Mathematical modeling and simulation are moving from being powerful development and analysis tools towards having increased roles in operational monitoring, control and decision support, in which models of specific entities are continually updated in the form of a digital twin. However, current digital twins are largely the result of bespoke technical solutions that are difficult to scale. We discuss two exemplar applications that motivate challenges and opportunities for scaling digital twins, and that underscore potential barriers to wider adoption of this technology. Development in digital-twin technology has been rapidly growing across a range of industries and disciplines. However, to ensure a wider and more robust adoption of such technology, various challenges must be addressed by the computational science community.

Scaling digital twins from the artisanal to the industrial

Digital twin modeling

A digital twin is a virtual model of a physical entity, with dynamic, bi-directional links between the physical entity and its corresponding twin in the digital domain. Digital twins are increasingly used today in different industry sectors. Applied to medicine and public health, digital twin technology can drive a much-needed radical transformation of traditional electronic health/medical records (focusing on individuals) and their aggregates (covering populations) to make them ready for a new era of precision (and accuracy) medicine and public health. Digital twins enable learning and discovering new knowledge, new hypothesis generation and testing, and in silico experiments and comparisons. They are poised to play a key role in formulating highly personalised treatments and interventions in the future. This paper provides an overview of the technology's history and main concepts. A number of application examples of digital twins for personalised medicine, public health, and smart healthy cities are presented, followed by a brief discussion of the key technical and other challenges involved in such applications, including ethical issues that arise when digital twins are applied to model humans.

https://www.mdpi.com/2075-4426/11/8/745/pdf

Digital Twins: From Personalised Medicine to Precision Public Health

An individualized innovative disease management is of great importance for people with multiple sclerosis (pwMS) to cope with the complexity of this chronic, multidimensional disease. However, an individual state of the art strategy, with precise adjustment to the patient's characteristics, is still far from being part of the everyday care of pwMS. The development of digital twins could decisively advance the necessary implementation of an individualized innovative management of MS. Through artificial intelligence-based analysis of several disease parameters - including clinical and para-clinical outcomes, multi-omics, biomarkers, patient-related data, information about the patient's life circumstances and plans, and medical procedures - a digital twin paired to the patient's characteristic can be created, enabling healthcare professionals to handle large amounts of patient data. This can contribute to a more personalized and effective care by integrating data from multiple sources in a standardized manner, implementing individualized clinical pathways, supporting physician-patient communication and facilitating a shared decision-making. With a clear display of pre-analyzed patient data on a dashboard, patient participation and individualized clinical decisions as well as the prediction of disease progression and treatment simulation could become possible. In this review, we focus on the advantages, challenges and practical aspects of digital twins in the management of MS. We discuss the use of digital twins for MS as a revolutionary tool to improve diagnosis, monitoring and therapy refining patients' well-being, saving economic costs, and enabling prevention of disease progression. Digital twins will help make precision medicine and patient-centered care a reality in everyday life.

/pdf/digital-twins-for-multiple-sclerosis-1v0rc1lo3a.pdf

Digital Twins for Multiple Sclerosis.

As a key service of the future 6G network, healthcare digital twin is the virtual replica of a person, which employs Internet of Things (IoT) technologies and AI-powered models to predict the state of health and provide suggestions to a range of clinical questions. To support healthcare digital twins, the right cyber resilience technologies and policies must be applied and maintained to preserve cyber resilience. Vulnerability detection is a fundamental technology for cyber resilience in healthcare digital twins. Recently, deep learning (DL) has been applied to address the limitations of traditional machine learning in vulnerability detection. However, it is important to consider code context relationships and pay attention on the vulnerability related keywords for searching an IoT vulnerability in healthcare digital twins. Due to massive software and complexity of healthcare digital twin, a full automatic solution is really needed for assisting cyber resilience check in the real-world scenarios. This article presents a novel scheme for recognising potential vulnerable functions to support healthcare digital twins. We develop a new deep neural model to capture bi-directional context relationships among the risky code keywords. A number of well-designed experiments are carried out on a large ground truth, which consists of tens of thousands of vulnerable and non-vulnerable functions from IoT related software. The results show our new scheme outperforms the state-of-the-art DL-based methods for vulnerability detection.

/pdf/cyber-resilience-in-healthcare-digital-twin-on-lung-cancer-17wq8oggrz.pdf

Cyber Resilience in Healthcare Digital Twin on Lung Cancer

Providing therapies tailored to each patient is the vision of precision medicine, enabled by the increasing ability to capture extensive data about individual patients. In this position paper, we argue that the second enabling pillar towards this vision is the increasing power of computers and algorithms to learn, reason, and build the 'digital twin' of a patient. Computational models are boosting the capacity to draw diagnosis and prognosis, and future treatments will be tailored not only to current health status and data, but also to an accurate projection of the pathways to restore health by model predictions. The early steps of the digital twin in the area of cardiovascular medicine are reviewed in this article, together with a discussion of the challenges and opportunities ahead. We emphasize the synergies between mechanistic and statistical models in accelerating cardiovascular research and enabling the vision of precision medicine.

https://hal.inria.fr/hal-02947289/document

Mehrdad Shamohammdi

Papers

The 'Digital Twin' to enable the vision of precision cardiology.