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BackgroundHealthy lifestyle interventions have a positive impact on multiple disease trajectories, including cancer-related outcomes. Specifically, appropriate habitual physical activity, adequate sleep, and a regular wholesome diet are of paramount importance for the wellness and supportive care of survivors of cancer. Mobile health (mHealth) apps have the potential to support novel tailored lifestyle interventions. ObjectiveThis observational pilot study aims to assess the feasibility of mHealth multidimensional longitudinal monitoring in survivors of cancer. The primary objective is to test the compliance (user engagement) with the monitoring solution. Secondary objectives include recording clinically relevant subjective and objective measures collected through the digital solution. MethodsThis is a monocentric pilot study taking place in Bangor, Wales, United Kingdom. We plan to enroll up to 100 adult survivors of cancer not receiving toxic anticancer treatment, who will provide self-reported behavioral data recorded via a dedicated app and validated questionnaires and objective data automatically collected by a paired smartwatch over 16 weeks. The participants will continue with their normal routine surveillance care for their cancer. The primary end point is feasibility (eg, mHealth monitoring acceptability). Composite secondary end points include clinically relevant patient-reported outcome measures (eg, the Edmonton Symptom Assessment System score) and objective physiological measures (eg, step counts). This trial received a favorable ethical review in May 2023 (Integrated Research Application System 301068). ResultsThis study is part of an array of pilots within a European Union funded project, entitled “GATEKEEPER,” conducted at different sites across Europe and covering various chronic diseases. Study accrual is anticipated to commence in January 2024 and continue until June 2024. It is hypothesized that mHealth monitoring will be feasible in survivors of cancer; specifically, at least 50% (50/100) of the participants will engage with the app at least once a week in 8 of the 16 study weeks. ConclusionsIn a population with potentially complex clinical needs, this pilot study will test the feasibility of multidimensional remote monitoring of patient-reported outcomes and physiological parameters. Satisfactory compliance with the use of the app and smartwatch, whether confirmed or infirmed through this study, will be propaedeutic to the development of innovative mHealth interventions in survivors of cancer. International Registered Report Identifier (IRRID)PRR1-10.2196/52957

BackgroundThe World Health Organization’s strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs. ObjectiveWe aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform. MethodsThe selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities. ResultsSeven European countries were selected, covering Europe’s geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence–based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors. ConclusionsThis paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space.

The World Health Organization and the American College of Sports Medicine have released guidelines on physical activity and sedentary behavior, as part of an effort to reduce inactivity worldwide. However, to date, there is no computational model that can facilitate the integration of these recommendations into health solutions (e.g., digital coaches). In this paper, we present an operational and machine-readable model that represents and is able to reason about these guidelines. To this end, we adopted a symbolic AI approach that combines two paradigms of research in knowledge representation and reasoning: ontology and rules. Thus, we first present HeLiFit, a domain ontology implemented in OWL, which models the main entities that characterize the definition of physical activity, as defined per guidance. Then, we describe HeLiFit-Rule, a set of rules implemented in the RDFox Rule language, which can be used to represent and reason with these recommendations in concrete real-world applications. Furthermore, to ensure a high level of syntactic/semantic interoperability across different systems, our framework is also compliant with the FHIR standard. Through motivating scenarios that highlight the need for such an implementation, we finally present an evaluation of our model that provides results that are both encouraging in terms of the value of our solution and also provide a basis for future work.

This paper presents the approach and tools created to critically investigate the roles and relationships among city stakeholders regarding data-related processes, in order to inform future design solutions for open data portals. The approach to explore the relational dimension of data in local activities is based on mapping the operational roles of the organizations involved in the city data ecosystem throughout a set of archetypes readapted from the characters found in Propp's theory on the narrative structure. A probes toolkit associated with storytelling techniques helped to test the proposed approach during a workshop organized in the city of Milton Keynes. The authors present their motivations and constraints, as well as the rationale regarding the definition of the approach and the construction of the toolkit as part of a design-oriented strategy of inquiry, and discuss the insights gained in the testing experience.

Increasingly over the last decade, there has been attention and expectations on the role that Information and Communication Technology (ICT) solutions can play in increasing accountability, participation, and transparency in the public administration. In addition, attention to citizen participation is more and more at the center of the debate about smart cities. However, technological solutions have been often proposed without considering the first citizen's needs and the sociotechnical misalignment within the city, i.e., in peripheral area. This paper outlines the design and implementation process of a we-government IT tool, called MiraMap. The project has been developed in the Mirafiori District in Torino (Italy), a neighborhood, which is characterized by the problems of marginality and by several undergoing urban transformations with a very high potential for social and economic development in the next few years. This makes Mirafiori Sud a valuable case study environment to experiment new methods and IT solutions to strengthen the connection between citizens and public administration. The object of MiraMap, indeed, is to facilitate communication and management between citizens and administration in reporting of issues and claims but also in submitting proposals. Collecting and handling of this information in an efficient way are crucial to improve the quality of life in urban suburbs, addressing more targeted and better performed public policies. In order to achieve those results, we combined First Life, a new local social network based on an interactive map, with a business process management system for easing reports about claims and proposals to be handled. The research process involves an interdisciplinary team, composed by architects, computer scientists, engineers, geographers, and legal experts, with the direct participation of local administrators and citizens.