Scientists often want to explain why an outcome is different in two groups. For instance, differences in patient mortality rates across two hospitals could be due to differences in the patients themselves (covariates) or differences in medical care (outcomes given covariates). The Oaxaca--Blinder decomposition (OBD) is a standard tool to tease apart these factors. It is well known that the OBD requires choosing one of the groups as a reference, and the numerical answer can vary with the reference. To the best of our knowledge, there has not been a systematic investigation into whether the choice of OBD reference can yield different substantive conclusions and how common this issue is. In the present paper, we give existence proofs in real and simulated data that the OBD references can yield substantively different conclusions and that these differences are not entirely driven by model misspecification or small data. We prove that substantively different conclusions occur in up to half of the parameter space, but find these discrepancies rare in the real-data analyses we study. We explain this empirical rarity by examining how realistic data-generating processes can be biased towards parameters that do not change conclusions under the OBD.

In this applied paper, we address the difficult open problem of when to discharge patients from the Intensive Care Unit. This can be conceived as an optimal stopping scenario with three added challenges: 1) the evaluation of a stopping strategy from observational data is itself a complex causal inference problem, 2) the composite objective is to minimize the length of intervention and maximize the outcome, but the two cannot be collapsed to a single dimension, and 3) the recording of variables stops when the intervention is discontinued. Our contributions are two-fold. First, we generalize the implementation of the g-formula Python package, providing a framework to evaluate stopping strategies for problems with the aforementioned structure, including positivity and coverage checks. Second, with a fully open-source pipeline, we apply this approach to MIMIC-IV, a public ICU dataset, demonstrating the potential for strategies that improve upon current care.

Recent attempts to achieve fairness in predictive models focus on the balance between fairness and accuracy.

China's humanoids were everywhere at America's top tech show An attendee shakes hands with a PaXini humanoid robot during the annual CES technology show in Las Vegas, Nevada, on Wednesday. One of Tesla CEO Elon Musk's worries was on full display at technology show CES in Las Vegas this week. Chinese-made human-like robots were everywhere across the exhibition floor, playing table tennis, sweeping floors and practicing kung fu. China's latest robotics innovations were delivered to the heart of America's technology showcase, serving a constant reminder of the technological race between the world's two biggest economies. While Santa Clara, California-based Nvidia and Advanced Micro Devices hosted keynotes touting ever faster artificial intelligence chips, a legion of budding Chinese robot creators occupied much humbler booths with machines giving life to the notion of physical AI.

A screenshot of Loverse app shows an AI-generated woman, characterized as a 25-year-old hair and makeup artist Miyu, registered as a female companion. When artificial intelligence first started receiving attention around the end of 2022, Goki Kusunoki was tinkering around to see what kind of services he could create with the technology. One thing clicked for him after he created an image of an attractive woman with AI -- an AI companion -- and wondered what it would be like to engage in a conversation with her. "As I kept talking with her, I found that the conversations were more enjoyable than I had expected and as the exchanges continued, my feelings gradually grew -- at some point I caught myself thinking, 'I might actually like her,'" he recounted. In a time of both misinformation and too much information, quality journalism is more crucial than ever. By subscribing, you can help us get the story right.

Severe heatwaves in urban areas significantly threaten public health, calling for establishing early warning strategies. Despite predicting occurrence of heatwaves and attributing historical mortality, predicting an incoming deadly heatwave remains a challenge due to the difficulty in defining and estimating heat-related mortality. Furthermore, establishing an early warning system imposes additional requirements, including data availability, spatial and temporal robustness, and decision costs. To address these challenges, we propose DeepTherm, a modular early warning system for deadly heatwave prediction without requiring heat-related mortality history. By highlighting the flexibility of deep learning, DeepTherm employs a dual-prediction pipeline, disentangling baseline mortality in the absence of heatwaves and other irregular events from all-cause mortality. We evaluated DeepTherm on real-world data across Spain. Results demonstrate consistent, robust, and accurate performance across diverse regions, time periods, and population groups while allowing trade-off between missed alarms and false alarms.

Tokenization strategies shape how models process electronic health records, yet fair comparisons of their effectiveness remain limited. We present a systematic evaluation of tokenization approaches for clinical time series modeling using transformer-based architectures, revealing task-dependent and sometimes counterintuitive findings about temporal and value feature importance. Through controlled ablations across four clinical prediction tasks on MIMIC-IV, we demonstrate that explicit time encodings provide no consistent statistically significant benefit for the evaluated downstream tasks. Value features show task-dependent importance, affecting mortality prediction but not readmission, suggesting code sequences alone can carry sufficient predictive signal. We further show that frozen pretrained code encoders dramatically outperform their trainable counterparts while requiring dramatically fewer parameters. Larger clinical encoders provide consistent improvements across tasks, benefiting from frozen embeddings that eliminate computational overhead. Our controlled evaluation enables fairer tokenization comparisons and demonstrates that simpler, parameter-efficient approaches can, in many cases, achieve strong performance, though the optimal tokenization strategy remains task-dependent.

Timely and personalized treatment decisions are essential across a wide range of healthcare settings where patient responses can vary significantly and evolve over time. Clinical data used to support these treatment decisions are often irregularly sampled, where missing data frequencies may implicitly convey information about the patient's condition. Existing Reinforcement Learning (RL) based clinical decision support systems often ignore the missing patterns and distort them with coarse discretization and simple imputation. They are also predominantly model-free and largely depend on retrospective data, which could lead to insufficient exploration and bias by historical behaviors. To address these limitations, we propose medDreamer, a novel model-based reinforcement learning framework for personalized treatment recommendation. medDreamer contains a world model with an Adaptive Feature Integration module that simulates latent patient states from irregular data and a two-phase policy trained on a hybrid of real and imagined trajectories. This enables learning optimal policies that go beyond the sub-optimality of historical clinical decisions, while remaining close to real clinical data. We evaluate medDreamer on both sepsis and mechanical ventilation treatment tasks using two large-scale Electronic Health Records (EHRs) datasets. Comprehensive evaluations show that medDreamer significantly outperforms model-free and model-based baselines in both clinical outcomes and off-policy metrics.

Intensive care unit (ICU) data are highly irregular, heterogeneous, and temporally fragmented, posing challenges for generalizable clinical prediction. We present PULSE-ICU, a self-supervised foundation model that learns event-level ICU representations from large-scale EHR sequences without resampling or manual feature engineering. A unified embedding module encodes event identity, continuous values, units, and temporal attributes, while a Longformer-based encoder enables efficient modeling of long trajectories. PULSE-ICU was fine-tuned across 18 prediction tasks, including mortality, intervention forecasting, and phenotype identification, achieving strong performance across task types. External validation on eICU, HiRID, and P12 showed substantial improvements with minimal fine-tuning, demonstrating robustness to domain shift and variable constraints. These findings suggest that foundation-style modeling can improve data efficiency and adaptability, providing a scalable framework for ICU decision support across diverse clinical environments.