AutoFocal Loss with Lightweight DNN for Stroke Prediction in Fog Computing
Received: 9 January 2026 | Revised: 8 February 2026 and 18 February 2026 | Accepted: 19 February 2026 | Online: 25 May 2026
Corresponding author: Vijayetha Thoday
Abstract
The growing volume of Internet of Things (IoT) healthcare data makes efficient patient monitoring and disease prediction increasingly important. Cloud Computing (CC) enables scalable storage and processing, but struggles with latency-sensitive applications. Fog Computing (FC) addresses this issue by placing resources closer to users. Existing fog-based Deep Learning (DL) models for disease monitoring often perform poorly on imbalanced healthcare datasets, are biased toward the majority class, and are typically designed for large cloud systems. This paper introduces a fog-based framework for real-time stroke prediction using a lightweight, quantization-optimized DNN with automatically weighted focal loss. The proposed model handles severe class imbalance, maintains diagnostic accuracy, and reduces model size for fog deployment. Experiments on a public stroke prediction dataset show that the proposed system achieves higher AUPRC, recall, and F1-score than baseline models, while remaining compact enough for fog computing.
Keywords:
internet of things, healthcare fog computing, Deep Neural Network (DNN), weighted focal loss, post training quantizationReferences
H.-L. Truong and S. Dustdar, "Principles for Engineering IoT Cloud Systems," IEEE Cloud Computing, vol. 2, no. 2, pp. 68–76, Mar. 2015.
M. Haghi Kashani, M. Madanipour, M. Nikravan, P. Asghari, and E. Mahdipour, "A systematic review of IoT in healthcare: Applications, techniques, and trends," Journal of Network and Computer Applications, vol. 192, Oct. 2021, Art.no. 103164.
C. Li, J. Wang, S. Wang, and Y. Zhang, "A review of IoT applications in healthcare," Neurocomputing, vol. 565, Jan. 2024, Art.no. 127017.
S. Selvaraj and S. Sundaravaradhan, "Challenges and opportunities in IoT healthcare systems: a systematic review," SN Applied Sciences, vol. 2, no. 1, Dec. 2019, Art.no. 139.
L. Hou et al., "Internet of Things Cloud: Architecture and Implementation," IEEE Communications Magazine, vol. 54, no. 12, pp. 32–39, Dec. 2016.
Junaid Latief Shah, Heena Farooq Bhat, and Asif Iqbal Khan, "Integration of Cloud and IoT for smart e-healthcare," in Healthcare Paradigms in the Internet of Things Ecosystem, Academic Press, 2021, pp. 101–136.
P. Verma and S. K. Sood, "Cloud-centric IoT based disease diagnosis healthcare framework," Journal of Parallel and Distributed Computing, vol. 116, pp. 27–38, June 2018.
A. V. Dastjerdi, H. Gupta, R. N. Calheiros, S. K. Ghosh, and R. Buyya, "Fog Computing: Principles, Architectures, and Applications." arXiv, Jan. 28, 2016.
R. K. Naha et al., "Fog Computing: Survey of Trends, Architectures, Requirements, and Research Directions," IEEE Access, vol. 6, pp. 47980–48009, 2018.
F. Bonomi, R. Milito, P. Natarajan, and J. Zhu, "Fog Computing: A Platform for Internet of Things and Analytics," in Big Data and Internet of Things: A Roadmap for Smart Environments, N. Bessis and C. Dobre, Eds. Cham: Springer International Publishing, 2014, pp. 169–186.
A. A. Mutlag, M. K. Abd Ghani, N. Arunkumar, M. A. Mohammed, and O. Mohd, "Enabling technologies for fog computing in healthcare IoT systems," Future Generation Computer Systems, vol. 90, pp. 62–78, Jan. 2019.
F. A. Kraemer, A. E. Braten, N. Tamkittikhun, and D. Palma, "Fog Computing in Healthcare–A Review and Discussion," IEEE Access, vol. 5, pp. 9206–9222, 2017.
A. Kumari, S. Tanwar, S. Tyagi, and N. Kumar, "Fog computing for Healthcare 4.0 environment: Opportunities and challenges," Computers & Electrical Engineering, vol. 72, pp. 1–13, Nov. 2018.
N. A. Mudawi, "Integration of IoT and Fog Computing in Healthcare Based the Smart Intensive Units," IEEE Access, vol. 10, pp. 59906–59918, 2022.
R. Priyadarshini, R. K. Barik, and H. Dubey, "DeepFog: Fog Computing-Based Deep Neural Architecture for Prediction of Stress Types, Diabetes and Hypertension Attacks," Computation, vol. 6, no. 4, Dec. 2018, Art.no. 62.
Shallu, Duggal, and P. Kaur, "Assessing classification algorithms in Fog computing for diabetes diagnosis: A TOPSIS analysis of kNN, Naïve Bayes, and SVM (Cubic)," in Smart Computing and Communication for Sustainable Convergence, CRC Press, 2025.
P. B. Corthis, G. P. Ramesh, and A. B. Jayachandra, "A Meta heuristic based deep learning classifier for effective dengue disease prediction in IoT-Fog system," Expert Systems, vol. 41, no. 9, 2024, Art.no. e13605.
Z. H. Ali, E. Hassan, S. Elgamal, and N. El-Rashidy, "Developing an explainable machine learning and fog computing-based visual rating scale for the prediction of dementia progression," Scientific Reports, vol. 15, no. 1, July 2025, Art.no. 25872.
N. A. El-Shoafy and S. I. Ghanem, "Intelligent Medical Service Monitoring Health Care System for the Elderly," in Proceedings of the 10th International Conference on Advanced Intelligent Systems and Informatics 2024, 2024, pp. 113–123.
Y. Gao, "Smart IoT with the hybrid evolutionary method and image processing for tumor detection," Scientific Reports, vol. 15, no. 1, Aug. 2025, Art.no. 31156.
I. Ungurean and N. C. Gaitan, "Software Architecture of a Fog Computing Node for Industrial Internet of Things," Sensors, vol. 21, no. 11, Jan. 2021, Art.no. 3715.
Md. S. Alom et al., "Stroke Prediction Using Ensemble Machine and Deep Learning Models," Biomedical Materials & Devices, Oct. 2025.
P. Verma, R. Tiwari, W.-C. Hong, S. Upadhyay, and Y.-H. Yeh, "FETCH: A Deep Learning-Based Fog Computing and IoT Integrated Environment for Healthcare Monitoring and Diagnosis," IEEE Access, vol. 10, pp. 12548–12563, 2022.
S. Tuli et al., "HealthFog: An ensemble deep learning based Smart Healthcare System for Automatic Diagnosis of Heart Diseases in integrated IoT and fog computing environments," Future Generation Computer Systems, vol. 104, pp. 187–200, Mar. 2020.
R. Abirami and P. E, "HAWKFOG-an enhanced deep learning framework for the Fog-IoT environment," Frontiers in Artificial Intelligence, vol. 7, June 2024.
A. Pati, M. Parhi, M. Alnabhan, B. K. Pattanayak, A. K. Habboush, and M. K. Al Nawayseh, "An IoT-Fog-Cloud Integrated Framework for Real-Time Remote Cardiovascular Disease Diagnosis," Informatics, vol. 10, no. 1, Mar. 2023, Art.no. 21.
A. M. Mohamed, H. M. Amer, A. H. Rabie, A. I. Saleh, and M.-E. A. Abo-Elsoud, "Real-time monitoring system for early stroke detection based on fog computing and enhanced deep learning techniques," Scientific Reports, vol. 15, no. 1, Dec. 2025, Art.no. 44671.
S. Iftikhar, M. Golec, D. Chowdhury, S. S. Gill, and S. Uhlig, "FogDLearner: A Deep Learning-based Cardiac Health Diagnosis Framework using Fog Computing," in Proceedings of the 2022 Australasian Computer Science Week, Mar. 2022, pp. 136–144.
M. S. Singh, K. Thongam, P. Choudhary, and P. K. Bhagat, "Stroke Risk Prediction and Prevention: Traditional versus Machine Learning Approaches," Archives of Computational Methods in Engineering, vol. 33, no. 3, pp. 3583–3634, Apr. 2026.
H. J. Suleiman, I. R. A. Hamid, and O. R. Olaniran, "Smart Health Monitoring for Predicting Heart Disease using IoT-Fog-Cloud Computing Model," Engineering, Technology & Applied Science Research, vol. 15, no. 3, pp. 22565–22572, June 2025.
S. Gupta and S. Raheja, "Stroke Prediction using Machine Learning Methods," in 2022 12th International Conference on Cloud Computing, Data Science & Engineering (Confluence), Jan. 2022, pp. 553–558.
N. Melnykova, Y. Patereha, S. Skopivskyi, M. Farion, S. Fedushko, and K. Drohomyretska, "Machine learning for stroke prediction using imbalanced data," Scientific Reports, vol. 15, no. 1, Sept. 2025, p. 33773.
S. Naveen and M. R. Kounte, "Optimized Convolutional Neural Network at the IoT edge for image detection using pruning and quantization," Multimedia Tools and Applications, vol. 84, no. 9, pp. 5435–5455, Mar. 2025.
K. S. Totad, A. R. Hanchinal, N. R. Shanbhog, T. V. Patgar, and P. M. Dhulavvagol, "Quantization Techniques for Optimizing MobileNetV3Large in Yoga Pose Recognition on Edge Devices," Procedia Computer Science, vol. 260, pp. 1000–1008, Jan. 2025.
W. Samek, L. Arras, A. Osman, G. Montavon, and K.-R. Müller, "Explaining the Decisions of Convolutional and Recurrent Neural Networks," in Mathematical Aspects of Deep Learning, G. Kutyniok and P. Grohs, Eds. Cambridge: Cambridge University Press, 2022, pp. 229–266.
N. Mahmoodi, H. Shirazi, M. Fakhredanesh, and K. DadashtabarAhmadi, "Automatically weighted focal loss for imbalance learning," Neural Computing and Applications, vol. 37, no. 5, pp. 4035–4052, Feb. 2025.
"Stroke Prediction Dataset." https://www.kaggle.com/datasets/fedesoriano/stroke-prediction-dataset.
V. Thoday, "Vijayetha/Autho-Focal-Loss-WIth-DNN." May 13, 2026, [Online]. Available: https://github.com/Vijayetha/Autho-Focal-Loss-WIth-DNN.
Downloads
How to Cite
License
Copyright (c) 2026 Vijayetha Thoday, Mary Posonia

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain the copyright and grant the journal the right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) after its publication in ETASR with an acknowledgement of its initial publication in this journal.
