The rapid growth and availability of event sequence data across domains requires effective analysis and exploration methods to facilitate decision-making. Visual analytics combines computational techniques with interactive visualizations, enabling the identification of patterns, anomalies, and attribute interactions. However, existing approaches frequently overlook the interplay between temporal and multivariate attributes. We introduce EventBox, a novel data representation and visual encoding approach for analyzing groups of events and their multivariate attributes. We have integrated EventBox into Sequen-C, a visual analytics system for the analysis of event sequences. To enable the agile creation of EventBoxes in Sequen-C, we have added user-driven transformations, including alignment, sorting, substitution and aggregation. To enhance analytical depth, we incorporate automatically generated statistical analyses, providing additional insight into the significance of attribute interactions. We evaluated our approach involving 21 participants (3 domain experts, 18 novice data analysts). We used the ICE-T framework to assess visualization value, user performance metrics completing a series of tasks, and interactive sessions with domain experts. We also present three case studies with real-world healthcare data demonstrating how EventBox and its integration into Sequen-C reveal meaningful patterns, anomalies, and insights. These results demonstrate that our work advances visual analytics by providing a flexible solution for exploring temporal and multivariate attributes in event sequences.

BACKGROUND: The STriTuVaD project, funded by Horizon 2020, aims to test through a Phase IIb clinical trial one of the most advanced therapeutic vaccines against tuberculosis. As part of this initiative, we have developed a strategy for generating in silico patients consistent with target population characteristics, which can then be used in combination with in vivo data on an augmented clinical trial. RESULTS: One of the most challenging tasks for using virtual patients is developing a methodology to reproduce biological diversity of the target population, ie, providing an appropriate strategy for generating libraries of digital patients. This has been achieved through the creation of the initial immune system repertoire in a stochastic way, and through the identification of a vector of features that combines both biological and pathophysiological parameters that personalise the digital patient to reproduce the physiology and the pathophysiology of the subject. CONCLUSIONS: We propose a sequential approach to sampling from the joint features population distribution in order to create a cohort of virtual patients with some specific characteristics, resembling the recruitment process for the target clinical trial, which then can be used for augmenting the information from the physical the trial to help reduce its size and duration.

BACKGROUND: In 2018, about 10 million people were found infected by tuberculosis, with approximately 1.2 million deaths worldwide. Despite these numbers have been relatively stable in recent years, tuberculosis is still considered one of the top 10 deadliest diseases worldwide. Over the years, Mycobacterium tuberculosis has developed a form of resistance to first-line tuberculosis treatments, specifically to isoniazid, leading to multi-drug-resistant tuberculosis. In this context, the EU and Indian DBT funded project STriTuVaD-In Silico Trial for Tuberculosis Vaccine Development-is supporting the identification of new interventional strategies against tuberculosis thanks to the use of Universal Immune System Simulator (UISS), a computational framework capable of predicting the immunity induced by specific drugs such as therapeutic vaccines and antibiotics. RESULTS: Here, we present how UISS accurately simulates tuberculosis dynamics and its interaction within the immune system, and how it predicts the efficacy of the combined action of isoniazid and RUTI vaccine in a specific digital population cohort. Specifically, we simulated two groups of 100 digital patients. The first group was treated with isoniazid only, while the second one was treated with the combination of RUTI vaccine and isoniazid, according to the dosage strategy described in the clinical trial design. UISS-TB shows to be in good agreement with clinical trial results suggesting that RUTI vaccine may favor a partial recover of infected lung tissue. CONCLUSIONS: In silico trials innovations represent a powerful pipeline for the prediction of the effects of specific therapeutic strategies and related clinical outcomes. Here, we present a further step in UISS framework implementation. Specifically, we found that the simulated mechanism of action of RUTI and INH are in good alignment with the results coming from past clinical phase IIa trials.

Different research communities have developed various approaches to assess the credibility of predictive models. Each approach usually works well for a specific type of model, and under some epistemic conditions that are normally satisfied within that specific research domain. Some regulatory agencies recently started to consider evidences of safety and efficacy on new medical products obtained using computer modelling and simulation (which is referred to as In Silico Trials); this has raised the attention in the computational medicine research community on the regulatory science aspects of this emerging discipline. But this poses a foundational problem: in the domain of biomedical research the use of computer modelling is relatively recent, without a widely accepted epistemic framing for model credibility. Also, because of the inherent complexity of living organisms, biomedical modellers tend to use a variety of modelling methods, sometimes mixing them in the solution of a single problem. In such context merely adopting credibility approaches developed within other research communities might not be appropriate. In this paper we propose a theoretical framing for assessing the credibility of a predictive models for In Silico Trials, which accounts for the epistemic specificity of this research field and is general enough to be used for different type of models.

EC funded STriTuVaD project aims to test, through a phase IIb clinical trial, two of the most advanced therapeutic vaccines against tuberculosis. In parallel, we have extended the Universal Immune System Simulator to include all relevant determinants of such clinical trial, to establish its predictive accuracy against the individual patients recruited in the trial, to use it to generate digital patients and predict their response to the HRT being tested, and to combine them to the observations made on physical patients using a new in silico-augmented clinical trial approach that uses a Bayesian adaptive design. This approach, where found effective could drastically reduce the cost of innovation in this critical sector of public healthcare. One of the most challenging task is to develop a methodology to reproduce biological diversity of the subjects that have to be simulated, i.e., provide an appropriate strategy for the generation of libraries of digital patients. This has been achieved through the the creation of the initial immune system repertoire in a stochastic way, and though the identification of a “vector of features” that combines both biological and pathophysiological parameters that personalize the digital patient to reproduce the physiology and the pathophysiology of the subject.

Tuberculosis (TB) is one of the deadliest diseases worldwide, with 1,5 million fatalities every year along with potential devastating effects on society, families and individuals. To address this alarming burden, vaccines can play a fundamental role, even though to date no fully effective TB vaccine really exists. Current treatments involve several combinations of antibiotics administered to TB patients for up to two years, leading often to financial issues and reduced therapy adherence. Along with this, the development and spread of drug-resistant TB strains is another big complicating matter. Faced with these challenges, there is an urgent need to explore new vaccination strategies in order to boost immunity against tuberculosis and shorten the duration of treatment. Computational modeling represents an extraordinary way to simulate and predict the outcome of vaccination strategies, speeding up the arduous process of vaccine pipeline development and relative time to market. Here, we present EU - funded STriTuVaD project computational platform able to predict the artificial immunity induced by RUTI and ID93/GLA-SE, two specific tuberculosis vaccines. Such an in silico trial will be validated through a phase 2b clinical trial. Moreover, STriTuVaD computational framework is able to inform of the reasons for failure should the vaccinations strategies against M. tuberculosis under testing found not efficient, which will suggest possible improvements.

MOTIVATION: Gene expression measurements are the most common data source for reverse engineering gene interaction networks. When dealing with destructive sampling in time course experiments, it is common to average any available measurements for each time point and to treat this as the actual time series data for fitting the network, neglecting the variability contained in the repeated measurements. Proceeding in such a way can affect the retrieved network topology. RESULTS: We propose a fully Bayesian method for reverse engineering a gene interaction network, based on time course data with repeated measurements. The observations are treated as surrogate measurements of the underlying gene expression. As these measurements often contain outliers, we use a non-Gaussian specification for dealing with measurement error. The network interactions are assumed linear and an autoregressive model is specified, augmented with indicator variables that allow inference on the topology of the network. We analyse two in silico and one in vivo experiments, the latter dealing with the circadian clock in Arabidopsis thaliana. A systematic attenuation of the estimated regulation strengths and a concomitant overestimation of their precision is demonstrated when measurement error is disregarded. Thus, a clear improvement in the inferred topology for the synthetic datasets is demonstrated when this is included. Also, the influence of outliers in the retrieved network is demonstrated when using the in vivo data. AVAILABILITY: Matlab code and data used in the article are available from http://go.warwick.ac.uk/majuarez/home/materials.