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Objective: Heart failure (HF) presents a healthcare challenge due to its high comorbidity burden, aging patient population and frequent hospitalizations. Remote monitoring offers a promising approach to managing HF patients by early detection of health deterioration. Developing autonomous systems to detect signs of worsening in telemonitoring data is of interest to reduce the workload of healthcare personnel. Methods: We propose the TRACER model, a Transformer with Contrastive Event Representation, designed to predict timelines leading to rare hospitalization events in low-resolution and irregularly sampled telemonitoring data. TRACER incorporates time-aware embeddings for each biomarker, contrastive pre-training to enhance anomaly detection via representation learning, and independent binary classifiers for detection. We used measurement data containing remotely recorded biomarker sequences from 276 HF patients segmented into overlapping windows based on temporal rules, and labeled the windows based on the occurrence of HF relevant hospitalizations at the latter edge of the window. Results: TRACER was able to correctly predict 66.7% timelines leading up to HF hospitalizations in the highly imbalanced real-world dataset with an overestimation of 7.9%. Reformulating the training of TRACER as an event detection problem improved the predictive performance compared with training directly on forecasting windows, enabling more effective use of the limited hospitalization events. Conclusion: TRACER demonstrated superior performance in detecting signs of worsening status in real-world telemonitoring data compared to the other tested models. Significance: TRACER shows promise in identifying signs of clinical deterioration that allow for alerts to be generated to provide counteractive treatment in patients with HF.
Machine Learning-Based Prediction of Childhood Stunting in Bangladesh: Fairness and Temporal Robustness Assessment
Childhood stunting remains a major public health concern in Bangladesh and reflects long-term growth failure influenced by child, maternal, household, socioeconomic, and health-service factors. This study used nationally representative Bangladesh Demographic and Health Survey data from 2007 to 2022 to develop machine learning models for population-level prediction of childhood stunting and to assess temporal robustness and subgroup fairness. Children aged 0-59 months with complete anthropometric and predictor data were included. Data from the 2007, 2011, and 2014 survey rounds were used for model development, while the 2018 and 2022 rounds were retained as temporal test datasets. Twelve feature-selection approaches were assessed, and the KNN permutation importance-selected predictor set was used for final model evaluation. Eleven machine learning models were evaluated: ten conventional algorithms and one pretrained tabular foundation model, TabPFN. Performance was assessed using balanced accuracy, AUROC, F1-score, Brier score, and expected calibration error. Subgroup fairness was examined by child sex, place of residence, and socioeconomic status. The final analytic sample included 18,844 children, of whom 35.05% were stunted. In the development hold-out test dataset, TabPFN showed the highest observed balanced accuracy overall at 67.58%, while AdaBoost showed the highest observed balanced accuracy among conventional models at 67.51%. In temporal testing, the highest observed balanced accuracy was found for Gradient Boosting in BDHS 2018 and XGBoost in BDHS 2022. Model performance varied across survey rounds and subgroups, highlighting the importance of temporal validation, subgroup fairness assessment, and transparent interpretation in public health prediction modeling.
On-Device Language Models for Privacy-Preserving Stress Prediction: A Multimodal Evaluation on Mobile Health
Stress is a pervasive determinant of mental health and a key target for mobile health interventions. On-device language models (ODLMs) offer privacy-preserving inference without cloud dependency, yet their feasibility for health prediction under mobile resource constraints remains underexplored. We evaluate ODLMs for multi-modal stress prediction using zero-shot prompting, measuring predictive accuracy alongside latency and throughput. Our results show that objective sensor features marginally outperform subjective self-reports on average, and that lightweight sub-2B models achieve low latency with predictable resource usage. Our findings highlight both the promise and the practical constraints of ODLMs for mobile mental health.
DeMMO: Longitudinal and Cross-Disease Modelling of Digital Mobility Outcomes via Multi-Task Learning
Digital mobility outcomes (DMOs) derived from wearable sensors characterise mobility in daily life and offer a promising means of monitoring disease progression. However, existing DMO studies have typically focused on either a single disease or a single visit. To the best of our knowledge, this is the first study to systematically model and analyse longitudinal multivariate DMOs across diverse mobility-limiting diseases. Specifically, we propose DeMMO, an interpretable framework for longitudinal, multi-disease, and multi-outcome learning. DeMMO represents each disease--outcome objective using a longitudinal DMO coefficient matrix and combines temporal regularisation with stable and visit-specific feature selection. Its central technical contribution is an automatic cross-disease and cross-outcome relation-learning mechanism that infers signed relations directly from these longitudinal mappings, thereby enabling selective information sharing across cohorts without requiring paired participants. We evaluate DeMMO on the recently released, large-scale, multicentre Mobilise-D dataset, which comprises four participant-disjoint cohorts representing distinct mobility-limiting diseases, with each cohort contributing one or more clinical measurement outcomes. Compared with eight strong structural longitudinal and deep-regression baselines, DeMMO achieves the best overall predictive performance and outperforms the baselines for most individual outcomes. Stability selection further identifies reliable longitudinal DMO patterns that can inform subsequent clinical validation and disease monitoring. The implementation code is available at https://github.com/menghui-zhou/DeMMO.
Predicting blood clot growth from sparse post-onset measurements with latent neural differential equations
Computational models of blood clotting improve understanding of thrombus formation, but their clinical application remains limited because many model inputs are difficult to measure and patient-specific data are often sparse. We present a computational framework based on latent neural differential equations that infers unknown model parameters from sparse measurements and forecasts thrombosis progression. We demonstrate the framework using data generated from a multiphysics blood-clotting model in which clot growth is governed by the coagulation cascade and diffusion. Four known biochemical inputs (fibrinogen and factors IX, VIII, and V), together with sparse early clot-size observations, are used to infer the tissue-factor parameter and predict subsequent clot growth. We compare seven probabilistic methods: stochastic neural ordinary differential equations (SNODE), stochastic neural functional differential equations (SNFDE), a latent neural-process baseline, a monotone probabilistic deep ensemble, empirical trajectory retrieval, PCA-ridge Gaussian posterior, and Gompertz-curve retrieval. SNODE achieved the best performance in inferring the unknown input and forecasting future clot-growth trajectories. SNFDE performed similarly and consistently outperformed the other non-differential models. Prediction accuracy improved as more observations became available, whereas longer forecasting horizons increased uncertainty and decreased accuracy. Latent neural differential equations thus effectively combine parameter inference and clot-growth forecasting from sparse measurements, providing a promising foundation for personalized thrombosis modeling.
Quality Diversity for Reliable Data Driven Time-Use Optimization
The daily allocation of the finite 24-hour time budget is strongly associated with physical, mental, and cognitive health. While predictive models can estimate the relationship between time-use compositions and health outcomes such as body mass index, life satisfaction, and cognition, most optimization approaches focus only on maximizing expected benefit and do not consider the uncertainty inherent in data-driven prediction. Ignoring uncertainty in health-related decisions can lead to unrealistic time-use recommendations. To address this gap, we introduce an uncertainty quantification Quality Diversity (QD) framework for a more reliable time-use recommendation. Objective functions are derived using compositional data analysis using a large child cohort dataset n > 1000, to capture the relationship between daily activity compositions and multiple health indicators. We develop a new approach that incorporates predictive uncertainty into QD processes and produces more reliable recommendations that balance the expected health benefits with the confidence of the model. We explore the solution space through variable-based and objective-based behavioral representations, revealing diverse high-quality time-use composition and explicit relationships between health outcomes under uncertainty. By embedding uncertainty directly into optimization, our framework shifts the time-use recommendations toward regions of lower uncertainty while preserving high-quality structures for more reliable decision-making in behavioral health.
Self-supervised DXA representations encode multi-system disease risk, biological aging and heritability
Whole-body dual-energy X-ray absorptiometry (DXA) scans are routinely acquired to measure bone density and regional body composition, leaving their spatial structure largely unused. Here, we show that self-supervised learning (SSL) can convert raw DXA images into representations of systemic health. We introduce LeDXA, a vision model based on a joint-embedding predictive architecture (JEPA) that learns by predicting latent representations rather than reconstructing pixels. Trained from scratch on 11,540 unlabeled Human Phenotype Project scans, LeDXA was evaluated internally and on 47,400 external UK Biobank (UKBB) scans. It improved cross-cohort prediction of prevalent diseases and biomarkers beyond scanner-derived DXA measurements and DINOv3, a state-of-the-art general-purpose model, despite approximately 150,000-fold fewer training images and nearly 40-fold fewer parameters. Over a median 4.3-year UKBB follow-up, LeDXA improved incident disease prediction over tabular DXA measures, with the largest gains for hip and knee arthrosis and type 2 diabetes. For hip arthrosis, 66% of incident cases occurred in the highest-risk quartile versus 41% for tabular measures. Its representations predicted chronological age externally (r = 0.88; mean absolute error = 2.90 years), and the biological-age gap tracked broader disease burden and a 45% higher mortality hazard in the oldest-appearing quartile. The gap also decreased in women after starting hormone-replacement therapy, suggesting it may be modifiable. Genome-wide associations recovered mostly known body-composition and bone-density loci, and LeDXA embeddings were more heritable than DINOv3's. These findings reveal prognostic information in DXA images that conventional readouts discard, learnable with relatively little data and modest compute.
Secrets Everywhere: Auditing Memorization in Mobility Prediction Models
Human mobility prediction models, which forecast the next location in a user's trajectory, are increasingly deployed in urban analytics, navigation, and personalized services. Yet, little is known about their potential to memorize and expose sensitive user trajectories from training data. While memorization has been extensively studied in language models, mobility prediction poses unique challenges: training sequences encode human behavior at various spatial and temporal scales, creating privacy risks at different granularities. In this paper, we conduct the first systematic audit of memorization in mobility prediction models. While prior work has shown that privacy leaks can arise from such models, we systematically assess and quantify memorization risks at scale. We identify key challenges, including the lack of a randomness space, the multi-scale structure of trajectories, and user-specific behavioral diversity. To address these challenges, we introduce a framework to quantify mobility memorization at different levels of granularity: individual locations, anchor pairs, and subtrajectory segments. We also develop user-grounded reference sets to assess how likely a model is to prefer training data over realistic alternatives. Our evaluation across multiple models and datasets reveals pervasive memorization patterns that correlate with user regularity and increase the risk of data extraction at inference time. Our findings call for mandatory privacy auditing in mobility prediction models.
HealthCAT: An Interpretable Encoder-only Transformer Framework for Health Indicator Prediction and Temporal Interpretation of Wearable Sensor Data
Wearable sensors continuously capture fine-grained multivariate time-series data, providing opportunities to model behavioural patterns associated with health outcomes. However, existing deep learning methods prioritise predictive accuracy over interpretability, limiting their application in health research. In this study, we present HealthCAT, a flexible framework that integrates an Encoder-only Transformer with an Attentive Class Activation Token (AttentiveCAT) to generate class-specific, time-step-level interpretations. These interpretations can be mapped back onto behavioural cycles that are relevant to the domain (e.g., time-of-day), supporting individual-level analysis of wearable sensor data. We evaluated HealthCAT using two real-world wearable sensor datasets (306 participants in total). HealthCAT outperformed deep learning baselines by up to 17% in F1-score and 12% in accuracy on both datasets (). In masking experiments, the time steps identified by HealthCAT carried significantly more predictive value than random selection across all masking conditions (), indicating that the identified time steps are predictively informative. By coupling predictive performance with validated time-step-level interpretability, HealthCAT moves wearable sensor analysis beyond aggregated metrics towards temporal patterns that support health monitoring, behavioural pattern analysis, and intervention design in health research. The significance of this work is that it enables accurate prediction of health indicators from wearable sensor data while providing insights into when and how physical activity patterns occur, rather than relying solely on aggregated summary measures.
TEDDY: A Pediatric Foundation Model for Risk Forewarning from ICD-Coded Diagnostic Histories
Pediatric electronic health records capture developmentally structured clinical trajectories, yet their potential for generative healthcare foundation models remains largely unexplored. Here we present TEDDY (Temporal Event Decoder for Disease in Youth), a 1.84-million-parameter decoder transformer trained on approximately 73 million ICD-10 diagnoses from 1.6 million children at a single pediatric institution. TEDDY models longitudinal diagnosis trajectories and visit timing. Predictions were made before visit codes were revealed, limited to first occurrences, and evaluated against sex- and age-matched controls. Across 797 disease-onset prediction tasks spanning 16 ICD-10 chapters, TEDDY achieved a median AUC of 72.0%, outperforming same-data DenseNet (50.0%), CNN (57.2%), RNN (60.1%), and LSTM (62.7%) baselines on 96-99% of tasks. Performance held across sex and age and was strongest among lower-prevalence diagnoses; 202 of the 225 rarest conditions (90%) had 95% confidence intervals above chance. Predictive signal remained detectable more than two years before first recorded diagnosis, with median AUCs of 59.7% in the unrestricted analysis and 64.4% in a fixed-cohort sensitivity analysis. In asthma and attention-deficit/hyperactivity disorder benchmarks, AUCs were 79.3% and 84.7%, compared with 62.7% and 71.7% for the strongest comparators, including a general-purpose language model three orders of magnitude larger. Visit-timing predictions had a 3.0-day mean absolute restricted mean survival-time error over 365 days, although median and long-tail return intervals remained miscalibrated. Together, these results establish pediatric diagnostic histories as a substrate for compact generative models supporting broad, rare-disease, and long-horizon risk forecasting without population-scale data or billion-parameter models.
Agent Delivery Engineering Predictive Reliability Framework
Long-horizon LLM multi-agent systems face reliability risks invisible to infrastructure monitoring. We propose the ADE Predictive Reliability Framework (ADE-PRF), enabling proactive health trajectory prediction from passive degradation detection. ADE-PRF aggregates 20 heterogeneous signals across five layers into a Trust Margin (TM) metric (39.2-point dynamic range). Triple-method parallel prediction enables 8-hour forecasts: the Exponential method achieves MAE=1.228, Direction Accuracy=76.8%, with 99.65% within +/-10-point tolerance. Production validation spans 380,227 predictions and 280,579 validations across six agent profiles over 15 continuous days, plus seven sandbox-controlled experiments. Key findings include detection of "false prosperity" -- degradation concealed by normal surface metrics -- and immediate TM coupling with ground-truth states upon ADE plugin integration, with 16/20 factors relying on ADE-collected data. Exponential consistently outperforms Kalman. ADE-PRF provides among the earliest reliability quantification with forward-looking warnings for production LLM agents.
Physical activities enable scalable foundation modelling for broad-spectrum health prediction
Wearable and mobile sensing technologies have demonstrated strong potential for health inference; however, most sensor models are designed for specific disease types, limiting their transferability across different health risks. Wearable foundation models offer a more generalizable approach in diverse health risk types. Nevertheless, most existing methods rely on high-frequency raw sensor data, raising concerns about privacy, computational overhead, and scalability across devices and populations. In this paper, we propose StepFM, a foundation model built solely on step counter data for broad-spectrum health prediction. Leveraging the ubiquity and low-dimensional nature of step data, StepFM provides a practical, privacy-preserving, and computation-efficient alternative to traditional sensor-based models. We design a scalable pre-training framework that captures temporal dynamics and behavioral patterns from large-scale step sequences, enabling transfer across more than 20 health risk prediction tasks spanning diverse devices, new regions, and novel disease types. Extensive experiments demonstrate that StepFM achieves strong performance compared to existing methods while maintaining robustness across heterogeneous settings. Furthermore, our analysis reveals interpretable and generalizable relationships between physical activity patterns and various health risks, offering new insights into activity-based health modeling. Our work establishes step-based sensing as a viable foundation for scalable and real-world health monitoring.
A time-series classification framework for individual-level absenteeism prediction under severe class imbalance
Staff absenteeism imposes substantial operational costs in high-demand work environments such as healthcare, emergency services, meat processing, construction, and courier and delivery services, where proactive workforce planning depends on reliable individual-level absence prediction. Existing regression and classification approaches share a structural limitation; they map features observed at time t to labels at the same time t, reproducing already-realised outcomes rather than predicting future events, and discard the sequential behavioural structure inherent in individual attendance histories. We propose a Time Series Classification (TSC) framework that separates historical attendance sequences from future absence labels, enabling genuinely proactive prediction. Due to the lack of public longitudinal attendance data, we construct a reproducible simulated dataset calibrated to the UCI dataset. We analyse Binary Focal Loss (BFL) and Geometric Mean (G-Mean) loss under severe class imbalance using only the imbalance ratio . For BFL, the initial gradient ratio is , implying the balanced weight . Experiments show that performance is governed mainly by , with BFL achieving specificity 0.813 and balanced accuracy 0.888, comparable to G-Mean. Unlike BFL, G-Mean adapts automatically without parameter calibration. Among three deep learning architectures evaluated, Long Short-Term Memory (LSTM), Convolutional Neural Network (CNN), and the hybrid LSTM-Fully Convolutional Network (LSTM-FCN), the LSTM-FCN delivers strong precision and specificity. Stable performance is obtained with batch sizes >= 64 and window sizes between 40-80 days, yielding balanced accuracy of approximately 80% on held-out test data.
ENC-ODE: Event-level Neurodegenerative Modeling in Continuous Time with Neural ODEs
Accurately predicting the temporal evolution of clinical biomarkers is crucial for the early diagnosis and management of neurodegenerative diseases such as Alzheimer's disease. However, this relies on longitudinal data to capture biomarker changes over time, which is often sparse and irregular due to the high cost, labor-intensive nature, and patient burden. To address these challenges, we propose ENC-ODE, an Event-level Neurodegenerative modeling in Continuous time with neural Ordinary Differential Equations. ENC-ODE predicts future biomarker evolution by modeling clinical events through diagnosis-conditioned continuous dynamics. A target-conditioned attention mechanism weights and aggregates event-level predictions for the target time and modality without history compression. Extensive experiments on Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset demonstrate that ENC-ODE outperforms representative sequence models while offering a scalable and neuroscientifically grounded solution for clinical support. The code is available at https://github.com/JardinDelSol/enc-ode.
Uncertainty-Aware Longitudinal Forecasting of Alzheimer's Disease Progression Using Deep Learning
Longitudinal modelling of Alzheimer's disease progression is clinically useful only if it can describe not just the most likely next diagnosis, but how a patient may evolve over time and how reliable that forecast is. Most deep learning approaches reduce this problem to single-step classification, treating cognitively normal, mild cognitive impairment, and dementia as flat categories while providing limited insight into how uncertainty accumulates across future visits. We propose a probabilistic framework that combines ordinal diagnosis prediction, multi-horizon trajectory generation, and decomposed uncertainty estimation. A Temporal Fusion Transformer encoder is adapted with a CORAL ordinal output layer, asymmetric loss weighting, and converter oversampling to respect disease-stage ordering and improve sensitivity to MCI-to-dementia transitions. Conditioned on the learned patient-context representation, an autoregressive Mixture Density Network generates five-year probabilistic trajectories for diagnosis state, CDR Sum of Boxes, MMSE orientation, and hippocampal volume. On ADNI, the model outperforms linear, recurrent, and transformer baselines for next-visit diagnosis prediction, with the strongest gains on MCI-versus-dementia discrimination. Generated trajectories achieve near-nominal 90% credible interval coverage, widening uncertainty across the forecast horizon, and biomarker dynamics consistent with expected Alzheimer's disease progression. We further separate aleatoric from epistemic uncertainty using analytic mixture variance and a five-member bootstrap ensemble, which provides the strongest encoder diversity and output-level epistemic signal. Epistemic uncertainty is higher for rare progression archetypes, MCI and dementia patients, and under external evaluation on OASIS-3, where it increases alongside prediction error.
Transition-Based Digital Twin Modelling for Alzheimer's Disease under Sparse Longitudinal Data
Alzheimer's disease (AD) progression is highly heterogeneous and is typically observed through sparse and irregular longitudinal data, posing challenges for prediction and personalised monitoring. Existing machine learning approaches have improved AD prediction using multimodal data, yet often focus on static classification or cohort-level risk estimation, providing limited support for subject-specific modelling and uncertainty-aware reasoning. To address these limitations, we present a personalised digital twin framework for AD prediction and scenario-based analysis using multimodal longitudinal data. The proposed approach integrates complementary modelling strategies to capture clinical transitions and temporal dependencies across visits. Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), including cognitive assessments, clinical variables, and MRI-derived phenotypes, the framework predicts cognitive status and diagnostic categories while quantifying predictive uncertainty and enabling patient-specific what-if trajectory analysis. Evaluation on leak-free subject-level splits demonstrates strong performance in score forecasting and diagnosis classification. In this sparse and irregular ADNI setting, transition-based modelling of adjacent visits achieved higher predictive accuracy than the sequence-based branch, suggesting that local transition modelling may be more data-efficient. While sequence models remain valuable for uncertainty-aware trajectory forecasting, local transition modelling offers a more data-efficient and robust predictive strategy. These findings highlight the importance of aligning temporal modelling strategies with clinical data structure and suggest that transition-based digital twin formulations may provide a practical and interpretable approach for personalised disease forecasting in neurodegenerative disorders.
Reconstructing and forecasting disease trajectories of patients with Alzheimer's disease using routine data in resource-constrained settings
Alzheimer's disease is a progressive neurodegenerative disorder, and its progression varies substantially across patients. Existing work aims to forecast patients' future cognitive state, with minimal focus on reconstructing the state from past visits. Furthermore, in current research, quantifying predictive uncertainty remains underexplored and relies on costly modalities such as MRI, PET, and CSF, limiting their deployment in resource-limited settings. In this research, our primary objectives are: First, bidirectional prediction of cognitive scores from irregular visits to present the complete disease trajectory. Second, to enable interpolation and extrapolation capabilities to assist clinicians in informed prognostic decision making, and third, to provide a well-calibrated uncertainty estimate for all predictions, and finally, to achieve the objectives using the modalities available during routine visits. We propose a unified framework, GNOVA: A GRU-Neural ODE Variational Autoencoder. The architecture combines a Gated Recurrent Unit encoder and a Neural ODE decoder within a variational autoencoder framework. In our work, we forecast the CDR-SB and MMSE Scores. The GRU encoder allows for any number of inputs at any time point. The Neural-ODE decoder performs continuous estimation, allowing interpolation and extrapolation at any desired time point. The Variational autoencoder allows for uncertainty estimation in predictions. We worked with 1,727 patients from the ADNI dataset over 10 years; the model achieved mean absolute errors of 1.35 and 2.28 for CDR-SB and MMSE scores, respectively, without requiring any neuroimaging or biomarker data. Feature-ablation studies revealed that age, BMI, and APOE4 status were strong predictors. The proposed framework enables the reconstruction of incomplete patient histories and the anticipation of future cognitive states.
GlucoFM-Bench: Benchmarking Time-Series Foundation Models for Blood Glucose Forecasting
Blood glucose forecasting models are foundational for modern diabetes management systems, as reliable short-term predictions can enable proactive interventions, support automated insulin delivery, and reduce the risk of hypo- and hyperglycemic events. From a modeling perspective, glucose forecasting poses unique challenges due to heterogeneous physiological dynamics across diabetes populations. Traditional machine learning and deep learning models have been extensively evaluated for glucose prediction, yet recent time-series foundation models (TSFMs) remain much less studied in this setting. To bridge this gap, we present GlucoFM-Bench, a comprehensive benchmark evaluating state-of-the-art TSFMs alongside supervised deep learning models for blood glucose forecasting. We assess eight representative architectures, including pre-trained TSFMs, time-series large language models, and task-specific deep learning models, across 15 publicly available diabetes-relevant datasets comprising 1,117 individuals with type 1 diabetes, type 2 diabetes, prediabetes, and no diabetes. Models are evaluated under zero-shot, few-shot, and full-shot protocols, with systematic variation in context length and prediction horizon. Across datasets, pre-trained TSFMs, especially Chronos-2 and TimesFM, show strong zero-shot and few-shot transfer, with the best zero-shot model performing within 5% of the best full-shot supervised model. Yet, when task-specific data are abundant, a lightweight LSTM remains strongest, outperforming TSFMs by 4--21% under full-shot training. Stratified analyses reveal persistent challenges in T1D cohorts and hypo-/hyperglycemic ranges, highlighting the need for evaluation beyond aggregate error metrics. Together, GlucoFM-Bench provides a standardized and reproducible foundation for evaluating, comparing, and improving foundation models for blood glucose forecasting.
Disentangling Latent Risk Pathways via Bayesian Hypergraph Inference
Electronic health records (EHR) pose large-scale multi-disease modeling problems in which many outcomes are rare and strongly influenced by shared risk factors. While modern approaches achieve strong predictive performance, they often treat diseases independently or rely on black-box architectures, offering limited insight into how risk factors organize disease risk and little principled uncertainty quantification. We introduce a Bayesian hypergraph inference framework that reframes multi-disease modeling around latent, risk-factor-modulated disease pathways. Risk factors act on hyperedges, latent disease subsets with shared risk patterns, allowing diseases to participate in multiple distinct pathways and enabling interpretable, higher-order structure beyond pairwise associations. A repulsion prior encourages parsimonious and identifiable structure, while posterior inference provides calibrated uncertainty over both disease groupings and risk-factor influence. To enable scalable inference on large EHR datasets, we develop a structured variational inference algorithm that preserves logical dependencies among hyperedge existence, disease membership, and pathway-level effects. Experiments on simulated data and UK Biobank demonstrate stable and interpretable disease pathway structure, well-calibrated uncertainty, improved estimation for rare diseases, and competitive predictive performance.
Learning to model pediatric asthma exacerbation from multiple risk factors: a case study in coastal Virginia
Childhood asthma is a common illness exacerbated by air pollution as well as meteorological and neighborhood-level socioeconomic factors. Modeling asthma exacerbation (AE) in large spatiotemporal datasets requires disentangling impacts from multiple contributors. In this case study, we compared three techniques that balance predictive power with interpretability to predict AE in Hampton Roads, a coastal Virginia region comprising 7 cities and over 1.5 million people. After collating ambient air pollution measurements, weather data, and measures of neighborhood opportunity, we modeled zip code-level acute AE visits to a regional children's hospital and affiliated providers from 2018-2023. Generalized linear models (GLM) provided a baseline while neural networks (NN) served as a maximally predictive target. To bridge between statistical models and deep learning, we developed a framework based on sparse dictionary learning to identify and interpret parsimonious nonlinear interacting equations. After comparing each model's predictive performance, we estimated relative risks for AE due to input exposure variables and found consensus across frameworks. Our work links statistical and interpretable machine learning models to highlight possible synergistic interactions influencing AE, and may enable future studies to guide public health interventions in coastal Virginia.
RIDE: An Open Dataset and Benchmark for Train Delay Prediction
Train delay prediction is an important problem for both passengers and railway operators, yet progress in the field remains difficult to assess due to the lack of standardized datasets, prediction targets, and evaluation protocols. To address this gap, we introduce RIDE, an open dataset and benchmark for train delay prediction built at nationwide scale over the Belgian railway network. RIDE covers 94.5M train events, 3.6M journeys, and 35.7M weather records from 2023 to 2025. It is organized as a layered data pipeline from raw railway and weather sources to two public releases: a reusable intermediate relational dataset and model-ready benchmark datasets. The benchmark standardizes the prediction task and the training and testing data. It also provides a unified evaluation protocol that supports direct comparison across models. Using this framework, we provide the first comprehensive comparative evaluation of non-learning, statistical learning, and deep learning models. We show that learning-based methods clearly outperform non-learning models, with graph neural networks achieving the best mean performance, while the strongest learning-based models remain relatively close to one another. Beyond aggregate mean absolute error (MAE) and root mean squared error (RMSE), the framework also provides breakdowns by prediction horizon and delay change, enabling more detailed analysis of model behavior across forecasting regimes.
Bayesian meta-learning for modeling Alzheimer's disease progression
Predicting whether an individual with Alzheimer's disease will experience mild or severe disease progression is essential for personalized treatment. Typically, practitioners seek to predict the distribution of a discrete disease score, conditional on an individual's current MRI volume and their historical disease trajectory. Classical statistical regression models and single-task neural networks are not well-suited for this purpose because fitting separate models is infeasible (since each individual typically has few observations), while ignoring individual-level correlation leads to poor generalization. Meta-learning, in contrast, provides a natural avenue to dynamically predict distributions without retraining and model nonlinear relationships between the outcome and covariates. Motivated by this, we propose a Bayesian meta-learner that is trained on multiple individuals but tailors the predictive disease score distribution to each individual's historical data. Our model predicts on unseen individuals without retraining, scales linearly with the number of historical observations, and is guaranteed to be less overconfident when predicting long-term disease scores compared to its deterministic counterpart. On real-world data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, our model achieves performance competitive with both single-task models and deterministic meta-learners, while substantially improving performance when predicting long-term disease progression.
Physically-Constrained Mamba-SDE for Remaining Useful Life Prediction under Irregular Observations
Accurate Remaining Useful Life prediction is critical for industrial predictive maintenance. However, real-world deployment is challenging due to the irregular nature of sensor observations, characterized by asynchronous sampling, burst missingness, and temporal jitter. Compounding this issue, purely data-driven models often generate physically implausible degradation trajectories that violate the irreversible nature of damage accumulation. To address this, we propose PC-MambaSDE, a unified continuous-time framework for robust RUL prediction under irregular observations. Specifically, we design a Mask-Aware Continuous Mamba Encoder that explicitly leverages observation masks to extract context-rich control signals. Furthermore, we introduce a Physics-Guided Latent SDE with parametrically rectified hybrid drift, superimposing a global physical bias to enforce monotonic degradation even amid severe observation gaps. Additionally, we formulate RUL prediction as a boundary value problem via a Terminal Degradation Penalty, which decouples a Health Index dimension and applies a penalty loss to guide trajectories toward the failure state. Theoretically, we prove that our variational objective is mathematically equivalent to minimizing the KL divergence via Girsanov's theorem, and we guarantee the global asymptotic stability of the learned dynamics through Lyapunov analysis. To enable rigorous evaluation, we develop a Hybrid Irregularity Generation Scheme that simulates realistic industrial imperfections. Extensive experiments on public benchmarks demonstrate that PC-MambaSDE significantly outperforms state-of-the-art methods, particularly under extreme observation scarcity, validating the efficacy of embedding physical priors into continuous-time latent dynamics.
Adaptive data selection improves wearable prediction under low baseline performance
Adaptive sensing strategies that selectively sample data are increasingly used in wearable health systems to improve prediction performance under limited data budgets, yet their benefits across individuals remain poorly understood. Here, we evaluate adaptive selection of time windows for model training under fixed measurement budgets across multiple sensing modalities, including heart rate, activity, and ecological momentary assessment (EMA), in a longitudinal wearable dataset. We quantify performance gains relative to random sampling using both area under the receiver operating characteristic curve (AUROC) and F1 score. Adaptive strategies yield substantial improvements in AUROC for participants with low baseline performance (with gains up to 0.7), while offering limited or negative gains for participants with strong baselines. Across modalities, adaptive gain is strongly inversely correlated with baseline performance (Pearson r = -0.67; Spearman p = -0.62). At the participant level, most individuals benefit in AUROC (60-80% across modalities), although improvements in F1 are smaller and less consistent. These findings show that adaptive sensing is not uniformly beneficial, but instead provides the greatest value in underperforming settings. Our results support selective deployment strategies that tailor adaptive sensing based on baseline performance to improve efficiency in wearable health monitoring.
GraD-IBD: Graph Representation Learning from Diagnosis Trajectories for Early Detection of Inflammatory Bowel Disease
International Classification of Diseases (ICD) is a globally recognized coding system that records diagnostic events during each patient encounter, providing a standardized data foundation for various clinical tasks. However, the irregular and hierarchical nature of ICD code sequences poses challenges for N-D lattice-based sequential modeling methods, leading to overly complex model designs. In this paper, we propose GraD-IBD, a graph diagnosis model that reformulates longitudinal ICD trajectories as visit-bucketized, temporally directed graphs to detect the risk of inflammatory bowel disease (IBD). A novel context-aware, time-decay message passing mechanism was developed to capture temporal dependencies while reducing model complexity. The experimental results using a real-world clinical dataset demonstrated consistent and robust improvements in IBD detection over state-of-the-art methods, with significant reductions in computational complexity compared to sequential models. These findings highlight the potential of graph representation learning to enable efficient, scalable, and accurate disease risk prediction from longitudinal ICD diagnosis codes.
Transfer Learning using 66 Diseases for Disease Forecasting Applications
Disease forecasting models typically rely on a single data stream, making models brittle when histories are short or noisy. Recent top-performing models have shown that synthesizing multiple reporting systems for the same disease improves performance. Other recent work takes this idea a step further, using transfer learning to train a forecasting model for one disease using data from a different disease. We expand upon each of these approaches greatly, training machine learning models on data that span 66 infectious diseases and several data streams. We investigate the value of incorporating different data streams for forecasting 20 different disease data streams. We find that incorporating other data streams improves forecasting in the vast majority (84.9%) of time series and model structures considered. However, our work highlights that the quality of the added data matters, where adding data extremely different from the target data stream can sometimes degrade forecast performance. A major contribution of this work is in compiling a publicly-available database of data for use by the infectious disease forecasting community.
A Reproducible Log-Driven AutoML Framework for Interpretable Pipeline Optimization in Healthcare Risk Prediction
Accurate disease risk prediction is challenged by heterogeneous features, limited data, and class imbalance. This study presents yvsoucom-iterkit, a deterministic AutoML framework that models pipeline optimization as a configuration-level system with full reproducibility and traceable execution logs, enabling systematic analysis of component attribution, interactions, similarity, and cross-seed robustness. Experiments on the Pima Indians Diabetes and Stroke datasets across more than 18,000 pipeline configurations reveal a structured yet partially redundant search space, where performance is dominated by a small subset of interacting components. Ensemble models achieve stable performance, reaching a Weighted-F1 of 0.89 on Pima and 0.94 on Stroke. Macro-F1 reaches approximately 0.88 on Pima but drops to 0.6560 on Stroke due to severe imbalance. Cross-seed experiments show that ensembles reduce variance compared to single models. Friedman testing () confirms significant ranking differences across configurations. Based on analysis of component attribution, interaction, and similarity, optimal configuration design reveals dataset-dependent behavior. For the Pima dataset, computational efficiency benefits from simplified search spaces where redundant components can be removed, with split ratio playing a key role. In contrast, the Stroke dataset requires enhanced imbalance-aware strategies, where RandomOverSampler improves Macro-F1 from 0.6560 to 0.6766. These findings demonstrate that effective AutoML optimization is achieved through optimal configuration design, where carefully constraining the search space to high-impact components can improve performance, stability, and interpretability while reducing unnecessary search complexity.
From Static Risk to Dynamic Trajectories: Toward World-Model-Inspired Clinical Prediction
Clinical decision-making is a feedback system where risk estimates influence treatment, which in turn changes disease trajectories, and both shape clinicians' measurement practices. Static prediction often fails clinically: models trained on observational care logs conflate disease biology with clinician behavior, particularly under treatment confounder feedback and irregular or informative observation. This Review focuses on intervention-aware disease trajectory modeling in clinical AI--methods estimating patient-specific longitudinal disease evolution and assessing trajectory changes under alternative treatments. We organize the field around six linked components: three decision tasks (factual forecasting, counterfactual estimation, policy evaluation) and three data-generating mechanisms (disease evolution, treatment assignment, observation process) that determine identifiability. We present the first unified framework bridging forecasting, counterfactual trajectories, and policy evaluation across discrete/continuous time, explicitly addressing treatment assignment, time-varying confounding, and observation bias. We synthesize key method families (multistate/joint models, temporal point-process, deep sequence architectures, longitudinal causal inference), map them to relevant components, and align evaluation with claim strength via overlap diagnostics, uncertainty quantification, off-policy robustness, and target-trial validation. This synthesis advances benchmark prediction to decision-grade clinical evidence, enabling treatment-sensitive individualized futures, pre-deployment policy stress-testing, and safer closed-loop learning health systems that adapt/abstain when evidence is insufficient.
Prognostic Value of Lung Ultrasound Biomarkers for Readmission Risk in Congestive Heart Failure: A Pilot Data-Driven Analysis
Hospital readmission within 30 days of discharge is a leading driver of morbidity, mortality, and avoidable healthcare expenditure in congestive heart failure (CHF). Current clinical risk stratification tools rely primarily on non-imaging data and exhibit limited predictive performance. Point-of-care lung ultrasound (LUS) offers a sensitive, noninvasive window into the pulmonary congestion that characterizes CHF decompensation, yet its prognostic utility for readmission prediction remains largely unexplored. We present a pilot feasibility study, the first systematic machine learning study using B-mode LUS acquired during hospitalization to predict 30-day CHF readmission. Quantitative spatiotemporal embeddings are extracted from a pretrained Temporal Shift Module (TSM) ResNet-18 encoder, and interpretable biomarker features are separately evaluated. Through structured ablations over lung view, temporal representation, multi-view fusion, and cross-lung augmentation, we identify the key imaging factors driving readmission risk. Our findings reveal that (1) dependent lower-lung regions (Left-3, Right-3) carry the strongest prognostic signal, consistent with their greater susceptibility to hydrostatic congestion; (2) temporal difference features between sequential examinations substantially outperform single-timepoint representations, highlighting the importance of capturing disease trajectory; and (3) multi-view feature concatenation yields the best overall performance, with our top MLP model achieving an F1 score of 0.80 (95% CI: 0.62-0.96). Biomarker analysis further reveals that pleural-line abnormalities, including breaks and indentations, are as informative as the canonical A-line and B-line markers. These results support POCUS-derived biomarkers as practical, interpretable tools for noninvasive CHF risk stratification.
DT-Transformer: A Foundation Model for Disease Trajectory Prediction on a Real-world Health System
Accurate disease trajectory prediction is critical for early intervention, resource allocation, and improving long-term outcomes. While electronic health records (EHRs) provide a rich longitudinal view of patient health in clinical environments, models trained on curated research cohorts may not reflect routine deployment settings, and those trained on single-hospital datasets capture only fragments of each patient's trajectory. This highlights the importance of leveraging large, multi-hospital health systems for training and validation to better reflect real-world clinical complexity. In this work, we develop DT-Transformer, a foundation model trained on 57.1M structured EHR entries over 1.7M patients from Mass General Brigham (MGB), spanning 11 hospitals and a broad network of outpatient clinics. DT-Transformer achieves strong discrimination in both held-out and prospective validation settings. Next-event prediction achieves a median age- and sex-stratified AUC of 0.871 across 896 disease categories, with all categories exceeding AUC 0.5. These results support health system-scale training as a path toward foundation models suited to real-world clinical forecasting.
Uncertainty-Driven Anomaly Detection for Psychotic Relapse Using Smartwatches: Forecasting and Multi-Task Learning Fusion
Digital phenotyping enables continuous passive monitoring of behavior and physiology, offering a promising paradigm for early detection of psychotic relapse. In this work, we develop and systematically study two smartwatch-based frameworks for daily relapse detection. The first forecasts cardiac dynamics and flags deviations between predicted and observed features as indicators of abnormality. The second adopts a multi-task formulation that fuses sleep with motion and cardiac-derived signals, learning time-aware embeddings and predicting measurement timing. Both pipelines use Transformer encoders and output a daily anomaly score, derived from predictive uncertainty estimated via an ensemble of multilayer perceptrons to improve robustness to real-world wearable variability. While each framework independently demonstrates strong predictive power, we show that they capture complementary physiological signatures. Consequently, we propose a late-fusion strategy that synergistically combines the anomaly signals from both architectures into a unified decision score. We benchmark our methodology on the 2nd e-Prevention Grand Challenge dataset, where our fused model achieves a 8% relative improvement over the competition-winning baseline. Our results, supported by extensive ablation studies, suggest that the integration of diverse digital phenotypes, cardiac, motion, and sleep, is essential for the high-fidelity detection of psychotic relapse in real-world settings.
An Integrated Forecasting Prototype for Emergency Department Boarding Time to Support Proactive Operational Decision Making
Overcrowding in emergency departments (ED) remains a persistent operational challenge worldwide, causing delays in care delivery and downstream congestion. ED boarding time, defined as the duration admitted patients remain in the ED while awaiting inpatient bed placement, is a key indicator of this congestion. Predicting ED boarding time in advance enables proactive operational decision making before congestion escalates. We developed and evaluated a multi-horizon time series forecasting framework to predict ED boarding time at 6, 8, 10, 12, and 24-hour horizons. Real-world data from a university-affiliated urban hospital in the United States were utilized and integrated with external contextual data sources, including weather, holidays, and major local events. Decomposition-based Linear (DLinear) and Normalization-based Linear (NLinear) time series forecasting deep learning models showed superior performance across multiple horizons. Models were also evaluated under extreme congestion scenarios characterized by elevated boarding times. In addition, a Machine Learning Operations (MLOps) web application prototype was developed to support translation of the forecasting framework into practice through integrated data ingestion, forecast visualization, experimentation, and retraining.
A Proof-of-Concept Simulation-Driven Digital Twin Framework for Decision-Aware Diabetes Modeling
This paper presents a proof-of-concept digital twin framework for simulation-driven diabetes modeling using benchmark clinical data, synthetic temporal augmentation, and illustrative continuous glucose monitoring (CGM) analysis. Unlike traditional predictive models, the framework focuses on generating interpretable simulated trajectories rather than clinically validated outcomes. Evaluation is conducted using a public dataset combined with controlled synthetic scenarios to illustrate temporal behavior and intervention effects. Results illustrate the feasibility of integrating prediction with counterfactual simulation for decision-aware analysis. This work does not claim clinical readiness but provides a foundation for future research on simulation-driven digital twin systems in healthcare.
Marrying Generative Model of Healthcare Events with Digital Twin of Social Determinants of Health for Disease Reasoning
Despite the central role of sensor-derived measurements such as imaging traits and plasma biomarkers in biomedical research and clinical practice, existing generative models for disease prediction largely depend on event-level representations from hospital and registry data. Given the multi-factorial nature of human disease, the absence of explicit modeling of social determinants of health (SDoH), even in the limited form of ICD-coded proxies (chapters Z and V--Y in ICD-10), limits the capacity for personalized disease modeling and clinical decision support. To address this limitation, we propose a generative model with ICD-coded proxies of SDoH for \textit{in silico} modeling of disease reasoning, a conditioned latent diffusion framework that establishes the connection between multi-organ sensor data with tokenized healthcare events. Specifically, we introduce a novel geometric diffusion model to characterize the temporal evolution of complex data representation such as brain networks (region-to-region connectivity encoded in a graph), in parallel with diffusion models for tabular data from other organ systems. Together, we integrate the generative model with digitalized SDoH proxies (coined \modelname{}) for simulated intervention and reasoning of future disease trajectories. We conduct extensive experiments on the UK Biobank (UKB) dataset, which contains organ-specific imaging traits, including brain (44,834), heart (23,987), liver (28,722), and kidney (32,155), along with nearly 500k medical history sequences (age range: 2589 years). Our \modelname{} achieves significant improvements over state-of-the-art human disease autoregressive models and imaging trait generative baselines.
SAGE: Scalable Agentic Grounded Evaluation for Crop Disease Diagnosis
Plant disease diagnosis is critical for food security, yet training disease-recognition models that generalize across crops, pathogens, and field conditions remains challenging because labeled disease images are far less abundant and standardized than data for other biotic stresses such as insects or weeds. Frontier vision-language models offer new opportunities through improved visual reasoning, but they still struggle with fine-grained disease identification due to the lack of structured, crop-specific symptom knowledge. To address this gap, we curate the largest plant disease image--symptom dataset to date, covering 335 crops, 1{,}251 disease classes, and approximately 839K images, designed to support training-free, agentic disease prediction. A scalable automated pipeline generates source-grounded symptom descriptions in which each claim is linked to a verbatim web quote; domain experts validate sampled crops and reconcile disease-name variants across sources. As a baseline, we introduce an autonomous visual reasoning agent that identifies anatomical context, narrows candidate diseases using symptom knowledge, sequentially compares reference images, and produces a fully explainable reasoning trace. Incorporating symptom knowledge improves accuracy by 16.2 percentage points on average at the full reference budget, with consistent gains across all four evaluation crops. Because the framework only requires crop-specific reference images and symptom knowledge, it can be extended to new crops without retraining, while the agentic baseline can directly benefit from future improvements in foundation model capabilities. Dataset and code are available at:https://sage-dataset.github.io/.
Event-Based Early Warning of Vineyard Disease Risk from Environmental Time Series
Accurate early warning of vineyard disease risk from environmental observations is essential for timely intervention and more sustainable crop protection. However, many existing studies formulate disease prediction as daily presence classification, which can favor persistence-driven predictions and provide only limited support for actionable short-horizon warning. In this paper, we present an event-based approach for early warning of vineyard disease risk from environmental time series and evaluate it through a vineyard case study. Rather than predicting daily disease status, the task is reformulated to predict transitions into annotated disease-risk periods within a future window of 3-7 days. To reduce fragmentation caused by short interruptions in the binary labels, new events are defined only after a minimum disease-free gap. This formulation encourages models to capture environmental precursors associated with upcoming risk periods instead of merely reproducing temporal persistence. Using multi-year agro-meteorological data, we construct input representations that capture humidity dynamics, rainfall accumulation, temperature variability, and seasonal structure through cyclic temporal encoding. We evaluate representative methods from classical machine learning and deep learning, including XGBoost, Long Short-Term Memory (LSTM) networks, and Temporal Convolutional Networks (TCNs), using both standard classification metrics and an event-oriented early warning protocol. The results show that the event-based formulation supports practical short-horizon warning, while the compared models exhibit distinct trade-offs between event recall, lead time, and false-alert behavior. Overall, the study underscores the importance of problem formulation in environmental time-series learning and demonstrates the value of event-based prediction for vineyard disease warning systems.
Forecasting Medium-Horizon Alzheimer's Disease Progression: Residual Gap-Aware Transformers for 24-Month CDR-SB Change from ADNI Clinical and Biomarker Histories
Medium-horizon Alzheimer's disease progression prediction is difficult because future clinical scores can remain tied to baseline severity, while biomarker histories are irregular and incompletely observed. We develop an anchor-based analysis of 24-month Clinical Dementia Rating Sum of Boxes (CDR-SB) change using harmonized Alzheimer's Disease Neuroimaging Initiative (ADNI) tables. Each labeled sample is anchored at a mild cognitive impairment visit, uses only clinical and biomarker history observed at or before that anchor, and defines the response as CDR-SB at the future visit closest to 24 months within an 18--30 month window minus anchor CDR-SB. The analytic cohort contains 2,600 labeled anchors from 858 participants and 7,276 longitudinal rows. We propose a residual gap-aware transformer that combines a mixed-effects statistical reference with transformer-based residual learning from pre-anchor clinical and biomarker histories. The model uses participant-level random intercepts in the mixed-effects reference, observation-level triplet tokenization for irregular histories, and a learned nonnegative time-gap penalty inside self-attention. We compare the proposed model with a Bayesian-information-criterion-selected linear mixed-effects baseline, GRU-D, and STraTS under repeated participant-level train--test splits. Across five participant-level random seeds, the proposed model achieves the best mean test performance across all reported metrics, reducing MSE by 13.1% and increasing prediction--observation correlation by 26.4% relative to the mixed-effects baseline. It also improves over both GRU-D and STraTS in mean error and correlation. These results show that statistical anchoring and gap-aware residual learning provide a useful structure for medium-horizon Alzheimer's disease progression prediction.
Temporal Data Requirement for Predicting Unplanned Hospital Readmissions
With the proliferation of Electronic Health Records (EHRs), a critical challenge in building predictive models is determining the optimal historical data time window to maximize accuracy. This study investigates the impact of various observation windows ranging from the day of surgery to three years prior on predicting 30-day readmission following hip and knee arthroplasties. The dataset encompasses both structured encounter records (over 4 million) and unstructured clinical notes (80,000) from 7,174 patients. To extract meaning from the clinical notes, we employed a suite of non neural (BOW, count BOW, TF IDF, LDA) and neural encoders (BERT, 1D CNN, BiLSTM, Average). We subsequently evaluated models utilizing clinical notes alone, structured data alone, and a combination of both modalities. Our results demonstrate that the optimal time window for unstructured clinical notes is significantly shorter than for structured data, maximum predictive performance was achieved using notes from just three to six months prior to surgery. In contrast, performance using structured data improved as the time window lengthened, but strictly plateaued after twelve months. These modality-specific temporal patterns remained consistent regardless of model complexity or encoder type. Ultimately, these findings challenge the general assumption that more historical data inherently yields better machine learning predictions, establishing targeted time-window guidelines for optimizing readmission prediction models.
An Integrated Framework for Explainable, Fair, and Observable Hospital Readmission Prediction: Development and Validation on MIMIC-IV
Objective: To propose and retrospectively validate an integrated framework addressing three barriers to clinical translation of readmission prediction: lack of explainability, absence of deployment reliability infrastructure, and inadequate demographic fairness evaluation. Materials and Methods: We constructed a cohort of 415231 adult admissions from the MIMIC-IV database (30-day readmission prevalence 18.0%), split 70/15/15. Logistic regression, XGBoost, and LightGBM models were trained on 26 features. SHAP provided per-patient explanations. Fairness was evaluated across 16 subgroups using AUC-ROC, false negative rate (FNR), and positive predictive value (PPV). Calibration was assessed using Brier scores and calibration curves. Results: XGBoost achieved AUC-ROC 0.696 (95% CI 0.691-0.701), outperforming or matching the LACE baseline (AUC 0.60-0.68). LightGBM achieved best calibration (Brier 0.146). Prior admissions were the dominant predictor. All subgroups met equity thresholds (delta AUC <= 0.05, delta FNR <= 0.10). Conclusion: This framework delivers competitive performance, clinically actionable explanations, and strong demographic equity. Code is publicly available at https://github.com/Tomisin92/readmission-prediction.
Revealing Geography-Driven Signals in Zone-Level Claim Frequency Models: An Empirical Study using Environmental and Visual Predictors
Geographic context is often consider relevant to motor insurance risk, yet public actuarial datasets provide limited location identifiers, constraining how this information can be incorporated and evaluated in claim-frequency models. This study examines how geographic information from alternative data sources can be incorporated into actuarial models for Motor Third Party Liability (MTPL) claim prediction under such constraints. Using the BeMTPL97 dataset, we adopt a zone-level modeling framework and evaluate predictive performance on unseen postcodes. Geographic information is introduced through two channels: environmental indicators from OpenStreetMap and CORINE Land Cover, and orthoimagery released by the Belgian National Geographic Institute for academic use. We evaluate the predictive contribution of coordinates, environmental features, and image embeddings across three baseline models: generalized linear models (GLMs), regularized GLMs, and gradient-boosted trees, while raw imagery is modeled using convolutional neural networks. Our results show that augmenting actuarial variables with constructed geographic information improves accuracy. Across experiments, both linear and tree-based models benefit most from combining coordinates with environmental features extracted at 5 km scale, while smaller neighborhoods also improve baseline specifications. Generally, image embeddings do not improve performance when environmental features are available; however, when such features are absent, pretrained vision-transformer embeddings enhance accuracy and stability for regularized GLMs. Our results show that the predictive value of geographic information in zone-level MTPL frequency models depends less on model complexity than on how geography is represented, and illustrate that geographic context can be incorporated despite limited individual-level spatial information.
Enhancing Construction Worker Safety in Extreme Heat: A Machine Learning Approach Utilizing Wearable Technology for Predictive Health Analytics
Construction workers are highly vulnerable to heat stress, yet tools that translate real-time physiological data into actionable safety intelligence remain scarce. This study addresses this gap by developing and evaluating deep learning models, specifically a baseline Long Short-Term Memory (LSTM) network and an attention-based LSTM, to predict heat stress among 19 workers in Saudi Arabia. Using Garmin Vivosmart 5 smartwatches to monitor metrics such as heart rate, HRV, and oxygen saturation, the attention-based model outperformed the baseline, achieving 95.40% testing accuracy and significantly reducing false positives and negatives. With precision, recall, and F1 scores of 0.982, this approach not only improves predictive performance but also offers interpretable results suitable for integration into IoT-enabled safety systems and BIM dashboards, advancing proactive, informatics-driven safety management in the construction industry.
Personalized and Context-Aware Transformer Models for Predicting Post-Intervention Physiological Responses from Wearable Sensor Data
Consumer wearables enable continuous measurement of physiological data related to stress and recovery, but turning these streams into actionable, personalized stress-management recommendations remains a challenge. In practice, users often do not know how a given intervention, defined as an activity intended to reduce stress, will affect heart rate (HR), heart rate variability (HRV), or inter-beat intervals (BBI) over the next 15 to 120 minutes. We present a framework that predicts post-intervention trajectories and the direction of change for these physiological indicators across time windows. Our methodology combines a Transformer model for multi-horizon trajectories of percent change relative to a pre-intervention baseline, direction-of-change calls (positive, negative, or neutral) at each horizon, and an empirical study using wearable sensor data overlaid with user-tagged events and interventions. This proof of concept shows that personalized post-intervention prediction is feasible. We encourage future integration into stress-management tools for personalized intervention recommendations tailored to each person's day following further validation in larger studies and, where applicable, appropriate regulatory review.
SDE-Driven Spatio-Temporal Hypergraph Neural Networks for Irregular Longitudinal fMRI Connectome Modeling in Alzheimer's Disease
Longitudinal neuroimaging is essential for modeling disease progression in Alzheimer's disease (AD), yet irregular sampling and missing visits pose substantial challenges for learning reliable temporal representations. To address this challenge, we propose SDE-HGNN, a stochastic differential equation (SDE)-driven spatio-temporal hypergraph neural network for irregular longitudinal fMRI connectome modeling. The framework first employs an SDE-based reconstruction module to recover continuous latent trajectories from irregular observations. Based on these reconstructed representations, dynamic hypergraphs are constructed to capture higher-order interactions among brain regions over time. To further model temporal evolution, hypergraph convolution parameters evolve through SDE-controlled recurrent dynamics conditioned on inter-visit intervals, enabling disease-stage-adaptive connectivity modeling. We also incorporate a sparsity-based importance learning mechanism to identify salient brain regions and discriminative connectivity patterns. Extensive experiments on the OASIS-3 and ADNI cohorts demonstrate consistent improvements over state-of-the-art graph and hypergraph baselines in AD progression prediction. The source code is available at https://anonymous.4open.science/r/SDE-HGNN-017F.
AD-DAE: Alzheimer's Disease Progression Modeling with Unpaired Longitudinal MRI using Diffusion Auto-Encoders
Generative modeling frameworks have emerged as an effective approach to capture high-dimensional image distributions from large datasets without requiring domain-specific knowledge, a capability essential for disease progression modeling. Recent generative approaches have attempted to capture progression by mapping images to a latent space and guiding representations to generate follow-up images from previous time points. However, these methods impose constraints on distribution learning, resulting in latent spaces with limited controllability for generating follow-up images without paired subject-specific longitudinal guidance. In order to enable controlled movements in the latent representational space and generate progression images from a previous time-point image without subject-specific guidance, we introduce a conditionable Diffusion Auto-encoder framework that forms a compact latent space capturing high-level semantics and providing means to control generation. Our approach leverages this latent space to condition and apply controlled shifts to the representations of previous time-point images by isolating progression and subject identity information for generating follow-up images. The shifts are implicitly guided by correlating with progression attributes and constraining to Alzheimer's disease specific regions, without paired longitudinal guidance. We validate the generations through image quality metrics, volumetric progression analysis, and downstream tasks in Alzheimer's disease datasets from different sources. This demonstrates the effectiveness of our approach for Alzheimer's progression modeling and longitudinal image generation.
Glucose-ML: A collection of longitudinal diabetes datasets for development of robust AI solutions
Artificial intelligence (AI) algorithms are a critical part of state-of-the-art digital health technology for diabetes management. Yet, access to large high-quality datasets is creating barriers that impede development of robust AI solutions. To accelerate development of transparent, reproducible, and robust AI solutions, we present Glucose-ML, a collection of 10 publicly available diabetes datasets, released within the last 7 years (i.e., 2018 - 2025). The Glucose-ML collection comprises over 300,000 days of continuous glucose monitor (CGM) data with a total of 38 million glucose samples collected from 2500+ people across 4 countries. Participants include persons living with type 1 diabetes, type 2 diabetes, prediabetes, and no diabetes. To support researchers and innovators with using this rich collection of diabetes datasets, we present a comparative analysis to guide algorithm developers with data selection. Additionally, we conduct a case study for the task of blood glucose prediction - one of the most common AI tasks within the field. Through this case study, we provide a benchmark for short-term blood glucose prediction across all 10 publicly available diabetes datasets within the Glucose-ML collection. We show that the same algorithm can have significantly different prediction results when developed/evaluated with different datasets. Findings from this study are then used to inform recommendations for developing robust AI solutions within the diabetes or broader health domain. We provide direct links to each longitudinal diabetes dataset and openly provide our code.
Explainable Graph-theoretical Machine Learning with Application to Alzheimer's Disease Prediction
Dementia affects over 55 million people worldwide, projected to reach 139 million by 2050, with Alzheimer's disease (AD) accounting for 60-70% of cases. AD is associated with disruptions in metabolic brain connectivity. Detecting these disruptions early is crucial for AD management. FDG-PET is a useful tool for identifying such impairments. However, most studies rely on group-level analyses or thresholding, potentially masking individual differences and overlooking weaker yet biologically critical brain connections. Moreover, AD prediction largely focuses on univariate rather than multivariate outcomes. To address this, we introduce explainable graph-theoretical machine learning (XGML), a framework for constructing individual metabolic brain graphs and identifying subgraphs most predictive of multivariate disease-related outcomes. Using Alzheimer's Disease Neuroimaging Initiative (ADNI) FDG-PET data, we compared six graph representations against three non-graph baselines, each with six machine learning models using repeated stratified 3-fold cross-validation (10 repeats). The best configuration combined kernel density estimation with Hellinger distance and random forest. Across eight cognitive scores, it reached an overall Fisher-z-averaged Pearson correlation of r=0.595, with strongest performance for ADAS13 (r=0.67), ADAS11 (r=0.65), and ADASQ4 (r=0.62). We identified key edges that were jointly but differentially predictive across outcomes, suggesting their potential as network biomarkers of cognitive decline. Preliminary external feasibility validation on an OASIS3 cohort yielded weak predictive performance for CDRSB (r=0.26) and MMSE (r=0.18), likely reflecting cohort, protocol, and diagnostic differences. Overall, our results suggest the promise of graph-theoretical machine learning for biomarker discovery, disease prediction, and understanding the neural mechanisms underlying AD.
Hierarchical Sparse Bayesian Multitask Learning for Disease Prediction in Pooled Microbiome Studies
This paper proposes a hierarchical Bayesian multitask learning model that is applicable to the general multi-task binary classification learning problem where the model assumes a shared sparsity structure across different tasks. We derive a computationally efficient inference algorithm based on variational inference to approximate the posterior distribution. We demonstrate the potential of the new approach on various synthetic datasets and for predicting human health status based on microbiome profile. Our analysis incorporates data pooled from multiple microbiome studies, along with a comprehensive comparison with other benchmark methods. Results in synthetic datasets show that the proposed approach has superior support recovery property when the underlying regression coefficients share a common sparsity structure across different tasks. Our experiments on microbiome classification demonstrate the utility of the method in extracting informative taxa while providing well-calibrated predictions with uncertainty quantification and achieving competitive performance in terms of prediction metrics. Notably, despite the heterogeneity of the pooled datasets (e.g., different experimental objectives, laboratory setups, sequencing equipment, patient demographics), our method delivers robust results.