The Crossroads of Digital Phenotyping

The term ‘Digital Phenotyping’ has started to appear with increasing regularity in medical research, especially within psychiatry. This aims to bring together digital traces (e.g., from smartphones), medical data (e.g., electronic health records), and lived experiences (e.g., daily activity, location, social contact), to better monitor, intervene, and diagnose various psychiatric conditions. However, is this notion any different from digital traces or the quantified self? While digital phenotyping has the potential to transform and revolutionize medicine as we know it; there are a number of challenges that must be addressed if research is to blossom. At present, these issues include; (1) methodological issues, for example, the lack of clear theoretical links between digital markers (e.g., battery life, interactions with smartphones) and condition relapses, (2) the current tools being employed, where they typically have a number of security or privacy issues, and are invasive by nature, (3) analytical methods and approaches, where I question whether research should start in larger-scale epidemiological scale or in smaller (and potentially highly vulnerable) patient populations as is the current norm, (4) the current lack of security and privacy regulation adherence of apps used, and finally, (5) how do such technologies become integrated into various healthcare systems? This aims to provide deep insight into how the Digital Phenotyping could provide huge promise if we critically reflect now and gather clinical insights with a number of other disciplines such as epidemiology, computer- and the social sciences to move forward

Requirements for a Bespoke Intensive Care Unit Dashboard in Response to the COVID-19 Pandemic:Semistructured Interview Study

BACKGROUND: Intensive care units (ICUs) around the world are in high demand due to patients with COVID-19 requiring hospitalization. As researchers at the University of Bristol, we were approached to develop a bespoke data visualization dashboard to assist two local ICUs during the pandemic that will centralize disparate data sources in the ICU to help reduce the cognitive load on busy ICU staff in the ever-evolving pandemic. OBJECTIVE: The aim of this study was to conduct interviews with ICU staff in University Hospitals Bristol and Weston National Health Service Foundation Trust to elicit requirements for a bespoke dashboard to monitor the high volume of patients, particularly during the COVID-19 pandemic. METHODS: We conducted six semistructured interviews with clinical staff to obtain an overview of their requirements for the dashboard and to ensure its ultimate suitability for end users. Interview questions aimed to understand the job roles undertaken in the ICU, potential uses of the dashboard, specific issues associated with managing COVID-19 patients, key data of interest, and any concerns about the introduction of a dashboard into the ICU. RESULTS: From our interviews, we found the following design requirements: (1) a flexible dashboard, where the functionality can be updated quickly and effectively to respond to emerging information about the management of this new disease; (2) a mobile dashboard, which allows staff to move around on wards with a dashboard, thus potentially replacing paper forms to enable detailed and consistent data entry; (3) a customizable and intuitive dashboard, where individual users would be able to customize the appearance of the dashboard to suit their role; (4) real-time data and trend analysis via informative data visualizations that help busy ICU staff to understand a patient’s clinical trajectory; and (5) the ability to manage tasks and staff, tracking both staff and patient movements, handovers, and task monitoring to ensure the highest quality of care. CONCLUSIONS: The findings of this study confirm that digital solutions for ICU use would potentially reduce the cognitive load of ICU staff and reduce clinical errors at a time of notably high demand of intensive health care

Social Media and Well-being: A Methodological Perspective

Due to the methodological challenges inherent in studying social media use (SMU), as well as the methodological choices that have shaped research into the effects of SMU on well-being, clear conclusions regarding relationships between SMU and well-being remain elusive. We provide a review of five methodological developments poised to provide increased understanding in this domain: (1) increased use of longitudinal and experimental designs; (2) the adoption of behavioural (rather than self-report) measures of SMU; (3) focusing on more nuanced aspects of SMU; (4) embracing effect heterogeneity; and (5) the use of formal modelling and machine learning. We focus on how these advances stand to bring us closer to understanding relations between SMU and well-being, as well as the challenges associated with these developments

Platform-controlled social media APIs threaten Open Science

Social media data enable insights into human behavior. Researchers can access these data via platform-provided Application Programming Interfaces (APIs), but these come with restrictive usage-terms that mean studies cannot be reproduced or replicated. Platform-owned APIs hinder access, transparency, and scientific knowledge.<br/

A Systematic Review and Meta-Analysis of Discrepancies Between Logged and Self-Reported Digital Media Use

There is widespread public and academic interest in understanding the uses and effects of digital media. Scholars primarily use self-report measures of the quantity or duration of media use as proxies for more objective measures, but the validity of these self-reports remains unclear. Advancements in data collection techniques have produced a collection of studies indexing both self-reported and log-based measures. To assess the alignment between these measures, we conducted a pre-registered meta-analysis of this research. Based on 106 effect sizes, we found that self-reported media use correlates only moderately with logged measurements, that self-reports were rarely an accurate reflection of logged media use and that measures of problematic media use show an even weaker association with usage logs. These findings raise concerns about the validity of findings relying solely on self-reported measures of media use

Integrative genomic analysis of peritoneal malignant mesothelioma: Understanding a case with extraordinary chemotherapy response

Peritoneal malignant mesothelioma is a rare disease with a generally poor prognosis and poor response to chemotherapy. To improve survival there is a need for increased molecular understanding of the disease, including chemotherapy sensitivity and resistance. We here present an unusual case concerning a young woman with extensive peritoneal mesothelioma who had a remarkable response to palliative chemotherapy (platinum/pemetrexed). Tumor samples collected at surgery before and after treatment were analyzed on the genomic and transcriptional levels (exome sequencing, RNA-seq, and smallRNA-seq). Integrative analysis of single nucleotide and copy-number variants, mutational signatures, and gene expression was performed to provide a comprehensive picture of the disease. LATS1/2 were identified as the main mutational drivers together with homozygous loss of BAP1 and PBRM1, which also may have contributed to the extraordinary chemotherapy response. The presence of the S3 mutational signature is consistent with homologous recombination DNA repair defects due to BAP1 loss. Up-regulation of the PI3K/AKT/mTOR pathway after treatment, supported by deactivated PTEN through miRNA regulation, is associated with cancer progression and could explain chemotherapy resistance. The molecular profile suggests potential benefit from experimental targeting of PARP, EZH2, the PI3K/AKT/mTOR pathway and possibly also from immune checkpoint inhibition. In addition to providing the molecular background for this unusual case of peritoneal mesothelioma, the results show the potential value of integrative genomic analysis in precision medicine

The multidrug/oligosaccharidyl-lipid/polysaccharide (MOP) exporter superfamily

The multidrug/oligosaccharidyl-lipid/polysaccharide (MOP) exporter superfamily (TC #2.A.66) consists of four previously recognized families: (a) the ubiquitous multi-drug and toxin extrusion (MATE)< family; (b) the prokaryotic polysaccharide transporter (PST) family; (c) the eukaryotic oligosaccharidyl-lipid flippase (OLF) family and (d) the bacterial mouse virulence factor family (MVF). Of these four families, only members of the MATE family have been shown to function mechanistically as secondary carriers, and no member of the MVF family has been shown to function as a transporter. Establishment of a common origin for the MATE, PST, OLF and MVF families suggests a common mechanism of action as secondary carriers catalyzing substrate/cation antiport. Most protein members of these four families exhibit 12 putative transmembrane alpha-helical segments (TMSs), and several have been shown to have arisen by an internal gene duplication event; topological variation is observed for some members of the superfamily. The PST family is more closely related to the MATE, OLF and MVF families than any of these latter three families are related to each other. This fact leads to the suggestion that primordial proteins most closely related to the PST family were the evolutionary precursors of all members of the MOP superfamily. Here, phylogenetic trees and average hydropathy, similarity and amphipathicity plots for members of the four families are derived and provide detailed evolutionary and structural information about these proteins. We show that each family exhibits unique characteristics. For example, the MATE and PST families are characterized by numerous paralogues within a single organism (58 paralogues of the MATE family are present in Arabidopsis thaliana ), while the OLF family consists exclusively of orthologues, and the MVF family consists primarily of orthologues. Only in the PST family has extensive lateral transfer of the encoding genes occurred, and in this family as well as the MVF family, topological variation is a characteristic feature. The results serve to define a large superfamily of transporters that we predict function to export substrates using a monovalent cation antiport mechanism