The global rise in type 2 diabetes underscores the need for scalable and cost-effective screening methods. Current diagnosis requires biochemical assays, which are invasive and costly. Advances in consumer wearables have enabled early explorations of machine learning-based disease detection, but prior studies were limited to controlled settings. We present SweetDeep, a compact neural network trained on physiological and demographic data from 285 (diabetic and non-diabetic) participants in the EU and MENA regions, collected using Samsung Galaxy Watch 7 devices in free-living conditions over six days. Each participant contributed multiple 2-minute sensor recordings per day, totaling approximately 20 recordings per individual. Despite comprising fewer than 3,000 parameters, SweetDeep achieves 82.5% patient-level accuracy (82.1% macro-F1, 79.7% sensitivity, 84.6% specificity) under three-fold cross-validation, with an expected calibration error of 5.5%. Allowing the model to abstain on less than 10% of low-confidence patient predictions yields an accuracy of 84.5% on the remaining patients. These findings demonstrate that combining engineered features with lightweight architectures can support accurate, rapid, and generalizable detection of type 2 diabetes in real-world wearable settings.

Objective. Type 2 diabetes mellitus (T2DM) is a highly prevalent non-communicable chronic disease that substantially reduces life expectancy. Accurate estimation of all-cause mortality risk in T2DM patients is crucial for personalizing and optimizing treatment strategies. Research Design and Methods. This study analyzed a cohort of 554 patients (aged 40-87 years) with diagnosed T2DM over a maximum follow-up period of 16.8 years, during which 202 patients (36%) died. Key survival-associated features were identified, and multiple machine learning (ML) models were trained and validated to predict all-cause mortality risk. To improve model interpretability, Shapley additive explanations (SHAP) was applied to the best-performing model. Results. The extra survival trees (EST) model, incorporating ten key features, demonstrated the best predictive performance. The model achieved a C-statistic of 0.776, with the area under the receiver operating characteristic curve (AUC) values of 0.86, 0.80, 0.841, and 0.826 for 5-, 10-, 15-, and 16.8-year all-cause mortality predictions, respectively. The SHAP approach was employed to interpret the model's individual decision-making processes. Conclusions. The developed model exhibited strong predictive performance for mortality risk assessment. Its clinically interpretable outputs enable potential bedside application, improving the identification of high-risk patients and supporting timely treatment optimization.

We present a foundation model-derived method to identify highly informative tokens and events in electronic health records. Our approach considers incoming data in the entire context of a patient's hospitalization and so can flag anomalous events that rule-based approaches would consider within a normal range. We demonstrate that the events our model flags are significant for predicting downstream patient outcomes and that a fraction of events identified as carrying little information can safely be dropped. Additionally, we show how informativeness can help interpret the predictions of prognostic models trained on foundation model-derived representations.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

$\textbf{Objective:}$ Brain-predicted age difference (BrainAGE) is a neuroimaging biomarker reflecting brain health. However, training robust BrainAGE models requires large datasets, often restricted by privacy concerns. This study evaluates the performance of federated learning (FL) for BrainAGE estimation in ischemic stroke patients treated with mechanical thrombectomy, and investigates its association with clinical phenotypes and functional outcomes. $\textbf{Methods:}$ We used FLAIR brain images from 1674 stroke patients across 16 hospital centers. We implemented standard machine learning and deep learning models for BrainAGE estimates under three data management strategies: centralized learning (pooled data), FL (local training at each site), and single-site learning. We reported prediction errors and examined associations between BrainAGE and vascular risk factors (e.g., diabetes mellitus, hypertension, smoking), as well as functional outcomes at three months post-stroke. Logistic regression evaluated BrainAGE's predictive value for these outcomes, adjusting for age, sex, vascular risk factors, stroke severity, time between MRI and arterial puncture, prior intravenous thrombolysis, and recanalisation outcome. $\textbf{Results:}$ While centralized learning yielded the most accurate predictions, FL consistently outperformed single-site models. BrainAGE was significantly higher in patients with diabetes mellitus across all models. Comparisons between patients with good and poor functional outcomes, and multivariate predictions of these outcomes showed the significance of the association between BrainAGE and post-stroke recovery. $\textbf{Conclusion:}$ FL enables accurate age predictions without data centralization. The strong association between BrainAGE, vascular risk factors, and post-stroke recovery highlights its potential for prognostic modeling in stroke care.

Background: Patients with both diabetes mellitus (DM) and atrial fibrillation (AF) face elevated mortality in intensive care units (ICUs), yet models targeting this high-risk group remain limited. Objective: To develop an interpretable machine learning (ML) model predicting 28-day mortality in ICU patients with concurrent DM and AF using early-phase clinical data. Methods: A retrospective cohort of 1,535 adult ICU patients with DM and AF was extracted from the MIMIC-IV database. Data preprocessing involved median/mode imputation, z-score normalization, and early temporal feature engineering. A two-step feature selection pipeline-univariate filtering (ANOVA F-test) and Random Forest-based multivariate ranking-yielded 19 interpretable features. Seven ML models were trained with stratified 5-fold cross-validation and SMOTE oversampling. Interpretability was assessed via ablation and Accumulated Local Effects (ALE) analysis. Results: Logistic regression achieved the best performance (AUROC: 0.825; 95% CI: 0.779-0.867), surpassing more complex models. Key predictors included RAS, age, bilirubin, and extubation. ALE plots showed intuitive, non-linear effects such as age-related risk acceleration and bilirubin thresholds. Conclusion: This interpretable ML model offers accurate risk prediction and clinical insights for early ICU triage in patients with DM and AF.

The global prevalence of diabetes, particularly type 2 diabetes mellitus (T2DM), is rapidly increasing, posing significant health and economic challenges. T2DM not only disrupts blood glucose regulation but also damages vital organs such as the heart, kidneys, eyes, nerves, and blood vessels, leading to substantial morbidity and mortality. In the US alone, the economic burden of diagnosed diabetes exceeded \$400 billion in 2022. Early detection of individuals at risk is critical to mitigating these impacts. While machine learning approaches for T2DM prediction are increasingly adopted, many rely on supervised learning, which is often limited by the lack of confirmed negative cases. To address this limitation, we propose a novel unsupervised framework that integrates Non-negative Matrix Factorization (NMF) with statistical techniques to identify individuals at risk of developing T2DM. Our method identifies latent patterns of multimorbidity and polypharmacy among diagnosed T2DM patients and applies these patterns to estimate the T2DM risk in undiagnosed individuals. By leveraging data-driven insights from comorbidity and medication usage, our approach provides an interpretable and scalable solution that can assist healthcare providers in implementing timely interventions, ultimately improving patient outcomes and potentially reducing the future health and economic burden of T2DM.

Diabetes mellitus (DM) is a global health issue of significance that must be diagnosed as early as possible and managed well. This study presents a framework for diabetes prediction using Machine Learning (ML) models, complemented with eXplainable Artificial Intelligence (XAI) tools, to investigate both the predictive accuracy and interpretability of the predictions from ML models. Data Preprocessing is based on the Synthetic Minority Oversampling Technique (SMOTE) and feature scaling used on the Diabetes Binary Health Indicators dataset to deal with class imbalance and variability of clinical features. The ensemble model provided high accuracy, with a test accuracy of 92.50% and an ROC-AUC of 0.975. BMI, Age, General Health, Income, and Physical Activity were the most influential predictors obtained from the model explanations. The results of this study suggest that ML combined with XAI is a promising means of developing accurate and computationally transparent tools for use in healthcare systems.

Fr\'echet regression is becoming a mainstay in modern data analysis for analyzing non-traditional data types belonging to general metric spaces. This novel regression method is especially useful in the analysis of complex health data such as continuous monitoring and imaging data. Fr\'echet regression utilizes the pairwise distances between the random objects, which makes the choice of metric crucial in the estimation. In this paper, existing dimension reduction methods for Fr\'echet regression are reviewed, and the effect of metric choice on the estimation of the dimension reduction subspace is explored for the regression between random responses and Euclidean predictors. Extensive numerical studies illustrate how different metrics affect the central and central mean space estimators. Two real applications involving analysis of brain connectivity networks of subjects with and without Parkinson's disease and an analysis of the distributions of glycaemia based on continuous glucose monitoring data are provided, to demonstrate how metric choice can influence findings in real applications.

Understanding the complex relationships of biomarkers in diabetes is pivotal for advancing treatment strategies, a pressing need in diabetes research. This study applies Bayesian network structure learning to analyze the Shanghai Type 1 and Type 2 diabetes mellitus datasets, revealing complex relationships among key diabetes-related biomarkers. The constructed Bayesian network presented notable predictive accuracy, particularly for Type 2 diabetes mellitus, with root mean squared error (RMSE) of 18.23 mg/dL, as validated through leave-one-domain experiments and Clarke error grid analysis. This study not only elucidates the intricate dynamics of diabetes through a deeper understanding of biomarker interplay but also underscores the significant potential of integrating data-driven and knowledge-driven methodologies in the realm of personalized diabetes management. Such an approach paves the way for more custom and effective treatment strategies, marking a notable advancement in the field.