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While adolescent–adult connections have been shown to be protective against violence perpetration and victimization, mechanisms through which these connections confer protection from violence are poorly understood. We assessed whether adolescent–adult connections protected youth in lower resource urban neighborhoods from exposure to environmental risk factors for violence during daily activities. We overlaid on the city landscape minute-by-minute activity paths from 274 randomly sampled predominantly African American male youth, ages 10 to 24, enrolled in a population-based study of daily activities in Philadelphia, PA, to calculate environmental exposures and to compare exposures along actual versus shortest potential travel routes. Adolescent–adult connections were defined using brief survey questions and detailed family genograms. Analyses demonstrated that youth's selected travel routes resulted in significantly lower exposure to several types of crime, including vandalism, narcotics arrests, and disorderly conduct, than would have occurred on shortest potential routes. On average, youth with adolescent–adult connections spent less time outdoors than youth without connections, although these differences did not reach statistical significance (p =.06). There were no significant differences in environmental risk factors encountered by youth with versus without adolescent–adult connections. Future mixed-methods research combining qualitative and geographic information systems (GIS) approaches should investigate which factors shape travel decisions during daily activities to guide multimodal violence prevention interventions. [ABSTRACT FROM AUTHOR]

The Brier score has been a popular measure of prediction accuracy for binary outcomes. However, it is not straightforward to interpret the Brier score for a prediction model since its value depends on the outcome prevalence. We decompose the Brier score into two components, the mean squares between the estimated and true underlying binary probabilities, and the variance of the binary outcome that is not reflective of the model performance. We then propose to modify the Brier score by removing the variance of the binary outcome, estimated via a general sliding window approach. We show that the new proposed measure is more sensitive for comparing different models through simulation. A standardized performance improvement measure is also proposed based on the new criterion to quantify the improvement of prediction performance. We apply the new measures to the data from the Breast Cancer Surveillance Consortium and compare the performance of predicting breast cancer risk using the models with and without its most important predictor. [ABSTRACT FROM AUTHOR]

Patients with obstructive sleep apnea (OSA) are at elevated risk of developing systemic vascular disease and cognitive dysfunction. Here, cerebral oxygen metabolism was assessed in patients with OSA by means of a magnetic resonance-based method involving simultaneous measurements of cerebral blood flow rate and venous oxygen saturation in the superior sagittal sinus for a period of 10 minutes at an effective temporal resolution of 1.3 seconds before, during, and after repeated 24-second breath-holds mimicking spontaneous apneas, yielding, along with pulse oximetry-derived arterial saturation, whole-brain CMRO2 via Fick's Principle. Enrolled subjects were classified based on their apnea-hypopnea indices into OSA (N = 31) and non-sleep apnea reference subjects (NSA = 21), and further compared with young healthy subjects (YH, N = 10). OSA and NSA subjects were matched for age and body mass index. CMRO2 was lower in OSA than in the YH group during normal breathing (105.6 ± 14.1 versus 123.7 ± 22.8 μmol O2/min/100g, P = 0.01). Further, the fractional change in CMRO2 in response to a breath-hold challenge was larger in OSA than in the YH group (15.2 ± 9.2 versus 8.5 ± 3.4%, P = 0.04). However, there was no significant difference in CMRO2 between OSA and NSA subjects. The data suggest altered brain oxygen metabolism in OSA and possibly in NSA as well. [ABSTRACT FROM AUTHOR]