| 1. |
- Berg, Hans E., et al.
(författare)
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Threshold-automated CT measurements of muscle size and radiological attenuation in multiple lower-extremity muscles of older individuals
- 2020
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Ingår i: Clinical Physiology and Functional Imaging. - : WILEY. - 1475-0961 .- 1475-097X. ; 40:3, s. 165-172
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Tidskriftsartikel (refereegranskat)abstract
- Muscle atrophy and fat infiltration, two indicators of deconditioning and weakness in elderly frail patients, are typically assessed by means of manual image analysis from computed tomography (CT) scans. As this time-consuming image analysis limits its wider use in clinical studies, the use of tissue thresholds to semi-automatically assess muscle composition has been suggested. Here, we aimed to investigate the relationship between manual and semi-automated analysis of both cross-sectional area (CSA) and radiological attenuation (RA), in multiple muscles of the lower extremities in aged (77 +/- 6 years) sedentary individuals (n = 40). The participants underwent CT scans of their lower limbs, including hip, thigh and calf muscles. The subsequent analysis of CSA and RA was conducted using both manual segmentation and semi-automatic thresholds (-30 to +150 Hounsfield units). Automated measurements were generally strongly correlated with manually encircled CSA in all muscle groups (R = 0.79-0.99, p < .05) and shortened the analysis time by 70% (p < .05). In m. iliopsoas, however, the CSA became overestimated (15%, p < .05) with thresholded measurements, while the assessment of both CSA and RA was underestimated in muscles with high-fat content (i.e., the gluteal muscles) and in individuals with high-fat infiltration. In conclusion, using the semi-automated technique with conventional thresholds is a time-saving method that delivers accurate gross size of the muscle groups, particularly in the thigh. However, caution should be exercised when using semi-automated techniques for assessing CSA and fat infiltration in muscles with high-fat content.
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| 2. |
- Listou, Tore, et al.
(författare)
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Performance Based Logistics : A Norwegian-Swedish Perspective
- 2020
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Ingår i: Necesse. - 2464-353X .- 2535-2903. ; 5:3, s. 118-135
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Tidskriftsartikel (refereegranskat)abstract
- Performance Based Logistics (PBL) as a support strategy for defence systems has been coined as a paradigmatic change within defence acquisition and maintenance. Originating from the defence industry, the concept has been adopted in many defence organisations. Although studies of its applicability has identified both enablers and barriers for implementation, these studies predominantly are performed in a few large nations. How the concept corresponds with a small state perspective needs to be addressed. Further on, perceived outputs of PBL practices would differ between the acquisition organisation, the supplier of PBL services, and the users of the services. Understanding these differences in perceptions would give valuable knowledge about how to design PBL contracts. Thirdly; assuming that PBL contracts indeed result in improved effectiveness, adapting the involved organisations to a new way of managing logistics should be accompanied by related organisational change processes. The purpose with this study is to contextualise the concept and define barriers and enablers for PBL in a small state perspective (represented by Norway and Sweden), identify different stakeholders’ expectations for output, and explore whether implementing such a concept is perceived as a significantly new way of organising defence supply chains with an accompanying organisational change strategy.
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| 3. |
- Skoglund, Elisabeth, et al.
(författare)
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Longitudinal Muscle and Myocellular Changes in Community-Dwelling Men Over Two Decades of Successful Aging : The ULSAM Cohort Revisited
- 2020
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1079-5006 .- 1758-535X. ; 75:4, s. 654-663
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Tidskriftsartikel (refereegranskat)abstract
- Participants of the population-based Uppsala longitudinal study of adult men (ULSAM) cohort reaching more than 88 years of age (survivors, S) were investigated at age 70, 82, and 88-90 and compared at 70 years with non-survivors (NS) not reaching 82 years. Body composition, muscle mass and muscle histology were remarkably stable over 18 years of advanced aging in S. Analysis of genes involved in muscle remodeling showed that S had higher mRNA levels of myogenic differentiation factors (Myogenin, MyoD), embryonic myosin (eMyHC), enzymes involved in regulated breakdown of myofibrillar proteins (Smad2, Trim32, MuRF1,) and NCAM compared with healthy adult men (n = 8). S also had higher mRNA levels of eMyHC, Smad 2, MuRF1 compared with NS. At 88 years, S expressed decreased levels of Myogenin, MyoD, eMyHC, NCAM and Smad2 towards those seen in NS at 70 years. The gene expression pattern of S at 70 years was likely beneficial since they maintained muscle fiber histology and appendicular lean body mass until advanced age. The expression pattern at 88 years may indicate a diminished muscle remodeling coherent with a decline of reinnervation capacity and/or plasticity at advanced age.
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| 4. |
- von Berens, Åsa, et al.
(författare)
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Sarcopenic obesity and associations with mortality in older women and men – a prospective observational study
- 2020
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318 .- 1471-2318. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The combined effect of sarcopenia and obesity, i.e., sarcopenic obesity, has been associated with disability and worse outcomes in older adults, but results are conflicting. The objectives of this study were to describe the prevalence of sarcopenic obesity (SO) in older adults, and to examine how the risk of mortality is associated with SO and its various components. Methods: Data were obtained from two Swedish population studies, the Gothenburg H70 Birth Cohort Studies of 521 women and men at the age of 75, and the Uppsala Longitudinal Study of Adult Men (ULSAM), which included 288 men aged 87 years. Sarcopenia was defined using the recently updated EWGSOP2 definition. Obesity was defined by any of three established definitions: body mass index ≥30 kg/m2 , fat mass > 30%/ > 42% or waist circumference ≥ 88 cm/≥102 cm for women and men, respectively. The Kaplan-Meier survival curve and the Cox proportional hazard model were used for 10-year and 4-year survival analyses in the H70 and ULSAM cohorts, respectively. Results: SO was observed in 4% of the women and 11% of the men in the H70 cohort, and in 10% of the ULSAM male cohort. The 75-year-old women with SO had a higher risk (HR 3.25, 95% confidence interval (1.2–8.9)) of dying within 10 years compared to those with a “normal” phenotype. A potential similar association with mortality among the 75-year-old men was not statistically significant. In the older men aged 87 years, obesity was associated with increased survival. Conclusions: SO was observed in 4–11% of community-dwelling older adults. In 75-year-old women SO appeared to associate with an increased risk of dying within 10 years. In 87-year-old men, the results indicated that obesity without sarcopenia was related to a survival benefit over a four-year period.
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