Nursing home staff networks and COVID-19.

Nursing homes and other long-term care facilities account for a disproportionate share of COVID-19 cases and fatalities worldwide. Outbreaks in US nursing homes have persisted despite nationwide visitor restrictions beginning in mid-March. An early report issued by the Centers for Disease Control and Prevention identified staff members working in multiple nursing homes as a likely source of spread from the Life Care Center in Kirkland, WA, to other skilled nursing facilities. The full extent of staff connections between nursing homes-and the role these connections serve in spreading a highly contagious respiratory infection-is currently unknown given the lack of centralized data on cross-facility employment. We perform a large-scale analysis of nursing home connections via shared staff and contractors using device-level geolocation data from 50 million smartphones, and find that 5.1% of smartphone users who visited a nursing home for at least 1 h also visited another facility during our 11-wk study period-even after visitor restrictions were imposed. We construct network measures of connectedness and estimate that nursing homes, on average, share connections with 7.1 other facilities. Traditional federal regulatory metrics of nursing home quality are unimportant in predicting outbreaks, consistent with recent research. Controlling for demographic and other factors, a home's staff network connections and its centrality within the greater network strongly predict COVID-19 cases.

Willingness of Participation in an Application-Based Digital Data Collection among Different Social Groups and Smartphone User Clusters.

The main question of this paper is what factors influence willingness to participate in a smartphone-application-based data collection where participants both fill out a questionnaire and let the app collect data on their smartphone usage. Passive digital data collection is becoming more common, but it is still a new form of data collection. Due to the novelty factor, it is important to investigate how willingness to participate in such studies is influenced by both socio-economic variables and smartphone usage behaviour. We estimate multilevel models based on a survey experiment with vignettes for different characteristics of data collection (e.g., different incentives, duration of the study). Our results show that of the socio-demographic variables, age has the largest influence, with younger age groups having a higher willingness to participate than older ones. Smartphone use also has an impact on participation. Advanced users are more likely to participate, while users who only use the basic functions of their device are less likely to participate than those who use it mainly for social media. Finally, the explorative analysis with interaction terms between levels has shown that the circumstances of data collection matter differently for different social groups. These findings provide important clues on how to fine-tune circumstances to improve participation rates in this novel passive digital data collection.

Piloting Smartphone Digital Phenotyping to Understand Problematic Internet Use in an Adolescent and Young Adult Sample.

Problematic Internet use (PIU) preferentially affects youth development, particularly youth with psychiatric conditions. Studies attempting to understand PIU and its impact on adolescent mental health have been limited by cross-sectional design and self-report data. Even with a small sample size, digital phenotyping (DP) methodology can address these limitations through repeated sampling and collection of survey and sensor data through personal smartphones. This study pilots a 6-week DP protocol in 28 youth in mental health treatment in order to assess relationships between PIU, mood symptoms, and daily behaviors like smartphone engagement and daily travel in this high-risk population. Our results found shared associations between depression and PIU, where symptom severity of both worsened in the setting of decreased smartphone engagement. These clinically relevant findings indicate that, rather than uniformly worsening mental health, increased digital engagement may actually provide short-term relief from negative affect in youth with psychiatric comorbidities.

Estimating the Necessary Amount of Driving Data for Assessing Driving Behavior.

The aim of this paper was to provide a methodological framework for estimating the amount of driving data that should be collected for each driver in order to acquire a clear picture regarding their driving behavior. We examined whether there is a specific discrete time point for each driver, in the form of total driving duration and/or the number of trips, beyond which the characteristics of driving behavior are stabilized over time. Various mathematical and statistical methods were employed to process the data collected and determine the time point at which behavior converges. Detailed data collected from smartphone sensors are used to test the proposed methodology. The driving metrics used in the analysis are the number of harsh acceleration and braking events, the duration of mobile usage while driving and the percentage of time driving over the speed limits. Convergence was tested in terms of both the magnitude and volatility of each metric for different trips and analysis is performed for several trip durations. Results indicated that there is no specific time point or number of trips after which driving behavior stabilizes for all drivers and/or all metrics examined. The driving behavior stabilization is mostly affected by the duration of the trips examined and the aggressiveness of the driver.

Secure and Usable User-in-a-Context Continuous Authentication in Smartphones Leveraging Non-Assisted Sensors.

Smartphones are equipped with a set of sensors that describe the environment (e.g., GPS, noise, etc.) and their current status and usage (e.g., battery consumption, accelerometer readings, etc.). Several works have already addressed how to leverage such data for user-in-a-context continuous authentication, i.e., determining if the porting user is the authorized one and resides in his regular physical environment. This can be useful for an early reaction against robbery or impersonation. However, most previous works depend on assisted sensors, i.e., they rely upon immutable elements (e.g., cell towers, satellites, magnetism), thus being ineffective in their absence. Moreover, they focus on accuracy aspects, neglecting usability ones. For this purpose, in this paper, we explore the use of four non-assisted sensors, namely battery, transmitted data, ambient light and noise. Our approach leverages data stream mining techniques and offers a tunable security-usability trade-off. We assess the accuracy, immediacy, usability and readiness of the proposal. Results on 50 users over 24 months show that battery readings alone achieve 97.05% of accuracy and 81.35% for audio, light and battery all together. Moreover, when usability is at stake, robbery is detected in 100 s for the case of battery and in 250 s when audio, light and battery are applied. Remarkably, these figures are obtained with moderate training and storage needs, thus making the approach suitable for current devices.

An Electronic Daily Diary Study of Anal Intercourse in Drug-Using Women.

Women (N = 138) with histories of illicit drug use were recruited into an electronic diary study that used Android smartphones for data collection. The diary was to be completed each day for 12 weeks using an "app" created in HTML5 and accessed over the Internet via smartphone. Data collection included information on sexual behaviors with up to 10 partners per day and contextual factors surrounding sexual behavior such as drug use before/after, type of sexual behavior (oral, vaginal, anal), and other activities such as using condoms for vaginal and anal intercourse and use of sexual lubricants. The sample was predominantly African American (58 %); 20 % Latina, 20 % White and 2 % reported as Other. Most women reported either less than a high school education (33 %) or having a high school diploma (33 %). The mean age was 39 years (SD = 11.78). Anal intercourse occurred on days when women also reported using illicit drugs, specifically methamphetamine and cocaine. Anal intercourse was not an isolated sexual activity, but took place on days when vaginal intercourse and giving and receiving oral sex also occurred along with illicit drug use. Anal intercourse also occurred on days when women reported they wanted sex. HIV prevention interventions must address the risks of anal intercourse for women, taking into account concurrent drug use and sexual pleasure that may reduce individual harm-reduction behaviors.

Blockchain-enabled secure and efficient data sharing scheme for trust management in healthcare smartphone network.

The Internet of Medical Things (IoMT) is an extended genre of the Internet of Things (IoT) where the Things collaborate to provide remote patient health monitoring, also known as the Internet of Health (IoH). Smartphones and IoMTs are expected to maintain secure and trusted confidential patient record exchange while managing the patient remotely. Healthcare organizations deploy Healthcare Smartphone Networks (HSN) for personal patient data collection and sharing among smartphone users and IoMT nodes. However, attackers gain access to confidential patient data via infected IoMT nodes on the HSN. Additionally, attackers can compromise the entire network via malicious nodes. This article proposes a Hyperledger blockchain-based technique to identify compromised IoMT nodes and safeguard sensitive patient records. Furthermore, the paper presents a Clustered Hierarchical Trust Management System (CHTMS) to block malicious nodes. In addition, the proposal employs Elliptic Curve Cryptography (ECC) to protect sensitive health records and is resilient against Denial-Of-Service (DOS) attacks. Finally, the evaluation results show that integrating blockchains into the HSN system improved detection performance compared to the existing state of the art. Therefore, the simulation results indicate better security and reliability when compared to conventional databases.

Exposure to urban and rural contexts shapes smartphone usage behavior.

Smartphones have profoundly changed human life. Nevertheless, the factors that shape how we use our smartphones remain unclear, in part due to limited availability of usage-data. Here, we investigate the impact of a key environmental factor: users' exposure to urban and rural contexts. Our analysis is based on a global dataset describing mobile app usage and location for ∼500,000 individuals. We uncover strong and nontrivial patterns. First, we confirm that rural users tend to spend less time on their phone than their urban counterparts. We find, however, that individuals in rural areas tend to use their smartphones for activities such as gaming and social media. In cities, individuals preferentially use their phone for activities such as navigation and business. Are these effects (1) driven by differences between individuals who choose to live in urban vs. rural environments or do they (2) emerge because the environment itself affects online behavior? Using a quasi-experimental design based on individuals that move from the city to the countryside-or vice versa-we confirm hypothesis (2) and find that smartphone use changes according to users's environment. This work presents a quantitative step forward towards understanding how the interplay between environment and smartphones impacts human lives. As such, our findings could provide information to better regulate persuasive technologies embedded in smartphone apps. Further, our work opens the door to understanding new mechanisms leading to urban/rural divides in political and socioeconomic attitudes.

Associations Between Product Type and Intensity of Tobacco and Cannabis Co-use on the Same Day Among Young Adult Smokers: Smartphone-Based Daily-Diary Study.

BACKGROUND: Co-use of tobacco and cannabis is highly prevalent among young US adults. Same-day co-use of tobacco and cannabis (ie, use of both substances on the same day) may increase the extent of use and negative health consequences among young adults. However, much remains unknown about same-day co-use of tobacco and cannabis, in part due to challenges in measuring this complex behavior. Nuanced understanding of tobacco and cannabis co-use in terms of specific products and intensity (ie, quantity of tobacco and cannabis use within a day) is critical to inform prevention and intervention efforts. OBJECTIVE: We used a daily-diary data collection method via smartphone to capture occurrence of tobacco and cannabis co-use within a day. We examined (1) whether the same route of administration would facilitate co-use of 2 substances on the same day and (2) whether participants would use more tobacco on a day when they use more cannabis. METHODS: This smartphone-based study collected 2891 daily assessments from 147 cigarette smokers (aged 18-26 years, n=76, 51.7% female) during 30 consecutive days. Daily assessments measured type (ie, cigarette, cigarillo, or e-cigarette) and intensity (ie, number of cigarettes or cigarillos smoked or number of times vaping e-cigarettes per day) of tobacco use and type (ie, combustible, vaporized, or edible) and intensity (ie, number of times used per day) of cannabis use. We estimated multilevel models to examine day-level associations between types of cannabis use and each type of tobacco use, as well as day-level associations between intensities of using cannabis and tobacco. All models controlled for demographic covariates, day-level alcohol use, and time effects (ie, study day and weekend vs weekday). RESULTS: Same-day co-use was reported in 989 of the total 2891 daily assessments (34.2%). Co-use of cigarettes and combustible cannabis (885 of the 2891 daily assessments; 30.6%) was most commonly reported. Participants had higher odds of using cigarettes (adjusted odds ratio [AOR] 1.92, 95% CI 1.31-2.81) and cigarillos (AOR 244.29, 95% CI 35.51-1680.62) on days when they used combustible cannabis. Notably, participants had higher odds of using e-cigarettes on days when they used vaporized cannabis (AOR 23.21, 95% CI 8.66-62.24). Participants reported a greater intensity of using cigarettes (AOR 1.35, 95% CI 1.23-1.48), cigarillos (AOR 2.04, 95% CI 1.70-2.46), and e-cigarettes (AOR 1.48, 95% CI 1.16-1.88) on days when they used more cannabis. CONCLUSIONS: Types and intensities of tobacco and cannabis use within a day among young adult smokers were positively correlated, including co-use of vaporized products. Prevention and intervention efforts should address co-use and pay attention to all forms of use and timeframes of co-use (eg, within a day or at the same time), including co-use of e-cigarettes and vaporized cannabis, to reduce negative health outcomes.

Aggravated social segregation during the COVID-19 pandemic: Evidence from crowdsourced mobility data in twelve most populated U.S. metropolitan areas.

The notion of social segregation refers to the degrees of separation between socially different population groups. Many studies have examined spatial and residential separations among different socioeconomic or racial populations. However, with the advancement of transportation and communication technologies, people's activities and social interactions are no longer limited to their residential areas. Therefore, there is a growing necessity to investigate social segregation from a mobility perspective by analyzing people's mobility patterns. Taking advantage of crowdsourced mobility data derived from 45 million mobile devices, we innovatively quantify social segregation for the twelve most populated U.S. metropolitan statistical areas (MSAs). We analyze the mobility patterns between different communities within each MSA to assess their separations for two years. Meanwhile, we particularly explore the dynamics of social segregation impacted by the COVID-19 pandemic. The results demonstrate that New York and Washington D.C. are the most and least segregated MSA respectively among the twelve MSAs. Since the COVID-19 began, six of the twelve MSAs experienced a statistically significant increase in segregation. This study also shows that, within each MSA, the most and least vulnerable groups of communities are prone to interacting with their similar communities, indicating a higher degree of social segregation.

Human activity recognition using tools of convolutional neural networks: A state of the art review, data sets, challenges, and future prospects.

Human Activity Recognition (HAR) plays a significant role in the everyday life of people because of its ability to learn extensive high-level information about human activity from wearable or stationary devices. A substantial amount of research has been conducted on HAR and numerous approaches based on deep learning have been exploited by the research community to classify human activities. The main goal of this review is to summarize recent works based on a wide range of deep neural networks architecture, namely convolutional neural networks (CNNs) for human activity recognition. The reviewed systems are clustered into four categories depending on the use of input devices like multimodal sensing devices, smartphones, radar, and vision devices. This review describes the performances, strengths, weaknesses, and the used hyperparameters of CNN architectures for each reviewed system with an overview of available public data sources. In addition, a discussion of the current challenges to CNN-based HAR systems is presented. Finally, this review is concluded with some potential future directions that would be of great assistance for the researchers who would like to contribute to this field. We conclude that CNN-based approaches are suitable for effective and accurate human activity recognition system applications despite challenges including availability of data regarding composite or group activities, high computational resource requirements, data privacy concerns, and edge computing limitations. For widespread adaptation, future research should be focused on more efficient edge computing techniques, datasets incorporating contextual information with activities, more explainable methodologies, and more robust systems.

A Machine Learning Approach for Continuous Mining of Nonidentifiable Smartphone Data to Create a Novel Digital Biomarker Detecting Generalized Anxiety Disorder: Prospective Cohort Study.

BACKGROUND: Anxiety is one of the leading causes of mental health disability around the world. Currently, a majority of the population who experience anxiety go undiagnosed or untreated. New and innovative ways of diagnosing and monitoring anxiety have emerged using smartphone sensor-based monitoring as a metric for the management of anxiety. This is a novel study as it adds to the field of research through the use of nonidentifiable smartphone usage to help detect and monitor anxiety remotely and in a continuous and passive manner. OBJECTIVE: This study aims to evaluate the accuracy of a novel mental behavioral profiling metric derived from smartphone usage for the identification and tracking of generalized anxiety disorder (GAD). METHODS: Smartphone data and self-reported 7-item GAD anxiety assessments were collected from 229 participants using an Android operating system smartphone in an observational study over an average of 14 days (SD 29.8). A total of 34 features were mined to be constructed as a potential digital phenotyping marker from continuous smartphone usage data. We further analyzed the correlation of these digital behavioral markers against each item of the 7-item Generalized Anxiety Disorder Scale (GAD-7) and its influence on the predictions of machine learning algorithms. RESULTS: A total of 229 participants were recruited in this study who had completed the GAD-7 assessment and had at least one set of passive digital data collected within a 24-hour period. The mean GAD-7 score was 11.8 (SD 5.7). Regression modeling was tested against classification modeling and the highest prediction accuracy was achieved from a binary XGBoost classification model (precision of 73%-81%; recall of 68%-87%; F1-score of 71%-79%; accuracy of 76%; area under the curve of 80%). Nonparametric permutation testing with Pearson correlation results indicated that the proposed metric (Mental Health Similarity Score [MHSS]) had a colinear relationship between GAD-7 Items 1, 3 and 7. CONCLUSIONS: The proposed MHSS metric demonstrates the feasibility of using passively collected nonintrusive smartphone data and machine learning-based data mining techniques to track an individuals' daily anxiety levels with a 76% accuracy that directly relates to the GAD-7 scale.

The year in basic vascular biology research: from mechanoreceptors and neutrophil extracellular traps to smartphone data and omics.

2020 has been an extraordinary year. The emergence of COVID-19 has driven urgent research in pulmonary and cardiovascular science and other fields. It has also shaped the way that we work with many experimental laboratories shutting down for several months, while bioinformatics approaches and other large data projects have gained prominence. Despite these setbacks, vascular biology research is stronger than ever. On behalf of the European Society of Cardiology Council for Basic Cardiovascular Science (ESC CBCS), here we review some of the vascular biology research highlights for 2020. This review is not exhaustive and there are many outstanding vascular biology publications that we were unable to cite due to page limits. Notwithstanding this, we have provided a snapshot of vascular biology research excellence in 2020 and identify topics that are in the ascendency and likely to gain prominence in coming years.

Temporal analysis of driving efficiency using smartphone data.

This paper attempts to shed light on the temporal evolution of driving safety efficiency with the aim to acquire insights useful for both driving behavior and road safety improvement. Data exploited herein are collected from a sophisticated platform that uses smartphone device sensors during a naturalistic driving experiment, at which the driving behavior from a sample of two hundred (200) drivers during 7-months is continuously recorded in real time. The main driving behavior analytics taken into consideration for the driving assessment include distance travelled, acceleration, braking, speed and smartphone usage. The analysis is performed using statistical, optimization and machine learning techniques. The driver's safety efficiency index is estimated both in total and in several consecutive time windows to allow for the investigation of safety efficiency evolution in time. Initial data analysis results to the most critical components of microscopic driving behaviour evolution, which are used as inputs in the k-means algorithm to perform the clustering analysis. The main driving characteristics of each cluster are identified and lead to the conclusion that there are three main driving groups of the a) moderate drivers, b) unstable drivers and c) cautious drivers.

The promise of machine learning in predicting treatment outcomes in psychiatry.

For many years, psychiatrists have tried to understand factors involved in response to medications or psychotherapies, in order to personalize their treatment choices. There is now a broad and growing interest in the idea that we can develop models to personalize treatment decisions using new statistical approaches from the field of machine learning and applying them to larger volumes of data. In this pursuit, there has been a paradigm shift away from experimental studies to confirm or refute specific hypotheses towards a focus on the overall explanatory power of a predictive model when tested on new, unseen datasets. In this paper, we review key studies using machine learning to predict treatment outcomes in psychiatry, ranging from medications and psychotherapies to digital interventions and neurobiological treatments. Next, we focus on some new sources of data that are being used for the development of predictive models based on machine learning, such as electronic health records, smartphone and social media data, and on the potential utility of data from genetics, electrophysiology, neuroimaging and cognitive testing. Finally, we discuss how far the field has come towards implementing prediction tools in real-world clinical practice. Relatively few retrospective studies to-date include appropriate external validation procedures, and there are even fewer prospective studies testing the clinical feasibility and effectiveness of predictive models. Applications of machine learning in psychiatry face some of the same ethical challenges posed by these techniques in other areas of medicine or computer science, which we discuss here. In short, machine learning is a nascent but important approach to improve the effectiveness of mental health care, and several prospective clinical studies suggest that it may be working already.

Combined impact of road and traffic characteristic on driver behavior using smartphone sensor data.

The objective of this research is to exploit high resolution driving behavior data collected via sensors of smartphones from 303 drivers in order to examine driver behavior at road segment and junction level. These sensor data are combined with traffic and road geometry characteristics and subsequently depicted spatially using Geographical Information System software. Events of harsh driver behavior (8592 harsh accelerations and 3946 harsh brakings) were mapped to delimited segments and junctions of two urban expressways in Athens, Greece. For the analysis, two multiple linear regression models and two log-linear regression models were developed. Results indicate that in road segments there is an increase in the number of harsh events if average traffic flow per lane increases in the respective areas. Furthermore, as the average occupancy increases in junctions, there is an increase in harsh accelerations, and as the average speed increases, more harsh deceleration events occur. It is evident that traffic characteristics (traffic flow & speed) have the most statistically significant impact on the frequency of harsh events compared to factors related to road geometry and driver behavior.

A critical overview of driver recording tools.

INTRODUCTION: Technological advancements during recent decades have led to the development of a wide array of tools and methods in order to record driving behavior and measure various aspects of driving performance. The aim of the present study is to present and comparatively assess the various driver recording tools that researchers have at their disposal. METHOD: In order to achieve this aim, a multitude of published studies from the international literature have been examined based on the driver recording methodologies that have been implemented. An examination of more traditional survey methods (questionnaires, police reports, and direct observer methods) is initially conducted, followed by investigating issues pertinent to the use of driving simulators. Afterwards, an extensive section is provided for naturalistic driving data tools, including the utilization of on-board diagnostics (OBD) and in-vehicle data recorders (IVDRs). Lastly, in-depth incident analysis and the exploitation of smartphone data are discussed. RESULTS: A critical synthesis of the results is conducted, providing the advantages and disadvantages of utilizing each tool and including additional knowledge regarding ease of experimental implementation, data handling issues, impacts on subsequent analyses, as well as the respective cost parameters. CONCLUSIONS: New technologies provide undeniably powerful tools that allow for seamless data handling, storage, and analysis, such as smartphones and in-vehicle data recorders. However, this sometimes comes at considerable costs (which may or may not pay off at a later stage), while legacy driver recording methods still have their own niches to fill in research. Practical Applications: The present research supports researchers when designing driver behavior monitoring studies. The present work enables better scheduling and pacing of research activities, but can also provide insights for the distribution of research funds.