A Mobile Health Solution Complementing Psychopharmacology-Supported Smoking Cessation: Randomized Controlled Trial.

BACKGROUND: Smoking cessation is a persistent leading public health challenge. Mobile health (mHealth) solutions are emerging to improve smoking cessation treatments. Previous approaches have proposed supporting cessation with tailored motivational messages. Some managed to provide short-term improvements in smoking cessation. Yet, these approaches were either static in terms of personalization or human-based nonscalable solutions. Additionally, long-term effects were neither presented nor assessed in combination with existing psychopharmacological therapies. OBJECTIVE: This study aimed to analyze the long-term efficacy of a mobile app supporting psychopharmacological therapy for smoking cessation and complementarily assess the involved innovative technology. METHODS: A 12-month, randomized, open-label, parallel-group trial comparing smoking cessation rates was performed at Virgen del Rocío University Hospital in Seville (Spain). Smokers were randomly allocated to a control group (CG) receiving usual care (psychopharmacological treatment, n=120) or an intervention group (IG) receiving psychopharmacological treatment and using a mobile app providing artificial intelligence-generated and tailored smoking cessation support messages (n=120). The secondary objectives were to analyze health-related quality of life and monitor healthy lifestyle and physical exercise habits. Safety was assessed according to the presence of adverse events related to the pharmacological therapy. Per-protocol and intention-to-treat analyses were performed. Incomplete data and multinomial regression analyses were performed to assess the variables influencing participant cessation probability. The technical solution was assessed according to the precision of the tailored motivational smoking cessation messages and user engagement. Cessation and no cessation subgroups were compared using t tests. A voluntary satisfaction questionnaire was administered at the end of the intervention to all participants who completed the trial. RESULTS: In the IG, abstinence was 2.75 times higher (adjusted OR 3.45, P=.01) in the per-protocol analysis and 2.15 times higher (adjusted OR 3.13, P=.002) in the intention-to-treat analysis. Lost data analysis and multinomial logistic models showed different patterns in participants who dropped out. Regarding safety, 14 of 120 (11.7%) IG participants and 13 of 120 (10.8%) CG participants had 19 and 23 adverse events, respectively (P=.84). None of the clinical secondary objective measures showed relevant differences between the groups. The system was able to learn and tailor messages for improved effectiveness in supporting smoking cessation but was unable to reduce the time between a message being sent and opened. In either case, there was no relevant difference between the cessation and no cessation subgroups. However, a significant difference was found in system engagement at 6 months (P=.04) but not in all subsequent months. High system appreciation was reported at the end of the study. CONCLUSIONS: The proposed mHealth solution complementing psychopharmacological therapy showed greater efficacy for achieving 1-year tobacco abstinence as compared with psychopharmacological therapy alone. It provides a basis for artificial intelligence-based future approaches. TRIAL REGISTRATION: ClinicalTrials.gov NCT03553173; https://clinicaltrials.gov/ct2/show/NCT03553173. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/12464.

Wearable Fall Detector Using Recurrent Neural Networks.

Falls have become a relevant public health issue due to their high prevalence and negative effects in elderly people. Wearable fall detector devices allow the implementation of continuous and ubiquitous monitoring systems. The effectiveness for analyzing temporal signals with low energy consumption is one of the most relevant characteristics of these devices. Recurrent neural networks (RNNs) have demonstrated a great accuracy in some problems that require analyzing sequential inputs. However, getting appropriate response times in low power microcontrollers remains a difficult task due to their limited hardware resources. This work shows a feasibility study about using RNN-based deep learning models to detect both falls and falls' risks in real time using accelerometer signals. The effectiveness of four different architectures was analyzed using the SisFall dataset at different frequencies. The resulting models were integrated into two different embedded systems to analyze the execution times and changes in the model effectiveness. Finally, a study of power consumption was carried out. A sensitivity of 88.2% and a specificity of 96.4% was obtained. The simplest models reached inference times lower than 34 ms, which implies the capability to detect fall events in real-time with high energy efficiency. This suggests that RNN models provide an effective method that can be implemented in low power microcontrollers for the creation of autonomous wearable fall detection systems in real-time.

Analyzing recommender systems for health promotion using a multidisciplinary taxonomy: A scoping review.

BACKGROUND: Recommender systems are information retrieval systems that provide users with relevant items (e.g., through messages). Despite their extensive use in the e-commerce and leisure domains, their application in healthcare is still in its infancy. These systems may be used to create tailored health interventions, thus reducing the cost of healthcare and fostering a healthier lifestyle in the population. OBJECTIVE: This paper identifies, categorizes, and analyzes the existing knowledge in terms of the literature published over the past 10 years on the use of health recommender systems for patient interventions. The aim of this study is to understand the scientific evidence generated about health recommender systems, to identify any gaps in this field to achieve the United Nations Sustainable Development Goal 3 (SDG3) (namely, "Ensure healthy lives and promote well-being for all at all ages"), and to suggest possible reasons for these gaps as well as to propose some solutions. METHODS: We conducted a scoping review, which consisted of a keyword search of the literature related to health recommender systems for patients in the following databases: ScienceDirect, PsycInfo, Association for Computing Machinery, IEEExplore, and Pubmed. Further, we limited our search to consider only English-language journal articles published in the last 10 years. The reviewing process comprised three researchers who filtered the results simultaneously. The quantitative synthesis was conducted in parallel by two researchers, who classified each paper in terms of four aspects-the domain, the methodological and procedural aspects, the health promotion theoretical factors and behavior change theories, and the technical aspects-using a new multidisciplinary taxonomy. RESULTS: Nineteen papers met the inclusion criteria and were included in the data analysis, for which thirty-three features were assessed. The nine features associated with the health promotion theoretical factors and behavior change theories were not observed in any of the selected studies, did not use principles of tailoring, and did not assess (cost)-effectiveness. DISCUSSION: Health recommender systems may be further improved by using relevant behavior change strategies and by implementing essential characteristics of tailored interventions. In addition, many of the features required to assess each of the domain aspects, the methodological and procedural aspects, and technical aspects were not reported in the studies. CONCLUSIONS: The studies analyzed presented few evidence in support of the positive effects of using health recommender systems in terms of cost-effectiveness and patient health outcomes. This is why future studies should ensure that all the proposed features are covered in our multidisciplinary taxonomy, including integration with electronic health records and the incorporation of health promotion theoretical factors and behavior change theories. This will render those studies more useful for policymakers since they will cover all aspects needed to determine their impact toward meeting SDG3.

A neuro-inspired spike-based PID motor controller for multi-motor robots with low cost FPGAs.

In this paper we present a neuro-inspired spike-based close-loop controller written in VHDL and implemented for FPGAs. This controller has been focused on controlling a DC motor speed, but only using spikes for information representation, processing and DC motor driving. It could be applied to other motors with proper driver adaptation. This controller architecture represents one of the latest layers in a Spiking Neural Network (SNN), which implements a bridge between robotics actuators and spike-based processing layers and sensors. The presented control system fuses actuation and sensors information as spikes streams, processing these spikes in hard real-time, implementing a massively parallel information processing system, through specialized spike-based circuits. This spike-based close-loop controller has been implemented into an AER platform, designed in our labs, that allows direct control of DC motors: the AER-Robot. Experimental results evidence the viability of the implementation of spike-based controllers, and hardware synthesis denotes low hardware requirements that allow replicating this controller in a high number of parallel controllers working together to allow a real-time robot control.

On algorithmic rate-coded AER generation.

This paper addresses the problem of converting a conventional video stream based on sequences of frames into the spike event-based representation known as the address-event-representation (AER). In this paper we concentrate on rate-coded AER. The problem is addressed as an algorithmic problem, in which different methods are proposed, implemented and tested through software algorithms. The proposed algorithms are comparatively evaluated according to different criteria. Emphasis is put on the potential of such algorithms for a) doing the frame-based to event-based representation in real time, and b) that the resulting event streams ressemble as much as possible those generated naturally by rate-coded address-event VLSI chips, such as silicon AER retinae. It is found that simple and straightforward algorithms tend to have high potential for real time but produce event distributions that differ considerably from those obtained in AER VLSI chips. On the other hand, sophisticated algorithms that yield better event distributions are not efficient for real time operations. The methods based on linear-feedback-shift-register (LFSR) pseudorandom number generation is a good compromise, which is feasible for real time and yield reasonably well distributed events in time. Our software experiments, on a 1.6-GHz Pentium IV, show that at 50% AER bus load the proposed algorithms require between 0.011 and 1.14 ms per 8 bit-pixel per frame. One of the proposed LFSR methods is implemented in real time hardware using a prototyping board that includes a VirtexE 300 FPGA. The demonstration hardware is capable of transforming frames of 64 x 64 pixels of 8-bit depth at a frame rate of 25 frames per second, producing spike events at a peak rate of 10(7) events per second.