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Health Recommender Systems are promising Articial-Intelligence-based tools endowing healthy lifestyles and therapy adherence in healthcare and medicine. Among the most supported areas, it is worth mentioning active aging. However, current HRS supporting AA raise ethical challenges that still need to be properly formalized and explored. This study proposes to rethink HRS for AA through an autonomy-based ethical analysis. In particular, a brief overview of the HRS' technical aspects allows us to shed light on the ethical risks and challenges they might raise on individuals' well-being as they age. Moreover, the study proposes a categorization, understanding, and possible preventive/mitigation actions for the elicited risks and challenges through rethinking the AI ethics core principle of autonomy. Finally, elaborating on autonomy-related ethical theories, the paper proposes an autonomy-based ethical framework and how it can foster the development of autonomy-enabling HRS for AA., (© 2024. The Author(s).)

The awareness about healthy lifestyles is increasing, opening to personalized intelligent health coaching applications. A demand for more than mere suggestions and mechanistic interactions has driven attention to nutrition virtual coaching systems (NVC) as a bridge between human-machine interaction and recommender, informative, persuasive, and argumentation systems. NVC can rely on data-driven opaque mechanisms. Therefore, it is crucial to enable NVC to explain their doing (i.e., engaging the user in discussions (via arguments) about dietary solutions/alternatives). By doing so, transparency, user acceptance, and engagement are expected to be boosted. This study focuses on NVC agents generating personalized food recommendations based on user-specific factors such as allergies, eating habits, lifestyles, and ingredient preferences. In particular, we propose a user-agent negotiation process entailing run-time feedback mechanisms to react to both recommendations and related explanations. Lastly, the study presents the findings obtained by the experiments conducted with multi-background participants to evaluate the acceptability and effectiveness of the proposed system. The results indicate that most participants value the opportunity to provide feedback and receive explanations for recommendations. Additionally, the users are fond of receiving information tailored to their needs. Furthermore, our interactive recommendation system performed better than the corresponding traditional recommendation system in terms of effectiveness regarding the number of agreements and rounds., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s) 2024.)

Personalized support and assistance are essential for cancer survivors, given the physical and psychological consequences they have to suffer after all the treatments and conditions associated with this illness. Digital assistive technologies have proved to be effective in enhancing the quality of life of cancer survivors, for instance, through physical exercise monitoring and recommendation or emotional support and prediction. To maximize the efficacy of these techniques, it is challenging to develop accurate models of patient trajectories, which are typically fed with information acquired from retrospective datasets. This paper presents a Machine Learning-based survival model embedded in a clinical decision system architecture for predicting cancer survivors' trajectories. The proposed architecture of the system, named PERSIST, integrates the enrichment and pre-processing of clinical datasets coming from different sources and the development of clinical decision support modules. Moreover, the model includes detecting high-risk markers, which have been evaluated in terms of performance using both a third-party dataset of breast cancer patients and a retrospective dataset collected in the context of the PERSIST clinical study., (Copyright © 2023. Published by Elsevier B.V.)

Intersections are at the core of congestion in urban areas. After the end of the Second World War, the problem of intersection management has benefited from a growing body of advances to address the optimization of the traffic lights' phase splits, timing, and offset. These contributions have significantly improved traffic safety and efficiency in urban areas. However, with the growth of transportation demand and motorization, traffic lights show their limits. At the end of the 1990s, the perspective of autonomous and connected driving systems motivated researchers to introduce a paradigm shift for controlling intersections. This new paradigm is well known today as autonomous intersection management (AIM). It harnesses the self-organization ability of future vehicles to provide more accurate control approaches that use the smallest available time window to reach unprecedented traffic performances. This is achieved by optimizing two main points of the interaction of connected and autonomous vehicles at intersections: the motion control of vehicles and the schedule of their accesses. Considering the great potential of AIM and the complexity of the problem, the proposed approaches are very different, starting from various assumptions. With the increasing popularity of AIM, this paper provides readers with a comprehensive vision of noticeable advances toward enhancing traffic efficiency. It shows that it is possible to tailor vehicles' speed and schedule according to the traffic demand by using distributed particle swarm optimization. Moreover, it brings the most relevant contributions in the light of traffic engineering, where flow-speed diagrams are used to measure the impact of the proposed optimizations. Finally, this paper presents the current challenging issues to be addressed.

Since its emergence in the 1960s, Artificial Intelligence (AI) has grown to conquer many technology products and their fields of application. Machine learning, as a major part of the current AI solutions, can learn from the data and through experience to reach high performance on various tasks. This growing success of AI algorithms has led to a need for interpretability to understand opaque models such as deep neural networks. Various requirements have been raised from different domains, together with numerous tools to debug, justify outcomes, and establish the safety, fairness and reliability of the models. This variety of tasks has led to inconsistencies in the terminology with, for instance, terms such as interpretable , explainable and transparent being often used interchangeably in methodology papers. These words, however, convey different meanings and are "weighted" differently across domains, for example in the technical and social sciences. In this paper, we propose an overarching terminology of interpretability of AI systems that can be referred to by the technical developers as much as by the social sciences community to pursue clarity and efficiency in the definition of regulations for ethical and reliable AI development. We show how our taxonomy and definition of interpretable AI differ from the ones in previous research and how they apply with high versatility to several domains and use cases, proposing a-highly needed-standard for the communication among interdisciplinary areas of AI., (© The Author(s) 2022.)

In the past decades, the incidence rate of cancer has steadily risen. Although advances in early and accurate detection have increased cancer survival chances, these patients must cope with physical and psychological sequelae. The lack of personalized support and assistance after discharge may lead to a rapid diminution of their physical abilities, cognitive impairment, and reduced quality of life. This paper proposes a personalized support system for cancer survivors based on a cohort and trajectory analysis (CTA) module integrated within an agent-based personalized chatbot named EREBOTS. The CTA module relies on survival estimation models, machine learning, and deep learning techniques. It provides clinicians with supporting evidence for choosing a personalized treatment, while allowing patients to benefit from tailored suggestions adapted to their conditions and trajectories. The development of the CTA within the EREBOTS framework enables to effectively evaluate the significance of prognostic variables, detect patient's high-risk markers, and support treatment decisions., (© 2021. The Author(s).)

Patients are often required to follow a medical treatment after discharge, e.g., for a chronic condition, rehabilitation after surgery, or for cancer survivor therapies. The need to adapt to new lifestyles, medication, and treatment routines, can produce an individual burden to the patient, who is often at home without the full support of healthcare professionals. Although technological solutions -in the form of mobile apps and wearables- have been proposed to mitigate these issues, it is essential to consider individual characteristics, preferences, and the context of a patient in order to offer personalized and effective support. The specific events and circumstances linked to an individual profile can be abstracted as a patient trajectory, which can contribute to a better understanding of the patient, her needs, and the most appropriate personalized support. Although patient trajectories have been studied for different illnesses and conditions, it remains challenging to effectively use them as the basis for data analytics methodologies in decentralized eHealth systems. In this work, we present a novel approach based on the multi-agent paradigm, considering patient trajectories as the cornerstone of a methodology for modelling eHealth support systems. In this design, semantic representations of individual treatment pathways are used in order to exchange patient-relevant information, potentially fed to AI systems for prediction and classification tasks. This paper describes the major challenges in this scope, as well as the design principles of the proposed agent-based architecture, including an example of its use through a case scenario for cancer survivors support.

Digital rehabilitation is a novel concept that integrates state-of-the-art technologies for motion sensing and monitoring, with personalized patient-centric methodologies emerging from the field of physiotherapy. Thanks to the advances in wearable and portable sensing technologies, it is possible to provide patients with accurate monitoring devices, which simplifies the tracking of performance and effectiveness of physical exercises and treatments. Employing these approaches in everyday practice has enormous potential. Besides facilitating and improving the quality of care provided by physiotherapists, the usage of these technologies also promotes the personalization of treatments, thanks to data analytics and patient profiling (e.g., performance and behavior). However, achieving such goals implies tackling both technical and methodological challenges. In particular, (i) the capability of undertaking autonomous behaviors must comply with strict real-time constraints (e.g., scheduling, communication, and negotiation), (ii) plug-and-play sensors must seamlessly manage data and functional heterogeneity, and finally (iii) multi-device coordination must enable flexible and scalable sensor interactions. Beyond traditional top-down and best-effort solutions, unsuitable for safety-critical scenarios, we propose a novel approach for decentralized real-time compliant semantic agents. In particular, these agents can autonomously coordinate with each other, schedule sensing and data delivery tasks (complying with strict real-time constraints), while relying on ontology-based models to cope with data heterogeneity. Moreover, we present a model that represents sensors as autonomous agents able to schedule tasks and ensure interactions and negotiations compliant with strict timing constraints. Furthermore, to show the feasibility of the proposal, we present a practical study on upper and lower-limb digital rehabilitation scenarios, simulated on the MAXIM-GPRT environment for real-time compliance. Finally, we conduct an extensive evaluation of the implementation of the stream processing multi-agent architecture, which relies on existing RDF stream processing engines.

Telerehabilitation in older adults is most needed in the patient environments, rather than in formal ambulatories or hospitals. Supporting such practices brings significant advantages to patients, their family, formal and informal caregivers, clinicians, and researchers. This paper presents a focus group with experts in physiotherapy and telerehabilitation, debating on the requirements, current techniques and technologies developed to facilitate and enhance the effectiveness of telerehabilitation, and the still open challenges. Particular emphasis is given to (i) the body-parts requiring the most rehabilitation, (ii) the typical environments, initial causes, and general conditions, (iii) the values and parameters to be observed, (iv) common errors and limitations of current practices and technological solutions, and (v) the envisioned and desired technological support. Consequently, it has been performed a systematic review of the state of the art, investigating what types of systems and support currently cope with telerehabilitation practices and possible matches with the outcomes of the focus group. Technological solutions based on video analysis, wearable devices, robotic support, distributed sensing, and gamified telerehabilitation are examined. Particular emphasis is given to solutions implementing agent-based approaches, analyzing and discussing strength, limitations, and future challenges. By doing so, it has been possible to relate functional requirements expressed by professional physiotherapists and researchers, with the need for extending multi-agent systems (MAS) peculiarities at the sensing level in wearable solutions establishing new research challenges. In particular, to be employed in safety-critical cyber-physical scenarios with user-sensor and sensor-sensor interactions, MAS are requested to handle timing constraints, scarcity of resources and new communication means, crucial to providing real-time feedback and coaching. Therefore, MAS pillars such as the negotiation protocol and the agent's internal scheduler have been investigated, proposing solutions to achieve the aforementioned real-time compliance., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Personal Health Systems (PHS) are mobile solutions tailored to monitoring patients affected by chronic non communicable diseases. In general, a patient affected by a chronic disease can generate large amounts of events: for example, in Type 1 Diabetic patients generate several glucose events per day, ranging from at least 6 events per day (under normal monitoring) to 288 per day when wearing a continuous glucose monitor (CGM) that samples the blood every 5 minutes for several days. Just by itself, without considering other physiological parameters, it would be impossible for medical doctors to individually and accurately follow every patient, highlighting the need of simple approaches towards querying physiological time series. Achieving this with current technology is not an easy task, as on one hand it cannot be expected that medical doctors have the technical knowledge to query databases and on the other hand these time series include thousands of events, which requires to re-think the way data is indexed. Anyhow, handling data streams efficiently is not enough. Domain experts' knowledge must be explicitly included into PHSs in a way that it can be easily readed and modified by medical staffs. Logic programming represents the perfect programming paradygm to accomplish this task. In this work, an Event Calculus-based reasoning framework to standardize and express domain-knowledge in the form of monitoring rules is suggested, and applied to three different use cases. However, if online monitoring has to be achieved, the reasoning performance must improve dramatically. For this reason, three promising mechanisms to index the Event Calculus Knowledge Base are proposed. All of them are based on different types of tree indexing structures: k-d trees, interval trees and red-black trees. The paper then compares and analyzes the performance of the three indexing techniques, by computing the time needed to check different type of rules (and eventually generating alerts), when the number of recorded events (e.g. values of physiological parameters) increases. The results show that customized jREC performs much better when the event average inter-arrival time is little compared to the checked rule time-window. Instead, where the events are more sparse, the use of k-d trees with standard EC is advisable. Finally, the Multi-Agent paradigm helps to wrap the various components of the system: the reasoning engines represent the agent minds, and the sensors are its body. The said agents have been developed in MAGPIE, a mobile event based Java agent platform., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Inspiration of CdCl2 results in a focally fibrotic response in rat lungs and markedly increases the activity of lung lysyl oxidase. Western blot analyses of urea-extractable rat lung proteins revealed that the levels of an immunoreactive, 32,000-Da protein were markedly increased in the cadmium-exposed rat lung tissue, consistent with the induction of lysyl oxidase protein. Anion exchange chromatography revealed low levels of multiple peaks of catalytically functional lysyl oxidase in control rat lung extracts, while the profile of cadmium-exposed rat lung extracts displayed markedly elevated levels of multiple peaks of enzyme activity indicating that the charge heterogeneity is expressed in the activated enzyme. The cadmium-induced enzyme was purified as a species of 32 kDa, without resolving individual ionic variants. The catalytic and physical properties of the isolated enzyme were very similar to those of previously well characterized basal enzyme of bovine aorta, including the presence of a pyrroloquinoline quinone-like carbonyl cofactor. The copper and cadmium content of the cadmium-induced enzyme indicated little if any replacement of tightly-bound copper by cadmium in the exposed lung.