Development and validation of a point-of-care nursing mobile tool to guide the diagnosis of malnutrition in hospitalized adult patients: a multicenter, prospective cohort study.

Malnutrition is a prevalent and severe issue in hospitalized patients with chronic diseases. However, malnutrition screening is often overlooked or inaccurate due to lack of awareness and experience among health care providers. This study aimed to develop and validate a novel digital smartphone-based self-administered tool that uses facial features, especially the ocular area, as indicators of malnutrition in inpatient patients with chronic diseases. Facial photographs and malnutrition screening scales were collected from 619 patients in four different hospitals. A machine learning model based on back propagation neural network was trained, validated, and tested using these data. The model showed a significant correlation (p < 0.05) and a high accuracy (area under the curve 0.834-0.927) in different patient groups. The point-of-care mobile tool can be used to screen malnutrition with good accuracy and accessibility, showing its potential for screening malnutrition in patients with chronic diseases.

Protein Supplements with Short Peptides Are Better than Complex Protein-Based Supplements on Improving Early Fat-Free Mass Loss Following Bariatric Surgery: A Retrospective Cohort Study.

INTRODUCTION: Bariatric surgery (BS) patients are advised to consume protein supplements to prevent fat-free mass (FFM) loss. However, limited research has explored the efficacy of diverse protein presentations on FFM preservation. This study assesses if short peptide-based (SPB) supplements surpass complex protein-based (CPB) supplements in reducing early FFM loss post-surgery. METHODS: In this retrospective cohort study, 138 patients who underwent BS other than Roux-en-Y-gastric bypass (RYGB) between January 2021 and March 2021 at the Department of Bariatric Surgery of the Third People's Hospital of Chengdu were included for analysis. Patients were divided into two groups based on their consumption of protein supplements after surgery: SPB group and CPB group. Multiple linear regressions separated by sex were employed to examine the associations between SPB supplements and FFM loss and percentage of FFM (%FFM) loss, respectively. RESULTS: Among participants, 69.6% were female, with a mean age of 33.3 years. In multiple linear regression analyses, SPB supplements were significantly and positively associated with a lower FFM loss in both female (ꞵ = - 1.14, P = 0.047) and male (ꞵ = - 2.36, P = 0.024), and were positively associated with a lower %FFM loss in both female (ꞵ = - 1.83) and male (ꞵ = - 2.26) but only significant in male (P = 0.049). CONCLUSION: SPB supplements may be more effective in preventing early FFM loss after BS, compared to CPB supplements, particularly among male patients. Therefore, SPB supplements may be recommended to patients undergoing BS. Further research is needed to validate these findings.

A New Dietary Fiber Can Enhance Satiety and Reduce Postprandial Blood Glucose in Healthy Adults: A Randomized Cross-Over Trial.

BACKGROUND: Dietary fiber plays a potential role in regulating energy intake and stabilizing postprandial blood glucose levels. Soluble dietary fiber has become an important entry point for nutritional research on the regulation of satiety. METHODS: this was a double-blind, randomized cross-over trial enrolling 12 healthy subjects to compare the effects of RPG (R+PolyGly) dietary fiber products (bread, powder, and capsule) and pectin administered with a standard meal on satiety, blood glucose, and serum insulin level. RESULTS: Adding 3.8% RPG dietary fiber to bread significantly increased the volume, water content, hardness, and chewiness of bread compared to 3.8% pectin bread and white bread and significantly improved the sensory quality of bread. RPG bread had better appetite suppression effects at some time points than the other two groups and the best postprandial blood glucose lowering effects among the three groups. Administration of RPG capsules containing 5.6 g of RPG dietary fiber with meals improved satiety and reduced hunger compared to 6 g of RPG powder and 6 g of pectin, which had the greatest effect on suppressing appetite and reducing prospective food consumption. The peak level of serum glucagon-like peptide-1 (GLP-1) in the RPG capsule group (578.17 ± 19.93 pg/mL) was significantly higher than that in other groups at 0 min and 30 min after eating. RPG powder had the best effect in reducing postprandial blood glucose and increasing serum insulin levels; the total area under the curve (AUC) of serum insulin with RPG powder was higher than other groups (5960 ± 252.46 µU min/mL). CONCLUSION: RPG dietary fiber products can improve the sensory properties of food, reduce postprandial blood glucose, and enhance satiety, especially in capsule and powder forms. Further research on the physiological effects of RPG dietary fiber is required to facilitate its use as a functional ingredient in food products.

Establishing a machine learning model for predicting nutritional risk through facial feature recognition.

Background: Malnutrition affects many worldwide, necessitating accurate and timely nutritional risk assessment. This study aims to develop and validate a machine learning model using facial feature recognition for predicting nutritional risk. This innovative approach seeks to offer a non-invasive, efficient method for early identification and intervention, ultimately improving health outcomes. Methods: We gathered medical examination data and facial images from 949 patients across multiple hospitals to predict nutritional status. In this multicenter investigation, facial images underwent preprocessing via face alignment and cropping. Orbital fat pads were isolated using the U-net model, with the histogram of oriented gradient (HOG) method employed for feature extraction. Standardized HOG features were subjected to principal component analysis (PCA) for dimensionality reduction. A support vector machine (SVM) classification model was utilized for NRS-2002 detection. Our approach established a non-linear mapping between facial features and NRS-2002 nutritional risk scores, providing an innovative method for evaluating patient nutritional status. Results: In context of orbital fat pad area segmentation with U-net model, the averaged dice coefficient is 88.3%. Our experimental results show that the proposed method to predict NRS-2002 scores achieves an accuracy of 73.1%. We also grouped the samples by gender, age, and the location of the hospital where the data were collected to evaluate the classification accuracy in different subsets. The classification accuracy rate for the elderly group was 85%, while the non-elderly group exhibited a classification accuracy rate of 71.1%; Furthermore, the classification accuracy rate for males and females were 69.2 and 78.6%, respectively. Hospitals located in remote areas, such as Tibet and Yunnan, yielded a classification accuracy rate of 76.5% for collected patient samples, whereas hospitals in non-remote areas achieved a classification accuracy rate of 71.1%. Conclusion: The attained accuracy rate of 73.1% holds significant implications for the feasibility of the method. While not impeccable, this level of accuracy highlights the potential for further improvements. The development of this algorithm has the potential to revolutionize nutritional risk assessment by providing healthcare professionals and individuals with a non-invasive, cost-effective, and easily accessible tool.

Transmissive Digital Coding Metasurfaces for Polarization-Dependent Dual-Mode Quad Orbital Angular Momentum Beams.

In wireless communication systems, a multibeam can be used to increase the number of spatial channels by space-division multiplexing. Furthermore, the multimode is used to enhance the channel capacity by mode-division multiplexing. However, few of the previously reported methods cannot achieve independent controls of orbital angular momentum (OAM) states by transmissive metasurfaces in both space-division and mode-division multiplexing simultaneously. To expand the wireless communication channel, a multilayer transmissive digital coding metasurface with a single emitting source is demonstrated for quad-OAM beam generation with a dual mode. By changing the geometry of the cross dipole for a unit cell, the polarization-dependent 3-bit phase responses are obtained to flexibly manipulate the multi-OAM beams with different modes in preset directions simultaneously. Two types of metasurfaces are designed and fabricated to realize four OAM beams with two topological charges in different directions by encoding the phase sequence in x- and y-directions, which is validated by both theoretical analyses and experimental results. This scheme of transmissive digital coding metasurface provides a simple way to the multiplexing, multichannel, and multiplatform communication and imaging systems.

Eliminate the hardware: Mobile terminals-oriented food recognition and weight estimation system.

Food recognition and weight estimation based on image methods have always been hotspots in the field of computer vision and medical nutrition, and have good application prospects in digital nutrition therapy and health detection. With the development of deep learning technology, image-based recognition technology has also rapidly extended to various fields, such as agricultural pests, disease identification, tumor marker recognition, wound severity judgment, road wear recognition, and food safety detection. This article proposes a non-wearable food recognition and weight estimation system (nWFWS) to identify the food type and food weight in the target recognition area via smartphones, so to assist clinical patients and physicians in monitoring diet-related health conditions. In addition, the system is mainly designed for mobile terminals; it can be installed on a mobile phone with an Android system or an iOS system. This can lower the cost and burden of additional wearable health monitoring equipment while also greatly simplifying the automatic estimation of food intake via mobile phone photography and image collection. Based on the system's ability to accurately identify 1,455 food pictures with an accuracy rate of 89.60%, we used a deep convolutional neural network and visual-inertial system to collect image pixels, and 612 high-resolution food images with different traits after systematic training, to obtain a preliminary relationship model between the area of food pixels and the measured weight was obtained, and the weight of untested food images was successfully determined. There was a high correlation between the predicted and actual values. In a word, this system is feasible and relatively accurate for one automated dietary monitoring and nutritional assessment.

Multifunctional Coding-Feeding Metasurface Based on Phase Manipulation.

Multiple functionalities on a shared aperture are crucial for metasurfaces (MSs) in many applications. In this paper, we propose a coding-feeding metasurface (CFMS) with the multiple functions of high-gain radiation, orbital angular momentum (OAM) generation, and radar cross-section (RCS) reduction based on phase manipulation. The unit cell of the CFMS is composed of a rectangular emission patch and two quasi-Minkowski patches for reflective phase manipulation, which are on a shared aperture. The high-gain radiation and multiple modes of ±1, ±2, and ±3 OAM generation were realized by rationally setting the elements and the phase of their excitation. The CFMS presents a broadband RCS reduction of 8 dB from 3.18 GHz to 7.56 GHz for y-polarization and dual-band RCS reduction for x-polarization based on phase interference. To validate the concept of the CFMS, a prototype was fabricated and measured. The results of the measurement agree well with the simulation. A CFMS with the advantages of light weight and low profile has potential application in detection and wireless communication systems for stealth aircraft.

A Digital Smartphone-Based Self-administered Tool (R+ Dietitian) for Nutritional Risk Screening and Dietary Assessment in Hospitalized Patients With Cancer: Evaluation and Diagnostic Accuracy Study.

BACKGROUND: Malnutrition is a common and severe problem in patients with cancer that directly increases the incidence of complications and significantly deteriorates quality of life. Nutritional risk screening and dietary assessment are critical because they are the basis for providing personalized nutritional support. No digital smartphone-based self-administered tool for nutritional risk screening and dietary assessment among hospitalized patients with cancer has been developed and evaluated. OBJECTIVE: This study aims to develop a digital smartphone-based self-administered mini program for nutritional risk screening and dietary assessment for hospitalized patients with cancer and to evaluate the validity of the mini program. METHODS: We have developed the R+ Dietitian mini program, which consists of 3 parts: (1) collection of basic information of patients, (2) nutritional risk screening, and (3) dietary energy and protein assessment. The face-to-face paper-based Nutritional Risk Screening (NRS-2002), the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and 3 days of 24-hour dietary recall (3d-24HRs) questionnaires were administered according to standard procedure by 2 trained dietitians as the reference methods. Sensitivity, specificity, positive predictive value, negative predictive value, κ value, and correlation coefficients (CCs) of nutritional risk screened in R+ Dietitian against the reference methods, as well as the difference and CCs of estimated dietary energy and protein intakes between R+ Dietitian and 3d-24HRs were calculated to evaluate the validity of R+ Dietitian. RESULTS: A total of 244 hospitalized patients with cancer were recruited to evaluate the validity of R+ Dietitian. The NRS-2002 and PG-SGA-SF tools in R+ Dietitian showed high accuracy, sensitivity, and specificity (77.5%, 81.0%, and 76.7% and 69.3%, 84.5%, and 64.5%, respectively), and fair agreement (κ=0.42 and 0.37, respectively; CC 0.62 and 0.56, respectively) with the NRS-2002 and PG-SGA-SF tools administered by dietitians. The estimated intakes of dietary energy and protein were significantly higher (P<.001 for both) in R+ Dietitian (mean difference of energy intake: 144.2 kcal, SD 454.8; median difference of protein intake: 10.7 g, IQR 9.5-39.8), and showed fair agreement (CC 0.59 and 0.47, respectively), compared with 3d-24HRs performed by dietitians. CONCLUSIONS: The identified nutritional risk and assessment of dietary intakes of energy and protein in R+ Dietitian displayed a fair agreement with the screening and assessment conducted by dietitians. R+ Dietitian has the potential to be a tool for nutritional risk screening and dietary intake assessment among hospitalized patients with cancer. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900026324; https://www.chictr.org.cn/showprojen.aspx?proj=41528.

FOXP3 facilitates the invasion and metastasis of non-small cell lung cancer cells through regulating VEGF, EMT and the Notch1/Hes1 pathway.

Forkhead box P3 (FOXP3) is a specific marker of regulatory T cells (Tregs) that is also expressed in tumour cells. Previous studies have revealed that FOXP3 can promote metastasis in several types of cancer, including non-small cell lung cancer (NSCLC); however, the underlying mechanism of FOXP3 remains unclear. The aim of the present study was to investigate the effect of FOXP3 on vascular endothelial growth factor (VEGF), epithelial-to-mesenchymal transition (EMT) and the Notch1/Hes1 pathway in NSCLC. After FOXP3 small interfering RNA (siRNAs) were transfected into A549 cells, the expression of FOXP3 mRNA and protein was determined by reverse transcription-quantitative PCR and western blotting. Cell migration and invasion were analyzed by Transwell assays. The concentrations of matrix metalloproteinase (MMP)-2, MMP-9 and VEGF in the cell supernatant were evaluated by ELISA. The expression of relevant proteins involved in EMT and Notch1/Hes1 pathway were assessed via western blotting. Additionally, the expression of FOXP3, CD31 and E-cadherin was detected by immunohistochemical (IHC) staining of 55 human NSCLC tissue samples. The results demonstrated that FOXP3 knockdown significantly inhibited the cell migratory and invasive abilities, decreased the concentrations of MMP-2, MMP-9 and VEGF, downregulated the protein expression of vimentin, N-cadherin, Notch1 and Hes family BHLH transcription factor 1 (Hes1), and upregulated the protein expression of E-cadherin. Furthermore, FOXP3 expression was positively associated with CD31+ vascular endothelial cells and negatively correlated with E-cadherin in NSCLC tissues. In addition, the Notch1/Hes1 pathway inhibitor DAPT significantly downregulated the expression of FOXP3 in a dose-dependent manner. Taken together, these findings demonstrated that FOXP3 may facilitate the invasive and migratory abilities of NSCLC cells via regulating the angiogenic factor VEGF, the EMT and the Notch1/Hes1 pathway.

Facile synthesis of palladium nanoparticles on hierarchical hollow silica spheres and its catalytic properties in Suzuki-reaction.

A novel well-dispersed Pd@HHSS catalyst was synthesized by reduction of Pd(OAc)2 immobilized on HHSS we reported. When the ratios of Pd/SiO2 were 5 : 100 and 10 : 100, the Pd nanoparticles size was about 5-10 nm. The Pd@HHSS catalyst (Pd/SiO2 = 10 : 100) showed high catalytic activity in Suzuki-reaction with yields of 91-99% and the catalyst is reusable after four successive cycles without obvious loss of catalytic activity.