Reliability of Multifrequency Bioelectrical Impedance Analysis to Quantify Body Composition in Patients After Musculoskeletal Trauma

BackgroundChanges in body composition, especially loss of lean mass, commonly occur in the orthopedic trauma population due to physical inactivity and inadequate nutrition. The purpose of this study was to assess inter-rater and intra-rater reliability of a portable bioelectrical impedance analysis (BIA) device to measure body composition in an orthopedic trauma population after operative fracture fixation. BIA uses a weak electric current to measure impedance (resistance) in the body and uses this to calculate the components of body composition using extensively studied formulas.MethodsTwenty subjects were enrolled, up to 72 hours after operative fixation of musculoskeletal injuries and underwent body composition measurements by two independent raters. One measurement was obtained by each rater at the time of enrollment and again between 1-4 hours after the initial measurement. Reliability was assessed using intraclass correlation coefficients (ICC) and minimum detectable change (MDC) values were calculated from these results.ResultsInter-rater reliability was excellent with ICC values for body fat mass (BFM), lean body mass (LBM), skeletal muscle mass (SMM), dry lean mass (DLM), and percent body fat (PBF) of 0.993, 0.984, 0.984, 0.979, and 0.986 respectively. Intra-rater reliability was also high for BFM, LBM, SMM, DLM, and PBF, at 0.994, 0.989, 0.990, 0.983, 0.987 (rater 1) and 0.994, 0.988, 0.989, 0.985, 0.989 (rater 2). MDC values were calculated to be 4.05 kg for BFM, 4.10 kg for LBM, 2.45 kg for SMM, 1.21 kg for DLM, and 4.83% for PBF.ConclusionPortable BIA devices are a versatile and attractive option that can reliably be used to assess body composition and changes in lean body mass in the orthopedic trauma population for both research and clinical endeavors. Level of Evidence: III     

Citric Acid Fermentation

Abstract

Dielectrophoresis is the motion of particles caused by electrical polarization effects in inhomogeneous (nonuniform) electric fields. Unlike electrophoresis, the particles do not require a net electrical charge for motion to occur and AC rather than DC fields are employed to exploit the dielectric properties of the particles. Factors controlling the effective dielectric properties of cells and microorganisms include electrical double layers associated with surface charges, the conductivity and permittivity of their membranes and any cell walls, and their morphologies and structural architectures. In recent years, several laboratories have developed separation and manipulation techniques for cells and microorganisms based on dielectrophoresis, using both static and traveling AC fields. In this article, the basic physical factors influencing the dielectrophoretic behavior of particles are outlined, and ways in which these can be employed to achieve selective separation of cells and microorganisms are described.     

Circadian Rhythms in Human Body Composition

The study investigates how the human body composition (BC) changes as a function of the day-night cycle. The BC was investigated using bioelec-trical impedance analysis (BIA) of 10 clinically healthy subjects (CHS), mon-itored in supine position (readings at 2-h intervals), avoiding mealtimes, di-etary abuses, and bladder and intestinal retention. Time series data were analyzed for their temporal characteristics and circadian rhythm (CR). Ail the variables of BC (lean body mass, fat body mass, body cell mass, total body water, intracellular and extracellular body water, sodium and potassium exchangeable pool) showed a within-day variability with nighttime crests. Such an oscillatory synchronism corroborates the hypothesis that the rest time plays a fundamental role, via its anabolic effects, in conferring the noc-turnal phase to the CR of the human BC.     

Estimation of human body composition by electrical impedance methods: a comparative study

This study 1) further validated the relationship between total body electrical conductivity (TOBEC) and densitometrically determined lean body mass (LBMd) and 2) compared with existing body composition techniques (densitometry, total body water, total body potassium, and anthropometry) two new electrical methods for the estimation of LBM: TOBEC, a uniform current induction method, and bioelectrical impedance analysis (BIA), a localized current injection method. In a sample of 75 male and female subjects ranging from 4.9 to 54.9% body fat the correlation between LBMd and LBM predicted from TOBEC by use of a previously developed regression equation was extremely strong (r = 0.962), thus confirming the validity of the TOBEC method. LBM predicted from BIA by use of prediction equations provided with the instrument also correlated with LBMd (r = 0.912) but overestimated LBM compared with LBMd in obese subjects. However, no such systematic error was apparent when new prediction equations derived from this heterogeneous sample of subjects were applied. Thus the TOBEC and BIA methods, which are based on the differing electrical properties of lean tissue and fat and which are convenient, rapid, and safe, correlate well with more cumbersome human body composition techniques.     

The daily,weekly, and seasonal cycles of body temperature analyzed at large scale

ABSTRACT

We performed large-scale analyses of circadian and infradian cycles of human body temperature, focusing on changes over the day, week, and year. Temperatures (n= 93,225) were collected using temporal artery thermometers from a Boston emergency department during 2009–2012 and were statistically analyzed using regression with cyclic splines. The overall mean body temperature was 36.7°C (98.1°F), with a 95% confidence interval of 36.7–36.7°C (98.1–98.1°F) and a standard deviation of 0.6°C (1.1°F). Over the day, mean body temperature followed a steady cycle, reaching its minimum at 6:00–8:00 and its maximum at 18:00–20:00. Across days of the week, this diurnal cycle was essentially unchanged, even though activities and sleeping hours change substantially during the weekly cycles of human behavior. Over the year, body temperatures were slightly colder in winter than summer (~0.2°C difference), consistent with most prior studies. We propose these seasonal differences might be due to ambient effects on body temperature that are not eliminated because they fall within the tolerance range of the thermoregulatory system. Over the year, bathyphase (daily time of minimum temperature) appeared to parallel sunrise times, as expected from sunrise’s zeitgeber role in circadian rhythms. However, orthophase (daily time of maximum temperature) and sunset times followed opposite seasonal patterns, with orthophase preceding nightfall in summer and following nightfall in winter. Throughout the year, bathyphase and orthophase remained separated by approximately 12 h, suggesting this interval might be conserved. Finally, although 37.0°C (98.6°F) is widely recognized as the mean or normal human body temperature, analysis showed mean temperature was <37.0°C during all times of day, days of the week, and seasons of the year, supporting prior arguments that the 37.0°C standard has no scientific basis. Overall, this large study showed robust and consistent behavior of the human circadian cycle at the population level, providing a strong example of circadian homeostasis.     

Defence responses of Arabidopsis thaliana to infection by Pseudomonas syringae are regulated by the circadian clock

The circadian clock allows plants to anticipate predictable daily changes in abiotic stimuli, such as light; however, whether the clock similarly allows plants to anticipate interactions with other organisms is unknown. Here we show that Arabidopsis thaliana (Arabidopsis) has circadian clock-mediated variation in resistance to the virulent bacterial pathogen Pseudomonas syringae pv. tomato DC3000 (Pst DC3000), with plants being least susceptible to infection in the subjective morning. We suggest that the increased resistance to Pst DC3000 observed in the morning in Col-0 plants results from clock-mediated modulation of pathogen associated molecular pattern (PAMP)-triggered immunity. Analysis of publicly available microarray data revealed that a large number of Arabidopsis defence-related genes showed both diurnal- and circadian-regulation, including genes involved in the perception of the PAMP flagellin which exhibit a peak in expression in the morning. Accordingly, we observed that PAMP-triggered callose deposition was significantly higher in wild-type plants inoculated with Pst DC3000 hrpA in the subjective morning than in the evening, while no such temporal difference was evident in arrhythmic plants. Our results suggest that PAMP-triggered immune responses are modulated by the circadian clock and that temporal regulation allows plants to anticipate and respond more effectively to pathogen challenges in the daytime.     

Comparison between monorhinal and birhinal olfactory stimulations in bilateral electrodermal recordings

The study of olfactory lateralization in human subjects has given rise to many publications, but the findings have often been contradictory. Most research used either birhinal or monorhinal stimulations, but rarely a comparison between these two types of olfactory input. The aim of this study was to investigate variations in psychophysiological measurements and test each side of the nose and binasal performances. This work used bilateral electrodermal recordings and compared the skin conductance responses (SCRs) for a pleasant odorant (isoamyl acetate) and an unpleasant odorant (triethylamine) in a suprathreshold concentration on 30 dextral subjects (16 females and 14 males). First, the results reported no differences between the two nostrils but differences in electrodermal activity (EDA) in relation to the odorant: 1) higher amplitude in response to unpleasant versus pleasant odorant; 2) no differences between monorhinal and birhinal stimulations for the unpleasant odour but higher amplitude in response to birhinal versus monorhinal for the pleasant odour. Second, the results showed constant bilateral differences in EDA recordings and are discussed in terms of hemispheric asymmetry activation.     

Circadian stress tolerance in adult Caenorhabditis elegans

Circadian rhythms control several behaviors through neural networks, hormones and gene expression. One of these outputs in invertebrates, vertebrates and plants is the stress resistance behavior. In this work, we studied the circadian variation in abiotic stress resistance of adult C. elegans as well as the genetic mechanisms that underlie such behavior. Measuring the stress resistance by tap response behavior we found a rhythm in response to osmotic (NaCl LC(50) = 340 mM) and oxidative (H(2)O(2) LC(50) = 50 mM) shocks, with a minimum at ZT0 (i.e., lights off) and ZT12 (lights on), respectively. In addition, the expression of glutathione peroxidase (C11E4.1) and glycerol-3-phosphate dehydrogenase (gpdh-1) (genes related to the control of stress responses) also showed a circadian fluctuation in basal levels with a peak at night. Moreover, in the mutant osr-1 (AM1 strain), a negative regulator of the gpdh-1 pathway, the osmotic resistance rhythms were masked at 350 mM but reappeared when the strain was treated with a higher NaCl concentration. This work demonstrates for the first time that in the adult nematode, C. elegans stress responses vary daily, and provides evidence of an underlying rhythmic gene expression that governs these behaviors.     

Dendritic cell vaccination in an allogeneic stem cell recipient receiving a transplant from a human cytomegalovirus (HCMV)-seronegative donor: induction of a HCMV-specific Thelper cell response

Background aimsIn the absence of a protective immune response, human cytomegalovirus (HCMV) infection remains a life-threatening complication after allogeneic stem cell transplantation (SCT), especially in recipients of grafts from HCMV-seronegative donors. After allogeneic SCT from a seronegative donor, prolonged and severe immune deficiency often leads to infectious complications. Vaccination with antigen-loaded dendritic cells (DC) has been shown to be a potent approach for the induction of antigen-specific cytotoxic T-cell responses in vivo. For protection from subsequent HCMV reactivation, a sustained immune response is necessary, including antigen-specific CD4⁺ T cells.MethodsWe report the case of an 18-year-old girl with high-risk acute lymphoblastic leukemia that received an allogeneic SCT in CR2. After an HCMV infection, the graft was rejected and she received a second transplant from an HLA-mismatched, HCMV-seronegative family donor. She was treated with pp65-pulsed monocyte-derived DC at day 200 post-SCT, using a recombinant pp65 protein. Until day 200 post-SCT, HCMV reactivated six times with emerging viral resistance to antiviral chemotherapy.ResultsAfter vaccination with protein-pulsed DC, an induction and expansion of HCMV-specific T_helper cells and cytotoxic T lymphocytes was observed, associated with a sustained clearance of the HCMV viremia. Antiviral treatment could be tapered without recurrence of viremia within the first year post-SCT.Conclusionspp65-pulsed DC could induce antigen-specific T-cell responses even after a SCT from an HCMV-seronegative donor. After vaccination with pp65-pulsed DC, a sustained antigen-specific T-cell response prevented concurrent HCMV viremia. Emergence of antigen-specific T_helper cells may be essential for a sustained, functional T-cell response post-SCT.     

New bioimpedance model accurately predicts lower limb muscle volume: validation by magnetic resonance imaging

Conventional bioimpedance analysis (BIA) methods now simplify the representation of lower limb geometry and electrical properties for body composition estimation. In the present study, a three-dimensional model of the lower limb was assembled by segmentation of magnetic resonance cross-sectional images (MRI) for adipose tissue, skeletal muscle, and bone. An electrical network was then associated with this model. BIA and MRI measurements were made in six lean subjects (3 men and 3 women, age 32.2 +/- 6.9 yr). Assuming 0.85 S/m for the longitudinal conductivity of the muscle, the model predicted in the examined subjects an impedance profile that conformed well to the BIA impedance profile; predicted and measured resistances were similar (261.3 +/- 7.7 vs. 249 +/- 9 Omega; P = not significant). The resistance profile provided, through a simpler model, muscle area estimates along the lower limb and total leg muscle volume (mean 4,534 cm(3) for men and 4,071 cm(3) for women) with a mean of the absolute value of relative error with respect to MRI of 6.2 +/- 3.9. The new approach suggests that BIA can reasonably estimate the distribution and volume of muscles in the lower extremities of lean subjects.     

在双脉冲光刺激下瞳孔系统的采样控制特性

本文用实验揭示了瞳孔对光动态反应具有采样控制特性。实验中采用各种不同时间间隔的双脉冲光,以开环的方式(Maxwellian View)刺激瞳孔,当双脉冲之间间隔较长时,瞳孔反应相当于对双脉冲光的两次脉冲分别产生瞬态收缩;当双脉冲时间间隔短于0.6s 时,其反应就成了一次瞬态收缩,与单个光脉冲所引起的瞳孔反应一样。同—受试者的多次实验结果相同,不同受试者所得结果也基本一致。故瞳孔对脉冲刺激光引起反应后,必须至少约隔0.6s 才能对另一次脉冲光产生反应,这就说明了瞳孔动态反应具有离散的采样控制特性。实验还进一步证明,瞳孔系统的控制机制是双重模式的控制:不同的刺激条件下,瞳孔反应可呈现为瞬态反应(AC)或持续反应(DC),瞬态反应的 AC 通道为离散的采样控制,持续反应的 DC 通道为连续控制。     

The extra domain A of fibronectin activates Toll-like receptor 4

Cellular fibronectin, which contains an alternatively spliced exon encoding type III repeat extra domain A (EDA), is produced in response to tissue injury. Fragments of fibronectin have been implicated in physiological and pathological processes, especially tissue remodeling associated with inflammation. Because EDA-containing fibronectin fragments produce cellular responses similar to those provoked by bacterial lipopolysaccharide (LPS), we examined the ability of recombinant EDA to activate Toll-like receptor 4 (TLR4), the signaling receptor stimulated by LPS. We found that recombinant EDA, but not other recombinant fibronectin domains, activates human TLR4 expressed in a cell type (HEK 293 cells) that normally lacks this Toll-like receptor. EDA stimulation of TLR4 was dependent upon co-expression of MD-2, a TLR4 accessory protein. Unlike LPS, the activity of EDA was heat-sensitive and persisted in the presence of the LPS-binding antibiotic polymyxin B and a potent LPS antagonist, E5564, which completely suppressed LPS activation of TLR4. These observations provided a mechanism by which EDA-containing fibronectin fragments promote expression of genes involved in the inflammatory response.     

Human Electroretinal Responses to Grating Patterns and Defocus Changes by Global Flash Multifocal Electroretinogram

The electrical response of the retina was examined as a function of retinal region, using stimuli of various spatial frequencies in the first experiment. In the second experiment, the regional response of the retina to defocus at high and low spatial frequencies was investigated. Twenty three subjects were recruited for global flash multifocal electroretinogram (mfERG) in experiment 1. Black and white gratings (printed on plastic transparent sheets) of four spatial frequencies (SF), 0.24, 1.2, 2.4 and 4.8 cycle per degree were presented in front of the mfERG stimulation. The amplitudes and implicit times of the direct (DC) and induced (IC) components of mfERG responses were pooled into six concentric rings for analysis. There was low amplitude DC at low SF, which increased with increasing SF, and which decreased with increasing eccentricity. The IC was high in amplitude at all SF and reduced in amplitude with increasing eccentricity. Our findings suggested that outer and inner retina had different characteristics in processing spatial details. In experiment 2, Twenty-three young adults were recruited for mfERG measurement. The retinal electrical responses for low (0.24cpd) and high (4.8cpd) SF under fully corrected conditions of short-term negative defocus (-2D) and short term positive defocus (+2D) conditions were measured. There was a sign-dependent response to defocus in the DC response, mainly in peripheral regions. The sign dependent response at low SF was more obvious than that at high SF, and was located more peripherally. The IC response showed no clear trends for either defocus condition. The human retina seems to have a decoding system for optical defocus, which was tuned for low spatial frequency, and was located in the retinal near periphery.     

Circadian clocks regulate adenylyl cyclase activity rhythms in human RPE cells

Genes and components of the circadian clock may represent relevant drug targets for diseases involving circadian dysfunctions. By exploiting an established cell line derived from human retinal pigment epithelium (HRPE), the cell constituting the blood-retinal barrier that is essential to maintain the visual functions of the sensorineural retina, we showed serum-shock induction of rhythmic changes in forskolin-evoked adenylyl cyclase (AC) activity. In the presence of Ca2+ and protein kinase A, the forskolin-induced AC activity is significantly, but not completely inhibited, suggesting the involvement of both Ca2+-sensitive and Ca2+-insensitive AC isoforms in the regulation of circadian rhythmicity in these cells. Semi-quantitative RT-PCR showed circadian profile in the expression of three AC isoforms, the Ca2+-inhibitable AC5 and AC6 and the Ca2+-insensitive AC7, and the clock genes hPer1 and hPer2. Our results demonstrate for the first time circadian rhythmicity in a human cell line, identifying the isoforms involved in the circadian profile of AC activity and showing a rhythmicity of the clock gene mRNA expression in these cells. Therefore, the results reported here provide evidence for an intertwine between AC/[Ca2+]i signalling pathways and Per genes in the HRPE circadian clockwork.     

The extra domain A from fibronectin targets antigens to TLR4-expressing cells and induces cytotoxic T cell responses in vivo

Vaccination strategies based on the in vivo targeting of Ags to dendritic cells (DCs) are needed to improve the induction of specific T cell immunity against tumors and infectious agents. In this study, we have used a recombinant protein encompassing the extra domain A from fibronectin (EDA), an endogenous ligand for TLR4, to deliver Ags to TLR4-expressing DC. The purified EDA protein was shown to bind to TLR4-expressing HEK293 cells and to activate the TLR4 signaling pathway. EDA also stimulated the production by DC of proinflammatory cytokines such as IL-12 or TNF-alpha and induced their maturation in vitro and in vivo. A fusion protein between EDA and a cytotoxic T cell epitope from OVA efficiently presented this epitope to specific T cells and induced the in vivo activation of a strong and specific CTL response. Moreover, a fusion protein containing EDA and the full OVA also improved OVA presentation by DC and induced CTL responses in vivo. These EDA recombinant proteins protected mice from a challenge with tumor cells expressing OVA. These results strongly suggest that the fibronectin extra domain A may serve as a suitable Ag carrier for the development of antiviral or antitumoral vaccines.     

USE OF BIOELECTRICAL IMPEDANCE ANALYSIS TO ASSESS BODY COMPOSITION OF SEALS

Abstract: Bioelectrical impedance analysis (BIA) measures resistance and reactance of a current as it passes through an organism. The validity of using BIA as a tool to measure body water content, and hence body composition and condition, was tested on harp and ringed seals. The resistance and reactance readings from BIA were compared to estimates of total body water (TBW) determined via tritiated water dilution. The relationship between resistance and TBW (% of body mass) was linear after logarithmic transformation and the two variables were highly correlated. We describe the electrode configuration and placements which provide reliable results in these seals. Our findings indicate that BIA has considerable potential as an inexpensive, rapid, and reliable technique for estimating body composition of phocid seals.     

The influence of posture change on measurements of relative body fat in the bioimpedance analysis method

The purpose of this study was to clarify the influence of posture change on relative body fat in the bioelectrical impedance analysis (BIA) method. The subjects were 30 Japanese healthy young adult males (age: 19.8 +/- 1.4 years, height: 172.3 +/- 5.8 cm, weight: 67.1 +/- 8.2 kg). We used devices with different body segment inductions, between the hand and foot (H-F BIA) and between hands (H-H BIA), and set four measurement conditions differing in posture (supine or sitting), during rest and measurement. The reliabilities of %BF in the H-H and H-F BIA methods were very high (r = 0.995, 0.966), and the relationship in %BF between the UW method and each BIA method was mid-range (r = 0.767, 0.709). Although there were no differences in %BF among different measurement postures in the H-F BIA method, %BF in the H-H BIA method increased significantly when the posture was changed just before measurement. This indicated that it is necessary to pay attention to the posture change just before measurement in the H-H BIA method.     

Pongamia pinnata influences the circadian variations of liver marker enzymes in hyperammonemic rats

In this study, the influences of Pongamia pinnata, an indigenous medicinal plant used in Ayurvedic and traditional Medicine in India, on the circadian variations of liver marker enzymes in ammonium chloride (AC) induced hyperammonemic rats were studied. Experimental rats (160 - 180 g) were divided into control, AC (daily i.p. injection of AC (100 mg kg^-1 body weight)) treated, AC + P. pinnata ethanolic leaf extract (PPEt) (300 mg kg^-1 body weight) treated and PPEt treated groups. Temporal characteristics (acrophase, amplitude and mesor) of liver marker enzymes; alkaline phosphatase (ALP), aspartate and alanine transaminases (ALT and AST) and γ-glutamyl transferase (GGT) were analyzed. Elevated liver marker enzymes (increased mesor and delayed acrophase of AST, ALT, ALP and GGT) were found in hyperammonemic rats. Administration of PPEt significantly alters these changes. Variations in acrophase, amplitude and r values were also found in control and experimental rats. The detectable circadian rhythms of hepatic marker enzymes and their alterations during AC/PPEt treatments, in the present study, deserve further investigation for the diagnosis and for the therapeutic efficacy of hyperammonemia.     

Neural network mosaic model for pupillary responses to spatial stimuli

A neural network mosaic model was developed to investigate the spatial-temporal properties of the human pupillary control system. It was based on the double-layer neural network model developed by Cannon and Robinson and the pupillary dual-path model developed by Sun and Stark. The neural network portion of the model received its input from a sensor array and consisted of a retina-like two-dimensional neuronal layer. The dual-path portion of the model was composed of interconnections of the neurons that formed a mosaic of AC transient and DC sustained paths. The spatial aggregates of the AC and DC signals were input to the AC and DC summing neurons, respectively. Finally, the weighted sum of the aggregate AC and DC signals provided the output for driving the pupillary response. An important property of the model was that it could adaptively learn from training samples by adjustment of the weights. The neural network mosaic model showed excellent performance in simulating both the traditional pupillary phenomena and the new spatial stimulation findings such as responses to change in stimulus pattern and shift of light spot. Moreover, the model could also be used for the diagnosis of clinical deficits and image processing in machine vision. Received: 12 December 1997 / Accepted in revised form: 22 April 1998