Potential predictors of type-2 diabetes risk: machine learning, synthetic data and wearable health devices

Toward mechanistic medical digital twins: some use cases in immunology

A fundamental challenge for personalized medicine is to capture enough of the complexity of an individual patient to determine an optimal way to keep them healthy or restore their health. This will require personalized computational models of sufficient resolution and with enough mechanistic information to provide actionable information to the clinician. Such personalized models are increasingly referred to as medical digital twins. Digital twin technology for health applications is still in its infancy, and extensive research and development is required. This article focuses on several projects in different stages of development that can lead to specific-and practical-medical digital twins or digital twin modeling platforms. It emerged from a two-day forum on problems related to medical digital twins, particularly those involving an immune system component. Open access video recordings of the forum discussions are available.

Enhancing health care through medical cognitive virtual agents

Objective

The modern era of cognitive intelligence in clinical space has led to the rise of 'Medical Cognitive Virtual Agents' (MCVAs) which are labeled as intelligent virtual assistants interacting with users in a context-sensitive and ambient manner. They aim to augment users' cognitive capabilities thereby helping both patients and medical experts in providing personalized healthcare like remote health tracking, emergency healthcare and robotic diagnosis of critical illness, among others. The objective of this study is to explore the technical aspects of MCVA and their relevance in modern healthcare.

Methods

In this study, a comprehensive and interpretable analysis of MCVAs are presented and their impacts are discussed. A novel system framework prototype based on artificial intelligence for MCVA is presented. Architectural workflow of potential applications of functionalities of MCVAs are detailed. A novel MCVA relevance survey analysis was undertaken during March-April 2023 at Bhubaneswar, Odisha, India to understand the current position of MCVA in society.

Results

Outcome of the survey delivered constructive results. Majority of people associated with healthcare showed their inclination towards MCVA. The curiosity for MCVA in Urban zone was more than in rural areas. Also, elderly citizens preferred using MCVA more as compared to youths. Medical decision support emerged as the most preferred application of MCVA.

Conclusion

The article established and validated the relevance of MCVA in modern healthcare. The study showed that MCVA is likely to grow in future and can prove to be an effective assistance to medical experts in coming days.

Quality, Usability, and Effectiveness of mHealth Apps and the Role of Artificial Intelligence: Current Scenario and Challenges

The use of artificial intelligence (AI) and big data in medicine has increased in recent years. Indeed, the use of AI in mobile health (mHealth) apps could considerably assist both individuals and health care professionals in the prevention and management of chronic diseases, in a person-centered manner. Nonetheless, there are several challenges that must be overcome to provide high-quality, usable, and effective mHealth apps. Here, we review the rationale and guidelines for the implementation of mHealth apps and the challenges regarding quality, usability, and user engagement and behavior change, with a special focus on the prevention and management of noncommunicable diseases. We suggest that a cocreation-based framework is the best method to address these challenges. Finally, we describe the current and future roles of AI in improving personalized medicine and provide recommendations for developing AI-based mHealth apps. We conclude that the implementation of AI and mHealth apps for routine clinical practice and remote health care will not be feasible until we overcome the main challenges regarding data privacy and security, quality assessment, and the reproducibility and uncertainty of AI results. Moreover, there is a lack of both standardized methods to measure the clinical outcomes of mHealth apps and techniques to encourage user engagement and behavior changes in the long term. We expect that in the near future, these obstacles will be overcome and that the ongoing European project, Watching the risk factors (WARIFA), will provide considerable advances in the implementation of AI-based mHealth apps for disease prevention and health promotion.

Machine learning for diabetes clinical decision support: a review

Type 2 diabetes has recently acquired the status of an epidemic silent killer, though it is non-communicable. There are two main reasons behind this perception of the disease. First, a gradual but exponential growth in the disease prevalence has been witnessed irrespective of age groups, geography or gender. Second, the disease dynamics are very complex in terms of multifactorial risks involved, initial asymptomatic period, different short-term and long-term complications posing serious health threat and related co-morbidities. Majority of its risk factors are lifestyle habits like physical inactivity, lack of exercise, high body mass index (BMI), poor diet, smoking except some inevitable ones like family history of diabetes, ethnic predisposition, ageing etc. Nowadays, machine learning (ML) is increasingly being applied for alleviation of diabetes health burden and many research works have been proposed in the literature to offer clinical decision support in different application areas as well. In this paper, we present a review of such efforts for the prevention and management of type 2 diabetes. Firstly, we present the medical gaps in diabetes knowledge base, guidelines and medical practice identified from relevant articles and highlight those that can be addressed by ML. Further, we review the ML research works in three different application areas namely—(1) risk assessment (statistical risk scores and ML-based risk models), (2) diagnosis (using non-invasive and invasive features), (3) prognosis (from normoglycemia/prior morbidity to incident diabetes and prognosis of incident diabetes to related complications). We discuss and summarize the shortcomings or gaps in the existing ML methodologies for diabetes to be addressed in future. This review provides the breadth of ML predictive modeling applications for diabetes while highlighting the medical and technological gaps as well as various aspects involved in ML-based diabetes clinical decision support.

Machine Learning and Smart Devices for Diabetes Management: Systematic Review

(1) Background: The use of smart devices to better manage diabetes has increased significantly in recent years. These technologies have been introduced in order to make life easier for patients with diabetes by allowing better control of the stability of blood sugar levels and anticipating the occurrence of dangerous events (hypo/hyperglycemia), etc. That being said, the main objectives of the self-management of diabetes is to improve the lifestyle and life quality of patients with diabetes; (2) Methods: We performed a systematic review based on articles that focus on the use of smart devices for the monitoring and better management of diabetes. The search was focused on keywords related to the topic, such as “Diabetes”, “Technology”, “Self-management”, “Artificial Intelligence”, etc. This was performed using databases, such as Scopus, Google Scholar, and PubMed; (3) Results: A total of 89 studies, published between 2011 and 2021, were included. The majority of the selected research aims to solve a diabetes management problem (e.g., blood glucose prediction, early detection of risk events, and the automatic adjustment of insulin doses, etc.). In these studies, wearable devices were used in combination with artificial intelligence (AI) techniques; (4) Conclusions: Wearable devices have attracted a great deal of scientific interest in the field of healthcare for people with chronic conditions, such as diabetes. They are capable of assisting in the management of diabetes, as well as preventing complications associated with this condition. Furthermore, the usage of these devices has improved illness management and quality of life.

Machine and cognitive intelligence for human health: systematic review

Brain informatics is a novel interdisciplinary area that focuses on scientifically studying the mechanisms of human brain information processing by integrating experimental cognitive neuroscience with advanced Web intelligence-centered information technologies. Web intelligence, which aims to understand the computational, cognitive, physical, and social foundations of the future Web, has attracted increasing attention to facilitate the study of brain informatics to promote human health. A large number of articles created in the recent few years are proof of the investment in Web intelligence-assisted human health. This study systematically reviews academic studies regarding article trends, top journals, subjects, countries/regions, and institutions, study design, artificial intelligence technologies, clinical tasks, and performance evaluation. Results indicate that literature is especially welcomed in subjects such as medical informatics and health care sciences and service. There are several promising topics, for example, random forests, support vector machines, and conventional neural networks for disease detection and diagnosis, semantic Web, ontology mining, and topic modeling for clinical or biomedical text mining, artificial neural networks and logistic regression for prediction, and convolutional neural networks and support vector machines for monitoring and classification. Additionally, future research should focus on algorithm innovations, additional information use, functionality improvement, model and system generalization, scalability, evaluation, and automation, data acquirement and quality improvement, and allowing interaction. The findings of this study help better understand what and how Web intelligence can be applied to promote healthcare procedures and clinical outcomes. This provides important insights into the effective use of Web intelligence to support informatics-enabled brain studies.

Emulating complex simulations by machine learning methods

BACKGROUND

The aim of the present paper is to construct an emulator of a complex biological system simulator using a machine learning approach. More specifically, the simulator is a patient-specific model that integrates metabolic, nutritional, and lifestyle data to predict the metabolic and inflammatory processes underlying the development of type-2 diabetes in absence of familiarity. Given the very high incidence of type-2 diabetes, the implementation of this predictive model on mobile devices could provide a useful instrument to assess the risk of the disease for aware individuals. The high computational cost of the developed model, being a mixture of agent-based and ordinary differential equations and providing a dynamic multivariate output, makes the simulator executable only on powerful workstations but not on mobile devices. Hence the need to implement an emulator with a reduced computational cost that can be executed on mobile devices to provide real-time self-monitoring.

RESULTS

Similarly to our previous work, we propose an emulator based on a machine learning algorithm but here we consider a different approach which turn out to have better performances, indeed in terms of root mean square error we have an improvement of two order magnitude. We tested the proposed emulator on samples containing different number of simulated trajectories, and it turned out that the fitted trajectories are able to predict with high accuracy the entire dynamics of the simulator output variables. We apply the emulator to control the level of inflammation while leveraging on the nutritional input.

CONCLUSION

The proposed emulator can be implemented and executed on mobile health devices to perform quick-and-easy self-monitoring assessments.

Toward computational modelling on immune system function

The 3rd edition of the computational methods for the immune system function workshop has been held in San Diego, CA, in conjunction with the IEEE International Conference on Bioinformatics and Biomedicine (BIBM 2019) from November 18 to 21, 2019. The workshop has continued its growing tendency, with a total of 18 accepted papers that have been presented in a full day workshop. Among these, the best 10 papers have been selected and extended for presentation in this special issue. The covered topics range from computer-aided identification of T cell epitopes to the prediction of heart rate variability to prevent brain injuries, from In Silico modeling of Tuberculosis and generation of digital patients to machine learning applied to predict type-2 diabetes risk.