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Robitaille E, Reilly T, Heipel S, Buttici H, Chasse E, Tingelstad HC. The Value of Strength as a Predictor of Musculoskeletal Injury in Canadian Armed Forces Basic Infantry Candidates. Mil Med 2024; 189:e1675-e1682. [PMID: 38330154 DOI: 10.1093/milmed/usae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/07/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Musculoskeletal injuries (MSKI) impact military organizations by threatening their operational readiness, warranting investigation into relevant factors to inform risk reduction strategies. While several self-reported and physical performance measures have been associated with MSKI among military personnel, few have been validated and none have been reported in Canadian basic infantry candidates. The purpose of this study was to investigate associations between self-reported and physical performance measures and MSKI, and determine their validity as predictors of MSKI, in Canadian basic infantry candidates. METHODS This was a planned secondary analysis of a study tracking MSKI at a basic infantry training facility in Ontario, Canada approved by Defence Research & Development Canada. Before the basic infantry training, consenting candidates completed a baseline testing session including self-reported questionnaires, measures of anthropometry, and physical performance previously associated with MSKI (ankle dorsiflexion test, Y-Balance Test, Isometric Mid-Thigh Pull, and the Fitness for Operational Requirements of CAF Employment (FORCE) evaluation). All MSKI reported by candidates were diagnosed by licensed healthcare providers. From a total sample of 129 candidates, 76% (n = 98) were used to determine any associations between baseline testing variables and MSKI and to develop a predictive model (Development Sample), while 24% (n = 33) were used to offer preliminary validation of the same predictive model (Validation Sample). The binary logistic regression and independent sample t-testing determined independent associations with MSKI in the Development Sample. All continuous variables and dichotomous variables previously associated with MSKI risk (Smoker Yes/No, previous history of MSKI, and physical inactivity) were entered into a backward stepwise logistic regression analysis to assess the predictive association with MSKI incidence in the Development Sample. The regression model was then applied to the Validation Sample. RESULTS A total of 35 MSKI were diagnosed by Health Services Centre staff. The majority of the MSKI were acute (63%), sustained to the hip, knee, and ankle (74%). The most common diagnoses were strains and sprains (71%). Uninjured participants performed significantly better on the Relative Isometric Mid-Thigh Pull, FORCE 20 mR, FORCE ILS, and FORCE Estimated VO2peak compared to injured participants. Logistic regression analysis showed that the only variable with significant independent association with diagnosed MSKI incidence was self-reported previous history of MSKI. However, the backward stepwise logistic regression analysis retained self-reported previous history of MSKI, FORCE SBD, FORCE Estimated VO2peak, and Isometric Mid-Thigh Pull Peak Force as predictors of MKSI. The logistic regression model including these variables could predict MSKI with an accuracy of 79% in the Development Sample and 67% in the Validation Sample. CONCLUSION This study provides preliminary support for the value of measures of absolute muscular strength and cardiorespiratory fitness as predictors of MSKI in Canadian basic infantry candidates. Given the associations between physical performance measures and MSKI, and their necessity during occupational tasks, it is recommended that Canadian basic infantry training facilities integrate resistance training with external loads to best prepare their candidates to meet their occupational demands and potentially minimize MSKI. Further investigations to confirm the predictive capacity of these variables in a larger sample across additional facilities are warranted.
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Affiliation(s)
- Eric Robitaille
- 31 Canadian Forces Health Services Center, Meaford, Ontario N4L 0A1, Canada
| | - Tara Reilly
- Canadian Forces Morale and Welfare Services, Personnel Support Program, Human Performance Research & Development, Ottawa, Ontario K1J 1J7, Canada
| | - Scott Heipel
- Canadian Forces Morale and Welfare Services, Personnel Support Program, Fitness & Sports Centre 4CDTC, Meaford, Ontario N4L 0A1, Canada
| | - Hollie Buttici
- 31 Canadian Forces Health Services Center, Meaford, Ontario N4L 0A1, Canada
| | - Etienne Chasse
- Canadian Forces Morale and Welfare Services, Personnel Support Program, Human Performance Research & Development, Ottawa, Ontario K1J 1J7, Canada
| | - Hans Christian Tingelstad
- Canadian Forces Morale and Welfare Services, Personnel Support Program, Human Performance Research & Development, Ottawa, Ontario K1J 1J7, Canada
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Deng HW, Li BR, Zhou SD, Luo C, Lv BH, Dong ZM, Qin C, Hu RT. Revealing Novel Genes Related to Parkinson's Disease Pathogenesis and Establishing an associated Model. Neuroscience 2024; 544:64-74. [PMID: 38458535 DOI: 10.1016/j.neuroscience.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
Parkinson's disease (PD) represents a multifaceted neurological disorder whose genetic underpinnings warrant comprehensive investigation. This study focuses on identifying genes integral to PD pathogenesis and evaluating their diagnostic potential. Initially, we screened for differentially expressed genes (DEGs) between PD and control brain tissues within a dataset comprising larger number of specimens. Subsequently, these DEGs were subjected to weighted gene co-expression network analysis (WGCNA) to discern relevant gene modules. Notably, the yellow module exhibited a significant correlation with PD pathogenesis. Hence, we conducted a detailed examination of the yellow module genes using a cytoscope-based approach to construct a protein-protein interaction (PPI) network, which facilitated the identification of central hub genes implicated in PD pathogenesis. Employing two machine learning techniques, including XGBoost and LASSO algorithms, along with logistic regression analysis, we refined our search to three pertinent hub genes: FOXO3, HIST2H2BE, and HDAC1, all of which demonstrated a substantial association with PD pathogenesis. To corroborate our findings, we analyzed two PD blood datasets and clinical plasma samples, confirming the elevated expression levels of these genes in PD patients. The association of the genes with PD, as reflected by the area under the curve (AUC) values for FOXO3, HIST2H2BE, and HDAC1, were moderate for each gene. Collectively, this research substantiates the heightened expression of FOXO3, HIST2H2BE, and HDAC1 in both PD brain and blood samples, underscoring their pivotal contribution to the pathogenesis of PD.
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Affiliation(s)
- Hao-Wei Deng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Bin-Ru Li
- Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Shao-Dan Zhou
- Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Chun Luo
- Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Bing-Hua Lv
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zi-Mei Dong
- Department of Neurology, People's Hospital of Chuxiong, Yi Autonomous Prefecture, Chuxiong, Yunnan, China
| | - Chao Qin
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
| | - Rui-Ting Hu
- Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China.
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Dickow J, Gunawardene MA, Willems S, Feldhege J, Wohlmuth P, Bachmann M, Bergmann MW, Gesierich W, Nowak L, Pape UF, Schreiber R, Wirtz S, Twerenbold R, Sheikhzadeh S, Gessler N. Higher in-hospital mortality in SARS-CoV-2 omicron variant infection compared to influenza infection-Insights from the CORONA Germany study. PLoS One 2023; 18:e0292017. [PMID: 37756299 PMCID: PMC10529565 DOI: 10.1371/journal.pone.0292017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND With the emergence of new subvariants, the disease severity of Severe Acute Respiratory Syndrome Coronavirus-2 has attenuated. This study aimed to compare the disease severity in patients hospitalized with omicron variant infection to those with influenza infection. METHODS We compared data from the multicenter observational, prospective, epidemiological "CORONA Germany" (Clinical Outcome and Risk in hospitalized COVID-19 patients) study on patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 to retrospective data on influenza infection cases from November 2016 to August 2022. Severe Acute Respiratory Syndrome Coronavirus-2 cases were classified as wild-type/delta variant before January 2022, or omicron variant from January 2022 onward. The primary outcome was in-hospital mortality, adjusted for age, gender, and comorbidities. RESULTS The study included 35,806 patients from 53 hospitals in Germany, including 4,916 patients (13.7%) with influenza infection, 16,654 patients (46.5%) with wild-type/delta variant infection, and 14,236 patients (39.8%) with omicron variant infection. In-hospital mortality was highest in patients with wild-type/delta variant infection (16.8%), followed by patients with omicron variant infection (8.4%) and patients with influenza infection (4.7%). In the adjusted analysis, higher age was the strongest predictor for in-hospital mortality (age 80 years vs. age 50 years: OR 4.25, 95% CI 3.10-5.83). Both, patients with wild-type/delta variant infection (OR 3.54, 95% CI 3.02-4.15) and patients with omicron variant infection (OR 1.56, 95% CI 1.32-1.84) had a higher risk for in-hospital mortality than patients with influenza infection. CONCLUSION After adjusting for age, gender and comorbidities, patients with wild-type/delta variant infection had the highest risk for in-hospital mortality compared to patients with influenza infection. Even for patients with omicron variant infection, the adjusted risk for in-hospital mortality was higher than for patients with influenza infection. The adjusted risk for in-hospital mortality showed a strong age dependency across all virus types and variants. TRIAL REGISTRATION NUMBER NCT04659187.
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Affiliation(s)
- Jannis Dickow
- Asklepios Hospital St. Georg, Department of Cardiology and Internal Intensive Care Medicine, Hamburg, Germany
| | - Melanie A. Gunawardene
- Asklepios Hospital St. Georg, Department of Cardiology and Internal Intensive Care Medicine, Hamburg, Germany
| | - Stephan Willems
- Asklepios Hospital St. Georg, Department of Cardiology and Internal Intensive Care Medicine, Hamburg, Germany
- Semmelweis University, Budapest, Hungary
| | | | - Peter Wohlmuth
- Semmelweis University, Budapest, Hungary
- Asklepios Proresearch, Research Institute, Hamburg, Germany
| | - Martin Bachmann
- Asklepios Hospital Harburg, Department of Intensive Care and Ventilatory Medicine, Hamburg, Germany
| | - Martin W. Bergmann
- Asklepios Hospital Wandsbek, Department of Internal Medicine – Cardiology and Pneumology, Hamburg, Germany
- Asklepios Hospital Altona, Department of Cardiology and Internal Medicine, Hamburg, Germany
| | - Wolfgang Gesierich
- Asklepios Hospital Munich-Gauting, Department of Pneumology, Munich, Germany
| | - Lorenz Nowak
- Asklepios Hospital München-Gauting, Department of Intensive Care and Ventilation Medicine, Munich, Germany
| | - Ulrich-Frank Pape
- Asklepios Hospital St. Georg, Department of Internal medicine - Gastroenterology, Hamburg, Germany
| | - Ruediger Schreiber
- Asklepios West-Clinic, Department Anesthesiology and Intensive Care Medicine, Hamburg, Germany
| | - Sebastian Wirtz
- Asklepios Hospital Barmbek, Department Anesthesiology, Intensive Care and Emergency Medicine, Hamburg, Germany
| | | | - Sara Sheikhzadeh
- Semmelweis University, Budapest, Hungary
- Asklepios Proresearch, Research Institute, Hamburg, Germany
- Asklepios Hospitals, Hamburg, Germany
| | - Nele Gessler
- Asklepios Hospital St. Georg, Department of Cardiology and Internal Intensive Care Medicine, Hamburg, Germany
- Semmelweis University, Budapest, Hungary
- Asklepios Proresearch, Research Institute, Hamburg, Germany
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Borna S, Maniaci MJ, Haider CR, Maita KC, Torres-Guzman RA, Avila FR, Lunde JJ, Coffey JD, Demaerschalk BM, Forte AJ. Artificial Intelligence Models in Health Information Exchange: A Systematic Review of Clinical Implications. Healthcare (Basel) 2023; 11:2584. [PMID: 37761781 PMCID: PMC10531020 DOI: 10.3390/healthcare11182584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
Electronic health record (EHR) systems collate patient data, and the integration and standardization of documents through Health Information Exchange (HIE) play a pivotal role in refining patient management. Although the clinical implications of AI in EHR systems have been extensively analyzed, its application in HIE as a crucial source of patient data is less explored. Addressing this gap, our systematic review delves into utilizing AI models in HIE, gauging their predictive prowess and potential limitations. Employing databases such as Scopus, CINAHL, Google Scholar, PubMed/Medline, and Web of Science and adhering to the PRISMA guidelines, we unearthed 1021 publications. Of these, 11 were shortlisted for the final analysis. A noticeable preference for machine learning models in prognosticating clinical results, notably in oncology and cardiac failures, was evident. The metrics displayed AUC values ranging between 61% and 99.91%. Sensitivity metrics spanned from 12% to 96.50%, specificity from 76.30% to 98.80%, positive predictive values varied from 83.70% to 94.10%, and negative predictive values between 94.10% and 99.10%. Despite variations in specific metrics, AI models drawing on HIE data unfailingly showcased commendable predictive proficiency in clinical verdicts, emphasizing the transformative potential of melding AI with HIE. However, variations in sensitivity highlight underlying challenges. As healthcare's path becomes more enmeshed with AI, a well-rounded, enlightened approach is pivotal to guarantee the delivery of trustworthy and effective AI-augmented healthcare solutions.
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Affiliation(s)
- Sahar Borna
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Michael J. Maniaci
- Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Clifton R. Haider
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA
| | - Karla C. Maita
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | | | | | - Jordan D. Coffey
- Center for Digital Health, Mayo Clinic, Rochester, MN 55902, USA
| | - Bart M. Demaerschalk
- Center for Digital Health, Mayo Clinic, Rochester, MN 55902, USA
- Department of Neurology, Mayo Clinic College of Medicine and Science, Phoenix, AZ 85054, USA
| | - Antonio J. Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
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Dritsas E, Trigka M. Supervised Machine Learning Models to Identify Early-Stage Symptoms of SARS-CoV-2. SENSORS (BASEL, SWITZERLAND) 2022; 23:s23010040. [PMID: 36616638 PMCID: PMC9824026 DOI: 10.3390/s23010040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 06/12/2023]
Abstract
The coronavirus disease (COVID-19) pandemic was caused by the SARS-CoV-2 virus and began in December 2019. The virus was first reported in the Wuhan region of China. It is a new strain of coronavirus that until then had not been isolated in humans. In severe cases, pneumonia, acute respiratory distress syndrome, multiple organ failure or even death may occur. Now, the existence of vaccines, antiviral drugs and the appropriate treatment are allies in the confrontation of the disease. In the present research work, we utilized supervised Machine Learning (ML) models to determine early-stage symptoms of SARS-CoV-2 occurrence. For this purpose, we experimented with several ML models, and the results showed that the ensemble model, namely Stacking, outperformed the others, achieving an Accuracy, Precision, Recall and F-Measure equal to 90.9% and an Area Under Curve (AUC) of 96.4%.
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