BACKGROUND: Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk.METHODS: Visceral Adipose Tissue Area Index (VATI cm 2/m 2) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves. RESULTS: In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs (p ≤ 0.013). In males and females respectively, a value of VATI of ≥38.7 cm 2/m 2 and ≥24.9 cm 2/m 2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC) = 0.702 vs AUC = 0.556 in males and AUC = 0.757 vs AUC = 0.630 in females). CONCLUSION: Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.
Background: Previous studies found that 40-60% of the sarcoidosis patients suffer from small fiber neuropathy (SFN), substantially affecting quality of life. SFN is difficult to diagnose, as a gold standard is still lacking. The need for an easily administered screening instrument to identify sarcoidosis-associated SFN symptoms led to the development of the SFN Screening List (SFNSL). The usefulness of any questionnaire in clinical management and research trials depends on its interpretability. Obtaining a clinically relevant change score on a questionnaire requires that the smallest detectable change (SDC) and minimal important difference (MID) are known. Objectives: The aim of this study was to determine the SDC and MID for the SFNSL in patients with sarcoidosis. Methods: Patients with neurosarcoidosis and/or sarcoidosis-associated SFN symptoms (N=138) included in the online Dutch Neurosarcoidosis Registry participated in a prospective, longitudinal study. Anchor-based and distribution-based methods were used to estimate the MID and SDC, respectively. Results: The SFNSL was completed both at baseline and at 6-months’ follow-up by 89/138 patients. A marginal ROC curve (0.6) indicated cut-off values of 3.5 points, with 73% sensitivity and 49% specificity for change. The SDC was 11.8 points. Conclusions: The MID on the SFNSL is 3.5 points for a clinically relevant change over a 6-month period. The MID can be used in the follow-up and management of SFN-associated symptoms in patients with sarcoidosis, though with some caution as the SDC was found to be higher.
CC-BY-NC-NDSTUDY DESIGN:prospective cohort study.OBJECTIVE:To analyze responsiveness and minimal clinically important change (MCIC) of the US National Institutes of Health (NIH) minimal dataset for chronic low back pain (CLBP).SUMMARY OF BACKGROUND DATA:The NIH minimal dataset is a 40-item questionnaire developed to increase use of standardized definitions and measures for CLBP. Longitudinal validity of the total minimal dataset and the subscale Impact Stratification are unknown.METHODS:Total outcome scores on the NIH minimal dataset, Dutch Language Version, were calculated ranging from 0-100 points with higher scores representing worse functioning. Responsiveness and MCIC were determined with an anchor based method, calculating the area under the receiver operating characteristics (ROC) curve (AUC) and by determining the optimal cut-off point. Smallest detectable change (SDC) was calculated as a parameter of measurement error.RESULTS:In total 223 patients with CLBP were included. Mean total score on the NIH minimal dataset was 44 ± 14 points at baseline. The total outcome score was responsive to change with an AUC of 0.84. MCIC was 14 points with a sensitivity of 72% and specificity 82%, and SDC was 23 points. Mean total score on Impact Stratification (scale 8-50) was 34.4 ± 7.4 points at baseline, with an AUC of 0.91, an MCIC of 7.5 with a sensitivity 96% of and specificity of 78%, and an SDC of 14 points.CONCLUSION:The longitudinal validity of the NIH minimal dataset is adequate. An improvement of 14 points in total outcome score and 7.5 points in Impact Stratification can be interpreted as clinically important in individual patients. However, MCIC depends on baseline values and the method that is chosen to determine the optimal cut-off point. Furthermore, measurement error is larger than the MCIC. This means that individual change scores should be interpreted with caution.LEVEL OF EVIDENCE:4This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal
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Een belangrijk vraagstuk waar we als samenleving een antwoord op moeten geven is: ?Wat te doen als grondstoffen niet meer voor handen zijn??. Want onze grondstoffenvoorraad is eindig. Het goede antwoord is dan: ?dat lossen we op door het sluiten van kringlopen en de realisatie van een circulaire economie?. Maar hoe doen we dat? Op dit moment weten we nog niet hoe een circulaire economie er idealiter uit zou moeten zien. Veel wordt erover gepraat en geschreven, maar te weinig aandacht bestaat nog voor de toepassing van circulaire processen in de praktijk. En juist in de bouw- en installatiesector, die vaak een conservatieve sector genoemd wordt, staan circulaire toepassingen nog vóór in de innovatie adoptie curve. En uitgerekend deze sector is een enorme materiaal- en grondstoffenverbruiker. De installaties in een gebouw zijn daarbij van groot belang. Bij renovatie van gebouwen heeft maar liefst 50 % van de totale aanneemsom betrekking op installaties. Grote winsten zijn dus te behalen bij de toepassing van circulaire uitgangspunten. De circulaire economie biedt hier kansen. De ontwikkeling van een aantal kennisproducten helpt de samenwerkingspartners in dit onderzoeksproject bij het ontdekken van en stappen zetten op het gebied van een circulaire economie en biedt kansen voor de sector in zijn geheel. Dit onderzoek draagt bij aan de realisatie van de circulaire economie door de ontwikkeling van verschillende kennisproducten. Deze kennisproducten worden ontwikkeld uitgaande van een relevante praktijkcase in de keten onderwijs, onderzoek, bedrijfsleven (Het Utrechtse Model). De praktijkcase is te vinden in de grootschalige renovatie van twee gebouwen. De Hogeschool heeft opdracht gegeven om in 2016 haar eigen gebouwen te renoveren: het gaat in deze samenwerking om de panden van de Hogeschool Utrecht aan de Padualaan 99 en 101 te Utrecht. Bij de aanbesteding van deze renovatie is geen expliciete uitvraag gedaan naar het circulair maken van de renovatie, maar wel naar duurzaamheid en energiebesparende maatregelen. De Hogeschool Utrecht (al drie jaar achtereenvolgend de meest duurzame hogeschool van Nederland ? aldus Studenten van Morgen) ziet deze renovatie als een kans om tevens een bijdrage te kunnen leveren aan de kennis over circulaire processen en circulaire mogelijkheden voor toekomstige renovaties.
Background:Many business intelligence surveys demonstrate that Digital Realities (Virtual reality and Augmented Reality) are becoming a huge market trend in many sectors, and North America is taking the lead in this emerging domain. Tourism is no exception and the sector in Europe must innovate to get ahead of the curve of this technological revolution, but this innovation needs public support.Project partnership:In order to provide labs, startups and SMEs willing to take this unique opportunity with the most appropriate support policies, 9 partner organizations from 8 countries (FR, IT, HU, UK, NO, ES, PL, NL) decided to work together: regional and local authorities, development agencies, private non-profit association and universities.Objective of the project:Thanks to their complementary experiences and know-how, they intend to improve policies of the partner regions (structural funds and regional policies), in order to foster a tourist channeled innovation in the Digital Realities sector.Approach:All partners will work together on policy analysis tasks before exchanging their best initiatives and transferring them from one country to another. This strong cooperation will allow them to build the best conditions to foster innovation thanks to more effective structural funds policies and regional policies.Main activities & outputs:8 policy instruments are addressed, among which 7 relate to structural funds programmes. Basis for exchange of experience: Reciprocal improvement analysis and 8 study trips with peer-review of each partner’s practices. Video reportages for an effective dissemination towards other territories in Europe.Main expected results:At least 16 good practices identified. 8 targeted policy instruments improved. At least 27 staff members will transfer new capacities in their intervention fields. At least 8 involved stakeholders with increased skills and knowledge from exchange of experience. Expected 17 appearances in press and media, including at European level.
The project is for protecting valuable museum contents against seismic actions. Assessment and protection methods and equipment will be developed and tested. - Assessment methods for seismic safety of museum contents- Protective devices for the musem contentsA museum virtual exhibition room (MVER) will be created, it will contain exhibits such as sculptures and artefacts of different size and geometry, while the proposed experimental work will first examine the seismic behaviour of the test specimens without any protection system. The tests will be repeated using different protective configurations, emphasising on low-mass base isolation systems. Two new and highly efficient base isolation systems will be extensively tested for the first time. The first isolator is a pendulum-based system, while the second utilises shape-memory-alloy wires.The project will also develop and calibrate novel numerical models for single- and two- block rocking systems, while experimental and numerical results will be combined in order to develop quick overturning assessment criteria for the artefacts considered.The final task of the project will combine the shaking table experimental outcomes with numerical results using calibrated numerical models in order to develop fragility curves for museum artefacts.
