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Background: Reinforcement learning (RL) is a computational approach to understanding and automating goal-directed learning and decision-making. It is designed for problems which include a learning agent interacting with its environment to achieve a goal. For example, blood glucose (BG) control in diabetes mellitus (DM), where the learning agent and its environment are the controller and the body of the patient respectively. RL algorithms could be used to design a fully closed-loop controller, providing a truly personalized insulin dosage regimen based exclusively on the patient's own data. Objective:In this review we aim to evaluate state-of-the-art RL approaches to designing BG control algorithms in DM patients, reporting successfully implemented RL algorithms in closedloop, insulin infusion, decision support and personalized feedback in the context of DM.Methods: An exhaustive literature search was performed using different online databases, analyzing the literature from 1990 to 2019. In a first stage, a set of selection criteria were established in order to select the most relevant papers according to the title, keywords and abstract. Research questions were established and answered in a second stage, using the information extracted from the articles selected during the preliminary selection.Results: The initial search using title, keywords, and abstracts resulted in a total of 404 articles.After removal of duplicates from the record, 347 articles remained. An independent analysis and screening of the records against our inclusion and exclusion criteria defined in Methods section resulted in removal of 296 articles, leaving 51 relevant articles. A full-text assessment was conducted on the remaining relevant articles, which resulted in 29 relevant articles that were critically analyzed. The inter-rater agreement was measured using Cohen Kappa test, and disagreements were resolved through discussion. Conclusions:The advances in health technologies and mobile devices have facilitated the implementation of RL algorithms for optimal glycemic regulation in diabetes. However, there exists few articles in the literature focused on the application of these algorithms to the BG regulation problem. Moreover, such algorithms are designed for control tasks as BG adjustment and their use have increased recently in the diabetes research area, therefore we foresee RL algorithms will be used more frequently for BG control in the coming years. Furthermore, in the literature there is a lack of focus on aspects that influence BG level such as meal intakes and physical activity (PA), which should be included in the control problem. Finally, there exists a need to perform clinical validation of the algorithms.

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There is a large proliferation of complex data-driven artificial intelligence (AI) applications in many aspects of our daily lives, but their implementation in healthcare is still limited. This scoping review takes a theoretical approach to examine the barriers and facilitators based on empirical data from existing implementations. We searched the major databases of relevant scientific publications for articles related to AI in clinical settings, published between 2015 and 2021. Based on the theoretical constructs of the Consolidated Framework for Implementation Research (CFIR), we used a deductive, followed by an inductive, approach to extract facilitators and barriers. After screening 2784 studies, 19 studies were included in this review. Most of the cited facilitators were related to engagement with and management of the implementation process, while the most cited barriers dealt with the intervention’s generalizability and interoperability with existing systems, as well as the inner settings’ data quality and availability. We noted per-study imbalances related to the reporting of the theoretic domains. Our findings suggest a greater need for implementation science expertise in AI implementation projects, to improve both the implementation process and the quality of scientific reporting.

Hyperspectral Imaging is an emerging technology for medical diagnosis issues due to the fact that it is a noncontact, non-ionizing and non-invasive sensing technique. The work presented in this paper tries to establish a novel way in the use of hyperspectral images to help neurosurgeons to accurately determine the tumour boundaries in the process of brain tumour resection, avoiding excessive extraction of healthy tissue and the accidental leaving of un-resected small tumour tissues. So as to do that, a hyperspectral database of in-vivo human brain samples has been created and a procedure to label the pixels diagnosed by the pathologists has been described. A total of 24646 samples from normal and tumour tissues from 13 different patients have been obtained. A pre-processing chain to homogenize the spectral signatures has been developed, obtaining 3 types of datasets (using different pre-processing chain) in order to determine which one provides the best classification results using a Random Forest classifier. The experimental results of this supervised classification algorithm to distinguish between normal and tumour tissues have achieved more than 99% of accuracy.