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BACKGROUND Hypoglycemia is a frequent and acute complication in type-1 diabetes mellitus (T1DM) and is associated with a higher risk of car mishaps. Currently, hypoglycemia can be detected and signaled through flash glucose monitoring (FGM) or continuous glucose monitoring (CGM) devices. These devices, however, require manual and visual interaction, removing the focus of attention from the driving task. Hypoglycemia is known to cause a decrease in attention, challenging the safety of using such devices behind the wheel. Here, we present an investigation of hands- and distraction-free technology: an in–vehicle voice–assistant–based warning. OBJECTIVE Designing and assessing a voice–assistant–based health warning for hypoglycemia while driving and addressing the limitations of the current warning solutions. METHODS We developed and assessed the warning in three studies, where participants received the warning while driving. In all studies, we measured participants’ self-reported technology readiness, perception of the warning, and compliance behavior (whether they stopped the car and their reaction time), and assessed any room for improvement through participants’ feedback. In Study 0, 10 healthy participants drove in a simulator and assessed the feasibility of using a voice assistant to deliver a warning. In Study 1, 18 participants with T1DM drove in a simulator and assessed the revised version of the warning. In Study 2, 20 participants with T1DM undergoing hypoglycemia assessed a further revised version of the warning while driving in a real car on a test track. In all studies, we also measured self-reported technology readiness, and acceptance of the warning, and assessed compliance behavior and reaction time in response to the warning. RESULTS In all studies, 100% of participants complied with the warning. In Study 0, healthy participants perceived the warning as usable and useful, and their feedback suggested reducing speech rate and increasing driver-assistant interaction. In Study 1, participants with T1DM reported good perception and their feedback suggested the warning to be less instructive. In Study 2, we observed moderate perception (lower than in Study 1), and participants’ feedback revealed the warning was too overloading. CONCLUSIONS To the best of the authors’ knowledge, this is the first study investigating the feasibility of an in–vehicle voice–assistant–based warning for hypoglycemia while driving. Drivers find such an implementation useful and effective, although individuals with T1DM preferred a simple and direct voice warning, rather than a conversational one. This may reflect the utility and unfamiliarity of proactive behavior in voice assistants. We anticipate this research to be a starting point for the combination of driver-state warnings and for voice–assistant–based health support, and to be a guide for the design of such a combination. CLINICALTRIAL ClinicalTrials.gov NCT04035993, NCT04569630

Contemporary information systems make widespread use of artificial intelligence (AI). While AI offers various benefits, it can also be subject to systematic errors, whereby people from certain groups (defined by gender, age, or other sensitive attributes) experience disparate outcomes. In many AI applications, disparate outcomes confront businesses and organizations with legal and reputational risks. To address these, technologies for so-called “AI fairness” have been developed, by which AI is adapted such that mathematical constraints for fairness are fulfilled. However, the financial costs of AI fairness are unclear. Therefore, the authors develop AI fairness for a real-world use case from e-commerce, where coupons are allocated according to clickstream sessions. In their setting, the authors find that AI fairness successfully manages to adhere to fairness requirements, while reducing the overall prediction performance only slightly. However, they find that AI fairness also results in an increase in financial cost. Thus, in this way the paper’s findings contribute to designing information systems on the basis of AI fairness.

BACKGROUND Micro- and macrovascular complications are a major burden for individuals with diabetes and can already arise in a prediabetic state. To allocate effective treatments and to possibly prevent these complications, identification of those at risk is essential. OBJECTIVE This study aimed to build machine learning (ML) models that predict the risk of developing a micro- or macrovascular complication in individuals with prediabetes or diabetes. METHODS In this study, we used electronic health records from Israel that contain information about demographics, biomarkers, medications, and disease codes; span from 2003 to 2013; and were queried to identify individuals with prediabetes or diabetes in 2008. Subsequently, we aimed to predict which of these individuals developed a micro- or macrovascular complication within the next 5 years. We included 3 microvascular complications: retinopathy, nephropathy, and neuropathy. In addition, we considered 3 macrovascular complications: peripheral vascular disease (PVD), cerebrovascular disease (CeVD), and cardiovascular disease (CVD). Complications were identified via disease codes, and, for nephropathy, the estimated glomerular filtration rate and albuminuria were considered additionally. Inclusion criteria were complete information on age and sex and on disease codes (or measurements of estimated glomerular filtration rate and albuminuria for nephropathy) until 2013 to account for patient dropout. Exclusion criteria for predicting a complication were diagnosis of this specific complication before or in 2008. In total, 105 predictors from demographics, biomarkers, medications, and disease codes were used to build the ML models. We compared 2 ML models: logistic regression and gradient-boosted decision trees (GBDTs). To explain the predictions of the GBDTs, we calculated Shapley additive explanations values. RESULTS Overall, 13,904 and 4259 individuals with prediabetes and diabetes, respectively, were identified in our underlying data set. For individuals with prediabetes, the areas under the receiver operating characteristic curve for logistic regression and GBDTs were, respectively, 0.657 and 0.681 (retinopathy), 0.807 and 0.815 (nephropathy), 0.727 and 0.706 (neuropathy), 0.730 and 0.727 (PVD), 0.687 and 0.693 (CeVD), and 0.707 and 0.705 (CVD); for individuals with diabetes, the areas under the receiver operating characteristic curve were, respectively, 0.673 and 0.726 (retinopathy), 0.763 and 0.775 (nephropathy), 0.745 and 0.771 (neuropathy), 0.698 and 0.715 (PVD), 0.651 and 0.646 (CeVD), and 0.686 and 0.680 (CVD). Overall, the prediction performance is comparable for logistic regression and GBDTs. The Shapley additive explanations values showed that increased levels of blood glucose, glycated hemoglobin, and serum creatinine are risk factors for microvascular complications. Age and hypertension were associated with an elevated risk for macrovascular complications. CONCLUSIONS Our ML models allow for an identification of individuals with prediabetes or diabetes who are at increased risk of developing micro- or macrovascular complications. The prediction performance varied across complications and target populations but was in an acceptable range for most prediction tasks.

Traditional risk scores for the prediction of type 2 diabetes (T2D) are typically designed for a general population and, thus, may underperform for people with prediabetes. Here, we developed machine learning (ML) models predicting the risk of T2D that are specifically tailored to people with prediabetes. We analyzed data of 13,943 individuals with prediabetes, and built a ML model to predict the risk of transition from prediabetes to T2D, integrating information about demographics, biomarkers, medications, and comorbidities defined by disease codes. Additionally, we developed a simplified ML model with only eight predictors, which can be easily integrated into clinical practice. For a forecast horizon of five years, the area under the receiver operating characteristic curve (AUROC) was 0.753 for our full ML model (79 predictors) and 0.752 for the simplified model. Our ML models allow for an early identification of people with prediabetes who are at risk of developing T2D.

Unmanned aerial vehicles (UAVs) operate with large degrees of autonomy when executing tasks from a ground-based controller. In this work, we design an (immersive) interface for drone management. Our interface supports operators in mission execution of one or several (automated) UAVs within a fleet. This allows operators to assign tasks to UAVs, while safe operations are ensured through in-flight conflict detection and prevention. Our interface fulfills both functional (e.g., reliability) and non-functional requirements (e.g., perceived cognitive load during use). A key design challenge is the latency in information exchanges, which introduces information asymmetries between the humans and UAVs. We then validate the effectiveness of our interface design across several experiments. We find that our design reduces the perceived cognitive load and improves task performance. Altogether, this work has implications for designing interfaces in human-machine collaboration, so humans can effectively control, interact, or collaborate with automated machines, such as UAVs., IEEE Access, 9, ISSN:2169-3536

In order to deliver effective care, health management must consider the distinctive trajectories of chronic diseases. These diseases recurrently undergo acute, unstable, and stable phases, each of which requires a different treatment regimen. However, the correct identification of trajectory phases, and thus treatment regimens, is challenging. In this paper, we propose a data-driven, dynamic approach for identifying trajectory phases of chronic diseases and thus suggesting treatment regimens. Specifically, we develop a novel variable-duration copula hidden Markov model (VDC-HMMX). In our VDC-HMMX, the trajectory is modeled as a series of latent states with acute, stable, and unstable phases, which are eventually recovered. We demonstrate the effectiveness of our VDC-HMMX model on the basis of a longitudinal study with 928 patients suffering from low back pain. A myopic classifier identifies correct treatment regimens with a balanced accuracy of slightly above 70%. In comparison, our VDC-HMMX model is correct with a balanced accuracy of 83.65%. This thus highlights the value of longitudinal monitoring for chronic disease management., European Journal of Operational Research, 305 (2), ISSN:0377-2217, ISSN:1872-6860

Aim: To develop a non-invasive machine learning (ML) approach to detect hypoglycemia during real car driving based on driving (CAN) , and eye and head motion (EHM) data. Methods: We logged CAN and EHM data in 21 subjects with type 1 diabetes (18 male, 41 ± yrs, A1c 6.8 ± 0.7 % [51 ± 7 mmol/mol]) during driving in eu- (EU) and hypoglycemia (< 3.0 mmol/L, HYPO) . Participants drove in a car (Volkswagen Touran) supervised by a driving instructor on a closed test-track. Using CAN and EHM data, we built ML models to predict the probability of the driver being in HYPO. To make our approach applicable to different generations of cars, we present 3 ML models: first, a model combining CAN+EHM, representing the modern car with integrated camera. Second, a CAN model using driving data only, since modern cars are not generally equipped with EHM tracking. Third, anticipating that autonomous driving will limit the role of CAN data in the future, we tested a model solely based on EHM. Results: Mean BG in EU and HYPO was 6.3 ± 0.8 mmol/L and 2.5 ± 0.5 mmol/L (p< 0.001) , respectively. The model CAN+EHM achieved an area under the receiver operating characteristic curve of 0.88 ± 0.05, sensitivity of 0.70 ± 0.30, and specificity of 0.83 ± 0.in detecting HYPO. Further results are in Fig. 1. Conclusion: We propose ML-based approaches to non-invasively detect HYPO from driver behavior, applicable to contemporary cars and anticipating developments in automotive technology. Disclosure V.Lehmann: None. E.Fleisch: None. T.Kowatsch: Advisory Panel; Pathmate Technologies AG, Research Support; CSS Insurance, Stock/Shareholder; Pathmate Technologies AG. S.N.Lagger: None. M.Laimer: None. F.Wortmann: None. C.Stettler: None. T.Zueger: None. M.Maritsch: None. M.Notter: None. S.Schallmoser: None. C.Bérubé: None. C.Albrecht: None. M.Kraus: None. S.Feuerriegel: None. Funding Swiss National Science Foundation (SNF CRSII5_183569) , Swiss Diabetes Foundation, Diabetes Center Berne, Automobile Club Switzerland (ACS) , Federal Department of Defence, Civil Protection and Sport (DDPS) and Department of Research of the University Hospital Berne

Non-pharmaceutical interventions, such as school closures and stay-at-home orders, have been implemented around the world to control the spread of SARS-CoV-2. Their effects on health-related outcomes have been the subject of numerous empirical studies. However, these studies show fairly large variation among methodologies in use, reflecting the absence of an established methodological framework. On the one hand, variation in methodologies may be desirable to assess the robustness of results; on the other hand, a lack of common standards can impede comparability among studies. To establish a comprehensive overview over the methodologies in use, we conducted a systematic review of studies assessing the effects of non-pharmaceutical interventions on health-related outcomes between January 1, 2020 and January 12, 2021 (n=248). We identified substantial variation in methodologies with respect to study setting, outcome, intervention, methodological approach, and effect assessment. On this basis, we point to shortcomings of existing studies and make recommendations for the design of future studies.

Textual materials represent a rich source of information for improving the decision-making of people, businesses and organizations. However, for natural language processing (NLP), it is difficult to correctly infer the meaning of narrative content in the presence of negations. The reason is that negations can be formulated both explicitly (e.g., by negation words such as “not”) or implicitly (e.g., by expressions that invert meanings such as “forbid”) and that their use is further domain-specific. Hence, NLP requires a dynamic learning framework for detecting negations and, to this end, we develop a reinforcement learning framework for this task. Formally, our approach takes document-level labels (e.g., sentiment scores) as input and then learns a negation policy based on the document-level labels. In this sense, our approach replicates human perceptions as provided by the document-level labels and achieves a superior prediction performance. Furthermore, it benefits from weak supervision; meaning that the need for granular and thus expensive word-level annotations, as in prior literature, is replaced by document-level annotations. In addition, we propose an approach to interpretability: by evaluating the state-action table, we yield a novel form of statistical inference that allows us to test which linguistic cues act as negations.

Purpose Trading on electricity markets occurs such that the price settlement takes place before delivery, often day-ahead. In practice, these prices are highly volatile as they largely depend upon a range of variables such as electricity demand and the feed-in from renewable energy sources. Hence, the purpose of this paper is to provide accurate forecasts.. Design/methodology/approach This paper aims at comparing different predictors stemming from supply-side (solar and wind power generation), demand-side, fuel-related and economic influences. For this reason, this paper implements a broad range of non-linear models from machine learning and draw upon the information-fusion-based sensitivity analysis. Findings This study disentangles the respective relevance of each predictor. This study shows that external predictors altogether decrease root mean squared errors by up to 21.96%. A Diebold-Mariano test statistically proves that the forecasting accuracy of the proposed machine learning models is superior. Research limitations/implications The performance gain from including more predictors might be larger than from a better model. Future research should place attention on expanding the data basis in electricity price forecasting. Practical implications When developing pricing models, practitioners can achieve reasonable performance with a simple model (e.g. seasonal-autoregressive moving-average) that is built upon a wide range of predictors. Originality/value The benefit of adding further predictors has only recently received traction; however, little is known about how the individual variables contribute to improving forecasts in machine learning.

Recent research has found the language sentiment in financial news to be a substantial driver of prices in financial markets, though there are two diametrically opposed interpretations for this: either markets perceive news sentiment as fundamental information (thus leading to changes in the valuation of assets) or news sentiment conveys a noise signal (thus contributing to the stochastic component of prices). The opposite roles are resolved in the context of crude oil prices by decomposing price movements into two components referring to fundamental and noise trading. Contrary to theoretical arguments in prior literature, we find empirical results supporting both interpretations.

Introduction Human mobility was considerably reduced during the COVID-19 pandemic. To support disease surveillance, it is important to understand the effect of mobility on transmission. Aim We compared the role of mobility during the first and second COVID-19 wave in Switzerland by studying the link between daily travel distances and the effective reproduction number (Rt) of SARS-CoV-2. Methods We used aggregated mobile phone data from a representative panel survey of the Swiss population to measure human mobility. We estimated the effects of reductions in daily travel distance on Rt via a regression model. We compared mobility effects between the first (2 March–7 April 2020) and second wave (1 October–10 December 2020). Results Daily travel distances decreased by 73% in the first and by 44% in the second wave (relative to February 2020). For a 1% reduction in average daily travel distance, Rt was estimated to decline by 0.73% (95% credible interval (CrI): 0.34–1.03) in the first wave and by 1.04% (95% CrI: 0.66–1.42) in the second wave. The estimated mobility effects were similar in both waves for all modes of transport, travel purposes and sociodemographic subgroups but differed for movement radius. Conclusion Mobility was associated with SARS-CoV-2 Rt during the first two epidemic waves in Switzerland. The relative effect of mobility was similar in both waves, but smaller mobility reductions in the second wave corresponded to smaller overall reductions in Rt. Mobility data from mobile phones have a continued potential to support real-time surveillance of COVID-19., Eurosurveillance, 27 (10), ISSN:1560-7917

Head-mounted displays (HMDs) for augmented reality (AR) have received much scholarly attention. Most studies on AR HMDs, however, rely on lab-based environments or simplistic tasks that do not reflect the complexity of industrial work processes. In this work, we conducted a field study in which professional machine operators performed a setup task for an injection molding machine. We assessed and compared task performance, perceived workload, and usability of an AR HMD versus a tablet computer. We find that the use of an AR HMD is perceived as positive overall and not mentally demanding. However, task completion times were not reduced, although participants felt they were., Procedia CIRP, 107, ISSN:2212-8271, Leading manufacturing systems transformation - Proceedings of the 55th CIRP Conference on Manufacturing Systems 2022

Advanced analytics offers new means by which to increase efficiency. However, real-world applications of advanced analytics in manufacturing are scarce. One reason is that the management task of selecting advanced analytics technologies (AATs) for application areas in manufacturing is not well understood. In practice, choosing AATs is difficult because a myriad of potential techniques (e.g. diagnostic, predictive, and prescriptive) are suitable for different areas in the value chain (e.g. planning, scheduling, or quality assurance). It is thus challenging for managers to identify AATs that yield economic benefit. We propose a multi-criteria decision model that managers can use to select efficient AATs tailored to company-specific needs. Based on a data envelopment analysis, our model evaluates the efficiency of each AAT with respect to cost drivers and performance across common application areas in manufacturing. The effectiveness of our decision model is demonstrated by applying it to two manufacturing companies. For each company, a customized portfolio of efficient AATs is derived for a sample of use cases. Thereby, we aid management decision-making concerning the efficient allocation of corporate resources. Our decision model not only facilitates optimal financial allocation for operations in the short-term but also guides long-term strategic investments in AATs., Production Planning & Control, ISSN:0953-7287, ISSN:1366-5871

BACKGROUND To provide effective care for inpatients with COVID-19, clinical practitioners need systems that monitor patient health and subsequently allow for risk scoring. Existing approaches for risk scoring in patients with COVID-19 focus primarily on intensive care units (ICUs) with specialized medical measurement devices but not on hospital general wards. OBJECTIVE In this paper, we aim to develop a risk score for inpatients with COVID-19 in general wards based on consumer-grade wearables (smartwatches). METHODS Patients wore consumer-grade wearables to record physiological measurements, such as the heart rate (HR), heart rate variability (HRV), and respiration frequency (RF). Based on Bayesian survival analysis, we validated the association between these measurements and patient outcomes (ie, discharge or ICU admission). To build our risk score, we generated a low-dimensional representation of the physiological features. Subsequently, a pooled ordinal regression with time-dependent covariates inferred the probability of either hospital discharge or ICU admission. We evaluated the predictive performance of our developed system for risk scoring in a single-center, prospective study based on 40 inpatients with COVID-19 in a general ward of a tertiary referral center in Switzerland. RESULTS First, Bayesian survival analysis showed that physiological measurements from consumer-grade wearables are significantly associated with patient outcomes (ie, discharge or ICU admission). Second, our risk score achieved a time-dependent area under the receiver operating characteristic curve (AUROC) of 0.73-0.90 based on leave-one-subject-out cross-validation. CONCLUSIONS Our results demonstrate the effectiveness of consumer-grade wearables for risk scoring in inpatients with COVID-19. Due to their low cost and ease of use, consumer-grade wearables could enable a scalable monitoring system. CLINICALTRIAL Clinicaltrials.gov NCT04357834; https://www.clinicaltrials.gov/ct2/show/NCT04357834

Particle swarm optimization (PSO) is an iterative search method that moves a set of candidate solution around a search-space towards the best known global and local solutions with randomized step lengths. PSO frequently accelerates optimization in practical applications, where gradients are not available and function evaluations expensive. Yet the traditional PSO algorithm ignores the potential knowledge that could have been gained of the objective function from the observations by individual particles. Hence, we draw upon concepts from Bayesian optimization and introduce a stochastic surrogate model of the objective function. That is, we fit a Gaussian process to past evaluations of the objective function, forecast its shape and then adapt the particle movements based on it. Our computational experiments demonstrate that baseline implementations of PSO (i. e., SPSO2011) are outperformed. Furthermore, compared to, state-of-art surrogate-assisted evolutionary algorithms, we achieve substantial performance improvements on several popular benchmark functions. Overall, we find that our algorithm attains desirable properties for exploratory and exploitative behavior., European Journal of Operational Research, 295 (1), ISSN:0377-2217, ISSN:1872-6860

False rumors (often termed “fake news”) on social media pose a significant threat to modern societies. However, potential reasons for the widespread diffusion of false rumors have been underexplored. In this work, we analyze whether sentiment words, as well as different emotional words, in social media content explain differences in the spread of true vs. false rumors. For this purpose, we collected NN=126,301 rumor cascades from Twitter, comprising more than 4.5 million retweets that have been fact-checked for veracity. We then categorized the language in social media content to (1) sentiment (i.e., positive vs. negative) and (2) eight basic emotions (i. e., anger, anticipation, disgust, fear, joy, trust, sadness, and surprise). We find that sentiment and basic emotions explain differences in the structural properties of true vs. false rumor cascades. False rumors (as compared to true rumors) are more likely to go viral if they convey a higher proportion of terms associated with a positive sentiment. Further, false rumors are viral when embedding emotional words classified as trust, anticipation, or anger. All else being equal, false rumors conveying one standard deviation more positive sentiment have a 37.58% longer lifetime and reach 61.44% more users. Our findings offer insights into how true vs. false rumors spread and highlight the importance of managing emotions in social media content., Scientific Reports, 11, ISSN:2045-2322

Decision-making often requires accurate estimation of treatment effects from observational data. This is challenging as outcomes of alternative decisions are not observed and have to be estimated. Previous methods estimate outcomes based on unconfoundedness but neglect any constraints that unconfoundedness imposes on the outcomes. In this paper, we propose a novel regularization framework for estimating average treatment effects that exploits unconfoundedness. To this end, we formalize unconfoundedness as an orthogonality constraint, which ensures that the outcomes are orthogonal to the treatment assignment. This orthogonality constraint is then included in the loss function via a regularization. Based on our regularization framework, we develop deep orthogonal networks for unconfounded treatments (DONUT), which learn outcomes that are orthogonal to the treatment assignment. Using a variety of benchmark datasets for estimating average treatment effects, we demonstrate that DONUT outperforms the state-of-the-art substantially.

Several sources of bias can affect the performance of machine learning systems used in medicine and potentially impact clinical care. Here, we discuss solutions to mitigate bias across the different development steps of machine learning-based systems for medical applications.

To manage the COVID-19 epidemic effectively, decision-makers in public health need accurate forecasts of case numbers. A potential near real-time predictor of future case numbers is human mobility; however, research on the predictive power of mobility is lacking. To fill this gap, we introduce a novel model for epidemic forecasting based on mobility data, called mobility marked Hawkes model. The proposed model consists of three components: (1) A Hawkes process captures the transmission dynamics of infectious diseases. (2) A mark modulates the rate of infections, thus accounting for how the reproduction number R varies across space and time. The mark is modeled using a regularized Poisson regression based on mobility covariates. (3) A correction procedure incorporates new cases seeded by people traveling between regions. Our model was evaluated on the COVID-19 epidemic in Switzerland. Specifically, we used mobility data from February through April 2020, amounting to approximately 1.5 billion trips. Trip counts were derived from large-scale telecommunication data, i.e., cell phone pings from the Swisscom network, the largest telecommunication provider in Switzerland. We compared our model against various state-of-the-art baselines in terms of out-of-sample root mean squared error. We found that our model outperformed the baselines by 15.52%. The improvement was consistently achieved across different forecast horizons between 5 and 21 days. In addition, we assessed the predictive power of conventional point of interest data, confirming that telecommunication data is superior. To the best of our knowledge, our work is the first to predict the spread of COVID-19 from telecommunication data. Altogether, our work contributes to previous research by developing a scalable early warning system for decision-makers in public health tasked with controlling the spread of infectious diseases., Comment: 9 pages, 3 figures. Accepted for publication in KDD '21: 27th ACM SIGKDD Conference on Knowledge Discovery and Data Mining

In this paper, we present an analysis of eye gaze patterns pertaining to visual cues in augmented reality (AR) for head-mounted displays (HMDs). We conducted an experimental study involving a picking and assembly task, which was guided by different visual cues. We compare these visual cues along multiple dimensions (in-view vs. out-of-view, static vs. dynamic, sequential vs. simultaneous) and analyze quantitative metrics such as gaze distribution, gaze duration, and gaze path distance. Our results indicate that visual cues in AR significantly affect eye gaze patterns. Specifically, we show that the effect varies depending on the type of visual cue. We discuss these empirical results with respect to visual attention theory., Paper accepted at the 2021 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct) Copyright 2021 IEEE

Background: Due to the high rate of asymptomatic patients, the impact of postprandial hypoglycemia after bariatric surgery (PBH) on daily activities such as driving remains controversial. We sought to assess driving performance in patients with PBH. Methods: In a random single-blind crossover study, 10 active drivers with PBH (2 males, age 38±15years, BMI 27.2±4.6kg/m2, gastric bypass 5±2years ago) ingested 75g glucose (GLU) to induce hypoglycemia or aspartame (ASP). A simulator was driven during 10min before and at 20 (D1), 80 (D2), 125 (D3) and 140min (D4) after GLU/ASP, reflective of expected blood glucose (BG) increase (D1), decrease (D2), and hypoglycemia (D3 and D4). Seven driving features (traffic violations and high accelerations) were integrated in a Bayesian hierarchical regression model to assess altered driving performance in GLU vs. ASP. Results: Mean peak and nadir BG after GLU were 182±24 and 47±14mg/dl, respectively. BG was stable after ASP (85±4mg/dl). Driving performance differed between GLU and ASP at times of hypoglycemia (Figure 1), particularly D4, whereas no differences were found for D1 and D2. The posterior probability for impaired driving after GLU was 16% in D1, 82% for D2, 81% for D3 and 98% for D4. Conclusion: Our findings suggest impaired driving performance during PBH. Disclosure A. Tripyla: None. V. Lehmann: None. D. Herzig: None. J. Meier: None. N. Banholzer: None. M. Maritsch: None. S. Feuerriegel: None. F. Wortmann: None. L. Bally: None. Funding Swiss National Science Foundation (PCEGP3_186978, CRSII5_183569, PCEGP1_186932); Dexcom, Inc. (OUS-2020-014)

Aim: To non-invasively detect hypoglycemia in individuals with type 1 diabetes (T1D) based on gaze behavior while driving. Methods: Controlled hypoglycemia was induced in 19 individuals (12 males, age 32 ± 7.1 yrs) with T1D (HbA1c 7.1 ± 0.6% [54 ± 6 mmol/mol]) using an adapted hypoglycemic clamp protocol. Gaze and blood glucose (BG) data were gathered while driving in a simulator during three 18 min sessions: session 1 (BG 90-144 mg/dL), session 2 (BG declining from 72 to 45 mg/dL), and session 3 (BG 36-45 mg/dL). A gradient-boosting machine learning (ML) model was built for hypoglycemia (BG Results: Mean venous BG was 105.4 ± 11.4 mg/dL during session 1, declined from 61.4 ± 6.1 mg/dL to 47.2 ± 8.5 mg/dL during session 2, and was 42.7 ± 4.1 mg/dL during session 3, respectively. Gaze analysis provided 29,968 data samples (1,577.5 ± 52 per subject, 10,041 euglycemia, 19,927 hypoglycemia). Overall, ML achieved an area under the receiver-operating-characteristics curve of 0.83 ± 0.09 for hypoglycemia detection with leave-one-subject-out cross-validation. Conclusion: ML-based gaze analysis shows high accuracy in non-invasive hypoglycemia detection while driving. Our approach offers promising potential in various settings where cameras are available. Disclosure V. Lehmann: None. E. Fleisch: Research Support; Self; CSS Health Insurance, Switzerland, Stock/Shareholder; Self; Pathmate-Technologies AG, Switzerland. F. Wortmann: None. C. Stettler: None. M. Maritsch: None. T. Zueger: None. A. Marxer: None. C. Berube: None. M. Kraus: None. C. Albrecht: None. S. Feuerriegel: None. T. Kowatsch: Advisory Panel; Self; Pathmate Technologies AG, Switzerland and Germany, Stock/Shareholder; Self; Pathmate Technologies AG, Switzerland and Germany. Funding Swiss National Science Foundation (SNF CRSII5_183569); Insel Group; Diabetes Center Berne

Postbariatric hypoglycaemia (PBH) is an increasingly recognized complication of bariatric surgery, but its effect on daily functioning remains unclear. In this randomized, single-blind, crossover trial we assessed driving performance in patients with PBH. Ten active drivers with PBH (eight females, age 38.2 ± 14.7 years, body mass index 27.2 ± 4.6 kg/m

UNSTRUCTURED In digital medicine, patient data typically record health events over time (eg, through electronic health records, wearables, or other sensing technologies) and thus form unique patient trajectories. Patient trajectories are highly predictive of the future course of diseases and therefore facilitate effective care. However, digital medicine often uses only limited patient data, consisting of health events from only a single or small number of time points while ignoring additional information encoded in patient trajectories. To analyze such rich longitudinal data, new artificial intelligence (AI) solutions are needed. In this paper, we provide an overview of the recent efforts to develop trajectory-aware AI solutions and provide suggestions for future directions. Specifically, we examine the implications for developing disease models from patient trajectories along the typical workflow in AI: problem definition, data processing, modeling, evaluation, and interpretation. We conclude with a discussion of how such AI solutions will allow the field to build robust models for personalized risk scoring, subtyping, and disease pathway discovery.

The effect of mobility and its value for surveillance in different waves of the COVID-19 epidemic is still unclear. In this study, we compared the role of mobility during the first and second epidemic wave in Switzerland by analysing the link between daily travel distances and the effective reproduction number Rt of SARS-CoV-2. Here we used aggregated mobile phone data from a representative panel survey of the Swiss population to measure human mobility. We estimated the effects of reductions in daily travel distance on Rt via a regression model. We compared mobility effects between the first wave (March 2-April 7, 2020) and the second wave (October 1-December 10, 2020) across mode of transport, travel purpose, sociodemographic subgroup and movement radius. We found that human mobility was associated with the effective reproduction number of SARS-CoV-2 during both the first and second epidemic wave in Switzerland. The estimated relative effects of mobility were similar in both waves for all modes of transport, travel purposes, and sociodemographic subgroups but differed by movement radius. Moreover, smaller mobility reductions in the second wave translated into smaller overall reductions of Rt. Mobility data from mobile phones have a continued potential to support real-time surveillance of COVID-19 during epidemic waves.

In medicine, comorbidities refer to the presence of multiple, co-occurring diseases. Due to their co-occurring nature, the course of one comorbidity is often highly dependent on the course of the other disease and, hence, treatments can have significant spill-over effects. Despite the prevalence of comorbidities among patients, a comprehensive statistical framework for modeling the longitudinal dynamics of comorbidities is missing. In this paper, we propose a probabilistic model for analyzing comorbidity dynamics over time in patients. Specifically, we develop a coupled hidden Markov model with a personalized, non-homogeneous transition mechanism, named Comorbidity-HMM. The specification of our Comorbidity-HMM is informed by clinical research: (1) It accounts for different disease states (i. e., acute, stable) in the disease progression by introducing latent states that are of clinical meaning. (2) It models a coupling among the trajectories from comorbidities to capture co-evolution dynamics. (3) It considers between-patient heterogeneity (e. g., risk factors, treatments) in the transition mechanism. Based on our model, we define a spill-over effect that measures the indirect effect of treatments on patient trajectories through coupling (i. e., through comorbidity co-evolution). We evaluated our proposed Comorbidity-HMM based on 675 health trajectories where we investigate the joint progression of diabetes mellitus and chronic liver disease. Compared to alternative models without coupling, we find that our Comorbidity-HMM achieves a superior fit. Further, we quantify the spill-over effect, that is, to what extent diabetes treatments are associated with a change in the chronic liver disease from an acute to a stable disease state. To this end, our model is of direct relevance for both treatment planning and clinical research in the context of comorbidities.

Background: Work stress affects individual health and well-being. These negative effects could be mitigated through regular monitoring of employees’ stress. Such monitoring becomes even more important as the digital transformation of the economy implies profound changes in working conditions. Objective: The goal of this study was to investigate the association between computer mouse movements and work stress in the field. Methods: We hypothesized that stress is associated with a speed-accuracy trade-off in computer mouse movements. To test this hypothesis, we conducted a longitudinal field study at a large business organization, where computer mouse movements from regular work activities were monitored over 7 weeks; the study included 70 subjects and 1829 observations. A Bayesian regression model was used to estimate whether self-reported acute work stress was associated with a speed-accuracy trade-off in computer mouse movements. Results: There was a negative association between stress and the two-way interaction term of mouse speed and accuracy (mean −0.32, 95% highest posterior density interval −0.58 to −0.08), which means that stress was associated with a speed-accuracy trade-off. The estimated association was not sensitive to different processing of the data and remained negative after controlling for the demographics, health, and personality traits of subjects. Conclusions: Self-reported acute stress is associated with computer mouse movements, specifically in the form of a speed-accuracy trade-off. This finding suggests that the regular analysis of computer mouse movements could indicate work stress., Journal of Medical Internet Research, 23 (4), ISSN:1438-8871