Fractal and Multifractal Facets in the Structure and Dynamics of Physiological Systems and Applications to Homeostatic Control, Disease Diagnosis and Integrated Cyber-Physical Platforms

Book excerpt: Widespread chronic diseases (e.g., heart diseases, diabetes and its complications, stroke, cancer, brain diseases) constitute a significant cause of rising healthcare costs and pose a significant burden on quality-of-life for many individuals. Despite the increased need for smart healthcare sensing systems that monitor / measure patients’ body balance, there is no coherent theory that facilitates the modeling of human physiological processes and the design and optimization of future healthcare cyber-physical systems (HCPS). The HCPS are expected to mine the patient’s physiological state based on available continuous sensing, quantify risk indices corresponding to the onset of abnormality, signal the need for critical medical intervention in real-time by communicating patient’s medical information via a network from individual to hospital, and most importantly control (actuate) vital health signals (e.g., cardiac pacing, insulin level, blood pressure) within personalized homeostasis. To prevent health complications, maintain good health and/or avoid fatal conditions calls for a cross-disciplinary approach to HCPS design where recent statistical-physics inspired discoveries done by collaborations between physicists and physicians are shared and enriched by applied mathematicians, control theorists and bioengineers. This critical and urgent multi-disciplinary approach has to unify the current state of knowledge and address the following fundamental challenges: One fundamental challenge is represented by the need to mine and understand the complexity of the structure and dynamics of the physiological systems in healthy homeostasis and associated with a disease (such as diabetes). Along the same lines, we need rigorous mathematical techniques for identifying the interactions between integrated physiologic systems and understanding their role within the overall networking architecture of healthy dynamics. Another fundamental challenge calls for a deeper understanding of stochastic feedback and variability in biological systems and physiological processes, in particular, and for deciphering their implications not only on how to mathematically characterize homeostasis, but also on defining new control strategies that are accounting for intra- and inter-patient specificity – a truly mathematical approach to personalized medicine. Numerous recent studies have demonstrated that heart rate variability, blood glucose, neural signals and other interdependent physiological processes demonstrate fractal and non-stationary characteristics. Exploiting statistical physics concepts, numerous recent research studies demonstrated that healthy human physiological processes exhibit complex critical phenomena with deep implications for how homeostasis should be defined and how control strategies should be developed when prolonged abnormal deviations are observed. In addition, several efforts have tried to connect these fractal characteristics with new optimal control strategies that implemented in medical devices such as pacemakers and artificial pancreas could improve the efficiency of medical therapies and the quality-of-life of patients but neglecting the overall networking architecture of human physiology. Consequently, rigorously analyzing the complexity and dynamics of physiological processes (e.g., blood glucose and its associated implications and interdependencies with other physiological processes) represents a fundamental step towards providing a quantifiable (mathematical) definition of homeostasis in the context of critical phenomena, understanding the onset of chronic diseases, predicting deviations from healthy homeostasis and developing new more efficient medical therapies that carefully account for the physiological complexity, intra- and inter-patient variability, rather than ignoring it. This Research Topic aims to open a synergetic and timely effort between physicians, physicists, applied mathematicians, signal processing, bioengineering and biomedical experts to organize the state of knowledge in mining the complexity of physiological systems and their implications for constructing more accurate mathematical models and designing QoL-aware control strategies implemented in the new generation of HCPS devices. By bringing together multi-disciplinary researchers seeking to understand the many aspects of human physiology and its complexity, we aim at enabling a paradigm shift in designing future medical devices that translates mathematical characteristics in predictable mathematical models quantifying not only the degree of homeostasis, but also providing fundamentally new control strategies within the personalized medicine era.