Publications
Search
1.
Saxon, Leslie; Faulk, Robert T; Boberg, Jill; Barrett, Trevor; McLelland, Steve
In: J. Spec. Oper. Med., 2024, ISSN: 1553-9768.
@article{saxon_continuous_2024,
title = {Continuous Assessment of Active-Duty Army Special Operations and Reconnaissance Marines Using Digital Devices and Custom Software: The Digital Comprehensive Operator Readiness Assessment (DcORA) Study},
author = {Leslie Saxon and Robert T Faulk and Jill Boberg and Trevor Barrett and Steve McLelland},
url = {https://www.jsomonline.org/Citations/PXKK-I23D.php},
doi = {10.55460/PXKK-I23D},
issn = {1553-9768},
year = {2024},
date = {2024-06-01},
urldate = {2024-06-25},
journal = {J. Spec. Oper. Med.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2.
Saxon, Leslie; Boberg, Jill; Faulk, Robert; Barrett, Trevor
Identifying relationships between compression garments and recovery in a military training environment Technical Report
In Review 2023.
@techreport{saxon_identifying_2023,
title = {Identifying relationships between compression garments and recovery in a military training environment},
author = {Leslie Saxon and Jill Boberg and Robert Faulk and Trevor Barrett},
url = {https://www.researchsquare.com/article/rs-3193173/v1},
doi = {10.21203/rs.3.rs-3193173/v1},
year = {2023},
date = {2023-07-01},
urldate = {2023-09-21},
institution = {In Review},
abstract = {Abstract
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.},
keywords = {},
pubstate = {published},
tppubtype = {techreport}
}
Abstract
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.
3.
Barrett, Trevor J.; Sobhani, Mona; Fox, Glenn R.; Files, Benjamin; Patitsas, Nicholas; Duhaime, Josiah; Ebert, Rebecca; Faulk, Rob; Saxon, Leslie
Diverse predictors of early attrition in an elite Marine training school Journal Article
In: Military Psychology, vol. 34, no. 4, pp. 388–397, 2022, ISSN: 0899-5605, 1532-7876.
@article{barrett_diverse_2022,
title = {Diverse predictors of early attrition in an elite Marine training school},
author = {Trevor J. Barrett and Mona Sobhani and Glenn R. Fox and Benjamin Files and Nicholas Patitsas and Josiah Duhaime and Rebecca Ebert and Rob Faulk and Leslie Saxon},
url = {https://www.tandfonline.com/doi/full/10.1080/08995605.2021.1993721},
doi = {10.1080/08995605.2021.1993721},
issn = {0899-5605, 1532-7876},
year = {2022},
date = {2022-07-01},
urldate = {2022-09-27},
journal = {Military Psychology},
volume = {34},
number = {4},
pages = {388–397},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
4.
Cleland, John G. F.; Bristow, Michael R.; Freemantle, Nicholas; Olshansky, Brian; Gras, Daniel; Saxon, Leslie; Tavazzi, Luigi; Boehmer, John; Ghio, Stefano; Feldman, Arthur M.; Daubert, Jean‐Claude; Mets, David
In: European J of Heart Fail, vol. 24, no. 6, pp. 1080–1090, 2022, ISSN: 1388-9842, 1879-0844.
@article{cleland_effect_2022,
title = {The effect of cardiac resynchronization without a defibrillator on morbidity and mortality: an individual patient data meta‐analysis of companion and care-hf},
author = {John G. F. Cleland and Michael R. Bristow and Nicholas Freemantle and Brian Olshansky and Daniel Gras and Leslie Saxon and Luigi Tavazzi and John Boehmer and Stefano Ghio and Arthur M. Feldman and Jean‐Claude Daubert and David Mets},
url = {https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2524},
doi = {10.1002/ejhf.2524},
issn = {1388-9842, 1879-0844},
year = {2022},
date = {2022-06-01},
urldate = {2022-09-27},
journal = {European J of Heart Fail},
volume = {24},
number = {6},
pages = {1080–1090},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
5.
Saxon, Leslie; Faulk, Robert T; Barrett, Travor; McLelland, Steve; Boberg, Jill
A Novel Digital Research Methodology for Continuous Health Assessment of the Special Operations Warfighter: The Digital cORA Study Journal Article
In: J. Spec. Oper. Med., vol. 22, no. 4, pp. 78, 2022, ISSN: 1553-9768.
@article{saxon_novel_2022,
title = {A Novel Digital Research Methodology for Continuous Health Assessment of the Special Operations Warfighter: The Digital cORA Study},
author = {Leslie Saxon and Robert T Faulk and Travor Barrett and Steve McLelland and Jill Boberg},
url = {https://www.jsomonline.org/Citations/4SSJ-AHIB.php},
doi = {10.55460/4SSJ-AHIB},
issn = {1553-9768},
year = {2022},
date = {2022-01-01},
urldate = {2023-03-31},
journal = {J. Spec. Oper. Med.},
volume = {22},
number = {4},
pages = {78},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
6.
We've Entered a New Era of Streaming Health Care. Now What? Journal Article
In: IEEE Spectrum, 2021.
@article{noauthor_weve_2021,
title = {We've Entered a New Era of Streaming Health Care. Now What?},
url = {https://spectrum.ieee.org/digital-health},
year = {2021},
date = {2021-11-01},
urldate = {2022-09-29},
journal = {IEEE Spectrum},
abstract = {COVID-19 forced the transition to digital medicine, but there's much still to do.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
COVID-19 forced the transition to digital medicine, but there's much still to do.
7.
Ghasem, Wesley; Valenzuela, Joshua; Saxon, Leslie A.
Player Tracking Technology and Data for Injury Prevention in the National Football League Journal Article
In: Curr Sports Med Rep, vol. 20, no. 9, pp. 436–439, 2021, ISSN: 1537-8918.
@article{ghasem_player_2021,
title = {Player Tracking Technology and Data for Injury Prevention in the National Football League},
author = {Wesley Ghasem and Joshua Valenzuela and Leslie A. Saxon},
url = {https://journals.lww.com/10.1249/JSR.0000000000000873},
doi = {10.1249/JSR.0000000000000873},
issn = {1537-8918},
year = {2021},
date = {2021-09-01},
urldate = {2022-09-28},
journal = {Curr Sports Med Rep},
volume = {20},
number = {9},
pages = {436–439},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
8.
Nikolovski, Janeta; Koldijk, Martin; Weverling, Gerrit Jan; Spertus, John; Turakhia, Mintu; Saxon, Leslie; Gibson, Mike; Whang, John; Sarich, Troy; Zambon, Robert; Ezeanochie, Nnamdi; Turgiss, Jennifer; Jones, Robyn; Stoddard, Jeff; Burton, Paul; Navar, Ann Marie
Factors indicating intention to vaccinate with a COVID-19 vaccine among older UṠ. adults Journal Article
In: PLOS ONE, vol. 16, no. 5, pp. e0251963, 2021, ISSN: 1932-6203, (Publisher: Public Library of Science).
@article{nikolovski_factors_2021,
title = {Factors indicating intention to vaccinate with a COVID-19 vaccine among older UṠ. adults},
author = {Janeta Nikolovski and Martin Koldijk and Gerrit Jan Weverling and John Spertus and Mintu Turakhia and Leslie Saxon and Mike Gibson and John Whang and Troy Sarich and Robert Zambon and Nnamdi Ezeanochie and Jennifer Turgiss and Robyn Jones and Jeff Stoddard and Paul Burton and Ann Marie Navar},
url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251963},
doi = {10.1371/journal.pone.0251963},
issn = {1932-6203},
year = {2021},
date = {2021-05-01},
urldate = {2023-03-31},
journal = {PLOS ONE},
volume = {16},
number = {5},
pages = {e0251963},
abstract = {Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.},
note = {Publisher: Public Library of Science},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.
9.
Miller, Jennifer C.; Skoll, Devin; Saxon, Leslie A.
Home Monitoring of Cardiac Devices in the Era of COVID-19 Journal Article
In: Curr Cardiol Rep, vol. 23, no. 1, pp. 1, 2020, ISSN: 1534-3170.
@article{miller_home_2020,
title = {Home Monitoring of Cardiac Devices in the Era of COVID-19},
author = {Jennifer C. Miller and Devin Skoll and Leslie A. Saxon},
url = {https://doi.org/10.1007/s11886-020-01431-w},
doi = {10.1007/s11886-020-01431-w},
issn = {1534-3170},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Curr Cardiol Rep},
volume = {23},
number = {1},
pages = {1},
abstract = {Despite the promise of remote patient monitoring (RPM), this technology remained underutilized secondary to a lack of data transparency and systems issues until the COVID-19 pandemic ushered in a new era of telehealth and virtual solutions out of necessity. This review will explore the data supporting the use of RPM via both implantable and wearable devices in the field of cardiology and the role of home monitoring using RPM in the era of COVID-19.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Despite the promise of remote patient monitoring (RPM), this technology remained underutilized secondary to a lack of data transparency and systems issues until the COVID-19 pandemic ushered in a new era of telehealth and virtual solutions out of necessity. This review will explore the data supporting the use of RPM via both implantable and wearable devices in the field of cardiology and the role of home monitoring using RPM in the era of COVID-19.
10.
Miller, Jennifer C; Barrett, Trevor; Patel, Neil; Souza, Andrew; Wood, John; Saxon, Leslie A
In: Circulation, vol. 142, no. Suppl_3, pp. A15845–A15845, 2020, (Publisher: American Heart Association).
@article{miller_heart_2020,
title = {Heart Heroes: A Gamified Mhealth Platform to Measure Continuous Cardiac Health Data in the Outpatient Setting of Adolescent Patients With Known and Suspected Heart Disease},
author = {Jennifer C Miller and Trevor Barrett and Neil Patel and Andrew Souza and John Wood and Leslie A Saxon},
url = {https://www.ahajournals.org/doi/abs/10.1161/circ.142.suppl_3.15845},
doi = {10.1161/circ.142.suppl_3.15845},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Circulation},
volume = {142},
number = {Suppl_3},
pages = {A15845–A15845},
abstract = {Introduction: Adolescents with heart disease report difficulty in communication about their health as a major inhibiting factor in their care. MHealth technologies collect health data in daily life and enable health data sharing between the provider and patient. The adolescent population has a high level of engagement with mobile devices and a willingness to use them for health-related activities.
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure},
note = {Publisher: American Heart Association},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Introduction: Adolescents with heart disease report difficulty in communication about their health as a major inhibiting factor in their care. MHealth technologies collect health data in daily life and enable health data sharing between the provider and patient. The adolescent population has a high level of engagement with mobile devices and a willingness to use them for health-related activities.
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure
11.
Skoll, Devin; Miller, Jennifer C.; Saxon, Leslie A.
COVID-19 testing and infection surveillance: Is a combined digital contact-tracing and mass-testing solution feasible in the United States? Journal Article
In: Cardiovascular Digital Health Journal, vol. 1, no. 3, pp. 149–159, 2020, ISSN: 2666-6936.
@article{skoll_covid-19_2020,
title = {COVID-19 testing and infection surveillance: Is a combined digital contact-tracing and mass-testing solution feasible in the United States?},
author = {Devin Skoll and Jennifer C. Miller and Leslie A. Saxon},
url = {https://www.sciencedirect.com/science/article/pii/S2666693620300360},
doi = {10.1016/j.cvdhj.2020.09.004},
issn = {2666-6936},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Cardiovascular Digital Health Journal},
volume = {1},
number = {3},
pages = {149–159},
abstract = {Background
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.
12.
Saxon, Leslie A.; Varma, Niraj; Epstein, Laurence M.; Ganz, Leonard I.; Epstein, Andrew E.
Rates of Adoption and Outcomes After Firmware Updates for Food and Drug Administration Cybersecurity Safety Advisories Journal Article
In: Circulation: Arrhythmia and Electrophysiology, vol. 13, no. 8, pp. e008364, 2020, (Publisher: American Heart Association).
@article{saxon_rates_2020,
title = {Rates of Adoption and Outcomes After Firmware Updates for Food and Drug Administration Cybersecurity Safety Advisories},
author = {Leslie A. Saxon and Niraj Varma and Laurence M. Epstein and Leonard I. Ganz and Andrew E. Epstein},
url = {https://www.ahajournals.org/doi/full/10.1161/CIRCEP.120.008364},
doi = {10.1161/CIRCEP.120.008364},
year = {2020},
date = {2020-08-01},
urldate = {2023-03-31},
journal = {Circulation: Arrhythmia and Electrophysiology},
volume = {13},
number = {8},
pages = {e008364},
note = {Publisher: American Heart Association},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
13.
Saxon, Leslie; DiPaula, Brooks; Fox, Glenn R; Ebert, Rebecca; Duhaime, Josiah; Nocera, Luciano; Tran, Luan; Sobhani, Mona
Continuous Measurement of Reconnaissance Marines in Training With Custom Smartphone App and Watch: Observational Cohort Study Journal Article
In: JMIR mHealth and uHealth, vol. 8, no. 6, pp. e14116, 2020, ISSN: 2291-5222.
@article{saxon_continuous_2020,
title = {Continuous Measurement of Reconnaissance Marines in Training With Custom Smartphone App and Watch: Observational Cohort Study},
author = {Leslie Saxon and Brooks DiPaula and Glenn R Fox and Rebecca Ebert and Josiah Duhaime and Luciano Nocera and Luan Tran and Mona Sobhani},
url = {https://mhealth.jmir.org/2020/6/e14116},
doi = {10.2196/14116},
issn = {2291-5222},
year = {2020},
date = {2020-06-01},
journal = {JMIR mHealth and uHealth},
volume = {8},
number = {6},
pages = {e14116},
abstract = {Background: Specialized training for elite US military units is associated with high attrition due to intense psychological and physical demands. The need to graduate more service members without degrading performance standards necessitates the identification of factors to predict success or failure in targeted training interventions. Objective: The aim of this study was to continuously quantify the mental and physical status of trainees of an elite military unit to identify novel predictors of success in training. Methods: A total of 3 consecutive classes of a specialized training course were provided with an Apple iPhone, Watch, and specially designed mobile app. Baseline personality assessments and continuous daily measures of mental status, physical pain, heart rate, activity, sleep, hydration, and nutrition were collected from the app and Watch data. Results: A total of 115 trainees enrolled and completed the study (100% male; age: mean 22 years, SD 4 years) and 64 (55.7%) successfully graduated. Most training withdrawals (27/115, 23.5%) occurred by day 7 (mean 5.5 days, SD 3.4 days; range 1-22 days). Extraversion, positive affect personality traits, and daily psychological profiles were associated with course completion; key psychological factors could predict withdrawals 1-2 days in advance (P=.009). Conclusions: Gathering accurate and continuous mental and physical status data during elite military training is possible with early predictors of withdrawal providing an opportunity for intervention.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: Specialized training for elite US military units is associated with high attrition due to intense psychological and physical demands. The need to graduate more service members without degrading performance standards necessitates the identification of factors to predict success or failure in targeted training interventions. Objective: The aim of this study was to continuously quantify the mental and physical status of trainees of an elite military unit to identify novel predictors of success in training. Methods: A total of 3 consecutive classes of a specialized training course were provided with an Apple iPhone, Watch, and specially designed mobile app. Baseline personality assessments and continuous daily measures of mental status, physical pain, heart rate, activity, sleep, hydration, and nutrition were collected from the app and Watch data. Results: A total of 115 trainees enrolled and completed the study (100% male; age: mean 22 years, SD 4 years) and 64 (55.7%) successfully graduated. Most training withdrawals (27/115, 23.5%) occurred by day 7 (mean 5.5 days, SD 3.4 days; range 1-22 days). Extraversion, positive affect personality traits, and daily psychological profiles were associated with course completion; key psychological factors could predict withdrawals 1-2 days in advance (P=.009). Conclusions: Gathering accurate and continuous mental and physical status data during elite military training is possible with early predictors of withdrawal providing an opportunity for intervention.
14.
Slotwiner, David J.; Tarakji, Khaldoun G.; Al-Khatib, Sana M.; Passman, Rod S.; Saxon, Leslie A.; Peters, Nicholas S.; McCall, Debbe; Turakhia, Mintu P.; Schaeffer, Jill; Mendenhall, G. Stuart; Hindricks, Gerhard; Narayan, Sanjiv M.; Davenport, Elizabeth E.; Marrouche, Nassir F.
Transparent sharing of digital health data: A call to action Journal Article
In: Heart Rhythm, vol. 16, no. 9, pp. e95–e106, 2019, ISSN: 1547-5271, 1556-3871, (Publisher: Elsevier).
@article{slotwiner_transparent_2019,
title = {Transparent sharing of digital health data: A call to action},
author = {David J. Slotwiner and Khaldoun G. Tarakji and Sana M. Al-Khatib and Rod S. Passman and Leslie A. Saxon and Nicholas S. Peters and Debbe McCall and Mintu P. Turakhia and Jill Schaeffer and G. Stuart Mendenhall and Gerhard Hindricks and Sanjiv M. Narayan and Elizabeth E. Davenport and Nassir F. Marrouche},
url = {https://www.heartrhythmjournal.com/article/S1547-5271(19)30371-6/fulltext#%20},
doi = {10.1016/j.hrthm.2019.04.042},
issn = {1547-5271, 1556-3871},
year = {2019},
date = {2019-09-01},
urldate = {2023-03-31},
journal = {Heart Rhythm},
volume = {16},
number = {9},
pages = {e95–e106},
note = {Publisher: Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Filter
2024
Saxon, Leslie; Faulk, Robert T; Boberg, Jill; Barrett, Trevor; McLelland, Steve
In: J. Spec. Oper. Med., 2024, ISSN: 1553-9768.
Links | BibTeX | Tags: CBC, DTIC
@article{saxon_continuous_2024,
title = {Continuous Assessment of Active-Duty Army Special Operations and Reconnaissance Marines Using Digital Devices and Custom Software: The Digital Comprehensive Operator Readiness Assessment (DcORA) Study},
author = {Leslie Saxon and Robert T Faulk and Jill Boberg and Trevor Barrett and Steve McLelland},
url = {https://www.jsomonline.org/Citations/PXKK-I23D.php},
doi = {10.55460/PXKK-I23D},
issn = {1553-9768},
year = {2024},
date = {2024-06-01},
urldate = {2024-06-25},
journal = {J. Spec. Oper. Med.},
keywords = {CBC, DTIC},
pubstate = {published},
tppubtype = {article}
}
2023
Saxon, Leslie; Boberg, Jill; Faulk, Robert; Barrett, Trevor
Identifying relationships between compression garments and recovery in a military training environment Technical Report
In Review 2023.
Abstract | Links | BibTeX | Tags: CBC, DTIC, UARC
@techreport{saxon_identifying_2023,
title = {Identifying relationships between compression garments and recovery in a military training environment},
author = {Leslie Saxon and Jill Boberg and Robert Faulk and Trevor Barrett},
url = {https://www.researchsquare.com/article/rs-3193173/v1},
doi = {10.21203/rs.3.rs-3193173/v1},
year = {2023},
date = {2023-07-01},
urldate = {2023-09-21},
institution = {In Review},
abstract = {Abstract
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.},
keywords = {CBC, DTIC, UARC},
pubstate = {published},
tppubtype = {techreport}
}
Abstract
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.
Development and maintenance of physical capabilities is an essential part of combat readiness in the military. This readiness requires continuous training and is therefore compromised by injury. Because Service Members (SMs) must be physically and cognitively prepared to conduct multifaceted operations in support of strategic objectives, and because the Department of Defense’s (DoD) non-deployable rate and annual costs associated with treating SMs continue to rise at an alarming rate, finding a far-reaching and efficient solution to prevent such injuries is a high priority. Compression garments (CGs) have become increasingly popular over the past decade in human performance applications, and reportedly facilitate post-exercise recovery by reducing muscle soreness, increasing blood lactate removal, and increasing perception of recovery, but the evidence is mixed, at best. In the current study we explored whether CG use, and duration of use, improves recovery and mitigates muscle soreness effectively in an elite Marine training course. In order to test this, we subjected Service Members to fatiguing exercise and then measured subjective and objective recovery and soreness using participant reports and grip and leg strength over a 72-hour recovery period. Findings from this study suggest that wearing CGs for post training recovery showed significant and moderate positive effects on subjective soreness, fatigue, and perceived level of recovery. We did not find statistically significant effects on physical performance while testing grip or leg strength. These findings suggest that CG may be a beneficial strategy for military training environments to accelerate muscle recovery after high-intensity exercise, without adverse effects to the wearer or negative impact on military training.
2022
Barrett, Trevor J.; Sobhani, Mona; Fox, Glenn R.; Files, Benjamin; Patitsas, Nicholas; Duhaime, Josiah; Ebert, Rebecca; Faulk, Rob; Saxon, Leslie
Diverse predictors of early attrition in an elite Marine training school Journal Article
In: Military Psychology, vol. 34, no. 4, pp. 388–397, 2022, ISSN: 0899-5605, 1532-7876.
Links | BibTeX | Tags: CBC, DTIC
@article{barrett_diverse_2022,
title = {Diverse predictors of early attrition in an elite Marine training school},
author = {Trevor J. Barrett and Mona Sobhani and Glenn R. Fox and Benjamin Files and Nicholas Patitsas and Josiah Duhaime and Rebecca Ebert and Rob Faulk and Leslie Saxon},
url = {https://www.tandfonline.com/doi/full/10.1080/08995605.2021.1993721},
doi = {10.1080/08995605.2021.1993721},
issn = {0899-5605, 1532-7876},
year = {2022},
date = {2022-07-01},
urldate = {2022-09-27},
journal = {Military Psychology},
volume = {34},
number = {4},
pages = {388–397},
keywords = {CBC, DTIC},
pubstate = {published},
tppubtype = {article}
}
Cleland, John G. F.; Bristow, Michael R.; Freemantle, Nicholas; Olshansky, Brian; Gras, Daniel; Saxon, Leslie; Tavazzi, Luigi; Boehmer, John; Ghio, Stefano; Feldman, Arthur M.; Daubert, Jean‐Claude; Mets, David
In: European J of Heart Fail, vol. 24, no. 6, pp. 1080–1090, 2022, ISSN: 1388-9842, 1879-0844.
@article{cleland_effect_2022,
title = {The effect of cardiac resynchronization without a defibrillator on morbidity and mortality: an individual patient data meta‐analysis of companion and care-hf},
author = {John G. F. Cleland and Michael R. Bristow and Nicholas Freemantle and Brian Olshansky and Daniel Gras and Leslie Saxon and Luigi Tavazzi and John Boehmer and Stefano Ghio and Arthur M. Feldman and Jean‐Claude Daubert and David Mets},
url = {https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2524},
doi = {10.1002/ejhf.2524},
issn = {1388-9842, 1879-0844},
year = {2022},
date = {2022-06-01},
urldate = {2022-09-27},
journal = {European J of Heart Fail},
volume = {24},
number = {6},
pages = {1080–1090},
keywords = {CBC},
pubstate = {published},
tppubtype = {article}
}
Saxon, Leslie; Faulk, Robert T; Barrett, Travor; McLelland, Steve; Boberg, Jill
A Novel Digital Research Methodology for Continuous Health Assessment of the Special Operations Warfighter: The Digital cORA Study Journal Article
In: J. Spec. Oper. Med., vol. 22, no. 4, pp. 78, 2022, ISSN: 1553-9768.
Links | BibTeX | Tags: CBC, UARC
@article{saxon_novel_2022,
title = {A Novel Digital Research Methodology for Continuous Health Assessment of the Special Operations Warfighter: The Digital cORA Study},
author = {Leslie Saxon and Robert T Faulk and Travor Barrett and Steve McLelland and Jill Boberg},
url = {https://www.jsomonline.org/Citations/4SSJ-AHIB.php},
doi = {10.55460/4SSJ-AHIB},
issn = {1553-9768},
year = {2022},
date = {2022-01-01},
urldate = {2023-03-31},
journal = {J. Spec. Oper. Med.},
volume = {22},
number = {4},
pages = {78},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
2021
We've Entered a New Era of Streaming Health Care. Now What? Journal Article
In: IEEE Spectrum, 2021.
Abstract | Links | BibTeX | Tags: CBC
@article{noauthor_weve_2021,
title = {We've Entered a New Era of Streaming Health Care. Now What?},
url = {https://spectrum.ieee.org/digital-health},
year = {2021},
date = {2021-11-01},
urldate = {2022-09-29},
journal = {IEEE Spectrum},
abstract = {COVID-19 forced the transition to digital medicine, but there's much still to do.},
keywords = {CBC},
pubstate = {published},
tppubtype = {article}
}
COVID-19 forced the transition to digital medicine, but there's much still to do.
Ghasem, Wesley; Valenzuela, Joshua; Saxon, Leslie A.
Player Tracking Technology and Data for Injury Prevention in the National Football League Journal Article
In: Curr Sports Med Rep, vol. 20, no. 9, pp. 436–439, 2021, ISSN: 1537-8918.
@article{ghasem_player_2021,
title = {Player Tracking Technology and Data for Injury Prevention in the National Football League},
author = {Wesley Ghasem and Joshua Valenzuela and Leslie A. Saxon},
url = {https://journals.lww.com/10.1249/JSR.0000000000000873},
doi = {10.1249/JSR.0000000000000873},
issn = {1537-8918},
year = {2021},
date = {2021-09-01},
urldate = {2022-09-28},
journal = {Curr Sports Med Rep},
volume = {20},
number = {9},
pages = {436–439},
keywords = {CBC},
pubstate = {published},
tppubtype = {article}
}
Nikolovski, Janeta; Koldijk, Martin; Weverling, Gerrit Jan; Spertus, John; Turakhia, Mintu; Saxon, Leslie; Gibson, Mike; Whang, John; Sarich, Troy; Zambon, Robert; Ezeanochie, Nnamdi; Turgiss, Jennifer; Jones, Robyn; Stoddard, Jeff; Burton, Paul; Navar, Ann Marie
Factors indicating intention to vaccinate with a COVID-19 vaccine among older UṠ. adults Journal Article
In: PLOS ONE, vol. 16, no. 5, pp. e0251963, 2021, ISSN: 1932-6203, (Publisher: Public Library of Science).
Abstract | Links | BibTeX | Tags: CBC, UARC
@article{nikolovski_factors_2021,
title = {Factors indicating intention to vaccinate with a COVID-19 vaccine among older UṠ. adults},
author = {Janeta Nikolovski and Martin Koldijk and Gerrit Jan Weverling and John Spertus and Mintu Turakhia and Leslie Saxon and Mike Gibson and John Whang and Troy Sarich and Robert Zambon and Nnamdi Ezeanochie and Jennifer Turgiss and Robyn Jones and Jeff Stoddard and Paul Burton and Ann Marie Navar},
url = {https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251963},
doi = {10.1371/journal.pone.0251963},
issn = {1932-6203},
year = {2021},
date = {2021-05-01},
urldate = {2023-03-31},
journal = {PLOS ONE},
volume = {16},
number = {5},
pages = {e0251963},
abstract = {Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.},
note = {Publisher: Public Library of Science},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
Background The success of vaccination efforts to curb the COVID-19 pandemic will require broad public uptake of immunization and highlights the importance of understanding factors associated with willingness to receive a vaccine. Methods U.S. adults aged 65 and older enrolled in the HeartlineTM clinical study were invited to complete a COVID-19 vaccine assessment through the HeartlineTM mobile application between November 6–20, 2020. Factors associated with willingness to receive a COVID-19 vaccine were evaluated using an ordered logistic regression as well as a Random Forest classification algorithm. Results Among 9,106 study participants, 81.3% (n = 7402) responded and had available demographic data. The majority (91.3%) reported a willingness to be vaccinated. Factors most strongly associated with vaccine willingness were beliefs about the safety and efficacy of COVID-19 vaccines and vaccines in general. Women and Black or African American respondents reported lower willingness to vaccinate. Among those less willing to get vaccinated, 66.2% said that they would talk with their health provider before making a decision. During the study, positive results from the first COVID-19 vaccine outcome study were released; vaccine willingness increased after this report. Conclusions Even among older adults at high-risk for COVID-19 complications who are participating in a longitudinal clinical study, 1 in 11 reported lack of willingness to receive COVID-19 vaccine in November 2020. Variability in vaccine willingness by gender, race, education, and income suggests the potential for uneven vaccine uptake. Education by health providers directed toward assuaging concerns about vaccine safety and efficacy can help improve vaccine acceptance among those less willing. Trial registration Clinicaltrials.gov NCT04276441.
2020
Miller, Jennifer C.; Skoll, Devin; Saxon, Leslie A.
Home Monitoring of Cardiac Devices in the Era of COVID-19 Journal Article
In: Curr Cardiol Rep, vol. 23, no. 1, pp. 1, 2020, ISSN: 1534-3170.
Abstract | Links | BibTeX | Tags: CBC, UARC
@article{miller_home_2020,
title = {Home Monitoring of Cardiac Devices in the Era of COVID-19},
author = {Jennifer C. Miller and Devin Skoll and Leslie A. Saxon},
url = {https://doi.org/10.1007/s11886-020-01431-w},
doi = {10.1007/s11886-020-01431-w},
issn = {1534-3170},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Curr Cardiol Rep},
volume = {23},
number = {1},
pages = {1},
abstract = {Despite the promise of remote patient monitoring (RPM), this technology remained underutilized secondary to a lack of data transparency and systems issues until the COVID-19 pandemic ushered in a new era of telehealth and virtual solutions out of necessity. This review will explore the data supporting the use of RPM via both implantable and wearable devices in the field of cardiology and the role of home monitoring using RPM in the era of COVID-19.},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
Despite the promise of remote patient monitoring (RPM), this technology remained underutilized secondary to a lack of data transparency and systems issues until the COVID-19 pandemic ushered in a new era of telehealth and virtual solutions out of necessity. This review will explore the data supporting the use of RPM via both implantable and wearable devices in the field of cardiology and the role of home monitoring using RPM in the era of COVID-19.
Miller, Jennifer C; Barrett, Trevor; Patel, Neil; Souza, Andrew; Wood, John; Saxon, Leslie A
In: Circulation, vol. 142, no. Suppl_3, pp. A15845–A15845, 2020, (Publisher: American Heart Association).
Abstract | Links | BibTeX | Tags: CBC, UARC
@article{miller_heart_2020,
title = {Heart Heroes: A Gamified Mhealth Platform to Measure Continuous Cardiac Health Data in the Outpatient Setting of Adolescent Patients With Known and Suspected Heart Disease},
author = {Jennifer C Miller and Trevor Barrett and Neil Patel and Andrew Souza and John Wood and Leslie A Saxon},
url = {https://www.ahajournals.org/doi/abs/10.1161/circ.142.suppl_3.15845},
doi = {10.1161/circ.142.suppl_3.15845},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Circulation},
volume = {142},
number = {Suppl_3},
pages = {A15845–A15845},
abstract = {Introduction: Adolescents with heart disease report difficulty in communication about their health as a major inhibiting factor in their care. MHealth technologies collect health data in daily life and enable health data sharing between the provider and patient. The adolescent population has a high level of engagement with mobile devices and a willingness to use them for health-related activities.
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure},
note = {Publisher: American Heart Association},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
Introduction: Adolescents with heart disease report difficulty in communication about their health as a major inhibiting factor in their care. MHealth technologies collect health data in daily life and enable health data sharing between the provider and patient. The adolescent population has a high level of engagement with mobile devices and a willingness to use them for health-related activities.
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure
Hypothesis: We hypothesized that our novel gamified mHealth platform Heart Hero can engage adolescent patients in the collection of cardiac health data in their daily life.
Methods: We designed the research app using ResearchKit to collect continuous physiological data from the Apple Watch and daily survey data on well-being, stress, medical adherence, and cardiac symptoms. Patients were provided the app, iPhone, and Apple Watch and enrolled for 27 days. A final in-app survey was provided to assess feedback. We enrolled 28 patients total who were scheduled for outpatient cardiopulmonary exercise testing.
Results: Mean age was 14.3 years old (SD +/-3.08) with a 1:1 M:F ratio. 61% of patients were ≥ 15 years of age. 94% of patients completed the final survey. Subjects on average completed 64% (SEM +/-5) of the daily quizzes with an average daily adherence of over 50% wearing the watch. 100% reported they liked using the watch and app, and 89% would like to continue wearing the Apple Watch. 53% reported the study encouraged them to exercise more while 21% reported encouragement to walk more. Fig 1 demonstrates A) Apple Watch and b) daily survey data collected from a patient throughout the study.
Conclusions: In conclusion, Heart Hero is a mHealth platform which can successfully be used to collect continuous health data from the adolescent population with high engagement characterized by adherence and positive patient feedback. Adherence to the app was notably superior to the initial 5 ResearchKit applications enrolling adult patients.
Download figure
Skoll, Devin; Miller, Jennifer C.; Saxon, Leslie A.
COVID-19 testing and infection surveillance: Is a combined digital contact-tracing and mass-testing solution feasible in the United States? Journal Article
In: Cardiovascular Digital Health Journal, vol. 1, no. 3, pp. 149–159, 2020, ISSN: 2666-6936.
Abstract | Links | BibTeX | Tags: CBC, UARC
@article{skoll_covid-19_2020,
title = {COVID-19 testing and infection surveillance: Is a combined digital contact-tracing and mass-testing solution feasible in the United States?},
author = {Devin Skoll and Jennifer C. Miller and Leslie A. Saxon},
url = {https://www.sciencedirect.com/science/article/pii/S2666693620300360},
doi = {10.1016/j.cvdhj.2020.09.004},
issn = {2666-6936},
year = {2020},
date = {2020-11-01},
urldate = {2023-03-31},
journal = {Cardiovascular Digital Health Journal},
volume = {1},
number = {3},
pages = {149–159},
abstract = {Background
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
Background
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.
In December 2019, the novel COVID-19 virus spread from a cluster of pneumonia cases in Wuhan, China, to every corner of the globe, creating a worldwide pandemic pushing hospital systems past capacity and bringing economies worldwide to a halt. The COVID-19 pandemic is unique in comparison to prior coronavirus epidemics in its superior ability to be spread by asymptomatic and presymptomatic patients, allowing the virus to silently evade traditional symptoms-based screening approaches. Countries have implemented cutting-edge digital solutions to enhance traditional contact-tracing methodologies in combination with novel testing strategies to combat the virus, with variable levels of success. Despite having one of the most advanced and expensive health care systems in the world, the United States (U.S.) response is arguably one of the world’s largest failures, as it leads the globe in case number as well as deaths. Until a successful vaccine can be broadly distributed, it is imperative that the U.S. curb the viral spread by rapidly developing a framework implementing both enhanced tracing and testing strategies balancing the needs of public health while respecting individual liberties. This review will explore the role of technology-augmented contact-based surveillance in tracking the outbreak in select countries in comparison to the current U.S. approach. It will evaluate barriers in the U.S. to implementing similar technologies, focusing on privacy concerns and a lack of unified testing and tracing strategy. Finally, it will explore strategies for rapidly scaling testing in a cost-effective manner.
Saxon, Leslie A.; Varma, Niraj; Epstein, Laurence M.; Ganz, Leonard I.; Epstein, Andrew E.
Rates of Adoption and Outcomes After Firmware Updates for Food and Drug Administration Cybersecurity Safety Advisories Journal Article
In: Circulation: Arrhythmia and Electrophysiology, vol. 13, no. 8, pp. e008364, 2020, (Publisher: American Heart Association).
Links | BibTeX | Tags: CBC, UARC
@article{saxon_rates_2020,
title = {Rates of Adoption and Outcomes After Firmware Updates for Food and Drug Administration Cybersecurity Safety Advisories},
author = {Leslie A. Saxon and Niraj Varma and Laurence M. Epstein and Leonard I. Ganz and Andrew E. Epstein},
url = {https://www.ahajournals.org/doi/full/10.1161/CIRCEP.120.008364},
doi = {10.1161/CIRCEP.120.008364},
year = {2020},
date = {2020-08-01},
urldate = {2023-03-31},
journal = {Circulation: Arrhythmia and Electrophysiology},
volume = {13},
number = {8},
pages = {e008364},
note = {Publisher: American Heart Association},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}
Saxon, Leslie; DiPaula, Brooks; Fox, Glenn R; Ebert, Rebecca; Duhaime, Josiah; Nocera, Luciano; Tran, Luan; Sobhani, Mona
Continuous Measurement of Reconnaissance Marines in Training With Custom Smartphone App and Watch: Observational Cohort Study Journal Article
In: JMIR mHealth and uHealth, vol. 8, no. 6, pp. e14116, 2020, ISSN: 2291-5222.
Abstract | Links | BibTeX | Tags: CBC
@article{saxon_continuous_2020,
title = {Continuous Measurement of Reconnaissance Marines in Training With Custom Smartphone App and Watch: Observational Cohort Study},
author = {Leslie Saxon and Brooks DiPaula and Glenn R Fox and Rebecca Ebert and Josiah Duhaime and Luciano Nocera and Luan Tran and Mona Sobhani},
url = {https://mhealth.jmir.org/2020/6/e14116},
doi = {10.2196/14116},
issn = {2291-5222},
year = {2020},
date = {2020-06-01},
journal = {JMIR mHealth and uHealth},
volume = {8},
number = {6},
pages = {e14116},
abstract = {Background: Specialized training for elite US military units is associated with high attrition due to intense psychological and physical demands. The need to graduate more service members without degrading performance standards necessitates the identification of factors to predict success or failure in targeted training interventions. Objective: The aim of this study was to continuously quantify the mental and physical status of trainees of an elite military unit to identify novel predictors of success in training. Methods: A total of 3 consecutive classes of a specialized training course were provided with an Apple iPhone, Watch, and specially designed mobile app. Baseline personality assessments and continuous daily measures of mental status, physical pain, heart rate, activity, sleep, hydration, and nutrition were collected from the app and Watch data. Results: A total of 115 trainees enrolled and completed the study (100% male; age: mean 22 years, SD 4 years) and 64 (55.7%) successfully graduated. Most training withdrawals (27/115, 23.5%) occurred by day 7 (mean 5.5 days, SD 3.4 days; range 1-22 days). Extraversion, positive affect personality traits, and daily psychological profiles were associated with course completion; key psychological factors could predict withdrawals 1-2 days in advance (P=.009). Conclusions: Gathering accurate and continuous mental and physical status data during elite military training is possible with early predictors of withdrawal providing an opportunity for intervention.},
keywords = {CBC},
pubstate = {published},
tppubtype = {article}
}
Background: Specialized training for elite US military units is associated with high attrition due to intense psychological and physical demands. The need to graduate more service members without degrading performance standards necessitates the identification of factors to predict success or failure in targeted training interventions. Objective: The aim of this study was to continuously quantify the mental and physical status of trainees of an elite military unit to identify novel predictors of success in training. Methods: A total of 3 consecutive classes of a specialized training course were provided with an Apple iPhone, Watch, and specially designed mobile app. Baseline personality assessments and continuous daily measures of mental status, physical pain, heart rate, activity, sleep, hydration, and nutrition were collected from the app and Watch data. Results: A total of 115 trainees enrolled and completed the study (100% male; age: mean 22 years, SD 4 years) and 64 (55.7%) successfully graduated. Most training withdrawals (27/115, 23.5%) occurred by day 7 (mean 5.5 days, SD 3.4 days; range 1-22 days). Extraversion, positive affect personality traits, and daily psychological profiles were associated with course completion; key psychological factors could predict withdrawals 1-2 days in advance (P=.009). Conclusions: Gathering accurate and continuous mental and physical status data during elite military training is possible with early predictors of withdrawal providing an opportunity for intervention.
2019
Slotwiner, David J.; Tarakji, Khaldoun G.; Al-Khatib, Sana M.; Passman, Rod S.; Saxon, Leslie A.; Peters, Nicholas S.; McCall, Debbe; Turakhia, Mintu P.; Schaeffer, Jill; Mendenhall, G. Stuart; Hindricks, Gerhard; Narayan, Sanjiv M.; Davenport, Elizabeth E.; Marrouche, Nassir F.
Transparent sharing of digital health data: A call to action Journal Article
In: Heart Rhythm, vol. 16, no. 9, pp. e95–e106, 2019, ISSN: 1547-5271, 1556-3871, (Publisher: Elsevier).
Links | BibTeX | Tags: CBC, UARC
@article{slotwiner_transparent_2019,
title = {Transparent sharing of digital health data: A call to action},
author = {David J. Slotwiner and Khaldoun G. Tarakji and Sana M. Al-Khatib and Rod S. Passman and Leslie A. Saxon and Nicholas S. Peters and Debbe McCall and Mintu P. Turakhia and Jill Schaeffer and G. Stuart Mendenhall and Gerhard Hindricks and Sanjiv M. Narayan and Elizabeth E. Davenport and Nassir F. Marrouche},
url = {https://www.heartrhythmjournal.com/article/S1547-5271(19)30371-6/fulltext#%20},
doi = {10.1016/j.hrthm.2019.04.042},
issn = {1547-5271, 1556-3871},
year = {2019},
date = {2019-09-01},
urldate = {2023-03-31},
journal = {Heart Rhythm},
volume = {16},
number = {9},
pages = {e95–e106},
note = {Publisher: Elsevier},
keywords = {CBC, UARC},
pubstate = {published},
tppubtype = {article}
}