Remote Medication Status Prediction for Individuals with Parkinson's Disease using Time-series Data from Smartphones

Medication for neurological diseases such as the Parkinson's disease usually happens remotely away from hospitals. Such out-of-lab environments pose challenges in collecting timely and accurate health status data. Individual differences in behavioral signals collected from wearable sensors also lead to difficulties in adopting current general machine learning analysis pipelines. To address these challenges, we present a method for predicting the medication status of Parkinson's disease patients using the public mPower dataset, which contains 62,182 remote multi-modal test records collected on smartphones from 487 patients. The proposed method shows promising results in predicting three medication statuses objectively: Before Medication (AUC=0.95), After Medication (AUC=0.958), and Another Time (AUC=0.976) by examining patient-wise historical records with the attention weights learned through a Transformer model. Our method provides an innovative way for personalized remote health sensing in a timely and objective fashion which could benefit a broad range of similar applications.Comment: Accepted to ICDH-2023. Camera ready with supplementary materia

Genetic Adverse Selection: Evidence from Long-Term Care Insurance and Huntington Disease

Individual, personalized genetic information is increasingly available, leading to the possibility of greater adverse selection over time, particularly in individual-payer insurance markets; this selection could impact the viability of these markets. We use data on individuals at risk for Huntington disease (HD), a degenerative neurological disorder with significant effects on morbidity, to estimate adverse selection in long-term care insurance. We find strong evidence of adverse selection: individuals who carry the HD genetic mutation are up to 5 times as likely as the general population to own long-term care insurance. We use these estimates to make predictions about the future of this market as genetic information increases. We argue that even relatively limited increases in genetic information may threaten the viability of private long-term care insurance.

Cross-Modal Health State Estimation

Individuals create and consume more diverse data about themselves today than any time in history. Sources of this data include wearable devices, images, social media, geospatial information and more. A tremendous opportunity rests within cross-modal data analysis that leverages existing domain knowledge methods to understand and guide human health. Especially in chronic diseases, current medical practice uses a combination of sparse hospital based biological metrics (blood tests, expensive imaging, etc.) to understand the evolving health status of an individual. Future health systems must integrate data created at the individual level to better understand health status perpetually, especially in a cybernetic framework. In this work we fuse multiple user created and open source data streams along with established biomedical domain knowledge to give two types of quantitative state estimates of cardiovascular health. First, we use wearable devices to calculate cardiorespiratory fitness (CRF), a known quantitative leading predictor of heart disease which is not routinely collected in clinical settings. Second, we estimate inherent genetic traits, living environmental risks, circadian rhythm, and biological metrics from a diverse dataset. Our experimental results on 24 subjects demonstrate how multi-modal data can provide personalized health insight. Understanding the dynamic nature of health status will pave the way for better health based recommendation engines, better clinical decision making and positive lifestyle changes.Comment: Accepted to ACM Multimedia 2018 Conference - Brave New Ideas, Seoul, Korea, ACM ISBN 978-1-4503-5665-7/18/1

The mPower Study, Parkinson Disease Mobile Data Collected Using Researchkit

Current measures of health and disease are often insensitive, episodic, and subjective. Further, these measures generally are not designed to provide meaningful feedback to individuals. The impact of high-resolution activity data collected from mobile phones is only beginning to be explored. Here we present data from mPower, a clinical observational study about Parkinson disease conducted purely through an iPhone app interface. The study interrogated aspects of this movement disorder through surveys and frequent sensor-based recordings from participants with and without Parkinson disease. Benefitting from large enrollment and repeated measurements on many individuals, these data may help establish baseline variability of real-world activity measurement collected via mobile phones, and ultimately may lead to quantification of the ebbs-and-flows of Parkinson symptoms. App source code for these data collection modules are available through an open source license for use in studies of other conditions. We hope that releasing data contributed by engaged research participants will seed a new community of analysts working collaboratively on understanding mobile health data to advance human health

Using AI to Measure Parkinson's Disease Severity at Home

We present an artificial intelligence system to remotely assess the motor performance of individuals with Parkinson's disease (PD). Participants performed a motor task (i.e., tapping fingers) in front of a webcam, and data from 250 global participants were rated by three expert neurologists following the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The neurologists' ratings were highly reliable, with an intra-class correlation coefficient (ICC) of 0.88. We developed computer algorithms to obtain objective measurements that align with the MDS-UPDRS guideline and are strongly correlated with the neurologists' ratings. Our machine learning model trained on these measures outperformed an MDS-UPDRS certified rater, with a mean absolute error (MAE) of 0.59 compared to the rater's MAE of 0.79. However, the model performed slightly worse than the expert neurologists (0.53 MAE). The methodology can be replicated for similar motor tasks, providing the possibility of evaluating individuals with PD and other movement disorders remotely, objectively, and in areas with limited access to neurological care

Integrated and patient-centred management of Parkinson’s disease:a network model for reshaping chronic neurological care

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Glide and Superclimb of Dislocations in Solid 4^4He

Glide and climb of quantum dislocations under finite external stress, variation of chemical potential and bias (geometrical slanting) in Peierls potential are studied by Monte Carlo simulations of the effective string model. We treat on unified ground quantum effects at finite temperatures $T$. Climb at low $T$ is assisted by superflow along dislocation core -- {\it superclimb}. Above some critical stress avalanche-type creation of kinks is found. It is characterized by hysteretic behavior at low $T$. At finite biases gliding dislocation remains rough even at lowest $T$ -- the behavior opposite to non-slanted dislocations. In contrast to glide, superclimb is characterized by quantum smooth state at low temperatures even for finite bias. In some intermediate $T$-range giant values of the compressibility as well as non-Luttinger type behavior of the core superfluid are observed.Comment: Updated version submitted to JLTP as QFS2010 proceedings; 11 pages, 6 figure

Classification of a supersolid: Trial wavefunctions, Symmetry breakings and Excitation spectra

A state of matter is characterized by its symmetry breaking and elementary excitations. A supersolid is a state which breaks both translational symmetry and internal $U(1)$ symmetry. Here, we review some past and recent works in phenomenological Ginsburg-Landau theories, ground state trial wavefunctions and microscopic numerical calculations. We also write down a new effective supersolid Hamiltonian on a lattice. The eigenstates of the Hamiltonian contains both the ground state wavefunction and all the excited states (supersolidon) wavefunctions. We contrast various kinds of supersolids in both continuous systems and on lattices, both condensed matter and cold atom systems. We provide additional new insights in studying their order parameters, symmetry breaking patterns, the excitation spectra and detection methods.Comment: REVTEX4, 19 pages, 3 figure

Using Smartphones and Machine Learning to Quantify Parkinson Disease Severity:The Mobile Parkinson Disease Score

IMPORTANCE: Current Parkinson disease (PD) measures are subjective, rater-dependent, and assessed in clinic. Smartphones can measure PD features, yet no smartphone-derived rating score exists to assess motor symptom severity in real-world settings. OBJECTIVES: To develop an objective measure of PD severity and test construct validity by evaluating the ability of the measure to capture intraday symptom fluctuations, correlate with current standard PD outcome measures, and respond to dopaminergic therapy. DESIGN, SETTING, AND PARTICIPANTS: This observational study assessed individuals with PD who remotely completed 5 tasks (voice, finger tapping, gait, balance, and reaction time) on the smartphone application. We used a novel machine-learning-based approach to generate a mobile Parkinson disease score (mPDS) that objectively weighs features derived from each smartphone activity (eg, stride length from the gait activity) and is scaled from 0 to 100 (where higher scores indicate greater severity). Individuals with and without PD additionally completed standard in-person assessments of PD with smartphone assessments during a period of 6 months. MAIN OUTCOMES AND MEASURES: Ability of the mPDS to detect intraday symptom fluctuations, the correlation between the mPDS and standard measures, and the ability of the mPDS to respond to dopaminergic medication. RESULTS: The mPDS was derived from 6148 smartphone activity assessments from 129 individuals (mean [SD] age, 58.7 [8.6] years; 56 [43.4%] women). Gait features contributed most to the total mPDS (33.4%). In addition, 23 individuals with PD (mean [SD] age, 64.6 [11.5] years; 11 [48%] women) and 17 without PD (mean [SD] age 54.2 [16.5] years; 12 [71%] women) completed in-clinic assessments. The mPDS detected symptom fluctuations with a mean (SD) intraday change of 13.9 (10.3) points on a scale of 0 to 100. The measure correlated well with the Movement Disorder Society Unified Parkinson Disease's Rating Scale total (r = 0.81; P < .001) and part III only (r = 0.88; P < .001), the Timed Up and Go assessment (r = 0.72; P = .002), and the Hoehn and Yahr stage (r = 0.91; P < .001). The mPDS improved by a mean (SD) of 16.3 (5.6) points in response to dopaminergic therapy. CONCLUSIONS AND RELEVANCE: Using a novel machine-learning approach, we created and demonstrated construct validity of an objective PD severity score derived from smartphone assessments. This score complements standard PD measures by providing frequent, objective, real-world assessments that could enhance clinical care and evaluation of novel therapeutics