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fication and tracking of interdependent COVID-19 knowledge resources.
Governments promote behavioral policies such as social distancing and phased reopening to control the spread of COVID-19. Digital phenotyping helps promote the compliance with these policies through the personalized behavioral knowledge it produces.
This study investigated the value of smartphone-derived digital phenotypes in (1) analyzing individuals' compliance with COVID-19 policies through behavioral responses and (2) suggesting ways to personalize communication through those policies.
We conducted longitudinal experiments that started before the outbreak of COVID-19 and continued during the pandemic. A total of 16 participants were recruited before the pandemic, and a smartphone sensing app was installed for each of them. We then assessed individual compliance with COVID-19 policies and their impact on habitual behaviors.
Our results show a significant change in people's mobility (P<.001) as a result of COVID-19 regulations, from an average of 10 visited places every week to approximately 2 places a week. We also discussed our results within the context of nudges used by the National Health Service in the United Kingdom to promote COVID-19 regulations.
Our findings show that digital phenotyping has substantial value in understanding people's behavior during a pandemic. Behavioral features extracted from digital phenotypes can facilitate the personalization of and compliance with behavioral policies. A rule-based messaging system can be implemented to deliver nudges on the basis of digital phenotyping.
Our findings show that digital phenotyping has substantial value in understanding people's behavior during a pandemic. Behavioral features extracted from digital phenotypes can facilitate the personalization of and compliance with behavioral policies. A rule-based messaging system can be implemented to deliver nudges on the basis of digital phenotyping.
Despite the limitations in the use of cycle threshold (CT) values for individual patient care, population distributions of CT values may be useful indicators of local outbreaks.
We aimed to conduct an exploratory analysis of potential correlations between the population distribution of cycle threshold (CT) values and COVID-19 dynamics, which were operationalized as percent positivity, transmission rate (R
), and COVID-19 hospitalization count.
In total, 148,410 specimens collected between September 15, 2020, and January 11, 2021, from the greater El Paso area were processed in the Dascena COVID-19 Laboratory. 5-Chloro-2'-deoxyuridine The daily median CT value, daily R
, daily count of COVID-19 hospitalizations, daily change in percent positivity, and rolling averages of these features were plotted over time. Two-way scatterplots and linear regression were used to evaluate possible associations between daily median CT values and outbreak measures. Cross-correlation plots were used to determine whether a time delay existed between changes in daily median CT values and measures of community disease dynamics.
Daily median CT values negatively correlated with the daily R
values (P<.001), the daily COVID-19 hospitalization counts (with a 33-day time delay; P<.001), and the daily changes in percent positivity among testing samples (P<.001). Despite visual trends suggesting time delays in the plots for median CT values and outbreak measures, a statistically significant delay was only detected between changes in median CT values and COVID-19 hospitalization counts (P<.001).
This study adds to the literature by analyzing samples collected from an entire geographical area and contextualizing the results with other research investigating population CT values.
This study adds to the literature by analyzing samples collected from an entire geographical area and contextualizing the results with other research investigating population CT values.
Both primary care practices based on the chronic care model (CCM) and digital therapeutics have been shown to improve the care of patients with diabetes.
The aim of this observational study was to examine the change in diabetes control for patients enrolled in a membership-based primary care service that is based on the CCM.
Using a diabetes registry, we analyzed the change in glycated hemoglobin (HbA
) for patients with uncontrolled diabetes mellitus (initial HbA
≥9%). All patients had access to a technology-enhanced primary care practice built on the CCM.
The registry included 621 patients diagnosed with uncontrolled diabetes. All patients had at least two HbA
measurements, with the average time between the first and last measurement of 1.2 years (SD 0.4). The average starting value of HbA
was 10.7, which decreased to 8.7, corresponding to a reduction of 2.03 (P<.001). Secondary analyses showed statistically significant reductions in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides.
Patients with initially uncontrolled diabetes who undergo care in a technology-enhanced primary care practice based on the CCM have long-term clinically meaningful reductions in HbA
.
Patients with initially uncontrolled diabetes who undergo care in a technology-enhanced primary care practice based on the CCM have long-term clinically meaningful reductions in HbA1c.
Various techniques are used to support contact tracing, which has been shown to be highly effective against the COVID-19 pandemic. To apply the technology, either quarantine authorities should provide the location history of patients with COVID-19, or all users should provide their own location history. This inevitably exposes either the patient's location history or the personal location history of other users. Thus, a privacy issue arises where the public good (via information release) comes in conflict with privacy exposure risks.
The objective of this study is to develop an effective contact tracing system that does not expose the location information of the patient with COVID-19 to other users of the system, or the location information of the users to the quarantine authorities.
We propose a new protocol called PRivacy Oriented Technique for Epidemic Contact Tracing (PROTECT) that securely shares location information of patients with users by using the Brakerski/Fan-Vercauteren homomorphic encryptireasonable size and developed it to an operable format. The developed app and web service can help contact tracing for not only the COVID-19 pandemic but also other epidemics.
This newly developed method for contact tracing shares location information by using homomorphic encryption, without exposing the location information of patients with COVID-19 and other users. Homomorphic encryption is challenging to apply to practical issues despite its high security value. In this study, however, we have designed a system using the Brakerski/Fan-Vercauteren scheme that is applicable to a reasonable size and developed it to an operable format. The developed app and web service can help contact tracing for not only the COVID-19 pandemic but also other epidemics.
The opioid crisis in the United States may be exacerbated by the COVID-19 pandemic. Increases in opioid use, emergency medical services (EMS) runs for opioid-related overdoses, and opioid overdose deaths have been reported. No study has examined changes in multiple naloxone administrations, an indicator of overdose severity, during the COVID-19 pandemic.
This study examines changes in the occurrence of naloxone administrations and multiple naloxone administrations during EMS runs for opioid-related overdoses during the COVID-19 pandemic in Guilford County, North Carolina (NC).
Using a period-over-period approach, we compared the occurrence of opioid-related EMS runs, naloxone administrations, and multiple naloxone administrations during the 29-week period before (September 1, 2019, to March 9, 2020) and after NC's COVID-19 state of emergency declaration (ie, the COVID-19 period of March 10 to September 30, 2020). Furthermore, historical data were used to generate a quasi-control distribution of period-orisis.
The occurrence of EMS runs for opioid-related overdoses, naloxone administrations, and multiple naloxone administrations during EMS runs increased during the COVID-19 pandemic in Guilford County, NC. For a host of reasons that need to be explored, the COVID-19 pandemic appears to have exacerbated the opioid crisis.
To discover new physiological markers of pains perception by reading out the brains electrical activity and its interaction with hemodynamics.
We present a prototype consisting of a compact setup that on one hand generates well-controlled thermal stimuli produced by a Peltier cell controlled by a computer, and on the other hand, captures simultaneous electroencephalography (EEG) and photoplethysmography (PPG) signals when varying stimuli. N=36 healthy subjects (mean age 30.47 years, SD 4.79 years, 20 males) were recruited to participate in the study. To account for the intersubject variability in the tolerance level to thermal pain, we first determined for each subject the thermoalgesic threshold, defined as the temperature at which pains perception starts when gradually increasing the temperature of the Peltier cell. Next, we defined two different conditions 1. Pain, obtained at a temperature equal to 90% of the threshold; 2. No-pain, at 50% of the threshold.
Both the one-dimensional and the two-dimensional spectral entropy (SE) in both signals EEG and PPG can significantly differentiate between the two conditions. In particular, SE reduced in the pain condition as compared to no-pain at specific frequency ranges.
Hemodynamics, brain dynamics, and their interaction can discriminate situations of thermal pains perception.
The possibility of monitoring on-line variations of thermal pains perception using such a class of measures is of high interest to study different pathologies affecting the peripheral nervous system, such as for instance, small fiber neuropathies, fibromyalgia syndrome, or painful diabetic neuropathy.
The possibility of monitoring on-line variations of thermal pains perception using such a class of measures is of high interest to study different pathologies affecting the peripheral nervous system, such as for instance, small fiber neuropathies, fibromyalgia syndrome, or painful diabetic neuropathy.Automatic and accurate detection of anatomical landmarks is an essential operation in medical image analysis with a multitude of applications. Recent deep learning methods have improved results by directly encoding the appearance of the captured anatomy with the likelihood maps (i.e., heatmaps). However, most current solutions overlook another essence of heatmap regression, the objective metric for regressing target heatmaps and rely on hand-crafted heuristics to set the target precision, thus being usually cumbersome and task-specific. In this paper, we propose a novel learning-to-learn framework for landmark detection to optimize the neural network and the target precision simultaneously. The pivot of this work is to leverage the reinforcement learning (RL) framework to search objective metrics for regressing multiple heatmaps dynamically during the training process, thus avoiding setting problem-specific target precision. We also introduce an early-stop strategy for active termination of the RL agent's interaction that adapts the optimal precision for separate targets considering exploration-exploitation tradeoffs.
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