Rationale: Patients with cancer of the upper gastrointestinal tract or lung are more likely to present with malnutrition at diagnosis than, for instance, patients with melanoma. Low muscle mass is an indicator of malnutrition and can be determined by computed tomography (CT) analysis of the skeletal muscle index (SMI) at the 3rd lumbar vertebra (L3) level. However, CT images at L3 are not always available. At each vertebra level, we determined if type of cancer, i.e., head and neck cancer (HNC), oesophageal cancer (OC) or lung cancer (LC) vs. melanoma (ME) was associated with lower SMI. Methods: CT images from adult patients with HNC, OC, LC or ME were included and analyzed. Scans were performed in the patient’s initial staging after diagnosis. MIM software version 7.0.1 was used to contour the muscle areas for all vertebra levels. Skeletal muscle area was corrected for stature to calculate SMI (cm2/m2). We tested for the association of HNC, OC, or LC diagnosis vs ME with SMI by univariate and multivariate linear regression analyses. In the multivariate analyses, age (years), sex, and body mass index (BMI; kg/m2) were included. Betas (B;95%CI) were calculated and statistical significance was set at p
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Purpose of reviewTo help guide metabolic support in critical care, an understanding of patients’ nutritional status and risk is important. Several methods to monitor lean body mass are increasingly used in the ICU and knowledge about their advantages and limitations is essential.Recent findingsComputed tomography scan analysis, musculoskeletal ultrasound, and bioelectrical impedance analysis are emerging as powerful clinical tools to monitor lean body mass during ICU stay. Accuracy, expertise, ease of use at the bedside, and costs are important factors, which play a role in determining, which method is most suitable. Exciting new research provides an insight into not only quantitative measurements, but also qualitative measurements of lean body mass, such as infiltration of adipose tissue and intramuscular glycogen storage.SummaryMethods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients at high nutritional risk and to evaluate metabolic support during critical illness.
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Bumping Elbows explores a workflow integrating 3D body scanning technology with robotic knitting to create personalized garments. Traditional 3D knitting development relies on 2D drafts and panels, rooted in industrial flatbed knitting practices. Our approach leverages accurate topology measurements from 3D body scans to directly inform garment design and production, allowing for custom fits to unique body shapes. We will demonstrate this process through live 3D scanning and software demonstrations, highlighting the challenges and opportunities integrating body scans and knitting techniques like goring. Our included software addresses limitations of previous work and outlines advancements needed for broader research adoption, emphasizing the potential of combining 3D scanning with robotic knitting. This method offers enhanced personalization and sustainability in garment production, showcasing the ongoing challenges and advancements in achieving precision in robotic knitting.
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Stereotactische radiotherapie van wervelmetastasen vereist een hoge precisie in alle stappen van de behandeling. Deze techniek werd in het VU medisch centrum in 2009 geïntroduceerd. Data met betrekking tot de behandeling van de eerste 17 klinische patiënten is geëvalueerd. Deze patiënten werden behandeld op een Novalis Tx versneller die beschikt over zowel een kilovolt (kV) cone beam CT (CBCT) scan als het ExacTrac® kV röntgensysteem. De gebruikte methode van de verschillende beeldmodaliteiten voor positionering en verificatie, de behandelingstijd en de intrafractie beweging worden in dit artikel beschreven.
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ObjectiveThe Plants for Joints (PFJ) intervention significantly improved pain, stiffness, and physical function, and metabolic outcomes, in people with metabolic syndrome-associated osteoarthritis (MSOA). This secondary analysis investigated its effects on body composition.MethodIn the randomized PFJ study, people with MSOA followed a 16-week intervention based on a whole-food plant-based diet, physical activity, and stress management, or usual care. For this secondary analysis, fat mass, muscle mass, and bone mineral density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n = 32), hepatocellular lipid (HCL) content and composition of visceral adipose tissue (VAT) were measured using magnetic resonance spectroscopy (MRS). An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyse between-group differences.ResultsOf 66 people randomized, 64 (97%) completed the study. The PFJ group experienced significant weight loss (−5.2 kg; 95% CI –6.9, −3.6) compared to controls, primarily from fat mass reduction (−3.9 kg; 95% CI –5.3 to −2.5). No significant differences were found in lean mass, muscle strength, or bone mineral density between groups. In the subgroup who underwent MRI scans, the PFJ group had a greater reduction in HCL (−6.5%; 95% CI –9.9, 3.0) compared to controls, with no observed differences in VAT composition.ConclusionThe PFJ multidisciplinary intervention positively impacted clinical and metabolic outcomes, and appears to significantly reduce body fat, including liver fat, while preserving muscle mass and strength.
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Background Emotional eating is a complex problem fostering obesity and resulting from maladaptive emotionregulation. Traditional behavioural weight loss interventions have shown insignificant effect. They can be improvedby targeting the specific needs of individuals with emotional eating.Objective The current study explored a tailored online approach with the aim to positively influence affect (positiveand negative) and emotion regulation by applying one of three exercises: body scan, opposite action, and positivereappraisal.Design An embedded mixed‑method design (questionnaire data (t0, t1, t2) and perceived usefulness of exercisesin t2) was used to evaluate the effects of a two‑week online quasi‑experimental pilot study.Subjects/setting In total, 80 participants with self‑reported emotional eating difficulties (DEBQ‑E; Memo = 3.48,SD = .64, range 1.62–4.92) finished baseline measurements; 15 completed the intervention. The study sample was pre‑dominantly female (95%), from 18 till 66 (Mage = 38,0 ± SD = 14.25).Results Participants reported that the exercises helped them to pay attention to their physical sensations, and to see positive aspects in negative matters. The exercises were considered difficult by the participants, with too littleexplanation, and dull, due to minor variation. The observed changes revealed small, and moreover, not significant improvements of the three exercises on positive and negative affect and overall emotion dysregulation. Although the quantitative results did not reach significance, the qualitative data highlighted which aspects of the tailored exer‑cises may have contributed to mood and emotion regulation outcomes. A notable observation in the present studyis the substantial dropout rate, with the number of participants decreasing from 80 at baseline (T0) to 15 at the post‑intervention stage (T2).Conclusions Future studies should identify tailored online exercises in emotion regulation skills in more detailand explore the contexts in which they are most effective in a personalized virtual coach virtual coach to be devel‑oped for individuals with emotional eating. Given the high dropout rate, more emphasis should be given to a properpresentation of the exercises, as well as more explanation of their usefulness and how to perform them.
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By use of a literature review and an environmental scan four plausible future scenarios will be created, based on the research question: How could the future of backpack tourism look like in 2030, and how could tourism businesses anticipate on the changing demand. The scenarios, which allow one to ‘think out of the box’, will eventually be translated into recommendations towards the tourism sector and therefore can create a future proof company strategy.
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In the Dutch armed forces clothing sizes are determined using 3D body scans. To evaluate if the predicted size based on the scan analysis matches the best fit, 35 male soldiers fitted a combat jacket and combat pants. It was shown that the predicted jacket size was slightly too large. Therefore, an adjustment was proposed. The predicted and preferred pant size matched rather well. We further investigated discrepancies between predicted and preferred sizes using virtual fitting analysis. Colour maps showing the difference between garment and body circumference illustrated that some soldiers selected a garment size that was obviously too small or too large. In order to minimize the effect of personal preference and maximize standardize ease, we recommend to maintain the current size prediction (with minor corrections for jackets) and use virtual fitting selectively as a control measure.
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Background & aims: Low muscle mass and -quality on ICU admission, as assessed by muscle area and -density on CT-scanning at lumbar level 3 (L3), are associated with increased mortality. However, CT-scan analysis is not feasible for standard care. Bioelectrical impedance analysis (BIA) assesses body composition by incorporating the raw measurements resistance, reactance, and phase angle in equations. Our purpose was to compare BIA- and CT-derived muscle mass, to determine whether BIA identified the patients with low skeletal muscle area on CT-scan, and to determine the relation between raw BIA and raw CT measurements. Methods: This prospective observational study included adult intensive care patients with an abdominal CT-scan. CT-scans were analysed at L3 level for skeletal muscle area (cm2) and skeletal muscle density (Hounsfield Units). Muscle area was converted to muscle mass (kg) using the Shen equation (MMCT). BIA was performed within 72 h of the CT-scan. BIA-derived muscle mass was calculated by three equations: Talluri (MMTalluri), Janssen (MMJanssen), and Kyle (MMKyle). To compare BIA- and CT-derived muscle mass correlations, bias, and limits of agreement were calculated. To test whether BIA identifies low skeletal muscle area on CT-scan, ROC-curves were constructed. Furthermore, raw BIA and CT measurements, were correlated and raw CT-measurements were compared between groups with normal and low phase angle. Results: 110 patients were included. Mean age 59 ± 17 years, mean APACHE II score 17 (11–25); 68% male. MMTalluri and MMJanssen were significantly higher (36.0 ± 9.9 kg and 31.5 ± 7.8 kg, respectively) and MMKyle significantly lower (25.2 ± 5.6 kg) than MMCT (29.2 ± 6.7 kg). For all BIA-derived muscle mass equations, a proportional bias was apparent with increasing disagreement at higher muscle mass. MMTalluri correlated strongest with CT-derived muscle mass (r = 0.834, p < 0.001) and had good discriminative capacity to identify patients with low skeletal muscle area on CT-scan (AUC: 0.919 for males; 0.912 for females). Of the raw measurements, phase angle and skeletal muscle density correlated best (r = 0.701, p < 0.001). CT-derived skeletal muscle area and -density were significantly lower in patients with low compared to normal phase angle. Conclusions: Although correlated, absolute values of BIA- and CT-derived muscle mass disagree, especially in the high muscle mass range. However, BIA and CT identified the same critically ill population with low skeletal muscle area on CT-scan. Furthermore, low phase angle corresponded to low skeletal muscle area and -density. Trial registration: ClinicalTrials.gov (NCT02555670).
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A growing body of evidence indicates that natural environments can positively influence people. This study investigated whether the use of motion nature projection in computed tomography (CT) imaging rooms is effective in mitigating psycho-physiological anxiety (vs. no intervention) using a quasirandomized experiment (N ¼ 97). Perceived anxiety and pleasantness of the room were measured using a questionnaire, and physiological arousal was measured using a patient monitor system. A mediation analysis showed that motion nature projection had a negative indirect effect on perceived anxietythrough a higher level of perceived pleasantness of the room. A linear-mixed-model showed that heart rate and diastolic blood pressure were lower when motion nature was projected. In conclusion, by creating a more pleasant imaging room through motion nature projection, hospitals can indirectly reduce patient's psycho-physiological anxiety (vs. no image projection) during a CT scan.
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