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Podrihalo, Olha, Leonid Podrigalo, Władysław Jagiełło, Sergii Iermakov, and Tetiana Yermakova. "Substantiation of Methods for Predicting Success in Artistic Swimming." International Journal of Environmental Research and Public Health 18, no. 16 (August 19, 2021): 8739. http://dx.doi.org/10.3390/ijerph18168739.
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To develop a methodology for predicting success in artistic swimming based on a set of morphofunctional indicators and indices, 30 schoolgirls, average age (12.00 ± 0.22), were divided into two groups. Group 1: 15 athletes, training experience 4–5 years. Group 2: 15 schoolgirls without training experience. For each participant, we determined the length and weight of the body, the circumference of the chest, vital lung capacity, and the circumference of the biceps in a tense and at rest. The Erisman index, biceps index, and the ratio of proper and actual vital lung capacity was calculated. Them, we conducted the Stange and Genchi hypoxic tests, and flexibility tests for “Split”, “Crab position”, and “Forward bend”. Prediction was conducted using the Wald test with the calculation of predictive coefficients and their informativeness. A predictive table containing results of functional tests and indices of artistic swimming athletes is developed. It includes nine criteria, which informativeness varied in the range of 395.70–31.98. The content of the prediction consists of evaluating the results, determining the appropriate predictive coefficient, and summing these coefficients before reaching one of the predictive thresholds. The conducted research allowed us to substantiate and develop a method for predicting the success of female athletes with the use of morphofunctional indicators and indices.
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Norton, Stata. "Correlation of Cerebral Cortical Morphology with Behavior." Toxicology and Industrial Health 5, no. 2 (April 1989): 247–60. http://dx.doi.org/10.1177/074823378900500209.
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Association between functional damage and damage to the central nervous system from toxic agents can be used to determine the value of behavioral tests as predictors of damage to the nervous system. Variability in data from behavioral tests may be caused, in part, by varying levels of structural differences in the nervous system. Stepwise multiple regression is one method for analyzing the relationship between variability in data resulting from linkage between functional and morphological or other parameters of the structure of the nervous system. As an example, the predictive value of four behavioral tests is assessed in detecting thinning of the cerebral cortex following gestational exposure of rats to ionizing radiation. In this analysis, there were seven independent variables for predicting cortical thickness. The sequence of number of times each variable was used in prediction, from most frequent to least frequent, was: angle of stride > negative geotaxis > continuous corridor> body weight > width of stride > length of stride > reflex suspension. The data support the concept that there are varying degrees of predictive associations between these functional and cortical parameters.
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Frimerman, Aaron, Gad Keren, Uri Rosenschein, Samuel Basan, and Hylton Miller. "Clinical parameters and functional tests are not predictive for in-stent restenosis." International Journal of Cardiovascular Interventions 5, no. 3 (January 2003): 151–55. http://dx.doi.org/10.1080/14628840310017816.
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Hurri, Heikki, Toni Vänni, Elli Muttonen, Fabrizio Russo, Sergio Iavicoli, and Leena Ristolainen. "Functional Tests Predicting Return to Work of Workers with Non-Specific Low Back Pain: Are There Any Validated and Usable Functional Tests for Occupational Health Services in Everyday Practice? A Systematic Review." International Journal of Environmental Research and Public Health 20, no. 6 (March 15, 2023): 5188. http://dx.doi.org/10.3390/ijerph20065188.
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The literature predominantly advocates subjective perception of disability and pain as an outcome measure for the functional evaluation of patients with low back pain (LBP). Physical outcome measurements are almost completely ignored. In this systematic review, we focused on physical functional measurements that can contribute to the prediction of patients’ return to work (RTW) readiness after sick leave or rehabilitation. Searches were conducted in July 2022 without any time limit in the Cochrane Library, PEDro, PubMed and Scopus databases for functional and clinical tests reliable and applicable in clinical practice without demanding equipment. Two independent researchers extracted the data from the included articles in a standardised data collection form, and a third researcher validated the data extraction. No date restriction was applied. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in conducting the review. We found seven original articles, including six with an impact on predicting RTW. We found four fair and three poor original studies fulfilling our criteria. We found the Back Performance Scale (BPS) and back endurance test to be the most promising tests for occupational health service and the clinical practitioner. Radiation of back pain, with or without neurological deficiencies, had some predictive value in terms of RTW, too. The working conditions vary a lot, which causes inconsistency in the studies and in their interpretation. Functional tests could complete the widely used working ability evaluations methods such as the Work Ability Index (WAI) and are worth considering for future research. Overall, more research is needed in this field. The question of when LBP patients can resume everyday activities and work is not possible to determine with functional tests alone. Psychosocial aspects and work demands must be considered. PROSPERO: CRD42022353955. The study was funded by the University of Helsinki.
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Greisberg, Justin, J. Turner Vosseller, Peter Gould, and Christopher Ahmad. "Performance Function Tests in Healthy Athletes." Foot & Ankle Orthopaedics 3, no. 3 (July 1, 2018): 2473011418S0022. http://dx.doi.org/10.1177/2473011418s00229.
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Category: Sports Introduction/Purpose: A challenge for physicians is determining when an injured athlete is ready to return to competition. While a wide variety of ankle strength and fitness tests have been described, there are no norms or minimum performance thresholds for any of them. In this study, healthy athletes were given a series of functional tests to complete. We propose that there will be a minimum performance level for each of the tests that all athletes can complete. We also propose, for tests which assess the right and left legs independently, that performance of the right leg will consistently be within 10% of the left. Finally, we propose that performance on one of the functional tests will be predictive of function on all of the tests. Methods: Healthy college athletes were put through a testing protocol, beginning with simple range of motion assessment and progressing through a series of functional ankle tests of increasing difficulty. The athlete began with the dorsiflexion lunge test, and then progressed to single leg heel raising, single leg hopping, side hopping, front-back hopping, functional hop test, and finally 180 degree rotational jump. Right and left legs were recorded separately for the first five tests. For each test, means, ranges, and standard deviations were calculated. Results: Eighty-one athletes (male and female from different sports) completed the protocol; no athlete was unable to finish the testing sequence. There was a wide variation in performance ability between athletes; the standard deviation for any of the individual tests was too high to determine a minimum threshold of normal performance. However, when comparing right to left leg in any one athlete, the difference in performance testing was always less than 10%. Furthermore, performance on any of the hopping tests was predictive of performance on all of them. Conclusion: Ideally, an athlete could be deemed ready to return to sports activity if he or she performed above a certain threshold on a performance test. Unfortunately, athletes had such a wide range of performance that it is not possible to define a minimum threshold for any of these tests. However, right and left leg performance was always within 10% of each other. For an athlete with a single leg injury, we propose that performance on a functional hopping test less than 10% different from the uninjured leg should be the standard.
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Kwak, Seyul, Dae Jong Oh, Yeong-Ju Jeon, Da Young Oh, Su Mi Park, Hairin Kim, and Jun-Young Lee. "Utility of Machine Learning Approach with Neuropsychological Tests in Predicting Functional Impairment of Alzheimer’s Disease." Journal of Alzheimer's Disease 85, no. 3 (February 1, 2022): 1357–72. http://dx.doi.org/10.3233/jad-215244.
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Background: In assessing the levels of clinical impairment in dementia, a summary index of neuropsychological batteries has been widely used in describing the overall functional status. Objective: It remains unexamined how complex patterns of the test performances can be utilized to have specific predictive meaning when the machine learning approach is applied. Methods: In this study, the neuropsychological battery (CERAD-K) and assessment of functioning level (Clinical Dementia Rating scale and Instrumental Activities of Daily Living) were administered to 2,642 older adults with no impairment (n = 285), mild cognitive impairment (n = 1,057), and Alzheimer’s disease (n = 1,300). Predictive accuracy on functional impairment level with the linear models of the single total score or multiple subtest scores (Model 1, 2) and support vector regression with low or high complexity (Model 3, 4) were compared across different sample sizes. Results: The linear models (Model 1, 2) showed superior performance with relatively smaller sample size, while nonlinear models with low and high complexity (Model 3, 4) showed an improved accuracy with a larger dataset. Unlike linear models, the nonlinear models showed a gradual increase in the predictive accuracy with a larger sample size (n > 500), especially when the model training is allowed to exploit complex patterns of the dataset. Conclusion: Our finding suggests that nonlinear models can predict levels of functional impairment with a sufficient dataset. The summary index of the neuropsychological battery can be augmented for specific purposes, especially in estimating the functional status of dementia.
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Goette, W., A. Carlew, J. Schaffert, H. Rossetti, and L. Lacritz. "A-16 Latent Item Response Theory Regression Using Neuropsychological Tests to Predict Functional Ability." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 790. http://dx.doi.org/10.1093/arclin/acaa067.16.
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Abstract Objective Examine prediction of functional ability with neuropsychological tests using latent item response theory. Method The sample included 3155 individuals (Mage = 69.72, SD = 9.41; Median education =13.15, SD = 4.40; white = 92.81%; female = 62.03%; MCI = 25.13%; Dementia = 28.87%) from the Texas Alzheimer’s Research and Care Consortium who completed functional and cognitive assessments [Mini Mental State Examination (MMSE), Logical Memory (LM), Visual Reproduction (VR), Controlled Oral Word Association Test (COWAT), Trail Making Test (TMT), Boston Naming Test, and Digit Span]. Functional measures [Clinical Dementia Rating Scale, Physical Self Maintenance Scale, and Instrumental Activities of Daily Living)] were combined into a single outcome variable using confirmatory factor analysis. Item response theory (IRT) was used to fit the data, and latent regression to predict the latent trait score using neuropsychological data. Results All three functional scales loaded onto a single factor and demonstrated good construct coverage and measurement reliability (Supporting Figure). A graded response IRT model best fit the functional ability composite measure. MMSE (b = −1.08, p < .001), LM II (b = −0.58, p < .001), VR I and II (b = −0.09, p = .02 and b = −0.43, p < .001, respectively), COWAT (b = −0.10, p = .003), and TMT-B (b = −0.30, p < .001) all significantly predicted functional abilities, as did age (b = 0.61, p < .001) and education (b = 0.31, p < .001). Conclusions Global cognition, memory and executive function tests predicted functional abilities while attention and language tasks did not. These results suggest that certain neuropsychological tests meaningfully predict functional abilities in elderly cognitively normal and cognitively impaired individuals. Further research is needed to determine whether these cognitive domains are predictive of functional abilities in other clinical disorders.
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Bryant, Mon S., Jyh-Gong Gabriel Hou, Craig D. Workman, and Elizabeth J. Protas. "Predictive ability of functional tests for postural instability and gait difficulty in Parkinson’s disease." European Geriatric Medicine 9, no. 1 (January 24, 2018): 83–88. http://dx.doi.org/10.1007/s41999-017-0021-3.
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Higinbotham, Sean E., Azhar A. Ali, Xiangyi (Cheryl) Liu, Clint Blackwood, and Kevin B. Shelburne. "Assessing The Predictive Value Of Patient-reported Outcome Measures On Performance-based Functional Tests." Medicine & Science in Sports & Exercise 55, no. 9S (September 2023): 888. http://dx.doi.org/10.1249/01.mss.0000988120.43138.dd.
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Ornelas, Fermin S., and C. Richard Shumway. "Multidimensional Evaluation of Flexible Functional Forms for Production Analysis." Journal of Agricultural and Applied Economics 25, no. 2 (December 1993): 106–18. http://dx.doi.org/10.1017/s1074070800019003.
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AbstractSeveral common flexible functional forms are evaluated for Texas agricultural production utilizing three procedures. Nested hypothesis tests indicate that the normalized quadratic is the marginally-preferred functional form followed by the generalized Leontief. Predictive accuracy results are ambiguous between the generalized Leontief and the normalized quadratic. Statistical performance favors the normalized quadratic. These two functional forms consistently dominate the translog.
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Dikici, Burak, and Remzi Tuntas. "An artificial neural network (ANN) solution to the prediction of age-hardening and corrosion behavior of an Al/TiC functional gradient material (FGM)." Journal of Composite Materials 55, no. 2 (August 12, 2020): 303–17. http://dx.doi.org/10.1177/0021998320948945.
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In this theoretical study, the prediction of the corrosion resistance and age-hardening behavior of an Al/TiC functional gradient material (FGM) has been investigated by using the artificial neural network (ANN). The input parameters have been selected as TiC volume fraction of the composite layers, aging periods of the composite, environmental conditions, and applied potential during the corrosion tests. Current and microhardness were used as the one output in the proposed network. Also, a new three-layered composite has been imaginarily designed to demonstrate the predictive capability and flexibilities of the ANN model as a case study. Artificially aging (T6) process and potentiodynamic scanning (PDS) tests were used for heat-treating and corrosion response of the FGS, respectively. The results showed that the generated PDS curves of the FGM and calculated corrosion parameters of the case study are quite near and in acceptable limits for similar composites obtained values in experimental studies. Besides, this study has been a great success in predicting peak-aging times and its corresponding hardness values more precisely.
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Fältström, Anne, Martin Hägglund, Henrik Hedevik, and Joanna Kvist. "Poor Validity of Functional Performance Tests to Predict Knee Injury in Female Soccer Players With or Without Anterior Cruciate Ligament Reconstruction." American Journal of Sports Medicine 49, no. 6 (April 12, 2021): 1441–50. http://dx.doi.org/10.1177/03635465211002541.
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Background: Various tests have been developed to evaluate athletes’ functional performance and for use as screening tools for injury prediction. Further validation of their accuracy to predict injury is needed. Purpose: To investigate the validity of predetermined cutoffs used to differentiate between high- and low-risk players in different functional performance tests to predict (1) anterior cruciate ligament (ACL) injury or (2) severe traumatic knee injury in a cohort of female soccer players with a primary unilateral ACL reconstruction and a cohort of knee-healthy players. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 117 active female soccer players (mean age ± SD, 20 ± 2 years) an average of 19 ± 9 months after ACL reconstruction and 119 knee-healthy players (age, 19 ± 3 years) were prospectively followed up for 2 years for new knee injuries. At baseline, all players underwent tests to assess postural control (Star Excursion Balance Test), hop performance (single-leg hop for distance, side hop), and movement asymmetries in the lower limbs and trunk (drop vertical jump [DVJ], tuck jump). The predictive validity of the test cutoffs to identify players who would sustain an ACL injury or a severe traumatic knee injury (absence from soccer play, >28 days) was assessed. The risk ratio (RR), area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated. Results: A total of 46 players (39%) with ACL reconstruction sustained 48 severe knee injuries, including 28 ACL ruptures. Of the knee-healthy players, 13 (11%) sustained 14 severe knee injuries, including 8 ACL ruptures. No association was found between the predetermined functional performance test cutoffs and the risk of a new ACL injury or severe knee injury in players with ACL reconstruction. In knee-healthy players, the only variable associated with future ACL injury was ≥6.5 cm knee valgus in the frontal plane (any knee) in the DVJ (RR, 4.93; 95% CI, 1.04-23.40; P = .045), but with only fair predictive validity (AUC, 0.7; sensitivity, 0.75; specificity, 0.65). Conclusion: In our cohorts of female soccer players, the validity of commonly used functional performance tests to predict new knee injuries was poor. Only knee valgus during the DVJ was associated with new ACL injuries in knee-healthy players, but with only fair predictive validity.
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Arnett, Anne B., Robin L. Peterson, Michael W. Kirkwood, H. Gerry Taylor, Terry Stancin, Tanya M. Brown, and Shari L. Wade. "Behavioral and Cognitive Predictors of Educational Outcomes in Pediatric Traumatic Brain Injury." Journal of the International Neuropsychological Society 19, no. 8 (June 21, 2013): 881–89. http://dx.doi.org/10.1017/s1355617713000635.
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AbstractResearch reveals mixed results regarding the utility of standardized cognitive and academic tests to predict educational outcomes in youth following a traumatic brain injury (TBI). Yet, deficits in everyday school-based outcomes are prevalent after pediatric TBI. The current study used path modeling to test the hypothesis that parent ratings of adolescents’ daily behaviors associated with executive functioning (EF) would predict long-term functional educational outcomes following pediatric TBI, even when injury severity and patient demographics were included in the model. Furthermore, we contrasted the predictive strength of the EF behavioral ratings with that of a common measure of verbal memory. A total of 132 adolescents who were hospitalized for moderate to severe TBI were recruited to participate in a randomized clinical intervention trial. EF ratings and verbal memory were measured within 6 months of the injury; functional educational outcomes were measured 12 months later. EF ratings and verbal memory added to injury severity in predicting educational competence post injury but did not predict post-injury initiation of special education. The results demonstrated that measurement of EF behaviors is an important research and clinical tool for prediction of functional outcomes in pediatric TBI. (JINS, 2013,19, 1–9)
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Zając, Bartosz, Anna Mika, Paulina Katarzyna Gaj, and Tadeusz Ambroży. "Does Cycling Training Reduce Quality of Functional Movement Motor Patterns and Dynamic Postural Control in Adolescent Cyclists? A Pilot Study." International Journal of Environmental Research and Public Health 19, no. 19 (September 24, 2022): 12109. http://dx.doi.org/10.3390/ijerph191912109.
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The aim of this study was to assess whether cycling training may influence quality of functional movement patterns and dynamic postural control. We also sought to determine if the Functional Movement Screen and Lower Quarter Y-balance tests could be predictive of injury risk among adolescent road cyclists. Twenty-three male road cyclists, aged 15–18 years, were involved in the study. Quality of functional movement patterns was assessed using the Functional Movement Screen test (FMS). Dynamic postural control was evaluated using the Lower Quarter Y-balance test (YBT-LQ). Information on injury occurrence was collected through a retrospective survey. The results showed the highest percentage of scores equalling 0 and 1 (>30% in total) in two FMS component tests: the hurdle step and trunk stability push-up. The results also demonstrated a low injury predictive value of the Functional Movement Screen (cut-off <14/21 composite score) and the Lower Quarter Y-balance test (cut-off <94% composite score and >4 cm reach distance asymmetry) in adolescent road cyclists. The most important information obtained from this study is that youth road cyclists may have functional deficits within the lumbo-pelvic-hip complex and the trunk, while neither the FMS nor the YBT-LQ test are not recommended for injury risk screening in cyclists.
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Foley, David P., Cameron T. Cox, Allison S. Foley, Rebecka J. Nisbet, Abdurrahman F. Kharbat, and Brendan J. MacKay. "Predicting metacarpal length using paired ratios with bilateral X-ray films." SAGE Open Medicine 9 (January 2021): 205031212110641. http://dx.doi.org/10.1177/20503121211064177.
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Introduction: When the metacarpal bones sustain severe osseous injury requiring reconstruction, functional recovery relies on the precise distribution of tension throughout full range of motion. While the small scale of hand structures compounds the effects of altering normal anatomy, literature lacks consensus recommendations for the acceptable degree of length alteration and/or appropriate methods of length estimation in reconstructive procedures. Length asymmetry has been reported in human metacarpal bones; however, studies assessing this phenomenon in living subjects with attention to functional implications or length prediction are lacking. Methods: Hand X-rays were obtained for 34 patients aged 25–80 without history of metacarpal trauma, joint degeneration, or pathologic bone metabolism. A scaled bivariate model predicted metacarpal length using an ipsilateral paired metacarpal and matching contralateral ratio: Estimate_Dx_R = Median_Dy_R * (Median_Dx_L/Median_Dy_L). A second set of predictions used the contralateral metacarpal as a control. Pearson correlation coefficients, paired t-tests, and chi-square tests evaluated the symmetry between bilateral metacarpal lengths and paired metacarpal ratios as well as the accuracy of each predictive method. Results: The contralateral control and target metacarpal differed significantly in digits 1, 2, 3, and 5. No significant difference in matched metacarpal ratios of the right and left hands was found. For all digits except 5D, bivariate model predictions generated were more strongly correlated with actual target length. Chi-square tests did not detect a significant difference in predictive value of the two models. Conclusion: The scaled bivariate model we describe may be useful and economic in generating accurate length estimates of metacarpals for reconstructive procedures.
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Anderson, Charles, and Jim Briggs. "A study of the effectiveness of ergonomically-based functional screening tests and their relationship to reducing worker compensation injuries." WORK: A Journal of Prevention, Assessment & Rehabilitation 31, no. 1 (January 2008): 27–37. https://doi.org/10.3233/wor-2008-00773.
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Objectives: This paper summarizes a series of studies of the effectiveness of ergonomically based functional screening tests for post offer pre-placement of applicants for physically demanding jobs, and their relationship to reducing worker compensation injuries. Three predictive validation studies and a meta-analysis of injury rates pre- and post-implementation of physical ability testing at 175 locations are included. Methods: The strength and energy expenditure demands of physically-strenuous warehouse jobs in three industries were documented through ergonomic analysis. A battery of strength and endurance tests were developed to assess applicants' abilities to meet the measured physical demands. Predictive validation studies were performed for the jobs in each of the three industries. In each study, new-hires were given the physical ability test battery and then placed on the job. Management was not informed of the results of the tests. Injury experience and work history were then monitored over a two year period in each study. Injury rates and retention were then compared for individuals who passed and individuals who failed the battery. As the battery was implemented in other locations, the injury rate for individuals starting employment in the year prior to implementation was compared to the injury rate for individuals starting employment in the year after implementation. Conclusions: A meta-analysis of the three predictive validation studies indicated that new-hires who passed the battery had a 47% lower worker compensation injury rate and 21% higher retention. A meta-analysis of the 175 pre/post-implementation studies indicated a 41% reduction in worker compensation injuries associated with implementation of ergonomically based physical ability tests.
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Boulgarides, Lois K., Susan M. McGinty, Jayne A. Willett, and Carole W. Barnes. "Use of Clinical and Impairment-Based Tests to Predict Falls by Community-Dwelling Older Adults." Physical Therapy 83, no. 4 (April 1, 2003): 328–39. http://dx.doi.org/10.1093/ptj/83.4.328.
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Abstract Background and Purpose. Few tests have been found to be strongly predictive of falls in community-dwelling older adults. The purpose of this study was to determine whether data from 5 balance tests—combined with data regarding fall history, number of medications, dizziness, visual problems, use of an assistive device, physical activity level, sex, and age—could predict falls in community-dwelling older adults who were independent. Subjects. Ninety-nine community-dwelling older adults aged 65 to 90 years (X̄= 74.02, SD=5.64) were tested. Methods. Subjects were tracked for falls over a 1-year period following testing. Impairment-based tests, which are tests that attempt to specifically identify which sensory systems are impaired or how motor control is impaired (eg, speed, accuracy of movement), were the Modified Clinical Tests of Sensory Interaction for Balance (Modified CTSIB) and the 100% Limits of Stability Test, both of which were done on the Balance Master 6.1. Performance-based tests, which are functional tests that identify functional limitations without necessarily identifying their causes, were the Berg Balance Scale, the Timed “Up & Go” Test, and the Dynamic Gait Index. Demographic and health data included age, sex, number of medications, physical activity level, presence of dizziness, vision problems, and history of falls over the previous year. Logistic regression was used to determine which combinations of data from balance tests, demographics, and health factors were predictive of falls. Results. Two models—(1) the “standing on a firm surface with eyes closed” (FEC) condition of the Modified CTSIB and (2) the FEC combined with age and sex—were predictive of falls, but predicted only 1 and 2 subjects who were at risk for falling, respectively, out of 20 people who were at risk for falling. Discussion and Conclusion. Five balance tests combined with health and demographic factors did not predict falls in a sample of community-dwelling older adults who were active and independent.
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Cárcamo, Jasmine, Anton J. Kociolek, Kayri K. Fernández, Yian Gu, Carolyn W. Zhu, Yaakov Stern, and Stephanie Cosentino. "Neuropsychological Predictors of Severe Functional Dependency in a Multiethnic Community Cohort of Individuals with Alzheimer’s Disease." Journal of Alzheimer's Disease 83, no. 2 (September 14, 2021): 539–44. http://dx.doi.org/10.3233/jad-210019.
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To assess the predictive value of neuropsychological tests for severe dependency in Alzheimer’s disease as defined by the Equivalent Institutional Care Rating Scale, in a multiethnic, community cohort. The sample included 146 elders from the Predictors 3 cohort. Cox proportional hazard models tested the predictive value of each neuropsychological test at baseline on relative risk of meeting severe dependency. Higher semantic processing and memory test scores at baseline were associated with lower risk of meeting severe dependency in the adjusted Cox models. The integrity of semantic processing and memory abilities in dementia appears to predict time to severe functional dependency.
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Vaillant, J., F. Bonnefoy-Crudaz, A. Ribes, J. L. Caillat-Miousse, and N. Vuillerme. "Assessing the value of two functional tests as predictive factors of ankle sprain in rugby players." Annals of Physical and Rehabilitation Medicine 54 (October 2011): e128. http://dx.doi.org/10.1016/j.rehab.2011.07.634.
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Duca, Francesca, Luisa Ruggeri, Guido Finazzi, Barbara Negri, Marco Moia, and Monica Galli. "Congenital Resistance to Activated Protein C in Patients with Lupus Anticoagulants: Evaluation of Two Functional Assays." Thrombosis and Haemostasis 80, no. 08 (1998): 246–49. http://dx.doi.org/10.1055/s-0037-1615182.
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SummaryThe R506Q mutation (“Factor V Leiden”) is responsible for the resistance to activated Protein C (aPCR), that is evaluated by coagulation tests. Such tests cannot be used in patients with lupus anticoagulants (LAs), due to the interfering effect exerted by these antibodies on “in vitro” phospholipid-dependent coagulation tests. For this reason, assays have been developed to evaluate aPCR that are insensitive to the presence of LA antibodies. We evaluated two such coagulation tests in the plasma of 82 consecutive patients with LAs. By polymerase chain reaction 3 patients (3.6%) were found heterozygous for the R506Q mutation. aPCR was evaluated by two clotting assays, proposed to be “insensitive” to the presence of LAs: 1. aPCR-tissue factor-based assay, using Factor V deficient plasma and 1:40 diluted test plasma; 2. aPCR-dRVVT-based assay with highly concentrated phospholipids. Their interassay coefficient of variation was 28% and 6.2%, respectively. Compared to the polymerase chain reaction analysis, the 2 tests displayed the following characteristics: sensitivity 67% vs 100%, specificity 92% vs 96%, positive predictive value 25% vs 50%, negative predictive value 99% vs 100%, respectively. Among LA patients without the R506Q mutation, 5 scored positive in the aPCR-tissue factor-based assay, 2 in the aPCR-dRVVT-based assay and another one in both assays. Our findings suggest that the aPCRdRVVT-based test is more reliable and sensitive than the aPCR-tissue factor-based one to the R506Q mutation in patients with LAs. Both assays, when negative, make unlikely the presence of the R506Q mutation. Polymerase chain reaction analysis remains, however, to be performed when either test is positive.
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Runser, Anne, Caroline Schaning, Frédéric Allemand, and Jean Amiral. "An Optimized and Standardized Rapid Flow Cytometry Functional Method for Heparin-Induced Thrombocytopenia." Biomedicines 9, no. 3 (March 13, 2021): 296. http://dx.doi.org/10.3390/biomedicines9030296.
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Heparin-induced thrombocytopenia (HIT) is a thrombocytopenia caused by heparin and mediated by an atypical immune mechanism leading to a paradoxical high thrombotic risk, associated with severe morbidity or death. The diagnosis of HIT combines a clinical scoring of pretest probability and laboratory testing. First-line routine tests are antigen binding assays detecting specific antibodies. The most sensitive of these tests have a high HIT-negative predictive value enabling HIT diagnosis to be ruled out when negative. However, HIT-positive predictive value is low, and a functional assay evaluating the pathogenicity of the antibodies should be performed to exclude false-positive results. In contrast to screening assays, functional assays are highly specific but technically challenging, and are thus performed in referral laboratories, where platelet activation is detected using radioactive serotonin (serotonin release assay, SRA) or visually (heparin-induced platelet activation, HIPA). Flow cytometry is a possible alternative. It is, however, currently not widely used, mostly because of the lack of standardization of the published assays. This article describes and discusses the standardization of a HIT flow cytometry assay (HIT-FCA) method, which subsequently led to the development and commercialization of a CE-marked assay (HIT Confirm®, Emosis, France) as a suitable rapid HIT functional test.
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Chamorro-Moriana, Gema, Fernando Espuny-Ruiz, Carmen Ridao-Fernández, and Eleonora Magni. "Clinical value of questionnaires & physical tests for patellofemoral pain: Validity, reliability and predictive capacity." PLOS ONE 19, no. 4 (April 17, 2024): e0302215. http://dx.doi.org/10.1371/journal.pone.0302215.
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Objectives To determine the most appropriate method of functional assessment for "patellofemoral pain" (PFP)/“chondromalacia patella” for its diagnostic value, (validity, reliability, sensitivity, specificity, predictive value and clinical applicability); to outline initial interpretations of the questionnaires and their appropriateness, through the cut-off points determined in their scores based on physical test and Magnetic Resonance Imaging (MRI); to establish which methods should be used in conjunction with each other to obtain clinical diagnoses that are robust effective and efficient. Methods (1)Intra- and inter-observer reliability and of the relationship among PFP questionnaires/physical tests validated. (2)Predictive capacity of the questionnaires. Subject: 113 knees with PFP, assessed using “Knee-injury-and-Osteoarthritis Outcome-Score-for-Patellofemoral-pain-and-osteoarthritis” (KOOS-PF), “Kujala-Patellofemoral-Score” (KPS), “Victorian-Institute-of-Sports-Assessment-for-Patellar-tendons-questionnaire” (VISA-P), and the physical tests: “patellar-palpation”, “patellar-tilt”, “patellar-apprehension”, “Clarke” and “squat”. Results Questionnaires correlations themselves was 0.78<r<0.86. Tests intra-rater reliability was “excellent”. Squat inter-rater reliability was “excellent”/“good”. Palpation, tilt, Clarke and squat showed a statistically significant relationship (p<0.05) with all questionnaires/specific items. AUC of the questionnaires showed a "useful" accuracy, except for Tilt. No statistically significant differences were found between grades 0 and 1 chondromalacia (by MRI) knee scores, but between 1 and ≥2. AUC of the questionnaires showed "useful" accuracy. Conclusions KOOS-PF, KPS and VISA-P demonstrated their diagnostic value in PFP/chondromalacia (validity, reliability, sensitivity, specificity, predictive value and clinical applicability). KOOS-PF was the most versatile, and the most appropriate in mild cases and for early detection and prevention. Squat was the best due to its reliability and clinical relationship with the questionnaires, which predicted it correctly. The functional assessment tools discussed should be applied by combining them with each other.
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Moreira, Ana Carolina silva de Souza, Giovana Zarpellon Mazo, and Fernando Luiz Cardoso. "Os testes de mobilidade funcionais predizem o risco de queda em idosos residentes na comunidade?" Manual Therapy, Posturology & Rehabilitation Journal 14 (December 31, 2016): 432. http://dx.doi.org/10.17784/mtprehabjournal.2016.14.432.
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The falls are associated with morbidity and mortality in the elderly. Numerous of functional mobility clinical tests have been created to identify older adults with potential for risk of falls. The purpose of this systematic review was to determine the predictive validity of functional mobility tests to predict the risk of falls in community-dwellingelderly. Articles in English were searching in MEDLINE, SCOPUS and CINAHL. We found 18,520 documents and, after applying the inclusion and exclusion criteria, 11 articles were part of the final analysis. All articles analyzed included subjects over 60 years old. The results showed that the TUG Test has good discriminative validity for elderly non-institutionalized, but it does not provide an adequate predictive validity for falls. The TUG Test may not be enough as a unique basic screening tool to detect the risk of falling. It is suggested that the TUG Test should be used in combination with other predictors of falling risk tools or should it be reconfigured for the different levels of active elderly functionality.
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Gawlitza, Joshua, Timo Sturm, Kai Spohrer, Thomas Henzler, Ibrahim Akin, Stefan Schönberg, Martin Borggrefe, Holger Haubenreisser, and Frederik Trinkmann. "Predicting Pulmonary Function Testing from Quantified Computed Tomography Using Machine Learning Algorithms in Patients with COPD." Diagnostics 9, no. 1 (March 21, 2019): 33. http://dx.doi.org/10.3390/diagnostics9010033.
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Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five distinct, partial-machine learning-based mathematical models to predict lung function parameters from qCT values in comparison with pulmonary function tests. Methods: 75 patients with diagnosed COPD underwent body plethysmography and a dose-optimized qCT examination on a third-generation, dual-source CT with inspiration and expiration. Delta values (inspiration—expiration) were calculated afterwards. Four parameters were quantified: mean lung density, lung volume low-attenuated volume, and full width at half maximum. Five models were evaluated for best prediction: average prediction, median prediction, k-nearest neighbours (kNN), gradient boosting, and multilayer perceptron. Results: The lowest mean relative error (MRE) was calculated for the kNN model with 16%. Similar low MREs were found for polynomial regression as well as gradient boosting-based prediction. Other models led to higher MREs and thereby worse predictive performance. Beyond the sole MRE, distinct differences in prediction performance, dependent on the initial dataset (expiration, inspiration, delta), were found. Conclusion: Different, partially machine learning-based models allow the prediction of lung function values from static qCT parameters within a reasonable margin of error. Therefore, qCT parameters may contain more information than we currently utilize and can potentially augment standard functional lung testing.
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Perpetuini, David, Antonio M. Chiarelli, Daniela Cardone, Chiara Filippini, Roberta Bucco, Michele Zito, and Arcangelo Merla. "Complexity of Frontal Cortex fNIRS Can Support Alzheimer Disease Diagnosis in Memory and Visuo-Spatial Tests." Entropy 21, no. 1 (January 1, 2019): 26. http://dx.doi.org/10.3390/e21010026.
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Decline in visuo-spatial skills and memory failures are considered symptoms of Alzheimer’s Disease (AD) and they can be assessed at early stages employing clinical tests. However, performance in a single test is generally not indicative of AD. Functional neuroimaging, such as functional Near Infrared Spectroscopy (fNIRS), may be employed during these tests in an ecological setting to support diagnosis. Indeed, neuroimaging should not alter clinical practice allowing free doctor-patient interaction. However, block-designed paradigms, necessary for standard functional neuroimaging analysis, require tests adaptation. Novel signal analysis procedures (e.g., signal complexity evaluation) may be useful to establish brain signals differences without altering experimental conditions. In this study, we estimated fNIRS complexity (through Sample Entropy metric) in frontal cortex of early AD and controls during three tests that assess visuo-spatial and short-term-memory abilities (Clock Drawing Test, Digit Span Test, Corsi Block Tapping Test). A channel-based analysis of fNIRS complexity during the tests revealed AD-induced changes. Importantly, a multivariate analysis of fNIRS complexity provided good specificity and sensitivity to AD. This outcome was compared to cognitive tests performances that were predictive of AD in only one test. Our results demonstrated the capabilities of fNIRS and complexity metric to support early AD diagnosis.
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Aponte, Raúl, Nefertiti Daulabani, Zuleyma De Jesús, Soberanía Rengifo, and Luis Pérez-Ybarra. "Non-erosive gastroesophageal reflux disease determination criteria by functional tests: a predictive model based on multivariate analysis." International Journal Of Community Medicine And Public Health 8, no. 11 (October 27, 2021): 5241. http://dx.doi.org/10.18203/2394-6040.ijcmph20214256.
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Background: Gastroesophageal reflux disease (GERD) in 2009 presented a prevalence of 11.5% in Venezuela. It is a complex, multifactorial disease that is difficult to define, since it consists of several signs and symptoms that may or may not coexist together, both in the presence and absence of the disease.Methods: A prospective study was conducted that consisted of a group of 85 patients diagnosed with non-erosive gastroesophageal reflux disease (NERD) and 20 asymptomatic volunteers. Functional tests were conducted on both groups that included high resolution manometry, 24-hour pH-metry - impedance study. The chi-square independence test, principal component analysis and multiple correspondence analysis were applied to identify which variables showed greater association and importance for the diagnosis of NERD.Results: The results indicated that it is possible to establish a rapid diagnostic test based on the solid drink test, distal contraction index, peristaltic jumps and presence of heartburn with a sensitivity of 96% and specificity of 90%.Conclusions: It is possible to establish a NERD rapid diagnostic test based on functional tests.
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Thaer Daoud Salman, Amjad Eabd Alhamid Almajid, Noura Amer Aliwi Al-Anazi, and Saad abbas Fadhil. "Forecasts some of functional indicators nervous system for dribbling skills in young basketball players from Baghdad Governorate." Eximia 13 (April 18, 2024): 387–403. http://dx.doi.org/10.47577/eximia.v13i1.465.
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The research study is important since it establishes predicted rates for various nervous system functional indicators.In terms of performing the skill of Dribbling in basketball for young players in Baghdad Governorate in order to reach scientific results that serve researchers, coaches, and players uniformly. The study's goal is to create predictive equations for specific functional indicators of the nervous system in relation to the Dribbling skill performance of young basketball players in Baghdad Governorate. The researchers used a descriptive approach with a survey method on (8) youth basketball league clubs in Baghdad Governorate for the 2022-2023 sports season, totaling (96) players . Three tests were used to measure the nervous system, and one test was used to measure the basketball dribbling skill . After processing the data statistically, the researchers concluded that there was a contribution rate for the Romberg test (maintaining balance) As an indicator of the nervous system in terms of the performance of the dribble skill in basketball for young players by (3.5%), a prediction equation was developed for it. There is a contribution rate for the Yarotsk test (evaluation of the state of the vestibular system) as an indicator of the nervous system in relation to the performance of the basketball dribbling skill for young players by (5.6%), and a prediction equation was developed for it. The researchers recommended the need to direct coaches and specialists to pay attention to the results of this study in planning future programs to develop the true performance level of young basketball players. It is necessary to circulate the results of this study to sports and youth centers and sports clubs in order to rely on the tests used to judge the suitability of players to practice basketball.It is necessary to conduct similar studies on functional indicators of the nervous system and try to determine the percentage of their contribution in relation to other basketball skills that were not addressed in the current study and to establish predictive coefficients for them.It is necessary to conduct similar studies on functional indicators of the nervous system in relation to the performance of the basketball skill at other levels and for both genders.
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Zhu, Lingling, Shuo Xu, Huaizhu Guo, Siqi Lu, Jiaqi Gao, Nan Hu, Chen Chen, et al. "Machine learning-based phenogroups and prediction model in patients with functional gastrointestinal disorders to reveal distinct disease subsets associated with gas production." Journal of Translational Internal Medicine 12, no. 4 (September 1, 2024): 355–66. http://dx.doi.org/10.2478/jtim-2024-0009.
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Abstract Background and Objectives Symptom-based subtyping for functional gastrointestinal disorders (FGIDs) has limited value in identifying underlying mechanisms and guiding therapeutic strategies. Small intestinal dysbiosis is implicated in the development of FGIDs. We tested if machine learning (ML) algorithms utilizing both gastrointestinal (GI) symptom characteristics and lactulose breath tests could provide distinct clusters. Materials and Methods This was a prospective cohort study. We performed lactulose hydrogen methane breath tests and hydrogen sulfide breath tests in 508 patients with GI symptoms. An unsupervised ML algorithm was used to categorize subjects by integrating GI symptoms and breath gas characteristics. Generalized Estimating Equation (GEE) models were used to examine the longitudinal associations between cluster patterns and breath gas time profiles. An ML-based prediction model for identifying excessive gas production in FGIDs patients was developed and internal validation was performed. Results FGIDs were confirmed in 300 patients. K-means clustering identified 4 distinct clusters. Cluster 2, 3, and 4 showed enrichments for abdominal distention and diarrhea with a high proportion of excessive gas production, whereas Cluster 1 was characterized by moderate lower abdominal discomforts with the most psychological complaints and the lowest proportion of excessive gas production. GEE models showed that breath gas concentrations varied among different clusters over time. We further sought to develop an ML-based prediction model to determine excessive gas production. The model exhibited good predictive capabilities. Conclusion ML-based phenogroups and prediction model approaches could provide distinct FGIDs subsets and efficiently determine FGIDs subsets with greater gas production, thereby facilitating clinical decision-making and guiding treatment.
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Geltser, B. I., M. M. Tsivanyuk, K. I. Shakhgeldyan, E. D. Emtseva, and A. A. Vishnevskiy. "Cardiometabolic risk factors in predicting obstructive coronary artery disease in patients with non-ST-segment elevation acute coronary syndrome." Russian Journal of Cardiology 26, no. 11 (June 25, 2021): 4494. http://dx.doi.org/10.15829/1560-4071-2021-4494.
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Aim. To develop predictive models of obstructive coronary artery disease (OPCA) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) based on the predictive potential of cardiometabolic risk (CMR) factors.Material and methods. This prospective observational cohort study included 495 patients with NSTE-ACS (median age, 62 years; 95% confidence interval [60; 64]), who underwent invasive coronary angiography (CAG). Two groups of persons were identified, the first of which consisted of 345 (69,6%) patients with OPCA (stenosis ≥50%), and the second — 150 (30,4%) without OPCA (<50%). The clinical and functional status of patients before CAG was assessed including 29 parameters. For data processing and analysis, the Mann-Whitney, Fisher, chi-squared tests and univariate logistic regression (LR) were used. In addition, for the development of predictive models, we used multivariate LR (MLR), support vector machine (SVM) and random forest (RF). The models was assessed using 4 metrics: area under the ROC-curve (AUC), sensitivity, specificity, and accuracy.Results. A comprehensive analysis of functional and metabolic status of patients made it possible to identify the CMR factors that have linear and nonlinear association with OPCA. Their weighting coefficients and threshold values with the highest predictive potential were determined using univariate LR. The quality metrics of the best predictive algorithm based on an ensemble of 10 MLR models were as follows: AUC — 0,82, specificity and accuracy — 0,73, sensitivity — 0,75. The predictors of this model were 7 categorical (total cholesterol (CS) ≥5,9 mmol/L, low-density lipoprotein cholesterol >3,5 mmol/L, waist-to-hip ratio ≥0,9, waist-to-height ratio ≥0,69, atherogenic index ≥3,4, lipid accumulation product index ≥38,5 cm*mmol/L, uric acid ≥356 pmol/L) and 2 continuous (high density lipoprotein cholesterol and insulin resistance index) variables.Conclusion. The developed algorithm for selecting predictors made it possible to determine their significant predictive threshold values and weighting coefficients characterizing the degree of influence on endpoints. The ensemble of MLR models demonstrated the highest accuracy of OPCA prediction before the CAG. The predictive accuracy of the SVM and RF models was significantly lower.
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O'Donoghue, John L. "Screening for Neurotoxicity Using a Neurologically Based Examination and Neuropathology." Journal of the American College of Toxicology 8, no. 1 (January 1989): 97–115. http://dx.doi.org/10.3109/10915818909009097.
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Testing chemicals for toxicity by screening methods is an integral part of providing high-quality products and processes. Screening tests must be sensitive, reproducible, readily performed by a trained staff, generally acceptable across laboratories, costeffective, timely, and predictive of significant hazards. The screening process begins with routine acute and subacute tests commonly in use in toxicology laboratories worldwide. When these tests indicate a neurotoxicologic effect or when structure-activity analysis suggests a concern, more specific tests, including a neurologically based functional observational battery (FOB) and neuropathology, are indicated. The FOB provides a highly structured framework for collection of clinical signs. When teamed together, the FOB and neuropathology examinations are complementary tests that provide a clinicopathologic description of a neurotoxicant that can be used for risk assessment.
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Faleide, Anne Gro Heyn, Liv Heide Magnussen, Torbjørn Strand, Bård Erik Bogen, Rolf Moe-Nilssen, Ingunn Fleten Mo, Willemijn Vervaat, and Eivind Inderhaug. "The Role of Psychological Readiness in Return to Sport Assessment After Anterior Cruciate Ligament Reconstruction." American Journal of Sports Medicine 49, no. 5 (March 3, 2021): 1236–43. http://dx.doi.org/10.1177/0363546521991924.
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Background: Knowledge about the predictive value of return to sport (RTS) test batteries applied after anterior cruciate ligament reconstruction (ACLR) is limited. Adding assessment of psychological readiness has been recommended, but knowledge of how this affects the predictive ability of test batteries is lacking. Purpose: To examine the predictive ability of a RTS test battery on return to preinjury level of sport and reinjury when evaluation of psychological readiness was incorporated. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 129 patients were recruited 9 months after ACLR. Inclusion criteria were age ≥16 years and engagement in sports before injury. Patients with concomitant ligamentous surgery or ACL revision surgery were excluded. Baseline testing included single-leg hop tests, isokinetic strength tests, the International Knee Documentation Committee (IKDC) Subjective Knee Form 2000, a custom-made RTS questionnaire, and the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale. The RTS criteria were IKDC 2000 score ≥85% and ≥85% leg symmetry index on hop and strength test. At a 2-year follow-up evaluation, further knee surgery and reinjuries were registered and the RTS questionnaire was completed again. Regression analyses and receiver operating characteristic analyses were performed to study the predictive ability of the test battery. Results: Out of the 103 patients who completed the 2-year follow-up, 42% returned to their preinjury level of sport. ACL-RSI 9 months after surgery (odds ratio [OR], 1.03) and age (OR, 1.05) predicted RTS. An ACL-RSI score <47 indicated that a patient was at risk of not returning to sport (area under the curve 0.69; 95% CI, 0.58-0.79), with 85% sensitivity and 45% specificity. The functional tests did not predict RTS. Six patients sustained ACL reinjuries and 7 underwent surgery for other knee complaints/injuries after RTS testing. None of the 29 patients who passed all RTS criteria, and were therefore cleared for RTS, sustained a second knee injury. Conclusion: ACL-RSI and age were predictors of 2-year RTS, while functional tests were not informative. Another main finding was that none of the patients who passed the 85% RTS criteria sustained another knee injury.
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Butler, Robert J., Michael Contreras, Lee C. Burton, Phillip J. Plisky, Adam Goode, and Kyle Kiesel. "Modifiable risk factors predict injuries in firefighters during training academies." WORK: A Journal of Prevention, Assessment & Rehabilitation 46, no. 1 (January 2013): 11–17. https://doi.org/10.3233/wor-121545.
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OBJECTIVE: To examine whether measures of physiologic function and fundamental movement are predictive of injury in firefighters during a training academy. PARTICIPANTS: 108 firefighter trainees enrolled in the training academy. METHODS: Baseline measures of physical performance and fundamental movement patterns were obtained in firefighters entering a training academy to determine predictors of injury. The physical performance measures were standardized tests of individual maximum performance on a set of four different total body tests and one firefighter specific performance test, the tower test. Measurements of fundamental movement patterns consisted of the seven tests of the Functional Movement Screen (FMS) along with the composite score.Performance on each of the individual tests was examinedto determine if any of the variables were predictive of injury. RESULTS: ROC curve analysis established that a FMS cut score of ⩽ 14 was able to discriminate between those at a greater risk for injury. In addition, the deep squat and push up component of the FMS were statistically significant predictors of injury status along with the sit and reach test. CONCLUSIONS: Injury in firefighters during academy can be predicted by baseline measures of musculoskeletal movement and physiology.
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Lajevardi, Laleh, Ghorban Taghizadeh, Akram Azad, and Amir Seyed Ahmadi. "Predictive Role of Ankle Muscle Strength, Pain and Activity Level in Ankle Functional Instability, Functional Mobility and Gait Speed in Individuals With Ankle Sprain." Function and Disability Journal 6, no. 1 (December 20, 2023): 0. http://dx.doi.org/10.32598/fdj.6.268.1.
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Background and Objectives: An ankle sprain is one of the most common musculoskeletal injuries and has various complications. Various factors can predict post-injury complications, including ankle muscle strength, pain, and activity level. So far, no study has exclusively investigated the predictive role of these factors. Therefore, this study aims to investigate the role of these factors in ankle instability, functional mobility, and gait speed in individuals with ankle sprain. Methods: This study was conducted on 140 individuals with ankle sprains who were referred to medical centers in Shiraz City, Iran. The demographic information of the patients (including the time elapsed since the sprain, etc.) was recorded by a demographic questionnaire. Related tests were also used to evaluate ankle muscle strength, pain, activity level, ankle functional instability, functional mobility, and gait speed, respectively. Results: In the regression models, the predictive value for each outcome of ankle functional instability, functional mobility, and walking speed was 45.5%, 58.8%, and 65.3% of the variance, respectively. In all stepwise models, ankle muscle strength was the strongest predictor for the outcomes of functional ankle instability, functional mobility, and gait speed. Conclusion: Ankle muscle strength, level of education, history of sprain in the last year, and age were the vital predictors of ankle functional instability. Muscle strength, age, and sprain status were the critical predictors of functional mobility respectively. Muscle strength, pain, age, duration of sprain, and activity level were the crucial predictors of gait speed.
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Vinnikov, V. A., and T. V. Rubleva. "Predictors of radiation-induced complications in radiation oncology based on cell survival tests after ex vivo exposure: literature review." Український радіологічний та онкологічний журнал 29, no. 1 (March 29, 2021): 89–118. http://dx.doi.org/10.46879/ukroj.1.2021.89-118.
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Background. Among cancer patients receiving radiotherapy about 5–15 % may have adverse reactions in normal tissues and organs that limit their treatment in a full, originally scheduled regimen. The development of biomarkers and assays for radiation oncology allowing the prediction of patients’ normal tissue toxicity requires a lot of resourses, threfore its current status amd potential directions for future research have to be periodically analyzed and re-evaluated.
Purpose – this review summarizes the methodological approaches and developments in the area of functional laboratory assays based on ex vivo cell survival for the prediction of the individual clinical radiosensitivity.
Materials and methods. Data for the analysis and systematization were obtained from the full-text articles published in peer review international scientific journals (in English) in 1990–2020, which were selected by the extensive search in PubMed information database and cross references on the topic “Functional cellular tests for intrinsic radiosensitivity to predict adverse radiation effects and radiotherapy complications”.
Results. In theory, it might be expected that clonogenic cell survival after ex vivo irradiation can surve as the best individual predictor of radiation toxicity, as it is an integral indicator of cell damage and decline of their regenerative potential. Tendentially, fibroblasts, as a test system for such studies, did not show significant advantages over lymphocytes either in detecting inter-individual variations in the intrinsic cellular radiosensitivity or in predicting clinical radiation toxicity, even for that in skin. It was found that clonogenic cell survival assay, being very time consuming and technically demanding, also suffers from the lack of sensitivity and specificity, essential uncertainty and low reproducibility of the results, and thus is not suitable for the sceening for the abnormal intrinsic radiosensitivity. However, this type of assays is applicable for the radiobiological expertise post factum in individual cases with unexpected, extreme radiation lesions. Radiation-induced lymphocyte apoptosis assay seems to be more promising however still requires further fundamental research for better understanding of its background and more validation studies in order to assess the optimum patient groups, radiotherapy regimens and adverse effects for its confident use in clinical practice. Changes in the regulation of cell cycle check-points (radiationinduced delay) ex vivo can have either positive or inverted association, or no correlation with clinical radiation responses in tissues, thus so far cannot be included in the toolbox of applied radiobiological tests.
Conclusions. To date, in the practice of clinical radiobiology, there are no fully validated and standardized functional tests based on the cell survival after ex vivo irradiation, which would allow a sufficiently accurate prediction of adverse radiation effects in normal tissues of radiotherapy patients. In general, ex vivo tests based on the evaluation of only one form of cell death in one cell type are not fully reliable as a “stand alone” assay, because different pathways of cell death probably play different roles and show different dose response within the overal reaction of the irradiated tissue or critical organ. Such tests should become a part of the multiparametric predictive platforms.
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Kiderman, Alex, Carey Balaban, Mikhaylo Szczupak, Hillary Snapp, and Michael Hoffer. "Evaluation of multisensory responses (oculomotor, vestibular, and reaction time) in 3, 8 and 15 days after mild traumatic brain injury." Neurology 91, no. 23 Supplement 1 (December 4, 2018): S5.1—S5. http://dx.doi.org/10.1212/01.wnl.0000550629.03524.71.
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BackgroundDespite the prevalence of mild traumatic brain injury (mTBI, concussion) in a wide range of occupational, sport, and military settings, accurate diagnosis and optimal treatment of concussive injuries are delayed by several challenging obstacles. Ability to measure the multisensory functional integrity of numerous neuroanatomical pathways with multiple tasks (oculomotor, vestibular and reaction time) can capture impairments of brain function.Methods106 mTBI patients and 300 control subjects were tested in the vestibular labs at 2 military hospitals. Patients were tested 3 times at average 2.5, 8.5 and 15.8 days post-injury. All patients completed a health history questionnaire, a dizziness handicap index (DHI), a functional gait index (FGI), and Trail Making Tests (TMTs) and were assessed by a battery of tests with video-oculography (I-Portal VOG) comprised of a head mounted, high speed eye tracking system on a rotary chair device (I-Portal Neuro-Otologic Test Center). The individuals in the study performed multiple tests including saccades, antisaccade, pursuit tracking, nystagmus, optokinetic, vestibular motion, and reaction time.ResultsNo single test was sufficiently predictive to have separation between controls and mTBI subjects but results from a computer controlled rotational head impulse test (crHIT), antisaccade and predictive saccade were highly correlated with mTBI for the first test session. Longitudinally, for example, 74% of patients in session 1, 56% in session 2% and 51% in session 3 had in crHIT gain or absolute asymmetry above 95% of the respective control's distribution.ConclusionThese results suggest that vestibular, oculomotor and reaction time tests using can provide an objective and reliable method of capturing and quantifying abnormal response in patients with mTBI. In addition, this type of testing can be used to monitor the recovery process.
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Polo-DeSantos, Mar, Juan Pablo, Chalco Orrego, Ana Isabel Hijas-Gómez, Setefilla Luengo-Matos, and Luis María Sánchez-Gómez. "PP141 Functional Connectivity Magnetic Resonance Imaging To Detect Autism." International Journal of Technology Assessment in Health Care 35, S1 (2019): 64–65. http://dx.doi.org/10.1017/s0266462319002551.
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IntroductionAutism is a neurodevelopmental disorder characterized by alterations in the intellectual, social, communication, and behavioral capabilities of an individual, and is rarely detected in children before 24 months of age. Early diagnosis and intervention may be more effective at a younger age. Functional connectivity magnetic resonance imaging (fcMRI) of 6-month old infants may be able to identify brain connection patterns related to at least one of the characteristics of autism, which normally appear at 24 months of age, by using a mathematical model to analyze the neuroimaging data.MethodsClinical studies published up to December 2018 that used fcMRI to detect autism in infants were reviewed. The literature databases searched included PubMed, Web of Science, the Trip Database, DynaMed, the Cochrane Library, the International Clinical Trials Registry Platform, and ClinicalTrials.gov. Early assessments of fcMRI analysis were identified through the Early Awareness and Alert System of the Agencia de Evaluación de Tecnologías Sanitarias.ResultsOnly one prospective study of 59 infants at 6-months of age was retrieved. A fcMRI analysis was performed to identify 2,635 pairs of functional connections from 230 brain regions. The infants were subsequently assessed for autism at 24 months of age using gold standard tests. The functional connections correlated with at least one of the behaviors related to autism evaluated at 24 months of age. Eleven infants (19%) were diagnosed with autism at 24 months. Compared with the gold standard test results, the predictive model achieved the following: sensitivity 0.82 (95% confidence interval [CI]: 0.52 - 0.95); specificity 1.00 (95% CI: 0.93–1.00); positive predictive value 1.00 (95% CI: 0.70–1.00); negative predictive value 0.96 (95% CI: 0.87–0.99); and negative likelihood ratio 0.18 (95% CI: 0.05–0.64). Adverse effects were not reported in the study.ConclusionsThe fcMRI analysis could help in early detection of autism and the development of preventive interventions. However, the evidence is sparse and more well-designed studies are needed.
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Marazzini, L., G. Cavigioli, B. Mastropasqua, and A. Pelucchi. "FEV1 decline in asymptomatic young adults: relationships with some tests of small airways function." European Respiratory Journal 2, no. 9 (October 1, 1989): 817–21. http://dx.doi.org/10.1183/09031936.93.02090817.
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The aim of this study is to determine whether some tests proposed as diagnostic of small airways obstruction (SAO) are useful in identifying the subjects at risk of developing chronic airflow limitation. Eighty five healthy male workers (46 nonsmokers and 39 smokers, aged 21-41 yrs), living in the same area and not exposed to occupational pollutants were re-examined after an interval of 6 yrs. At the first survey 39 had functional evidence of SAO as determined by the presence of one of: maximal mid-expiratory flow (MMEF) less than 65% of predicted value (pred); maximal expiratory flow when 25% forced vital capacity remains to be expired (Vmax25) less than 60% pred; closing capacity (CC) greater than 130% pred; 46 had all functional values in the normal range. We considered four subgroups: smokers and nonsmokers with and without SAO. The rate of decline in FEV1, the decline in %delta FEV1 and delta FEV1.height-3, have been evaluated and compared in the subgroups. Initial values of specific tests (MMEF, Vmax25, CC and slope of phase III) have been examined for a possible relationship with decline of FEV1. Statistical analysis of our data showed that only CC was related to FEV1 decline. However, there were no significant differences in FEV1 decline among the subgroups. We conclude that in young adult subjects functional characteristics of SAO have no predictive value for development of chronic airways obstruction.
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Edelstein, Beatrise, and Jillian Scandiffio. "Predictors of Functional Improvement, Length of Stay, and Discharge Destination in the Context of an Assess and Restore Program in Hospitalized Older Adults." Geriatrics 7, no. 3 (April 20, 2022): 50. http://dx.doi.org/10.3390/geriatrics7030050.
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Assess and restore programs such as Humber’s Elderly Assess and Restore Team (HEART) provide short-term restorative care to prevent functional decline in hospitalized older adults. The aim of this retrospective observational study was to determine which HEART participant characteristics are predictive of functional improvement, decreased length of stay, return to home, and decreased readmission to hospital. Electronic health records were retrospectively examined to gather predictor data. Differences in functional status, excessive length of stay, discharge destination, and hospital readmissions were compared in 547 HEART patients and 547 matched eligible non-participants using ANOVAs, Mann–Whitney, and chi-square tests. The greatest functional improvements (percent Barthel change) were seen in those requiring a one-person assist (M = 39.56) and using a walker (M = 46.07). Difference in excessive length of stay between HEART and non-HEART participants was greatest in those who used a walker (Mdn = 3.80), required a one-person assist (Mdn = 2.00), had a high falls risk (Mdn = 1.80), and had either a lower urinary tract infection (Mdn = 2.25) or pneumonia (Mdn = 1.70). Predictor variables did not affect readmission to the hospital nor return to home. Predictive characteristics should be considered when enrolling patients to assess and restore programs for optimal clinical outcomes.
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Chen, Kailai. "Criteria for Return to Sport after ACL Injury." Highlights in Science, Engineering and Technology 74 (December 29, 2023): 620–25. http://dx.doi.org/10.54097/66pe8d79.
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This review study seeks to give a general overview of the requirements for ACL (anterior cruciate ligament) recovery and return to sports. ACL tears are a common occurrence in athletes, and deciding whether it is safe for the players to return to play presents considerable hurdles. This paper examines the current understanding of various considerations and tests involved in the decision-making process. These considerations encompass functional assessments, including ligament stability tests, balance tests, single-leg hop tests, psychological factors, and so on. The review concludes with some prevalent and valid tests. The predictive value in assessing the risk of reinjury can guide the patient back to play. It is necessary for patients to follow those criteria in order to back to sport safely. Additionally, some other considerations, such as pain and psychological factors, can determine if a patient can return to sports and predict the possibility of re-injury.
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O’Meara, Matthew J., Jackson R. Rapala, Connie B. Nichols, A. Christina Alexandre, R. Blake Billmyre, Jacob L. Steenwyk, J. Andrew Alspaugh, and Teresa R. O’Meara. "CryptoCEN: A Co-Expression Network for Cryptococcus neoformans reveals novel proteins involved in DNA damage repair." PLOS Genetics 20, no. 2 (February 15, 2024): e1011158. http://dx.doi.org/10.1371/journal.pgen.1011158.
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Elucidating gene function is a major goal in biology, especially among non-model organisms. However, doing so is complicated by the fact that molecular conservation does not always mirror functional conservation, and that complex relationships among genes are responsible for encoding pathways and higher-order biological processes. Co-expression, a promising approach for predicting gene function, relies on the general principal that genes with similar expression patterns across multiple conditions will likely be involved in the same biological process. For Cryptococcus neoformans, a prevalent human fungal pathogen greatly diverged from model yeasts, approximately 60% of the predicted genes in the genome lack functional annotations. Here, we leveraged a large amount of publicly available transcriptomic data to generate a C. neoformans Co-Expression Network (CryptoCEN), successfully recapitulating known protein networks, predicting gene function, and enabling insights into the principles influencing co-expression. With 100% predictive accuracy, we used CryptoCEN to identify 13 new DNA damage response genes, underscoring the utility of guilt-by-association for determining gene function. Overall, co-expression is a powerful tool for uncovering gene function, and decreases the experimental tests needed to identify functions for currently under-annotated genes.
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Urlings, Judith H. J., Ariane Cuenen, Tom Brijs, Mark Lutin, and Ellen M. M. Jongen. "Aiding medical professionals in fitness-to-drive screenings for elderly drivers: development of an office-based screening tool." International Psychogeriatrics 30, no. 8 (December 10, 2017): 1211–25. http://dx.doi.org/10.1017/s1041610217002678.
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ABSTRACTBackground:Elderly drivers are an increasing group in society. Previous research has found that functional and cognitive abilities are more important for driving abilities than biological age. In an attempt to conserve independent mobility for elderly drivers, many researchers have focused on elderly drivers diagnosed with cognitive decline (mild cognitive impairment or mild Dementia). This study is the first to focus on elderly drivers with cognitive complaints or suspected of diminished fitness to drive by an (in)formal caregiver as an at-risk group.Methods:The main objective of this study was to develop a fitness to drive screening tool for elderly drivers to be used in a doctor's office. Furthermore, this study investigated the additional value of driving simulator tests in the assessment of fitness to drive. Both screenings (functional abilities and driving simulator test) were benchmarked against the official Belgian fitness to drive licensing procedure.Results:One-hundred thirty-six elderly drivers participated in a functional abilities screening, a driving simulator assessment and an on-road driving test. Sixty-five percent of the sample was considered fit to drive. Visual acuity, physical flexibility, and knowledge of road signs were found to be the best predictive set of tests for the on-road fitness to drive outcome. A performance based driving simulator assessment increased predictive accuracy significantly.Conclusion:The proposed screening procedure saves part of the at-risk elderly driver population from stressful and costly on-road driving evaluations. This procedure provides more information of an individual driver's specific driving parameters. This opens doors for personalized older driver training to maintain independent mobility in later life.
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Mascanzoni, Marta, Alessia Luciani, Federica Tamburella, Marco Iosa, Emanuela Lena, Sergio Di Fonzo, Valerio Pisani, et al. "The Role of Psychological Variables in Predicting Rehabilitation Outcomes After Spinal Cord Injury: An Artificial Neural Networks Study." Journal of Clinical Medicine 13, no. 23 (November 25, 2024): 7114. http://dx.doi.org/10.3390/jcm13237114.
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Background: Accurate prediction of neurorehabilitation outcomes following Spinal Cord Injury (SCI) is crucial for optimizing healthcare resource allocation and improving rehabilitation strategies. Artificial Neural Networks (ANNs) may identify complex prognostic factors in patients with SCI. However, the influence of psychological variables on rehabilitation outcomes remains underexplored despite their potential impact on recovery success. Methods: A cohort of 303 patients with SCI was analyzed with an ANN model that employed 17 input variables, structured into two hidden layers and a single output node. Clinical and psychological data were integrated to predict functional outcomes, which were measured by the Spinal Cord Independence Measure (SCIM) at discharge. Paired Wilcoxon tests were used to evaluate pre–post differences and linear regression was used to assess correlations, with Pearson’s coefficient and the Root Mean Square Error calculated. Results: Significant improvements in SCIM scores were observed (21.8 ± 15.8 at admission vs. 57.4 ± 22.5 at discharge, p < 0.001). The model assigned the highest predictive weight to SCIM at admission (10.3%), while psychological factors accounted for 36.3%, increasing to 40.9% in traumatic SCI cases. Anxiety and depression were the most influential psychological predictors. The correlation between the predicted and actual SCIM scores was R = 0.794 for the entire sample and R = 0.940 for traumatic cases. Conclusions: The ANN model demonstrated the strong impact, especially for traumatic SCI, of psychological factors on functional outcomes. Anxiety and depression emerged as dominant negative predictors. Conversely, self-esteem and emotional regulation functioned as protective factors increasing functional outcomes. These findings support the integration of psychological assessments into predictive models to enhance accuracy in SCI rehabilitation outcomes.
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Mettu, Niharika B., Blake Waechter, Tyler J. Zemla, Yingmiao Liu, John C. Brady, Lynn Lin, Sacha Gnjatic, et al. "Correlation of single-cell cytokine secretion with clinical outcome in patients (pts) with metastatic colorectal cancer (mCRC) treated with capecitabine (C), bevacizumab (B), ± atezolizumab (A)." Journal of Clinical Oncology 41, no. 16_suppl (June 1, 2023): 3533. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.3533.
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3533 Background: The BACCI trial (NCT02873195) randomized 133 mCRC pts to C+B+A (investigational) or C+B+placebo. Longer progression free survival (PFS) was observed in the investigational vs placebo arm. To investigate T-cell functional heterogeneity, we performed single-cell proteomic analyses on pts with either long or short PFS and evaluated T-cell function as a prognostic and predictive biomarker. Methods: Isolated CD8+ and CD4+ cells were analyzed at baseline and first restaging from pts with long ( > 6 mo, N = 14) or short ( < 2 mo, N = 13) PFS. Single-cell, functional proteomic analyses were conducted using the IsoLight system (Isoplexis), which assessed secretion of 32 cytokines from an average of 786 cells per sample. The cumulative readout was polyfunctional strength index (PSI), a composite score of frequency and magnitude of secreted cytokines. Cytokines are organized into effector (E), stimulatory, chemoattractive (CA), regulatory, and inflammatory (I) clusters. Differential expression analyses were done using Wilcoxon rank-sum tests. Potential predictive effects were assessed using logistic regressions with interaction between treatment and biomarkers. No multiple comparison control was done due to the exploratory nature of analyses. Results: Baseline CD8+ and CD4+ cells were stimulated ex vivo and single-cell cytokine analyses performed. Prognostic analyses indicated that CD8+ cells from pts with long PFS had ~3-fold higher PSI compared to pts with short PFS (p = 0.005). Further analysis identified that the E (p = 0.005) and CA clusters (p = 0.005) most impacted PSI, significant individual cytokines are listed in the table. Baseline CD8+ cell function was not predictive of outcome. Baseline CD4+ cell function was not prognostic or predictive of outcome. Analysis of CD8+ cells after treatment identified that changes in CA cluster was prognostic of long PFS (p = 0.024). Cytokine changes from CD4+ cells were not prognostic; however, early changes in the CD4+ CA cluster were predictive of outcome (p-int = 0.055). Similarly, early changes in the CD8+ I cluster were predictive of outcome (p-int = 0.073). Conclusions: These results reveal pts with long PFS had more functional CD8+ T-cells with a higher PSI than pts with short PFS. Predictive analyses suggested that early changes in the CD4+ CA and CD8+ I clusters were associated with benefit from immunotherapy. These preliminary results highlight the importance of single-cell functional proteomic analyses. [Table: see text]
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Nagler, Michael, and Tamam Bakchoul. "Clinical and laboratory tests for the diagnosis of heparin-induced thrombocytopenia." Thrombosis and Haemostasis 116, no. 11 (September 2016): 823–34. http://dx.doi.org/10.1160/th16-03-0240.
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SummaryA rapid diagnostic work-up is required in patients with suspected heparin-induced thrombocytopenia (HIT). However, diagnosis of HIT is challenging due to a number of practical issues and methodological limitations. Many laboratory tests and a few clinical scoring systems are available but the individual characteristics and the diagnostic accuracy of these are hard to appraise. The 4Ts score is a well evaluated clinical assessment tool with the potential to rule out HIT in many patients. Still, it requires experience and is subject to a relevant inter-observer variability. Immunoassays such as enzyme-linked immunosorbent assays or recently developed rapid assays are able to exclude HIT in a number of patients. But, accuracy of immunoassays differs depending on type of assay, threshold, antibody specificity and even manufacturer. Due to a comparatively low positive predictive value, HIT cannot be confirmed by immunoassays alone. In addition, only some of them are immediately accessible, particularly in small laboratories. While functional assays such as the serotonin release assay (SRA) and the heparin-induced platelet activation assay (HIPA) are considered as gold standard for diagnosis of HIT, they require a highly specialised laboratory. In addition, some of them are not adequately evaluated. In clinical practice, we recommend an integrated diagnostic approach combining not only clinical assessment (the 4Ts score) but immunoassays and functional assays as well. We propose a clear diagnostic algorithm supporting clinical decision-making. Furthermore, we provide an overview of all current laboratory techniques for HIT and discuss diagnostic pathways and strategies to reduce diagnostic errors, and future perspectives.
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Dammavalam, Vikalpa, Deborah Rupert, Marcos Lanio, Zhaosheng Jin, Neil Nadkarni, Stella E. Tsirka, and Sergio D. Bergese. "Dementia after Ischemic Stroke, from Molecular Biomarkers to Therapeutic Options." International Journal of Molecular Sciences 25, no. 14 (July 16, 2024): 7772. http://dx.doi.org/10.3390/ijms25147772.
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Ischemic stroke is a leading cause of disability worldwide. While much of post-stroke recovery is focused on physical rehabilitation, post-stroke dementia (PSD) is also a significant contributor to poor functional outcomes. Predictive tools to identify stroke survivors at risk for the development of PSD are limited to brief screening cognitive tests. Emerging biochemical, genetic, and neuroimaging biomarkers are being investigated in an effort to unveil better indicators of PSD. Additionally, acetylcholinesterase inhibitors, NMDA receptor antagonists, dopamine receptor agonists, antidepressants, and cognitive rehabilitation are current therapeutic options for PSD. Focusing on the chronic sequelae of stroke that impair neuroplasticity highlights the need for continued investigative trials to better assess functional outcomes in treatments targeted for PSD.
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Elizagárate, E., P. Sánchez, A. B. Yoller, J. Peña, N. Ojeda, J. Larumbe, M. Gutiérrez, and J. Ezcurra. "the Deleterious Effect of Cognitive Impairment, Negative Symptoms and Functional Disability on Quality of Life in Chronic Schizophrenia." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71425-7.
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Aims:To examine the relative contributions of psychiatric symptoms, functional disability, neuropsychological functioning and sociodemographic variables to quality of life (QOL) in patients with chronic schizophrenia.Method:We examined 165 hospitalised patients with long term schizophrenia (DSM-IV). Measures of psychiatric symptoms included depression (Calgary depression Scale), insight (David Insight Scale), symptom severity (BPRS) and PANSS (Positive and Negative Symptom Scale). Neuropsychological battery included tests for verbal memory, executive functioning, verbal fluency, working memory, motor speed and processing speed. Functional disability was assessed with the Disability Assessment Schedule (DAS-WHO) and Quality of life was assessed with the Quality of Life Scale.Results:Age, years of evolution, negative symptoms, insight and neuropsychological variables (except motor speed) all were significantly related to level of quality of life. in a multiple regression analysis, entering the neuropsychological functioning, functional disability and negative symptoms generated a model which accounted for a 74.9% of the variance in QOL. Functional disability, as expected, accounted for 56% of the variance, whereas Processing Speed explained an additional 6.2%. Symptom Severity and Verbal Fluency predicted 3.7% and 3.5% of the variance, respectively. Negative symptoms, Verbal Memory and Vocabulary, were also significant predictors in the model, but had less predictive value. However, Positive Symptoms and Sociodemographic Variables did not significantly contribute to predict quality of life.Conclusion:Our findings support the predictive value of neuropsychological functioning, functional disability and severity of negative symptoms in long term quality of life in schizophrenia.
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Minson, Christopher T. "Thermal provocation to evaluate microvascular reactivity in human skin." Journal of Applied Physiology 109, no. 4 (October 2010): 1239–46. http://dx.doi.org/10.1152/japplphysiol.00414.2010.
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With increased interest in predictive medicine, development of a relatively noninvasive technique that can improve prediction of major clinical outcomes has gained considerable attention. Current tests that are the target of critical evaluation, such as flow-mediated vasodilation of the brachial artery and pulse-wave velocity, are specific to the larger conduit vessels. However, evidence is mounting that functional changes in the microcirculation may be an early sign of globalized microvascular dysfunction. Thus development of a test of microvascular reactivity that could be used to evaluate cardiovascular risk or response to treatment is an exciting area of innovation. This mini-review is focused on tests of microvascular reactivity to thermal stimuli in the cutaneous circulation. The skin may prove to be an ideal site for evaluation of microvascular dysfunction due to its ease of access and growing evidence that changes in skin vascular reactivity may precede overt clinical signs of disease. Evaluation of the skin blood flow response to locally applied heat has already demonstrated prognostic utility, and the response to local cooling holds promise in patients in whom cutaneous disorders are present. Whether either of these tests can be used to predict cardiovascular morbidity or mortality in a clinical setting requires further evaluation.
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Jaffe, Russell, and Jayashree Mani. "Importance of Predictive Biomarkers and Epigenetics in Health: Novel Solutions in Clinical Care." American Journal of Clinical Pathology 152, Supplement_1 (September 11, 2019): S138. http://dx.doi.org/10.1093/ajcp/aqz127.000.
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Abstract Introduction/Objective Chronic health issues precipitate from a myriad of origins. We underline three common underlying causes: cumulative repair deficits, oxidative damage and metabolic acidosis. A unique set of predictive biomarkers (PBs) addressing these aspects is presented that has been developed on the premise that epigenetics influence 92% and genetics influence the remaining 8% of health. Together with an individualized and personalized treatment plan, this approach has shown to provide best health outcomes. Methods (1) To tailor therapeutic management of chronic conditions, predictive tests that have a variance of 5% or less are used and their “least risk, most gain” goal values are adhered to instead of usual or normal statistical ranges. This helps confirm specific individual need and facilitates effective monitoring of outcome results. Repair deficit is measured by hsCRP, oxidative damage measured by homocysteine, Omega 3 index, and 8OhdG; immune intolerance indicated by lymphocyte response assays and metabolic acidosis indicated by urine pH assessment. (2) Individualized nutrient protocols are formulated based on predictive biomarker results. (3) A metabolically alkalinizing diet is initiated with the goal to providing a buffering effect on cellular chemistry. For example, dietary sugars and refined flours are the single biggest triggers of inflammation driving hyperinsulinemia leading to a biochemical cascade that alters gene expression promoting inflammation. Results This proactive approach is evidence based and has been shown to lower costs while enhancing individual outcomes when compared to current best standards of care, reducing risks, and adding “years to life and life to years.” Conclusion There is a difference between known tests and functional predictive tests—identifies individual epigenetic risks better. Least risk-highest gain goal values are more relevant than normal lab values. Choosing the right kind of high-sensitivity biomarkers and adopting an associated lifestyle plan can improve quality of clinical care.
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Maita, Hiroki, Tadashi Kobayashi, Takashi Akimoto, Hiroshi Osawa, and Hiroyuki Kato. "Pseudo-fever caused by predictive electronic thermometers: A case report." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2211297. http://dx.doi.org/10.1177/2050313x221129772.
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A 33-year-old man was referred to our hospital with chief complaints of fever, dizziness, and headache. Although he had recurring fever and dizziness for 7 months, neurological examination, magnetic resonance imaging, computed tomography, electrocardiograms, and blood tests were normal. He was diagnosed with functional hyperthermia, cervical vertigo, and tension headache and was treated with oral medication and physical therapy. After treatment, the dizziness and headache resolved; however, the fever and anxiety did not. During follow-up, he noticed differing results from different electronic thermometers. The physician decided to use an accurate analog thermometer, a gallium thermometer, in combination with the other thermometers. The results differed significantly among the thermometers, and the electronic thermometer readings were found to be inappropriately high. The physician made a diagnosis of pseudo-fever, and the patient recognized that the gallium thermometer’s results were the most accurate reflection of his physical condition, resolving his anxiety.
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Chubenko, V. A. "The emerging field of checkpoint inhibitors." Practical oncology 23, no. 2 (June 30, 2022): 93–99. http://dx.doi.org/10.31917/2302093.
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Immunotherapy as a new method allows effective control of the tumor growth. At the same time, the continuous treatment and the novel mechanism of action leads to the possible appearance of the specific immune-mediated adverse events, some of which can be fatal. Functional tests, analysis of the risk factors for the development of the complications, the search for the predictive markers will improve the effectiveness of immunotherapy. The perspective is the development of the prophylaxis based on in-depth understanding of the immune tolerance disorders