Systems, techniques and methods for estimating the metabolic state or flux, e.g., the body energy state (BES) of a patient, are disclosed. The BES provides a deep insight into the nutritional needs of the patient, thus allowing for a sort of exquisite glycemic control with regard to the patient. The invention discloses systems and methods for estimating fractional gluconeogenesis. The invention also discloses systems and methods for estimating and targeting patient blood lactate concentration, both as a target itself and as an intermediate step to estimating and targeting patient fractional gluconeogenesis glucose production. Nutritional support methods and formulations are also disclosed. The invention is suitable for any sort of patient, including those who are injured, such as with traumatic brain injury, ill, or have other conditions that stress the metabolic system.

The present invention describes a global metabolomic profile of patients with community acquired pneumonia (CAP) and sepsis. The metabolomic profile of endogenous small molecules blood was determined using mass-spectrometry. The global metabolomic profile in plasma demonstrated broad differences between CAP and sepsis patients when comparing those who do and do not survive at 90 days. Increases in specific metabolite biomarkers displayed on a heat map provide early diagnosis of these medical conditions to allow for early intervention and aggressive treatment.

A method for determining in a sample, by mass spectrometry, the amount of one or more analytes selected from the group consisting of N-acetylthreonine, TMAP, phenylacetylglutamine, tryptophan, creatinine, meso-erythritol, arabitol, myo-inositol, N-acetyl serine, N-acetylalanine, 3-methylhistidine, trans-4-hydroxyproline, kynurenine, urea, C-glycosyltryptophan, 3-indoxyl sulfate, pseudouridine, and combinations thereof is described. The method comprises subjecting the sample to an ionization source under conditions suitable to produce one or more ions detectable by mass spectrometry from each of the one or more of the analytes; measuring, by mass spectrometry, the amount of the one or more ions from each of the one or more analytes; and using the measured amount of the one or more ions to determine the amount of each of the one or more analytes in the sample. Also described is a kit comprising one or more isotopically labeled analogues as internal standards for each of the one or more analytes.

A diagnostic method for the prediction of tumor prognosis including the likelihood of formation of metastases or of relapse or local recurrence in tumor related diseases in a mammal and the provision of a therapy recommendation for a patient the enzyme activity of key enzymes of the energy metabolism is determined in fresh tumor tissue or fresh tumor cell mass after 24 hours incubation in a cell culture medium. Incubation reduces nutrition, drug and biopsy/surgery effects on the energy metabolism of the tissue slices or the cell mass. The quotients of enzyme activity of anaerobic enzymes are put in ratio to the enzyme activity of aerobic enzymes or vice versa. Said ratio can be taken into account for prognosis of metastasis and a therapy recommendation.

In some implementations, a system is capable of obtaining and processing both actively monitored and passively monitored data in parallel in order to improve the accuracy and the specificity by which pathological risks are identified for a user. Data indicating measured levels of one or more metabolic biomarkers and activity data associated with a user is obtained. A biological state for the user is determined based on the measured levels of the one or more metabolic biomarkers. One or more user inputs indicated within the activity data, and scores reflecting respective likelihoods that a particular user input indicates a change to one or more aspects of the biological state for the user for each of the one or more user inputs is determined. Data corresponding to the biological state for the user is then adjusted. A communication that is generated based on the adjusted data is then provided for output.

The invention provides methods of determining a therapeutically effective dose of an agent that targets a metabolic pathway based on measured levels of a metabolite in the pathway. The methods, which may include providing the agent in a therapeutically effective dose, are useful for treating disorders, such as cancer, in a subject. The invention also provides methods for assessing the impact of a therapeutic agent on a tumor in a subject by monitoring, in real time, metabolism of a molecule in the tumor, oxygenation of the tumor, or both. The invention further provides devices that determine a therapeutically effective dose of an agent that targets a metabolic pathway based on measured levels of a metabolite in the pathway and notify a subject to administer the dose.

Compositions and methods for determining post-transfusion survival or toxicity of red blood cells and the suitability of red blood cell units for transfusion by measuring the levels of one or more markers in a red blood cell sample are provided.

Compositions and methods for determining post-transfusion survival of platelets and the suitability of platelet units for transfusion by measuring the levels of one or more markers in a platelet sample are provided.

Provided are methods of antagonizing the oncogenic activity of FGF19 in a subject. Also provided are methods of treating a FGF19-dependent cancer or tumor, or a symptom thereof in a subject.

Systems and methods for sensing target molecules such as redox reactive agents, comprising a sample compartment and a sensing compartment being in fluid communication, are disclosed. A sensing compartment which comprises nanostructures to which a functional moiety is covalently attached and which is such that upon contacting a redox reactive agent a change in electrical property of the nanostructure occurs, and integration of such a sensing compartment with sensing systems as described herein are also disclosed. Methods of monitoring a metabolic activity of cells, and uses thereof, are also disclosed.