Patient-oriented computerized clinical guidelines for mobile decision support in gestational diabetes

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients’ self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient’s access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients’ personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients’ acceptance of the whole system.

Designer-driven 3D buildings generated using variable neighborhood search

This paper presents a mechanism to generate virtual buildings considering designer constraints and guidelines. This mechanism is implemented as a pipeline of different Variable Neighborhood Search (VNS) optimization processes in which several subproblems are tackled (1) rooms locations, (2) connectivity graph, and (3) element placement. The core VNS algorithm includes some variants to improve its performance, such as, for example constraint handling and biased operator selection. The optimization process uses a toolkit of construction primitives implemented as "smart objects" providing basic elements such as rooms, doors, staircases and other connectors. The paper also shows experimental results of the application of different designer constraints to a wide range of buildings from small houses to a large castle with several underground levels.