Background: Timely recognition of cancer progression and treatment complications is important for treatment guidance. Digital phenotyping is a promising method for precise and remote monitoring of patients in their natural environments by using passively generated data from sensors of personal wearable devices. Further studies are needed to better understand the potential clinical benefits of digital phenotyping approaches to optimize care of patients with cancer. Objective: We aim to evaluate whether passively generated data from smartphone sensors are feasible for remote monitoring of patients with cancer to predict their disease trajectories and patient-centered health outcomes. Methods: We will recruit 200 patients undergoing treatment for cancer. Patients will be followed up for 6 months. Passively generated data by sensors of personal smartphone devices (eg, accelerometer, gyroscope, GPS) will be continuously collected using the developed LAIMA smartphone app during follow-up. We will evaluate (1) mobility data by using an accelerometer (mean time of active period, mean time of exertional physical activity, distance covered per day, duration of inactive period), GPS (places of interest visited daily, hospital visits), and gyroscope sensors and (2) sociability indices (frequency of duration of phone calls, frequency and length of text messages, and internet browsing time). Every 2 weeks, patients will be asked to complete questionnaires pertaining to quality of life (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and anxiety symptoms (General Anxiety Disorder-7 [GAD-7]) that will be deployed via the LAIMA app. Clinic visits will take place at 1-3 months and 3-6 months of the study. Patients will be evaluated for disease progression, cancer and treatment complications, and functional status (Eastern Cooperative Oncology Group) by the study oncologist and will complete the questionnaire for evaluating quality of life (EORTC QLQ-C30), depression symptoms (PHQ-9), and anxiety symptoms (GAD-7). We will examine the associations among digital, clinical, and patient-reported health outcomes to develop prediction models with clinically meaningful outcomes. Results: As of July 2023, we have reached the planned recruitment target, and patients are undergoing follow-up. Data collection is expected to be completed by September 2023. The final results should be available within 6 months after study completion. Conclusions: This study will provide in-depth insight into temporally and spatially precise trajectories of patients with cancer that will provide a novel digital health approach and will inform the design of future interventional clinical trials in oncology. Our findings will allow a better understanding of the potential clinical value of passively generated smartphone sensor data (digital phenotyping) for continuous and real-time monitoring of patients with cancer for treatment side effects, cancer complications, functional status, and patient-reported outcomes as well as prediction of disease progression or trajectories. International Registered Report Identifier (IRRID): PRR1-10.2196/49096

Forest ecosystems and forestry face challenges from increased timber demand, climate change, evolving global markets, rural depopulation, and growing emphasis on forests' social values. As critical carbon sinks, biodiversity reservoirs, and sources of sustainable materials, forests are vital for climate change mitigation and rural employment. However, climate change and past management practices are intensifying natural disturbances, such as storms, droughts, and wildfires. Addressing these challenges requires innovative approaches, including the integration of advanced digital technologies associated with the Fourth Industrial Revolution, such as Artificial Intelligence (AI), the Internet of Things (IoT), blockchain, and big data analytics. These technologies collectively form the foundation of the Forest 4.0 concept, which aims to enhance forest management practices. This presentation introduces the ambitions and achievements of the newly established Lithuanian research infrastructure, Forest 4.0. Developed as part of the Forest 4.0 Teaming for Excellence project, this initiative integrates research facilities and expertise from major forestry research centers at Vytautas Magnus University and the Lithuanian Research Centre for Agriculture and Forestry. The presentation highlights several case studies showcasing innovative methods for collecting, integrating, and analyzing heterogeneous environmental data. One example is the modernization of the Lithuanian National Forest Inventory to explore new aspects of forest ecosystems, such as carbon sequestration, tree micro-habitat assessment, and genetic diversity monitoring. Another example involves the digitalization of observation processes at the Aukštaitija and Žemaitija stations of integrated monitoring, which are part of the Lithuanian eLTER network. Research topics covered in these cases include forest ecosystem dynamics under a changing climate, AI-driven monitoring and prediction techniques for forest management and threat detection, the use of remote sensing and ubiquitous computing to advance geospatial methods, modeling forest processes, conducting multimodal data analyses, and developing decision-support tools to improve forest management practices.

Complications are frequent in cancer patients and contribute to adverse outcomes and higher healthcare costs, underscoring the need for earlier identification and prediction. This study evaluated the feasibility of using passively generated smartphone sensor data to explore early-warning signals of complications and symptom worsening during cancer treatment. A total of 108 patients were continuously monitored using accelerometer, GPS, and screen on/off data collected through the LAIMA application, while symptoms of depression, fatigue, and nausea were assessed every two weeks and complications were confirmed during clinic visits or emergency presentations. Smartphone data streams were aggregated into variables describing activity and sociability patterns. Machine learning models, including Decision Tree, Extreme Gradient Boosting, K-Nearest Neighbors, and Support Vector Machine, were used for complication prediction, and time-series models such as Autoregressive Integrated Moving Average, Holt–Winters, TBATS, Long Short-Term Memory neural network, and General Regression Neural Network were applied to identify early behavioral changes preceding symptom reports. In this exploratory analysis, the ensemble model demonstrated high sensitivity (89%) for identifying complication events. Smartphone-derived behavioral indicators enabled earlier detection of depression, fatigue, and vomiting by about nine days in a subset of patients. These findings demonstrate the feasibility of passive smartphone sensor data as exploratory early-warning signals, warranting validation in larger cohorts.

BACKGROUND Timely recognition of cancer progression and treatment complications is important for treatment guidance. Digital phenotyping is a promising method for precise and remote monitoring of patients in their natural environments by using passively generated data from sensors of personal wearable devices. Further studies are needed to better understand the potential clinical benefits of digital phenotyping approaches to optimize care of patients with cancer. OBJECTIVE We aim to evaluate whether passively generated data from smartphone sensors are feasible for remote monitoring of patients with cancer to predict their disease trajectories and patient-centered health outcomes. METHODS We will recruit 200 patients undergoing treatment for cancer. Patients will be followed up for 6 months. Passively generated data by sensors of personal smartphone devices (eg, accelerometer, gyroscope, GPS) will be continuously collected using the developed LAIMA smartphone app during follow-up. We will evaluate (1) mobility data by using an accelerometer (mean time of active period, mean time of exertional physical activity, distance covered per day, duration of inactive period), GPS (places of interest visited daily, hospital visits), and gyroscope sensors and (2) sociability indices (frequency of duration of phone calls, frequency and length of text messages, and internet browsing time). Every 2 weeks, patients will be asked to complete questionnaires pertaining to quality of life (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and anxiety symptoms (General Anxiety Disorder-7 [GAD-7]) that will be deployed via the LAIMA app. Clinic visits will take place at 1-3 months and 3-6 months of the study. Patients will be evaluated for disease progression, cancer and treatment complications, and functional status (Eastern Cooperative Oncology Group) by the study oncologist and will complete the questionnaire for evaluating quality of life (EORTC QLQ-C30), depression symptoms (PHQ-9), and anxiety symptoms (GAD-7). We will examine the associations among digital, clinical, and patient-reported health outcomes to develop prediction models with clinically meaningful outcomes. RESULTS As of July 2023, we have reached the planned recruitment target, and patients are undergoing follow-up. Data collection is expected to be completed by September 2023. The final results should be available within 6 months after study completion. CONCLUSIONS This study will provide in-depth insight into temporally and spatially precise trajectories of patients with cancer that will provide a novel digital health approach and will inform the design of future interventional clinical trials in oncology. Our findings will allow a better understanding of the potential clinical value of passively generated smartphone sensor data (digital phenotyping) for continuous and real-time monitoring of patients with cancer for treatment side effects, cancer complications, functional status, and patient-reported outcomes as well as prediction of disease progression or trajectories. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/49096