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Recent advances in neuroimaging analysis have enabled accurate decoding of mental state from brain activation patterns during functional magnetic resonance imaging scans. A commonly applied tool for this purpose is principal components regression regularized with the least absolute shrinkage and selection operator (LASSO PCR), a type of multi-voxel pattern analysis (MVPA). This model presumes that all components are equally likely to harbor relevant information, when in fact the task-related signal may be concentrated in specific components. In such cases, the model will fail to select the optimal set of principal components that maximizes the total signal relevant to the cognitive process under study. Here, we present modifications to LASSO PCR that allow for a regularization penalty tied directly to the index of the principal component, reflecting a prior belief that task-relevant signal is more likely to be concentrated in components explaining greater variance. Additionally, we propose a novel hybrid method, Joint Sparsity-Ranked LASSO (JSRL), which integrates component-level and voxel-level activity under an information parity framework and imposes ranked sparsity to guide component selection. We apply the models to brain activation during risk taking, monetary incentive, and emotion regulation tasks. Results demonstrate that incorporating sparsity ranking into LASSO PCR produces models with enhanced classification performance, with JSRL achieving up to 51.7\% improvement in cross-validated deviance $R^2$ and 7.3\% improvement in cross-validated AUC. Furthermore, sparsity-ranked models perform as well as or better than standard LASSO PCR approaches across all classification tasks and allocate predictive weight to brain regions consistent with their established functional roles, offering a robust alternative for MVPA.

Older adult patients constitute a rapidly growing subgroup of Intensive Care Unit (ICU) patients. In these situations, their family caregivers are expected to represent the unconscious patients to access and interpret patients' medical information. However, caregivers currently have to rely on overloaded clinicians for information updates and typically lack the health literacy to understand complex medical information. Our project aims to explore the information needs of caregivers of ICU older adult patients, from which we can propose design opportunities to guide future AI systems. The project begins with formative interviews with 11 caregivers to identify their challenges in accessing and interpreting medical information; From these findings, we then synthesize design requirements and propose an AI system prototype to cope with caregivers' challenges. The system prototype has two key features: a timeline visualization to show the AI extracted and summarized older adult patients' key medical events; and an LLM-based chatbot to provide context-aware informational support. We conclude our paper by reporting on the follow-up user evaluation of the system and discussing future AI-based systems for ICU caregivers of older adults.

Artificial Intelligence (AI) has become essential in modern healthcare, with large language models (LLMs) offering promising advances in clinical decision-making. Traditional model-based approaches, including those leveraging in-context demonstrations and those with specialized medical fine-tuning, have demonstrated strong performance in medical language processing but struggle with real-time adaptability, multi-step reasoning, and handling complex medical tasks. Agent-based AI systems address these limitations by incorporating reasoning traces, tool selection based on context, knowledge retrieval, and both short- and long-term memory. These additional features enable the medical AI agent to handle complex medical scenarios where decision-making should be built on real-time interaction with the environment. Therefore, unlike conventional model-based approaches that treat medical queries as isolated questions, medical AI agents approach them as complex tasks and behave more like human doctors. In this paper, we study the choice of the backbone LLM for medical AI agents, which is the foundation for the agent's overall reasoning and action generation. In particular, we consider the emergent o1 model and examine its impact on agents' reasoning, tool-use adaptability, and real-time information retrieval across diverse clinical scenarios, including high-stakes settings such as intensive care units (ICUs). Our findings demonstrate o1's ability to enhance diagnostic accuracy and consistency, paving the way for smarter, more responsive AI tools that support better patient outcomes and decision-making efficacy in clinical practice.

This review paper explores recent advances in deep learning approaches for non-invasive cognitive impairment detection. We examine various non-invasive indicators of cognitive decline, including speech and language, facial, and motoric mobility. The paper provides an overview of relevant datasets, feature-extracting techniques, and deep-learning architectures applied to this domain. We have analyzed the performance of different methods across modalities and observed that speech and language-based methods generally achieved the highest detection performance. Studies combining acoustic and linguistic features tended to outperform those using a single modality. Facial analysis methods showed promise for visual modalities but were less extensively studied. Most papers focused on binary classification (impaired vs. non-impaired), with fewer addressing multi-class or regression tasks. Transfer learning and pre-trained language models emerged as popular and effective techniques, especially for linguistic analysis. Despite significant progress, several challenges remain, including data standardization and accessibility, model explainability, longitudinal analysis limitations, and clinical adaptation. Lastly, we propose future research directions, such as investigating language-agnostic speech analysis methods, developing multi-modal diagnostic systems, and addressing ethical considerations in AI-assisted healthcare. By synthesizing current trends and identifying key obstacles, this review aims to guide further development of deep learning-based cognitive impairment detection systems to improve early diagnosis and ultimately patient outcomes.

This study reports a comprehensive environmental scan of the generative AI (GenAI) infrastructure in the national network for clinical and translational science across 36 institutions supported by the Clinical and Translational Science Award (CTSA) Program led by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) at the United States. With the rapid advancement of GenAI technologies, including large language models (LLMs), healthcare institutions face unprecedented opportunities and challenges. This research explores the current status of GenAI integration, focusing on stakeholder roles, governance structures, and ethical considerations by administering a survey among leaders of health institutions (i.e., representing academic medical centers and health systems) to assess the institutional readiness and approach towards GenAI adoption. Key findings indicate a diverse range of institutional strategies, with most organizations in the experimental phase of GenAI deployment. The study highlights significant variations in governance models, with a strong preference for centralized decision-making but notable gaps in workforce training and ethical oversight. Moreover, the results underscore the need for a more coordinated approach to GenAI governance, emphasizing collaboration among senior leaders, clinicians, information technology staff, and researchers. Our analysis also reveals concerns regarding GenAI bias, data security, and stakeholder trust, which must be addressed to ensure the ethical and effective implementation of GenAI technologies. This study offers valuable insights into the challenges and opportunities of GenAI integration in healthcare, providing a roadmap for institutions aiming to leverage GenAI for improved quality of care and operational efficiency.

Large Language Models have advanced clinical Natural Language Generation, creating opportunities to manage the volume of medical text. However, the high-stakes nature of medicine requires reliable evaluation, which remains a challenge. In this narrative review, we assess the current evaluation state for clinical summarization tasks and propose future directions to address the resource constraints of expert human evaluation.

Spinal cord injury (SCI) is a devastating incidence leading to permanent paralysis and loss of sensory-motor functions potentially resulting in the formation of lesions within the spinal cord. Imaging biomarkers obtained from magnetic resonance imaging (MRI) scans can predict the functional recovery of individuals with SCI and help choose the optimal treatment strategy. Currently, most studies employ manual quantification of these MRI-derived biomarkers, which is a subjective and tedious task. In this work, we propose (i) a universal tool for the automatic segmentation of intramedullary SCI lesions, dubbed SCIsegV2, and (ii) a method to automatically compute the width of the tissue bridges from the segmented lesion. Tissue bridges represent the spared spinal tissue adjacent to the lesion, which is associated with functional recovery in SCI patients. The tool was trained and validated on a heterogeneous dataset from 7 sites comprising patients from different SCI phases (acute, sub-acute, and chronic) and etiologies (traumatic SCI, ischemic SCI, and degenerative cervical myelopathy). Tissue bridges quantified automatically did not significantly differ from those computed manually, suggesting that the proposed automatic tool can be used to derive relevant MRI biomarkers. SCIsegV2 and the automatic tissue bridges computation are open-source and available in Spinal Cord Toolbox (v6.4 and above) via the sct_deepseg -task seg_sc_lesion_t2w_sci and sct_analyze_lesion functions, respectively. Keywords: Spinal Cord Injury Segmentation MRI Deep Learning Tissue Bridges these authors contributed equally to this work joint senior authors arXiv:2407.17265v1

The escalating challenge of misinformation, particularly in political discourse, requires advanced fact-checking solutions; this is even clearer in the more complex scenario of multimodal claims. We tackle this issue using a multimodal large language model in conjunction with retrieval-augmented generation (RAG), and introduce two novel reasoning techniques: Chain of RAG (CoRAG) and Tree of RAG (ToRAG). They fact-check multimodal claims by extracting both textual and image content, retrieving external information, and reasoning subsequent questions to be answered based on prior evidence. We achieve a weighted F1-score of 0.85, surpassing a baseline reasoning technique by 0.14 points. Human evaluation confirms that the vast majority of our generated fact-check explanations contain all information from gold standard data.

We present ABEX, a novel and effective generative data augmentation methodology for low-resource Natural Language Understanding (NLU) tasks. ABEX is based on ABstract-and-EXpand, a novel paradigm for generating diverse forms of an input document -- we first convert a document into its concise, abstract description and then generate new documents based on expanding the resultant abstraction. To learn the task of expanding abstract descriptions, we first train BART on a large-scale synthetic dataset with abstract-document pairs. Next, to generate abstract descriptions for a document, we propose a simple, controllable, and training-free method based on editing AMR graphs. ABEX brings the best of both worlds: by expanding from abstract representations, it preserves the original semantic properties of the documents, like style and meaning, thereby maintaining alignment with the original label and data distribution. At the same time, the fundamental process of elaborating on abstract descriptions facilitates diverse generations. We demonstrate the effectiveness of ABEX on 4 NLU tasks spanning 12 datasets and 4 low-resource settings. ABEX outperforms all our baselines qualitatively with improvements of 0.04% - 38.8%. Qualitatively, ABEX outperforms all prior methods from literature in terms of context and length diversity.