Measuring and understanding adherence in a home-based exercise intervention during chemotherapy for early breast cancer

Purpose: Ensuring and measuring adherence to prescribed exercise regimens are fundamental challenges in intervention studies to promote exercise in adults with cancer. This study reports exercise adherence in women who were asked to walk 150 min/week throughout chemotherapy treatment for early breast cancer. Participants were asked to wear a FitbitTM throughout their waking hours, and Fitbit steps were uploaded directly into study computers. Methods: Descriptive statistics are reported, and both unadjusted and multivariable linear regression models were used to assess associations between participant characteristics, breast cancer diagnosis, treatment, chemotherapy toxicities, and patient-reported symptoms with average Fitbit steps/week. Results: Of 127 women consented to the study, 100 had analyzable Fitbit data (79%); mean age was 48 and 31% were non-white. Mean walking steps were 3956 per day. Nineteen percent were fully adherent with the target of 6686 steps/day and an additional 24% were moderately adherent. In unadjusted analysis, baseline variables associated with fewer Fitbit steps were: non-white race (p = 0.012), high school education or less (p = 0.0005), higher body mass index (p = 0.0024), and never/almost never drinking alcohol (p = 0.0048). Physical activity variables associated with greater Fitbit steps were: pre-chemotherapy history of vigorous physical activity (p = 0.0091) and higher self-reported walking minutes/week (p < 0.001), and higher outcome expectations from exercise (p = 0.014). Higher baseline anxiety (p = 0.03) and higher number of chemotherapy-related symptoms rates “severe/very severe” (p = 0.012) were associated with fewer steps. In multivariable analysis, white race was associated with 12,146 greater Fitbit steps per week (p = 0.004), as was self-reported walking minutes prior to start of chemotherapy (p < 0.0001). Conclusions: Inexpensive commercial-grade activity trackers, with data uploaded directly into research computers, enable objective monitoring of home-based exercise interventions in adults diagnosed with cancer. Analysis of the association of walking steps with participant characteristics at baseline and toxicities during chemotherapy can identify reasons for low/non-adherence with prescribed exercise regimens

Seaflux

High-resolution surface fluxes over the global ocean are needed to evaluate coupled atmosphere–ocean models and weather forecasting models, provide surface forcing for ocean models, understand the regional and temporal variations of the exchange of heat between the atmosphere and ocean, and provide a large-scale context for field experiments. Under the auspices of the World Climate Research Programme (WCRP) Global Energy and Water Cycle Experiment (GEWEX) Radiation Panel, the SEAFLUX Project has been initiated to investigate producing a high-resolution satellite-based dataset of surface turbulent fluxes over the global oceans to complement the existing products for surface radiation fluxes and precipitation. The SEAFLUX Project includes the following elements: a library of in situ data, with collocated satellite data to be used in the evaluation and improvement of global flux products; organized intercom-parison projects, to evaluate and improve bulk flux models and determination from the satellite of the input parameters; and coordinated evaluation of the flux products in the context of applications, such as forcing ocean models and evaluation of coupled atmosphere–ocean models. The objective of this paper is to present an overview of the status of global ocean surface flux products, the methodology being used by SEAFLUX, and the prospects for improvement of satellite-derived flux products

Genus-Wide Comparative Genomics of Malassezia Delineates Its Phylogeny, Physiology, and Niche Adaptation on Human Skin

10.1371/journal.pgen.1005614PLoS Genetics1111e100561