Abstract: The present disclosure relates to a system (1) for remote assessment of a patient (P1), comprising: a first device (2) associated to a physician (P2), a second device (3) associated to the patient (P1), a medical device (4) associated to the patient (P1), wherein the second device (3) is configured to communicate with the medical device (4), and wherein the medical device (4) is configured to be programmed via the second device (3), wherein the first device (2) is further configured to communicate with the second device (3), and wherein the second device (3) is configured to be controlled via the first device (2), and wherein the second device (3) is configured to acquire data (S1, S2) indicative of at least one physiological parameter or of several physiological parameters (HR, F, P) of the patient (P1). Furthermore, a method for remote assessment is provided.

Abstract: A method is provided for lowering blood pressure in a subject in need thereof by administering an angiotensin II receptor blocker pharmaceutical composition to a subject qualified for over-the-counter access to the angiotensin II receptor blocker pharmaceutical composition. In some embodiments, the angiotensin II receptor blocker pharmaceutical composition includes azilsartan medoxomil, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, or valsartan. In some embodiments, the angiotensin II receptor blocker pharmaceutical composition comprises an active ingredient that is (5-methyl-2-oxo-1,3-dioxol-4-yl)methyl 2-ethoxy-1-{[2?-(5-oxo-4,5-dihydro-1,2,4-oxadiazol-3-yl)biphenyl-4-yl]methyl}-1H-benzimidazole-7-carboxylate or a pharmaceutically acceptable salt thereof.

Abstract: A handheld device measures all vital signs and some hemodynamic parameters from the human body and transmits measured information wirelessly to a web-based system, where the information can be analyzed by a clinician to help diagnose a patient. The system utilizes our discovery that bio-impedance signals used to determine vital signs and hemodynamic parameters can be measured over a conduction pathway extending from the patient's wrist to a location on their thoracic cavity, e.g. their chest or navel. The device's form factor can include re-usable electrode materials to reduce costs. Measurements made by the handheld device, which use the belly button as a ‘fiducial’ marker, facilitate consistent, daily measurements, thereby reducing positioning errors that reduce accuracy of standard impedance measurements. In this and other ways, the handheld device provides an effective tool for characterizing patients with chronic diseases, such as heart failure, renal disease, and hypertension.

Abstract: Described herein are to frameworks and methodologies configured to enable real-time adaptive delivery of skills training data based on monitoring of user performance data. Embodiments of the invention have been particularly to enable real-time control over a performance instruction user interface (for example in terms of rate), and/or control over delivery of media data (for example in terms of rate and/or pan/zoom position).

Abstract: An improved analyte monitoring system having a sensor and a transceiver with improved communication and/or user interface capabilities. The transceiver may communicate with and power the sensor. The transceiver may receive one or more analyte measurements from the sensor and may calculate one or more analyte concentrations based on the received analyte measurements. The transceiver may generate analyte concentration trends, alerts, and/or alarms based on the calculated analyte concentrations. The system may also include a display device, which may be, for example, a smartphone and may be used to display analyte measurements received from the transceiver. The display device may execute a mobile medical application. The system may include a data management system, which may be web-based.

Abstract: A machine learning based recommendation model, including a supervised learning classifier configured to receive input training data that includes a plurality of behavioral determinants, a supervised learning model configured to receive subject input data that includes a plurality of behavior determinants, wherein the supervised learning model outputs a predicted behavior of a subject, and a channel selection module configured to receive the subject input data and the predicted behavior and to determine a recommended communication channel for the subject to follow to achieve the predicted behavior.

Abstract: Provided in various example embodiments a mobile device integrated in a body that is sized and shaped to be held in a palm of a hand of a user, the mobile device configured to take a plurality of physiological measurements of a patient, including electrocardiographic measurements, blood oxygen saturation level measurements, pulse rate measurements, body temperature measurements, blood pressure measurements when connected with a removable inflatable cuff, and blood glucose measurements when connected with an elongated test strip, and to display and wirelessly communicate data corresponding to said physiological measurements. The mobile device may comprise some or all of the features of an Internet enabled smartphone. The mobile device may be provided with selectable modes of operation for use with one or more patients. Wireless peripherals may provide additional physiological data to the device. Systems are provided for secure communication and storage of data.

Abstract: This liquid sample measurement device is provided with: a lancet mounting part to and from which a lancet device having a skin contact section for puncturing skin can be attached and detached; a sensor mounting part to which a biosensor, which is spotted with blood that comes out from the punctured skin, can be attached; and a measurement part that uses the biosensor attached to the sensor mounting part to measure the amounts of substances in the blood. The liquid sample measurement device includes a feature that makes it necessary to replace a lancet device that has been attached to the lance mounting part and has punctured skin, each time a lancet device is used to puncture skin.

Abstract: A method is provided for making recommendations for a user of an activity tracking system. The method includes receiving activity data for the user over a period of days, the activity data collected by a geo-position device. The method further includes determining routine travel paths for the user based on the activity data, and then determining recommendations, the recommendations based at least in part on the routine travel paths of the user. The method also includes sending the recommendations to the user.

Abstract: The present invention provides a method of conducting a sleep analysis by collecting physiologic and kinetic data from a subject, preferably via a wireless in-home data acquisition system, while the subject attempts to sleep at home. The sleep analysis, including clinical and research sleep studies and cardiorespiratory studies, can be used in the diagnosis of sleeping disorders and other diseases or conditions with sleep signatures, such as Parkinson's, epilepsy, chronic heart failure, chronic obstructive pulmonary disorder, or other neurological, cardiac, pulmonary, or muscular disorders. The method of the present invention can also be used to determine if environmental factors at the subject's home are preventing restorative sleep.

Abstract: A method of controlling a biometric parameter, such as heart rate and/or breathing rate, of a subject engaged in an activity includes sensing the biometric parameter via a monitoring device worn by the subject, determining frequency characteristics of the biometric parameter, and presenting to the subject musical audio having a tempo correlated to the frequency characteristics of the biometric parameter. The tempo of the musical audio presented to the subject may be changed in order to cause a change in the biometric parameter. A method of modulating heart rate of a subject engaged in an activity includes sensing a breathing rate of the subject via a monitoring device worn by the subject, and then presenting to the subject musical audio having a tempo selected to change the breathing rate by an amount sufficient to cause a change in the heart rate.

Abstract: A falling asleep prediction device includes a biological data acquisition unit that acquires biological information on a subject, a falling asleep prediction unit that predicts that the subject falls asleep after predetermined time by using the biological information, and a notification processing unit that notifies that the subject falls asleep after the predetermined time.

Abstract: A platform lift, in particular a stairlift, including a rail, a drive unit having a platform, in particular a chair, for driving along the rail, at least one control unit arranged at the drive unit, a speech communication device located at the drive unit, a base station located at a fixed location, and one wireless transmission path connecting the control unit and the speech communication device to the base station.

Abstract: In general, a dialysis device includes a first processing device for monitoring dialysis functions of the dialysis device, a second processing device, a display device, and memory. The memory is configured to store instructions that, when executed, cause the dialysis device to provide, on the display device, a first display region and a second display region, where the first display region is associated with the first processing device and the second display region is associated with the second processing device. At least a portion of the first display region cannot be obscured by the second display region.

Abstract: A method, system and medium are provided for enabling re-creation of a time-ordered sequence of clinical data. Sets of data elements for a patient are received in sequence from a clinical system, and for each data element a time stamp is attached. For any given set of data elements, a maximum time stamp is determined, implying that all events in a clinical system resulting in modifications to data elements contained in the set occurred on or before the maximum time stamp. A subsequent retrieval from a clinical system yields a set of data elements in which the time stamp for each data element occurs after the maximum time stamp from the previous set.

Abstract: Provided herein is an engagement and care support platform (“ECSP”) computer system including at least one processor in communication with at least one memory device for facilitating senior user engagement. The processor is programmed to: (i) register a user through an application, (ii) register a caregiver associated with the user through the application, (iii) generate a senior profile based upon user personal and scheduling data, (iv) build a daily interactive user interface that reflects the senior profile, (v) display the daily interactive user interface at a first client device associated with the user, (vi) cause the first client device to initiate a daily interaction prompt to the user, (vii) determine whether any user interaction was received in response to the daily interaction prompt, and (viii) transmit a daily update message to a second client device associated with the caregiver, including an indication of whether any user interaction was received.

Abstract: An electrocardiography patch is provided. A backing forms an elongated strip with a mid-section connecting two ends of the backing. The mid-section is narrower than the two ends of the backing. An electrocardiographic electrode is provided on each end of the backing to capture electrocardiographic signals. A flexible circuit includes a pair of circuit traces electrically coupled to the electrocardiographic electrodes. A wireless transceiver communicates at least a portion of the electrocardiographic signals.

Abstract: Systems and methods include one or more entities including a sensor configured to provide data in at least a first protocol or standard from a first manufacturer and a second protocol or standard from a second manufacturer; and an electronic health record database configured to translate between the protocols and save the data in an intermediate format.

Abstract: The present disclosure pertains to a system configured to adjust a volume of auditory stimulation delivered to a subject during sleep. The system is configured to determine a deepening time indicative of a rate at which sleep of the subject deepens during the sleep session. The deepening time is determined based on (i) a ratio of power in a high frequency band of an EEG signal to power in a low frequency band, (ii) a density of slow waves, or (iii) a hypnogram, indicative of sleep depth in the subject during the sleep session. The system is configured to determine a rate of volume increase for auditory stimulation during a subsequent sleep session based on the deepening time; and control the one or more sensory stimulators to adjust the volume of auditory stimulation provided to the subject during the subsequent sleep session based on the determined rate of volume increase.

Abstract: Provided is a method of a host device managing at least one external device connected to the host device through a management server. The method includes: obtaining measurement information measured by the at least one external device; requesting authorization by the management server; transmitting the obtained measurement information to the management server when the authentication succeeds; receiving management information for managing the at least one external device, where the management information is generated based on the measurement information by the management server; and managing the at least one external device based on the received management information.

Abstract: Systems and methods are disclosed that facilitate visualizing how a user will appear in response to adhering to a health and fitness program. In an aspect, a system includes a reception component configured to receive information corresponding to a user's physical appearance and physical health, an analysis component configured to determine or infer one or more changes to the user's physical appearance based on predicted performance of a health and fitness program by the user and the user's physical health, and a visualization component is configured to generate a visual representation of the user based on the information and the one or more changes to the user's physical appearance.

Abstract: Systems and methods are disclosed for monitoring adherence to healthcare guidelines defining a recommended level of physical activity. Metabolic Equivalent (MET) data for a user over a plurality of days is analysed to determine whether sufficient MET data is available, by determining whether the obtained MET data includes at least a minimum amount of MET data within a defined time period. In response to a determination that sufficient MET data is available, the MET data is compared to guideline MET values relating to the recommended level of physical activity, to determine whether the user has achieved the recommended level of physical activity. An adherence result is outputted in accordance with the result of the comparison, indicating whether the user has achieved the recommended level of physical activity. The adherence result can be outputted in the form of a message displayed on a display unit.

Abstract: A sensor includes a probe that acquires a blood light absorber concentration in a subject and a cuff that acquires a non-invasive blood pressure of the subject. In the sensor, the probe is configured to be attached to a first portion of a digit of the subject, and the cuff is configured to be attached to a second portion of the digit, the second portion being located on a periphery side with respect to the first portion.

Abstract: The present invention is directed to a computer application for seizure detection using biometric data and responsivity testing. The computer application collects biometric data and responsiveness test results from biometric sensors and an interactive user interface in order to identify and confirm seizures and monitor for severity, duration, and permit logging and notification. The computer application collects data such as heart rate, movement, and responsivity testing results. The computer application facilitates caregiver notification of seizures at or before seizure onset if the user has a warning aura and/or during prolonged or severe seizures (e.g. long duration or convulsive movements).

Abstract: A blood glucose control system can generate an indication of total carbohydrate therapy over a period during use by a subject. The system can be connected to a medicament pump configured to deliver insulin therapy, other types of medicament therapy, or a combination of medicament therapies to the subject. The system can determine an amount of a counter-regulatory agent to respond to an impending risk of hypoglycemia or an episode of hypoglycemia and determine a dose of carbohydrate therapy based at least in part on the amount of the counter-regulatory agent. The system can track determined doses of carbohydrate therapy to generate the indication of total carbohydrate therapy over the period.

Abstract: Activity and aggression detection and monitoring in a controlled-environment facility includes gathering audio, video and/or telemetry input from one or more dedicated and/or ad hoc sensors disposed in portions of the controlled-environment facility. A baseline normal input level from each of the sensors indicative of normal activity in the controlled-environment facility (proximate to a subject sensor) is predetermined. A determination is then made whether the input from each of the sensors rises above or falls below the predetermined normal input level, and when it does, the sensor input of the subject sensor may be recorded. When input from a sensor rises above or falls below the predetermined normal input level, an alert may be issued to controlled-environment facility personnel and/or law enforcement, the input from the subject sensor may be streamed to the personnel, and/or a recording of the sensor input may be offered.

Abstract: Non-invasive sensor apparatus and method for assessing cardiac performance. A wide variety of different sensor components can capture sensor readings relating to patient attributes. Those sensor readings can then be compared by a processor component to derive a cardiac performance indicator relating to the patient.

Abstract: A computing device displays a data visualization interface and receives user selection of a data source and a natural language command directed to the data source. The device identifies a first keyword and second keyword(s) in the natural language command. The second keyword(s) include adjectives that modify the first keyword. The device generates a visual specification that specifies the data source, a plurality of visual variables, and a plurality of data fields from the data source. Each of the visual variables is associated with a respective data field of the plurality of data fields. The first keyword corresponds to one or more first data fields of the plurality of data fields, and the one or more visual variables are associated with the one or more first data fields according to the one or more second keywords. The device generates and displays a data visualization based on the visual specification.

Abstract: The present disclosure relates to a mock-up medicament injector for training purposes or an actual medicament injection device (1) comprising a sensor device (2) configured to detect movements of the whole device, and a logging device (3) configured to record said movements and thus track user behaviour of the device. The sensor can be e.g. an accelerometer, gyroscope or magnetometer. The device can communicate the logged data either in real time or at a later point in time from its memory to an external computer device. The present disclosure also relates to a corresponding method for tracking behaviour of a user using the medicament injector or training device (1).

Abstract: An information displaying system according to an embodiment of the present disclosure includes a first display section configured to display a time axis of detected signals along a first direction, a second display section configured to display a plurality of signal waveforms based on the detected signals in parallel so that the signal waveforms are arranged side by side in a second direction different from the first direction, and a controller configured to control the first display section and the second display section. When, in the second display section, a location on at least one of the plurality of the signal waveforms or near the at least one of the plurality of the signal waveforms is designated, the controller highlights the designated location, and displays a designated result on a time location in the first display section corresponding to the designated location.

Abstract: A tool for distress management. The tool determines a level of distress associated with a user. The tool identifies a next action to be performed by the user. The tool determines a level of distress associated with the next action. The tool determines whether the associated level of distress exceeds a predetermined threshold. Responsive to a determination that the associated level of distress exceeds the predetermined threshold, the tool alerts the user of an impact to the level of distress associated with the user.

Abstract: Mechanisms are provided for administering health care assessments to a patient. The mechanisms analyze patient information stored in a patient registry and determine a plurality of health care assessments to be administered to the patient based on the patient information and one or more pre-defined health care assessment guidelines specifying conditions for which health care assessments are to be administered to patients and timing for administering the assessments to the patients. The mechanisms generate a sequence of health care assessments, in the plurality of health care assessments, based on the guidelines and the patient information. The sequence comprises an ordering of the health care assessments, and a timing interval between health care assessments, determined based on the guidelines and the patient information. The mechanisms administer at least one health care assessment to the patient in accordance with the determined sequence of health care assessments.

Abstract: A computer-implemented method comprising: obtaining text from text-based messages sent between a patient and a therapist providing psychological therapy; determining at least one feature of the text; and determining a characteristic of the patient and/or the therapist using the at least one feature.

Abstract: A system and method for collecting, communicating, displaying, and/or analyzing data from multiple medical devices is disclosed. The system includes a local data collection module and a number of medical device adapters. The medical device adapters are coupled to respective medical devices via hardwired connections to receive data from the respective medical devices. The medical device adapters wirelessly transmit the data to the local data collection module. The local data collection module communicates the data received from the medical device adapters to an Electronic Medical Records (EMR) system for automatic entry of at least some of the data in the electronic medical record of a patient associated with the medical devices.

Abstract: Methods, systems, and computer program products are provided for monitoring an entity for personal water retention management. Health data for the entity is monitored via one or more sensors. Changes in the monitored health data are tracked over time. Based on the monitored health data, occurrence of a water retention triggering event associated with a provided medical recommendation is determined. When the water retention triggering event is determined to have occurred, the medical recommendation is provided to the entity.

Abstract: A mechanism is provided in a data processing system comprising at least one processor and at least one memory comprising instructions, which are executed by the at least one processor and configure the processor to implement a patient information extractor. The patient information extractor receives a query specification for executing a query on a patient electronic medical record (EMR). The query specification provides parameters indicating a methodology for extracting search results from the patient EMR. The patient information extractor retrieves the patient EMR from a patient registry. The patient information extractor automatically executes the query specification on the retrieved patient EMR to thereby extract the search results from the patient EMR in accordance with the parameters of the query specification. The patient information extractor automatically processes the extracted search results to generate a patient indicator value.

Abstract: An apparatus for pricing offers of healthcare services includes an application server providing a pricing tool, and a service pricing information database and a cost adjustment information database that are accessible by the application server. The pricing tool is operable to receive an indication of a healthcare service set that is respectively associated with a service detail information record included in the service pricing information database, determine a base physician fee for a primary service of the indicated healthcare service set based on base pricing metrics for the primary service included in the service detail information record, receive an indication specifying a location for performing the primary service, calculate an adjusted physician fee for the primary service based on cost adjustment metrics for a geographic zone that corresponds to the specified location, and provide a recommended price for the indicated healthcare service set based on the calculated adjusted physician fee.

Abstract: A method of evaluating lung cancer risk by generating a set of features comprising a plurality of current blood test results from a blood collected from a target individual, providing at least one classifier generated according to an analysis of a plurality of respective historical blood test results of each of another of a plurality of sampled individuals, and evaluating, using a processor, a lung cancer risk of said target individual by classifying said set of features using said at least one classifier. Each of said plurality of historical and current blood test results comprises results of one or more selected blood tests such as white blood cells blood test results, biochemistry test results, platelets blood test results including at least one of platelets count and mean platelet volume (MPV) and/or a combination of smoking history and red cell test results.

Abstract: The present disclosure relates to an earphone apparatus and method. The earphone apparatus includes an earpiece, including a speaker, configured for arrangement relative to a user's ear for listening to audio from the speaker, a bio-sensor, a motion sensor, and a controller configured to determine an activity state of the user based on aggregated sensor data from the bio-sensor and the motion sensor over time, and to control audio output to the user based on the determined activity state.

Abstract: The present invention extends to methods, systems, and computer program products for event detection from signal data removing private information. A signal is ingested. A portion of the signal is selected from within the signal. A first score is computed from the selected portion. The first score indicates a likelihood of the signal including information related to an event type. It is determined that processing of another signal is warranted based on the indicated likelihood. Resources are allocated to process the other signal. The other signal is ingested. Parameters associated with the other signal are accessed. A second score is computed from the parameters utilizing the allocated resources. A previously unidentified event of the event type is identified based on the second score and utilizing the allocated resources. A privacy infrastructure spans signal ingestion, event detection, and event notification and protects the integrity of private information.

Abstract: The present disclosure provides alert implants that comprise a medical device and an implantable reporting processor (IRP), where one example of such a medical device includes a component for a total knee arthroplasty (TKA) such as a tibial extension, a femoral component for hip replacements, a breast implant, a distal rod for arm or leg breakage repair, a scoliosis rod, a dynamic hip screw, a spinal interbody spacer, and tooling and methods that may be used to form the alert implant, and uses of such alert implants in the health maintenance of patients who receive the implant.

Abstract: A method for controlling one or more operations of an autonomous mobile robot maneuverable within a home includes establishing wireless communication between an autonomous mobile robot and a remote computing system and, in response to receiving a wireless command signal from the remote computing system, initiating one or more operations of the autonomous mobile robot. The autonomous mobile robot is remote from an audio media device stationed within the home. The audio media device is capable of receiving and emitting audio. The remote computing system is configured to associate identification data of the autonomous mobile robot with identification data of the audio media device. The wireless command signal corresponds to an audible user command received by the audio media device.

Abstract: A method for measuring health metrics of a user is provided. A base of an electronic device is attached to the skin of the user. A housing of the electronic device is attached to the base, such that (i) the housing is secured to the base, and (ii) a window of the housing is positioned outside an opening in the base. One or more sensors within the housing generates first physiological data associated with the health metrics of the user through the housing window and the base opening. Second physiological data associated with the health metrics of the user is generated using a set of electrodes positioned outside of the housing. The set of electrodes are coupled to the base, and the set of electrodes facilitate movement of electrical signals between the skin of the user and a sensor printed circuit board within the housing of the electronic device.

Abstract: User interface systems for sterile fields and other working environments are disclosed herein. In some embodiments, a user interface system can include a projector that projects a graphical user interface onto a data board or other substrate disposed within a working environment. The system can also include a camera or other sensor that detects user interaction with the data board or substrate. Detected user interactions can be processed or interpreted by a controller that interfaces with equipment disposed outside of the working environment, thereby allowing user interaction with such equipment from within the working environment. The data board can be an inexpensive, disposable, single-use component of the system that can be easily sterilized or another component suitably prepared for use in a sterile field.

Abstract: Methods, systems, and computer programs are presented for managing counters with automatic obsolescence of outdated values. One method includes operations for initializing a counter at a first time, and receiving, at a second time, a request to add a value to the counter. Further, a time period corresponding to the second time is calculated, as well as a promotion factor based on the time period. The method further includes calculating an incremental value based on the received value and the promotion factor, and adding the incremental value to the counter. Additionally, a prediction or estimate is based on a current value of the counter, such as identifying areas of interest for a user on an online service, identifying languages spoken by the user, strength of connections between users, determining if the user is actively searching for a new job, and so forth.

Abstract: Disclosed herein are systems and methods for non-invasively monitoring blood glucose levels with a level of accuracy that is high enough to replace invasive methods such as finger prick devices and others. In some examples, glucose values are determined using a patient's electrocardiogram (ECG) signals. Additionally, glucose values may additionally be determined using an impedance spectroscopy based method and then combined with glucose values determined using an ECG waveform to output a blood glucose value.

Abstract: A modular medical system employing a bedside patient monitor (20), a portable patient monitor (40), a monitor docking station (50), a therapy applicator (30) and a therapy docking station (60). In operation, the portable patient monitor (40) is docked to the bedside patient via the monitor docking station (50) whereby the bedside patient monitor (20) and the portable patient monitor (40) measure patient parameters (e.g., ECG, Sp O2, pulse rate, NIBP, Et CO2, etc.) upon the portable patient monitor (40) being coupled to a patient. Alternatively, the portable patient monitor (40) is docked to the therapy applicator (30) via the therapy docking station (60) whereby the therapy applicator (30) conditionally delivers the electrical therapy (e.g., defibrillation shock, synchronized conversion, transcutaneous pacing, etc.) to the patient upon the portable patient monitor (40) being coupled to the patient.

Abstract: Described herein are methods of making and using and apparatus for wirelessly communicating data and providing power, particularly from a location exterior to a body and to an implantable device disposed within a body with tissue. The described embodiments provide apparatus and methods for efficiently transfer data and power between an external transceiver and an (implanted) biomedical device. The method is to modulate power carrier, which wirelessly powers the device, using an asynchronous modulation scheme, such as amplitude shift keying (ASK) modulation, with minimal modulation depth in order to not disrupt the power flow. The digital data is encoded in the pulse width, eliminating the need for synchronization to the power carrier signal and further minimizing the power consumption necessary for data transfer. Additionally, a reverse backscatter method for obtaining data from the implant is described that has flexible, low power operation.

Abstract: Disclosed herein is a new and improved non-invasive bed sensing system for detecting and monitoring physiological movements such as heartbeat and respiration. The system may employ a hydraulic fluid to transduce the physiological pressures to an integrated pressure sensor and a new and improved signal processing method to identify individual cardiac pulses from the electronic signals generated by the hydraulic transducer. The system provides increased sensitivity capable of capturing quantitative pulse and respiration rates with subtle changes, ability to distinguish between instances of low pulse rate and shallow breathing, and improved comfort over existing systems.

Abstract: In some aspects, a computing system can generate and optimize a neural network for risk assessment. The neural network can be trained to enforce a monotonic relationship between each of the input predictor variables and an output risk indicator. The training of the neural network can involve solving an optimization problem under a monotonic constraint. This constrained optimization problem can be converted to an unconstrained problem by introducing a Lagrangian expression and by introducing a term approximating the monotonic constraint. Additional regularization terms can also be introduced into the optimization problem. The optimized neural network can be used both for accurately determining risk indicators for target entities using predictor variables and determining explanation codes for the predictor variables. Further, the risk indicators can be utilized to control the access by a target entity to an interactive computing environment for accessing services provided by one or more institutions.