Physical Sciences and Mathematics Commons^™

Unintended Consequences Of Air Cleaning Chemistry, Douglas B. Collins, Delphine K. Farmer

Faculty Journal Articles

Amplified interest in maintaining clean indoor air associated with the airborne transmission risks of SARS-CoV-2 have led to an expansion in the market for commercially available air cleaning systems. While the optimal way to mitigate indoor air pollutants or contaminants is to control (remove) the source, air cleaners are a tool for use when absolute source control is not possible. Interventions for indoor air quality management include physical removal of pollutants through ventilation or collection on filters and sorbent materials, along with chemically reactive processes that transform pollutants or seek to deactivate biological entities. This perspective intends to highlight the …

Effect Of An Antenatal Lifestyle Intervention On Dietary Inflammatory Index And Its Associations With Maternal And Fetal Outcomes: A Secondary Analysis Of The Pears Trial, Sarah Louise Killen, Catherine M. Phillips, Anna Delahunt, Cara A. Yelverton, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Maria A. Kennelly, Martina Cronin, John Mehegan, Fionnuala M. Mcauliffe

Faculty Publications

We investigated the effect of an antenatal lifestyle intervention of a low-glycaemic index (GI) diet and physical activity on energy-adjusted dietary inflammatory index (E-DIITM) and explored its relationship with maternal and child health in women with overweight and obesity. This was a secondary analysis of 434 mother−child pairs from the Pregnancy Exercise and Nutrition Study (PEARS) trial in Dublin, Ireland. E-DII^TM scores were calculated for early (10–16 weeks) and late (28 weeks) pregnancy. Outcomes included lipids, inflammation markers, insulin resistance, mode of delivery, infant size, pre-eclampsia, and gestational diabetes. T-tests were used to assess changes in E-DII^TM. …

Associations Between Fasting Duration, Timing Of First And Last Meal, And Cardiometabolic Endpoints In The National Health And Nutrition Examination Survey, Michael David Wirth, Longgang Zhao, Gabrielle Turner-Mcgrievy, Andrew Ortaglia

Faculty Publications

Background: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Cross-sectional data from NHANES (2005–2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures …

Predictors Of Chronic Opioid Therapy In Medicaid Beneficiaries With Hiv Who Initiated Antiretroviral Therapy, Gyeon Oh, Emily S. Brouwer, Erin L. Abner, David W. Fardo, Patricia R. Freeman, Chris Delcher, Daniela C. Moga

Epidemiology and Environmental Health Faculty Publications

The factors associated with chronic opioid therapy (COT) in patients with HIV is understudied. Using Medicaid data (2002-2009), this retrospective cohort study examines COT in beneficiaries with HIV who initiated standard combination anti-retroviral therapy (cART). We used generalized estimating equations on logistic regression models with backward selection to identify significant predictors of COT initiation. COT was initiated among 1014 out of 9615 beneficiaries with HIV (male: 10.4%; female: 10.7%). Those with older age, any malignancy, Hepatitis C infection, back pain, arthritis, neuropathy pain, substance use disorder, polypharmacy, (use of) benzodiazepines, gabapentinoids, antidepressants, and prior opioid therapies were positively associated with …

Treatment Patterns And Outcomes In Elderly Patients With Newly Diagnosed Multiple Myeloma: Results From The Connect® Mm Registry, Hans C. Lee, Sikander Ailawadhi, Cristina J. Gasparetto, Sundar Jagannath, Robert M. Rifkin, Brian G.M. Durie, Mohit Narang, Howard R. Terebelo, Kathleen Toomey, James W. Hardin Ph.D., Lynne Wagner, James L. Omel, Mazaher Dhalla, Liang Liu, Prashant Joshi, Rafat Abonour

Faculty Publications

No abstract provided.

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five …

Understanding Covid-19 Dynamics And The Effects Of Interventions In The Philippines: A Mathematical Modelling Study, Jamie M. Caldwell, Elvira P. De Lara-Tuprio, Timothy Robin Y. Teng, Ma. Regina Justina E. Estuar, Raymond Francis R. Sarmiento, Milinda Abayawardana B. Eng, Robert Neil F. Leong, Richard T. Gray, James G. Wood, Linh-Vi Le, Emma S. Mcbryde, Romain Ragonnet, James M. Trauer

Mathematics Faculty Publications

Background

COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries; possibly because of differing demographics; socioeconomics; surveillance; and policy responses. Here; we investigate the role of multiple factors on COVID-19 dynamics in the Philippines; a LMIC that has had a relatively severe COVID-19 outbreak.

Methods

We applied an age-structured compartmental model that incorporated time-varying mobility; testing; and personal protective behaviors (through a “Minimum Health Standards” policy; MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon; Central Visayas; and the National Capital …

Association Of Chronic Pain With Participation In Motor Skill Activities In Children With Cerebral Palsy, Haresh Rochani, Christopher M. Modlesky, Barbara Weissman, Joshua Vova, Gavin T. Colquitt

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Many children with cerebral palsy (CP) experience the secondary condition of pain, which is problematic because children with CP face barriers to participation in motor skill activities.^1,2 Motor performance in activities of daily living among children with CP is markedly lower than that among their age-matched peers.³ Because of the potential effect of pain on children with CP, we sought to examine the association between pain and activities requiring motor skill performance (ie, difficulty dressing or bathing and participation in sport) among a nationally representative sample of US children with CP.

Pattern Of Use Of Electronic Health Record (Ehr) Among The Chronically Ill: A Health Information National Trend Survey (Hints) Analysis, Rose Calixte, Sumaiya Islam, Zainab Toteh Osakwe, Argelis Rivera, Marlene Camacho-Rivera

Publications and Research

Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging …

Cognitive Complaints In Age-Related Chronic Conditions: A Systematic Review, Nikki L. Hill, Sakshi Bhargava, Monique J. Brown Ph.D., Mph, Hyejin Kim, Iris Bhang, Katilyn Mullin, Kathleen Phillips, Jacqueline Mogle

Faculty Publications

Introduction

Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and …

Identification Of Novel And Rare Variants Associated With Handgrip Strength Using Whole Genome Sequence Data From The Nhlbi Trans-Omics In Precision Medicine (Topmed) Program, Chloé Sarnowski, Han Chen, Mary L. Biggs, Sylvia Wassertheil-Smoller, Jan Bressler, Marguerite R. Irvin, Kathleen A. Ryan, David Karasik, Donna K. Arnett, L. Adrienne Cupples, David W. Fardo, Stephanie M. Gogarten, Benjamin D. Heavner, Deepti Jain, Hyun Min Kang, Charles Kooperberg, Arch G. Mainous, Braxton D. Mitchell, Alanna C. Morrison, Jeffrey R. O'Connell

Epidemiology and Environmental Health Faculty Publications

Handgrip strength is a widely used measure of muscle strength and a predictor of a range of morbidities including cardiovascular diseases and all-cause mortality. Previous genome-wide association studies of handgrip strength have focused on common variants primarily in persons of European descent. We aimed to identify rare and ancestry-specific genetic variants associated with handgrip strength by conducting whole-genome sequence association analyses using 13,552 participants from six studies representing diverse population groups from the Trans-Omics in Precision Medicine (TOPMed) Program. By leveraging multiple handgrip strength measures performed in study participants over time, we increased our effective sample size by 7-12%. Single-variant …

Comparing Dietary Score Associations With Lipoprotein Particle Subclass Profiles: A Cross-Sectional Analysis Of A Middle-To Older-Aged Population, Seán R. Millar, Pilar Navarro, Janas M. Harrington, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ivan J. Perry, Catherine M. Phillips

Faculty Publications

Background and objectives: Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile.

Materials and methods: This …

Evaluation Of Circulating Levels Of Interleukin-10 And Interleukin-16 And Dietary Inflammatory Index In Lebanese Knee Osteoarthritis Patients, Zeina El-Ali, Germine El-Kassas, Fouad M. Ziade, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Nisrine Bissar

Faculty Publications

Objectives

To investigate plasma concentrations of Interleukin-16 (IL-16) and Interleukin-10 (IL-10) in Lebanese knee osteoarthritis (KOA) patients and to examine the association between the diet-associated inflammation and increased risk for KOA.

Methods

A total of 208 study participants were assigned to one of the 3 groups: Diagnosed Knee Osteoarthritis group (DKOA) (N = 78); Undiagnosed Knee Osteoarthritis group (UKOA) (N = 60) and controls matched on age, sex and sociodemographic characteristics (N = 70). UKOA represents KOA features before they are altered by therapeutic intervention and lifestyle modifications that follow the diagnosis. Energy-adjusted dietary inflammatory index (E-DII™) scores were calculated …

Mental Health Services Provision In Primary Care And Emergency Department Settings: Analysis Of Blended Fee-For-Service And Blended Capitation Models In Ontario, Canada., Thyna Vu, Kelly K Anderson, Nibene H Somé, Amardeep Thind, Sisira Sarma

Epidemiology and Biostatistics Publications

Treating mental illnesses in primary care is increasingly emphasized to improve access to mental health services. Although family physicians (FPs) or general practitioners are in an ideal position to provide the bulk of mental health care, it is unclear how best to remunerate FPs for the adequate provision of mental health services. We examined the quantity of mental health services provided in Ontario's blended fee-for-service and blended capitation models. We evaluated the impact of FPs switching from blended fee-for-service to blended capitation on the provision of mental health services in primary care and emergency department using longitudinal health administrative data …

Adapting An Agent-Based Model Of Infectious Disease Spread In An Irish County To Covid-19, Elizabeth Hunter, John D. Kelleher

Articles

The dynamics that lead to the spread of an infectious disease through a population can be characterized as a complex system. One way to model such a system, in order to improve preparedness, and learn more about how an infectious disease, such as COVID-19, might spread through a population, is agent-based epidemiological modelling. When a pandemic is caused by an emerging disease, it takes time to develop a completely new model that captures the complexity of the system. In this paper, we discuss adapting an existing agent-based model for the spread of measles in Ireland to simulate the spread of …

Landscape-Based Mutational Sensitivity Cartography And Network Community Analysis Of The Sars-Cov-2 Spike Protein Structures: Quantifying Functional Effects Of The Circulating D614g Variant, Gennady M. Verkhivker, Steve Agajanian, Deniz Yasar Oztas, Grace Gupta

Mathematics, Physics, and Computer Science Faculty Articles and Research

We developed and applied a computational approach to simulate functional effects of the global circulating mutation D614G of the SARS-CoV-2 spike protein. All-atom molecular dynamics simulations are combined with deep mutational scanning and analysis of the residue interaction networks to investigate conformational landscapes and energetics of the SARS-CoV-2 spike proteins in different functional states of the D614G mutant. The results of conformational dynamics and analysis of collective motions demonstrated that the D614 site plays a key regulatory role in governing functional transitions between open and closed states. Using mutational scanning and sensitivity analysis of protein residues, we identified the stability …

Knowledge And Anxiety About Covid-19 In The State Of Qatar, And The Middle East And North Africa Region—A Cross Sectional Study, Sathyanarayanan Doraiswamy, Sohaila Cheema, Maisonneuve Patrick, Amit Abraham, Ingmar Weber, Jisun An, Albert B. Lowenfels, Ravinder Mamtani

Research Collection School Of Computing and Information Systems

While the coronavirus disease 2019 (COVID-19) pandemic wreaked havoc across the globe, we have witnessed substantial mis- and disinformation regarding various aspects of the disease. We conducted a cross-sectional study using a self-administered questionnaire for the general public (recruited via social media) and healthcare workers (recruited via email) from the State of Qatar, and the Middle East and North Africa region to understand the knowledge of and anxiety levels around COVID-19 (April–June 2020) during the early stage of the pandemic. The final dataset used for the analysis comprised of 1658 questionnaires (53.0% of 3129 received questionnaires; 1337 [80.6%] from the …

Construct Validity And Invariance Assessment Of The Social Impacts Of Occupational Heat Stress Scale (Siohss) Among Ghanaian Mining Workers, Victor F. Nunfam, Ebenezer Afrifa-Yamoah, Kwadwo Adusei-Asante, Eddie J. Van Etten, Kwasi Frimpong, Isaac Adjei-Mensah, Jacques Oosthuizen

Research outputs 2014 to 2021

Heat exposure studies over the last decade have shown little attention in assessing and reporting the psychometric properties of the various scales used to measure impacts of occupational heat stress on workers. A descriptive cross-sectional survey including 320 small- and large-scale mining workers was employed to assess the construct validity of the social impacts of occupational heat stress scale (SIOHSS) in the Western Region of Ghana in 2017. A confirmatory factor analysis (CFA) and invariance analysis were carried out using AMOS version 25 and statistical product and service solutions (SPSS) version 26 to examine the model fit and establish consistency …

Computational Analysis Of Protein Stability And Allosteric Interaction Networks In Distinct Conformational Forms Of The Sars Cov 2 Spike D614g Mutant: Reconciling Functional Mechanisms Through Allosteric Model Of Spike Regulation, Gennady M. Verkhivker, Steve Agajanian, Deniz Oztas, Grace Gupta

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we used an integrative computational approach to examine molecular mechanisms underlying functional effects of the D614G mutation by exploring atomistic modeling of the SARS-CoV-2 spike proteins as allosteric regulatory machines. We combined coarse-grained simulations, protein stability and dynamic fluctuation communication analysis with network-based community analysis to examine structures of the native and mutant SARS-CoV-2 spike proteins in different functional states. Through distance fluctuations communication analysis, we probed stability and allosteric communication propensities of protein residues in the native and mutant SARS-CoV-2 spike proteins, providing evidence that the D614G mutation can enhance long-range signaling of the allosteric spike …

Spatially Refined Time-Varying Reproduction Numbers Of Covid-19 By Health District In Georgia, Usa, March–December 2020, Chigozie A. Ogwara, Arshpreet Kaur Mallhi, Xinyi Hua, Kamalich Muniz-Rodriguez, Jessica S. Schwind, Xiaolu Zhou, Jeffery A. Jones, Joanne Chopak-Foss, Gerardo Chowell, Isaac Chun-Hai Fung

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

This study quantifies the transmission potential of SARS-CoV-2 across public health districts in Georgia, USA, and tests if per capita cumulative case count varies across counties. To estimate the time-varying reproduction number, Rt of SARS-CoV-2 in Georgia and its 18 public health districts, we apply the R package ‘EpiEstim’ to the time series of historical daily incidence of confirmed cases, 2 March–15 December 2020. The epidemic curve is shifted backward by nine days to account for the incubation period and delay to testing. Linear regression is performed between log10-transformed per capita cumulative case count and log10-transformed population size. We observe …

Time Series Forecasting Of Covid-19 Deaths In Massachusetts, Andrew Disher

Honors Program Theses and Projects

The aim of this study was to use data provided by the Department of Public Health in the state of Massachusetts on its online dashboard to produce a time series model to accurately forecast the number of new confirmed deaths that have resulted from the spread of CoViD-19. Multiple different time series models were created, which can be classified as either an Auto-Regressive Integrated Moving Average (ARIMA) model or a Regression Model with ARIMA Errors. Two ARIMA models were created to provide a baseline forecasting performance for comparison with the Regression Model with ARIMA Errors, which used the number of …

Extreme Weather And Its Impacts On Human Civilizations: An In-Depth Investigation Of Causes And Effects, Jason Zabel

Senior Honors Theses

Extreme weather has impacted humanity since creation and is an important topic that deserves examination. In this thesis, the main event that is presented and analyzed is the extreme haze that clouded much of China’s skies in 2013. Further, the impacts this major event had on people, including changes in population movement, death/injury rate, and changes in atmospheric chemistry due to the high concentration of particulates are discussed. Subsequent examples that will be explored include Hurricane Katrina and the eruption of Mt. St. Helens. The main contention of this thesis is that the effects extreme weather has on human civilization …

Mathematical Models Of Covid-19, Kate Faria

Honors Program Theses and Projects

For more than a year, the COVID-19 pandemic has been a major public health issue, affecting the lives of most people around the world. With both people’s health and the economy at great risks, governments rushed to control the spread of the virus. Containment measures were heavily enforced worldwide until a vaccine was developed and distributed. Although researchers today know more about the characteristics of the virus, a lot of work still needs to be done in order to completely remove the disease from the population. However, this is true for most of the infectious diseases in existence, including Influenza, …

Association Between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index And The Risk Of Obesity, Yoko B. Wang, Nitin Shivappa, James R. Hébert Scd, Amanda J. Page, Yohannes Adama Melaku

Faculty Publications

Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent …

Diet Quality And Risk Of Lung Cancer In The Multiethnic Cohort Study, Song-Yi Park, Carol J. Boushey, Yurii B. Shvetsov, Michael David Wirth Msph,Ph.D., Nitin Shivappa Ph.D., James R. Hébert Sc.D., Christopher A. Haiman, Lynee R. Wilkens, Loic Le Marchand

Faculty Publications

Diet quality, assessed by the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII®), was examined in relation to risk of lung cancer in the Multiethnic Cohort Study. The analysis included 179,318 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 5350 incident lung cancer cases during an average follow-up of 17.5 ± 5.4 years. In multivariable Cox models comprehensively adjusted for cigarette smoking, the hazard ratios (95% confidence intervals) for the highest vs. lowest …

Association Between Appendicular Skeletal Muscle Index And Leukocyte Telomere Length In Adults: A Study From National Health And Nutrition Examination Survey (Nhanes) 1999-2002, Lingzhi Chen, Nitin Shivappa Mbbs, Mph, Ph.D., Xiuxun Dong, Jinjing Ming

Faculty Publications

Background

A higher body mass index (BMI) is associated with shorter telomeres. The loss of muscle mass with aging is associated with adverse outcomes. The appendicular skeletal muscle index (ASMI) is currently used to quantify muscle mass.

Objective

We investigated the association of the ASMI with leukocyte telomere length in adult Americans.

Methods

This cross-sectional study used the National Health and Nutrition Examination Survey (NHANES) 1999–2002 dataset. Body composition was measured by dual-energy X-ray absorptiometry. Low muscle mass was defined using sex-specific thresholds of the appendicular skeletal muscle mass index (ASMI). The telomere-to-single-copy gene ratio (T/S ratio) was converted to …

The Effects Of Differences In Vaccination Rates Across Socioeconomic Groups On The Size Of Measles Outbreaks, Elizabeth Hunter, John D. Kelleher

Conference papers

Vaccination rates are often presented at the level of a country or region. However, within those areas there might be geographic or demographic pockets that have higher or lower vaccination rates. We use an agent-based model designed to simulate the spread of measles in Irish towns to examine if the effectiveness of vaccination rates to reduce disease at a population level is sensitive to the uniformity of vaccinations across socioeconomic groups. We find that when vaccinations are not applied evenly across socioeconomic groups we see more outbreaks and outbreaks with larger magnitudes.

Technology And Sustainability: The New Business Playing Field, Havovi Joshi

Asian Management Insights

Two topics that have consistently cropped up in conversations among business leaders during the pandemic are technology, in the context of the pervasiveness and quickening pace of digital transformation, and sustainability, especially how we should be doing business without harming the environment and society. The collective belief is that both topics will continue to rise on the world’s agenda, reshaping entire industries while creating new ones. They have changed the way of doing business. So what does the new playbook look like?

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …

Randomised Trials At The Level Of The Individual, Jay J H. Park, Nathan Ford, Denis Xavier, Per Ashorn, Rebecca F. Grais, Zulfiqar Ahmed Bhutta, Herman Goossens, Kristian Thorlund, Maria Eugenia Socias, Edward J. Mills

Centre of Excellence in Women and Child Health

In global health research, short-term, small-scale clinical trials with fixed, two-arm trial designs that generally do not allow for major changes throughout the trial are the most common study design. Building on the introductory paper of this Series, this paper discusses data-driven approaches to clinical trial research across several adaptive trial designs, as well as the master protocol framework that can help to harmonise clinical trial research efforts in global health research. We provide a general framework for more efficient trial research, and we discuss the importance of considering different study designs in the planning stage with statistical simulations. We …