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Effect modification occurs when the impact of the treatment on an outcome varies based on the levels of other covariates known as effect modifiers. Modeling of these effect differences is important for etiological goals and for purposes of optimizing treatment. Structural nested mean models (SNMMs) are useful causal models for estimating the potentially heterogeneous effect of a time-varying exposure on the mean of an outcome in the presence of time-varying confounding. A data-driven approach for selecting the effect modifiers of an exposure may be necessary if these effect modifiers are a priori unknown and need to be identified. Although variable selection techniques are available in the context of estimating conditional average treatment effects using marginal structural models, or in the context of estimating optimal dynamic treatment regimens, all of these methods consider an outcome measured at a single point in time. In the context of an SNMM for repeated outcomes, we propose a doubly robust penalized G-estimator for the causal effect of a time-varying exposure with a simultaneous selection of effect modifiers and use this estimator to analyze the effect modification in a study of hemodiafiltration. We prove the oracle property of our estimator, and conduct a simulation study for evaluation of its performance in finite samples and for verification of its double-robustness property. Our work is motivated by and applied to the study of hemodiafiltration for treating patients with end-stage renal disease at the Centre Hospitalier de l'Universit\'e de Montr\'eal. We apply the proposed method to investigate the effect heterogeneity of dialysis facility on the repeated session-specific hemodiafiltration outcomes.

The heterogeneous micromechanical properties of biological tissues have profound implications across diverse medical and engineering domains. However, identifying the full-field heterogeneous elastic properties of soft materials using traditional computational and engineering approaches is fundamentally challenging due to difficulties in estimating local stress fields. Recently, there has been a growing interest in using data-driven models to learn full-field mechanical responses such as displacement and strain from experimental or synthetic data. However, research studies on inferring the full-field elastic properties of materials, a more challenging problem, are scarce, particularly for large deformation, hyperelastic materials. Here, we propose a novel approach to identify the elastic modulus distribution in nonlinear, large deformation hyperelastic materials utilizing physics-informed neural networks (PINNs). We evaluate the prediction accuracies and computational efficiency of PINNs, informed by mechanic features and principles, across three synthetic materials with structural complexity that closely resemble real tissue patterns, such as brain tissue and tricuspid valve tissue. Our improved PINN architecture accurately estimates the full-field elastic properties, with relative errors of less than 5% across all examples. This research has significant potential for advancing our understanding of micromechanical behaviors in biological materials, impacting future innovations in engineering and medicine.

Analyzing longitudinal data in health studies is challenging due to sparse and error-prone measurements, strong within-individual correlation, missing data and various trajectory shapes. While mixed-effect models (MM) effectively address these challenges, they remain parametric models and may incur computational costs. In contrast, Functional Principal Component Analysis (FPCA) is a non-parametric approach developed for regular and dense functional data that flexibly describes temporal trajectories at a lower computational cost. This paper presents an empirical simulation study evaluating the behaviour of FPCA with sparse and error-prone repeated measures and its robustness under different missing data schemes in comparison with MM. The results show that FPCA is well-suited in the presence of missing at random data caused by dropout, except in scenarios involving most frequent and systematic dropout. Like MM, FPCA fails under missing not at random mechanism. The FPCA was applied to describe the trajectories of four cognitive functions before clinical dementia and contrast them with those of matched controls in a case-control study nested in a population-based aging cohort. The average cognitive declines of future dementia cases showed a sudden divergence from those of their matched controls with a sharp acceleration 5 to 2.5 years prior to diagnosis.

We consider the numerical behavior of the fixed-stress splitting method for coupled poromechanics as undrained regimes are approached. We explain that pressure stability is related to the splitting error of the scheme, not the fact that the discrete saddle point matrix never appears in the fixed-stress approach. This observation reconciles previous results regarding the pressure stability of the splitting method. Using examples of compositional poromechanics with application to geological CO$_2$ sequestration, we see that solutions obtained using the fixed-stress scheme with a low order finite element-finite volume discretization which is not inherently inf-sup stable can exhibit the same pressure oscillations obtained with the corresponding fully implicit scheme. Moreover, pressure jump stabilization can effectively remove these spurious oscillations in the fixed-stress setting, while also improving the efficiency of the scheme in terms of the number of iterations required at every time step to reach convergence.

Non-Hermitian topological phases can produce some remarkable properties, compared with their Hermitian counterpart, such as the breakdown of conventional bulk-boundary correspondence and the non-Hermitian topological edge mode. Here, we introduce several algorithms with multi-layer perceptron (MLP), and convolutional neural network (CNN) in the field of deep learning, to predict the winding of eigenvalues non-Hermitian Hamiltonians. Subsequently, we use the smallest module of the periodic circuit as one unit to construct high-dimensional circuit data features. Further, we use the Dense Convolutional Network (DenseNet), a type of convolutional neural network that utilizes dense connections between layers to design a non-Hermitian topolectrical Chern circuit, as the DenseNet algorithm is more suitable for processing high-dimensional data. Our results demonstrate the effectiveness of the deep learning network in capturing the global topological characteristics of a non-Hermitian system based on training data.

Personal science is the practice of addressing personally relevant health questions through self-research. Implementing personal science can be challenging, due to the need to develop and adopt research protocols, tools, and methods. While online communities can provide valuable peer support, tools for systematically accessing community knowledge are lacking. The objective of this study is to apply a participatory design process involving a community of personal science practitioners to develop a peer-produced knowledge base that supports the needs of practitioners as consumers and contributors of knowledge. The process led to the development of the Personal Science Wiki, an open repository for documenting and accessing individual self-tracking projects while facilitating the establishment of consensus knowledge. After initial design iterations and a field testing phase, we performed a user study with 21 participants to test and improve the platform, and to explore suitable information architectures. The study deepened our understanding of barriers to scaling the personal science community, established an infrastructure for knowledge management actively used by the community, and provided lessons on challenges, information needs, representations, and architectures to support individuals with their personal health inquiries

This study investigates GPT-4's assessment of its performance in healthcare applications. A simple prompting technique was used to prompt the LLM with questions taken from the United States Medical Licensing Examination (USMLE) questionnaire and it was tasked to evaluate its confidence score before posing the question and after asking the question. The questionnaire was categorized into two groups-questions with feedback (WF) and questions with no feedback(NF) post-question. The model was asked to provide absolute and relative confidence scores before and after each question. The experimental findings were analyzed using statistical tools to study the variability of confidence in WF and NF groups. Additionally, a sequential analysis was conducted to observe the performance variation for the WF and NF groups. Results indicate that feedback influences relative confidence but doesn't consistently increase or decrease it. Understanding the performance of LLM is paramount in exploring its utility in sensitive areas like healthcare. This study contributes to the ongoing discourse on the reliability of AI, particularly of LLMs like GPT-4, within healthcare, offering insights into how feedback mechanisms might be optimized to enhance AI-assisted medical education and decision support.

The integration of large language models (LLMs) into the medical field has gained significant attention due to their promising accuracy in simulated clinical decision-making settings. However, clinical decision-making is more complex than simulations because physicians' decisions are shaped by many factors, including the presence of cognitive bias. However, the degree to which LLMs are susceptible to the same cognitive biases that affect human clinicians remains unexplored. Our hypothesis posits that when LLMs are confronted with clinical questions containing cognitive biases, they will yield significantly less accurate responses compared to the same questions presented without such biases. In this study, we developed BiasMedQA, a novel benchmark for evaluating cognitive biases in LLMs applied to medical tasks. Using BiasMedQA we evaluated six LLMs, namely GPT-4, Mixtral-8x70B, GPT-3.5, PaLM-2, Llama 2 70B-chat, and the medically specialized PMC Llama 13B. We tested these models on 1,273 questions from the US Medical Licensing Exam (USMLE) Steps 1, 2, and 3, modified to replicate common clinically-relevant cognitive biases. Our analysis revealed varying effects for biases on these LLMs, with GPT-4 standing out for its resilience to bias, in contrast to Llama 2 70B-chat and PMC Llama 13B, which were disproportionately affected by cognitive bias. Our findings highlight the critical need for bias mitigation in the development of medical LLMs, pointing towards safer and more reliable applications in healthcare.

Metastases increase the risk of fracture when affecting the femur. Consequently, clinicians need to know if the patients femur can withstand the stress of daily activities. The current tools used in clinics are not sufficiently precise. A new method, the CT-scan-based finite element analysis, gives good predictive results. However, none of the existing models were tested for reproducibility. This is a critical issue to address in order to apply the technique on a large cohort around the world to help evaluate bone metastatic fracture risk in patients. Please see pdf file

We hypothesize that due to the greedy nature of learning in multi-modal deep neural networks, these models tend to rely on just one modality while under-fitting the other modalities. Such behavior is counter-intuitive and hurts the models' generalization, as we observe empirically. To estimate the model's dependence on each modality, we compute the gain on the accuracy when the model has access to it in addition to another modality. We refer to this gain as the conditional utilization rate. In the experiments, we consistently observe an imbalance in conditional utilization rates between modalities, across multiple tasks and architectures. Since conditional utilization rate cannot be computed efficiently during training, we introduce a proxy for it based on the pace at which the model learns from each modality, which we refer to as the conditional learning speed. We propose an algorithm to balance the conditional learning speeds between modalities during training and demonstrate that it indeed addresses the issue of greedy learning. The proposed algorithm improves the model's generalization on three datasets: Colored MNIST, Princeton ModelNet40, and NVIDIA Dynamic Hand Gesture.