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Digital clinical measures based on data collected by wearable devices have seen rapid growth in both clinical trials and healthcare. The widely-used measures based on wearables are epoch-based physical activity counts using accelerometer data. Even though activity counts have been the backbone of thousands of clinical and epidemiological studies, there are large variations of the algorithms that compute counts and their associated parameters—many of which have often been kept proprietary by device providers. This lack of transparency has hindered comparability between studies using different devices and limited their broader clinical applicability. ActiGraph devices have been the most-used wearable accelerometer devices for over two decades. Recognizing the importance of data transparency, interpretability and interoperability to both research and clinical use, we here describe the detailed counts algorithms of five generations of ActiGraph devices going back to the first AM7164 model, and publish the current counts algorithm in ActiGraph’s ActiLife and CentrePoint software as a standalone Python package for research use. We believe that this material will provide a useful resource for the research community, accelerate digital health science and facilitate clinical applications of wearable accelerometry.

Subcortical structures play a critical role in brain function. However, options for assessing electrophysiological activity in these structures are limited. Electromagnetic fields generated by neuronal activity in subcortical structures can be recorded noninvasively, using magnetoencephalography (MEG) and electroencephalography (EEG). However, these subcortical signals are much weaker than those generated by cortical activity. In addition, we show here that it is difficult to resolve subcortical sources because distributed cortical activity can explain the MEG and EEG patterns generated by deep sources. We then demonstrate that if the cortical activity is spatially sparse, both cortical and subcortical sources can be resolved with M/EEG. Building on this insight, we develop a hierarchical sparse inverse solution for M/EEG. We assess the performance of this algorithm on realistic simulations and auditory evoked response data, and show that thalamic and brainstem sources can be correctly estimated in the presence of cortical activity. Our work provides alternative perspectives and tools for characterizing electrophysiological activity in subcortical structures in the human brain.

Distributed energy resources (DERs) and demand side management (DSM) strategy implementation in smart grids (SGs) lead to environmental and economic benefits. In this paper, a new DSM strategy is proposed for the day-ahead scheduling problem in SGs with a high penetration of wind energy to optimize the tri-objective problem in SGs: operating cost and pollution emission minimization, the minimization of the cost associated with load curtailment, and the minimization of the deviation between wind turbine (WT) output power and demand. Due to climatic conditions, the nature of the wind energy source is uncertain, and its prediction for day-ahead scheduling is challenging. Monte Carlo simulation (MCS) was used to predict wind energy before integrating with the SG. The DSM strategy used in this study consists of real-time pricing and incentives, which is a hybrid demand response program (H-DRP). To solve the proposed tri-objective SG scheduling problem, an optimization technique, the multi-objective genetic algorithm (MOGA), is proposed, which results in non-dominated solutions in the feasible search area. Besides, the decision-making mechanism (DMM) was applied to find the optimal solution amongst the non-dominated solutions in the feasible search area. The proposed scheduling model successfully optimizes the objective functions. For the simulation, MATLAB 2021a was used. For the validation of this model, it was tested on the SG using multiple balancing constraints for power balance at the consumer end.

Coverage and capacity are optimized in fifth generation (5G) networks by small base station (SBS) distribution in the coverage realm of macro base station (MBS). However, system performance is significantly reduced by inter-cell interference (ICI) because of the orthogonal frequency division multiple access assumption. In addition to ICI, this work considers intentional jammers’ interference (IJI) due to the presence of jammers. These Jammers try to inject undesirable energies into the legitimate communication band, which significantly degrade uplink (UL) signal-to-interference ratio (SIR). To reduce ICI and IJI, in this work, we employ SBS muting, where the SBSs near MBS are switched off. To further mitigate ICI and IJI, we use one of the effective interference management schemes a.k.a reverse frequency allocation (RFA). We presume that due to mitigation in ICI and IJI, the UL coverage performance of the proposed network model can be further improved.

Wearable accelerometers are widely used as an ecologically valid and scalable solution for long-term at-home sleep monitoring in both clinical research and care. In this study, we applied a deep learning domain adversarial convolutional neural network (DACNN) model to this task and demonstrated that this new model outperformed existing sleep algorithms in classifying sleep–wake and estimating sleep outcomes based on wrist-worn accelerometry. This model generalized well to another dataset based on different wearable devices and activity counts, achieving an accuracy of 80.1% (sensitivity 84% and specificity 58%). Compared to commonly used sleep algorithms, this model resulted in the smallest error in wake after sleep onset (MAE of 48.7, Cole–Kripke of 86.2, Sadeh of 108.2, z-angle of 57.5) and sleep efficiency (MAE of 11.8, Cole–Kripke of 18.4, Sadeh of 23.3, z-angle of 9.3) outcomes. Despite being around for many years, accelerometer-alone devices continue to be useful due to their low cost, long battery life, and ease of use. Improving the accuracy and generalizability of sleep algorithms for accelerometer wrist devices is of utmost importance. We here demonstrated that domain adversarial convolutional neural networks can improve the overall accuracy, especially the specificity, of sleep–wake classification using wrist-worn accelerometer data, substantiating its use as a scalable and valid approach for sleep outcome assessment in real life.

Expectation can shape the perception of pain within a fraction of time, but little is known about how perceived expectation unfolds over time and modulates pain perception. Here, we combine magnetoencephalography (MEG) and machine learning approaches to track the neural dynamics of expectations of pain in healthy participants with both sexes. We found that the expectation of pain, as conditioned by facial cues, can be decoded from MEG as early as 150 ms and up to 1100 ms after cue onset, but decoding expectation elicited by unconsciously perceived cues requires more time and decays faster compared to consciously perceived ones. Also, results from temporal generalization suggest that neural dynamics of decoding cue-based expectation were predominately sustained during cue presentation but transient after cue presentation. Finally, although decoding expectation elicited by consciously perceived cues were based on a series of time-restricted brain regions during cue presentation, decoding relied on the medial prefrontal cortex and anterior cingulate cortex after cue presentation for both consciously and unconsciously perceived cues. These findings reveal the conscious and unconscious processing of expectation during pain anticipation and may shed light on enhancing clinical care by demonstrating the impact of expectation cues.

Organizing sensory information into coherent perceptual objects is fundamental to everyday perception and communication. In the visual domain, indirect evidence from cortical responses suggests that children with autism spectrum disorder (ASD) have anomalous figure–ground segregation. While auditory processing abnormalities are common in ASD, especially in environments with multiple sound sources, to date, the question of scene segregation in ASD has not been directly investigated in audition. Using magnetoencephalography, we measured cortical responses to unattended (passively experienced) auditory stimuli while parametrically manipulating the degree of temporal coherence that facilitates auditory figure–ground segregation. Results from 21 children with ASD (aged 7–17 years) and 26 age- and IQ-matched typically developing children provide evidence that children with ASD show anomalous growth of cortical neural responses with increasing temporal coherence of the auditory figure. The documented neurophysiological abnormalities did not depend on age, and were reflected both in the response evoked by changes in temporal coherence of the auditory scene and in the associated induced gamma rhythms. Furthermore, the individual neural measures were predictive of diagnosis (83% accuracy) and also correlated with behavioral measures of ASD severity and auditory processing abnormalities. These findings offer new insight into the neural mechanisms underlying auditory perceptual deficits and sensory overload in ASD, and suggest that temporal-coherence-based auditory scene analysis and suprathreshold processing of coherent auditory objects may be atypical in ASD.

Oral Potentially Malignant Disorders (OPMDs) are chronic lesions or conditions characterized by a potential for malignant transformation. While recent meta-analyses show that smokeless tobacco (SLT) use is a risk factor for oral cancer in South Asia, there is a lack of pooled evidence regarding SLT use and the development of OPMDs. We searched Medline via PubMed, the Science Citation Index (SCI) via Web of Science, Scopus, CINAHL, Global Index Medicus and Google Scholar databases for relevant literature using a combination of keywords and MeSH terms. Eighteen case-control studies were included in the review, all of which reported significantly elevated risk estimates for OPMDs associated with SLT use. Overall and subgroup, Meta Odds Ratios (mOR) were calculated through a random effects analysis using “generic inverse variance” method in Rev Man 5.3. Heterogeneity was quantified by calculating the I² statistic. The mOR for any OPMD with the use of any SLT product was 15.5 [95% Confidence Interval (CI), 9.9–24.2]. Women had a higher risk, mOR = 22.2 (95% CI, 9.1–54.1) compared to men, mOR = 8.7 (95% CI, 2.1–34.8). Betel quid with tobacco carried the highest risk for OPMD, mOR = 16.1 (95% CI, 7.8–33.5). Although the cumulative evidence is informed by case-control studies only, the magnitude of the pooled estimates and the presence of exposure-response indicate a very strong association between OPMDs and SLT use. In addition to tobacco control, results of this review may help in informing oral cancer control policies in South Asia, since OPMDs lie on the causal pathway for oral cancer.

Long-range cortical functional connectivity is often reduced in autism spectrum disorders (ASD), but the nature of local cortical functional connectivity in ASD has remained elusive. We used magnetoencephalography to measure task-related local functional connectivity, as manifested by coupling between the phase of alpha oscillations and the amplitude of gamma oscillations, in the fusiform face area (FFA) of individuals diagnosed with ASD and typically developing individuals while they viewed neutral faces, emotional faces, and houses. We also measured task-related long-range functional connectivity between the FFA and the rest of the cortex during the same paradigm. In agreement with earlier studies, long-range functional connectivity between the FFA and three distant cortical regions was reduced in the ASD group. However, contrary to the prevailing hypothesis in the field, we found that local functional connectivity within the FFA was also reduced in individuals with ASD when viewing faces. Furthermore, the strength of long-range functional connectivity was directly correlated to the strength of local functional connectivity in both groups; thus, long-range and local connectivity were reduced proportionally in the ASD group. Finally, the magnitude of local functional connectivity correlated with ASD severity, and statistical classification using local and long-range functional connectivity data identified ASD diagnosis with 90% accuracy. These results suggest that failure to entrain neuronal assemblies fully both within and across cortical regions may be characteristic of ASD.

Mitochondrial disorders are collectively common, genetically heterogeneous disorders in both pediatric and adult populations. They are caused by molecular defects in oxidative phosphorylation, failure of essential bioenergetic supply to mitochondria, and apoptosis. Here, we present three affected individuals from a consanguineous family of Pakistani origin with variable seizures and intellectual disability. Both females display primary ovarian insufficiency (POI), while the male shows abnormal sex hormone levels. We performed whole exome sequencing and identified a recessive missense variant c.694C > T, p.Arg232Cys in TFAM that segregates with disease. TFAM (mitochondrial transcription factor A) is a component of the mitochondrial replisome machinery that maintains mtDNA transcription and replication. In primary dermal fibroblasts, we show depletion of mtDNA and significantly altered mitochondrial function and morphology. Moreover, we observed reduced nucleoid numbers with significant changes in nucleoid size or shape in fibroblasts from an affected individual compared to controls. We also investigated the effect of tfam impairment in zebrafish; homozygous tfam mutants carrying an in-frame c.141_149 deletion recapitulate the mtDNA depletion and ovarian dysgenesis phenotypes observed in affected humans. Together, our genetic and functional data confirm that TFAM plays a pivotal role in gonad development and expands the repertoire of mitochondrial disease phenotypes.