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Radhika Aditya Jadhav, Animesh Hazari, Ashma Monterio, Sampath Kumar, and Arun G. Maiya

Background:

Prediabetes is a strong risk factor for the development of Type2 Diabetes Mellitus (T2DM). Modification in lifestyle plays an important role to avoid the prognosis of T2DM and its complications in future. The aim of our study was to focus on the effectiveness of physical activity (PA) intervention program on different outcome measures in individuals with prediabetes. The effort of the present review was to contribute to the existing literature by strengthening the evidence pointing toward the positive impact of physical activity in individuals with prediabetes.

Methods:

Studies have been identified through database like PubMed, Scopus, and ProQuest. Randomized and nonrandomized controlled trials have been included. Nineteen articles have been selected for the qualitative analysis and 08 for meta-analysis.

Results:

PA intervention showed a favorable effect on improving oral glucose tolerance (Risk ratio [RR] –0.26, 95% CI –0.06 to 0.07) and fasting blood sugar (RR –0.05, 95% CI –0.14 to 0.04). It also showed the favorable effect on glycated hemoglobin (HbA1C), maximum oxygen uptake (VO2max), and body composition.

Conclusion:

Present review suggests that the PA promotion and participation can help to slow down the progression of disease in individuals with prediabetes and thus reduces the morbidity and mortality associated with T2DM.

Open access

Supun Nakandala, Marta M. Jankowska, Fatima Tuz-Zahra, John Bellettiere, Jordan A. Carlson, Andrea Z. LaCroix, Sheri J. Hartman, Dori E. Rosenberg, Jingjing Zou, Arun Kumar, and Loki Natarajan

Background: Machine learning has been used for classification of physical behavior bouts from hip-worn accelerometers; however, this research has been limited due to the challenges of directly observing and coding human behavior “in the wild.” Deep learning algorithms, such as convolutional neural networks (CNNs), may offer better representation of data than other machine learning algorithms without the need for engineered features and may be better suited to dealing with free-living data. The purpose of this study was to develop a modeling pipeline for evaluation of a CNN model on a free-living data set and compare CNN inputs and results with the commonly used machine learning random forest and logistic regression algorithms. Method: Twenty-eight free-living women wore an ActiGraph GT3X+ accelerometer on their right hip for 7 days. A concurrently worn thigh-mounted activPAL device captured ground truth activity labels. The authors evaluated logistic regression, random forest, and CNN models for classifying sitting, standing, and stepping bouts. The authors also assessed the benefit of performing feature engineering for this task. Results: The CNN classifier performed best (average balanced accuracy for bout classification of sitting, standing, and stepping was 84%) compared with the other methods (56% for logistic regression and 76% for random forest), even without performing any feature engineering. Conclusion: Using the recent advancements in deep neural networks, the authors showed that a CNN model can outperform other methods even without feature engineering. This has important implications for both the model’s ability to deal with the complexity of free-living data and its potential transferability to new populations.

Open access

John Bellettiere, Supun Nakandala, Fatima Tuz-Zahra, Elisabeth A.H. Winkler, Paul R. Hibbing, Genevieve N. Healy, David W. Dunstan, Neville Owen, Mikael Anne Greenwood-Hickman, Dori E. Rosenberg, Jingjing Zou, Jordan A. Carlson, Chongzhi Di, Lindsay W. Dillon, Marta M. Jankowska, Andrea Z. LaCroix, Nicola D. Ridgers, Rong Zablocki, Arun Kumar, and Loki Natarajan

Background: Hip-worn accelerometers are commonly used, but data processed using the 100 counts per minute cut point do not accurately measure sitting patterns. We developed and validated a model to accurately classify sitting and sitting patterns using hip-worn accelerometer data from a wide age range of older adults. Methods: Deep learning models were trained with 30-Hz triaxial hip-worn accelerometer data as inputs and activPAL sitting/nonsitting events as ground truth. Data from 981 adults aged 35–99 years from cohorts in two continents were used to train the model, which we call CHAP-Adult (Convolutional Neural Network Hip Accelerometer Posture-Adult). Validation was conducted among 419 randomly selected adults not included in model training. Results: Mean errors (activPAL − CHAP-Adult) and 95% limits of agreement were: sedentary time −10.5 (−63.0, 42.0) min/day, breaks in sedentary time 1.9 (−9.2, 12.9) breaks/day, mean bout duration −0.6 (−4.0, 2.7) min, usual bout duration −1.4 (−8.3, 5.4) min, alpha .00 (−.04, .04), and time in ≥30-min bouts −15.1 (−84.3, 54.1) min/day. Respective mean (and absolute) percent errors were: −2.0% (4.0%), −4.7% (12.2%), 4.1% (11.6%), −4.4% (9.6%), 0.0% (1.4%), and 5.4% (9.6%). Pearson’s correlations were: .96, .92, .86, .92, .78, and .96. Error was generally consistent across age, gender, and body mass index groups with the largest deviations observed for those with body mass index ≥30 kg/m2. Conclusions: Overall, these strong validation results indicate CHAP-Adult represents a significant advancement in the ambulatory measurement of sitting and sitting patterns using hip-worn accelerometers. Pending external validation, it could be widely applied to data from around the world to extend understanding of the epidemiology and health consequences of sitting.