Utilizing Digital Health to Collect Electronic Patient-Reported Outcomes in Prostate Cancer: Single-Arm Pilot Trial

Background: Measuring patient-reported outcomes (PROs) requires an individual’s perspective on their symptoms, functional status, and quality of life. Digital health enables remote electronic PRO (ePRO) assessments as a clinical decision support tool to facilitate meaningful provider interactions and personalized treatment. Objective: This study explored the feasibility and acceptability of collecting ePROs using validated health-related quality of life (HRQoL) questionnaires for prostate cancer. Methods: Using Apple ResearchKit software, the Strength Through Insight app was created with content from validated HRQoL tools 26-item Expanded Prostate Cancer Index Composite (EPIC) or EPIC for Clinical Practice and 8-item Functional Assessment of Cancer Therapy Advanced Prostate Symptom Index. In a single-arm pilot study with patients receiving prostate cancer treatment at Thomas Jefferson University Hospital and affiliates, participants were recruited, and instructed to download Strength Through Insight and complete ePROs once a week over 12 weeks. A mixed methods approach, including qualitative pre- and poststudy interviews, was used to evaluate the feasibility and acceptability of Strength Through Insight for the collection and care management of cancer treatment. Results: Thirty patients consented to the study; 1 patient failed to complete any of the questionnaires and was left out of the analysis of the intervention. Moreover, 86% (25/29) reached satisfactory questionnaire completion (defined as completion of 60% of weekly questions over 12 weeks). The lower bound of the exact one-sided 95% CI was 71%, exceeding the 70% feasibility threshold. Most participants self-identified with having a high digital literacy level (defined as the ability to use, understand, evaluate, and analyze information from multiple formats from a variety of digital sources), and only a few participants identified with having a low digital literacy level (defined as only having the ability to gather information on the Web). Interviews were thematically analyzed to reveal the following: (1) value of emotional support and wellness in cancer treatment, (2) rise of social patient advocacy in online patient communities and networks, (3) patient concerns over privacy, and (4) desire for personalized engagement tools. Conclusions: Strength Through Insight was demonstrated as a feasible and acceptable method of data collection for ePROs. A high compliance rate confirmed the app as a reliable tool for patients with localized and advanced prostate cancer. Nearly all participants reported that using the smartphone app is easier than or equivalent to the traditional paper-and-pen approach, providing evidence of acceptability and support for the use of remote PRO monitoring. This study expands on current research involving the value of digital health, as a social and behavioral science, augmented with technology, can begin to contribute to population health management, as it shapes psychographic segmentation by demographic, socioeconomic, health condition, or behavioral factors to group patients by their distinct personalities and motivations, which influence their choices

Enumeration of distinct mechanically stable disk packings in small systems

We create mechanically stable (MS) packings of bidisperse disks using an algorithm in which we successively grow or shrink soft repulsive disks followed by energy minimization until the overlaps are vanishingly small. We focus on small systems because this enables us to enumerate nearly all distinct MS packings. We measure the probability to obtain a MS packing at packing fraction $\phi$ and find several notable results. First, the probability is highly nonuniform. When averaged over narrow packing fraction intervals, the most probable MS packing occurs at the highest $\phi$ and the probability decays exponentially with decreasing $\phi$. Even more striking, within each packing-fraction interval, the probability can vary by many orders of magnitude. By using two different packing-generation protocols, we show that these results are robust and the packing frequencies do not change qualitatively with different protocols.Comment: 4 pages, 3 figures, Conference Proceedings for X International Workshop on Disordered System

Self-duality of the D1-D5 near-horizon

We explore fermionic T-duality and self-duality in the geometry AdS3 x S3 x T4 in type IIB supergravity. We explicitly construct the Killing spinors and the fermionic T-duality isometries and show that the geometry is self-dual under a combination of two bosonic AdS3 T-dualities, four fermionic T-dualities and either two additional T-dualities along T4 or two T-dualities along S3. In addition, we show that the presence of a B-field acts as an obstacle to self-duality, a property attributable to S- duality and fermionic T-duality not commuting. Finally, we argue that fermionic T-duality may be extended to CY2 = K3, a setting where we cannot explicitly construct the Killing spinors.Comment: 24 pages, references added, changes made to reinforce the point that S-duality and fermionic T-duality generically do not commute, version accepted to JHE

From Correlators to Wilson Loops in Chern-Simons Matter Theories

We study n-point correlation functions for chiral primary operators in three dimensional supersymmetric Chern-Simons matter theories. Our analysis is carried on in N=2 superspace and covers N=2,3 supersymmetric CFT's, the N=6 ABJM and the N=8 BLG models. In the limit where the positions of adjacent operators become light-like, we find that the one-loop n-point correlator divided by its tree level expression coincides with a light-like n-polygon Wilson loop. Remarkably, the result can be simply expressed as a linear combination of five dimensional two-mass easy boxes. We manage to evaluate the integrals analytically and find a vanishing result, in agreement with previous findings for Wilson loops.Comment: 32 pages, 6 figures, JHEP

Reputation Agent: Prompting Fair Reviews in Gig Markets

Our study presents a new tool, Reputation Agent, to promote fairer reviews from requesters (employers or customers) on gig markets. Unfair reviews, created when requesters consider factors outside of a worker's control, are known to plague gig workers and can result in lost job opportunities and even termination from the marketplace. Our tool leverages machine learning to implement an intelligent interface that: (1) uses deep learning to automatically detect when an individual has included unfair factors into her review (factors outside the worker's control per the policies of the market); and (2) prompts the individual to reconsider her review if she has incorporated unfair factors. To study the effectiveness of Reputation Agent, we conducted a controlled experiment over different gig markets. Our experiment illustrates that across markets, Reputation Agent, in contrast with traditional approaches, motivates requesters to review gig workers' performance more fairly. We discuss how tools that bring more transparency to employers about the policies of a gig market can help build empathy thus resulting in reasoned discussions around potential injustices towards workers generated by these interfaces. Our vision is that with tools that promote truth and transparency we can bring fairer treatment to gig workers.Comment: 12 pages, 5 figures, The Web Conference 2020, ACM WWW 202

Fermionic T-duality in the pp-wave limit

AdS5 X S5 and its pp-wave limit are self-dual under transformations involving eight fermionic T-dualities, a property which accounts for symmetries seen in scattering amplitudes in N=4 super-Yang-Mills. Despite strong evidence for similar symmetries in the amplitudes of three-dimensional N=6 ABJM theory, a corresponding self-duality in the dual geometry AdS4 X CP3 currently eludes us. Here, working with the type IIA pp-wave limit of AdS4 X CP3 preserving twenty four supercharges, we show that the pp-wave is self-dual with respect to eight commuting fermionic T-dualities and not the six expected. In addition, we show the same symmetry can be found in a superposition pp-wave and a generic pp-wave with twenty and sixteen unbroken supersymmetries respectively, strongly suggesting that self-duality under fermionic T-duality may be a symmetry of all pp-waves.Comment: 21 pages, typos fixe

VEGF Trap In Combination With Radiotherapy Improves Tumor Control In U87 Glioblastoma

Purpose To determine the effect of vascular endothelial growth factor VEGF Trap (Regeneron Pharmaceuticals, Tarrytown, NY), a humanized soluble vascular endothelial growth factor (VEGF) receptor protein, and radiation (RT) on tumor growth in U87 glioblastoma xenografts in nude mice. Methods and Materials U87 cell suspensions were implanted subcutaneously into hind limbs of nude mice. VEGF Trap (2.5–25 mg/kg) was administered every 3 days for 3 weeks alone or in combination with a single dose of 10 Gy or fractionated RT (3 x 5 Gy). In addition, three scheduling protocols for VEGF Trap plus fractionated RT were examined. Results Improved tumor control was seen when RT (either single dose or fractionated doses) was combined with the lowest dose of VEGF Trap (2.5 mg/kg). Scheduling did not significantly affect the efficacy of combined therapy. Although high-dose VEGF Trap (10 mg/kg or 25 mg/kg) significantly reduced tumor growth over that of RT alone, there was no additional benefit to combining high-dose VEGF Trap with RT. Conclusions Vascular endothelial growth factor Trap plus radiation is clearly better than radiation alone in a U87 subcutaneous xenograft model. Although high doses of VEGF Trap alone are highly efficacious, it is unclear whether such high doses can be used clinically without incurring normal tissue toxicities. Thus, information on lower doses of VEGF Trap and ionizing radiation is of clinical relevance. Int. J. Radiation Oncol. Biol. Physics, Volume 67, Issue 5, pages 1526-1537, 2007

Financial Accounting 3B

Exam paper for second semester: Financial Accounting 3

Factors Associated with Severe Late Toxicity After Concurrent Chemoradiation for Locally Advanced Head and Neck Cancer: An RTOG Analysis

Purpose Concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN) increases both local tumor control and toxicity. This study evaluates clinical factors that are associated with and might predict severe late toxicity after CCRT. Methods Patients were analyzed from a subset of three previously reported RTOG trials of concurrent chemoradiotherapy for locally advanced SCCHN (RTOG 91-11; 97-03; and 99-14). Severe late toxicity was defined in this secondary analysis as chronic Grade 3-4 pharyngeal/laryngeal toxicity (RTOG/EORTC late toxicity scoring system) and/or requirement for a feeding tube ≥2 years after registration and/or potential treatment-related death (e.g. pneumonia) within 3 years. Case-control analysis was performed, with a multivariable logistic regression model that included pre-treatment and treatment potential factors. Results A total of 230 patients were evaluable for this analysis, 99 cases (patients with severe late toxicities) and 131 controls; thus 43% of evaluable patients had a severe late toxicity. On multivariable analysis, significant variables correlated with the development of severe late toxicity were older age (odds ratio 1.05 per year; p = 0.001); advanced T-stage (odds ratio 3.07; p=0.0036); larynx/hypopharynx primary site (odds ratio 4.17; p=0.0041); and neck dissection after chemo-RT (odds ratio 2.39; p=0.018). Conclusions Severe late toxicity following CCRT is common. Older age, advanced T-stage, and larynx/ hypopharynx primary site were strong independent risk American Society of Clinical Oncology. Machtay, M. et al: J. Clin. Oncol. 26 (21), 2008:3582-3589

Cross-sectional associations between air pollution and chronic bronchitis: an ESCAPE meta-analysis across five cohorts

BACKGROUND: This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. METHODS: Annual average particulate matter (PM10, PM2.5, PMabsorbance, PMcoarse), NO2, nitrogen oxides (NOx) and road traffic measures modelled from ESCAPE measurement campaigns 2008-2011 were assigned to home address at most recent assessments (1998-2011). Symptoms examined were chronic bronchitis (cough and phlegm for ≥3 months of the year for ≥2 years), chronic cough (with/without phlegm) and chronic phlegm (with/without cough). Cohort-specific cross-sectional multivariable logistic regression analyses were conducted using common confounder sets (age, sex, smoking, interview season, education), followed by meta-analysis. RESULTS: 15 279 and 10 537 participants respectively were included in the main NO2 and PM analyses at assessments in 1998-2011. Overall, there were no statistically significant associations with any air pollutant or traffic exposure. Sensitivity analyses including in asthmatics only, females only or using back-extrapolated NO2 and PM10 for assessments in 1985-2002 (ECRHS, NSHD, SALIA, SAPALDIA) did not alter conclusions. In never-smokers, all associations were positive, but reached statistical significance only for chronic phlegm with PMcoarse OR 1.31 (1.05 to 1.64) per 5 µg/m(3) increase and PM10 with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM2.5abs (black carbon) exposures. CONCLUSIONS: Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations