of predefined gestures. The predefined gestures were designed to encompass a broad spectrum of hand movements, including intricate and subtle variations, to challenge the robustness of the proposed methodology. The machine learning model using the K-Nearest Neighbors (KNN), Gradient Boosting Machine (GBM), Naive Bayes (NB), Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM) algorithms demonstrated notable precision in performance evaluations. The individual accuracy values for each algorithm are as follows: KNN, 86%; GBM, 86%; NB, 84%; LR, 89%; RF, 87%; and SVM, 87%. These results emphasize the importance of impedance features in the refinement of gesture recognition. The adaptability of the model was confirmed under different conditions, highlighting its broad applicability.

[Safety and efficacy of a therapeutic exercise program in young adults with repaired congenital diaphragmatic hernia]. / Seguridad y eficacia de un programa de ejercicio terapéutico en jóvenes intervenidos de hernia diafragmática congénita.

INTRODUCTION AND OBJECTIVE: Patients with congenital diaphragmatic hernia (CDH) can have up to 40 times more frequency of muskuloskeletal deformities and decreased perception of physical activity tan their pairs. The objective of this study is to evaluate the safety and efficacy of an individualized exercise program in late adolescents and young adults with repaired CDH, as well as a description of their basal status. MATERIAL AND METHODS: Non randomized prospective trial of 13 patients with repaired CDH between 1997-2005. An initial physical exploration and a pre-post assessment of bioimpedance (BIA), dynamometry, maximal inspiratory and expiratory pressure (MIP/MEP), 6-minute walk test (6MWT), physical activity level (IPAQ) and quality of life (QoL) was made. The training program last for 4 weeks. For the statistical analysis, the Student's t test for paired samples and Wilcoxon test were used. RESULTS: 77% (n=10) were male with a mean age of 19.23±2.13 years. In baseline BIA, 62% (n=8) had truncal sarcopenia that improved in -0.43±0.58, and P=.016. MIP, MEP, 6MWT and QoL tests increased by -7.27±8.26 cmH2O, P=.008; -11.91±10.20 cmH2O, P=.002; -70.63±17.88 m, P=.001; -42,19±26.79, P=.00 respectively. The IPAQ did not change significantly (P=0.86), however the time dedicated to muscle strengthening increased. No adverse effects were reported. CONCLUSIONS: A personalized rehabilitation program is safe and could improve the respiratory muscle strength and truncal sarcopenia as well as the submaximal effort capacity in late adolescents and young adults with repaired CDH.

Assessment of volume status of pediatric hemodialysis patients.

BACKGROUND: Accurate volume status assessment and dry weight achievement are the most challenging goals for a nephrologist. We aimed to evaluate the role of ultrasonographic parameters including lung ultrasound and inferior vena cava (IVC) measurements as practical methods of volume status assessment in children on hemodialysis by comparing them with established techniques, such as clinical evaluation and bioimpedance spectroscopy. METHODS: A prospective cross-sectional study compared pre- and post-dialysis volume status using bioimpedance spectroscopy (BIS) parameters and clinical data with ultrasonographic lung B-lines and IVC parameters in children on regular hemodialysis. RESULTS: A total 60 children (mean age 9.4 ± 2.8 years) were enrolled. Twenty patients (33.3%) were clinically overloaded to varying degrees (17 patients had mild to moderate signs of fluid overload and 3 patients had moderate to severe signs of fluid overload). All other patients (66.7%) were clinically euvolemic. Sonographic parameters were significantly lower post-dialysis than pre-dialysis, including lung B-line count and IVC diameter. IVC collapsibility index mean was significantly higher post-dialysis than pre-dialysis. There was a significant correlation between the lung B-line count, IVC parameters, and BIS-measured overhydration both before and after hemodialysis. Nine patients had ≥ 8 B-lines post-dialysis, only three of them were hypertensive. CONCLUSIONS: Clinical criteria alone are not specific for determining accurate fluid status in pediatric hemodialysis patients. Lung B-line score, IVC parameters, and BIS may be complementary to each other and to clinical data. Lung B-lines outperform IVC measurements and BIS in subclinical volume overload detection in pediatric hemodialysis patients.

SGLT2 Inhibitors Correct Fluid Overload in Adult Kidney Transplant Recipients-A Prospective Observational Study.

In this longitudinal observational study, we measured urinary glucose concentration, body composition and volume status (bioimpedance spectroscopy) and plasma renin and aldosterone concentrations in n = 22 kidney transplant recipients (KTRs) initiating on SGLT2I at baseline (BL), and after 1 week and 1, 3, and 6 months. Estimated glomerular filtration rate (eGFR) decreased by -2 mL/min/1.73 m2 (IQR -10-0) after 1 week and remained stable thereafter. Urinary glucose concentration was 10 (3-24) g/g creatinine after 1 week and correlated with eGFR (r2 = 0.273; p = 0.057). SGLT2I did not affect HbA1c, fasting blood glucose, body weight, fat or lean mass. SGLT2I decreased fluid overload dependent on baseline overhydration (OH, r2 = 0.54, p = 0.0003) without occurrence of dehydration. Plasma aldosterone increased at day 7, while plasma renin did not change significantly. In conclusion, SGLT2I corrected fluid overload in patients with elevated overhydration at baseline, while in euvolemic KTRs fluid status remained stable without reduction of body water below the reference range, thus promoting the safety of SGLT2I therapy in patients following kidney transplantation. Glucosuria, together with effects of SGLT2I on blood glucose control and body weight, is attenuated in KTRs dependent on eGFR.

Integrating classification and regression learners with bioimpedance methods for estimating weight status in infants and juveniles from the southern Cuba region.

OBJECTIVE: The search for other indicators to assess the weight and nutritional status of individuals is important as it may provide more accurate information and assist in personalized medicine. This work is aimed to develop a machine learning predictions of weigh status derived from bioimpedance measurements and other physical parameters of healthy younger volunteers from Southern Cuba Region. METHODS: A pilot random study at the Pediatrics Hospital was conducted. The volunteers were selected between 2002 and 2008, ranging in age between 2 and 18 years old. In total, 776 female and male volunteers are studied. Along the age and sex in the cohort, volunteers with class I obesity, overweight, underweight and with normal weight are considered. The bioimpedance parameters are obtained by measuring standard tetrapolar whole-body configuration. The bioimpedance analyser is used, collecting fundamental bioelectrical and other parameters of interest. A classification model are performed, followed by a prediction of the body mass index. RESULTS: The results derived from the classification leaner reveal that the size, body density, phase angle, body mass index, fat-free mass, total body water volume according to Kotler, body surface area, extracellular water according to Kotler and sex largely govern the weight status of this population. In particular, the regression model shows that other bioparameters derived from impedance measurements can be associated with weight status estimation with high accuracy. CONCLUSION: The classification and regression predictive models developed in this work are of the great importance to assist the diagnosis of weigh status with high accuracy. These models can be used for prompt weight status evaluation of younger individuals at the Pediatrics Hospital in Santiago de Cuba, Cuba.

Phase angle and impedance ratio as meta-inflammation biomarkers after a colon cleansing protocol in a group of overweight young women.

Objective. Blood C-reactive protein (CRP) and the electrical bioimpedance spectroscopy (EBIS) variables phase angle (PhA) and impedance ratio (IR) have been proposed as biomarkers of metainflammation in overweight/obesity. CRP involves taking blood samples, while PhA and IR imply a less-than-2-minute-non-invasive procedure. In this study, values for these variables and percent body fat mass (PBFM) were obtained and compared before and immediately after a colon cleansing protocol (CCP), aimed at modulating intestinal microbiota and reducing metainflammation, as dysbiosis and the latter are intrinsically related, as well as along a period of 8 weeks after it.Approach. 20 female volunteers (20.9-24.9 years old) participated: 12 in an overweight group (OG), and 8 in a lean group (LG). TheOGwas divided in two subgroups (n= 6, each): control (CSG) and experimental (ESG). TheESGunderwent a 6-day CCP at week 2, while 5 volunteers in theCSGunderwent it at week 9.Main results.Pre/post-CCP mean values for the variables in theOGwere: PBFM (34.3/31.3%), CRP (3.7/0.6 mg dl-1), PhA (6.9/7.5°) and IR*10 (0.78/0.77). CalculatedR2correlation factors among these variables are all above 0.89. The favourable changes first seen in theESGwere still present 8 weeks after the CCP.Significance.(a) the CCP drastically lowers meta-inflammation, (b) EBIS can be used to measure metainflammation, before and after treatment, (c) for microbiota modulation, CCP could be a good alternative to more drastic procedures like faecal microbiota transplantation; (d) reestablishing eubiosis by CCP could be an effective coadjutant in the treatment of overweight young adult women.

Phase angle as an indicator of body composition and physical performance in handball players.

BACKGROUND: Phase angle (PhA), obtained from the bioimpedance analysis, is widely used in clinical situations and in sports. This study evaluated the association between PhA with body composition and physical performance of handball athletes. METHODS: 43 national-level players (22.19 ± 3.86 years) of both sexes were evaluated regarding anthropometry, body composition, squat (SJ) and countermovement (CMJ) jumps, handgrip strength, and cardiorespiratory fitness. RESULTS: We verified a correlation between PhA of the whole body and fat-free mass (r = 0.511), body mass index (r = 0.307), and body fat % (r = -0.303). There was a positive correlation between PhA of the whole body and SJ (r = 0.376), CMJ (r = 0.419), and handgrip for the dominant hand (r = 0.448). Moreover, PhA of the upper limbs was more strongly correlated with handgrip for the dominant (r = 0.630) and non-dominant hand (r = 0.575) compared to PhA of the whole body considering both sexes. Similarly, segmental PhA had a stronger significant correlation with SJ (r = 0.402) and handgrip for the dominant hand (r = 0.482) in males, as well as CMJ (r = 0.602) in females, compared to PhA of the whole body. CONCLUSION: PhA of the whole body was positively related to fat-free mass, body mass index, body fat %, and lower- and upper-limbs strength in handball athletes. Segmental PhA might be used as a tool for estimating lower and upper limbs performance considering the sex, in preference to the PhA of the whole body.

The role of various physiological and bioelectrical parameters for estimating the weight status in infants and juveniles cohort from the Southern Cuba region: a machine learning study.

OBJECTIVE: The search for other indicators to assess the weight status of individuals is important as it may provide more accurate information and assist in personalized medicine.This work is aimed to develop a machine learning predictions of weigh status derived from bioimpedance measurements and other physical parameters of healthy infant juvenile cohort from the Southern Cuba Region, Santiago de Cuba. METHODS: The volunteers were selected between 2002 and 2008, ranging in age between 2 and 18 years old. In total, 393 female and male infant and juvenile individuals are studied. The bioimpedance parameters are obtained by measuring standard tetrapolar whole-body configuration. A classification model are performed, followed by a prediction of other bioparameters influencing the weight status. RESULTS: The results obtained from the classification model indicate that fat-free mass, reactance, and corrected resistance primarily influence the weight status of the studied population. Specifically, the regression model demonstrates that other bioparameters derived from impedance measurements can be highly accurate in estimating weight status. CONCLUSION: The classification and regression predictive models developed in this work are of the great importance for accessing to the weigh status with high accuracy of younger individuals at the Oncological Hospital in Santiago de Cuba, Cuba.