Timothée Aubourg

Background: Digital health technologies offer high-frequency, objective measures for Parkinson’s disease (PD) yet individual stratification is lacking. This study aimed to identify and predict fast versus slow PD motor progressors by integrating longitudinal clinical evaluation with smartphone motor testing. Methods: In this 96-week subgroup analysis of participants in the Exenatide-PD3 trial, motor progression was measured using Movement Disorder Society-Unified Parkinson’s Disease Rating Scale Part III OFF scores and smartphone testing (baseline, weeks 24, 48, 72, 96). Fast versus slow progressors were identified using data-driven subtyping; linear mixed-effects models assessed longitudinal OFF scores. Baseline clinical and digital features (in-clinic and at-home) were used to predict 96-week motor progression. Model performance was quantified by the area under the receiver operating curve (AUC). Results: Data-driven clustering identified 26.5% (26/98) as fast progressors, with higher baseline OFF scores (+18.16, 95% CI 13.70 to 22.62; adjusted p96% support future in-clinic use) and predictive value in a deployment scenario (AUC 0.80, 95% CI 0.79 to 0.82). Conclusion: Data-driven clustering identified one in four early-to-mid stage PD patients as fast motor progressors. Integrating smartphone-derived features with clinical scores improved baseline motor prediction. High user acceptability supports this approach for individual-level PD stratification, addressing heterogeneity in motor progression that may obscure treatment trial effects.

The development of phylogenetic trees based on RNA or DNA sequences generally requires a precise and limited choice of important RNAs, e.g., messenger RNAs of essential proteins or ribosomal RNAs (like 16S), but rarely complete genomes, making it possible to explain evolution and speciation. In this article, we propose revisiting a classic phylogeny of archaea from only the information on the succession of nucleotides of their entire genome. For this purpose, we use a new tool, the unsupervised classifier Maxwell, whose principle lies in the Burrows–Wheeler compression transform, and we show its efficiency in clustering whole archaeal genomes.

Background: Patients suffering from inflammatory bowel disease (IBD) frequently need long-term medical treatment. Mobile apps promise to complement and improve IBD management, but so far there has been no scientific analysis of their quality. Objective: This study evaluated the quality of German mobile apps targeting IBD patients and physicians treating IBD patients using the Mobile Application Rating Scale (MARS). Methods: The German Apple App Store and Google Play Store were systematically searched to identify German IBD mobile apps for patient and physician use. MARS was used by 6 physicians (3 using Android smartphones and 3 using iPhones) to independently assess app quality. Apps were randomly assigned so that the 4 apps with the most downloads were rated by all raters and the remaining apps were rated by 1 Android and 1 iOS user. Results: In total, we identified 1764 apps in the Apple App Store and Google Play Store. After removing apps that were not related to IBD (n=1386) or not available in German (n=317), 61 apps remained. After removing duplicates (n=3) and apps for congresses (n=7), journals (n=4), and clinical studies (n=6), as well as excluding apps that were available in only 1 of the 2 app stores (n=20) and apps that could only be used with an additional device (n=7), we included a total of 14 apps. The app “CED Dokumentation und Tipps” had the highest overall median MARS score at 4.11/5. On the whole, the median MARS scores of the 14 apps ranged between 2.38/5 and 4.11/5. As there was no significant difference between iPhone and Android raters, we used the Wilcoxon comparison test to calculate P values. Conclusions: The MARS ratings showed that the quality of German IBD apps varied. We also discovered a discrepancy between app store ratings and MARS ratings, highlighting the difficulty of assessing perceived app quality. Despite promising results from international studies, there is little evidence for the clinical benefits of German IBD apps. Clinical studies and patient inclusion in the app development process are needed to effectively implement mobile apps in routine care.

Background: Axial spondyloarthritis (axSpA) is a subgroup of inflammatory rheumatic diseases. Practicing regular exercise is critical to manage pain and stiffness, reduce disease activity, and improve physical functioning, spinal mobility, and cardiorespiratory function. Accordingly, monitoring physical activity and sedentary behavior in patients with axSpA is relevant for clinical outcomes and disease management. Objective: This review aims to determine which wearable devices, assessment methods, and associated metrics are commonly used to quantify physical activity or sedentary behavior in patients with axSpA. Methods: The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane electronic databases will be searched, with no limit on publication date, to identify all the studies matching the inclusion criteria. Only original English-language articles published in a peer-reviewed journal will be included. The search strategy will include a combination of keywords related to the study population, wearable devices, physical activity, and sedentary behavior. We will use the Boolean operators “AND” and “OR” to combine keywords as well as Medical Subject Headings terms. Results: Search strategy was completed in June 2020 with 23 records obtained. Data extraction and synthesis are currently ongoing. Dissemination of study results in peer-reviewed journals is expected at the end of 2021. Conclusions: This review will provide a comprehensive and detailed synthesis of published studies that examine the use of wearable devices for objective assessment of physical activity and sedentary behavior in patients with axSpA. Trial Registration: PROSPERO CRD42020182398; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=182398

BACKGROUND Patients suffering from inflammatory bowel disease (IBD) frequently need long-term medical treatment. Mobile apps promise to complement and improve IBD management, but so far there has been no scientific analysis of their quality. OBJECTIVE This study evaluated the quality of German mobile apps targeting IBD patients and physicians treating IBD patients using the Mobile Application Rating Scale (MARS). METHODS The German Apple App Store and Google Play Store were systematically searched to identify German IBD mobile apps for patient and physician use. MARS was used by 6 physicians (3 using Android smartphones and 3 using iPhones) to independently assess app quality. Apps were randomly assigned so that the 4 apps with the most downloads were rated by all raters and the remaining apps were rated by 1 Android and 1 iOS user. RESULTS In total, we identified 1764 apps in the Apple App Store and Google Play Store. After removing apps that were not related to IBD (n=1386) or not available in German (n=317), 61 apps remained. After removing duplicates (n=3) and apps for congresses (n=7), journals (n=4), and clinical studies (n=6), as well as excluding apps that were available in only 1 of the 2 app stores (n=20) and apps that could only be used with an additional device (n=7), we included a total of 14 apps. The app “CED Dokumentation und Tipps” had the highest overall median MARS score at 4.11/5. On the whole, the median MARS scores of the 14 apps ranged between 2.38/5 and 4.11/5. As there was no significant difference between iPhone and Android raters, we used the Wilcoxon comparison test to calculate P values. CONCLUSIONS The MARS ratings showed that the quality of German IBD apps varied. We also discovered a discrepancy between app store ratings and MARS ratings, highlighting the difficulty of assessing perceived app quality. Despite promising results from international studies, there is little evidence for the clinical benefits of German IBD apps. Clinical studies and patient inclusion in the app development process are needed to effectively implement mobile apps in routine care.

BACKGROUND Mobile applications promise to improve current health care. A growing number app quality studies exist to help patients and physicians choose appropriate, helpful and useful applications. However, current mobile app quality ratings are mostly physician-based. They exclude patients although as end-users, patients are able to provide the most relevant feedback. In a recent physician-based review of rheumatic apps, Rheuma Auszeit received the best overall rating (4.2/5), however this app has never been systematically evaluated by the intended end-users, rheumatic patients. OBJECTIVE The aim of this study was (1) to assess the quality of Rheuma Auszeit by rheumatic patients and (2) to evaluate the association between uMARS (User Version of the Mobile App Rating Scale) scores and patients’ characteristics. METHODS Consecutive patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis were seen at the rheumatology clinic at university hospital Erlangen, Germany. They were asked to evaluate the app Rheuma Auszeit using the uMARS and to complete a paper-based survey evaluating the individual preferences, attitudes and ehealth literacy. uMARS assesses the dimensions of engagement, functionality, aesthetics, information, and subjective quality on 5-point scales. The association between uMARS scores and patients’ characteristics was further explored. RESULTS Between December 2018 and January 2019, a total of 126 patients evaluated Rheuma Auszeit using uMARS and filled out the paper-based survey. The median uMARS score was 3.9, IQR 0.7. Functionality was the domain with the highest rating (median 4.8, IQR 0.8), followed by aesthetics (median 4.0, IQR 0.7), information (median 3.5, IQR 0.8), and engagement (median 3.2, IQR 1.0). Subjective quality was average (median 3.0, IQR 1.0). The lowest scoring individual item was customization with a median of 2.5/5. Lower functionality scores were reported among older female rheumatic patients (P<.004). Older male rheumatic patients reported a higher subjective quality score (P<.024). Perceived disease activity and disease duration did not significantly correlate with any uMARS subdomain scores. eHealth literacy significantly correlated with functionality uMARS subdomain ratings (Rho=0.18; P<.042). Preferred time of app usage significantly correlated with engagement (Rho=0.20; P<.024), functionality (Rho=0.19; P<.029), total uMARS score (Rho=0.21; P<.017) and subjective quality score (Rho=0.21; P<.017). The vast majority of rheumatic patients would consider recommending Rheuma Auszeit to other patients (117/126; 92.9%). CONCLUSIONS Rheuma Auszeit was well accepted by patients suffering from rheumatoid arthritis, psoriatic arthritis and ankylosing spondyloarthritis. Lacking customization could lead to low app compliance and should be improved. The study highlights the potential and feasibility of therapeutic complementary digital solutions in rheumatology.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

How circadian rhythms of activity manifest themselves in social life of humans remains one of the most intriguing questions in chronobiology and a major issue for personalized medicine. Over the past years, substantial advances have been made in understanding the personal nature and the robustness—i.e. the persistence—of the circadian rhythms of social activity by the analysis of phone use. At this stage however, the consistency of such advances as their statistical validity remains unclear. The present paper has been specifically designed to address this issue. To this end, we propose a novel statistical procedure for the measurement of the circadian rhythms of social activity which is particularly well-suited for the existing framework of persistence analysis. Furthermore, we illustrate how this procedure works concretely by assessing the persistence of the circadian rhythms of telephone call activity from a 12-month call detail records (CDRs) dataset of adults over than 65 years. The results show the ability of our approach for assessing persistence with a statistical significance. In the field of CDRs analysis, this novel statistical approach can be used for completing the existing methods used to analyze the persistence of the circadian rhythms of a social nature. More importantly, it provides an opportunity to open up the analysis of CDRs for various domains of application in personalized medicine requiring access to statistical significance such as health care monitoring.

Background: In the elderly population, analysis of the circadian rhythms of social activity may help in supervising homebound disabled and chronically ill populations. Circadian rhythms are monitored over time to determine, for example, the stability of the organization of daily social activity rhythms and the occurrence of particular desynchronizations in the way older adults act and react socially during the day. Recently, analysis of telephone call detail records has led to the possibility of determining circadian rhythms of social activity in an objective unobtrusive way for young patients from their outgoing telephone calls. At this stage, however, the analysis of incoming call rhythms and the comparison of their organization with respect to outgoing calls remains to be performed in underinvestigated populations (in particular, older populations). Objective: This study investigated the persistence and synchronization of circadian rhythms in telephone communication by older adults. Methods: The study used a longitudinal 12-month data set combining call detail records and questionnaire data from 26 volunteers aged 70 years or more to determine the existence of persistent and synchronized circadian rhythms in their telephone communications. The study worked with the following four specific telecommunication parameters: (1) recipient of the telephone call (alter), (2) time at which the call began, (3) duration of the call, and (4) direction of the call. We focused on the following two issues: (1) the existence of persistent circadian rhythms of outgoing and incoming telephone calls in the older population and (2) synchronization with circadian rhythms in the way the older population places and responds to telephone calls. Results: The results showed that older adults have their own specific circadian rhythms for placing telephone calls and receiving telephone calls. These rhythms are partly structured by the way in which older adults allocate their communication time over the day. In addition, despite minor differences between circadian rhythms for outgoing and incoming calls, our analysis suggests the two rhythms could be synchronized. Conclusions: These results suggest the existence of potential persistent and synchronized circadian rhythms in the outgoing and incoming telephone activities of older adults.

BACKGROUND Axial spondyloarthritis (axSpA) is a subgroup of inflammatory rheumatic diseases. Practicing regular exercise is critical to manage pain and stiffness, reduce disease activity, and improve physical functioning, spinal mobility, and cardiorespiratory function. Accordingly, monitoring physical activity and sedentary behavior in patients with axSpA is relevant for clinical outcomes and disease management. OBJECTIVE This review aims to determine which wearable devices, assessment methods, and associated metrics are commonly used to quantify physical activity or sedentary behavior in patients with axSpA. METHODS The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane electronic databases will be searched, with no limit on publication date, to identify all the studies matching the inclusion criteria. Only original English-language articles published in a peer-reviewed journal will be included. The search strategy will include a combination of keywords related to the study population, wearable devices, physical activity, and sedentary behavior. We will use the Boolean operators “AND” and “OR” to combine keywords as well as Medical Subject Headings terms. RESULTS Search strategy was completed in June 2020 with 23 records obtained. Data extraction and synthesis are currently ongoing. Dissemination of study results in peer-reviewed journals is expected at the end of 2021. CONCLUSIONS This review will provide a comprehensive and detailed synthesis of published studies that examine the use of wearable devices for objective assessment of physical activity and sedentary behavior in patients with axSpA. CLINICALTRIAL PROSPERO CRD42020182398; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=182398 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/23359