Tag: pubmed

JMIR Med Inform. 2025 Apr 23;13:e63709. doi: 10.2196/63709.

ABSTRACT

BACKGROUND: Critically ill patients in intensive care units (ICUs) require continuous monitoring, generating vast amounts of data. Clinical decision support systems (CDSS) leveraging artificial intelligence (AI) technologies have shown promise in improving diagnostic, prognostic, and therapeutic decision-making. However, these models are rarely implemented in clinical practice.

OBJECTIVE: The aim of this study was to survey ICU physicians to understand their expectations, opinions, and level of knowledge regarding a proposed AI-based CDSS for continuous renal replacement therapy (CRRT) weaning, a clinical decision-making process that is still complex and lacking in guidelines. This will be used to guide the development of an AI-based CDSS on which our team is working to ensure user-centered design and successful integration into clinical practice.

METHODS: A prospective cross-sectional survey of French-speaking physicians with clinical activity in intensive care was conducted between December 2023 and April 2024. The questionnaire consisted of 20 questions structured around 4 axes: overview of the problem and current practices concerning weaning from CRRT, opinion on AI-based CDSS, implementation in daily clinical practice, real-life operation and willingness to adopt the CDSS in everyday practice. Statistical analyses included Wilcoxon rank sum tests for quantitative variables and χ2 or Fisher exact tests for qualitative variables, with multivariate analyses performed using ordinal logistic regression.

RESULTS: A total of 171 complete responses were received. Physicians expressed an interest in a CDSS for CRRT weaning, with 70.2% (120/171) viewing AI-based CDSS favorably. Opinions were split regarding the difficulty of the weaning decision itself, with 46.2% (79/171) disagreeing that it is challenging, while 31.6% (54/171) agreed. However, 66.1% (113/171) of respondents supported the value of an AI-based CDSS to assist them in this decision, with younger physicians showing stronger support (81.8%, 27/33 vs 62.3%; 86/138; P=.01). Most respondents (163/171, 95.3%) emphasized the importance of understanding the criteria used by the model to make its predictions.

CONCLUSIONS: Our findings highlight an optimistic attitude among ICU physicians toward AI-based CDSS for CRRT weaning, emphasizing the need for transparency, integration into existing workflows, and alignment with clinicians’ decision-making processes. Actionable recommendations include incorporating key variables such as urine output and biological parameters, defining probability thresholds for recommendations and ensuring model transparency to facilitate the successful adoption and integration into clinical practice. The methodology of this survey may help the development of further predevelopment studies accompanying AI-based CDSS projects.

PMID:40267422 | DOI:10.2196/63709

J Strength Cond Res. 2025 Apr 23. doi: 10.1519/JSC.0000000000005121. Online ahead of print.

ABSTRACT

Meechan, D, McErlain-Naylor, SA, Phua, Juan Peng, and Comfort, P. The effect of load on subphase analysis during the hang pull. J Strength Cond Res XX(X): 000-000, 2025-The effect of load on temporally aligned time-series data has yet to be investigated during weightlifting derivatives. Such data may provide greater insight regarding any differences in stimulus between relative loads during each phase. This study compared the effect of load on the force-time and velocity-time curves during the hang pull (HP). Twenty-seven males performed the HP at relative loads of 40, 60, 80, 100, 120, and 140% one repetition maximum (1RM) power clean (PC). A force plate measured the vertical ground reaction force, which calculated the barbell-lifter system velocity. Time-series were time-normalized to 101 data points (0-100% of the movement duration) via piecewise linear length normalization of the individual phases (unweighting, braking, propulsion) and assessed via statistical parametric mapping. Relative loads of 40% 1RM PC maximized propulsion velocity, whereas 140% 1RM maximized force. Statistical parametric mapping analysis showed greater force at 140% 1RM PC throughout 55-100% of total movement duration compared with all loads, with greater propulsion velocity at lighter loads during the propulsion phase (79-100% of the movement) for all loads, with greater negative velocity at 140% 1RM PC compared with 60 and 100% 1RM PC during late unweighting/early braking phase (32-54% of the movement). Braking, propulsion, and total absolute durations increased with load. It may be appropriate to prescribe the HP during a maximal strength and strength-speed mesocycle given the ability to use supramaximal loads.

PMID:40267416 | DOI:10.1519/JSC.0000000000005121

Hum Factors. 2025 Apr 23:187208251335149. doi: 10.1177/00187208251335149. Online ahead of print.

ABSTRACT

ObjectiveThis study investigated how user characteristics and driving context influence auditory experiences (AX) in electric vehicles (EVs), identifying distinct user types and their specific auditory needs and evaluation.BackgroundElectric vehicles (EVs) present unique opportunities for designing auditory experiences (AX) due to their quiet operation characteristics and acoustic vehicle alert systems (AVAS).MethodForty participants conducted real-driving experiments with an EV, experiencing sounds at low, medium, and high speeds. We applied systematic analysis combining topic modeling (BERTopic) and qualitative coding of think-aloud interviews and statistical analysis of questionnaire responses.ResultsFour user types were segmented by attitude (Dynamic vs. Conservative) and car type (EV vs. ICV owners). Text analysis revealed varying frequencies of concerns across user types regarding driving contexts, functional aspects, and affective aspects of AX. Statistical analysis showed significant differences among user types in sporty preferences and perceptions of affective properties (Sporty, Stylish, Comfort, and Calm). Driving contexts significantly influenced perceived Stylish and Calm characteristics.ConclusionThis study provides empirical evidence and design implications for customized AX in EVs design based on user characteristics and driving contexts.ApplicationThe findings can guide the development of personalized AX systems in EVs, enhancing both user satisfaction and safety through context-aware and user-centered design approaches.

PMID:40267415 | DOI:10.1177/00187208251335149

J Strength Cond Res. 2025 Apr 23. doi: 10.1519/JSC.0000000000005111. Online ahead of print.

ABSTRACT

Li, W, Lin, J, Dos’Santos, T, and Turner, A. Mechanical determinants of superior horizontal deceleration performance in multidirectional sportspersons. J Strength Cond Res XX(X): 000-000, 2025-This study aimed to (a) examine the mechanical determinants of superior horizontal deceleration and (b) compare ground reaction force (GRF) characteristics of the first and second braking foot contacts during horizontal deceleration between higher and lower deceleration performers. Forty-two trained male student-athletes from multidirectional team sports performed 3 maximal deceleration trials after a 15-m sprint, with GRF data over the first 2 braking steps collected using force plates. Horizontal velocity was collected using a radar gun, and p < 0.05 was considered statistically significant. Greater mean and peak deceleration were statistically significantly correlated with greater mean horizontal GRF ratio at both braking foot contacts (ρ = 0.31-0.49, p < 0.05). Comparing lower mean and peak deceleration performers, greater performers displayed statistically significantly greater mean horizontal GRF ratios at both braking steps (effects size [ES] = 3.53-5.00, p < 0.05) and lower approach momentum (ES = 0.62 and 0.66). Compared with lower approach momentum performers, greater performers displayed statistically significantly greater mean and peak deceleration scores (ES = 0.70 and 0.66, p < 0.05). Practitioners should aim to maximize horizontal GRF production and orientate force more horizontally for more effective deceleration. However, faster approach velocities, especially when accompanied with greater body mass (and thus momentum), will likely see a reduction in deceleration performance on account of higher braking demands. This is likely an unavoidable paradox, and thus, deceleration performance must always be presented considering approach velocity and momentum.

PMID:40267408 | DOI:10.1519/JSC.0000000000005111

J Strength Cond Res. 2025 Apr 23. doi: 10.1519/JSC.0000000000005069. Online ahead of print.

ABSTRACT

Kearney, C, Coughlan, EK, O’Connell, A, Lacey, S, and Burns, C. Bigger but are they better? Investigating growth, maturation, and physical performance metrics in underage Gaelic games development squads. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this study was to examine (a) maturation status distribution across intercounty underage Gaelic games development squads and (b) differences in physical performance metrics relative to maturation status. The study is the first to assess physical performance metrics in intercounty development squad Gaelic Games players, with reference to maturation status. The Khamis & Roche method was used to establish maturation status in 254 male U15 and U16 Gaelic Games development squad players. Tests for lower body power (countermovement jump [CMJ] height), linear speed (10, 20 m), upper body strength (maximum chin-up test), and aerobic endurance (GAA modified Bronco) were conducted. One-way multivariate analysis of variance and analysis of variance were conducted, with an alpha level of p < 0.05 set to determine statistical significance. In both U15 and U16 groups, early developers (EDs) comprised 64.9 and 64.0%, respectively, while on-time (OT) developers comprised 31.5% (U15) and 33.7% (U16), and late developers (LDs) comprised 3.6% (U15) and 2.3% (U16). For U15, ED exhibited significantly faster 10 m speed than LD (p = 0.045) and faster 20 m speed than both OT (p = 0.007) and LD (p = 0.006). After post hoc tests for U16, CMJ scores showed no significant differences (p > 0.05), while U16 ED and OT displayed faster 20 m speed than LD (p = 0.023, p = 0.024, respectively). Coach education around growth and maturation and strategies such as biobanding should be used in talent development settings. Practitioners should interpret speed times relative to maturation status as opposed to chronological age.

PMID:40267407 | DOI:10.1519/JSC.0000000000005069

J Strength Cond Res. 2025 Apr 23. doi: 10.1519/JSC.0000000000005100. Online ahead of print.

ABSTRACT

Arévalo-Chico, H, Sellés-Pérez, S, Fernández-Sáez, J, and Cejuela, R. Physiologic performance, training, and its evolution in international- versus national-level triathletes of both sexes: What differences are there? J Strength Cond Res XX(X): 000-000, 2025-Limited data for elite male and female triathletes exist in the academic literature. This comparative study examined the training loads and physiologic performance data, for the general preparatory period(s) within the training years 2021-2024, as a function of both sex and competition level, in 33 top triathletes. Twenty-three male and 10 female international- or national-level elite athletes took part in the study. The individual athlete’s training data were collected for an average period of 18 ± 2 weeks, at the outset and end of which cardiorespiratory and lactate testing was performed. The nonparametric Mann-Whitney U test was performed to detect statistical differences. Running speed at maximum oxygen uptake (SVO2max) was the test-related variable that showed the greatest differences with performance tier in male (p = 0.001; effect size [ES]: 2.07) and female athletes (p = 0.031; ES: 1.74). Training volume was higher in the international athletes (p = 0.001; ES: 1.52). Moreover, mean weekly training load was significantly positively correlated with physiologic performance in the running and cycling tests, especially with SVO2max (ρ = 0.651; p < 0.05). However, the extent of physiologic performance improvements that occurred during this period did not differ statistically between groups in any variable. It is important, therefore, that the professional level of an athlete is considered when the coach(es) decide what is his/her most appropriate, assimilable, training load. Both SVO2max and the ability to assimilate high training loads seem to be important variables to take into account in the triathlon talent detection process.

PMID:40267406 | DOI:10.1519/JSC.0000000000005100

J Strength Cond Res. 2025 Apr 23. doi: 10.1519/JSC.0000000000005098. Online ahead of print.

ABSTRACT

Stuart, A, Vetrovsky, T, Cochrane-Snyman, KC, Vieira, A, and Tufano, JJ. Investigating the consistency in countermovement jump performance after high-velocity and high-force PAPE: A multiday analysis. J Strength Cond Res XX(X): 000-000, 2025-Postactivation performance enhancement (PAPE) is widely acknowledged in both practical application and research. However, studies have primarily focused on single experimental PAPE sessions, neglecting the repeatability of protocols with the same individuals over time. The purpose of this study was to determine whether PAPE, involving high-velocity and high-force conditioning activities, could be observed at consistent time points across multiple sessions. Sixteen elite speed skaters (9 men: 23.1 ± 2.6 years and 7 women: 24.2 ± 4.7 years) participated in 6 sessions for each independent study. For all sessions, a standardized warm-up was performed, followed by 3 baseline bodyweight countermovement jumps (CMJ), and a potentiation protocol of 5 repeated band-assisted countermovement jumps at approximately 20% bodyweight reduction, or a single 5-second maximal effort isometric squat. Subsequently, subjects rested for 3, 5, and 7 minutes before performing a single bodyweight CMJ at each time point. Multiday analyses of variance showed mixed results for both protocols, with most effect sizes ranging from trivial to small. Linear mixed models indicated that at the individual level, subjects did not consistently jump higher at any specific post-PAPE rest time. The variance between baseline and post-PAPE jump height at the rest time that produced the greatest result was neither statistically significant nor statistically different (p > 0.05), compared with other rest times. Postactivation performance enhancement was identifiable across sessions but variability in jump performance and inconsistent effects made it difficult to observe repeatable responses within individuals over time, thus questioning the idea of “individualizing” PAPE in practice.

PMID:40267397 | DOI:10.1519/JSC.0000000000005098

Eur J Public Health. 2025 Apr 23:ckaf059. doi: 10.1093/eurpub/ckaf059. Online ahead of print.

ABSTRACT

Cervical cancer is the fourth leading cause of cancer-related deaths in women, resulting in an estimated 350 000 deaths worldwide in 2022. Public health preventive strategies can modify the burden of cervical cancer. This study aimed to assess the mortality trends of cervical cancer in Montenegro from 1990 to 2018 and identify the impact of preventive measures on mortality rates associated with cervical cancer. The data concerning cervical cancer mortality from 1990 to 2018 were collected. The joinpoint, linear, and Poisson regressions were applied. The rate was adjusted to the world standard population. Overall and age-specific trends were assessed. Joinpoint regression revealed a statistically significant increase in cervical cancer mortality rates by an average of 2.6% per year [average annual percentage change (AAPC) (95%CI) = 2.6 (1.3-3.8); P < .001] and the number of death cases by 3.5% [AAPC (95%CI) = 3.5 (2.2-4.7); P < .001] for the overall level for the period 1990-2018. Among the women who died from cervical cancer, the majority were aged 55-64 (28.3%), then aged 45-54 (27.6%) and aged 65-74 (17.4%). This analysis highlights a growing trend of mortality from cervical cancer in Montenegro, underscoring the need for additional research into the causes of this serious public health concern.

PMID:40267395 | DOI:10.1093/eurpub/ckaf059

JCO Glob Oncol. 2025 Apr;11:e2400488. doi: 10.1200/GO-24-00488. Epub 2025 Apr 23.

ABSTRACT

PURPOSE: Despite rising cancer incidence and mortality in Saudi Arabia, access to radiotherapy (RT) services is limited in some regions. This study aimed to examine the travel burdens of RT patients and assess the benefits of hypofractionated RT (HFRT).

METHODS: This multicenter retrospective study included patients with breast cancer (BC) and prostate cancer (PC) treated with HFRT (26 Gy/5 fractions for BC and 60 Gy/20 fractions for PC) between 2020 and 2024. Patient data were collected from electronic records, and an online questionnaire assessed experiences and financial burdens. Google Maps determined the shortest driving distance from patients’ residences to our RT center. Descriptive statistics compared accommodation, transportation costs, and time expenditure for shorter versus longer RT courses.

RESULTS: A survey of 153 out of 187 patients (average age 57 years for BC, 70 years for PC) revealed significant travel burdens. Notably, 43% traveled from outside Jeddah, averaging 415 km, compared with 17.9 km for those within Jeddah. HFRT offered substantial transportation cost-savings, estimated at $101 in US dollars (USD) for patients with BC (an additional $133 (USD) for those outside Jeddah) and $213 (USD) for patients with PC (an additional $320 (USD) for those outside Jeddah). Median accommodation cost-savings were $733 (USD) for BC and $1,600 (USD) for PC. Median time-savings were 9.25 hours for BC and 30 hours for PC. All patients were satisfied with the treatment duration, with 42% preferring the shorter hospital stay and 8% citing financial reasons.

CONCLUSION: Patients with cancer in Saudi Arabia travel significant distances for RT. HFRT using shorter RT courses reduces patient-related costs, enhances satisfaction, and may improve access by addressing logistical challenges.

PMID:40267380 | DOI:10.1200/GO-24-00488

Neurology. 2025 May 27;104(10):e213599. doi: 10.1212/WNL.0000000000213599. Epub 2025 Apr 23.

ABSTRACT

BACKGROUND AND OBJECTIVES: Young-onset dementia (YOD) poses substantial societal and health care burdens. Although metabolic syndrome (MetS) is recognized as a contributor to late-onset dementia, its effect on YOD remains unclear. This study aimed to determine whether MetS and its individual components increase the risk of YOD, including all-cause dementia, Alzheimer disease (AD), and vascular dementia (VaD).

METHODS: We conducted a nationwide population-based cohort study using data from the Korean National Insurance Service. Individuals aged 40-60 who underwent national health check-ups in 2009 were included and followed until December 31, 2020, or age 65, whichever came first. MetS was defined according to established guidelines, incorporating measurements of waist circumference, blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Covariates included age, sex, income level, smoking status, alcohol consumption, and comorbidities such as hypertension, diabetes, dyslipidemia, and depression. The primary outcome was incident all-cause YOD, defined as a dementia diagnosis before age 65; secondary outcomes included young-onset AD and VaD. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% CIs.

RESULTS: A total of 1,979,509 participants (mean age, 49.0 years; 51.3% men; 50.7% with MetS) were included. Over an average follow-up of 7.75 years, 8,921 individuals (0.45%) developed YOD. MetS was associated with a 24% higher risk of all-cause YOD (adjusted HR 1.24, 95% CI 1.19-1.30), a 12.4% increased risk of AD (HR 1.12, 95% CI 1.03-1.22), and a 20.9% increased risk of VaD (HR 1.21, 95% CI 1.08-1.35). Significant interactions were noted with younger age (40-49 vs 50-59), female sex, drinking status, obesity, and depression.

DISCUSSION: In this large Korean cohort, MetS and its individual components were significantly associated with an increased risk of YOD. These findings suggest that interventions targeting MetS may help mitigate YOD risk. However, the observational design precludes definitive causal inferences, and reliance on claims data could introduce misclassification bias. Future research using longitudinal designs and comprehensive data collection is needed to validate and expand on these associations.

PMID:40267374 | DOI:10.1212/WNL.0000000000213599