Abstract: Plan adaptation during the course of (chemo)radiotherapy of H&N cancer requires repeat CT scanning to capture anatomy changes such as parotid gland shrinkage. Hydration, applied to prevent nephrotoxicity from cisplatin, could temporarily alter the hydrogen balance and hence the captured anatomy. The aim of this study was to determine geometric changes of parotid glands as function of hydration during chemoradiotherapy compared to a control group treated with radiotherapy only.
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Digitalization enables public organizations to personalize their services, tuning them to the specific situation, abilities, and preferences of the citizens. At the same time, digital services can be experienced as being less personal than face-to-face contact by citizens. The large existing volume of academic literature on personalization mainly represents the service provider perspective. In contrast, in this paper we investigate what makes citizens experience a service as personal. The result are eight dimensions that capture the full range of individual experiences and expectations that citizens expressed in focus groups. These dimensions can serve as a framework for public sector organizations to explore the expectations of citizens of their own services and identify the areas in which they can improve the personal experiences they offer.
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Studies of brain size of children classified with ADHD appear to reveal smaller brains when compared to ‘normal’ children. Yet, what does this mean? Even with the use of rigorously screened case and control groups, these studies show only small, average group differences between children with and without an ADHD classification. However, academic textbooks used in the Netherlands often portray individual children with an ADHD classification as having a different, malfunctioning brain that necessitates medical intervention. This conceptualisation of ADHD might serve professional interests, but not necessarily the interests of children.
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Objective: Post-mortem computed tomography (PMCT) is an established method for disease, complications, and cause of death determination in both clinical and forensic cases. By adding intravascular infusion of contrast medium, computed tomography angiography (PMCTA) provides additional information on vascular structures and hemorrhages. When easily applicable and low in costs, this technique would be more frequently applied and of additional value to clinical and educational purposes, particularly in forensic scientific context. Materials and Methods: PMCTA was performed on 10 bodies of the anatomy department. First, a metal T-piece was inserted into the femoral artery as part of standard practice for conservation. Secondly, surplus contrast medium with sodium chloride was infused into the body through a catheter tube set attached to the metal T-piece, using a readily available enteroclysis pump from our radiology department. Results: With added costs of approximately € 266 (personnel and materials) and an additional procedure time of 15-20 minutes, successful infusion of contrast mixture was achieved with the enteroclysis pump. Partial or complete opacification was measured in 89% of arteries, with enhancement of soft tissue visualization. Conclusion: This study successfully evaluated an inexpensive and easy to use method to perform PMCTA for post-mortem investigations.
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Covid has flooded our lives with online encounters and interactions. We work, minding our image on screen, or struggle to socialise in a hall of mirrors. Geert Lovink considers what we have lost and how we can reclaim our bodies, relationships and shared physical spaces.
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Background: Lumbar multifidus (LM) is regarded as the major stabilizing muscle of the spine. The effects of exercise therapy in low back pain (LBP) are attributed to this muscle. A current literature review is warranted, however, given the complexity of LM morphology and the inconsistency of anatomical descriptions in the literature.Methods: Scoping review of studies on LM morphology including major anatomy atlases. All relevant studies were searched in PubMed (Medline) and EMBASE until June 2019. Anatomy atlases were retrieved from multiple university libraries and online. All studies and atlases were screened for the following LM parameters: location, imaging methods, spine levels, muscle trajectory, muscle thickness, cross-sectional area, and diameter. The quality of the studies and atlases was also assessed using a five-item evaluation system.Results: In all, 303 studies and 19 anatomy atlases were included in this review. In most studies, LM morphology was determined by MRI, ultrasound imaging, or drawings – particularly for levels L4–S1. In 153 studies, LM is described as a superficial muscle only, in 72 studies as a deep muscle only, and in 35 studies as both superficial and deep. Anatomy atlases predominantly depict LM as a deep muscle covered by the erector spinae and thoracolumbar fascia. About 42% of the studies had high quality scores, with 39% having moderate scores and 19% having low scores. The quality of figures in anatomy atlases was ranked as high in one atlas, moderate in 15 atlases, and low in 3 atlases.Discussion: Anatomical studies of LM exhibit inconsistent findings, describing its location as superficial (50%), deep (25%), or both (12%). This is in sharp contrast to anatomy atlases, which depict LM predominantly as deep muscle. Within the limitations of the self-developed quality-assessment tool, high-quality scores were identified in a majority of studies (42%), but in only one anatomy atlas.Conclusions: We identified a lack of standardization in the depiction and description of LM morphology. This could affect the precise understanding of its role in background and therapy in LBP patients. Standardization of research methodology on LM morphology is recommended. Anatomy atlases should be updated on LM morphology.
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This contribution explores the anatomy of “safe uncertainty” in the research process of students in higher education. Uncertainty and research go hand in hand, as uncertainty is omnipresent in the process of research. Mostly in the background, but sometimes looming large in the foreground. We tend to expel uncertainty from research. We try to make the research process as predictable as possible by creating clear criteria, planning, making agreements and organizing supervision. Also with regard to the content, uncertainty has to be decreased. We try to reduce uncertainty by emphasizing precision, objectivity, logic, accountablility, measurability, validity, reliablility. And in the process, we are actually searching for the right concepts, language, or even shared images, in order to get as much grip as possible on the intangible research process.
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