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UNSTRUCTURED The administration of treatments according to circadian rhythms (chronotherapy) aims at advancing precision medicine through tailoring health care and drug delivery to the patients’ biological clocks. The objective of this paper is to present the IoT platform ‘Clinikali’. ‘Clinikali’ is the first-of-its kind IoT mobile platform of artificial intelligence-assisted home care that we develop, conceptualized as domomedicine. Multidimensional telemonitoring of rest-activity and body temperature circadian rhythms, sleep, and physical activity, jointly with subjective symptoms and quality of life is implemented through wireless BLE sensors and electronic tablets connected via GPRS to the ‘Clinikali’ platform server. Parameters are automatically computed in real time. Alerts are generated whenever threshold values are bypassed. A graphical user interface allows for data and parameters dynamics to be seen by health professionals. Feasibility, compliance and reliability are validated in a field test. The domomedicine platform is currently implemented in the MultiDom trial (NCT04263948), for improving outcomes in frail pancreatic cancer patients receiving chemotherapy. Gathering real time information on individual patients’ circadian rhythms and symptoms generates sensitive early warning signals in order to enhance safety through triggering proactive interventions. Quantitative measures of circadian biomarkers further provide cues for the personalization of chronotherapy. Such domomedicine platform should also help improving outcomes in patients with chronic or infectious diseases, which account for most human mortality.

In the last few decades, Brain-Computer Interface (BCI) research has focused predominantly on clinical applications, notably to enable severely disabled people to interact with the environment. However, recent studies rely mostly on the use of non-invasive electroencephalographic (EEG) devices, suggesting that BCI might be ready to be used outside laboratories. In particular, Industry 4.0 is a rapidly evolving sector that aims to restructure traditional methods by deploying digital tools and cyber-physical systems. BCI-based solutions are attracting increasing attention in this field to support industrial performance by optimizing the cognitive load of industrial operators, facilitating human-robot interactions, and make operations in critical conditions more secure. Although these advancements seem promising, numerous aspects must be considered before developing any operational solutions. Indeed, the development of novel applications outside optimal laboratory conditions raises many challenges. In the current study, we carried out a detailed literature review to investigate the main challenges and present criteria relevant to the future deployment of BCI applications for Industry 4.0.

e13617 Background: There is an unmet need for improved treatment outcomes along with safer care of patients (pts) at home, at risk of severe adverse events from chemotherapy. Methods: MultiDom (NCT04263948; Ramsay Santé Research GCS) aims to reduce emergency hospitalisations of pancreatic adenocarcinoma pts on mFOLFIRINOX with a novel telemonitoring-telecare platform (Clinikali). Accelerometry and body temperature are measured q1-min using a continuously-worn telecommunicating chest surface sensor, daily body weight is self-measured with a telecommunicating balance, and 23 electronic pt-reported outcomes (ePROs) are self-rated using a tablet for 1 week before (baseline) and 6 weeks after the first course. Hidden Markov, spectrum and other algorithms automatically compute physical activity, sleep, temperature, body weight change, ePROs severity, and dichotomy index I7 data were teletransmitted. At baseline, rest-activity rhythm was robust for 7 pts (I97.5%) and disrupted for 2 pts (IoC above median), and 2 (0-9) for body weight loss >5%, A median of 6 alerts per pt was generated for one or more severe ePROs (pain, 7 pts; fatigue, 6 pts; impact on activity, 5 pts; anorexia, 4 pts). Supportive treatment was mostly initiated at home, avoiding undue hospitalization. Pts rated the median global evaluation factor as 5 (4-5), i.e. the highest score, in the 23-items research participation questionnaire. Conclusions: Continuous multidimensional telemonitoring of physiology and e-PROs met excellent patient compliance, thus supporting exploration of biological mechanisms linking e-PROs to circadian rhythms and treatment activity. Study is ongoing to assess whether such telemonitoring-telecare platform may drive practice-changes in patient pathways and digitized clinical trials in the current era of precision medicine. Clinical trial information: NCT04263948.

Les Living Labs (LLs) sont de nouvelles formes de laboratoires mettant en œuvre des approches collaboratives et experimentales centrees sur les utilisateurs. Recemment, les capacites des LLs a developper des reseaux d’innovation ouverts et collaboratifs ont ete soulignees. Mais les recherches sont encore peu nombreuses, alors meme que le phenomene ne cesse d’evoluer en pratique. En s’appuyant sur l’analyse longitudinale d’une initiative en cours, les « Concept Maturity Levels Sante », impulsee par le Forum des Living Labs en Sante et Autonomie, cet article presente une recherche abductive visant a explorer et caracteriser la maniere dont les LLs peuvent contribuer, au-dela de projets d’innovation temporaires, a structurer des ecosystemes d’innovation ouverts et collaboratifs sur le long terme. En sus de contribuer a la litterature sur les LLs, l’article ouvre de nouvelles pistes de caracterisation des ecosystemes communautaires d’innovation jusqu’ici encore peu etudies.Code JEL : M100

International audience; IT consulting and engineering firms generally develop strategic knowledge for their clients based on their own competences in various business methods and processes. Knowledge and competences can be improved through collaborative research projects and further leveraged for their own strategic development. The aim of this paper is to build and experiment an organizational management tool within a consulting firm. The tool allows the creation of value and differentiation levers on the competitive market of research and innovation consultancy and illustrates how to benefit from internal research activities that can be viewed as intangible resources. In light of competence-based theory this work shows how strategic knowledge developed on an emerging field such as e-health can be rearranged into strategic processes in order to inspire a proactive strategic vision within a consulting firm.

TPS4673 Background: Pancreatic cancer is a poor prognosis and fast-growing cancer, whose five-year survival is 6% in Europe and the US. FOLFIRINOX has been established as the reference medical treatment for this disease worldwide, yet it also causes leuko-neutropenia, thrombocytopenia, diarrhea, anorexia, asthenia, weight loss, and peripheral sensory neuropathy. Its indication is usually limited to patients having a WHO performance status of 0 or 1. This treatment is often interrupted once Grade 3-4 clinical or hematological toxicities occur, resulting in poor patient performance status and quality of life. Presently, no prospective study monitor and evaluate the qualitative and quantitative effects of FOLFIRINOX on the daily life of pancreatic cancer patients in real-time. Such monitoring would provide early warning signals for the identification of any improvement or deterioration of the patient condition. Whenever necessary, proactive interventions would be triggered to avoid emergency hospitalization for severe adverse events and to enhance treatment compliance. Methods: Our study involves the use of the mobile e-Health platform PiCADo (JMIR 2018) to track and analyse circadian rhythms, symptoms, and body weight in real time in 45 advanced pancreatic cancer patients at 4 centres. The patients are continuously telemonitored for rest-activity, temperature and 3D-orientation via a BLE sensor during the six weeks following the first FOLFIRINOX course. Patients weigh themselves daily on a BLE scale and self-rate their symptoms using a touchscreen on GPRS tablet. Alerts are generated according to preset yet modifiable thresholds of automatically computed critical parameters. From these data, we will evaluate the rate of emergency hospital admissions and the admission-free survival, the rates of severe adverse events, patients’ symptoms dynamics, and their relations with the disruption of the patients’ circadian rhythm. Patient satisfaction and research experience will also be assessed, since engagement is at the core of the success of the approach. The results will guide a future randomized trial comparing standard pancreatic cancer patient care with a personalized FOLFIRINOX approach, including chronotherapy delivery. Support: Ramsay-Sante, Altran.

BACKGROUND Experimental and epidemiologic studies have shown that circadian clocks’ disruption can play an important role in the development of cancer and metabolic diseases. The cellular clocks outside the brain are effectively coordinated by the body temperature rhythm. We hypothesized that concurrent measurements of body temperature and rest-activity rhythms would assess circadian clocks coordination in individual patients, thus enabling the integration of biological rhythms into precision medicine. OBJECTIVE The objective was to evaluate the circadian clocks’ coordination in healthy subjects and patients through simultaneous measurements of rest-activity and body temperature rhythms. METHODS Noninvasive real-time measurements of rest-activity and chest temperature rhythms were recorded during the subject’s daily life, using a dedicated new mobile electronic health platform (PiCADo). It involved a chest sensor that jointly measured accelerations, 3D orientation, and skin surface temperature every 1-5 min and relayed them out to a mobile gateway via Bluetooth Low Energy. The gateway tele-transmitted all stored data to a server via General Packet Radio Service every 24 hours. The technical capabilities of PiCADo were validated in 55 healthy subjects and 12 cancer patients, whose rhythms were e-monitored during their daily routine for 3-30 days. Spectral analyses enabled to compute rhythm parameters values, with their 90% confidence limits, and their dynamics in each subject. RESULTS All the individuals displayed a dominant circadian rhythm in activity with maxima occurring from 12:09 to 20:25. This was not the case for the dominant temperature period, which clustered around 24 hours for 51 out of 67 subjects (76%), and around 12 hours for 13 others (19%). Statistically significant sex- and age-related differences in circadian coordination were identified in the noncancerous subjects, based upon the range of variations in temperature rhythm amplitudes, maxima (acrophases), and phase relations with rest-activity. The circadian acrophase of chest temperature was located at night for the majority of people, but it occurred at daytime for 26% (14/55) of the noncancerous people and 33% (4/12) of the cancer patients, thus supporting important intersubject differences in circadian coordination. Sex, age, and cancer significantly impacted the circadian coordination of both rhythms, based on their phase relationships. CONCLUSIONS Complementing rest-activity with chest temperature circadian e-monitoring revealed striking intersubject differences regarding human circadian clocks’ coordination and timing during daily routine. To further delineate the clinical importance of such finding, the PiCADo platform is currently applied for both the assessment of health effects resulting from atypical work schedules and the identification of the key determinants of circadian disruption in cancer patients.

Background: \ud \ud Experimental and epidemiologic studies have shown that circadian clocks disruption can play an important role in the development of cancer and metabolic diseases. The cellular clocks outside the brain are effectively coordinated by the body temperature rhythm. We hypothesized that concurrent measurements of body temperature and rest-activity rhythms would assess circadian clocks coordination in individual patients, thus enabling the integration of biological rhythms into precision medicine. \ud \ud Objective\ud \ud The objective was to evaluate the circadian clocks’ coordination in healthy subjects and patients through simultaneous measurements of rest-activity and body temperature rhythms.\ud \ud Methods\ud \ud Non-invasive real-time measurements of rest-activity and chest temperature rhythms were recorded during the subject’s daily life, using a dedicated new mobile e-health platform (PiCADo). It involved a chest sensor that jointly measured accelerations, 3D-orientation and skin surface temperature every 1-5 min, and relayed them out to a mobile gateway via Bluetooth-Low-Energy. The gateway tele-transmitted all stored data to a server via GPRS every 24 h. The technical capabilities of PiCADo were validated in 55 healthy subjects and 12 cancer patients, whose rhythms were e-monitored during their daily routine for 3-30 days. Spectral analyses enabled to compute rhythm parameters values, with their 90% confidence limits, and their dynamics in each subject. \ud \ud Results \ud \ud All the individuals displayed a dominant circadian rhythm in activity with maxima occurring from 12:09 to 20:25. This was not the case for the dominant temperature period, which clustered around 24 h for 51 out of 67 subjects (76%), and around 12 h for 13 others (19%). Statistically significant sex- and age- related differences in circadian coordination were identified in the non-cancerous subjects, based upon the range of variations in temperature rhythm amplitudes, maxima (acrophases), and phase relations with rest-activity. The circadian acrophase of chest temperature was located at night for the majority of people, but it occurred at daytime for 26% (14/55) of the non-cancerous people and 33% (4/12) of the cancer patients, hence supporting important inter-subject differences in circadian coordination. Sex, age and cancer significantly impacted on the circadian coordination of both rhythms, based on their phase relationships. \ud \ud Conclusions \ud \ud Complementing rest-activity with chest temperature circadian e-monitoring revealed striking inter-subject differences regarding human circadian clocks coordination and timing during daily routine. To further delineate the clinical importance of such finding, the PiCADo platform is currently applied for both the assessment of health effects resulting from atypical work schedules, and the identification of the key determinants of circadian disruption in cancer patients. \ud