JCSM clinical reports最新文献

{"title":"Predictive influence of artificial intelligence-based body composition analysis in trauma patients with pelvic injuries","authors":"Johannes Kolck,&nbsp;Frederik Maximilian Schäfer,&nbsp;Kirsten Labbus,&nbsp;Silvan Wittenberg,&nbsp;Clarissa Hosse,&nbsp;Timo Alexander Auer,&nbsp;Uli Fehrenbach,&nbsp;Dominik Geisel,&nbsp;Nick Lasse Beetz","doi":"10.1002/crt2.61","DOIUrl":"10.1002/crt2.61","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High-energy trauma patients represent the ultimate challenge to trauma care and are at risk of injury-related mortality and morbidity—a common cause of loss of productivity. The aim of this study was to implement computed tomography (CT)-derived, artificial intelligence (AI)-based body composition analysis (BCA) to identify predictors of morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospectively, we enrolled 104 patients (38 females and 66 males) who underwent CT imaging for assessment of injuries caused by high-energy trauma (motor vehicle accidents, falls from significant height, or blast injury). We sought to identify risk factors for prolonged length of stay in hospital and intensive care unit (ICU) and fractures requiring pelvic surgery. Cox and logistic regression analysis were performed using BCA parameters as covariates besides conventional risk factors. Additionally, the effects of pre-existing conditions, obesity, and sarcopenia were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Increased subcutaneous adipose tissue (SAT), determined by BCA, at hospital admittance is a predictor of prolonged hospital stay (<i>P</i> = 0.02) independent of treatment regime and occurrence of related complications, whereas muscle mass does not influence the length of stay. Individuals with sarcopenia and a decreased psoas muscle index (PMI) sustaining high-energy trauma are at risk of pelvic injuries requiring surgical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCA parameters are easily available from routine CT and significantly predict outcomes in trauma patients with pelvic injuries. Patients with reduced muscle mass are at risk for injuries requiring pelvic surgery, and increased SAT is a risk factor for longer hospital stays. These findings underline the potential of BCA, which may be valuable in identifying trauma patients who require specific support to optimize their physiological reserves and clinical outcome.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"8 3","pages":"49-57"},"PeriodicalIF":0.0,"publicationDate":"2023-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.61","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41412323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of radiological definitions of sarcopenia in cancer","authors":"James W. Wang,&nbsp;Jiarong Chen,&nbsp;Alison H. McGregor,&nbsp;Matthew Williams","doi":"10.1002/crt2.60","DOIUrl":"10.1002/crt2.60","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia in cancer impacts overall survival, surgical complications, and side effects of oncological treatments. Cancer patients frequently receive cross-sectional imaging, allowing incidental capture of radiological sarcopenia biomarkers. These biomarkers vary by imaging modality, tumour group, patient demographics, and anatomy but lack a consensus with regard to clinical application. In this article, we provide an overview of radiology-based sarcopenia biomarkers by anatomy and their prevalence in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In accordance with previously published scoping review protocol, we searched PubMed/MEDLINE, Embase, Scopus, and Cochrane between 2007 and June 2021. Studies were independently reviewed by two authors with Cohen's kappa 0.81 and reported using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 5649 titles and abstracts reviewed, including 459 full-text articles. There were 23 additions found through references, resulting in 482 total studies. There is a consistent year-on-year increase of new radiological sarcopenia landmarks since 2015, with 49.8% studies reporting novel definitions of sarcopenia. The majority of studies ranged between 50 and 300 participants and featured an abdominal sarcopenia marker (94.4%), of which 75.2% used the skeletal muscle index at L3 (L3SMI). Sarcopenia prevalence ranged from 8.33% to 89.66%. Biomarkers are often applied across genders and ethnicities, regardless of the original population the definition originated from, despite the emergence and availability of ethnic-specific alternatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There remains a need to incorporate demographics and age into predictive models derived from sarcopenia biomarkers obtained through routine clinical imaging. Use of individual biomarkers needs to be made with careful consideration of the population in which the biomarkers were generated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"8 2","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.60","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46381799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of low muscle mass on prognosis following neoadjuvant chemotherapy for resectable locally advanced rectal cancer: a systematic review and meta-analysis","authors":"Jacob Hatt,&nbsp;Thomas F.F. Smart,&nbsp;Edward J. Hardy,&nbsp;Brett Doleman,&nbsp;Jonathan N. Lund,&nbsp;Bethan E. Philips","doi":"10.1002/crt2.59","DOIUrl":"10.1002/crt2.59","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia is characterized by the progressive and generalized loss of muscle mass and function. There is an increasing body of evidence to suggest that cancer patients with pre-existing sarcopenia are at a greater risk of both short- and long-term clinical complications. The aim of this review is to examine the impact of low muscle mass on prognostic outcomes in patients with locally advanced rectal cancer (LARC) who undergo neoadjuvant chemoradiotherapy (nCRT) prior to surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, PubMed, and Embase databases were searched from inception to October 2021. Any comparative studies relating to the prognostic outcomes of sarcopenic versus non-sarcopenic patients with LARC who received nCRT prior to surgery were included. Risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I). Meta-analysis was performed on reported hazard ratios (HR) and 95% confidence intervals (CI) using DerSimonian–Laird random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 598 patients from five studies were included in the analysis of hazard ratios for overall survival, whereas 505 patients from four studies were available for analysis of HR for disease-free survival. Meta-regression analysis showed a significant association between pre-existing sarcopenia and worse overall survival (HR: 1.69, 95% CI: 1.15–2.48). The association between pre-existing sarcopenia and shorter disease-free survival was not statistically significant (HR: 1.07, 95% CI: 0.63–1.82).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The review highlights the role that body composition can play on prognostic outcomes in patients undergoing multimodal cancer treatment. Given the complex underpinnings of sarcopenia progression, more research is needed to develop strategies to mitigate this impact in a physiologically vulnerable population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"8 2","pages":"27-35"},"PeriodicalIF":0.0,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.59","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41559384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle flexor/extensor strength and muscle density are complementary determinants of balance during dual-task engagement: The ankle quality study","authors":"Andy K. O. Wong,&nbsp;Hugo J. W. Fung,&nbsp;Steven P. Pretty,&nbsp;Andrew C. Laing,&nbsp;Adrian H. Chan,&nbsp;Sunita Mathur,&nbsp;Karl Zabjek,&nbsp;Lora Giangregorio,&nbsp;Angela M. Cheung","doi":"10.1002/crt2.58","DOIUrl":"10.1002/crt2.58","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated relative contributions of ankle flexor torque, muscle size, and density on balance and falls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Men and women ≥50 years of age completed a peripheral quantitative computed tomography scan of the mid-leg to quantify muscle density (MD) and cross-sectional area; Biodex dynamometry to evaluate maximal isometric ankle flexor torque; and a single-leg balance test on a force platform with/without eyes closed and cognitive task. Ankle flexor torque, muscle size, and density individually, together, or as interactions were examined for associations with balance (mean step duration, steps/trial) in general linear models, or with falls in Poisson regression, adjusting for age, sex, BMI, glucocorticoid use, osteoarthritis, and physical activity. Visuo-cognitive conditions were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 105 participants (age: 63.3 ± 9.9 years, BMI: 25.8 ± 5.4 kg/m², 77.1% female), 41.8% experienced ≥1 fall in the last year. Balance on one leg was dependent on ankle flexor torque when eyes were open (<i>r</i> = −0.220 to −0.284) and on having leaner mid-leg muscles when eyes were closed (<i>r</i> = −0.123 to −0.142); cognitive challenge blunted these correlations. Individuals with leaner muscles tended to rely more on plantarflexors than dorsiflexors. A 2% lower step-free fraction in the eyes-closed paradigm associated with having 1 additional fall [−0.701(−1.235, −0.167)], but neither torque, muscle density, nor size related to number of falls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among ambulatory adults, ankle flexor torque and muscle density showed an interactive influence on balance that depended on visuo-cognitive input. The complementary roles of torque and muscle density on balance suggest redundancy is important under dual-tasking conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"8 1","pages":"12-23"},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.58","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45564514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between computed tomography-derived sarcopenia, cardiopulmonary exercise testing performance, systemic inflammation, and survival in good performance status patients with oesophago-gastric cancer undergoing neoadjuvant treatment","authors":"Josh McGovern,&nbsp;Jenna Delaney,&nbsp;Matthew J. Forshaw,&nbsp;Gerard McCabe,&nbsp;Andrew B. Crumley,&nbsp;David McIntosh,&nbsp;Barry J. Laird,&nbsp;Paul G. Horgan,&nbsp;Donald C. McMillan,&nbsp;Stephen T. McSorley,&nbsp;Ross D. Dolan","doi":"10.1002/crt2.57","DOIUrl":"10.1002/crt2.57","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thought to capture the nutritional and functional reserve of the cancer patient, whether the computed tomography (CT)-derived sarcopenia score (CT-SS) has complimentary prognostic value to commonly utilized pre-treatment host assessments in patients with oesophago-gastric (OG) cancer is unknown. The aim of the present study was to examine if the CT-SS can stratify survival in OG cancer patients with good performance status [Eastern Cooperative Oncology Group Performance Status (ECOG-PS) 0/1]. Furthermore, if the CT-SS had complimentary prognostic value to cardiopulmonary exercise testing (CPET) performance and systemic inflammation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients with confirmed OG cancer and good performance status, who received neoadjuvant chemotherapy (NAC) with a view to surgical resection with curative intent, between 1 January 2010 and 31 December 2015, within NHS Greater Glasgow and Clyde (NHSGGC) and NHS Forth Valley (NHSFV), were identified from a prospectively maintained database. CT-SSs were grouped as 0/1/2. CPET variables recorded included VO₂ anaerobic threshold (AT) and peak. Systemic inflammatory response was determined by modified Glasgow prognostic score (mGPS) and neutrophil/lymphocyte ratio (NLR). Associations between categorical variables were examined using <i>χ</i>² test and binary logistics regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 232 patients met the inclusion criteria. 75% (<i>n</i> = 174) of patients were male, 54% (<i>n</i> = 126) were 65 years or older, and 60% (<i>n</i> = 139) were overweight [body mass index (BMI) ≥25 kg/m²]; 33% (<i>n</i> = 77) of patients had CT-SS ≥ 1, 36% (<i>n</i> = 83) had a low VO₂ AT (≤11 ml/kg/min), and 57% (<i>n</i> = 132) had a low VO₂ peak (≤19 ml/kg/min). Of the 200 patients who had pre-NAC bloods facilitating calculation of the mGPS, 28% (<i>n</i> = 55) had mGPS ≥ 1. Of the 211 patients who had pre-NAC bloods facilitating calculation of NLR, 38% (<i>n</i> = 80) had an NLR ≥ 3; 82% (<i>n</i> = 190) and 53% (<i>n</i> = 122) were alive at 1 and 3 years post-NAC, respectively. On univariate analysis, CT-SS was significantly associated with sex (<i>P</i> &lt; 0.05), histological cell type (<i>P</i> &lt; 0.05), low VO₂ AT (<i>P</i> &lt; 0.05), low VO₂ peak (<i>P</i> &lt; 0.05), BMI (<i>P</i> &lt; 0.05), mGPS (<i>P</i> &lt; 0.05), and 3-year survival (<i>P</i> &lt; 0.05). On multivariate analysis, tumour, node, and metastasis (TNM) stage (<i>P</i> &lt; 0.05) and CT-SS (<i>P</i> &lt; 0.05) remained significant","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"8 1","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.57","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48251292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malnutrition and nutritional screening in patients undergoing surgery in low and middle income countries: A systematic review","authors":"Debra Jones,&nbsp;Stephen R. Knight,&nbsp;Jana Sremanakova,&nbsp;Marie Carmela M. Lapitan,&nbsp;Ahmad U. Qureshi,&nbsp;Thomas M. Drake,&nbsp;Stephen Tabiri,&nbsp;Dhruva Ghosh,&nbsp;Maria Thomas,&nbsp;Pamela A. Kingsley,&nbsp;Sudha Sundar,&nbsp;Mayaba Maimbo,&nbsp;Edwin Yenli,&nbsp;Catherine Shaw,&nbsp;Apple P. Valparaiso,&nbsp;Aneel Bhangu,&nbsp;Laura Magill,&nbsp;John Norrie,&nbsp;Tracey E. Roberts,&nbsp;Evropi Theodoratou,&nbsp;Thomas G. Weiser,&nbsp;Ewen M. Harrison,&nbsp;Sorrel T. Burden,&nbsp;NIHR Global Health Research Unit on Global Surgery","doi":"10.1002/crt2.55","DOIUrl":"10.1002/crt2.55","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a high incidence of preoperative undernutrition in hospitalised patients in low and middle-income countries (LMICs), leading to increased postoperative complications, length of hospital stay and early mortality. Review aims are to establish the prevalence of undernutrition and assess the use of validated nutritional screening tools in surgical patients across LMICs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Protocol was PRISMA compliant and Prospero registered (CRD42019126765). Twelve international databases were searched from January 1990 to April 2021. Included studies were on nutritional screening in adults (≥16 years) undergoing surgery in LMICs. Two researchers screened studies and assessed quality. Prevalence of undernutrition was presented as a weighted percentage with confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 4649 records identified, 16 studies (<i>n</i> = 4032) were eligible. Subjective global assessment (SGA) or patient generated (PG)-SGA were the tools used most widely. SGA and PG-SGA showed a high prevalence of undernutrition overall (0.61, 95% CI 0.50, 0.73), with a proportion identified with moderate undernutrition (0.44, 95% CI 0.31, 0.57) or severe undernutrition (0.32, 95% CI 0.19, 0.45).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Data show the prevalence of undernutrition in surgical patients as high as three in five patients within LMICs. Results indicate that the SGA is suitable for assessing this group of patients and that it may be the most appropriate tool to use due to its subjectivity and reliability. PG-SGA although similar includes more symptom assessment, which is important for nutritionally depleted cancer patients. The limited data on validity and reliability of nutritional screening tools in LMICs indicates further research is required.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"7 4","pages":"79-92"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.55","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44212416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of nicotinamide adenine dinucleotide precursors on measures of physical performance and physical frailty: A systematic review","authors":"Fred J. Barker,&nbsp;Ashley Hart,&nbsp;Avan A. Sayer,&nbsp;Miles D. Witham","doi":"10.1002/crt2.56","DOIUrl":"10.1002/crt2.56","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nicotinamide adenine dinucleotide (NAD) is a key molecule in muscle metabolism and energy production; skeletal muscle concentrations are low in older people with sarcopenia. Although preclinical data suggest beneficial effects of NAD precursor supplementation, the effects on skeletal muscle function and physical frailty in humans are unclear. This systematic review evaluated the effects of NAD precursor supplementation on measures of physical performance and physical frailty in humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included randomized controlled trials assessing outcomes relevant to either physical performance or any of Fried's frailty phenotype domains: slowness, weakness, exhaustion, low physical activity and weight loss. All review stages were conducted independently by two separate authors. A systematic search strategy was used searching multiple databases (MEDLINE, EMBASE, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, NHS e-Library, and Google Scholar) to find appropriate trials. Risk of bias was assessed using the Cochrane Risk-of-Bias 2 tool. Results were grouped by intervention and phenotypic domain and were described through narrative synthesis. Sensitivity analyses were conducted for trials with a mean age &gt;60 years and trials with low risk of bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six trial populations across 23 studies met inclusion criteria; size ranged from 2 to 77 participants. No trials assessed frailty as a composite outcome, though at least one Fried frailty domain was assessed in almost all included trials. A range of interventions were investigated; niacin (<i>n</i> = 8) and nicotinamide riboside (<i>n</i> = 7) were the most commonly assessed. Most trials examined short-term interventions of up to 6 months duration, with 13 out of 26 trials lasting 1 week or less. A total of 96 primary outcomes were assessed across trials, 10 of which were in favour of an NAD precursor whereas 1 was in favour of placebo; the remainder were not statistically significant in any clear direction. Methodological heterogeneity across trials precluded meta-analysis for any outcome. Trial populations were heterogeneous and only four trials enrolled participants with a mean age ≥60 years. Risk of bias analysis found unclear or high risk of bias in all but one trial. There was no clear pattern as to whether NAD precursors improved any measure of physical performance or any domain of the frailty phenotype; the majority of trials reported neutral findings for most outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conc","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"7 4","pages":"93-106"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.56","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The combination of computed tomography-derived muscle mass and muscle density and relationship with clinicopathological characteristics and survival in patients undergoing potentially curative surgery for colorectal cancer","authors":"Josh McGovern,&nbsp;Allan M. Golder,&nbsp;Ross D. Dolan,&nbsp;Campbell S.D. Roxburgh,&nbsp;Paul G. Horgan,&nbsp;Donald C. McMillan","doi":"10.1002/crt2.54","DOIUrl":"10.1002/crt2.54","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcopenia has been defined as a loss of muscle mass and function. CT-derived muscle measurements, skeletal muscle index (SMI) and density (SMD), taken together may provide an objective measure of sarcopenia. The aim of the present study was to examine the relationship between CT-derived sarcopenia (low SMI and SMD), clinicopathological characteristics, systemic inflammation and survival in patients undergoing surgery for colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients who underwent resections for colorectal cancer (TNM I–III) at our institution, between April 2008 and 2018, were identified from a prospectively maintained database. CT-derived muscle mass (SMI) and density (SMD) measurements were combined to form the CT-Sarcopenia score (CT-SS). Thresholds for low SMI and SMD reported by Martin and co-workers and Caan/Xiao and co-workers were combined to form two iterations of the CT-SS. Patients were categorized as normal/high SMI (irrespective of SMD) = 0, low SMI and normal/high SMD = 1 and low SMI and low SMD = 2. The Pearson Chi square test was used to examine the associations between categorical variables and the Chi square test for linear trend was used for ordered variables with multiple categories. Survival data were analysed using univariate and multivariate Cox regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand and two patients met the study inclusion criteria. Fifty-five per cent (<i>n</i> = 554) of patients were male and 66% (<i>n</i> = 657) were aged 65 years or older. Twenty-four per cent (<i>n</i> = 240) of patients had TNM stage I disease, 40% (<i>n</i> = 404) stage II and 36% (<i>n</i> = 358) stage III. Eighteen per cent (<i>n</i> = 174) of patients were at risk of malnutrition. Forty-eight per cent (<i>n</i> = 479) of patients had an NLR ≥ 3 and 27% (<i>n</i> = 271) had an mGPS ≥ 1. Similar numbers of patients defined as CT-SS 0, 1 and 2 irrespective of thresholds applied (49%/12%/39% vs. 43%/19%/38%, respectively). Eight hundred and thirty four (<i>n</i> = 834) patients who underwent surgical resection for non-metastatic colorectal cancer with curative intent were alive at 3 years. On univariate analysis, both the CT-SS (Martin/Martin) and CT-SS (Caan/Xaio) were significantly associated with age (<i>P</i> &lt; 0.001 and <i>P</i> &lt; 0.001, respectively), ASA (<i>P</i> &lt; 0.01 and <i>P</i> &lt; 0.001, respectively), MUST (<i>P</i> &lt; 0.001 and <i>P</i> &lt; 0.005, respectively), mGPS (<i>P</i> &lt; 0.001 and <i>P</i> &lt; 0.001, respectively), NLR (<i>P</i> &lt; 0.001 and <i>P</i> &lt; 0.001, respectively), and overall survival (","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"7 3","pages":"65-76"},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.54","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41903199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body composition assessment by artificial intelligence from routine computed tomography scans in colorectal cancer: Introducing BodySegAI","authors":"Dena Helene Alavi,&nbsp;Tomas Sakinis,&nbsp;Hege Berg Henriksen,&nbsp;Benedicte Beichmann,&nbsp;Ann-Monica Fløtten,&nbsp;Rune Blomhoff,&nbsp;Peter Mæhre Lauritzen","doi":"10.1002/crt2.53","DOIUrl":"10.1002/crt2.53","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Body composition is of clinical importance in colorectal cancer patients, but is rarely assessed because of time-consuming manual segmentation. We developed and tested BodySegAI, a deep learning-based software for automated body composition quantification from routinely acquired computed tomography (CT) scans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-dimensional U-Net convolutional network was trained on 2989 abdominal CT slices from L2 to S1 to segment skeletal muscle (SM), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular and intramuscular adipose tissue (IMAT). Human ground truth was established by combining segmentations from three human readers. BodySegAI was tested using 154 slices against the human ground truth and compared with a software named AutoMATiCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median Dice scores for BodySegAI against human ground truth were 0.969, 0.814, 0.986, and 0.990 for SM, IMAT, VAT, and SAT, respectively. The mean differences per slice for SM were −0.09 cm³, IMAT: −0.17 cm³, VAT: −0.12 cm³, and SAT: 0.67 cm³. Median absolute errors for SM, IMAT, VAT, and SAT were 1.35, 10.54, 0.91, and 1.07%, respectively. When analysing different anatomical levels separately, L3 and S1 demonstrated the overall highest and lowest Dice scores, respectively. On average, BodySegAI segmented 148 times faster than human readers (4.9 vs. 726.5 seconds, <i>P</i> &lt; 0.001). Also, BodySegAI presented higher Dice scores for SM, IMAT, SAT, and VAT than AutoMATiCA (slices = 154).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BodySegAI rapidly generates excellent segmentation of SM, VAT, and SAT and good segmentation of IMAT in L2 to S1 among colorectal cancer patients and may replace semi-manual segmentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"7 3","pages":"55-64"},"PeriodicalIF":0.0,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46753501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are older adults with hip fractures a specific risk group for vitamin B12 deficiency?","authors":"José Luis Dinamarca-Montecinos,&nbsp;Alejandra Vásquez-Leiva","doi":"10.1002/crt2.48","DOIUrl":"10.1002/crt2.48","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hip fractures (HF) are a high-impact geriatric syndrome. Vitamin B12 deficiency is an HF risk factor. There are few studies on prevalence of B12 deficiency in older adults with HF. The objectives are as follows: in older adults with HF, to describe/characterize plasma levels of vitamin B12 (PL-B12); to verify presence/absence of a subgroup with borderline, near-deficient PLB12; to describe HF incidence; and to analyse relationships between PL-B12 and studied variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional, observational study, analytical component. Complete Collection sample (01.08.2016–31.08.2018). Variables: PL-B12, age, sex, HF location, time of year, in-hospital stay length. Medians/percentiles, non-parametric tests. PL-B12 cut-off points according to the WHO, proposing new cut-off points to capture borderline values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 580 subjects. HF incidence = 264/100 000 ≥ 65 years, 79% female, 72% extracapsular HF. Medians: age = 83 years; PL-B12 = 349 pg/cc; hospitalization = 13 days. Significantly lower PL-B12 in males (<i>P</i> = 0.023) and extracapsular fractures (<i>P</i> = 0.013). No significant differences between age groups, length of hospitalization, and season of the year. Thirty-five per cent B12 deficiency (16% deficiency and 19% mild deficiency). By increasing cut-off point for deficiency to 400 pg/cc, prevalence increased to 58%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High prevalence of vitamin B12 deficiency among older adults with HF, significantly higher in men and extracapsular HF. Twenty-four per cent normal PL-B12 according to WHO criteria, but with borderline, near-deficient levels, at the time of HF. In older adults with HF, we recommend measuring PL-B12 and raising the cut-off level required to diagnose deficiency. We consider that older adults with HF are a specific risk group for vitamin B12 deficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":73543,"journal":{"name":"JCSM clinical reports","volume":"7 2","pages":"44-52"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/crt2.48","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44207843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}