Search

Physical activity (PA) is significantly associated with many health outcomes. The wide usage of wearable accelerometer-based activity trackers in recent years has provided a unique opportunity for in-depth research on PA and its relations with health outcomes and interventions. Past analysis of activity tracker data relies heavily on aggregating minute-level PA records into day-level summary statistics, in which important information of PA temporal/diurnal patterns is lost. In this paper we propose a novel functional data analysis approach based on Riemann manifolds for modeling PA and its longitudinal changes. We model smoothed minute-level PA of a day as one-dimensional Riemann manifolds and longitudinal changes in PA in different visits as deformations between manifolds. The variability in changes of PA among a cohort of subjects is characterized via variability in the deformation. Functional principal component analysis is further adopted to model the deformations and PC scores are used as a proxy in modeling the relation between changes in PA and health outcomes and/or interventions. We conduct comprehensive analyses on data from two clinical trials: Reach for Health (RfH) and Metabolism, Exercise and Nutrition at UCSD (MENU), focusing on the effect of interventions on longitudinal changes in PA patterns and how different modes of changes in PA influence weight loss, respectively. The proposed approach reveals unique modes of changes including overall enhanced PA, boosted morning PA, and shifts of active hours specific to each study cohort. The results bring new insights into the study of longitudinal changes in PA and health and have the potential to facilitate designing of effective health interventions and guidelines.

Cohort studies are increasingly using accelerometers for physical activity and sedentary behavior estimation. These devices tend to be less error-prone than self-report, can capture activity throughout the day, and are economical. However, previous methods for estimating sedentary behavior based on hip-worn data are often invalid or suboptimal under free-living situations and subject-to-subject variation. In this paper, we propose a local Markov switching model that takes this situation into account, and introduce a general procedure for posture classification and sedentary behavior analysis that fits the model naturally. Our method features changepoint detection methods in time series and also a two stage classification step that labels data into 3 classes(sitting, standing, stepping). Through a rigorous training-testing paradigm, we showed that our approach achieves > 80% accuracy. In addition, our method is robust and easy to interpret.

Currently in the United States, lungs are allocated to transplant candidates based on the Lung Allocation Score (LAS). The LAS is an empirically derived score aimed at increasing total life span pre- and post-transplantation, for patients on lung transplant waiting lists. The goal here is to develop efficient allocation strategies in the context of lung transplantation. In this study, patient and organ arrivals to the waiting list are modeled as independent homogeneous Poisson processes. Patients' health status prior to allocations are modeled as evolving according to independent and identically distributed finite-state inhomogeneous Markov processes, in which death is treated as an absorbing state. The expected post-transplantation residual life is modeled as depending on time on the waiting list and on current health status. For allocation strategies satisfying certain minimal fairness requirements, the long-term limit of expected average total life exists, and is used as the standard for comparing allocation strategies. Via the Hamilton-Jacobi-Bellman equations, upper bounds as a function of the ratio of organ arrival rate to the patient arrival rate for the long-term expected average total life are derived, and corresponding to each upper bound is an allocable set of (state, time) pairs at which patients would be optimally transplanted. As availability of organs increases, the allocable set expands monotonically, and ranking members of the waiting list according to the availability at which they enter the allocable set provides an allocation strategy that leads to long-term expected average total life close to the upper bound. Simulation studies are conducted with model parameters estimated from national lung transplantation data from United Network for Organ Sharing (UNOS). Results suggest that compared to the LAS, the proposed allocation strategy could provide a 7% increase in average total life.

Background Hip-worn accelerometer cut-points have poor validity for assessing children’s sedentary time, which may partly explain the equivocal health associations shown in prior research. Improved processing/classification methods for these monitors would enrich the evidence base and inform the development of more effective public health guidelines. The present study aimed to develop and evaluate a novel computational method (CHAP-child) for classifying sedentary time from hip-worn accelerometer data. Methods Participants were 278, 8–11-year-olds recruited from nine primary schools in Melbourne, Australia with differing socioeconomic status. Participants concurrently wore a thigh-worn activPAL (ground truth) and hip-worn ActiGraph (test measure) during up to 4 seasonal assessment periods, each lasting up to 8 days. activPAL data were used to train and evaluate the CHAP-child deep learning model to classify each 10-s epoch of raw ActiGraph acceleration data as sitting or non-sitting, creating comparable information from the two monitors. CHAP-child was evaluated alongside the current practice 100 counts per minute (cpm) method for hip-worn ActiGraph monitors. Performance was tested for each 10-s epoch and for participant-season level sedentary time and bout variables (e.g., mean bout duration). Results Across participant-seasons, CHAP-child correctly classified each epoch as sitting or non-sitting relative to activPAL, with mean balanced accuracy of 87.6% (SD = 5.3%). Sit-to-stand transitions were correctly classified with mean sensitivity of 76.3% (SD = 8.3). For most participant-season level variables, CHAP-child estimates were within ± 11% (mean absolute percent error [MAPE]) of activPAL, and correlations between CHAP-child and activPAL were generally very large (> 0.80). For the current practice 100 cpm method, most MAPEs were greater than ± 30% and most correlations were small or moderate (≤ 0.60) relative to activPAL. Conclusions There was strong support for the concurrent validity of the CHAP-child classification method, which allows researchers to derive activPAL-equivalent measures of sedentary time, sit-to-stand transitions, and sedentary bout patterns from hip-worn triaxial ActiGraph data. Applying CHAP-child to existing datasets may provide greater insights into the potential impacts and influences of sedentary time in children.