Brain injury prediction using the translational energy criterion: an experimental study. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

The utility of a workplace injury instrument in prediction of workplace injury

Workplace injuries are common and destructive to persons, organisations, and society. Various instruments presently exist that are designed to assess the factors underlying workplace injury. The study reports on the construct and predictive validity of a 46-item instrument, the safety perception survey (SPS), currently used to assess safety climate in industrial organisations throughout Australia. Initially, factor analysis was conducted on the data from a sample of 1238 employees from nine organisations, which indicated a one-factor solution, was the best fit. A structural equation model (SEM) linking injury rates to the safety climate measure for 16 sub-groups of six industrial organisations indicated that the measure contributed just 23% of the variance in injury rates. Interestingly, the results indicated that the number of employees was a better and more significant predictor of injury (R² = 0.48). It is proposed that the SPS as is would need to be modified significantly from its current form to produce improvements in validity, as in its current form the survey is no more predictive of injury than organisational size. Future research into safety climate measures should incorporate predictive validity analysis on injury rates, as for many organisations; this is a performance outcome measure.

1RM prediction: a data mining case study

In the last few years there has been a heightened interest in data treatment and analysis with the aim of discovering hidden knowledge and eliciting relationships and patterns within this data. Data mining techniques (also known as Knowledge Discovery in Databases) have been applied over a wide range of fields such as marketing, investment, fraud detection, manufacturing, telecommunications and health. In this study, well-known data mining techniques such as artificial neural networks (ANN), genetic programming (GP), forward selection linear regression (LR) and k-means clustering techniques, are proposed to the health and sports community in order to aid with resistance training prescription. Appropriate resistance training prescription is effective for developing fitness, health and for enhancing general quality of life. Resistance exercise intensity is commonly prescribed as a percent of the one repetition maximum. 1RM, dynamic muscular strength, one repetition maximum or one execution maximum, is operationally defined as the heaviest load that can be moved over a specific range of motion, one time and with correct performance. The safety of the 1RM assessment has been questioned as such an enormous effort may lead to muscular injury. Prediction equations could help to tackle the problem of predicting the 1RM from submaximal loads, in order to avoid or at least, reduce the associated risks. We built different models from data on 30 men who performed up to 5 sets to exhaustion at different percentages of the 1RM in the bench press action, until reaching their actual 1RM. Also, a comparison of different existing prediction equations is carried out. The LR model seems to outperform the ANN and GP models for the 1RM prediction in the range between 1 and 10 repetitions. At 75% of the 1RM some subjects (n = 5) could perform 13 repetitions with proper technique in the bench press action, whilst other subjects (n = 20) performed statistically significant (p < 0:05) more repetitions at 70% than at 75% of their actual 1RM in the bench press action. Rate of perceived exertion (RPE) seems not to be a good predictor for 1RM when all the sets are performed until exhaustion, as no significant differences (p < 0:05) were found in the RPE at 75%, 80% and 90% of the 1RM. Also, years of experience and weekly hours of strength training are better correlated to 1RM (p < 0:05) than body weight. O'Connor et al. 1RM prediction equation seems to arise from the data gathered and seems to be the most accurate 1RM prediction equation from those proposed in literature and used in this study. Epley's 1RM prediction equation is reproduced by means of data simulation from 1RM literature equations. Finally, future lines of research are proposed related to the problem of the 1RM prediction by means of genetic algorithms, neural networks and clustering techniques. RESUMEN En los últimos años ha habido un creciente interés en el tratamiento y análisis de datos con el propósito de descubrir relaciones, patrones y conocimiento oculto en los mismos. Las técnicas de data mining (también llamadas de \Descubrimiento de conocimiento en bases de datos\) se han aplicado consistentemente a lo gran de un gran espectro de áreas como el marketing, inversiones, detección de fraude, producción industrial, telecomunicaciones y salud. En este estudio, técnicas bien conocidas de data mining como las redes neuronales artificiales (ANN), programación genética (GP), regresión lineal con selección hacia adelante (LR) y la técnica de clustering k-means, se proponen a la comunidad del deporte y la salud con el objetivo de ayudar con la prescripción del entrenamiento de fuerza. Una apropiada prescripción de entrenamiento de fuerza es efectiva no solo para mejorar el estado de forma general, sino para mejorar la salud e incrementar la calidad de vida. La intensidad en un ejercicio de fuerza se prescribe generalmente como un porcentaje de la repetición máxima. 1RM, fuerza muscular dinámica, una repetición máxima o una ejecución máxima, se define operacionalmente como la carga máxima que puede ser movida en un rango de movimiento específico, una vez y con una técnica correcta. La seguridad de las pruebas de 1RM ha sido cuestionada debido a que el gran esfuerzo requerido para llevarlas a cabo puede derivar en serias lesiones musculares. Las ecuaciones predictivas pueden ayudar a atajar el problema de la predicción de la 1RM con cargas sub-máximas y son empleadas con el propósito de eliminar o al menos, reducir los riesgos asociados. En este estudio, se construyeron distintos modelos a partir de los datos recogidos de 30 hombres que realizaron hasta 5 series al fallo en el ejercicio press de banca a distintos porcentajes de la 1RM, hasta llegar a su 1RM real. También se muestra una comparación de algunas de las distintas ecuaciones de predicción propuestas con anterioridad. El modelo LR parece superar a los modelos ANN y GP para la predicción de la 1RM entre 1 y 10 repeticiones. Al 75% de la 1RM algunos sujetos (n = 5) pudieron realizar 13 repeticiones con una técnica apropiada en el ejercicio press de banca, mientras que otros (n = 20) realizaron significativamente (p < 0:05) más repeticiones al 70% que al 75% de su 1RM en el press de banca. El ínndice de esfuerzo percibido (RPE) parece no ser un buen predictor del 1RM cuando todas las series se realizan al fallo, puesto que no existen diferencias signifiativas (p < 0:05) en el RPE al 75%, 80% y el 90% de la 1RM. Además, los años de experiencia y las horas semanales dedicadas al entrenamiento de fuerza están más correlacionadas con la 1RM (p < 0:05) que el peso corporal. La ecuación de O'Connor et al. parece surgir de los datos recogidos y parece ser la ecuación de predicción de 1RM más precisa de aquellas propuestas en la literatura y empleadas en este estudio. La ecuación de predicción de la 1RM de Epley es reproducida mediante simulación de datos a partir de algunas ecuaciones de predicción de la 1RM propuestas con anterioridad. Finalmente, se proponen futuras líneas de investigación relacionadas con el problema de la predicción de la 1RM mediante algoritmos genéticos, redes neuronales y técnicas de clustering.

Empirical crash injury modeling and vehicle-size mix. Technical report.

Mode of access: Internet.

Highway safety: causes of injury in automobile crashes.

Mode of access: Internet.

Physical and psychological factors maintain long-term predictive capacity post-whiplash injury

Higher initial levels of pain and disability, older age, cold hyperalgesia, impaired sympathetic vasoconstriction and moderate post-traumatic stress symptoms have been shown to be associated with poor outcome 6 months following whiplash injury. This study prospectively investigated the predictive capacity of these variables at a long-term follow-up. Sixty-five of an initial cohort of 76 acutely injured whiplash participants were followed to 2-3 years post-accident. Motor function (ROM; kinaesthetic sense; activity of the superficial neck flexors (EMG) during cranio-cervical flexion), quantitative sensory testing (pressure, thermal pain thresholds and brachial plexus provocation test), sympathetic vasoconstrictor responses and psychological distress (GHQ-28, TSK and IES) were measured. The outcome measure was Neck Disability Index (NDI) scores. Participants with ongoing moderate/severe symptoms at 2-3 years continued to manifest decreased ROM, increased EMG during cranio-cervical flexion, sensory hypersensitivity and elevated levels of psychological distress when compared to recovered participants and those with milder symptoms. The latter two groups showed only persistent deficits in cervical muscle recruitment patterns. Higher initial NDI scores (OR 1.00-1.1), older age (OR 1.00-1.13), cold hyperalgesia (OR 1.1-1.13) and post-traumatic stress symptoms (OR 1.03-1.2) remained significant predictors of poor outcome at long-term follow-up (r(2) = 0.56). The robustness of these physical and psychological factors suggests that their assessment in the acute stage following whiplash injury will be important. (c) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Automobile consumer information study crash test program. Volume I. Summary report. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Highway safety: reliability and validity of DOT crash tests.

Mode of access: Internet.

Statistical analysis of crash conditions and their relationship to injuries. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Computer simulation of human thoracic skeletal response - volume I, theory.

National Highway Traffic Safety Administration, Washington, D.C.

Computer simulation of human thoracic skeletal response - volume II, THORAX programmer's and user's manual. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Resting energy expenditure in non-ventilated, non-sedated patients recovering from serious traumatic brain injury: Comparison of prediction equations with indirect calorimetry values

Background & aims: Little is known about energy requirements in brain injured (TBI) patients, despite evidence suggesting adequate nutritional support can improve clinical outcomes. The study aim was to compare predicted energy requirements with measured resting energy expenditure (REE) values, in patients recovering from TBI.

Methods: Indirect calorimetry (IC) was used to measure REE in 45 patients with TBI. Predicted energy requirements were determined using FAO/WHO/UNU and Harris–Benedict (HB) equations. Bland– Altman and regression analysis were used for analysis.

Results: One-hundred and sixty-seven successful measurements were recorded in patients with TBI. At an individual level, both equations predicted REE poorly. The mean of the differences of standardised areas of measured REE and FAO/WHO/UNU was near zero (9 kcal) but the variation in both directions was substantial (range 591 to þ573 kcal). Similarly, the differences of areas of measured REE and HB demonstrated a mean of 1.9 kcal and range 568 to þ571 kcal. Glasgow coma score, patient status, weight and body temperature were signi?cant predictors of measured REE (p < 0.001; R²⁼ 0.47).

Conclusions: Clinical equations are poor predictors of measured REE in patients with TBI. The variability in REE is substantial. Clinicians should be aware of the limitations of prediction equations when estimating energy requirements in TBI patients.

A prediction model for establishing the disability degree in adults with spinal cord injury: results based on WHO-DAS II perspective

Objective: To establish a prediction model of the degree of disability in adults with Spinal CordInjury (SCI ) based on the use of the WHO-DAS II . Methods: The disability degree was correlatedwith three variable groups: clinical, sociodemographic and those related with rehabilitation services.A model of multiple linear regression was built to predict disability. 45 people with sci exhibitingdiverse etiology, neurological level and completeness participated. Patients were older than 18 andthey had more than a six-month post-injury. The WHO-DAS II and the ASIA impairment scale(AIS ) were used. Results: Variables that evidenced a significant relationship with disability were thefollowing: occupational situation, type of affiliation to the public health care system, injury evolutiontime, neurological level, partial preservation zone, ais motor and sensory scores and number ofclinical complications during the last year. Complications significantly associated to disability werejoint pain, urinary infections, intestinal problems and autonomic disreflexia. None of the variablesrelated to rehabilitation services showed significant association with disability. The disability degreeexhibited significant differences in favor of the groups that received the following services: assistivedevices supply and vocational, job or educational counseling. Conclusions: The best predictiondisability model in adults with sci with more than six months post-injury was built with variablesof injury evolution time, AIS sensory score and injury-related unemployment.

A novel clinical scoring system for outcome prediction in dogs with acute kidney injury managed by hemodialysis.

BACKGROUND No reliable tool to predict outcome of acute kidney injury (AKI) exists. HYPOTHESIS A statistically derived scoring system can accurately predict outcome in dogs with AKI managed with hemodialysis. ANIMALS One hundred and eighty-two client-owned dogs with AKI. METHODS Logistic regression analyses were performed initially on clinical variables available on the 1st day of hospitalization for relevance to outcome. Variables with P< or = .1 were considered for further analyses. Continuous variables outside the reference range were divided into quartiles to yield quartile-specific odds ratios (ORs) for survival. Models were developed by incorporating weighting factors assigned to each quartile based on the OR, using either the integer value of the OR (Model A) or the exact OR (Models B or C, when the etiology was known). A predictive score for each model was calculated for each dog by summing all weighting factors. In Model D, actual values for continuous variables were used in a logistic regression model. Receiver-operating curve analyses were performed to assess sensitivities, specificities, and optimal cutoff points for all models. RESULTS Higher scores were associated with decreased probability of survival (P < .001). Models A, B, C, and D correctly classified outcomes in 81, 83, 87, and 76% of cases, respectively, and optimal sensitivities/specificities were 77/85, 81/85, 83/90 and 92/61%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The models allowed outcome prediction that corresponded with actual outcome in our cohort. However, each model should be validated further in independent cohorts. The models may also be useful to assess AKI severity.

External validation study of a clinical prediction rule for ambulation outcomes after traumatic spinal cord injury

The main objective of this study was to determine the external validity of a clinical prediction rule developed by the European Multicenter Study on Human Spinal Cord Injury (EM-SCI) to predict the ambulation outcomes 12 months after traumatic spinal cord injury. Data from the North American Clinical Trials Network (NACTN) data registry with approximately 500 SCI cases were used for this validity study. The predictive accuracy of the EM-SCI prognostic model was evaluated using calibration and discrimination based on 231 NACTN cases. The area under the receiver-operating-characteristics curve (ROC) curve was 0.927 (95% CI 0.894 – 0.959) for the EM-SCI model when applied to NACTN population. This is lower than the AUC of 0.956 (95% CI 0.936 – 0.976) reported for the EM-SCI population, but suggests that the EM-SCI clinical prediction rule distinguished well between those patients in the NACTN population who were able to achieve independent ambulation and those who did not achieve independent ambulation. The calibration curve suggests that higher the prediction score is, the better the probability of walking with the best prediction for AIS D patients. In conclusion, the EM-SCI clinical prediction rule was determined to be generalizable to the adult NACTN SCI population.^