Adaptive intervention design in mobile health: Intervention design and development in the Cell Phone Intervention for You trial.

BACKGROUND/AIMS: The obesity epidemic has spread to young adults, and obesity is a significant risk factor for cardiovascular disease. The prominence and increasing functionality of mobile phones may provide an opportunity to deliver longitudinal and scalable weight management interventions in young adults. The aim of this article is to describe the design and development of the intervention tested in the Cell Phone Intervention for You study and to highlight the importance of adaptive intervention design that made it possible. The Cell Phone Intervention for You study was a National Heart, Lung, and Blood Institute-sponsored, controlled, 24-month randomized clinical trial comparing two active interventions to a usual-care control group. Participants were 365 overweight or obese (body mass index≥25 kg/m2) young adults. METHODS: Both active interventions were designed based on social cognitive theory and incorporated techniques for behavioral self-management and motivational enhancement. Initial intervention development occurred during a 1-year formative phase utilizing focus groups and iterative, participatory design. During the intervention testing, adaptive intervention design, where an intervention is updated or extended throughout a trial while assuring the delivery of exactly the same intervention to each cohort, was employed. The adaptive intervention design strategy distributed technical work and allowed introduction of novel components in phases intended to help promote and sustain participant engagement. Adaptive intervention design was made possible by exploiting the mobile phone's remote data capabilities so that adoption of particular application components could be continuously monitored and components subsequently added or updated remotely. RESULTS: The cell phone intervention was delivered almost entirely via cell phone and was always-present, proactive, and interactive-providing passive and active reminders, frequent opportunities for knowledge dissemination, and multiple tools for self-tracking and receiving tailored feedback. The intervention changed over 2 years to promote and sustain engagement. The personal coaching intervention, alternatively, was primarily personal coaching with trained coaches based on a proven intervention, enhanced with a mobile application, but where all interactions with the technology were participant-initiated. CONCLUSION: The complexity and length of the technology-based randomized clinical trial created challenges in engagement and technology adaptation, which were generally discovered using novel remote monitoring technology and addressed using the adaptive intervention design. Investigators should plan to develop tools and procedures that explicitly support continuous remote monitoring of interventions to support adaptive intervention design in long-term, technology-based studies, as well as developing the interventions themselves.

Rapid design of a single chip adaptive beamformer

This paper presents the design of a single chip adaptive beamformer which contains 5 million transistors and can perform 50 GigaFlops. The core processor of the adaptive beamformer is a QR-array processor implemented on a fully efficient linear systolic architecture. The paper highlights a number of rapid design techniques that have been used to realize the design. These include an architecture synthesis tool for quickly developing the circuit architecture and the utilization of a library of parameterizable silicon intellectual property (IP) cores, to rapidly develop the circuit layouts.

Logic and Memory Design Based on Unequal Error Protection for Voltage-scalable, Robust and Adaptive DSP Systems

In this paper, we propose a system level design approach considering voltage over-scaling (VOS) that achieves error resiliency using unequal error protection of different computation elements, while incurring minor quality degradation. Depending on user specifications and severity of process variations/channel noise, the degree of VOS in each block of the system is adaptively tuned to ensure minimum system power while providing "just-the-right" amount of quality and robustness. This is achieved, by taking into consideration block level interactions and ensuring that under any change of operating conditions, only the "less-crucial" computations, that contribute less to block/system output quality, are affected. The proposed approach applies unequal error protection to various blocks of a system-logic and memory-and spans multiple layers of design hierarchy-algorithm, architecture and circuit. The design methodology when applied to a multimedia subsystem shows large power benefits ( up to 69% improvement in power consumption) at reasonable image quality while tolerating errors introduced due to VOS, process variations, and channel noise.

Adaptive backstepping droop controller design for multi-terminal high-voltage direct current systems

Wind power is one of the most developed renewable energy resources worldwide. To integrate offshore wind farms to onshore grids, the high-voltage direct current (HVDC) transmission cables interfaced with voltage source converters (VSCs) are considered to be a better solution than conventional approaches. Proper DC voltage indicates successive power transfer. To connect more than one onshore grid, the DC voltage droop control is one of the most popular methods to share the control burden between different terminals. However, the challenges are that small droop gains will cause voltage deviations, while higher droop gain settings will cause large oscillations. This study aims to enhance the performance of the traditional droop controller by considering the DC cable dynamics. Based on the backstepping control concept, DC cables are modelled with a series of capacitors and inductors. The final droop control law is deduced step-by-step from the original remote side. At each step the control error from the previous step is considered. Simulation results show that both the voltage deviations and oscillations can be effectively reduced using the proposed method. Further, power sharing between different terminals can be effectively simplified such that it correlates linearly with the droop gains, thus enabling simple yet accurate system operation and control.

Design and low-power implementation of an adaptive image rejection receiver

This paper deals with and details the design and implementation of a low-power; hardware-efficient adaptive self-calibrating image rejection receiver based on blind-source-separation that alleviates the RF analog front-end impairments. Hybrid strength-reduced and re-scheduled data-flow, low-power implementation of the adaptive self-calibration algorithm is developed and its efficiency is demonstrated through simulation case studies. A behavioral and structural model is developed in Matlab as well as a low-level architectural design in VHDL providing valuable test benches for the performance measures undertaken on the detailed algorithms and structures.

Analysis and Design of an Adaptive Polynomial Predistorter with the Loop Delay Estimator

Most adaptive linearization circuits for the nonlinear amplifier have a feedback loop that returns the output signal oj'tne eunplifier to the lineurizer. The loop delay of the linearizer most be controlled precisely so that the convergence of the linearizer should be assured lot this Letter a delay control circuit is presented. It is a delay lock loop (ULL) with it modified early-lute gate and can he easily applied to a DSP implementation. The proposed DLL circuit is applied to an adaptive linearizer with the use of a polynomial predistorter, and the simulalion for a 16-QAM signal is performed. The simulation results show that the proposed DLL eliminates the delay between the reference input signal and the delayed feedback signal of the linearizing circuit perfectly, so that the predistorter polynomial coefficients converge into the optimum value and a high degree of linearization is achieved

eCAT-Listening : Design and psychometric properties of a computerized adaptive test on English Listening

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An adaptive group sequential design for phase II/III clinical trials that select a single treatment from several

There is increasing interest in combining Phases II and III of clinical development into a single trial in which one of a small number of competing experimental treatments is ultimately selected and where a valid comparison is made between this treatment and the control treatment. Such a trial usually proceeds in stages, with the least promising experimental treatments dropped as soon as possible. In this paper we present a highly flexible design that uses adaptive group sequential methodology to monitor an order statistic. By using this approach, it is possible to design a trial which can have any number of stages, begins with any number of experimental treatments, and permits any number of these to continue at any stage. The test statistic used is based upon efficient scores, so the method can be easily applied to binary, ordinal, failure time, or normally distributed outcomes. The method is illustrated with an example, and simulations are conducted to investigate its type I error rate and power under a range of scenarios.