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AbstractThis study describes patients’ interaction with a personalized web-based visualization displaying daily electronic patient-reported outcomes and wearable device data during outpatient chemotherapy.

BackgroundChemotherapy can cause symptoms that impair quality of life and functioning. Remote monitoring of daily symptoms and activity during outpatient treatment may enable earlier detection and management of emerging toxicities but requires patients, including older and acutely ill patients, to engage with technology to report symptoms through smartphones and to charge and wear mobile devices. ObjectiveThis study aimed to identify factors associated with participant engagement with collecting 3 data streams (ie, daily patient-reported symptom surveys, passive smartphone sensing, and a wearable Fitbit device [Google]) during chemotherapy. MethodsWe enrolled 162 patients receiving outpatient chemotherapy into a 90-day prospective study. Patients were asked to install apps on their smartphones to rate daily symptoms and to collect passive sensor data and to wear a Fitbit device for the duration of the study. Participants completed baseline demographic and quality of life questionnaires, and clinical information was extracted from the electronic medical record. We fit a series of logistic generalized estimating equations to evaluate the association between demographic and clinical factors and daily engagement with each data stream. ResultsParticipants completed daily surveys on 61% (SD 27%) of days and collected sufficient smartphone data and wearable sensor data on 73% (SD 35%) and 70% (SD 33%) of enrolled days, respectively, on average. Relative to White participants, non-White patients demonstrated lower odds of engagement with both symptom surveys (odds ratio [OR] 0.49, 95% CI 0.29-0.81; P=.006) and wearable data collection (OR 0.35, 95% CI 0.17-0.73; P=.005). Patients with stage 4 cancer also exhibited lower odds of engagement with symptom reporting than those with earlier stage disease (OR 0.69, 95% CI 0.48-1.00; P=.048), and patients were less likely to complete symptom ratings on the weekend (OR 0.90, 95% CI 0.83-0.97; P=.008). Older patients (OR 1.03, 95% CI 1.01-1.06; P=.01) and those who reported better cognitive functioning at study entry (OR 1.18, 95% CI 1.03-1.34; P=.02) were more likely to engage with Fitbit data collection, and patients who reported higher levels of depressive symptoms were less likely to engage with smartphone data collection (OR 1.18, 95% CI 1.03-1.36; P=.02). ConclusionsRemote patient monitoring during chemotherapy has the potential to improve clinical management, but only if patients engage with these systems. Our results suggest significant associations between demographic and clinical factors and long-term engagement with smartphone and wearable device assessments during chemotherapy. Non-White participants, those with metastatic cancer, or those with existing cognitive impairment may benefit from additional resources to optimize engagement. Contrary to hypotheses, older adults were more likely than younger adults to engage consistently with wearable device assessments.

Abstract Theories of human neurobehavioral development suggest executive functions mature from childhood through adolescence, underlying adolescent risk-taking and the emergence of psychopathology. Investigations with relatively small datasets or narrow subsets of measures have identified general executive function development, but the specific maturational timing and independence of potential executive function subcomponents remain unknown. Integrating four independent datasets (N = 10,766; 8–35 years old) with twenty-three measures from seventeen tasks, we provide a precise charting, multi-assessment investigation, and replication of executive function development from adolescence to adulthood. Across assessments and datasets, executive functions follow a canonical non-linear trajectory, with rapid and statistically significant development in late childhood to mid-adolescence (10–15 years old), before stabilizing to adult-levels in late adolescence (18–20 years old). Age effects are well captured by domain-general processes that generate reproducible developmental templates across assessments and datasets. Results provide a canonical trajectory of executive function maturation that demarcates the boundaries of adolescence and can be integrated into future studies.

Adolescents’ relationship to social media (SM) use shifted significantly during the COVID-19 lockdown. However, less is known about how adolescents’ social media use behaviors and mood were associated during this time. This study examined objective (passively sensed) SM use—including ‘screen time’ (duration of use) and checking (frequency of opening apps), retrospective daily reports of positive and negative affect during SM use, and general negative mood among adolescents during the COVID-19 lockdown period. Participants included 19 adolescents (Mean age = 15.8; 37 % female). Bayesian multilevel models examined whether within person-changes in SM ‘screen time’ and checking were associated with 1) retrospectively reported positive and negative affect while using SM and daily duration of SM use, 2) daily reports of overall negative mood. These relationships were examined both within the same day and prospectively (one day's SM behaviors predicting next-day mood and vise versa). On the same day, stronger positive or negative mood during SM use were associated with more SM ‘screen time’ (duration) and checking. Prospectively (next-day models), checking SM more frequently than usual was uniquely associated with within-person increases in adolescents’ positive mood when using SM the next day (p < .05), but not negative mood when using SM the next day. However, neither ‘screen time’ nor checking were associated with general negative mood on the same day or next day. These findings support the notion that SM is rewarding by highlighting that higher-than-usual SM checking is associated with within-person increases in positive mood during use. These findings also add to growing evidence that social media may not be directly tied to adolescents’ general mood state.

Changes in brain structure asymmetry have been reported in autism spectrum disorder. Here the authors investigate this issue using a large-scale sample consisting of 54 data sets.

Background: Autism Spectrum Disorder (ASD) is associated with atypical activation in the ventral stream during face processing. The current study further characterizes the development of face processing in ASD using a multivoxel pattern analysis, which assesses the similarity in the representation of exemplars from the same category. Methods: Ninety-two children, adolescents and adults - with and without ASD - performed the Cambridge Face Memory Test, the Australian Face Memory Test, and a matched car memory test. Regions of interest during these tasks included Fusiform Face Area (FFA), based on the literature, and additional, structurally-defined regions in the ventral stream. Group differences in the patterns of activity within these ROIs when memorizing exemplars were examined using a representational similarity analysis (RSA). Results: The RSA revealed significant interactions between age group and diagnostic group in R FFA, with increasing similarity within a category (faces, cars) into adulthood typically but not in those with ASD. This pattern was also evident in structurally defined ventral stream regions, namely L inferior frontal gyrus (IFG), bilateral temporoparietal junction (TPJ), L inferior temporal lobule, and the R fusiform gyrus. Conclusions: The specialization of face and object processing from adolescence to adulthood evident in typical development may be impaired in ASD, undermining the ability to reach adult-level visual processing in those with ASD.