Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
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Item Restricted AI Conversational Agents in Healthcare for Type-2 Diabetes(University of Technology Sydney, 2024-09-12) Sawad, Abdullah Bin; Kocaballi, Baki; Prasad, Mukesh; Narayan, Bhuva; Lin, ShanshanType 2 diabetes (T2D) is a global health crisis with significant impacts on individuals and healthcare systems. This thesis develops AI conversational agents (CAs) to promote physical activity and lifestyle changes for those at risk of T2D through a multi-phase study, including a systematic review, a design framework, and empirical testing. The systematic review identified gaps in digital interventions, particularly the limited use of CAs in T2D prevention. A standardised framework was then developed, focusing on personalisation, user engagement, and proactive health management. This framework guided the iterative design and refinement of a CA prototype, tested across diverse populations in Sydney and Jeddah. The thesis integrated real-time activity tracking via Fitbit and enhanced conversational capabilities using large language models. Findings demonstrated that AI-driven, personalised interactions significantly encouraged physical activity, a key factor in preventing T2D progression. This thesis contributes to health informatics by demonstrating AI’s role in preventive healthcare. It highlights the importance of a user-centred design approach, ensuring that digital health tools are effective and align with the users’ needs and preferences. Future research should focus on long-term engagement strategies and integrating conversational agents with broader healthcare systems to enhance their effectiveness and reach.14 0Item Restricted MRI assessment of Subclinical Cardiac Dysfunction and its association with Ectopic fat in adults with Type 2 Diabetes(Saudi Digital Library, 2023-09-15) Althagafi, Loai; Maccann, Gerry; Brady, EmerBackground Visceral adipose tissue (VAT) is metabolically active and has been implicated in the development of Heart Failure with Preserved Ejection Fraction (HFpEF) through dysregulation of circulating adipokines in people with type 2 diabetes (T2D). Objective The purpose of this research was to determine whether VAT is independently related to subclinical cardiac dysfunction in a multi-ethnic cohort of obese people with T2D using magnetic resonance imaging (MRI). Methods Data was derived from two randomised controlled trials: the LYDIA study (NCT02043054) and the DIASTOLIC study (NCT02590822). Participants had T2D and obesity with no history or symptoms of cardiovascular disease. They underwent one of five interventions in open-label, blinded endpoint designs: 1) standard care, 2) supervised exercise training, 3) a meal replacement program, and 4) liraglutide or sitagliptin. Multiparametric cardiovascular MRI strain rate analysis using feature tracking and 2-point Dixon (fat-water) imaging for VAT quantification were performed at baseline and follow-up. Multivariable regression was used to identify the associations between VAT and liver fat with LV systolic strain/diastolic strain rates and LV mass:volume in subjects with T2D. Multivariable models were adjusted for age, sex, ethnicity, systolic BP, BMI, and WHR at baseline and for change in SBP and weight at follow-up, with leptin and adiponectin added to the final model. Results At baseline, 132 working-age adults, respectively, with T2D (mean age: 47.5±7.3, 54.5% male and 59.8% White European, VAT: 100/mL) showed a significant association with circumferential PEDSR (P = 0.046) independent of age, sex, ethnicity, systolic BP, BMI, and WHR. This association shows that for every 100 mL or VAT mL/cm increase in VAT volume is associated with a decrease in circumferential PEDSR (s-1) that is equivalent to the coefficient ( = -3.225). A total of 103 working-age adults with T2D (mean age of 47.5±7.3 years, 54.5% male and 60% WE) completed the trials. A significant reduction in weight was reported (mean change 4.3 kg, (3.3, 5.4), p < 0.001), systolic BP (3.5(1.5,5.4), p < 0.001) and strain and strain rates were reported. A reduction in VAT volume was associated with an improvement in circumferential PEDSR (p = 0.019) independent of independent of age, sex, ethnicity, systolic BP, and weight. This equated to reduction in circumferential PEDSR, s-1 of 0.022 (, (0.004, 0.040)) for every 100 mL reduction in VAT volume. The association continued to do show significance when leptin and adiponectin were added to the model separately (p = 0.004, p = 0.007) respectively. Conclusion VAT (100/mL) and a reduction in VAT (100/mL) are independently associated with diastolic strain rates. These findings support the putative role of VAT in the development and possible management of HFpEF in people living with obesity and T2D19 0