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Full-Text Articles in Physical Sciences and Mathematics

A Context-Aware Activity Recommendation Smartphone Application To Mitigate Sedentary Lifestyles, Qian He, Emmanuel Agu Dec 2015

A Context-Aware Activity Recommendation Smartphone Application To Mitigate Sedentary Lifestyles, Qian He, Emmanuel Agu

Emmanuel O. Agu

A sedentary lifestyle involves irregular or no physical activity. In this kind of lifestyle, people’s activities do not increase their energy expenditure substantially above resting levels. Long periods of sitting, lying, watching television, playing video games, and using the computer are typical examples. Energy expenditures at 1.0-1.5 Metabolic Equivalent Units (METs) are considered sedentary behaviors. A recent study of sedentary lifestyles found that the length of sedentary times is associated with an increased risk of diabetes, cardiovascular disease, and cardiovascular and all-cause mortality. In this study, we developed a smartphone application called “On11”, which continuously tracks and informs the user …


Effects Of Cost Sharing On Seeking Care For Serious And Minor Symptoms. Results Of A Randomized Controlled Trial, Martin Shapiro, John Ware, Cathy Sherbourne Dec 2015

Effects Of Cost Sharing On Seeking Care For Serious And Minor Symptoms. Results Of A Randomized Controlled Trial, Martin Shapiro, John Ware, Cathy Sherbourne

Martin Shapiro

To estimate the effect of cost sharing on seeking care for serious and minor symptoms, we analyzed data for 3539 persons aged 17 to 61 from the Rand Health Insurance Experiment. Participants were randomly assigned to a free-care group or to insurance plans requiring them to pay part of the costs (cost-sharing group). Annual surveys were administered to determine if participants had serious and minor symptoms during the preceding month and whether they saw a physician. Serious symptoms were judged by a panel of physicians to warrant care in most instances; minor symptoms were judged neither to be severe nor …


Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw Jul 2015

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.

Methods: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the …


Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw Jul 2015

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer. Methods: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee. Results: The systematic review …


Cyclosporin Versus Tacrolimus For Liver Transplanted Patients, Elizabeth Haddad, Vivian Mcalister, Elizabeth Renouf, Richard Malthaner, Mette Kjaer, Lise Gluud Jul 2015

Cyclosporin Versus Tacrolimus For Liver Transplanted Patients, Elizabeth Haddad, Vivian Mcalister, Elizabeth Renouf, Richard Malthaner, Mette Kjaer, Lise Gluud

Richard A. Malthaner

A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched. Using fixed and random effects model, relative risk (RR), values <1 favoring>tacrolimus, with 95% confidence intervals (CI) were calculated. Of 717 potentially relevant references, 16 RCTs were eligible for inclusion. Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients (Death: RR 0.85, 95% CI 0.73-0.99; graft loss: RR 0.73, 95% CI 0.61-0.86). Tacrolimus reduced the number of recipients …


Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw Jul 2015

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Systematic Review And Meta-Analysis, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis.

Methods: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the …


Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw Jul 2015

Neoadjuvant Or Adjuvant Therapy For Resectable Esophageal Cancer: A Clinical Practice Guideline, Richard Malthaner, Rebecca Wong, R. Rumble, Lisa Zuraw

Richard A. Malthaner

Background: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. A clinical practice guideline was developed based on a systematic review investigating neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer.

Methods: A systematic review with meta-analysis was developed and clinical recommendations were drafted. External review of the practice guideline report by practitioners in Ontario, Canada was obtained through a mailed survey, and incorporated. Final approval of the practice guideline was obtained from the Practice Guidelines Coordinating Committee.

Results: The systematic review …


Cyclosporin Versus Tacrolimus For Liver Transplanted Patients, Elizabeth Haddad, Vivian Mcalister, Elizabeth Renouf, Richard Malthaner, Mette Kjaer, Lise Gluud Jul 2015

Cyclosporin Versus Tacrolimus For Liver Transplanted Patients, Elizabeth Haddad, Vivian Mcalister, Elizabeth Renouf, Richard Malthaner, Mette Kjaer, Lise Gluud

Richard A. Malthaner

A systematic review of randomized clinical trials (RCT) was undertaken to evaluate the beneficial and harmful effects of immunosuppression with cyclosporin versus tacrolimus for liver transplanted patients. MEDLINE, EMBASE, Cochrane Central and Hepato-Biliary Group Controlled Trials Registers were searched. Using fixed and random effects model, relative risk (RR), values <1 favoring>tacrolimus, with 95% confidence intervals (CI) were calculated. Of 717 potentially relevant references, 16 RCTs were eligible for inclusion. Mortality and graft loss at 1 year were significantly reduced in tacrolimus-treated recipients (Death: RR 0.85, 95% CI 0.73-0.99; graft loss: RR 0.73, 95% CI 0.61-0.86). Tacrolimus reduced the number of recipients …


Leukoaraiosis Predicts Poor 90-Day Outcome After Acute Large Cerebral Artery Occlusion, Nils Henninger, Eugene Lin, Stephen Baker, Ajay Wakhloo, Deepak Takhtani, Majaz Moonis Apr 2015

Leukoaraiosis Predicts Poor 90-Day Outcome After Acute Large Cerebral Artery Occlusion, Nils Henninger, Eugene Lin, Stephen Baker, Ajay Wakhloo, Deepak Takhtani, Majaz Moonis

Nils Henninger

BACKGROUND: To date limited information regarding outcome-modifying factors in patients with acute intracranial large artery occlusion (ILAO) in the anterior circulation is available. Leukoaraiosis (LA) is a common finding among patients with ischemic stroke and has been associated with poor post-stroke outcomes but its association with ILAO remains poorly characterized. This study sought to clarify the contribution of baseline LA and other common risk factors to 90-day outcome (modified Rankin Scale, mRS) after stroke due to acute anterior circulation ILAO. METHODS: We retrospectively analyzed 1,153 consecutive patients with imaging-confirmed ischemic stroke during a 4-year period (2007-2010) at a single academic …


Challenges And Best Practices In Real-Time Prediction Of Infectious Disease: A Case Study Of Dengue In Thailand, Nicholas Reich, Stephen Lauer, Krzysztof Sakrejda, Sopon Iamsirithaworn, Soawapak Hinjoy, Paphanij Suangtho, Suthanun Suthachana, Hannah Clapham, Henrik Salje, Derek Cummings, Justin Lessler Jan 2015

Challenges And Best Practices In Real-Time Prediction Of Infectious Disease: A Case Study Of Dengue In Thailand, Nicholas Reich, Stephen Lauer, Krzysztof Sakrejda, Sopon Iamsirithaworn, Soawapak Hinjoy, Paphanij Suangtho, Suthanun Suthachana, Hannah Clapham, Henrik Salje, Derek Cummings, Justin Lessler

Nicholas G Reich

Epidemics of communicable diseases place a huge burden on public health infrastructures across the world. Producing accurate and actionable forecasts of infectious disease incidence at short and long time scales will improve public health response to outbreaks. However, scientists and public health officials face many obstacles in trying to create accurate and actionable real-time forecasts of infectious disease incidence. Dengue is a mosquito-borne virus that annually infects over 400 million people worldwide. We developed a real-time forecasting model for dengue hemorrhagic fever in the 77 provinces of Thailand. We created an operational and computational infrastructure that generated multi-step predictions of …


Estimating Controlled Direct Effects Of Restrictive Feeding Practices In The `Early Dieting In Girls' Study, Yeying Zhu, Debashis Ghosh, Donna L. Coffman, Jennifer S. Williams Jan 2015

Estimating Controlled Direct Effects Of Restrictive Feeding Practices In The `Early Dieting In Girls' Study, Yeying Zhu, Debashis Ghosh, Donna L. Coffman, Jennifer S. Williams

Debashis Ghosh

In this article, we examine the causal effect of parental restrictive feeding practices on children’s weight status. An important mediator we are interested in is children’s self-regulation status. Traditional mediation analysis (Baron and Kenny, 1986) applies a structural equation modelling (SEM) approach and decomposes the intent-to-treat (ITT) effect into direct and indirect effects. More recent approaches interpret the mediation effects based on the potential outcomes framework. In practice, there often exist confounders that jointly influence the mediator and the outcome. Inverse probability weighting based on propensity scores are used to adjust for confounding and reduce the dimensionality of confounders simultaneously. …


Case Studies In Evaluating Time Series Prediction Models Using The Relative Mean Absolute Error, Nicholas G. Reich, Justin Lessler, Krzysztof Sakrejda, Stephen A. Lauer, Sopon Iamsirithaworn, Derek A T Cummings Dec 2014

Case Studies In Evaluating Time Series Prediction Models Using The Relative Mean Absolute Error, Nicholas G. Reich, Justin Lessler, Krzysztof Sakrejda, Stephen A. Lauer, Sopon Iamsirithaworn, Derek A T Cummings

Nicholas G Reich

Statistical prediction models inform decision-making processes in many real-world settings. Prior to using predictions in practice, one must rigorously test and validate candidate models to ensure that the proposed predictions have sufficient accuracy to be used in practice. In this paper, we present a framework for evaluating time series predictions that emphasizes computational simplicity and an intuitive interpretation using the relative mean absolute error metric. For a single time series, this metric enables comparisons of candidate model predictions against naive reference models, a method that can provide useful and standardized performance benchmarks. Additionally, in applications with multiple time series, this …


Use Of Geographical Information Systems To Identify Counties In Georgia With High Risk For Childhood Lead Poisoning, R. Christopher Rustin, Christy Kuriatnyk, Byron Lobsinger, Simone Charles Dec 2014

Use Of Geographical Information Systems To Identify Counties In Georgia With High Risk For Childhood Lead Poisoning, R. Christopher Rustin, Christy Kuriatnyk, Byron Lobsinger, Simone Charles

R. Christopher Rustin

Background: For children in Georgia, lead poisoning is a substantial public health problem. Primary risk factors include low socioeconomic status and poor-quality housing built prior to 1978. The Environmental Health Team of the Georgia Department of Public Health (DPH) utilized geographical information system (GIS) technology and census housing data to identify counties in which children have high risk for lead poisoning. The purpose of this research was to update and refine previous maps developed with older technology and on a different geographic scale so that targeted public health interventions can be developed.

Methods: Data related to stratified and …


Epidemiology Of Latency And Relapse In Plasmodium Vivax Malaria, Andrew A. Lover Dec 2014

Epidemiology Of Latency And Relapse In Plasmodium Vivax Malaria, Andrew A. Lover

Andrew Lover

Malaria is a major contributor to health burdens throughout the regions where it is endemic. Historically, it was believed that there was limited morbidity and essentially no mortality associated with Plasmodium vivax; however, evidence from diverse settings now suggests that infections with P. vivax can be both severe and fatal. This awareness has highlighted a critical gap: the vast majority of research has been directed towards P. falciparum, leading to a decades-long neglect of epidemiological and clinical studies of P. vivax. There exists a large body of historical data on human experimental infections with P. vivax; these studies in controlled …


Considerations For Comprehensive Analyses Of Sporozoite-Based Controlled Human Malaria Infection Studies, Andrew A. Lover Dec 2014

Considerations For Comprehensive Analyses Of Sporozoite-Based Controlled Human Malaria Infection Studies, Andrew A. Lover

Andrew Lover

There has been renewed interest in the use of sporozoite-based approaches for controlled human malaria infections (CHMIs), and several sets of human challenge studies have recently completed. A study undertaken in Tanzania and published in 2014 found dose dependence between 10,000 and 25,000 sporozoite doses, as well as divergent times-to-parasitemia relative to earlier studies in European volunteers, with important implications for planning future studies. Analysis of time-to-event data has had extensive development in recent years, but these methods have had limited exposure outside biostatistics. Expansion of the published analyses to include recent methodological approaches optimized for the types of data …


Short Report: Study Variability In Recent Human Challenge Experiments With Plasmodium Falciparum Sporozoites (Pfspz Challenge), Andrew A. Lover Dec 2014

Short Report: Study Variability In Recent Human Challenge Experiments With Plasmodium Falciparum Sporozoites (Pfspz Challenge), Andrew A. Lover

Andrew Lover

There has been renewed interest in the use of sporozoite-based approaches for malaria vaccination and controlled human infections, and several sets of human challenge studies have recently completed. A study undertaken in Tanzania and published in 2014 found dose-dependence between 10,000 and 25,000 sporozoite doses, as well as divergent times-to-parasitemia relative to earlier studies in European volunteers. However, this analysis shows that these conclusions are based upon suboptimal analytical methods; with more optimal analysis, there is no evidence for dose-dependence within this dose range; and more importantly, no evidence for differences in event times between Dutch and Tanzanian study sites. …