Applying machine learning to predict future adherence to physical activity programs.

BackgroundIdentifying individuals who are unlikely to adhere to a physical exercise regime has potential to improve physical activity interventions. The aim of this paper is to develop and test adherence prediction models using objectively measured physical activity data in the Mobile Phone-Based Physical Activity Education program (mPED) trial. To the best of our knowledge, this is the first to apply Machine Learning methods to predict exercise relapse using accelerometer-recorded physical activity data.MethodsWe use logistic regression and support vector machine methods to design two versions of a Discontinuation Prediction Score (DiPS), which uses objectively measured past data (e.g., steps and goal achievement) to provide a numerical quantity indicating the likelihood of exercise relapse in the upcoming week. The respective prediction accuracy of these two versions of DiPS are compared, and then numerical simulation is performed to explore the potential of using DiPS to selectively allocate financial incentives to participants to encourage them to increase physical activity.Resultswe had access to a physical activity trial data that were continuously collected every 60 sec every day for 9 months in 210 participants. By using the first 15 weeks of data as training and test on weeks 16-30, we show that both versions of DiPS have a test AUC of 0.9 with high sensitivity and specificity in predicting the probability of exercise adherence. Simulation results assuming different intervention regimes suggest the potential benefit of using DiPS as a score to allocate resources in physical activity intervention programs in reducing costs over other allocation schemes.ConclusionsDiPS is capable of making accurate and robust predictions for future weeks. The most predictive features are steps and physical activity intensity. Furthermore, the use of DiPS scores can be a promising approach to determine when or if to provide just-in-time messages and step goal adjustments to improve compliance. Further studies on the use of DiPS in the design of physical activity promotion programs are warranted.Trial registrationClinicalTrials.gov NCT01280812 Registered on January 21, 2011

The mPED randomized controlled clinical trial: applying mobile persuasive technologies to increase physical activity in sedentary women protocol

<p>Abstract</p> <p>Background</p> <p>Despite the significant health benefits of regular physical activity, approximately half of American adults, particularly women and minorities, do not meet the current physical activity recommendations. Mobile phone technologies are readily available, easily accessible and may provide a potentially powerful tool for delivering physical activity interventions. However, we need to understand how to effectively apply these mobile technologies to increase and maintain physical activity in physically inactive women. The purpose of this paper is to describe the study design and protocol of the mPED (<b>m</b>obile phone based <b>p</b>hysical activity <b>ed</b>ucation) randomized controlled clinical trial that examines the efficacy of a 3-month mobile phone and pedometer based physical activity intervention and compares two different 6-month maintenance interventions.</p> <p>Methods</p> <p>A randomized controlled trial (RCT) with three arms; 1) PLUS (3-month mobile phone and pedometer based physical activity intervention and 6-month mobile phone diary maintenance intervention), 2) REGULAR (3-month mobile phone and pedometer based physical activity intervention and 6-month pedometer maintenance intervention), and 3) CONTROL (pedometer only, but no intervention will be conducted). A total of 192 physically inactive women who meet all inclusion criteria and successfully complete a 3-week run-in will be randomized into one of the three groups. The mobile phone serves as a means of delivering the physical activity intervention, setting individualized weekly physical activity goals, and providing self-monitoring (activity diary), immediate feedback and social support. The mobile phone also functions as a tool for communication and real-time data capture. The primary outcome is objectively measured physical activity.</p> <p>Discussion</p> <p>If efficacy of the intervention with a mobile phone is demonstrated, the results of this RCT will be able to provide new insights for current behavioral sciences and mHealth.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov#:<a href="http://www.clinicaltrials.gov/ct2/show/NCTO1280812">NCTO1280812</a></p

Using appropriate body mass index cut points for overweight and obesity among Asian Americans

Objective. Asian Americans have low prevalence of overweight/obesity based on standard BMI cut points yet have higher rates of diabetes. We examined the prevalence of overweight/obesity, using lower BMI cut points recommended by the World Health Organization (WHO) for Asians, and diabetes in Asian American subgroups in California. Method. were applied for other groups. Results. Among Asian subgroups, overweight/obesity was highest among Filipinos (78.6%), which was higher than NHWs (p b 0.001) but similar to African Americans and Hispanics. Compared to NHW, diabetes prevalence was higher for Vietnamese, Koreans, Filipinos and South Asians with BMI = 23-24.9 kg/m 2 and Koreans, Filipinos and Japanese with BMI = 27.5-29.9 kg/m 2 , the ranges WHO recommends as overweight or obese for Asians but not for other groups. Conclusions. Filipinos should be a priority population for overweight/obesity screening. Filipinos, Vietnamese, Korean, South Asians and Japanese have higher diabetes prevalence at lower BMI cut points. WHO Asian BMI cut points may have clinical utility to identify at-risk Asian Americans

長期間の多職種連携による離床

Early mobilization is an effective way to improve the physical function of critically ill patients, but there are numerous barriers to mobilization. One such is an early ward transfer. Mobilization is often insufficient in a ward, and the patient cannot be liberated from mechanical ventilation. We experienced a case of a successfully liberated patient from prolonged mechanical ventilation in long-term mobilization as orchestrated by a multidisciplinary team in the ICU. A ４５-year-old female was admitted to the ICU and placed on mechanical ventilation for acute respiratory distress syndrome（ARDS）. We deployed a mobilization protocol, which was mostly restricted to passive exercise in the first ２ weeks after admission. On day ３０, the patient recovered from unstable respiration, but could not be liberated from mechanical ventilation because of muscle weakness, diagnosed as ICU-acquired weakness. The patient was gradually mobilized and transferred to a chair on day ３５, and she was able to stand on day ５６. On day ６５, she was completely liberated from mechanical ventilation and discharged from the ICU ７０ days after her initial admission. Long-term mobilization is important for liberation of a patient from prolonged mechanical ventilation as well as early mobilization in the ICU

Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2010: General view of the pathogens\u27 antibacterial susceptibility

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from patients in Japan, was conducted by Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases and Japanese Society for Clinical Microbiology in 2010.The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period from January and April 2010 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical and Laboratory Standard Institutes using maximum 45 antibacterial agents.Susceptibility testing was evaluable with 954 strains (206 Staphylococcus aureus, 189 Streptococcus pneumoniae, 4 Streptococcus pyogenes, 182 Haemophilus influenzae, 74 Moraxella catarrhalis, 139 Klebsiella pneumoniae and 160 Pseudomonas aeruginosa). Ratio of methicillin-resistant S.aureus was as high as 50.5%, and those of penicillin-intermediate and -resistant S.pneumoniae were 1.1% and 0.0%, respectively. Among H.influenzae, 17.6% of them were found to be β-lactamase-non-producing ampicillin (ABPC)-intermediately resistant, 33.5% to be β-lactamase-non-producing ABPC-resistant and 11.0% to be β-lactamase-producing ABPC-resistant strains. Extended spectrum β-lactamase-producing K.pneumoniae and multi-drug resistant P.aeruginosa with metallo β-lactamase were 2.9% and 0.6%, respectively.Continuous national surveillance of antimicrobial susceptibility of respiratory pathogens is crucial in order to monitor changing patterns of susceptibility and to be able to update treatment recommendations on a regular basis