Background/Aims: To investigate the relation between skeletal muscle measurements (muscle mass, radiation attenuation, and sarcopenic obesity), postoperative morbidity, and survival after treatment of locally advanced rectal cancer. Methods: This explorative retrospective study identified 99 consecutive patients who underwent neoadjuvant chemoradiation and surgery between January 2007 and May 2012. Skeletal muscle mass was measured as total psoas area and total abdominal muscle area (TAMA) at 3 anatomical levels using the patient’s preoperative computed tomography scan. Radiation attenuation was measured using corresponding mean Hounsfield units for TAMA. Sarcopenic obesity was defined as body mass index above 25 kg·m^–2 combined with skeletal muscle mass index below the sex-specific median. Postoperative complications were graded by using the ­Clavien-Dindo classification. Results: Twenty-five patients (25.3%) developed a grade 3–5 complication. Lower radiation attenuation was independently associated with overall (p = 0.003) and grade 3–5 complications (p = 0.002). Sarcopenic obesity was associated with overall complications (all p < 0.05). Skeletal muscle measurements and survival were not significantly related. Conclusion: Radiation attenuation was associated with overall and grade 3–5 postoperative morbidity after neoadjuvant chemoradiation and non-laparoscopic resection for rectal cancer. Sarcopenic obesity was associated with overall complications.

Self speech recognition tests in quiet and noise at home are compared to the standard tests performed in the clinic. Potential effects of stimuli presentation modes (loudspeaker or audio cable) and assessment (clinician or self-assessment at home) on test results were investigated. Speech recognition in quiet was assessed using the standard Dutch test with monosyllabic words. Speech recognition in noise was assessed with the digits-in-noise test. Sixteen experienced CI users (aged between 44 and 83 years) participated. No significant difference was observed in speech recognition in quiet between and presentation modes. Speech recognition in noise was significantly better with the audio cable than with the loudspeaker. There was no significant difference in speech recognition in quiet at 65 dB and in speech recognition in noise between self-assessment at home and testing in the clinic. At 55 dB, speech recognition assessed at home was slightly but significantly better than that assessed in the clinic. The results demonstrate that it is feasible for experienced CI users to perform self-administered speech recognition tests at home. Self-assessment by CI users of speech recognition in quiet and noise within the home environment could serve as an alternative to the tests performed in the clinic.

The number of cochlear implant (CI) users is increasing annually, resulting in an increase in the workload of implant centers in ongoing patient management and evaluation. Remote testing of speech recognition could be time-saving for both the implant centers as well as the patient. This study addresses two methodological challenges we encountered in the development of a remote speech recognition tool for adult CI users. First, we examined whether speech recognition in noise performance differed when the steady-state masking noise was presented throughout the test (i.e. continuous) instead of the standard clinical use for evaluation where the masking noise stops after each stimulus (i.e. discontinuous). A direct coupling between the audio port of a tablet computer to the accessory input of the sound processor with a personal audio cable was used. The setup was calibrated to facilitate presentation of stimuli at a predefined sound level. Finally, differences in frequency response between the audio cable and microphones were investigated.

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Purpose: To compare the accuracy, inter‐ and intrarater reliability, and user‐experience of manual and semi‐automatic preoperative leg‐alignment measurement planning software for high tibial osteotomy (HTO).Methods: Thirty patients (31 lower limbs) who underwent a medial opening wedge HTO between 2017 and 2019 were retrospectively included. The mechanical lateral distal femur angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and planned correction angle were measured on preoperative long‐leg full weight‐bearing radiographs utilising PACS Jivex Review® v5.2 manual and TraumaCad® v2.4 semi‐automatic planning software. Independent measurements were performed by four raters. Two raters repeated the measurements. Accuracy in the standard error of measurement (SEM), inter‐ and intrarater reliability, and user‐experience were analysed. Additionally, measurements errors of more than 3° were remeasured and reanalysed.Results: The SEMs of all measured varus malalignment angles and planned correction angle were within 0.8° of accuracy for both software programs. Measurements utilising the manual software demonstrated moderate interrater intraclass correlation coefficient (ICC)‐values for the mLDFA and mMPTA, and an excellent interrater ICC‐value for the correction angle (0.810, 0.779, and 0.981, respectively). Measurements utilising the semi‐automatic software indicated excellent interrater ICC‐values for the mLDFA, mMPTA, and correction angle (0.980, 0.909, and 0.989, respectively). The intrarater reliability varied substantially per angle, presenting excellent intrarater agreements by both raters (ICC > 0.900) for the correction angle in each software program as well as poor‐to‐excellent ICC‐values for the mLDFA (0.282–0.951 and 0.316–0.926) and mMPTA (0.893–0.934 and 0.594–0.941) in both the manual planning and semi‐automatic software. Regarding user‐experience, semi‐automatic software was preferred by two raters, while the other two raters had no distinctive preference. After remeasurement of five outliers, excellent interrater ICC‐values were found for the mLDFA (0.913) and mMPTA (0.957).Conclusions: Semi‐automatic software outperforms the manual software when user‐experience and outliers are considered. However, both software programs provide similar performance after remeasurement of the human‐related erroneous outliers. For clinical practice, both programs can be utilised for HTO planning.Level of evidence: Diagnostic study, Level III.