Early trials using mobile technology including text messaging and apps lack rigor and show mixed results
By Lucas Laursen
SMS messages in Africa provide reminders to patients to take antiretroviral drugs, reducing HIV virus counts. Image: Flickr/The Reboot
Health care via mobile technology is still in its infancy. Of 75 trials in which patients used mobile tech, such as text messaging and downloadable apps, to manage a disease or adopt healthier behaviors, only three showed reliable signs of success, according to a systematic survey. In an accompanying survey of medical personnel who used smart phones and other devices, to help deliver care, the same team found more success: 11 of 42 trials had positive, reliable results.
Yet mobile device-aided health care, called mHealth, attracts a lot of attention and dollars, as U.S. National Institutes of Health director Francis Collins wrote last year in Scientific American. In 2012 venture capital firms invested more than $900 million in mHealth, according to a report by Mobile Health Market News.
?There?s a lot of enthusiasm for [mHealth] but [its effectiveness] wasn?t very clear,? says epidemiologist Caroline Free of the London School of Hygiene and Tropical Medicine in England, the lead author of the reviews. In 2011, for example, the World Health Organization found that only 12 percent of mobile health initiatives included an evaluation.
So Free and colleagues conducted the reviews, which appear in PLoS Medicine, she says, to ?put us in the position of knowing exactly in which areas there was good evidence where the evidence was promising.? That information could help investors and researchers make better decisions about how to identify, improve and promote the best mobile health treatments.
In the first review, the team identified 334 relevant mHealth trials in seven medical databases. Most of the trials used text messaging to interact with patients, although some interacted through dedicated applications, downloadable audio and video or the Web. Only 75 of those trials included a control group, which allows researchers to compare experimental interventions with doing nothing.
Of the 75 controlled trials, 26 sought to change patient behavior by methods that included increasing exercise and 49 sought to help patients manage diseases medically such as by taking pills on time. That may not seem like many studies, but medical doctor Rahul Chakrabarti at Monash University in Australia, co-editor of the Journal of Mobile Technology in Medicine, calls it the most comprehensive meta-analysis of mHealth evidence to date.
The bad news is that most trials had weak designs, such as failing to randomize participants in the control group and the experimental group. Others relied on participants to self-report the results, but such methods can be unreliable. Free says such trials should use biochemical tests, instead. In some cases, it?s too early to tell whether a result, such as smaller waist size, would last long enough to improve participants? health. Most trials also neglected the developing world, where mobile phones have the most potential to improve access to health care. ?This does not undermine the outcomes,? Chakrabarti says, ?but shows that going forward, there is a clear need for improved methodology.?
There were a few promising, reliable trials: For instance, receiving text messages helped smokers quit in one trial that did verify its results with biochemical tests. Reminders also helped diabetics stick to their treatments in another trial. In the only successful developing-world trial, in Kenya, SMS reminders to take antiretroviral drugs helped reduce HIV virus counts.
BEIJING (AP) ? Personal computer maker Lenovo Group said Wednesday its quarterly profit rose 34 percent on strong sales of smartphones and tablet computers but warned this year's market will be tough.
The company, vying with Hewlett-Packard Co. to become the world's biggest PC maker, said it earned $205 million in the three months ending in December. Global revenue rose 12 percent to a record $9.4 billion.
The results reflected a rapid shift in global consumer tastes toward mobile services. That is forcing traditional technology leaders to scramble to roll out new products and diversify into services as well as hardware.
Sales by Lenovo's mobile and digital home unit soared 77 percent to $998 million, though that was only 11 percent of total revenue.
The company said its smartphone business in China was profitable for the first time and handsets were launched in India, Indonesia, Russia and other markets. Shipments of media tablets rose 77 percent.
"Lenovo has not only achieved record revenue, profit and global PC market share last quarter, but also our smartphone and tablet businesses have delivered hyper growth," said chairman Yang Yuanqing in a statement. "We are confident that we can win through differentiation and will be the innovation leader in the PC Plus era."
Revenues in the bigger but slower-growing PC market rose 7 percent to $7.9 billion.
Lenovo, which is based in Beijing and in Research Triangle Park, North Carolina, warned PC demand "remains challenging" due to weakening global economic conditions but said it plans to expand its cloud, services and other businesses.
In its home China market, PC shipments rose 2 percent, down from the previous quarter's 8 percent. Lenovo said that outpaced an industry-wide decline of 2 percent in China, raising its market share by 1.4 percentage points to a record 36.7 percent.
Shipments in the United States and the rest of North America rose 11 percent over a year earlier.
Lenovo released a new version of its ThinkPad notebook computer, the X1 Carbon, in August that it said was lighter and quicker to mimic the convenience of a tablet. Lenovo acquired the ThinkPad brand with IBM Corp.'s personal computer unit in 2005.
In this file photo running back Danny Woodhead of the New England Patriots fights off a tackle in the Super Bowl on Feb. 5, 2012. The game was the most watched television broadcast in U.S. history.
By John Roach, NBC News
As millions of Americans huddle around TVs with friends and family this Sunday to watch the Super Bowl, they?ll neglect their laundry, skip vacuuming the carpet and abandon just about anything else that requires electricity, according to a new study. As a result, energy usage will plummet.
During the 2012 Super Bowl, which ranked as the most watched television broadcast in U.S. history with 111.3 million viewers, energy usage dropped 5 percent in the Western U.S. and 3.8 percent in the East, energy consultancy Opower reported.?
Given all the TVs aglow at once ? which collectively consumed 11 million kilowatt hours of electricity during the game, equivalent to the amount of power generated by 10 medium-sized coal-fired power plants ? the finding seems counter intuitive, according to Barry Fischer, who conducted the analysis.
The drop in energy consumption is the result of "two related phenomena," he told NBC News.
"One is the fact that we are exclusively focusing our attention in one room, on one appliance, at the expense of doing other energy using activities. Number two is we are doing that exclusive activity together."
Energy usage does increase more than a typical midwinter Sunday in the hours prior to the game ? perhaps because people are busy in the kitchen cooking food to munch in front of the tube, and cleaning the house to get it ready for an onslaught of guests.
"But that slight blip upwards is more than offset by the dramatic decrease during the game," Fischer said.?
What?s more, that decrease holds when the game is over, probably because people stay glued to their couches, eyes glazed over and staring at the screen. In the West, where the game ends around dinnertime, people probably socialize for a few more hours instead of going home to do chores.
The study focused just on Sunday, so it?s possible people put off their chores to Monday, but for the big game, the act of getting together with family and friends to watch TV has the benefit of reducing overall energy use.
"While that might not solve the energy crisis, I think it?s an important concept to keep in mind," said Fischer, who plans to head to a Washington D.C. area bar to watch this year?s Super Bowl with friends.
A native of the San Francisco Bay Area, Fischer said he'll be rooting for the 49ers to beat the Baltimore Ravens, though he noted "that did not bias this analysis at all." To learn more about the study, read his blog post.?
?? via New York Times Green?
John Roach is a contributing writer for NBC News. To learn more about him, check out his website.
Aging brains show a weakening in brain waves associated with deep sleep (right) compared with younger adults (left), with consequent memory impairments.Image: Bryce Mander
Deterioration of a specific brain region impairs sleep quality as people age, leading to poorer memory retention, according to research published today in Nature Neuroscience.?
Aging is associated with the gradual loss of brain cells, sleep disturbances and declining memory function, but how these factors are related to each other has been unclear.
Neuroscientist Bryce Mander at the University of California, Berkeley, and his colleagues recruited 33 healthy adults ? 18 around the age of 20, and 15 ranging from late sixties to late seventies ? all with normal mental function, and asked them to memorize a list of word pairs.
The participants were asked to recall some of the word pairs ten minutes later, then left to sleep overnight while the researchers recorded the electrical activity of their brains. The next morning, volunteers were asked to recall selected words from the list again while having their brains scanned.
In keeping with earlier studies, the older adults performed less well than the younger ones on the memory test, and showed significant reductions in the slow brain waves associated with deep sleep.
The extent of deep-sleep disruption was related to the degree of memory impairment, with those exhibiting the least slow-wave activity performing the worst. These differences were also associated with a reduction of grey matter in a part of the brain called the medial prefrontal cortex.
?We?ve known for decades that sleep is disrupted in older adults, but we didn't know why,? says Mander. ?Our findings show that brain deterioration, bad memory and bad sleep are not independent, but instead are significantly interrelated.?
Memory waves It is well established that sleep strengthens newly formed memories, and slow brain waves are thought to enhance the transfer of information from the hippocampus, a brain structure that is crucial to memory formation, to other parts of the brain for long-term storage. ??
Mander and colleagues' findings suggest that deterioration of the medial prefrontal cortex diminishes the slow waves that occur during deep sleep. Consequently, the older participants were less able than the younger ones to solidify their memories of the word pairs.?
?This study provides valuable insight into the relationship between sleep and cognition,? says Roxanne Sterniczuk, a neurophysiologist at Dalhousie University in Halifax, Canada. However, she urges caution because the observed anatomical differences may be indicative of early neurodegeneration, rather than simply a natural loss of volume.
?The inability to examine the participants? brains for pathology is a major limitation,? she adds. ?It would be interesting to follow the older adults over time, or add a dementia group and compare the differences.?
Last year, Sterniczuk and her colleagues presented preliminary findings showing that sleep disturbances accurately predict a subsequent diagnosis of Alzheimer?s disease.
?Sleep disruption is even more pronounced in Alzheimer's,? says Mander, ?so a good next step will be to see if sleep disruption in these populations is associated with their memory symptoms. If so, targeting sleep may reduce some of their deficits.?
This article is reproduced with permission from the magazine Nature. The article was first published on January 27, 2013.
The saga of what steps that must be taken to deal with the evolving threat of Earth-circling orbital debris is a work in progress.? This menacing problem ? and the possible cleanup solutions ? is international in scope.
Space junk is an assortment of objects in Earth orbit that is a mix of everything from spent rocket stages, derelict satellites, chunks of busted up spacecraft to paint chips, springs and bolts. A satellite crash in February 2009, for example, marked the first accidental hypervelocity crash between two intact artificial satellites in Earth orbit. That cosmic crash created significant debris ? a worrisome amount of leftover bits and pieces.
Against this backdrop of untidiness in space and the global worry among spacefaring countries it causes, experts continue to tackle the issue of exactly what to do about orbital debris. A number of rules have been pondered to address the space debris problem, from regulations that attempt to cut down on the shedding of new debris to better tracking of the human-made refuge, as well as scavenging concepts including fishing nets, lasers and garbage scows.
But how to best characterize the orbital debris dilemma, and its future, also stirs up debate and heated dialogue.
Point of no return
The clutter in Earth orbit is a situation that will continue to worsen, according to Marshall Kaplan, founder and principal of Launchspace in Bethesda, Md.
"The problem is that we've already fallen off that cliff," Kaplan told SPACE.com. "That's the reality of it and people don't want to admit that reality." [Photos of Space Junk & Cleanup Ideas]
Spending millions of dollars to retrieve space junk isn't effective, Kaplan said.
Now, ways to better track and identify space debris are being devised. Low-Earth orbit is where the main problem is ? from roughly 435 miles (700 kilometers) to about 745 miles (1,200 km), he said.
"It's a serious, serious challenge," Kaplan said. "This is not a U.S. problem ? it's everybody's problem. And most of the people that produced the debris, the serious offenders, like Russia, China, and the United States, are not going to spend that kind of money. It's just not a good investment."
While the creation of orbiting junk continues rise with each rocket launch, there is no market for tackling the issue directly, Kaplan said.
"We've reached the point of no return. The debris will continue to get worse in terms of collision threats ? even if not another satellite were launched, the problem will continue to get worse," he added.
Speeding debris crashes
Kaplan said the frequency of collisions between active satellites and debris pieces is going to increase.
The real question, Kaplan said, is not what everyone is going to do about debris. Rather, the true question is what needs to be done about active satellites in harm's way of speeding riffraff.
"My prediction is that we are going to evacuate the areas of high debris density. It's just too dangerous to operate there. We're going to need to reinvent how we use space," Kaplan said. [Worst Space Debris Events of All Time]
In the case of large national security satellite assets, one option may be to distribute smaller satellites in lower altitudes, Kaplan added. These multiple layers of spacecraft would collectively create virtual products, such as imagery and other intelligence data. The users of this information would receive the same kind of data, but from a different satellite constellation, he said.
As one step toward that future, Kaplan is working with multiple universities to help establish new research centers on space debris and a next-generation national security space architecture.
Environmental stability
Darren McKnight, technical director for Integrity Applications Incorporated, headquartered in Chantilly, Va., suggested that the current debate on active debris removal and the evolution of the debris environment is still developing.
McKnight said that, currently, policymakers and engineers examine environmental stability, preventing the cascading of derelict collisions from increasing exponentially over the next century. This scenario, known as the "Kessler Syndrome," is the primary metric to judge how many derelicts need to be removed and when they should be removed.
The Kessler Syndrome is one in which the density of objects in low Earth orbit is high enough that collisions between objects could cause a cascade. Each collision generates space debris, which increases the likelihood of further collisions. [Solar Sails Could Sweep Up Space Junk (Video)]
"The overall issue is that as we continue to consider active debris removal options, I question whether or not environment stability is the only metric to be tracking," McKnight told SPACE.com.
Lethal space debris
McKnight, along with company colleague Frank Di Pentino, propose that the probability of satellite failure from impact from non-trackable, yet lethal debris fragments ? in the 5 millimeter to 10 centimeter size range ? is a more appropriate metric. The reason is because it directly reflects harmful effects of space debris on space operations. Furthermore, these effects are likely to occur much sooner than observable manifestations of the cascading effect.
McKnight and Di Pentino's research suggests that any mitigation scheme, be it just-in-time collision avoidance, active debris removal or other methods, cannot rely on a model that does not account for projected add rates, new launches on other factors. They contend that collision rate is ?not a sufficient metric? for assessing operational risk.
Wanted: A long-term plan
There is much work to do regarding orbital debris, said Donald Kessler, chair of the 2011 National Research Council (NRC) report "Limiting Future Collision Risk to Spacecraft: An Assessment of NASA's Meteoroid and Orbital Debris Programs." He is a retired head of NASA?s Orbital Debris Program Office and is a space debris and meteoroid consultant in Asheville, N.C.
Kessler said that the NRC committee that produced the report strongly felt that what was missing from the programs was a long-term strategic plan ? one that outlined a path that eventually determines how ?manage future space operations in a way that preserves the environment.
"However, this is not simply a NASA issue ? it is an international issue, and will require a carefully coordinated effort," Kessler said.
Can the space junk problem be solved?
NASA and the international community, Kessler said, "have already done enough research to know that the environment will continue to get worse if we continue on the same path ? the only environmental issue to be resolved is how quickly the environment in various regions deteriorates."
The international community, through the Inter-Agency Space Debris Coordination Committee (IADC), has been very active in understanding the current environmental trends, sharing information and establishing internationally recognized mitigation requirements.
However, Kessler said that current mitigation practices are insufficient, even with 100 percent compliance. Missing in action is a plan to determine what do about the predicted worsening space environment, he said ? that is, how to stop or reverse the trend of increased debris resulting from increased collisions.
Sustainable environment
Kessler added that the fundamental issues to be resolved are:
How do we minimize the possibility of future high-velocity collisions between spacecraft and upper stage rockets?
If we cannot eliminate that prospect, how do we clean up after a collision?
"Removal from orbit, collision avoidance, satellite servicing and repair, satellite recycling in orbit, debris storage locations, change to using a 'stable plane' at higher altitudes especially in Geosynchronous Earth Orbit (GEO) ? are all possibilities," Kessler added. "Some are mutually exclusive and may not be appropriate at all altitudes, while others could combine to be more effective."
Still to be sorted out is what type of legal structure might be needed in order to implement any plan, Kessler said.
"I believe it is time that the international community takes a serious look at the future of space operations," Kessler said. "There's need to begin a process to answer these questions and determine which path will most effectively provide a sustainable environment for spacecraft in Earth orbit."
Leonard David has been reporting on the space industry for more than five decades. He is former director of research for the National Commission on Space and a past editor-in-chief of the National Space Society's Ad Astra and Space World magazines. He has written for SPACE.com since 1999.
Copyright 2013 SPACE.com, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Foursquare launched a new app on Tuesday morning, the company?s second standalone application, and the first aimed squarely at the business side of the market.
The app is an extension of Foursquare?s additions to its merchant tools updates from mid-2012, which allowed business owners to better control special offers to nearby customers using a more robust desktop dashboard.
One problem with that, said Foursquare: If you?re a small outfit, running around your store helping customers willy-nilly, you may not have the time to run back to your computer and update customers with your latest happenings, like turning time-sensitive specials on and off, or pushing those items directly to Facebook and Twitter.
Not sure I buy that argument entirely; if I were running around my shop, I would think I?d type faster on a big keyboard than the smaller one on my smartphone. Still, if I?m out of the shop and on the town, I could see it being a convenient way of pushing out specials to my Foursquare account.
The new app comes at a time when Foursquare faces questions about the long-term sustainability of its business, as it has pivoted to a more discovery-focused model. As it happens, the startup now faces more competition in the space, as Yelp already handles many local discovery queries, and Facebook?s Graph Search seems to push into the discovery space.
Of note: The new app is aimed solely at local business owners, not the major retailers looking to update their specials across an entire chain ? those folks still need to update via the desktop.
Head over to the App Store or Google Play to download the new app.
Contact: Karen N. Peart karen.peart@yale.edu 203-432-1326 Yale University
New Haven, Conn. In a major breakthrough for uterine serous carcinoma (USC) a chemo-resistant, aggressive form of endometrial cancer, Yale researchers have defined the genetic landscape of USC tumors, findings that point to new treatment opportunities.
The collaborative teamwhich included researchers with expertise in gynecological cancer, genomics, and computational biology identified a number of new genes that are frequently mutated in USC. The results of this comprehensive genetic analysis of USC are published in the Jan. 28 Proceedings of the National Academy of Sciences (PNAS) online early edition. The researchers were supported as part of a collaborative program with Gilead Sciences, Inc.
Endometrial cancer is the most prevalent gynecologic tumor in women, with over 47,000 newly diagnosed cases and about 8,000 deaths in 2012 in the United States alone. Patients with type I endometrial cancer tumors generally have a good outcome, but those with type II, or USC, have more relapses and deaths, and the disease is more aggressive.
"We have clearly identified the mutations that are responsible for USC tumors," said senior author of the study Alessandro Santin, M.D., professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, and program leader of the gynecological cancers program at Smilow Cancer Hospital at Yale-New Haven and a member of Yale Cancer Center. "In addition to a number of well-known cancer genes, we found three genes that had not previously been associated with cancer that are found in these tumors. This finding points to new pathways that could be important in developing therapies down the road."
The team collected tumors from 57 women affected with USC to try to determine the molecular basis of the tumor's aggressive behavior. They sequenced all the genes from the tumors and identified mutations that are crucial for these tumors to grow. The team also studied the copy number variationsgenes that are not mutated but are amplified in the tumors to give them a growth advantage over normal tissues.
The newly-identified cancer-related genes included two CHD4 and MBD3 that are found in the same protein complex and play a role in remodeling the genome to allow certain regions to be turned on and off. The discovery of a third gene, TAF1, was a surprise to researchers because it is a core component of the machinery responsible for transcribing a large fraction of the protein coding genes in the human genome.
"The detailed study of different cancers continues to produce new and unexpected discoveries," said corresponding author Richard P. Lifton, M.D., Sterling Professor, chair of genetics at Yale, and a Howard Hughes Medical Institute investigator. "These new findings define the biological basis of this cancer, and suggest new opportunities for personalized therapy."
###
Other authors on the study include first author Siming Zhao, Murim Choi, John D. Overton, Stefania Bellone, Dana M. Roque, Emiliano Cocco, Federica Guzzo, Diana P. English, Joyce Varughese, Sara Gasparrini, Ileana Bortolomai, Natalia Buza, Pei Hui, Maysa Abu-Khalaf, Antonella Ravaggi, Eliana Bignotti, Elisabetta Bandiera, Chiara Romani, Paola Todeschini, Renata Tassi, Laura Zanotti, Luisa Carrara, Sergio Pecorelli, Dan-Arin Silasi, Elena Ratner, Masoud Azodi, Peter E. Schwartz, Thomas J. Rutherford, Amy L. Stiegler, Shrikant Mane, Titus J. Boggon, and Joseph Schlessinger.
In addition to Gilead, the study was funded in part by grants from the National Institutes of Health, the National Cancer Institute, and the Howard Hughes Medical Institute.
Citation: PNAS doi/10.1073/pnas.1222577110
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Contact: Karen N. Peart karen.peart@yale.edu 203-432-1326 Yale University
New Haven, Conn. In a major breakthrough for uterine serous carcinoma (USC) a chemo-resistant, aggressive form of endometrial cancer, Yale researchers have defined the genetic landscape of USC tumors, findings that point to new treatment opportunities.
The collaborative teamwhich included researchers with expertise in gynecological cancer, genomics, and computational biology identified a number of new genes that are frequently mutated in USC. The results of this comprehensive genetic analysis of USC are published in the Jan. 28 Proceedings of the National Academy of Sciences (PNAS) online early edition. The researchers were supported as part of a collaborative program with Gilead Sciences, Inc.
Endometrial cancer is the most prevalent gynecologic tumor in women, with over 47,000 newly diagnosed cases and about 8,000 deaths in 2012 in the United States alone. Patients with type I endometrial cancer tumors generally have a good outcome, but those with type II, or USC, have more relapses and deaths, and the disease is more aggressive.
"We have clearly identified the mutations that are responsible for USC tumors," said senior author of the study Alessandro Santin, M.D., professor of obstetrics, gynecology and reproductive sciences at Yale School of Medicine, and program leader of the gynecological cancers program at Smilow Cancer Hospital at Yale-New Haven and a member of Yale Cancer Center. "In addition to a number of well-known cancer genes, we found three genes that had not previously been associated with cancer that are found in these tumors. This finding points to new pathways that could be important in developing therapies down the road."
The team collected tumors from 57 women affected with USC to try to determine the molecular basis of the tumor's aggressive behavior. They sequenced all the genes from the tumors and identified mutations that are crucial for these tumors to grow. The team also studied the copy number variationsgenes that are not mutated but are amplified in the tumors to give them a growth advantage over normal tissues.
The newly-identified cancer-related genes included two CHD4 and MBD3 that are found in the same protein complex and play a role in remodeling the genome to allow certain regions to be turned on and off. The discovery of a third gene, TAF1, was a surprise to researchers because it is a core component of the machinery responsible for transcribing a large fraction of the protein coding genes in the human genome.
"The detailed study of different cancers continues to produce new and unexpected discoveries," said corresponding author Richard P. Lifton, M.D., Sterling Professor, chair of genetics at Yale, and a Howard Hughes Medical Institute investigator. "These new findings define the biological basis of this cancer, and suggest new opportunities for personalized therapy."
###
Other authors on the study include first author Siming Zhao, Murim Choi, John D. Overton, Stefania Bellone, Dana M. Roque, Emiliano Cocco, Federica Guzzo, Diana P. English, Joyce Varughese, Sara Gasparrini, Ileana Bortolomai, Natalia Buza, Pei Hui, Maysa Abu-Khalaf, Antonella Ravaggi, Eliana Bignotti, Elisabetta Bandiera, Chiara Romani, Paola Todeschini, Renata Tassi, Laura Zanotti, Luisa Carrara, Sergio Pecorelli, Dan-Arin Silasi, Elena Ratner, Masoud Azodi, Peter E. Schwartz, Thomas J. Rutherford, Amy L. Stiegler, Shrikant Mane, Titus J. Boggon, and Joseph Schlessinger.
In addition to Gilead, the study was funded in part by grants from the National Institutes of Health, the National Cancer Institute, and the Howard Hughes Medical Institute.
Citation: PNAS doi/10.1073/pnas.1222577110
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Foursquare launched a new app on Tuesday morning, the company?s second standalone application, and the first aimed squarely at the business side of the market.![[ Back to EurekAlert! ]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_tDZgG7HiKg07af1hEhH-PEsqQe0zaozakGFdFxMlS04n-s-yi4iNRUzptk3RncS32LJJwGeYeaMBoMKigAMDnx9lNMO3_iq2AEtNLwWM8=s0-d){kind=small}
Public release date: 28-Jan-2013
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