IntroductionDespite the progress in the management of the pandemic caused by COVID-19, it is necessary to continue exploring and explaining how this situation affected the athlete population around the world to improve their circumstances and reduce the negative impact of changes in their lifestyle conditions that were necessitated due to the pandemic. The aim of this study was to analyze the moderating influence of physical activity (PA) and dietary habits on the impact of the COVID-19 pandemic experience on sleep quality in elite and amateur athletes.Materials and methodsA total of 1,420 elite (40.1%) and amateur (59.9%) athletes (41% women; 59% men) from 14 different countries participated in a cross-sectional design study. Data were collected using a battery of questionnaires that identified sociodemographic data, sleep quality index, PA levels, dietary habits, and the athletes' perception of their experience during the COVID-19 pandemic. Means and standard deviations were calculated for each variable. The analysis of variances and the correlation between variables were carried out with non-parametric statistics. A simple moderation effect was calculated to analyze the interaction between PA or dietary habits on the perception of the COVID-19 experience effect on sleep quality in elite and amateur athletes.ResultsThe PA level of elite athletes was higher than amateur athletes during COVID-19 (p < 0.001). However, the PA level of both categories of athletes was lower during COVID-19 than pre-COVID-19 (p < 0.01). In addition, amateurs had a higher diet quality than elite athletes during the pandemic (p = 0.014). The perception of the COVID-19 experience as controllable was significantly higher (p = 0.020) among elite athletes. In addition, two moderating effects had significant interactions. For amateur athletes, the PA level moderated the effect of controllable COVID-19 experience on sleep quality [F(3,777) = 3.05; p = 0.028], while for elite athletes, the same effect was moderated by dietary habits [F(3,506) = 4.47, p = 0.004].ConclusionElite athletes had different lifestyle behaviors compared to amateurs during the COVID-19 lockdown. Furthermore, the relevance of maintaining high levels of PA for amateurs and good quality dietary habits by elite athletes was noted by the moderating effect that both variables had on the influence of the controllable experience during the COVID-19 pandemic on sleep quality.

Heart disease detection using machine learning methods has been an outstanding research topic as heart diseases continue to be a burden on healthcare systems around the world. Therefore, in this study, the performances of machine learning methods for predictive classification of coronary heart disease were compared. Material and Method: In the study, three different models were created with Random Forest (RF), Logistic Regression (LR), and Support Vector Machine (SVM) algorithms for the classification of coronary heart disease. For hyper parameter optimization, 3-repeats 10-fold repeated cross validation method was used. The performance of the models was evaluated based on Accuracy, F1 Score, Specificity, Sensitivity, Positive Predictive Value, Negative Predictive Value, and Confusion Matrix (Classification matrix). Results: RF 0.929, SVM 0.897 and LR 0.861 classified coronary heart disease with accuracy. Specificity, Sensitivity, F1-score, Negative predictive and Positive predictive values of the RF model were calculated as 0.929, 0.928, 0.928, 0.929 and 0.928, respectively. The Sensitivity value of the SVM model was higher compared to the RF. Conclusion:Considering the accurate classification rates of Coronary Heart disease, the RF model outperformed the SVM and LR models. Also, the RF model had the highest sensitivity value. We think that this result, which has a high sensitivity criterion in order to minimize overlooked heart patients, is clinically very important.

Background: The primary aim of this study was to create a machine learning (ML) model that can predict perforated and nonperforated acute appendicitis (AAp) with high accuracy and to demonstrate the clinical interpretability of the model with explainable artificial intelligence (XAI). Method: A total of 1797 patients who underwent appendectomy with a preliminary diagnosis of AAp between May 2009 and March 2022 were included in the study. Considering the histopathological examination, the patients were divided into two groups as AAp (n = 1465) and non-AAp (NA; n = 332); the non-AAp group is also referred to as negative appendectomy. Subsequently, patients confirmed to have AAp were divided into two subgroups: nonperforated (n = 1161) and perforated AAp (n = 304). The missing values in the data set were assigned using the Random Forest method. The Boruta variable selection method was used to identify the most important variables associated with AAp and perforated AAp. The class imbalance problem in the data set was resolved by the SMOTE method. The CatBoost model was used to classify AAp and non-AAp patients and perforated and nonperforated AAp patients. The performance of the model in the holdout test set was evaluated with accuracy, F1- score, sensitivity, specificity, and area under the receiver operator curve (AUC). The SHAP method, which is one of the XAI methods, was used to interpret the model results. Results: The CatBoost model could distinguish AAp patients from non-AAp individuals with an accuracy of 88.2% (85.6–90.8%), while distinguishing perforated AAp patients from nonperforated AAp individuals with an accuracy of 92% (89.6–94.5%). According to the results of the SHAP method applied to the CatBoost model, it was observed that high total bilirubin, WBC, Netrophil, WLR, NLR, CRP, and WNR values, and low PNR, PDW, and MCV values increased the prediction of AAp biochemically. On the other hand, high CRP, Age, Total Bilirubin, PLT, RDW, WBC, MCV, WLR, NLR, and Neutrophil values, and low Lymphocyte, PDW, MPV, and PNR values were observed to increase the prediction of perforated AAp. Conclusion: For the first time in the literature, a new approach combining ML and XAI methods was tried to predict AAp and perforated AAp, and both clinical conditions were predicted with high accuracy. This new approach proved successful in showing how well which demographic and biochemical parameters could explain the current clinical situation in predicting AAp and perforated AAp.

Since COVID-19 is a worldwide pandemic, COVID-19 detection using a convolutional neural network (CNN) has been an extraordinary research technique. In the reported studies, many models that can predict COVID-19 based on deep learning methods using various medical images have been created; however, clinical decision support systems have been limited. The aim of this study is to develop a successful deep learning model based on X-ray images and a computer-assisted, fast, free and web-based diagnostic tool for accurate detection of COVID-19. Methods: In this study a 15-layer CNN model was used to detect COVID-19 using X-ray images, which outperformed many previously published CNN models in terms of classification. The model performance is evaluated according to Accuracy, Matthews Correlation Coefficient (MCC), F1 Score, Specificity, Sensitivity (Recall), Youden's Index, Precision (Positive Predictive Value: PPV), Negative Predictive Value (NPV), and Confusion Matrix (Classification matrix). In the second phase of the study, the computer-aided diagnostic tool for COVID-19 disease was developed using Python Flask library, JavaScript and Html codes. Results:The model to diagnose COVID-19 has an average accuracy of 98.68 % in the training set and 96.98 % in the testing set. Among the evaluation metrics, the minimum value is 93.4 % for MCC and Youden's index, and the maximum value is 97.8 for sensitivity and NPV. A higher sensitivity value means a lower false negative (FN) value, and a low FN value is an encouraging outcome for COVID-19 cases. This conclusion is crucial because minimizing the overlooked cases of COVID-19 (false negatives) is one of the main goals of this research. Conclusions: In this period when COVID-19 is spreading rapidly around the world, it is thought that the free and web-based COVID-19 X-Ray clinical decision support tool can be a very effective and fast diagnostic tool. The computer-aided system can assist physicians and radiologists in making clinical decisions about the disease, as well as provide support in diagnosis, follow-up, and prognosis. The developed computer-assisted diagnosis tool can be publicly accessed at http://biostatapps.inonu.edu.tr/CSYX/..

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