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- Donini, Lorenzo M., et al.
(författare)
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Definition and diagnostic criteria for sarcopenic obesity : ESPEN and EASO consensus statement
- 2022
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 41:4, s. 990-1000
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of an universally established SO Definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes.Aims and methods: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a Definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into Stage I in the absence of clinical complications, or Stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction.Conclusions: ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO Definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing datasets, to study the predictive value, treatment efficacy, and clinical impact of this SO definition. (c) 2022 The Author(s). Published by Elsevier Ltd. on behalf of European Society for Clinical Nutrition and Metabolism and Obesity Facts published by S. Karger AG. This article is published under the Creative Commons CC-BY license. All rights reserved.
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| 2. |
- Gepner, B. D., et al.
(författare)
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Evaluation of GHBMC, THUMS and SAFER Human Body Models in Frontal Impacts in Reclined Postures
- 2022
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Ingår i: Conference proceedings International Research Council on the Biomechanics of Injury, IRCOBI. - 2235-3151. ; 2022-September, s. 116-143
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Konferensbidrag (refereegranskat)abstract
- Virtual tools, such as human body models (HBMs), can support advances in vehicle development and restraint system design. The goal of this study is to evaluate selected HBMs against data from recent reclined post-mortem human subject (PMHS) tests. Three HBMs - the Global Human Body Modelling Consortium detailed model v.6.0, Total Human Model for Safety v.6.0, and SAFER HBM v.10 - were used in this study. The models were positioned with respect to the average PMHS position and utlised a previously developed environment model. The HBMs were evaluated comparing belt engagement, boundary forces and displacements (in the seat and belt), and the trajectories of the head, T1, T8, T11, L1, L3, and pelvis. The HBMs' belt engagement, boundary forces and displacements, and X-direction (fore-aft) trajectories were all generally consistent with the PMHS. All HBMs predicted more downward motion of the head and T1 compared to the PMHS. The HBMs also showed rearward pelvis pitch at peak lap belt force, opposite to the PMHS. Some of these differences were associated with differences in flexion of the lumbar spine. This is the first study to provide an in-depth evaluation of multiple reclined HBMs in frontal crashes compared to reclined PMHS.
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| 3. |
- Tushak, Sophia K., et al.
(författare)
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Evaluation of the GHBMC Lumbar Spine in Sub-injurious and Injurious Loading
- 2022
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Ingår i: Conference proceedings International Research Council on the Biomechanics of Injury, IRCOBI. - 2235-3151. ; 2022-September, s. 866-883
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Konferensbidrag (refereegranskat)abstract
- Accurate prediction of lumbar spine response and how it relates to kinematics, kinetics, and injury is critical since lumbar spine loading is predicted to be amplified in reclined postures. The objective was to evaluate the Global Human Body Models Consortium (GHBMC) lumbar spine (v5.1.1) model relative to postmortem human subjects (PMHS) in two different loading modes using data from recent experiments. The model's whole ligamentous lumbar spine was first evaluated in sub-injurious quasi-static loading in multiple directions with three different levels of axial compression. Compared to PMHS, the GHBMC responses varied widely across loading direction and axial compression level, exhibiting higher stiffness in some conditions and lower stiffness in other conditions. Then, three-vertebra sections of the model's ligamentous lumbar spine were subjected to high-rate compression-flexion loading to failure. Compared to PMHS, GHBMC responses and stiffness coefficients did not display the same bilinear response behavior, but instead displayed linear behavior. Additionally, the GHBMC and PMHS did not respond similarly when increased levels of axial compression were applied. The outcomes from this study shed light on the usefulness of the model.
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