Datamama, bringing pregnancy research into the future: design, development, and evaluation of a citizen science pregnancy mobile application

Background: Pregnancy mobile applications (apps) have grown in popularity over the past decade, with some being used to promote study recruitment or health behaviors. However, no app serves as an all-in-one solution for collecting general data for research purposes and providing women with useful and desirable features. Aim: To create and develop a Swiss pregnancy mobile app as an innovative means to collect research data and provide users with reliable information. Methods: Determining the key features of the app involved a review of the literature and assessment of popular apps in the Swiss AppStore. A team of engineers developed the app, which includes a pregnancy timeline, questionnaires for data collection, medical and psychological articles and a checklist with appointment reminders. The content was written and reviewed by healthcare providers considered experts in the topics adressed. The questionnaires are distributed based on the user’s gestational age, by a chatbot. The project was authorized by the ethics commission in the canton of Vaud. An online survey of ten questions, advertised on Datamama’s home screen, was conducted to assess the users’ use of the app (27.11- 19.12.2022). Results: A review of 84 articles and 25 popular apps showed the need for a comprehensive pregnancy app. The development of Datamama took 2 years and included the creation of 70 medical and psychological articles and 29 questionnaires covering 300 unique variables. Six months after the launch, there were 800 users with a 73% average participation rate in the questionnaires. Sixty-five women completed the survey, with 70.8% using the app once to multiple times per week. The primary reason for using the app was to help research by answering the questionnaires, followed by access to reliable medical information. The reason most frequently ranked first for using the app was to help research by answering the questionnaires (42/65, 67% of women rated it first), followed by access to reliable medical information (34/65, 54% women rated it second). Women rated the information as clear, understandable, and interesting with a trust rating in data handling at 98.5%. The average grade for recommending the app was 8/10, with suggestions for increasing the amount of medical content and tailoring it based on gestational age. Conclusion: Datamama is the first pregnancy app to address the needs of both patients and researchers. Initial feedback from users was positive, highlighting future challenges for success. Future work will consist in improving the app, validating the data and use it to answer specific pregnancy-related research questions

Utilité de la mesure en continu de la glycémie chez les patients diabétiques de type 2

Management of type 1 and type 2 diabetes mellitus is getting complex with the apparition of new treatments, but also new technologies. Among these, continuous glucose monitoring systems (CGMS) lead to a better glycemic control and less hypoglycemia in type 1 diabetic patients. Studies are scarce in type 2 diabetes but also seem to show a benefit, particularly in patients using insulin. Nevertheless, type 2 diabetic patients taking advantage of CGMS must be better defined. In any case, a multidisciplinary approach to the use of CGMS and interpretation of data is warranted

Diabète de type 1, activité physique et nouvelles technologies

L’activité physique est recommandée pour tous les patients avec un diabète, mais une attention particulière est nécessaire en cas de diabète de type 1. En effet, ces patients sont à haut risque d’hypoglycémie. Le défi des soignants et du patient est donc de trouver la meilleure stratégie possible pour pouvoir pratiquer l’activité physique souhaitée, et cela sans faire d’hypo ou d’hyperglycémie. Une adaptation du traitement d’insuline et/ou de l’alimentation est nécessaire, en fonction du type, de l’intensité et de la durée de l’activité physique. Il existe désormais plusieurs outils technologiques permettant d’améliorer la prise en charge du patient, lesquels ont également des limitations. Ainsi, une prise en charge interdisciplinaire diabétologique est recommandée en vue de la pratique d’une activité physique régulière ou ponctuelle

Cardio-Metabolic and Mental Health Outcomes Before and During the COVID-19 Pandemic in a Cohort of Women With Gestational Diabetes Mellitus in Switzerland

BackgroundThe COVID-19 pandemic has been associated with worsened metabolic and mental health in the general and perinatal population. The postpartum is a critical moment regarding these outcomes particularly in women with gestational diabetes mellitus (GDM). We investigated the cardio-metabolic and mental health outcomes before and during the pandemic in this population.MethodsThis cohort study included 418 women with GDM, recruited during two distinct periods. This included 180 women exposed to the pandemic (E+) and recruited between May 2020-April 2021 and 238 women who were not exposed to the pandemic during their postpartum period (attended a year before=non-exposed (E-)) and recruited between January-December 2019. Among the E+, a nested-subcohort of 120 women were exposed both during pregnancy and postpartum. During the pandemic, we adopted a hybrid follow-up of women that consisted of in-person consultations, regular contact via phone calls (35%), sent recorded exercise guide to patients to follow at home and linked to our website. We specifically focused on maintaining motivation and keeping a strong focus on healthy lifestyle behaviors. Obstetric, neonatal, cardio-metabolic and mental health outcomes were assessed during pregnancy and postpartum.ResultsThe pandemic was not associated with worsened weight, weight retention, glucose tolerance, metabolic syndrome, well-being or depression in the postpartum with the exception of a minimally increased HbA1c, diastolic blood pressure and lower emotional eating scores in E+ women (all p ≤ 0.046). In the nested subcohort, E+ women had a slightly increased HbA1c at the first GDM visit and a higher need for glucose-lowering medication (both p ≤ 0.014), but HbA1c at the end of pregnancy and other cardio-metabolic, mental health, obstetric and neonatal outcomes during pregnancy were similar.ConclusionsThe pandemic was not associated with any clinically relevant worsening of cardio-metabolic, mental health, obstetrical and neonatal outcomes in our GDM cohort. This was possibly due to a continued hybrid follow-up, and the partial lockdown in Switzerland

Dynamics and control of global instabilities in open-flows: A linearized approach

International audienceThis review article addresses the dynamics and control of low-frequency unsteadiness, as observed in some aerodynamic applications. It presents a coherent and rigorous linearized approach, which enables both to describe the dynamics of commonly encountered open-flows and to design open-loop and closed-loop control strategies, in view of suppressing or delaying instabilities. The approach is global in the sense that both cross-stream and streamwise directions are discretized in the evolution operator. New light will therefore be shed on the streamwise properties of open-flows. In the case of oscillator flows, the unsteadiness is due to the existence of unstable global modes, i.e., unstable eigenfunctions of the linearized Navier-Stokes operator. The influence of nonlinearities on the dynamics is studied by deriving nonlinear amplitude equations, which accurately describe the dynamics of the flow in the vicinity of the bifurcation threshold. These equations also enable us to analyze the mean flow induced by the nonlinearities as well as the stability properties of this flow. The open-loop control of unsteadiness is then studied by a sensitivity analysis of the eigenvalues with respect to base-flow modifications. With this approach, we manage to a priori identify regions of the flow where a small control cylinder suppresses unsteadiness. Then, a closed-loop control approach was implemented for the case of an unstable open-cavity flow. We have combined model reduction techniques and optimal control theory to stabilize the unstable eigenvalues. Various reduced-order-models based on global modes, proper orthogonal decomposition modes, and balanced modes were tested and evaluated according to their ability to reproduce the input-output behavior between the actuator and the sensor. Finally, we consider the case of noise-amplifiers, such as boundary-layer flows and jets, which are stable when viewed in a global framework. The importance of the singular value decomposition of the global resolvent will be highlighted in order to understand the frequency selection process in such flows. © 2010 by ASME