Wednesday, January 17, 2024

Video gamers worldwide may be risking irreversible hearing loss and/or tinnitus

Studies suggest game sound levels often near, or exceed, permissible safe limits. Greater public health efforts needed to raise awareness of potential risks, urge researchers

Peer-Reviewed Publication

BMJ

Video gamers worldwide may be risking irreversible hearing loss and/or tinnitus—persistent ringing/buzzing in the ears—finds a systematic review of the available evidence, published in the open access journal BMJ Public Health.

What evidence there is suggests that the sound levels reported in studies of more than 50,000 people often near, or exceed, permissible safe limits, conclude the researchers.

And given the popularity of these games, greater public health efforts are needed to raise awareness of the potential risks, they urge.

While headphones, earbuds, and music venues have been recognised as sources of potentially unsafe sound levels, relatively little attention has been paid to the effects of video games, including e-sports, on hearing loss, say the researchers.

Gamers often play at high-intensity sound levels and for several hours at a time, they add. And one estimate indicates that there were more than 3 billion gamers worldwide in 2022.

To try and build an evidence base, the researchers trawled research databases looking for relevant studies and white papers, newsletters, reports, and proceedings, collectively referred to as ‘grey literature,’ published at any point in English, Spanish, or Chinese.

Some 14 peer reviewed studies from 9 countries in North America, Europe, South East Asia, Asia and Australasia, and involving a total of 53,833 people, were included in the review.

Eleven were cohort (epidemiological observational) studies, 6 of which looked at the associations between hearing and computer or video games; 4 focused on gaming centres or personal computer rooms, which are popular in Asia; and 1 focused on mobile devices.

Reported sound levels ranged from 43.2 decibels (dB) (mobile devices) up to 80-89 dB (gaming centres) while length of noise exposure varied by mode and frequency of access–from daily to once a month, for at least an hour at a time, averaging 3 hours/week.

Impulse sounds consist of bursts lasting less than 1 second, with peak levels at least 15 dB higher than the background sound. One study reported that impulse sounds reached levels as high as 119 dB during game play; permissible exposure limits are around 100 dB for children and 130–140 dB for adults.

The International Telecommunication Union (ITU), in collaboration with the World Health Organization, describes a time–intensity trade-off, known as an exchange rate, for permissible levels and duration of exposure, explain the researchers.

For example, a permissible noise exposure level of 80 dB for 40 hours a week with a 3 dB exchange rate means the permissible exposure time halves with every 3 dB increase in noise level: at 83 dB it’s 20 hours; at 86 dB it’s 10 hours; at 92 dB it’s 2.5 hours; and at 98 dB it’s 38 minutes.

For children, the permissible noise exposure level is defined as 75 dB for 40 hours a week. Children can therefore safely listen to an 83 dB sound for around 6.5 hours, 86 dB for around 3.25 hours, 92 dB for 45 minutes, and 98 dB for only 12 minutes a week, explain the researchers.

Six studies reported on video gaming prevalence among young people, which ranged from 20% to 68%. Two South Korean studies reported a prevalence of gaming centre use at around 60%.

Five studies evaluated associations between gaming and self-reported hearing loss, hearing thresholds, or tinnitus. Of these, 2 found that school pupils’ gaming centre use was linked to increased odds of severe tinnitus and high-frequency sound hearing loss in both ears.

Another large observational study reported that video gaming was associated with increased odds of self-reported hearing loss severity.

One study reported that over 10 million people in the USA may be exposed to ‘loud’ or ‘very loud’ sound levels from video or computer games.

One study measured sound levels of 5 video games through headphones attached to the gaming console, and found that these averaged 88.5, 87.6, 85.6 and 91.2 dB for 4 separate shooter games, and 85.6 dB for a racing game.

The authors therefore concluded that the daily level of sound exposure from these video games is close to maximum permissible levels of sound exposure.

An additional 16 peer-reviewed articles and 14 grey literature sources mention gaming as a potential source of excessive sound exposure.

One grey literature source sought to discover gamers’ preferred listening levels while wearing headphones. The author concluded that gaming headphones can reach unsafe listening levels, “which could place some gamers at risk of sound-induced hearing loss.”

Three studies evaluated gender differences in gaming behaviours. Altogether, these indicated that boys played video games more often than girls, for longer periods of time, and at higher sound intensity levels.

The researchers acknowledge that some of the included studies date back to the early 1990s, and only 2 published in the past 10 years objectively measured average sound levels from video games or at gaming centres, although both reported high sound levels in these circumstances.

“Although the data provided in this review are limited, they suggest that some gamers, particularly those who play frequently, and at or above the average sound levels described by papers included in this review, probably exceed permissible sound exposure limits, and are thus engaging in unsafe listening practices, which could put them at risk for developing permanent hearing loss and/or tinnitus,” they nevertheless conclude.

There are also several key gaps in the available evidence, they add. For example, the impact of esports, geographic region, sex, and age, on hearing loss. Further research is essential to inform preventive measures and global policy initiatives, they suggest.

“The findings suggest that there may be a need to prioritise interventions, such as initiatives focused on education and awareness of the potential risks of gaming, that can help promote safe listening among gamers,” they suggest.

JOURNAL

BMJ Public Health

DOI

10.1136/bmjph-2023-000253

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Risk of sound-induced hearing loss from exposure to video gaming or e-sports: a systematic scoping review

ARTICLE PUBLICATION DATE

16-Jan-2024

COI STATEMENT

None declared

Disclaimer: AAAS a

Supports help keep Aussie firefighters safe

Peer-Reviewed Publication

UNIVERSITY OF SOUTH AUSTRALIA

House fires, road crashes and emergency rescues – they’re all part of the job for Aussie firefighters. And in such physically demanding roles, maintaining a high level of fitness and movement quality is essential.

Now, new research from health and fitness experts at the University of South Australia shows that professional firefighters have reduced movement quality as they age, which could put them at greater risk of injury.

Conducted by UniSA masters researcher, Alex Redshaw, in partnership with the South Australian Metropolitan Fire Service (MFS), the findings indicate that firefighters over the age of 50 generally have lower movement quality than their younger counterparts, and would benefit from additional functional strength training to maintain a fit and healthy workforce.

Good movement quality underpins all essential movements required to safely perform critical components of physical function, including balance, stability, and muscular strength. It is developed through functional strength training using exercises that replicate body movements and patterns seen in daily activities (such as lunging, squatting, bracing, pressing).

This is the first study on the effect of age on movement quality in Australian firefighters, and largest firefighter cohort in the world.

Statistics shows that firefighters have an injury rate more than three times that of the non-tactical workforce. It is well-established that movement quality deteriorates with age in the general population, but there is conflicting evidence in older tactical populations.

With an ageing population and more than 40% of South Australian firefighters aged over 50, the MFS was keen to understand how they could best support their members to maintain a safe and healthy career for as long as possible.

Assessing movement quality, physical activity, injury history and body mass index (BMI) among 324 South Australian MFS firefighters, researchers found that firefighters older than 50 were more likely to have poor movement quality.

It also found that firefighters with a high BMI, who participate in less than 150 minutes of physical exercise per week, and have had a musculoskeletal injury in the past 12 months, have lower movement quality, and may be at an increased risk of injury.

UniSA researcher, Dr Hunter Bennett, says exercise interventions could be offered as part of a supportive workplace health and safety program.

“Firefighters are routinely exposed to unique physiological and physical hazards, including extreme temperatures, heavy personal protective gear and unstable workspaces, all of which contribute to an increased risk of injury,” Dr Bennett says.

“Good movement quality supports well-coordinated performance within these environments, but ageing can deteriorate these functions, which may put older firefighters at risk.

“The MFS deploys a range of supports to maintain a fit and healthy workforce but is always on the lookout for additional improvements to benefit their members.

“In this study we found that older firefighters had poorer movement quality than their younger counterparts, and that this increased with age. Additionally, firefighters who did more exercise (more than five hours a week) had better movement quality.

“Knowing this, the MFS can support their members by offering specific movement quality programs to better maintain their physical capabilities as they age.”

Notes to editors:

The University of South Australia would like to thank the South Australian Metropolitan Fire Service for supporting this UniSA postgraduate research project.

The research paper can be accessed here: Redshaw, Alex & Carrick-Ranson, Graeme & Bennett, Hunter & Norton, Kevin & Walker, Anthony. (2023). Effect of Aging on Movement Quality in Australian Urban Firefighters. Journal of Strength and Conditioning Research. 37. e601-e608. 10.1519/JSC.0000000000004528

…………………………………………………………………………………………………………………………..

Media contact: Annabel Mansfield M: +61 479 182 489 E: Annabel.Mansfield@unisa.edu.au

Researcher: Dr Hunter Bennett E: Hunter.Bennett@unisa.edu.au

JOURNAL

The Journal of Strength and Conditioning Research

DOI

10.1519/JSC.0000000000004528

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Effect of Aging on Movement Quality in Australian Urban Firefighters

Allen Fawcett named Director of the Joint Global Change Research Institute

JGCRI provides scientific input on how human, energy and environmental systems interact to national and international governing and advising bodies

Business Announcement

DOE/PACIFIC NORTHWEST NATIONAL LABORATORY

By Greg Koller

COLLEGE PARK, Md.— Allen Fawcett — an energy expert and economist who has played a leading role in formulating and coordinating U.S. climate policy — is the new director of the Joint Global Change Research Institute.

Fawcett joined the Environmental Protection Agency in 2003 and, since 2012, served as the chief of EPA’s Climate Economics Branch, which advances the science of climate economics to inform policy. From 2010 to 2011, Fawcett took leave from EPA to serve as the deputy associate director for energy and climate at the White House Council on Environmental Quality.

Fawcett began his appointment Jan. 8, 2024.

JGCRI is a partnership between the U.S. Department of Energy's Pacific Northwest National Laboratory and the University of Maryland in College Park. It brings together expertise in research, modeling and analysis to advance scientific understanding of the ways in which human, energy and environmental systems interact. Since its formation, JGCRI has provided input to the White House, Congress, United Nations and other national and international governing and advising bodies.

“Allen’s technical expertise in human-Earth systems modeling and his experience helping governments and communities draw on science and economics to make policy decisions make him the ideal person to lead JGCRI,” said Malin Young, PNNL’s associate laboratory director for Earth and Biological Sciences. “Allen sits at the intersection between science, economics and policy and is uniquely qualified to help see that JGCRI meets the needs of policy makers.”

Greg Ball, vice president for research at the University of Maryland, said, “We are extraordinarily fortunate to have such a strong, broad and collaborative research partnership between UMD and PNNL through JGCRI, and Dr. Fawcett’s policy and science expertise will accelerate JGCRI’s already remarkable success in responding to key grand challenges of our time.”

Nate Hultman, director of the Center for Global Sustainability at the University of Maryland and associate director for JGCRI, agreed. “Allen brings remarkable experience through his leadership in the scientific community and his long record of leading teams to support domestic and international policy,” he said. “These strengths are ideally suited to deliver research impact on issues of the utmost importance today as the world seeks to respond to our climate, energy, and sustainability challenges with science-informed strategies that can create new economic opportunities and broader societal benefits.”

While at EPA, Fawcett was responsible for the agency’s economic analyses of various cap-and-trade proposals, including the Waxman-Markey Bill passed by the U.S. House of Representatives in 2009.

In 2015, Fawcett collaborated with the U.S. State Department and White House on analysis of the proposed international treaty on climate change that, once ratified, became known as the Paris Agreement. His work with JGCRI scientists, published in the journal Science during the Paris meeting in 2015, was the first assessment of the worldwide impact of that agreement.

“The 2020s are a critical decade when it comes to addressing climate change — one of the most important challenges of our time,” said Fawcett. “We’re just now beginning to take truly meaningful action. But as we consider what comes next, it will be critical for decision-makers to understand interactions between science, economics and policy. This is where JGCRI can make important contributions that will make a difference for our future.”

Fawcett earned a bachelor’s degree in economics from the College of William & Mary and both a master’s degree and doctorate in economics from the University of Texas. He has authored or co-authored more than 40 peer-reviewed scientific and technical papers and journal articles.

###

About the University of Maryland

The University of Maryland, College Park is one of the nation's preeminent public research universities and Maryland's flagship university. A global leader in research, entrepreneurship and innovation, the university is home to more than 41,000 students, 14,000 faculty and staff, and 280 academic programs. UMD’s faculty include two Nobel laureates, three Pulitzer Prize winners, 60 members of the national academies and scores of Fulbright scholars. For more information about the University of Maryland, College Park, visit www.umd.edu.

About Pacific Northwest National Laboratory

Pacific Northwest National Laboratory draws on its distinguishing strengths in chemistry, Earth sciences, biology and data science to advance scientific knowledge and address challenges in sustainable energy and national security. Founded in 1965, PNNL is operated by Battelle for the Department of Energy’s Office of Science, which is the single largest supporter of basic research in the physical sciences in the United States. DOE’s Office of Science is working to address some of the most pressing challenges of our time. For more information, visit https://energy.gov/science. For more information on PNNL, visit PNNL's News Center. Follow us on Twitter, Facebook, LinkedIn and Instagram.

What if cows could talk?

By using acoustic data and machine learning to decipher cows' vocalizations, Virginia Tech researchers hope to shed new light on the animals' health, welfare, and environmental impact.

Grant and Award Announcement

VIRGINIA TECH

What if cows could talk? — IMAGE:
VIRGINIA TECH RESEARCHERS PLAN TO USE AUDIO DATA FROM COWS TO UNCOVER PATTERNS IN THEIR VOCALIZATIONS THAT MAY SHED LIGHT ON THEIR WELL-BEING, EMOTIONS, AND “LANGUAGE.”
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CREDIT: PHOTO BY MADI HAHN FOR VIRGINIA TECH.

You may not know it, but cows share information every time they burp, moo, and chew that speaks volumes about their health and welfare.

Through the work of researchers in Virginia Tech’s College of Agriculture and Life Sciences, we may soon know more about what cows are “telling” us and be able to use that information to improve their well-being.

James Chen, an animal data sciences researcher and assistant professor in the School of Animal Sciences is using a $650,000 grant from the U.S. Department of Agriculture's National Institute of Food and Agriculture to develop an acoustic, data-driven tool to help enhance animal welfare and lower methane emissions in precision livestock farming.

“Vocalization is a major way cows express their emotions, and it is about time to listen to what they’re telling us,” Chen said.

Because sound data can be collected from cows individually and continuously, Chen said it’s better than video or other observation methods for monitoring cows’ emotions and health, including even subtle changes in breathing.

“The assessment of animal welfare has become a central discussion in society and is a controversial issue simply because the lack of objective tools leads to biased interpretations,” he said. “By matching audio data with biological and visual cues, we can be more objective in our approach to analyzing their behavior.”

Using artificial intelligence to interpret moos

Chen and his co-investigator, Virginia Cooperative Extension dairy scientist and Associate Professor Gonzalo Ferreira, plan to collect audio data from cows, their calves, and beef cattle in the pasture. They will then use machine learning to analyze and catalog thousands of points of acoustic data and interpret cow vocalizations such as mooing, chewing, and burping for signs of stress or illness.

“Let’s think about a baby crying inside a plane or in church,” Ferreira said. “As a father, I have an idea whether the baby is crying because it’s hungry or wants attention. Our research question then is: Can we use audio data to interpret animals’ needs?”

Chen and Ferreira are particularly interested in identifying vocal patterns for how cows’ communicate distress. By analyzing the frequency, amplitude, and duration of cow’s moos and vocalizations and correlating the sound data with saliva cortisol samples taken from the cow, they can classify whether cows are experiencing no stress, mild stress, or severe stress and begin to decode their “language.”

As part of the project, Chen is building a computational pipeline that integrates acoustic data management, pre-trained machine-learning models, and interactive visualization of animal sounds. The resulting data will be shared in an open-source, web-based application available to scientists, producers, and the public. Chen said his hope is that the information will help guide future protocols to improve animal welfare.

“Anyone can directly plug in and use our model to run their own experiment,” he said. “This allows people to transform cows’ vocalizations into interpretable information that humans can recognize.”

Researchers plan to place small recording devices on the halters or collars of cows to capture their vocalizations for the study. Here, Dairy scientist and Associate Professor Gonzalo Ferreira fastens a halter outfitted with a tiny recorder to a dairy cow. Photo courtesy of Gonzalo Ferreira.

Decoding burps

Because cows’ burps can release small amounts of methane, the researchers also will try to identify cows that burp less through audio data. By comparing the sound data to DNA samples from the cows, they hope to understand whether a genetic variant causes some cows to burp more than others. They also plan to examine the impact of rumen modifiers — food additives that inhibit methane gas production — to gauge the effects.

“Measuring methane emissions from cattle requires very expensive equipment, which would be prohibitive to farmers,” Ferreira said. “If burping sounds are indeed related to methane emissions, then we might have the potential for selecting low methane-emitting animals at the commercial farm level in an affordable manner.”

“Our eventual goal is to use this model on a larger scale,” Chen said. “We hope to build a public data set that can help inform policy and regulations.”

Lead researcher James Chen is developing an acoustic data-driven tool to help enhance animal welfare and lower methane emissions in precision livestock farming.

CAPTION

Unpacking social equity from biodiversity data: an interdisciplinary policy perspective

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SANTA BARBARA

Biodiversity data collection is growing exponentially. The increase is driven in part by international commitments to conservation, market investments and technological advances, and the growing urgency of human impacts including climate change. Nations increasingly rely on biodiversity data in order to strategically meet global conservation targets for the coming decades. But not all data is collected equally.

Millie Chapman, a postdoctoral scholar at the UC Santa Barbara-based National Center for Ecological Analysis and Synthesis (NCEAS), studies the social and political context of biodiversity data collection. In a recent Science publication, Chapman and her colleagues demonstrate that biodiversity data is increasingly concentrated in wealthy countries. They argue that this context should be unearthed to prevent inequitable implementation of conservation projects.

Biodiversity data gives us “unprecedented insight into ecological patterns at global scales,” Chapman explains, which can greatly inform nations’ priorities for future conservation. But applying these data sets to decision-making often reveals more about us humans as a species than about any other species.

“Biodiversity data trace not only cities and roads but the rise of surveillance technology, shadows of colonial histories, and echoes of contemporary racial and economic disparities,” she said. “We can see everything from red-lining to armed conflict to macroeconomic patterns.”

These human dimensions impact not only the actual diversity of non-human species, but also how that diversity is observed and quantified. For example, the extent of European colonialism is still evidenced by the distribution of European plant and animal species around the world. Areas most impacted by extractive industries are sometimes the most studied. In those cases, the data collection is dependent on continued resource extraction. The map and graph, pictured below, show how biodiversity data is disproportionately collected in high income countries, and how that inequitable trend has grown exponentially over time.

Chapman began this work as a graduate student of environmental science and policy at UC Berkeley. She started a reading group with peers in sociology and political ecology to dive further into questions of data justice and algorithmic equity. Her current interdisciplinary research stems from that serendipitous reading group. Today, she and her co-authors, including experts in computer science and ecology, ask, “are the best available data really a suitable standard?”

Better conservation isn’t just about more data collection or better statistical methods, Chapman argued. It’s also about better understanding of the social, cultural and political context behind environmental data.

“No one domain, I think, has the answer to this problem,” she said. “And that’s a cool reason to be at NCEAS.” For nearly 30 years, NCEAS has been a leading center of synthesis science, where interdisciplinary expert groups leverage existing data to answer complex questions.

Scientists have understood these contextual inequities of data for a long time, according to Chapman. But with a dramatic increase in global attention and application of biodiversity data for on-the-ground conservation, including a multi-billion-dollar market for biodiversity offsets, these inequities can be amplified and preserved through policy.

“The path forward will require more than technocratic fixes,” she and her colleagues argue. The research team hopes to see more interdisciplinary, inclusive science policy collaboration to ensure that biodiversity data, with all of its inherent limitations and inequities, will be applied as justly as possible.

JOURNAL

Science

ARTICLE TITLE

Biodiversity monitoring for a just planetary future

The medical community should not stand silent on medicalized rape at CIA secret prisons, BU researchers argue in new commentary

In a new JAMA viewpoint, Boston University School of Public Health researchers Sondra Crosby and Leonard Glantz denounce rectal feeding practices that occurred at these prisons, and call for medical officers to be held accountable.

Peer-Reviewed Publication

BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH

FOR IMMEDIATE RELEASE

January 16, 2023

In a new JAMA viewpoint, Boston University School of Public Health researchers Sondra Crosby and Leonard Glantz denounce rectal feeding practices that occurred at these prisons, and call for medical officers who enabled this “medicalized rape” to be held accountable for violating ethical and legal standards.

Nearly 10 years ago, a US Senate Intelligence committee report detailed for the first time the horrors of forced rectal feeding inflicted upon detainees at CIA secret prisons. The victims of this abuse were later transferred to the Guantánamo Bay detention camp for indefinite confinement.

Now, as the country marks the 22nd year of the opening of Guantánamo Bay, two Boston University School of Public Health (BUSPH) researchers are calling for the medical officers involved in this unethical and discredited practice to be held accountable.

Published in the journal JAMA, Dr. Sondra Crosby, professor of health law, ethics & human rights at BUSPH and Leonard Glantz, emeritus professor of health law, policy & management at BUSPH, equate rectal feeding to torture and argue that medical officers who authorized, ordered, or participated in this nonconsensual and medically ineffective practice have committed acts that meet the legal definition of rape. These officials have never been identified or formally punished for their actions.

“Medical officers are not absolved of ethical and legal responsibility for their actions when they commit heinous acts on behalf of and with permission of the state,” Crosby and Glantz write. “We believe that any CIA physicians and all other medical officers who authorized or participated in the rectal feeding of these prisoners cannot be entrusted to protect the welfare of patients once they return to civilian positions.”

Modern medicine has long rejected rectal feeding, which was once thought to be an alternative method of providing nutrition. CIA officials alleged that this forced feeding was a necessary action to end detainees’ hunger strikes. But last August, a military judge ruled that it was an illegitimate medical practice.

“The sequelae of rape can persist for decades and even a lifetime,” the authors write, stating that anal rape survivors often experience both physical and psychological harms, from depression and posttraumatic stress disorder, to rectal perforation, infections, and chronic pain.

“Both ethical and legal standards require reasonable medical judgment and prohibit providing treatment that cannot benefit a patient,” Crosby and Glantz write. “…Furthermore, international human rights laws, and basic human decency, prohibit participation in cruel, inhuman, and degrading treatment that can constitute torture. If any of the involved medical officers were physicians, they would have violated their fundamental ethical obligations by using their medical skills to intentionally inflict harm on individuals.”

Both Crosby and Glantz have studied health law and human rights issues extensively. Crosby, who is also a professor of medicine at Boston University Chobanian & Avedisian School of Medicine, serves as a court-approved medical expert on torture. In 2008, she and colleagues at Physicians for Human Rights led the first investigation of human rights violations associated with CIA interrogations of detained individuals. Last February, she testified in court to denounce the rectal feeding practices in the secret prisons, describing graphic details of the effects of torture, based on exclusive interviews she conducted with suspected terrorist Abd al-Rahim al-Nashiri.

Identifying the medical officers who enabled or participated in sexual assault by rectal feeding is crucial, the authors conclude, to determine whether legal or professional action against them is warranted.

“The medical profession should not stand silent when its members commit atrocities under the guise of medicine.”

About Boston University School of Public Health

Founded in 1976, Boston University School of Public Health is one of the top ten ranked schools of public health in the world. It offers master's- and doctoral-level education in public health. The faculty in six departments conduct policy-changing public health research around the world, with the mission of improving the health of populations—especially the disadvantaged, underserved, and vulnerable—locally and globally.

JOURNAL

JAMA

DOI

10.1001/jama.2023.25866

METHOD OF RESEARCH

Commentary/editorial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

“Rectal Feeding”—Unethical Medical Officer Participation at CIA Secret Interrogation Facilities

ARTICLE PUBLICATION DATE

21-Dec-2023

COI STATEMENT

Dr. Crosby reported being employed by the US Department of Defense Office of Military Commissions as a medical expert on torture and has provided testimony in the pretrial hearings on this topic.

AI model predicts death, complications for patients undergoing angioplasty, stents

It showed high levels of accuracy at predicting death, major bleeding events and the need for blood transfusion

Peer-Reviewed Publication

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

When a person has one or more blocked arteries, providers may choose to conduct a minimally invasive procedure known as percutaneous coronary intervention, or PCI.

By inflating a balloon and potentially placing a stent, blood can flow more freely from the heart.

Despite carrying less risk than open surgery, stenting and balloon angioplasty can result in complications like bleeding and kidney injury.

Researchers at Michigan Medicine developed an AI-driven algorithm that accurately predicts death and complications after PCI — which could emerge as a tool for clinicians as they determine treatment for blocked heart arteries.

The results are published in European Heart Journal.

“The risks for patients undergoing percutaneous coronary intervention vary greatly depending on the individual patient, and both patients and clinicians have historically both over and underestimated the harms associated with PCI,” said lead David E. Hamilton, M.D., a cardiology-critical care fellow at Michigan Medicine.

“Precise risk prediction is critical to treatment selection and the shared decision-making process. Our tool can recognize a wide array of outcomes after PCI and can be used by care providers and patients together to decide the best course of treatment.”

While other risk stratification tools have been created to identify risk after PCI, researcher say, many have modest accuracy and were made without involving a key party: patients.

The Michigan Medicine team collected data from all adult patients who underwent PCI between April 2018 and the end of 2021 using the Blue Cross Blue Shield of Michigan Cardiovascular Consortium, or BMC2, registry.

The consortium is comprised of hospitals across the state of Michigan that use data they collect to inform quality projects, and improve care and patient outcomes.

Researchers used that data — including more than 20 pre-procedural characteristics, such as age, blood pressure and total cholesterol — to create a risk prediction model with the machine learning software “XGBoost”.

The AI-driven model showed high levels of accuracy at predicting death, major bleeding events and the need for blood transfusion. It outperformed other models that used the same pre-procedural characteristics.

“We combined the predictive model with patient feedback from the PCI Patient Advisory Council to transform machine learning into this patient-centered, individualized risk prediction tool,” said senior author Hitinder Gurm, MBBS, interim chief medical officer at U-M Health.

“In the age of widespread smartphones and electronic medical records, this computerized risk score could be integrated into electronic health systems and made easy to use at the bedside. It would not only help relay complex information to the provider quickly, but it could also be used to enhance patient education on the risks related to PCI.”

The innovative technology has been harnessed into a computer and phone application to allow for free and widespread use.

Jeremy Albright Ph.D., Milan Seth, Devraj Sukul M.Sc., M.D., all of Michigan Medicine, Ian Painter Ph.D., of Washington State Department of Health and Foundations for Health Care Quality, Charles Maynard Ph.D., of Foundations for Health Care Quality and University of Washington, and Ravi S. Hira M.D., of University of Washington and Pulse Heart Institute and Multicare Health System.

Support for BMC2 is provided by Blue Cross and Blue Shield of Michigan and Blue Care Network as part of the BCBSM Value Partnerships program. Although Blue Cross Blue Shield of Michigan and BMC2 work collaboratively, the opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees.

Paper cited: “Merging Machine Learning and Patient Preference: Patient-Centered Tool for Predicting Risk of Percutaneous Coronary Intervention,” European Heart Journal. DOI: 10.1093/eurheartj/ehad836

JOURNAL

European Heart Journal

DOI

10.1093/eurheartj/ehad836

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Merging Machine Learning and Patient Preference: Patient-Centered Tool for Predicting Risk of Percutaneous Coronary Intervention

ARTICLE PUBLICATION DATE

17-Jan-2024

COI STATEMENT

SDG-washing found among Canada's top companies

Canadian corporations that commit their operations and financial capital to SDG's found to have decreased their community investment

Peer-Reviewed Publication

UNIVERSITY OF WATERLOO

Canada's biggest companies often speak of their plans to be more sustainable, but a new study found corporations aren't fully backing up those commitments.

A team of University of Waterloo researchers concluded that corporate investing in communities fell despite an increase in companies committing to the United Nation's Sustainable Development Goals (SDGs) over the last decade.

Researchers investigated the community investment of Canada's 58 leading private-sector companies as a percentage of their net profit after tax to determine whether introducing SDGs created a material impact on how firms are supporting philanthropic endeavours.

The findings ran contrary to researchers' expectations, proving that despite commitments made, investment aimed at supporting economically disadvantaged communities declined.

The results provide evidence of SDG-washing, indicating that corporations' public commitments to global sustainability movements aren't translating into socially responsible investments for Canadians.

"The companies studied in our research are accountable for roughly $1 billion in community investment every year," said David Benjamin Billedeau, PhD candidate in the School of Environment, Enterprise and Development.

"This gap between promise and practice is not just a missed opportunity, it's a wake-up call. These companies have the potential to drive real change. Instead, we're observing a trend of 'SDG-washing,' where public pledges are not translating into increased investments in Canadian communities."

Among the companies studied, those that pledged to use their operations and resources to support the SDGs were found to have a lower average of community investment relative to their net profits after tax. Meanwhile, companies that had not formally committed to the SDGs were donating more of their overall profits.

The researchers highlighted the need to help corporations deliver on their promises and offered several solutions to ensure that the ambitious targets set by the SDGs are not merely aspirational but attainable. These include policymakers mandating financial contributions, enforcing regulations, and encouraging transparent reporting practices.

"Greenwashing isn't just about emissions. We need to really check if companies are living up to their promises on sustainability and helping communities," Billedeau said. "Our study aims to show where Canada's leading private sector companies are falling short and to push for real change."

The study, Assessing the impact of the sustainable development goals on corporate philanthropy: A study of Canada's leading private sector companies, appears in the journal of Business Strategy and Development. Dr. Jeffrey Wilson, a professor in Waterloo's School of Environment, Enterprise and Development, co-authors this research.

JOURNAL

Business Strategy & Development

DOI

10.1002/bsd2.315