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

Fastpath Speculative Parallelization ⋆

Abstract. We describe Fastpath, a system for speculative parallelization of sequential programs on conventional multicore processors. Our system distinguishes between the lead thread, which executes at almostnative speed, and speculative threads, which execute somewhat slower. This allows us to achieve nontrivial speedup, even on two-core machines. We present a mathematical model of potential speedup, parameterized by application characteristics and implementation constants. We also present preliminary results gleaned from two different Fastpath implementations, each derived from an implementation of software transactional memory.

Video-based Parkinson’s disease assessments in a nationwide cohort of Fox Insight participants

Introduction: Parkinson’s disease (PD) research is hampered by slow, inefficient recruitment and burdensome in-person assessments that may be challenging to conduct in a world affected by COVID-19. Fox Insight is an ongoing prospective clinical research study that enables individuals to participate in clinical research from their own homes by completing online questionnaires. To date, over 45,000 participants with and without PD have enrolled. We sought to validate self-reported PD diagnosis in the Fox Insight cohort, assess the validity of other self-reported health information, and evaluate the willingness of participants to participate in video-based research studies. Methods: Individuals with and without self-reported PD enrolled in Fox Insight were invited to participate in this virtual research study. Participants completed online questionnaires and two virtual visits, during which we conducted standard cognitive and motor assessments. A movement disorder expert determined the most likely diagnosis, which was compared to self-reported diagnosis. Results: A total of 203 participants from 40 U.S. states, 159 with remote clinician-determined PD and 44 without, completed the study (59% male, mean (SD) age 65.7 (9.8)). Level of agreement between self-reported PD diagnosis in Fox Insight and clinician-determined diagnosis was very good ((kappa = 0.85, 95% CI 0.76–0.94). Overall, 97.9% of participants were satisfied with the study, 98.5% were willing to participate in a future observational study with virtual visits, and 76.1% were willing to participate in an interventional trial with virtual visits. Conclusion: Among the Fox Insight cohort, self-reported diagnosis is accurate and interest in virtual research studies is high

Video-based Parkinson's disease assessments in a nationwide cohort of Fox Insight participants.

IntroductionParkinson's disease (PD) research is hampered by slow, inefficient recruitment and burdensome in-person assessments that may be challenging to conduct in a world affected by COVID-19. Fox Insight is an ongoing prospective clinical research study that enables individuals to participate in clinical research from their own homes by completing online questionnaires. To date, over 45,000 participants with and without PD have enrolled. We sought to validate self-reported PD diagnosis in the Fox Insight cohort, assess the validity of other self-reported health information, and evaluate the willingness of participants to participate in video-based research studies.MethodsIndividuals with and without self-reported PD enrolled in Fox Insight were invited to participate in this virtual research study. Participants completed online questionnaires and two virtual visits, during which we conducted standard cognitive and motor assessments. A movement disorder expert determined the most likely diagnosis, which was compared to self-reported diagnosis.ResultsA total of 203 participants from 40 U.S. states, 159 with remote clinician-determined PD and 44 without, completed the study (59% male, mean (SD) age 65.7 (9.8)). Level of agreement between self-reported PD diagnosis in Fox Insight and clinician-determined diagnosis was very good ((kappa&nbsp;=&nbsp;0.85, 95% CI 0.76-0.94). Overall, 97.9% of participants were satisfied with the study, 98.5% were willing to participate in a future observational study with virtual visits, and 76.1% were willing to participate in an interventional trial with virtual visits.ConclusionAmong the Fox Insight cohort, self-reported diagnosis is accurate and interest in virtual research studies is high

Paleoproterozoic orogenesis in the southeastern Gawler Craton, South Australia

Integrated structural, metamorphic and geochronological data demonstrate the existence of a contractional orogen preserved in the ca 1850 Ma Donington Suite batholith along the eastern margin of the Gawler Craton, South Australia. The earliest structures are a pervasive gneissic foliation developed in the Donington Suite and interleaved metasedimentary rocks. This has been overprinted by isoclinal and non-cylindrical folding, and zones of pervasive non-coaxial shear with north-directed transport, suggesting that deformation was the result of orogenic contraction. SHRIMP U - Pb zircon data indicate that a syn-contractional granitic dyke was emplaced at 1846 ± 4 Ma. Overprinting the contractional structures are a series of discrete, migmatitic high-strain zones that show a normal geometry with a component of oblique dextral shear. U - Pb zircon data from a weakly foliated microgranite in one such shear zone give an emplacement age of 1843 ± 5 Ma. Rare aluminous metasedimentary rocks in the belt preserve a granulite-grade assemblage of garnet + biotite + plagioclase + K-feldspar + silicate melt that formed at ∼600 MPa and ∼750°C. Peak metamorphic garnets are partially replaced by biotite + sillimanite+ cordierite assemblages suggesting post-thermal peak cooling and decompression, and are indicative of a clockwise P - T evolution. Chemical U - Th - Pb electron microprobe ages from monazites in retrograde biotite yield a minimum estimate for the timing of retrogression of ca 1830 Ma, indicating that decompression may be linked to the development of the broadly extensional shear zones and that the clockwise P - T path occurred during a single tectonothermal cycle. We define this ca 1850 Ma phase of crustal evolution in the eastern Gawler Craton as the Cornian Orogeny.A. Reid, M. Hand, E. Jagodzinski, D. Kelsey, N. Pearso