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Lisbôa FD, de Aguiar RA, Soares Pereira G, Caputo F. Acute Effects of a Practical Blood Flow Restriction Device During Swimming Exercise. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:466-475. [PMID: 37851855 DOI: 10.1080/02701367.2023.2263050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 09/11/2023] [Indexed: 10/20/2023]
Abstract
Purpose: The present study aimed to analyze: 1) the reliability of the tissue saturation index (TSI) and ratings of perceived discomfort (RPD) responses wearing a neoprene practical cuff (PrC), comparing with the responses from traditional (TrC) pneumatic cuffs (study I); 2) the effects of PrC on metabolic (blood lactate concentration, BLC), perceptual (rate of perceived effort, RPE) and kinematic responses at sub-maximal swimming velocities (study II). Methods: Study I; 1) PrC test-retest at rest and during swimming ergometer exercise; 2) BFR at rest with TrC inflated to different percentages of the minimum arterial occlusion pressure (MAOP; 60, 80, 100, 120 and 140%). Test-retest reliability of TSI and RPD was assessed by the intraclass correlation coefficient (ICC) and comparisons among conditions were analyzed by one-way repeated-measures ANOVA. Study II; 1) 50, 200 and 400 m swimming performances; 2) sub-maximal incremental swimming protocol with and without PrC. Two-way repeated measures ANOVA was used to compare all variables during sub-maximal velocities. Results: TSI (ICC = 0.81; 95%CI 0.62-0.91) and RPD (ICC = 0.97; 95%CI 0.94-0.99) were reliable under restricted exercise using PrC. TSI during restricted exercise was lower (p <.001) compared to unrestricted exercise (6.8 ± 6.1% vs. 21.6 ± 8.2% of physiological normalization). PrC showed higher BLC only at or above 91% of critical velocity (p < .03), while stroke rate and RPE were higher (p < .005), and stroke length was lower (p < .03) during all swimming velocities. Conclusion: This easy-to-handle and affordable practical BFR device increased physiological stress at sub-maximal efforts which could be an additional training tool for swimmers.
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Starkoff BE, Nickerson BS. Emergence of imaging technology beyond the clinical setting: Utilization of mobile health tools for at-home testing. Nutr Clin Pract 2024; 39:518-529. [PMID: 38591753 DOI: 10.1002/ncp.11151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Body composition assessment plays a pivotal role in understanding health, disease risk, and treatment efficacy. This narrative review explores two primary aspects: imaging techniques, namely ultrasound (US) and dual-energy x-ray absorptiometry (DXA), and the emergence of artificial intelligence (AI) and mobile health apps in telehealth for body composition. Although US is valuable for assessing subcutaneous fat and muscle thickness, DXA accurately quantifies bone mineral content, fat mass, and lean mass. Despite their effectiveness, accessibility and cost remain barriers to widespread adoption. The integration of AI-powered image analysis may help explain tissue differentiation, whereas mobile health apps offer real-time metabolic monitoring and personalized feedback. New apps such as MeThreeSixty and Made Health and Fitness offer the advantages of clinic-based imaging techniques from the comfort of home. These innovations hold the potential for individualizing strategies and interventions, optimizing clinical outcomes, and empowering informed decision-making for both healthcare professionals and patients/clients. Navigating the intricacies of these emerging tools, critically assessing their validity and reliability, and ensuring inclusivity across diverse populations and conditions will be crucial in harnessing their full potential. By integrating advancements in body composition assessment, healthcare can move beyond the limitations of traditional methods and deliver truly personalized, data-driven care to optimize well-being.
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Affiliation(s)
- Brooke E Starkoff
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Brett S Nickerson
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
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Kara ZG, Özdemir Kara D. Anthrometric dimensions and their impact on cardiovascular risk factors. Medicine (Baltimore) 2024; 103:e38140. [PMID: 38788016 PMCID: PMC11124677 DOI: 10.1097/md.0000000000038140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/15/2024] [Indexed: 05/26/2024] Open
Abstract
Central obesity is an important risk factor for cardiovascular disease. The abdominal subcutaneous adipose tissue thickness (ASATT) can be used to evaluate central obesity. The objective of this study was to compare ASATT with cardiovascular risk factors and other anthropometric parameters to show that ASATT can be a useful tool for the early assessment of heart disease risk. In this observational cross-sectional study, anthropometric measurements of 100 autopsied decedents, including waist circumference, hip circumference, waist/height and waist/hip ratio, aortic outlet and coronary artery atheroma plaque densities, heart weight, ventricular wall thickness, and ASATT, were assessed. The research data were evaluated using the Statistical Package for the Social Sciences for Windows 25.0. The average ASATT of the male group was 40.36 mm (SD: 11.00), and the average of female cases was 46.34 mm (SD: 18.12). There was no statistically significant difference between the sexes and both age groups in terms of the ASATT score (P > .05). There was a positive correlation between ASATT and waist circumference, hip circumference, and waist/height ratio in both sexes (P < .05). While ASATT was not related to atheroma density in the coronary arteries of men (P > .05), it was correlated with atheroma density in all 3 coronary arteries of women (P < .05). In the male group, the aortic inner surface atheroma density was positively correlated with ASATT (P < .05). In both sexes, there was a positive correlation (P < .05) between ASATT and heart weight; however, no such correlation was observed with right and left ventricular wall thickness (P > .05). ASATT is related to other anthropometric measurements, atherosclerosis of critical vessels, and heart weight, and can be used to scan the patient population for heart disease risk assessment with noninvasive methods.
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Affiliation(s)
- Zekiye Gözde Kara
- Department of Autopsy, Turkish Council of Forensic Medicine Ankara Head Office, Ankara, Turkey
| | - Doğuş Özdemir Kara
- Department of Pathology, Turkish Council of Forensic Medicine Ankara Head Office, Ankara, Turkey
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Hoffmann J, Thiele J, Kwast S, Borger MA, Schröter T, Schmidt J, Busse M. A new approach to quantify visceral fat via bioelectrical impedance analysis and ultrasound compared to MRI. Int J Obes (Lond) 2024; 48:209-217. [PMID: 37891402 PMCID: PMC10824659 DOI: 10.1038/s41366-023-01400-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/19/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Visceral adipose tissue (VAT) has been linked to systemic proinflammatory characteristics, and measuring it accurately usually requires sophisticated instruments. This study aimed to estimate VAT applying a simpler method that uses total subcutaneous fat and total body fat (BF) measurements. METHOD As part of our experimental approach, the subcutaneous fat mass (SFT) was measured via US (SFTtotal), and VAT was quantified by assessing MRI data. Both parameters were added to obtain total body fat (BFcalc). Those results were then compared to values obtained from a bioelectrical impedance analysis (BFBIA). Multiple regression analyses were employed to develop a simplified sex-specific equation for SFT, which was subsequently used in conjunction with BFBIA to determine VAT (VATEq). RESULT We observed excellent reliability between BFBIA and BFcalc, with no significant difference in body fat values (20.98 ± 8.36 kg vs. 21.08 ± 8.81 kg, p = 0.798, ICC 0.948). VATEq_female/male revealed excellent reliability when compared to VATMRI, and no significant difference appeared (women: 0.03 ± 0.66 kg with a 95% CI ranging from -1.26 kg to 1.32 kg, p = 0.815, ICC: 0.955.; men: -0.01 ± 0.85 kg with a 95% CI ranging from -1.69 kg to 1.66 kg, p = 0.925, ICC: 0.952). CONCLUSION Taking an experimental approach, VAT can be determined without MRI.
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Affiliation(s)
- Jana Hoffmann
- Outpatient Clinic of Sports Medicine, University of Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany.
| | - Jens Thiele
- Department of Radiology, Helios Klinik, 04435, Schkeuditz, Germany
| | | | | | - Thomas Schröter
- University Department of Cardiac Surgery, Heart Center, 04289, Leipzig, Germany
| | - Jochen Schmidt
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany
| | - Martin Busse
- Outpatient Clinic of Sports Medicine, University of Leipzig, Rosa-Luxemburg-Str. 20-30, 04103, Leipzig, Germany
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Aruna R, Sivarajan AA, Madhumitha M, Vasanth CJ. Association of Hand Grip Strength with Ultrasound-derived Forearm Muscle Thickness and Echo Intensity in Young Indian Adults. J Med Ultrasound 2023; 31:206-210. [PMID: 38025016 PMCID: PMC10668901 DOI: 10.4103/jmu.jmu_28_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/29/2022] [Accepted: 07/27/2022] [Indexed: 12/01/2023] Open
Abstract
Background Muscle thickness (MT) quantification, which reflects the muscle function, can be measured using ultrasonography. Echo intensity (EI) quantified from the ultrasonography-derived skeletal muscle images reflects muscle quality. This study aimed to analyze the associations between handgrip strength, ultrasound-measured forearm MT, and EI in healthy young adults. Methods Sixty healthy volunteers between the ages of 18 and 25 years participated in the study. Brightness mode ultrasonography (USG) was done to measure forearm radial and ulna MT. The EI was measured from an ultrasound image as a mean pixel value using a histogram in Adobe Photoshop. Individuals were tested for forearm handgrip strength using hand dynamometry. Results Males had higher forearm MT and handgrip strength compared to females. Handgrip strength had a significant positive correlation with forearm radius, ulna MT (r = 0.726, 0.757 and P < 0.01), and forearm circumference (r = 0.529 and P < 0.01) and a negatively correlation with subcutaneous fat thickness (r = -0.496 and P < 0.01) and EI (r = -0.618 and P < 0.01). Linear regression showed a significant correlation between MT, circumference, and EI with handgrip strength (r = 0.825 and P < 0.001). After adjustment for the other two parameters, the forearm MT correlated positively and EI negatively with handgrip strength. Conclusion USG can be more easily used than other imaging methods in research and clinical setting as it is nonhazardous, less expensive, versatile, and provides results faster. Thus, USG measurements in skeletal muscle are useful for measuring MT and subcutaneous fat thickness. EI measurement can be a convenient and noninvasive method for assessing muscle quality.
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Affiliation(s)
- R. Aruna
- Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Armel Arputha Sivarajan
- Department of Radiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Meenakshi Madhumitha
- BDS Student, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
| | - C. J. Vasanth
- Department of Radiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
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Chen YL, Chiang HK. Development of Single-Channel Dual-Element Custom-Made Ultrasound Scanner with Miniature Optical Position Tracker for Freehand Imaging. BIOSENSORS 2023; 13:bios13040431. [PMID: 37185505 PMCID: PMC10136573 DOI: 10.3390/bios13040431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023]
Abstract
Handheld ultrasound has great potential in resource-limited areas, and can improve healthcare for rural populations. Single-channel ultrasound has been widely used in many clinical ultrasound applications, and optical tracking is considered accurate and reliable. In this study, we developed a 10 MHz lead magnesium niobate-lead titanate (PMN-PT) dual-element ultrasound transducer combined with a miniature optical position tracker, and then measured the rectus femoris of the thigh, upper arm, and cheek muscles. Compared to single-element transducers, dual-element transducers improve the contrast of near-field signals, effectively reduce noise, and are suitable for measuring curved surfaces. The purpose of position tracking is to calculate the location of the ultrasound transducer during the measurement process. By utilizing positioning information, 2D ultrasound imaging can be achieved while maintaining structural integrity. The dual-element ultrasound scanner presented in this study can enable continuous scanning over a large area without a scanning width limitation. The custom-made dual-element ultrasound scanner has the advantage of being a portable, reliable, and low-cost ultrasound device, and is helpful in popularizing medical care for remote villages.
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Affiliation(s)
- Yen-Lung Chen
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Huihua Kenny Chiang
- Department of BioMedical Engineering, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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PINEAU JC. Prediction of percent body fat in adult men using ultrasonic and anthropometric measurements versus dual-energy X-ray absorptiometry. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04422-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Prasetyo M, Andreas S, Sunardi D, Prihartono J, Imanuel Setiawan S, Christian A. Ultrasonographic measurement of abdominal and gluteal-femoral fat thickness as a predictor for android/gynoid ratio. Eur J Radiol 2022; 154:110387. [PMID: 35660916 DOI: 10.1016/j.ejrad.2022.110387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/29/2022] [Accepted: 05/26/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To evaluate the use of ultrasonography (US) as an alternative to dual-energy x-ray absorptiometry (DXA) to predict the percentage ratio of android/gynoid (A/G) fat mass. METHODS This was a cross-sectional study. Twenty-eight participants included in the study underwent whole-body DXA examinations and the A/G ratio was calculated. Soft-tissue US was performed in several standardised anthropometric areas of the body. Correlation analysis between abdominal and gluteal-femoral fat thickness based on US and A/G ratio was conducted using the Pearson or Spearman test depending on the data normality. Multiple regression analysis using the backward stepwise method was performed to establish an equation for estimating the A/G ratio. RESULTS There was a strong and significant correlation between fat thickness in the six anthropometric areas and the A/G ratio in female participants. The analysis revealed three anthropometric areas: upper abdomen (S4), lower abdomen (S5), and mid-xiphoid-umbilical region (S7), that can accurately predict the A/G ratio by 82.3%. (P < 0.05). However, no such correlation was found in male participants. CONCLUSIONS US measurement of fat thickness can predict A/G ratio in the female population. However, this method is not recommended for men.
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Affiliation(s)
- Marcel Prasetyo
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia.
| | - Steven Andreas
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Diana Sunardi
- Department of Clinical Nutrition, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Joedo Prihartono
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Stefanus Imanuel Setiawan
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Andreas Christian
- Department of Radiology, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
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Gomez-Perez SL, Zhang Y, Mourtzakis M, Tussing-Humphreys L, Ridlon J, Gaskins HR, Mutlu E. Comparison between handheld ultrasound and regional and whole-body dual energy x-ray absorptiometry (DXA) for body fat assessment. Clin Nutr ESPEN 2021; 46:386-393. [PMID: 34857225 DOI: 10.1016/j.clnesp.2021.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To determine the extent of agreement between a handheld ultrasound (US) attached to an android tablet and the reference method dual energy x-ray absorptiometry (DXA) for the measurement of adiposity. METHODS A whole-body DXA scan and abdominal adipose tissue thickness measurements using a handheld US were obtained from 104 adults (63 females, 41 males). Body fat percent (BF%), total fat mass (kg), and trunk fat mass (kg) were obtained from DXA. Subcutaneous adipose tissue (SAT), superficial subcutaneous adipose tissue (SSAT), and deep subcutaneous adipose tissue (DSAT) thickness were obtained from US. Sex-specific total fat mass, trunk fat mass, and BF% estimates by US were compared with DXA. Spearman's correlations and Bland-Altman plots were used to assess agreement between the methods. RESULTS US SAT correlated strongly with total fat mass for both females (rs = 0.74) and males (rs = 0.87) as did trunk fat mass (females, rs = 0.81; males, rs = 0.83); as did SSAT and DSAT (females: rs = 0.65 and rs = 0.66; males: rs = 0.63 and rs = 0.85, respectively, all p-values < 0.0001). Bland-Altman plots demonstrated strong agreement for total and trunk fat mass for both males and females. For BF%, acceptable limits of agreement were observed for males but not for females, substantial proportional bias as indicated by a negative slope was noted for BF% using SAT (r = -0.298, p = 0.0177). CONCLUSION The handheld US and technique to analyze abdominal adipose tissue thickness showed strong agreement with DXA results and generated highly comparable estimates for total and trunk fat mass for both sexes.
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Affiliation(s)
| | - Yanyu Zhang
- Rush University Medical Center, Rush Bioinformatics and Biostatistics Core, Chicago, IL, USA
| | - Marina Mourtzakis
- University of Waterloo, Department of Kinesiology, Waterloo, Ontario, Canada
| | - Lisa Tussing-Humphreys
- University of Illinois at Chicago, Department of Kinesiology and Nutrition, UIC Cancer Center, Chicago, IL, USA
| | - Jason Ridlon
- University of Illinois Urbana-Champaign, Department of Animal Sciences, Urbana-Champaign, IL, USA; Cancer Center at Illinois, Urbana-Champaign, IL, USA
| | - H Rex Gaskins
- University of Illinois Urbana-Champaign, Department of Animal Sciences, Urbana-Champaign, IL, USA; Cancer Center at Illinois, Urbana-Champaign, IL, USA
| | - Ece Mutlu
- Rush University Medical Center, Department of Medicine, Chicago, IL, USA
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Boebinger SE, Brothers RO, Bong S, Sanders B, McCracken C, Ting LH, Buckley EM. Diffuse Optical Spectroscopy Assessment of Resting Oxygen Metabolism in the Leg Musculature. Metabolites 2021; 11:496. [PMID: 34436437 PMCID: PMC8400025 DOI: 10.3390/metabo11080496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 07/27/2021] [Indexed: 11/20/2022] Open
Abstract
We lack reliable methods to continuously assess localized, resting-state muscle activity that are comparable across individuals. Near-infrared spectroscopy (NIRS) provides a low-cost, non-invasive means to assess localized, resting-state muscle oxygen metabolism during venous or arterial occlusions (VO2VO and VO2AO, respectively). However, this technique is not suitable for continuous monitoring, and its utility is limited to those who can tolerate occlusions. Combining NIRS with diffuse correlated spectroscopy (DCS) enables continuous measurement of an index of muscle oxygen metabolism (VO2i). Despite the lack of previous validation, VO2i is employed as a measure of oxygen metabolism in the muscle. Here we characterized measurement repeatability and compared VO2i with VO2VO and VO2AO in the medial gastrocnemius (MG) in 9 healthy adults. Intra-participant repeatability of VO2i, VO2VO, and VO2AO were excellent. VO2i was not significantly correlated with VO2AO (p = 0.15) nor VO2VO (p = 0.55). This lack of correlation suggests that the variability in the calibration coefficient between VO2i and VO2AO/VO2VO in the MG is substantial across participants. Thus, it is preferable to calibrate VO2i prior to every monitoring session. Important future work is needed to compare VO2i against gold standard modalities such as positron emission tomography or magnetic resonance imaging.
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Affiliation(s)
- Scott E. Boebinger
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Rowan O. Brothers
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Sistania Bong
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Bharat Sanders
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
| | - Courtney McCracken
- Center for Research and Evaluation, Kaiser Permanente of Georgia, Atlanta, GA 30309, USA;
| | - Lena H. Ting
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, Atlanta, GA 30322, USA
| | - Erin M. Buckley
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332, USA; (S.E.B.); (R.O.B.); (S.B.); (B.S.); (L.H.T.)
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA 30322, USA
- Children’s Healthcare of Atlanta, Children’s Research Scholar, Atlanta, GA 30322, USA
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Nagel EM, Hickey M, Teigen LM, Kuchnia A, Schifsky H, Holm T, Earthman CP, Demerath E, Ramel SE. Ultrasound measurements of abdominal muscle thickness are associated with postmenstrual age at full oral feedings in preterm infants: A preliminary study. Nutr Clin Pract 2021; 36:1207-1214. [PMID: 34101241 DOI: 10.1002/ncp.10670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A premature infant's discharge from the neonatal intensive care unit (NICU) is dependent on factors such as respiratory stability, adequate growth, and the ability to consume oral feeds. Once infants have achieved respiratory stability, a tool that can better predict age at discharge is desirable. Thus, we conducted a secondary data analysis to assess the association between ultrasound measurements of abdominal muscle thickness and postmenstrual age (PMA) at full oral feedings. METHODS Forty-nine (n = 49) healthy, premature infants (mean gestational age = 32 weeks) were recruited from the NICU. Anthropometric measurements and ultrasound measurements of the rectus abdominis were conducted when infants were medically stable. Fat-free mass (FFM) was obtained using air displacement plethysmography. The relationship between ultrasound measurements of muscle thickness and PMA at full oral feedings was assessed using linear regression analysis. The relationship between FFM z-scores and PMA at full oral feedings was also assessed for comparison. RESULTS When adjusting for gestational age at birth, PMA at measurement, days of positive pressure respiratory support, weight, and length, ultrasound measurements of abdominal muscle thickness were independently, negatively associated with PMA at full oral feedings (β estimate: -0.71, P = .03). CONCLUSION Preliminary results suggest infants with greater abdominal muscle thickness may reach full oral feedings at an earlier PMA (nearly 1 week per millimeter). Thus, ultrasound measurements of abdominal muscle thickness may be helpful in assessing readiness for discharge in healthy preterm infants. Further research is needed for development and validation of a prediction equation.
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Affiliation(s)
- Emily M Nagel
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA.,School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Marie Hickey
- Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Levi M Teigen
- Department of Gastroenterology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Adam Kuchnia
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Holly Schifsky
- Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Tara Holm
- Department of Radiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Ellen Demerath
- School of Public Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
| | - Sara E Ramel
- Department of Pediatrics, University of Minnesota-Twin Cities, Minneapolis, Minnesota, USA
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Perteet-Jackson AD, Earthman CP, Price KL, Hanson A, Shyne MP, Larson-Nath CM. Body composition assessment after pediatric liver transplant. JPEN J Parenter Enteral Nutr 2021; 46:172-179. [PMID: 33686654 DOI: 10.1002/jpen.2105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/20/2021] [Accepted: 03/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pediatric liver transplantation generally restores metabolic function; yet after transplantation, some children remain malnourished, have increased adiposity, and develop obesity. Measurement of body composition in the assessment of nutrition status could reduce adverse consequences in children. METHODS Anthropometric measurements, multiple-frequency bioelectrical impedance analysis, air displacement plethysmography, and ultrasound measurements were conducted on children recruited from the liver transplant program at the University of Minnesota Masonic Children's Hospital. A cross-sectional study was conducted to describe the quality of weight gain in post-liver transplant children between the ages of 2 and 17 years using multiple assessment tools (air displacement plethysmography, multiple-frequency bioelectrical impedance analysis, and ultrasound) and to determine whether multiple-frequency bioelectrical impedance analysis and ultrasound accurately describe body composition and quality of weight gain. RESULTS Mean percent body fat by air displacement plethysmography and multiple-frequency bioelectrical impedance analysis was 18.4% (±3.3) and 19.0% (±3.9), respectively (P > .99). There were insufficient data to examine the relationship between summed muscle and adipose thickness measures by ultrasound and percent body fat determined by air displacement plethysmography or multiple-frequency bioelectrical impedance analysis. CONCLUSION Percent body fat, fat mass, and fat-free mass measures determined by air displacement plethysmography and multiple-frequency bioelectrical impedance analysis were not statistically different, which suggests the stand-on device used in this study could be a useful body composition assessment tool for the pediatric population.
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Affiliation(s)
- Alissa D Perteet-Jackson
- Department of Food Science and Nutrition, University of Minnesota Twin Cities, St. Paul, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Kathleen L Price
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, Tennessee, USA
| | - Amy Hanson
- Department of Pediatrics, University of Minnesota Twin Cities, St. Paul, Minnesota, USA
| | - Michael P Shyne
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota Twin Cities, St. Paul, Minnesota, USA
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Bertini G, Elia S, Dani C. Using ultrasound to examine muscle mass in preterm infants at term-equivalent age. Eur J Pediatr 2021; 180:461-468. [PMID: 33083899 DOI: 10.1007/s00431-020-03846-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 11/28/2022]
Abstract
The aim of this study was to compare the skeletal muscle thickness of three different muscles and muscle groups in 44 preterm infants studied at term-equivalent age and 44 full-term controls: the biceps brachii, quadriceps femoris, and anterior tibial. The study was carried out at the Careggi University Hospital, Florence, Italy, from January 2018 to December 2019. We assumed that impaired muscle thickness in premature infants would be correlated with exposure to risk factors in the postnatal period. When the premature babies reached term-equivalent age, they were statistically significantly thinner and shorter and had a lower head circumference and lower body mass index than the full-term controls. The muscle thicknesses in the proximal and distal districts were statistically significantly smaller in prematurely born than term-born infants. The skeletal muscle thickness was related to the revised Clinical Risk Index for Babies score and days of invasive mechanical ventilation.Conclusion: Our data show that at term-equivalent age the premature babies had lower skeletal muscle mass acquisition than the full-term controls. This was particularly due to critical conditions at birth and the subsequent duration of invasive mechanical ventilation. What is Known: • The deleterious effects of prolonged mechanical ventilation on skeletal muscle function have been reported by adult intensive care studies. • Ultrasound imagines of fat and muscle thickness have been used in neonatology, as the method is safe, portable, and noninvasive. What is New: • Premature babies studied at term-equivalent age had lower muscle acquisition, but similar subcutaneous fat thickness, to full-term controls. • A high revised Clinical Risk Index for Babies score at birth, and prolonged invasive mechanical ventilation, was associated with skeletal muscle impairment.
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Affiliation(s)
- Giovanna Bertini
- Division of Neonatology, Careggi University Hospital, Largo Brambilla, n°3, 50134, Florence, Italy.
| | - S Elia
- Division of Neonatology, Careggi University Hospital, Largo Brambilla, n°3, 50134, Florence, Italy
| | - C Dani
- Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Florence, Italy
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14
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Perteet-Jackson AD, Earthman CP, Larson-Nath CM. Body Composition Post Pediatric Liver Transplant: Implications and Assessment. Nutr Clin Pract 2020; 36:1173-1184. [PMID: 33242232 DOI: 10.1002/ncp.10601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022] Open
Abstract
Liver disease has a negative influence on growth and development of children. Measurement of body composition as a component of nutrition status assessment in children before and after transplant would facilitate tailoring of nutrition therapy. A comprehensive literature search on pediatric liver transplant and body composition assessment was performed using a modified systematic approach. This review includes evidence specific to body composition of children undergoing liver transplant and a discussion of relevant body composition assessment methods for this population. Malnutrition is commonly seen in children with liver disease prior to transplant because of the disrupted metabolic pathways from liver dysfunction; however, malnutrition is not consistently diagnosed. Within 1 year of transplant, children tend to quickly recover with weight gain and linear growth. In some children, obesity and sarcopenia have been observed as long-term posttransplant outcomes. Body composition assessment tools have been utilized in diagnosing nutrition status in adults; yet there are limited studies that use these tools in the pediatric liver-transplant population. Technologies available to assess body composition include air displacement plethysmography, dual-energy x-ray absorptiometry, bioimpedance, and ultrasound. Total body potassium has been used for body composition assessment in adults and children post liver transplant; however, this method is not applicable in a clinical setting. We conclude that understanding posttransplant body composition could help clinicians diagnose and treat malnutrition.
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Affiliation(s)
- Alissa D Perteet-Jackson
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St. Paul, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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15
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Nagel E, Hickey M, Teigen L, Kuchnia A, Holm T, Earthman C, Demerath E, Ramel S. Can Ultrasound Measures of Muscle and Adipose Tissue Thickness Predict Body Composition of Premature Infants in the Neonatal Intensive Care Unit? JPEN J Parenter Enteral Nutr 2020; 45:323-330. [DOI: 10.1002/jpen.1829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 03/03/2020] [Indexed: 01/19/2023]
Affiliation(s)
- Emily Nagel
- Department of Food Science and Nutrition University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Marie Hickey
- Department of Pediatrics University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Levi Teigen
- Department of Gastroenterology University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Adam Kuchnia
- Department of Nutritional Sciences University of Wisconsin–Madison Madison Wisconsin USA
| | - Tara Holm
- Department of Radiology University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Carrie Earthman
- Department of Behavioral Health and Nutrition University of Delaware Newark Delaware USA
| | - Ellen Demerath
- School of Public Health University of Minnesota–Twin Cities Minneapolis Minnesota USA
| | - Sara Ramel
- Department of Pediatrics University of Minnesota–Twin Cities Minneapolis Minnesota USA
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16
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Nagel E, Hickey M, Teigen L, Kuchnia A, Curran K, Soumekh L, Earthman C, Demerath E, Ramel S. Clinical Application of Body Composition Methods in Premature Infants. JPEN J Parenter Enteral Nutr 2020; 44:785-795. [DOI: 10.1002/jpen.1803] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Emily Nagel
- Department of Food Science and NutritionUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Marie Hickey
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Levi Teigen
- Department of GastroenterologyUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Adam Kuchnia
- Department of Nutritional SciencesUniversity of Wisconsin‐Madison Madison WI USA
| | - Kent Curran
- Department of PediatricsAlbany Medical Center Albany NY USA
| | - Lisa Soumekh
- School of MedicineUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | | | - Ellen Demerath
- School of Public HealthUniversity of Minnesota‐Twin Cities Minneapolis MN USA
| | - Sara Ramel
- Department of PediatricsUniversity of Minnesota‐Twin Cities Minneapolis MN USA
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17
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Fitzgerald O'Connor E, Ruston J, Loh CYY, Tare M. Technical refinements of the free medial sural artery perforator (MSAP) flap in reconstruction of multifaceted ankle soft tissue defects. Foot Ankle Surg 2020; 26:233-238. [PMID: 30910585 DOI: 10.1016/j.fas.2019.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Peri-ankle defects are difficult to reconstruct due to sharp contours, thin skin, aesthetic value, function and footwear impact. The medial sural artery perforator flap (MSAP) is increasing in popularity as a thin and pliable flap. This study aims to demonstrate its versatility in reconstructing defects around the ankle area and our approach to insetting these flaps in difficult areas around the ankle without the need for subsequent flap revisions. METHODS A retrospective review of the senior author's series of peri-ankle reconstructions using the MSAP flap was undertaken. RESULTS Between 2011-2015, 15 patients underwent peri-ankle reconstruction with the MSAP flap. There were 4 dorsal foot, 4 medial malleolar, 4 lateral malleolar, and 3 tendo-achilles defects. All flaps in this series survived. There was one episode of partial flap necrosis in one patient and no incidences of donor site dehiscence. All patients returned to full ambulation and none required subsequent flap revision. CONCLUSIONS The MSAP flap offers the benefits of a fasciocutaneous flap, whilst providing a thin, pliable, single stage and robust reconstruction for peri-ankle defects, with a cosmetically ideal donor site.
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Affiliation(s)
- Edmund Fitzgerald O'Connor
- St. Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, CM17ET, UK; STAAR, St. Andrews Anglia Ruskin Research Group, UK
| | - Julia Ruston
- St. Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, CM17ET, UK; STAAR, St. Andrews Anglia Ruskin Research Group, UK
| | - Charles Yuen Yung Loh
- St. Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, CM17ET, UK
| | - Makarand Tare
- St. Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, CM17ET, UK; STAAR, St. Andrews Anglia Ruskin Research Group, UK.
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18
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Thiebaud RS, Abe T, Loenneke JP, Fujita E, Akamine T. Body fat percentage assessment by ultrasound subcutaneous fat thickness measurements in middle-aged and older adults. Clin Nutr 2019; 38:2659-2667. [DOI: 10.1016/j.clnu.2018.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 08/16/2018] [Accepted: 11/25/2018] [Indexed: 12/25/2022]
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19
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Schlink BR, Ferris DP. A Lower Limb Phantom for Simulation and Assessment of Electromyography Technology. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2378-2385. [DOI: 10.1109/tnsre.2019.2944297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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20
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da Silva Siqueira K, Maia JM. High-power therapeutic ultrasound for treatment of abdominal localized adiposity-double-blind randomized clinical trial. Lasers Med Sci 2019; 35:927-938. [PMID: 31686255 DOI: 10.1007/s10103-019-02895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022]
Abstract
This study aimed to evaluate the effects of high-power therapeutic ultrasound in the treatment of abdominal localized adiposity in an isolated manner, with the use of neutral gel comparing ultrasonic application with 5% lipolytic active caffeine gel (phonophoresis). A total of 90 healthy women aged between 18 and 40 years were randomized and divided into two groups. The volunteers underwent anamnesis evaluation, perimetry, bioimpedance, ultrasound examination, and blood tests (complete lipidogram, creatinine, and vitamin D) before and after the end of the 10-session ultrasound protocol (3 MHz, 2 W/cm2, and 30w). Comparisons between groups and pre-post evaluation were performed by a two-way repeated-measures analysis of variance. Values of p < 0.05 indicated statistical significance. The results demonstrated a significant reduction in both groups, for the perimetry (p < 0.001) and measurements of adipose tissue thickness (p < 0.001). The examinations exhibited a significant alteration only of the complete lipidogram, but without significance (p > 0.05). When comparing the groups, no statistically significant difference was identified in any of the analyzed parameters. The high-power ultrasonic therapy is efficient in reducing localized adiposity, regardless of whether it is applied with neutral gel or 5% caffeine gel.
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Affiliation(s)
- Karina da Silva Siqueira
- Graduate Program in Electrical and Computer Engineering (CPGEI), Federal University of Technology Paraná (UTFPR), Curitiba, PR, Brazil.
| | - Joaquim Miguel Maia
- Electronics Engineering Department (DAELN) and Graduate Program in Electrical and Computer Engineering (CPGEI), Federal University of Technology Paraná (UTFPR), Curitiba, PR, Brazil
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21
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Pineau JC, Bouslah M. Prediction of body fat in male athletes from ultrasound and anthropometric measurements versus DXA. J Sports Med Phys Fitness 2019; 60:251-256. [PMID: 31663316 DOI: 10.23736/s0022-4707.19.09985-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To compare the accuracy of body fat percentage (BF%) measured by an ultrasound portable device and anthropometric measurements with a Dual energy X-ray absorptiometry (DXA) as the reference technique in male athletes. METHODS A total of 100 athletes: 16 boxers, 4 rowers, 5 gymnasts, 6 base ball players, 19 judo players, 10 taekwondo players, 7 basket-ball players, 21 wrestlers, 6 cyclists on track and 6 karate expert aged from 18 to 30 years participated. All athletes were selected from the French National Institute of Sports and Physical Education. Ultrasound measurements were made with a sonographic US BOX at the mid-thigh level. We developed a multi -linear model of body fat estimation from ultrasound and anthropometric dimensions (height, weight, waist circumference) using the DXA reference method. A cross-validation study was then performed with this linear regression on 62 males athletes proportionally stratified across the sports. RESULTS The best accuracy of BF was obtained using a multi-linear model from ultrasonic and anthropometric measurements with a concordance correlation ρc=0.941. This model was then used to estimate BF on the 62 males athletes. The concordance correlation ρc=0.931 and SEE=1.60. The 95% limits of agreement for individual BF% were [-4.1;3.6%] with symmetrically distributed deviations. CONCLUSIONS Comparing to DXA, ultrasonic and anthropometric measurements are both accurate techniques to estimates BF%. Our results suggest that this regression model is practical to apply to different sports.
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Affiliation(s)
- Jean-Claude Pineau
- Faculty of Dental Surgery, Paris-Descartes University, Montrouge, France -
| | - Mustapha Bouslah
- Faculty of Dental Surgery, Paris-Descartes University, Montrouge, France
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22
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Chen LS, Li YY, Chen H, Liu BW, Wang DW, Zhao YH. Polyglycolic acid sutures embedded in abdominal acupoints for treatment of simple obesity in adults: a randomized control trial. Chin Med 2019; 14:32. [PMID: 31548850 PMCID: PMC6749682 DOI: 10.1186/s13020-019-0258-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/11/2019] [Indexed: 12/15/2022] Open
Abstract
Background Acupoint catgut embedding therapy characterized by acupoint, needle and catgut are superior to traditional acupuncture, due to exerting more comprehensive therapeutic efficacy. However, it is still deficient in clinical evidence for polyglycolic acid sutures, a novel biodegradable material instead of catgut, embedded for the treatment of simple obesity. In our study, we investigate the efficacy and related mechanism of polyglycolic acid sutures embedded in abdominal acupoints on simple obese persons by a randomized control trial. Methods A total of 51 eligible participators were randomly allocated to a polyglycolic acid sutures embedding therapy (PASET) group (n = 28) or control group (n = 23). Participators in PASET group received polyglycolic acid sutures alternatively embedded in abdominal I group and II group acupoints in odd and even number therapeutic courses, and participators in control group were required to perform lifestyle modification. The duration of the study was 10 weeks. Results It suggested that PASET significantly reduced weight, body mass index, hip circumference, waist circumference, waist/hip ratio, waist-to-height ratio and thickness of abdominal subcutaneous fat tissue compared with those before treatment (p < 0.01), but lifestyle modification only illustrated downward trend of weight (p < 0.05). Moreover, PASET group also improved the evaluated scores in aspects of physical function, self-esteem, public distress and sexual life, as well as decreased blood pressure, glycemia, low density lipoprotein, uric acid and the levels of tumor necrosis factor-alpha, interleukin-1β, and increased high density lipoprotein in comparison with those before treatment (p < 0.05), whose efficacies are superior to control group. Additionally, our results also indicate PASET is relative safe and its pain and discomfort can be tolerable. Conclusions PASET distinctly ameliorates anthropometric data and quality of life in obese population, which associates with improvements of metabolic profile and inflammatory response. Based on the advantageous actions, we think PASET is an effective therapeutic approach to simple obesity treatment. Trial registration ChiCTR, ChiCTR1800015591. Registered 10 April 2018, http://www.chictr.org.cn/showproj.aspx?proj=23258
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Affiliation(s)
- Li-Shu Chen
- 1Ningbo College of Health Sciences, Ningbo, 315100 China
| | - Yue-Ying Li
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060 China
| | - Hao Chen
- 3Nanjing University of Chinese Medicine, Nanjing, 210046 China
| | - Bo-Wen Liu
- 4Department of Neurology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008 China
| | - Da-Wei Wang
- Shunde Hospital of Guangzhou University of Chinese Medicine, Shunde, 528333 China
| | - Yong-Hua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, 999078 Macao SAR China
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Fernández-Lao C, Cantarero-Villanueva I, López-Barajas IB, Arroyo-Morales M. Mobile health and supervised rehabilitation versus mobile health alone in breast cancer survivors: Randomized controlled trial. Ann Phys Rehabil Med 2019; 63:316-324. [PMID: 31454561 DOI: 10.1016/j.rehab.2019.07.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Survival rates in cancer are increasing exponentially, with a corresponding increase/influence in disability-adjusted life-years. Efforts should be made to explore the optimal balance between unsupervised/distance-based and supervised/onsite approaches to cancer care. OBJECTIVE This study aimed to compare the clinical efficacy of the BENECA mobile Health (mHealth) lifestyle application combined with a supervised rehabilitation program (BENECA and supervised rehabilitation) versus the BENECA mHealth lifestyle application alone on quality of life (QoL) and functional outcomes of breast cancer survivors. METHODS This randomized controlled trial included 80 survivors of breast cancer diagnosed at stage I-IIIA, who completed adjuvant therapy and were overweight or obese at diagnosis. Participants were randomly allocated (ratio 1:1, 3 waves) to BENECA mHealth and rehabilitation for 2months (n=40) or BENECA mHealth and usual care (BENECA mHealth alone; n=40). Participants completed a questionnaire at baseline (T1), 8-weeks post-intervention (T2) and 6-month follow-up (T3). The primary outcome was QoL assessed with the EORT QLQ-C30. Secondary outcomes included upper-limb functionality and body composition. Statistical (between-group analyses of covariance) and clinical effects were analyzed by intention to treat. RESULTS Both groups showed improved outcomes, but global QoL was significantly better with BENECA mHealth and rehabilitation than BENECA mHealth alone (mean difference, 12.76; 95% confidence interval 4.85; 20.67; P=0.004), with a moderate-to-large effect size (d=72). The proportion of participants reporting reliable clinical improvement on global QoL at T2 was higher with BENECA mHealth and rehabilitation than BENECA mHealth alone (57.5% vs 26.3%, P=0.008). Improvement in subjective and objective upper-limb functionality was also higher with BENECA mHealth and rehabilitation. CONCLUSIONS The BENECA mHealth lifestyle application with a supervised rehabilitation program had a statistically and clinically significant effect on QoL and upper-limb functionality in breast cancer survivors and is a unique and important promising new approach.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain.
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Avda. de la Ilustración, 60, 18016 Granada, Spain; Sport and Health Joint University Institute (iMUDS), Granada, Spain; Biohealth Research Institute in Granada (ibs.GRANADA), Granada, Spain; "Cuídate" Support Unit for Oncology Patients (UAPO-Cuídate), Granada, Spain
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24
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Lozano-Lozano M, Cantarero-Villanueva I, Martin-Martin L, Galiano-Castillo N, Sanchez MJ, Fernández-Lao C, Postigo-Martin P, Arroyo-Morales M. A Mobile System to Improve Quality of Life Via Energy Balance in Breast Cancer Survivors (BENECA mHealth): Prospective Test-Retest Quasiexperimental Feasibility Study. JMIR Mhealth Uhealth 2019; 7:e14136. [PMID: 31237570 PMCID: PMC6614997 DOI: 10.2196/14136] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/13/2019] [Accepted: 05/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background Energy balance is defined as the difference between energy expenditure and energy intake. The current state of knowledge supports the need to better integrate mechanistic approaches through effective studies of energy balance in the cancer population because of an observed significant lack of adherence to healthy lifestyle recommendations. To stimulate changes in breast cancer survivors’ lifestyles based on energy balance, our group developed the BENECA (Energy Balance on Cancer) mHealth app. BENECA has been previously validated as a reliable energy balance monitoring system. Objective Based on our previous results, the goal of this study was to investigate the feasibility of BENECA mHealth in an ecological clinical setting with breast cancer survivors, by studying (1) its feasibility and (2) pretest-posttest differences with regard to breast cancer survivor lifestyles, quality of life (QoL), and physical activity (PA) motivation. Methods Eighty breast cancer survivors diagnosed with stage I to IIIA and with a body mass index over 25 kg/m2 were enrolled in this prospective test-retest quasi-experimental study. Patients used BENECA mHealth for 8 weeks and were assessed at baseline and the postintervention period. Feasibility main outcomes included percentage of adoption, usage, and attrition; user app quality perception measured with the Mobile App Rating Scale (MARS); satisfaction with the Net Promoter Score (NPS); and barriers and facilitators of its use. Clinical main outcomes included measuring QoL with the European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORT QLQ-C30), PA assessment with accelerometry, PA motivation measure with a Spanish self-efficacy scale for physical activity (EAF), and body composition with dual-energy x-ray absorptiometry. Statistical tests (using paired-sample t tests) and Kaplan-Meier survival curves were analyzed. Results BENECA was considered feasible by the breast cancer survivors in terms of use (76%, 58/76), adoption (69%, 80/116), and satisfaction (positive NPS). The app quality score did not make it one of the best-rated apps (mean 3.71, SD 0.47 points out of 5). BENECA mHealth improved the QoL of participants (global health mean difference [MD] 12.83, 95% CI 8.95-16.71, P<.001), and EAF score (global MD 36.99, 95% CI 25.52-48.46, P<.001), daily moderate-to-vigorous PA (MD 7.38, 95% CI 0.39-14.37, P=.04), and reduced body weight (MD −1.42, 95% CI −1.97 to −0.87, P<.001). Conclusions BENECA mHealth can be considered feasible in a real clinical context to promote behavioral changes in the lifestyles of breast cancer survivors, but it needs to be enhanced to improve user satisfaction with use and functionality. This study highlights the importance of the use of mobile apps based on energy balance and how the QoL of breast cancer survivors can be improved via monitoring.
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Affiliation(s)
- Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Irene Cantarero-Villanueva
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Lydia Martin-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Noelia Galiano-Castillo
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Maria-José Sanchez
- Biohealth Research Institute in Granada, Granada, Spain.,Andalusian School of Public Health, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health, Madrid, Spain
| | - Carolina Fernández-Lao
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Paula Postigo-Martin
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
| | - Manuel Arroyo-Morales
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute, Granada, Spain.,Biohealth Research Institute in Granada, Granada, Spain.,Cuidate-Support Unit for Oncology Patients, Granada, Spain
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25
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Azzi AJ, Lafrenière AS, Gilardino M, Hemmerling T. Ultrasonography Technique in Abdominal Subcutaneous Adipose Tissue Measurement: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:877-888. [PMID: 30208232 DOI: 10.1002/jum.14789] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
There are currently several reported techniques of sonographic subcutaneous adipose tissue (SAT) measurement described in the literature. This systematic review aims to report techniques of SAT measurement using ultrasonography. A systematic literature search was performed and identified 39 relevant articles using ultrasonography to quantify abdominal SAT. The following parameters were collected: type of measurement, ultrasound machine make/model, transducer frequency, external/internal landmarks, pressure applied on probe, special techniques and inter-/intraobserver reliability. Literature findings related to the above parameters were summarized. A summary of the most common techniques and parameters is provided, serving as a reference for a necessary standardized approach.
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Affiliation(s)
| | | | | | - Thomas Hemmerling
- Department of Anesthesia and Experimental Surgery, McGill University, Montreal, QC, Canada
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Kelso A, Vogel K, Steinacker JM. Ultrasound measurements of subcutaneous adipose tissue thickness show sexual dimorphism in children of three to five years of age. Acta Paediatr 2019; 108:514-521. [PMID: 29992657 PMCID: PMC6585817 DOI: 10.1111/apa.14496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 04/24/2018] [Accepted: 07/09/2018] [Indexed: 11/30/2022]
Abstract
Aim A standard approach to measure subcutaneous adipose tissue (SAT) using ultrasound has proved successful in adults, but has not been studied in children. This study addressed that gap in children aged three to five years. Methods In autumn 2016, 24 preschools in Southwest Germany, recruited via mail, agreed to take part in this study and 274 children (51.4% boys) with a mean age of 4.6 ± 0.7 years participated in measurements of SAT and anthropometry. Differences in measurements were explored between the sexes and anthropometric predictors of mean SAT thickness were identified. Intra‐observer reliability for ultrasound measurements of SAT was also assessed. Results The mean SAT thickness showed significant differences between the boys and girls (5.3 ± 2.0 and 6.3 ± 2.0 mm, respectively, p < 0.01). The children's body mass, height and sex explained 66% of the variance in the mean SAT thickness, as SAT was larger with a higher body mass, a smaller stature and in girls. Intra‐observer reliability resulted in an intra‐class correlation coefficient of 0.994 (p < 0.01) with a 95% confidence interval of 0.983–0.998. Conclusion Subcutaneous adipose tissue thickness differed between boys and girls with a mean age of 4.6 years. Intra‐observer reliability was excellent. This standardised approach enabled high‐precision measurements of SAT in a paediatric population.
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Affiliation(s)
- Anne Kelso
- Division of Sports and Rehabilitation Medicine Ulm University Medical Center Ulm Germany
| | - Katharina Vogel
- Division of Sports and Rehabilitation Medicine Ulm University Medical Center Ulm Germany
| | - Jürgen M. Steinacker
- Division of Sports and Rehabilitation Medicine Ulm University Medical Center Ulm Germany
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27
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Prognostic Value of Vascular Calcifications and Regional Fat Depots Derived From Conventional Chest Computed Tomography. J Thorac Imaging 2019; 34:33-40. [DOI: 10.1097/rti.0000000000000370] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Development of a bedside-applicable ultrasound protocol to estimate fat mass index derived from whole body dual-energy x-ray absorptiometry scans. Nutrition 2019; 57:225-230. [DOI: 10.1016/j.nut.2018.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/22/2018] [Indexed: 12/24/2022]
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29
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Azzi AJ, Lafrenière AS, Viezel-Mathieu A, Hemmerling TM, Gilardino M. Objective Quantification of Liposuction Results. J Cutan Aesthet Surg 2018; 11:105-109. [PMID: 30533983 PMCID: PMC6243817 DOI: 10.4103/jcas.jcas_102_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Currently, no reliable gold standard exists for the objective outcome measurement following liposuction. The purpose of this systematic review was to summarize reported methods of monitoring liposuction results by objectively measuring subcutaneous adipose tissue. A systematic literature search was performed to identify relevant articles that described techniques for objectively quantifying adipose tissue following traditional liposuction. The search included published articles in three electronic databases—Ovid MEDLINE, Embase, and PubMed. Subcutaneous adipose tissue was estimated using the following techniques: ultrasound, dual-energy X-ray absorptiometry, magnetic resonance imaging, computed tomography, and three-dimensional imaging volumetric analysis. Reported benefits of liposuction objective measurements included providing patients with a quantitative assessment of the liposuction results pre- and postoperatively, detecting significant changes in body fat deposits, and following patterns of fat redistribution. This review provides a summary of various techniques for quantification of liposuction results. More studies are needed to study the clinical relevancy and impact of the various imaging modalities reviewed as well as to develop automated volumetric measurement technology with improved accuracy, efficacy, and reproducibility.
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Affiliation(s)
- Alain J Azzi
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
| | | | - Alex Viezel-Mathieu
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
| | - Thomas M Hemmerling
- Department of Anesthesia and Experimental Surgery, McGill University, Montreal, Quebec, Canada
| | - Mirko Gilardino
- Division of Plastic and Reconstructive Surgery, McGill University, Montreal, Quebec, Canada
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30
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Reference data on thickness and mechanics of tissue layers and anthropometry of musculoskeletal extremities. Sci Data 2018; 5:180193. [PMID: 30251995 PMCID: PMC6154283 DOI: 10.1038/sdata.2018.193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/02/2018] [Indexed: 11/08/2022] Open
Abstract
Musculoskeletal extremities exhibit a multi-layer tissue structure that is composed of skin, fat, and muscle. Body composition and anthropometric measurements have been used to assess health status and build anatomically accurate biomechanical models of the limbs. However, comprehensive datasets inclusive of regional tissue anatomy and response under mechanical manipulation are missing. The goal of this study was to acquire and disseminate anatomical and mechanical data collected on extremities of the general population. An ultrasound system, instrumented with a load transducer, was used for in vivo characterization of skin, fat, and muscle thicknesses in the extremities of 100 subjects at unloaded (minimal force) and loaded (through indentation) states. For each subject, the unloaded and loaded state provided anatomic tissue layer measures and tissue indentation response for 48 and 8 regions, respectively. A publicly available web-based system has been used for data management and dissemination. This comprehensive database will provide the foundation for comparative studies in regional musculoskeletal composition and improve visual and haptic realism for computational models of the limbs.
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Lenz M, Meyer C, Boese CK, Siewe J, Eysel P, Scheyerer MJ. The impact of obesity measured by outer abdominal fat on instability of the adjacent segments after rigid pedicle screw fixation. Orthop Rev (Pavia) 2018; 10:7684. [PMID: 30057725 PMCID: PMC6042051 DOI: 10.4081/or.2018.7684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/21/2018] [Indexed: 11/22/2022] Open
Abstract
Previous studies have shown coherence between obesity and higher rates of complications following spinal surgery. However, there is a lack of information about the influence of obesity and the mass of outer abdominal fat (OAF) on adjacent segment instability after spinal fusion surgery. Radiographs of 194 patients with spinal fusion surgery were assessed retrospectively. Radiographs were performed after surgery during two years' follow-up and signs of adjacent segment instability were documented. Patients were classified regarding their BMI and extent of OAF was assessed using CT at the umbilical level. In 20 patients (10.3%) instability of adjacent segments occurred during followup. In this cohort mean OAF was significantly thicker (28.07 mm) compared to the patients without instability (22.39) (P=0.038). A total of 45% of patients with instability showed OAF of more than 30 mm at time of intervention compared to 10% in those without signs of instability. There exists significant correlation between the extent of OAF and development of adjacent segment instability postoperatively. Thus, weight reduction before spinal surgery could potentially decrease risk of adjacent segment instability.
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Affiliation(s)
- Maximilian Lenz
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
| | - Carolin Meyer
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
| | - Christoph Kolja Boese
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
| | - Jan Siewe
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
| | - Peer Eysel
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
| | - Max Joseph Scheyerer
- Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Germany
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Gabison S, Mathur S, Verrier MC, Nussbaum E, Popovic MR, Gagnon DH. Quantitative ultrasound imaging over the ischial tuberosity: An exploratory study to inform tissue health. J Tissue Viability 2018; 27:173-180. [PMID: 29886122 DOI: 10.1016/j.jtv.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/01/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Characterization of ischial tissue health using a standardized diagnostic ultrasound protocol capturing thickness and gray scale analysis has not been established. OBJECTIVES This study evaluates inter-participant and inter-trial reliability of thickness and gray scale analysis of ultrasound images of tissues overlying the ischial tuberosity. It provides recommendations for the number of images required to minimize the standard error of measurement (SEM) and determines the number of images required for thickness, gray scale and contrast values that exceed an a-priori minimal detectable change (MDC) for repeated tissue assessment. METHODS Brightness mode ultrasound images using a 12 MHz linear probe were collected on the dominant limb in the side lying position for ten healthy participants and partitioned into three regions of interest: skin, subcutaneous tissue and muscle. Thickness and gray scale measures of skin, muscle and subcutaneous tissue were calculated using a customized MATLAB program. Contrast of each region of interest was calculated using the Gray Scale Level Co-Occurrence Matrix. Generalizability theory was used to quantify indices of dependability and corresponding SEMs and MDCs with 90% Confidence Intervals. RESULTS Participants accounted for most of the total variance (75.56% to 94.78%). Coefficient of dependability (ϕ) for thickness, grey scale and contrast measures was greater than 0.80 when more than two images were averaged. In order to detect a MDC of 21% in thickness and echogenicity measures, at least three images are required, while at least 5 images are required for a MDC of 25% for contrast measures. CONCLUSIONS Obtaining reliable thickness, echogenicity and contrast measures of tissue overlying the ischial tuberosity can be achieved from two ultrasound images by a single therapist on an individual participant however three and five images are required to use a MDC of 21% for thickness measures and MDC of 25% for contrast measures respectively.
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Affiliation(s)
- Sharon Gabison
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada; SCI Mobility Lab, Lyndhurst Centre, Toronto Rehab-University Health Network, 520 Sutherland Drive, Room 236, Toronto, Ontario, M4G 3V9, Canada.
| | - Sunita Mathur
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Mary C Verrier
- Department of Physical Therapy, University of Toronto, 500 University Avenue, Toronto, Ontario, M5G 1V7, Canada; SCI Mobility Lab, Lyndhurst Centre, Toronto Rehab-University Health Network, 520 Sutherland Drive, Room 236, Toronto, Ontario, M4G 3V9, Canada
| | - Ethne Nussbaum
- MCISc Program in Field of Wound Healing, Western University, School of Physical Therapy, Elborn College, London, Ontario, M8G 1H1, Canada
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Room 236, Toronto, Ontario, M4G 3V9, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Rosebrugh Bldg, 164 Room 407, Toronto, Ontario, M5S 3G9, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Université de Montréal, C.P. 6128, Succursale Centre-ville, Montreal, Quebec, H3C 3J7, Canada
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Woessner MN, Levinger I, Neil C, Smith C, Allen JD. Effects of Dietary Inorganic Nitrate Supplementation on Exercise Performance in Patients With Heart Failure: Protocol for a Randomized, Placebo-Controlled, Cross-Over Trial. JMIR Res Protoc 2018; 7:e86. [PMID: 29625952 PMCID: PMC5910532 DOI: 10.2196/resprot.8865] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/04/2017] [Accepted: 12/05/2017] [Indexed: 01/22/2023] Open
Abstract
Background Chronic heart failure is characterized by an inability of the heart to pump enough blood to meet the demands of the body, resulting in the hallmark symptom of exercise intolerance. Chronic underperfusion of the peripheral tissues and impaired nitric oxide bioavailability have been implicated as contributors to the decrease in exercise capacity in these patients. nitric oxide bioavailability has been identified as an important mediator of exercise tolerance in healthy individuals, but there are limited studies examining the effects in patients with chronic heart failure. Objective The proposed trial is designed to determine the effects of chronic inorganic nitrate supplementation on exercise tolerance in both patients with heart failure preserved ejection fraction (HFpEF) and heart failure reduced ejection fraction (HFrEF) and to determine whether there are any differential responses between the 2 cohorts. A secondary objective is to provide mechanistic insights into the 2 heart failure groups’ exercise responses to the nitrate supplementation. Methods Patients with chronic heart failure (15=HFpEF and 15=HFrEF) aged 40 to 85 years will be recruited. Following an initial screen cardiopulmonary exercise test, participants will be randomly allocated in a double-blind fashion to consume either a nitrate-rich beetroot juice (16 mmol nitrate/day) or a nitrate-depleted placebo (for 5 days). Participants will continue daily dosing until the completion of the 4 testing visits (maximal cardiopulmonary exercise test, submaximal exercise test with echocardiography, vascular function assessment, and vastus lateralis muscle biopsy). There will then be a 2-week washout period after which the participants will cross over to the other treatment and complete the same 4 testing visits. Results This study is funded by National Heart Foundation of Australia and Victoria University. Enrolment has commenced and the data collection is expected to be completed in mid 2018. The initial results are expected to be submitted for publication by the end of 2018. Conclusions If inorganic nitrate supplementation can improve exercise tolerance in patients with chronic heart failure, it has the potential to aid in further refining the treatment of patients in this population. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615000906550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368912 (Archived by WebCite at http://www.webcitation.org/6xymLMiFK)
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Affiliation(s)
- Mary N Woessner
- Institute of Health and Sport, Victoria University, Melbourne, Australia.,Western Center for Health and Research Education, Victoria University, St Albans, Australia
| | - Itamar Levinger
- Institute of Health and Sport, Victoria University, Melbourne, Australia.,Australian Institute for Musculoskeletal Science, Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Christopher Neil
- Institute of Health and Sport, Victoria University, Melbourne, Australia.,Department of Medicine-Western Health, University of Melbourne, Melbourne, Australia
| | - Cassandra Smith
- Institute of Health and Sport, Victoria University, Melbourne, Australia.,Australian Institute for Musculoskeletal Science, Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Jason D Allen
- Institute of Health and Sport, Victoria University, Melbourne, Australia.,Western Center for Health and Research Education, Victoria University, St Albans, Australia.,Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
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How Should Results of Nonsurgical Subcutaneous Fat Removal Be Assessed? Accuracy of B-Mode Ultrasound. Plast Reconstr Surg 2017; 138:624e-629e. [PMID: 27673533 DOI: 10.1097/prs.0000000000002540] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nonsurgical fat reduction has become extremely popular among patients; however, a reliable method of measuring its efficacy has not been established. METHODS Ultrasound measurement of human female abdominal subcutaneous fat thickness was carried out on five volunteers. Forty-seven measurements were performed using a GE Venue 40 diagnostic ultrasound device with a 12-MHz transducer. Transducer pressure measurements were recorded simultaneously according to the protocol described by Toomey et al.. RESULTS Reproducible measurements of abdomen subcutaneous fat could be consistently achieved with a margin of error (95 percent CI) of ±0.558 mm. CONCLUSIONS Using a protocol with a transducer pressure less than 1 N (Toomey protocol) allows accurate and reliable measurement of subcutaneous fat. The authors further conclude that such a protocol is practically reproducible in the clinical setting and should be the standard for evaluating the results of nonsurgical fat removal, particularly in the abdomen. CLINICAL QUESTION/LEVEL OF EVIDENCE Diagnostic, IV.
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35
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Kelso A, Trájer E, Machus K, Treff G, Müller W, Steinacker JM. Assessment of subcutaneous adipose tissue using ultrasound in highly trained junior rowers. Eur J Sport Sci 2017; 17:576-585. [PMID: 28120641 DOI: 10.1080/17461391.2016.1277788] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION There is a large variety of body fat (BF) measurements, which differ in validity and reliability. The aim of this study was to measure subcutaneous adipose tissue (SAT) using ultrasound (US) in highly trained junior rowers in a field setting, establish fat patterning profiles, and compare the profiles between male and female athletes. Skinfold thickness (SKF) measurements were also taken and compared to US measurements. METHODS Sixteen athletes participated. US measurements were taken at eight sites and reported as a sum of SAT (D): DExcl (without embedded structures) and DIncl (including embedded structures). SKF was measured at three sites and reported as a sum of adipose tissue thickness (SUMSKF). RESULTS Mean SAT thickness (DIncl) was 27.6 ± 12.4 mm for males and 65.5 ± 11.8 mm for females. Females had significantly more embedded structures than males (P = .016). Significant correlations were found (P < .001, r = 0.92) comparing SUMSKF to DIncl and between SKF and US measurements at the thigh site (P < .001, r = 0.86). CONCLUSION US is a suitable tool to measure BF in the field testing of athletes and enables measurements of SAT with an accuracy and reliability not reached before. The sum of thicknesses (DIncl or DExcl) can be used to represent subcutaneous fat based on accurate measurements of uncompressed SAT thicknesses.
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Affiliation(s)
- Anne Kelso
- a Division of Sports and Rehabilitation Medicine , University of Ulm , Ulm , Germany
| | - Emese Trájer
- a Division of Sports and Rehabilitation Medicine , University of Ulm , Ulm , Germany.,b Department of Health and Sports Medicine , University of Physical Education , Budapest , Hungary
| | - Katja Machus
- a Division of Sports and Rehabilitation Medicine , University of Ulm , Ulm , Germany
| | - Gunnar Treff
- a Division of Sports and Rehabilitation Medicine , University of Ulm , Ulm , Germany
| | - Wolfram Müller
- c Institute of Biophysics , Medical University of Graz , Graz , Austria
| | - Jürgen M Steinacker
- a Division of Sports and Rehabilitation Medicine , University of Ulm , Ulm , Germany
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36
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Smith-Ryan AE, Blue MNM, Trexler ET, Hirsch KR. Utility of ultrasound for body fat assessment: validity and reliability compared to a multicompartment criterion. Clin Physiol Funct Imaging 2016; 38:220-226. [PMID: 27981810 DOI: 10.1111/cpf.12402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/25/2016] [Indexed: 02/03/2023]
Abstract
Measurement of body composition to assess health risk and prevention is expanding. Accurate portable techniques are needed to facilitate use in clinical settings. This study evaluated the accuracy and repeatability of a portable ultrasound (US) in comparison with a four-compartment criterion for per cent body fat (%Fat) in overweight/obese adults. Fifty-one participants (mean ± SD; age: 37·2 ± 11·3 years; BMI: 31·6 ± 5·2 kg m-2 ) were measured for %Fat using US (GE Logiq-e) and skinfolds. A subset of 36 participants completed a second day of the same measurements, to determine reliability. US and skinfold %Fat were calculated using the seven-site Jackson-Pollock equation. The Wang 4C model was used as the criterion method for %Fat. Compared to a gold standard criterion, US %Fat (36·4 ± 11·8%; P = 0·001; standard error of estimate [SEE] = 3·5%) was significantly higher than the criterion (33·0 ± 8·0%), but not different than skinfolds (35·3 ± 5·9%; P = 0·836; SEE = 4·5%). US resulted in good reliability, with no significant differences from Day 1 (39·95 ± 15·37%) to Day 2 (40·01 ± 15·42%). Relative consistency was 0·96, and standard error of measure was 0·94%. Although US overpredicted %Fat compared to the criterion, a moderate SEE for US is suggestive of a practical assessment tool in overweight individuals. %Fat differences reported from these field-based techniques are less than reported by other single-measurement laboratory methods and therefore may have utility in a clinical setting. This technique may also accurately track changes.
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Affiliation(s)
- Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Human Movement Sciences, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Malia N M Blue
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Eric T Trexler
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Human Movement Sciences, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
| | - Katie R Hirsch
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Human Movement Sciences, Department of Allied Health Science, University of North Carolina, Chapel Hill, NC, USA
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Lozano-Lozano M, Martín-Martín L, Galiano-Castillo N, Álvarez-Salvago F, Cantarero-Villanueva I, Fernández-Lao C, Sánchez-Salado C, Arroyo-Morales M. Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial. BMC Med Inform Decis Mak 2016; 16:150. [PMID: 27887610 PMCID: PMC5124301 DOI: 10.1186/s12911-016-0394-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. METHODS This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. DISCUSSION This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).
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Affiliation(s)
- Mario Lozano-Lozano
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain
| | | | - Noelia Galiano-Castillo
- Department Physical Therapy, University of Granada, Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | | | - Irene Cantarero-Villanueva
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | - Carolina Fernández-Lao
- Department Physical Therapy, University of Granada, Granada, Spain.,Mixed University Sport and Health Institute (iMUDS), Granada, Spain.,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain
| | | | - Manuel Arroyo-Morales
- Department Physical Therapy, University of Granada, Granada, Spain. .,Mixed University Sport and Health Institute (iMUDS), Granada, Spain. .,Institute for Biomedical Research ibs.GRANADA, University Hospital Complex of Granada/ University of Granada, Granada, Spain.
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Smith S, Madden AM. Body composition and functional assessment of nutritional status in adults: a narrative review of imaging, impedance, strength and functional techniques. J Hum Nutr Diet 2016; 29:714-732. [PMID: 27137882 DOI: 10.1111/jhn.12372] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The accurate and valid assessment of body composition is essential for the diagnostic evaluation of nutritional status, identifying relevant outcome measures, and determining the effectiveness of current and future nutritional interventions. Developments in technology and our understanding of the influences of body composition on risk and outcome will provide practitioners with new opportunities to enhance current practice and to lead future improvements in practice. This is the second of a two-part narrative review that aims to critically evaluate body composition methodology in diverse adult populations, with a primary focus on its use in the assessment and monitoring of under-nutrition. Part one focused on anthropometric variables [Madden and Smith (2016) J Hum Nutr Diet 29: 7-25] and part two focuses on the use of imaging techniques, bioelectrical impedance analysis, markers of muscle strength and functional status, with particular reference to developments relevant to practice.
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Affiliation(s)
- S Smith
- School of Health Sciences, Queen Margaret University, Edinburgh, UK
| | - A M Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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39
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Bazzocchi A, Filonzi G, Ponti F, Albisinni U, Guglielmi G, Battista G. Ultrasound: Which role in body composition? Eur J Radiol 2016; 85:1469-80. [PMID: 27235340 DOI: 10.1016/j.ejrad.2016.04.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 03/01/2016] [Accepted: 04/13/2016] [Indexed: 01/21/2023]
Abstract
Ultrasound is a non-invasive, fast, relatively inexpensive and available tool for estimating adiposity in clinical practice, and in several research settings. It does not expose patients to ionizing radiation risks, making the method ideal for the evaluation, and for follow-up studies. Several parameters and indexes based on adipose tissue thickness have been introduced and tested, and these have been correlated with clinical and laboratoristic parameters. Moreover, ultrasound can also be directed to the estimation of adipose tissue and intracellular fat indirectly, at cellular-molecular level: an opportunity for many radiologists who already and sometimes unconsciously perform "body composition" assessment when looking at the liver, at muscle as well as at other organs. However, standardized procedure and parameters are needing to improve accuracy and reproducibility. The purposes of this review are: 1) to provide a complete overview of the most used and shared measurements of adiposity; 2) to analyze technical conditions, accuracy, and clinical meaning of ultrasound in the study of body composition; 3) to provide some elements for the use of ultrasound in the evaluation of intra-cellular lipids accumulation, in two hot spots: liver and skeletal muscle.
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Affiliation(s)
- Alberto Bazzocchi
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy.
| | - Giacomo Filonzi
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Federico Ponti
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy; Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna. Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
| | - Ugo Albisinni
- Diagnostic and Interventional Radiology, The "Rizzoli" Orthopaedic Institute, Via G. C. Pupilli 1, 40136 Bologna, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100 Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Battista
- Department of Specialized, Diagnostic, and Experimental Medicine, University of Bologna. Sant'Orsola-Malpighi Hospital, Via G. Massarenti 9, 40138 Bologna, Italy
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Estimation of body fat in adults using a portable A-mode ultrasound. Nutrition 2016; 32:441-6. [DOI: 10.1016/j.nut.2015.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 10/08/2015] [Accepted: 10/10/2015] [Indexed: 11/24/2022]
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Ripka WL, Ulbricht L, Menghin L, Gewehr PM. Portable A-Mode Ultrasound for Body Composition Assessment in Adolescents. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:755-760. [PMID: 26960803 DOI: 10.7863/ultra.15.02026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Ultrasound (US) imaging is a low-cost, highly feasible alternative method for monitoring the nutritional status of a population; however, only a few studies have tested the body composition agreement between US and reference standard methods, especially in adolescents. The purposes of this study were to assess the agreement of portable US with a reference standard method, dual-energy x-ray absorptiometry (DXA), for body fat percentage (BF%) in adolescents and to verify whether the use of a new mathematical model, based on the anatomic thickness obtained by US, is capable of improving BF% prediction. METHODS This research was a descriptive study. Measures of total body mass, BF% on DXA, and BF% on US were collected from 105 adolescents. RESULTS The participants included 71 male adolescents (median age ・} interquartile range, 14.0 ・} 2.0 years) and 34 female adolescents (13.0 ・} 2.3 years). Ultrasound yielded significantly lower BF% values than DXA for male (mean ・} SD, US, 9.6% ・} 6.6%; DXA, 20.0% ・} 7.2%; R= 0.848; P< .05) and female (US, 22.5% ・} 5.7%; DXA, 30.3% ・} 4.9%; R = 0.495; P < .05) participants. In addition, Bland-Altman analysis showed low concordance. When a multivariate regression was tested, the results improved for both sexes (US, 20.3% ・} 4.6%; R= 0.848; P= .503) and female participants (US, 29.0% ・} 5.7%; R= 0.712; P = .993) with a standard estimate of error of 1.57%. CONCLUSIONS This study has shown that US applied in a specific regression for BF% prediction in adolescents
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Lei K, Ma Q, Yu L, Ding J. Functional biomedical hydrogels for in vivo imaging. J Mater Chem B 2016; 4:7793-7812. [DOI: 10.1039/c6tb02019d] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In vivo imaging of biomedical hydrogels enables real-time and non-invasive visualization of the status of structure and function of hydrogels.
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Affiliation(s)
- Kewen Lei
- State Key Laboratory of Molecular Engineering of Polymers
- Department of Macromolecular Science
- Fudan University
- Shanghai 200433
- China
| | - Qian Ma
- State Key Laboratory of Molecular Engineering of Polymers
- Department of Macromolecular Science
- Fudan University
- Shanghai 200433
- China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers
- Department of Macromolecular Science
- Fudan University
- Shanghai 200433
- China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers
- Department of Macromolecular Science
- Fudan University
- Shanghai 200433
- China
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Jones S, Chiesa ST, Chaturvedi N, Hughes AD. Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen. Artery Res 2016; 16:25-33. [PMID: 27942271 PMCID: PMC5134760 DOI: 10.1016/j.artres.2016.09.001] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose of review Continuous wave near infrared spectroscopy (CW NIRS) provides non-invasive technology to measure relative changes in oxy- and deoxy-haemoglobin in a dynamic environment. This allows determination of local skeletal muscle O2 saturation, muscle oxygen consumption (V˙O2) and blood flow. This article provides a brief overview of the use of CW NIRS to measure exercise-limiting factors in skeletal muscle. Recent findings NIRS parameters that measure O2 delivery and capacity to utilise O2 in the muscle have been developed based on response to physiological interventions and exercise. NIRS has good reproducibility and agreement with gold standard techniques and can be used in clinical populations where muscle oxidative capacity or oxygen delivery (or both) are impaired. CW NIRS has limitations including: the unknown contribution of myoglobin to the overall signals, the impact of adipose tissue thickness, skin perfusion during exercise, and variations in skin pigmentation. These, in the main, can be circumvented through appropriate study design or measurement of absolute tissue saturation. Summary CW NIRS can assess skeletal muscle O2 delivery and utilisation without the use of expensive or invasive procedures and is useable in large population-based samples, including older adults. An overview of CW NIRS to measure O2 utilisation and delivery is presented. CW NIRS is cheap, non-invasive, portable and useable in population-based samples. It is useful for understanding underlying mechanisms of deterioration in capacity.
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Affiliation(s)
- Siana Jones
- Corresponding author. UCL Institute of Cardiovascular Science, 10th Floor, 1-19 Torrington Place, London WC1E 7HB, UK. Fax: +44 207 594 1706.UCL Institute of Cardiovascular Science10th Floor, 1-19 Torrington PlaceLondonWC1E 7HEUK
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Noites A, Nunes R, Gouveia AI, Mota A, Melo C, Viera Á, Adubeiro N, Bastos JM. Effects of aerobic exercise associated with abdominal microcurrent: a preliminary study. J Altern Complement Med 2015; 21:229-36. [PMID: 25875939 DOI: 10.1089/acm.2014.0114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To analyze the short- and long-term effects of microcurrent used with aerobic exercise on abdominal fat (visceral and subcutaneous). METHODS Forty-two female students from a university population were randomly assigned into five group: intervention group (IG) 1 (n=9), IG2 (n=9), IG3 (n=7), IG4 (n=8), and placebo group (PG) (n=9). An intervention program of 10 sessions encompassing microcurrent and aerobic exercise (performed with a cycloergometer) was applied in all groups, with slightly differences between them. In IG1 and IG2, microcurrent with transcutaneous electrodes was applied, with different frequency values; 30-minute exercise on the cycloergometer was subsequently performed. IG3 used the same protocol as IG1 but with different electrodes (percutaneous), while in IG4 the microcurrent was applied simultaneously with the cycloergometer exercise. Finally, the PG used the IG1 protocol but with the microcurrent device switched off. All groups were evaluated through ultrasound and abdominal perimeter measurement for visceral and subcutaneous abdominal fat assessment; through calipers for skinfolds measurement; through bioimpedance to evaluate weight, fat mass percentage, and muscular mass; and through blood analyses to measure cholesterol, triglyceride, and glucose levels. RESULTS After intervention sessions, visceral fat decreased significantly in IG1 compared with the PG. Subcutaneous fat was reduced significantly in all groups compared with the PG. After 4 weeks, almost all results were maintained. CONCLUSION The addition of microcurrent to aerobic exercise may reduce fat more than does aerobic exercise alone.
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Affiliation(s)
- Andreia Noites
- 1 Department of Physiotherapy, School of Allied Health Technologies, Polytechnic Institute of Porto , Vila Nova de Gaia, Portugal
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Toomey C, Leahy S, McCreesh K, Coote S, Jakeman P. The body composition phenotype of Irish adults aged 18–81 years. Ir J Med Sci 2015; 185:537-44. [DOI: 10.1007/s11845-015-1338-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/18/2015] [Indexed: 01/17/2023]
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Wojda TR, Cardone MS, Lo WD, Stawicki SPA, Evans DC. Ultrasound and Computed Tomography Imaging Technologies for Nutrition Assessment in Surgical and Critical Care Patient Populations. CURRENT SURGERY REPORTS 2015. [DOI: 10.1007/s40137-015-0099-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abe T, Loenneke JP, Young KC, Thiebaud RS, Nahar VK, Hollaway KM, Stover CD, Ford MA, Bass MA, Loftin M. Validity of ultrasound prediction equations for total and regional muscularity in middle-aged and older men and women. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:557-564. [PMID: 25444689 DOI: 10.1016/j.ultrasmedbio.2014.09.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/07/2014] [Accepted: 09/02/2014] [Indexed: 06/04/2023]
Abstract
To test the validity of published equations, 79 Caucasian adults (40 men and 39 women) aged 50-78 y had muscle thickness (MT) measured by ultrasound at nine sites of the body. Fat-free mass (FFM), lean soft tissue mass (LM) and total muscle mass (TMM) were estimated from MT using equations previously published in the literature. Appendicular LM (aLM) was estimated using dual-energy X-ray absorptiometry (DXA) and this method served as the reference criterion. There were strong correlations (range r = 0.85-0.94) between DXA-derived aLM and estimated FFM, leg LM or TMM. Total error between DXA-derived aLM and TMM (∼2 kg) was lower compared with the three other selected equations (6-10 kg). A Bland-Altman plot revealed that there was no systematic bias between aLM and TMM; however, the other three equations included systematic error. Our results suggest that an ultrasound equation for TMM is appropriate and useful for evaluating skeletal muscle mass in the body.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA.
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA
| | - Kaelin C Young
- Department of Human Performance Studies, College of Education, Wichita State University, Wichita, KS, USA
| | - Robert S Thiebaud
- Department of Kinesiology, School of Education, Texas Wesleyan University, Fort Worth, TX, USA
| | - Vinayak K Nahar
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA
| | - Kaitlyn M Hollaway
- Department of Human Performance Studies, College of Education, Wichita State University, Wichita, KS, USA
| | - Caitlin D Stover
- Department of Human Performance Studies, College of Education, Wichita State University, Wichita, KS, USA
| | - M Allison Ford
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA
| | - Martha A Bass
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA
| | - Mark Loftin
- Department of Health, Exercise Science, and Recreation Management, School of Applied Science, The University of Mississippi, University, MS, USA
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Gold Nanoparticle-assisted Selective Photothermolysis of Adipose Tissue (NanoLipo). PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 2:e283. [PMID: 25587517 PMCID: PMC4292265 DOI: 10.1097/gox.0000000000000251] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/06/2014] [Indexed: 11/30/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Conventional suction-assisted lipectomy (SAL) often results in contour irregularity. Selective photothermal heating of adipose tissue by polymer-coated gold nanorods energized by an external near-infrared exposure at 800 nm is introduced in this work to facilitate fat removal. Methods: The effects of NanoLipo were examined in food-grade porcine abdominal tissue (skin, fat, and fascia) by histology. The efficacy of NanoLipo was compared with that of conventional SAL in vivo in Yucatan mini pigs by quantification of removed subcutaneous tissue and fatty acids and ultrasound measurement of adipose layer thickness. Results: NanoLipo led to the appearance of disruptions in adipose tissue that were not apparent in control groups in ex vivo samples. NanoLipo allowed removal of more subcutaneous tissue (~33% vs ~25% of removed material, P < 0.05) and approximately twice as much free fatty acids (~60% vs ~30% of removed tissue, P < 0.05) in comparison with conventional SAL. Most importantly, NanoLipo led to a greater decrease in adipose layer thickness at 1 month post surgery (P < 0.001). Conclusions: NanoLipo facilitates removal of a greater quantity of fat and requires less suction time (4 vs 10 minutes) than conventional SAL. As the safety of poly(ethylene-glycol)-coated gold nanorods is well-established, a clinical trial is currently being organized.
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Smith-Ryan AE, Fultz SN, Melvin MN, Wingfield HL, Woessner MN. Reproducibility and validity of A-mode ultrasound for body composition measurement and classification in overweight and obese men and women. PLoS One 2014; 9:e91750. [PMID: 24618841 PMCID: PMC3950249 DOI: 10.1371/journal.pone.0091750] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/14/2014] [Indexed: 11/18/2022] Open
Abstract
Identifying portable methods to measure body composition may be more advantageous than using body mass index (BMI) to categorize associated health consequences. Purpose: To compare the validity and reliability of a portable A-mode ultrasound (US) to a criterion three compartment model (3C) for the measurement of body composition. Methods: Forty-seven overweight and obese subjects participated in this study. Body composition was measured once via air displacement plethysmography for body density (Bd) and bioelectrical impedance spectroscopy for total body water (TBW) for the 3C calculations. Ultrasound measurements (BodyMetrix, Intelametrix) were made using an A mode, 2.5- MHz transmitter. All measurements were made on the right side of the body at 7 skinfold sites. The US software calculated percent body fat (%BF), fat mass (FM) and fat free mass (FFM) from the 7-site Jackson and Pollock equation. Results: %BF and FM, respectively, measured by the US (29.1±6.5%; 27.4±8.1 kg) was significantly lower compared to the 3C model (33.7±7.6%; 31.8±9.8 kg; p<0.0005). Fat free mass was significantly higher for the US (66.7±13.0 kg) compared to the 3C model (62.3±12.6; p = 0.001). The US demonstrated respectable reliability for %BF, FM, and FFM with intraclass correlation coefficients (ICC) ranging from 0.84–0.98 and standard error of the measurement (SEM) values and 2.2%BF, 1.9 kg, 1.9 kg, respectively. Discussion: The US was found to under predict %BF and FM with large deviations from the criterion (n = 10>4%BF error). While the US was not valid in this population, it was reliable producing results with minimal error, suggesting this technique may be effective for tracking changes in a weight loss or clinical setting.
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Affiliation(s)
- Abbie E. Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Sarah N. Fultz
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Malia N. Melvin
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Hailee L. Wingfield
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Mary N. Woessner
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, United States of America
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Liao YK, Tseng SH. Reliable recovery of the optical properties of multi-layer turbid media by iteratively using a layered diffusion model at multiple source-detector separations. BIOMEDICAL OPTICS EXPRESS 2014; 5:975-89. [PMID: 24688828 PMCID: PMC3959844 DOI: 10.1364/boe.5.000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 02/09/2014] [Accepted: 02/21/2014] [Indexed: 05/13/2023]
Abstract
Accurately determining the optical properties of multi-layer turbid media using a layered diffusion model is often a difficult task and could be an ill-posed problem. In this study, an iterative algorithm was proposed for solving such problems. This algorithm employed a layered diffusion model to calculate the optical properties of a layered sample at several source-detector separations (SDSs). The optical properties determined at various SDSs were mutually referenced to complete one round of iteration and the optical properties were gradually revised in further iterations until a set of stable optical properties was obtained. We evaluated the performance of the proposed method using frequency domain Monte Carlo simulations and found that the method could robustly recover the layered sample properties with various layer thickness and optical property settings. It is expected that this algorithm can work with photon transport models in frequency and time domain for various applications, such as determination of subcutaneous fat or muscle optical properties and monitoring the hemodynamics of muscle.
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Affiliation(s)
- Yu-Kai Liao
- Department of Photonics, National Cheng-Kung University, Tainan 701, Taiwan
| | - Sheng-Hao Tseng
- Department of Photonics, National Cheng-Kung University, Tainan 701, Taiwan
- Advanced Optoelectronic Technology Center, National Cheng-Kung University, Tainan 701, Taiwan
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