Karoline Leavitt's family member'abruptly arrested' by ICE after living in US for decades Residents in liberal Western US city feel'isolated' as state turns extremely red What HAS happened to Beyoncé? Suddenly desperate, I know what's really going on... and it's ugly: CAROLINE BULLOCK LIZ JONES: Sorry, but it's now time for Kate to stop making excuses'I fell for Joan the moment I saw her': The emotional love letter Sir Richard Branson penned to his'rock' on their anniversary - as he announces her death after 50 years together Ina Garten, 77, vulnerably addresses her decision not to have children: 'I can't imagine my life any other way' Sports broadcaster's wife suffers unimaginable tragedy just before he goes on air New'Hollywood of the South' emerges as booming industry generates $1bn... but long-time residents are furious University of Minnesota program offers guidelines to'reverse the whiteness pandemic' Emmy-winning CBS anchor reveals her devastating health battle: 'I've been silently struggling' Bethany MaGee's family issue heartbreaking statement about her injuries after devout Christian, 26, was set ablaze'by 72-time arrestee' on Chicago train Celebrities are known for living life in the fast lane - but being famous really can prove deadly, according to a new study. Researchers have discovered that being in the limelight comes with a higher mortality risk compared to those who never quite'make it'. It could explain why some singers such as Janis Joplin, Whitney Houston and Jimi Hendrix died so young. And it suggests that fame comes with'unique psychosocial stress' that leads to'harmful coping behaviours' like substance abuse, they said.

Many sequential decision settings in healthcare feature funnel structures characterized by a series of stages, such as screenings or evaluations, where the number of patients who advance to each stage progressively decreases and decisions become increasingly costly. For example, an oncologist may first conduct a breast exam, followed by a mammogram for patients with concerning exams, followed by a biopsy for patients with concerning mammograms. A key challenge is that the ground truth outcome, such as the biopsy result, is only revealed at the end of this funnel. The selective censoring of the ground truth can introduce statistical biases in risk estimation, especially in underserved patient groups, whose outcomes are more frequently censored. We develop a Bayesian model for funnel decision structures, drawing from prior work on selective labels and censoring. We first show in synthetic settings that our model is able to recover the true parameters and predict outcomes for censored patients more accurately than baselines. We then apply our model to a dataset of emergency department visits, where in-hospital mortality is observed only for those who are admitted to either the hospital or ICU. We find that there are gender-based differences in hospital and ICU admissions. In particular, our model estimates that the mortality risk threshold to admit women to the ICU is higher for women (5.1%) than for men (4.5%).

Objective. Type 2 diabetes mellitus (T2DM) is a highly prevalent non-communicable chronic disease that substantially reduces life expectancy. Accurate estimation of all-cause mortality risk in T2DM patients is crucial for personalizing and optimizing treatment strategies. Research Design and Methods. This study analyzed a cohort of 554 patients (aged 40-87 years) with diagnosed T2DM over a maximum follow-up period of 16.8 years, during which 202 patients (36%) died. Key survival-associated features were identified, and multiple machine learning (ML) models were trained and validated to predict all-cause mortality risk. To improve model interpretability, Shapley additive explanations (SHAP) was applied to the best-performing model. Results. The extra survival trees (EST) model, incorporating ten key features, demonstrated the best predictive performance. The model achieved a C-statistic of 0.776, with the area under the receiver operating characteristic curve (AUC) values of 0.86, 0.80, 0.841, and 0.826 for 5-, 10-, 15-, and 16.8-year all-cause mortality predictions, respectively. The SHAP approach was employed to interpret the model's individual decision-making processes. Conclusions. The developed model exhibited strong predictive performance for mortality risk assessment. Its clinically interpretable outputs enable potential bedside application, improving the identification of high-risk patients and supporting timely treatment optimization.

Intensive Care Unit (ICU) mortality prediction, which estimates a patient's mortality status at discharge using EHRs collected early in an ICU admission, is vital in critical care. For this task, predictive accuracy alone is insufficient; interpretability is equally essential for building clinical trust and meeting regulatory standards, a topic that has attracted significant attention in information system research. Accordingly, an ideal solution should enable intrinsic interpretability and align its reasoning with three key elements of the ICU decision-making practices: clinical course identification, demographic heterogeneity, and prognostication awareness. However, conventional approaches largely focus on demographic heterogeneity, overlooking clinical course identification and prognostication awareness. Recent prototype learning methods address clinical course identification, yet the integration of the other elements into such frameworks remains underexplored. To address these gaps, we propose ProtoDoctor, a novel ICU mortality prediction framework that delivers intrinsic interpretability while integrating all three elements of the ICU decision-making practices into its reasoning process. Methodologically, ProtoDoctor features two key innovations: the Prognostic Clinical Course Identification module and the Demographic Heterogeneity Recognition module. The former enables the identification of clinical courses via prototype learning and achieves prognostication awareness using a novel regularization mechanism. The latter models demographic heterogeneity through cohort-specific prototypes and risk adjustments. Extensive empirical evaluations demonstrate that ProtoDoctor outperforms state-of-the-art baselines in predictive accuracy. Human evaluations further confirm that its interpretations are more clinically meaningful, trustworthy, and applicable in ICU practice.

Background: Patients with both diabetes mellitus (DM) and atrial fibrillation (AF) face elevated mortality in intensive care units (ICUs), yet models targeting this high-risk group remain limited. Objective: To develop an interpretable machine learning (ML) model predicting 28-day mortality in ICU patients with concurrent DM and AF using early-phase clinical data. Methods: A retrospective cohort of 1,535 adult ICU patients with DM and AF was extracted from the MIMIC-IV database. Data preprocessing involved median/mode imputation, z-score normalization, and early temporal feature engineering. A two-step feature selection pipeline-univariate filtering (ANOVA F-test) and Random Forest-based multivariate ranking-yielded 19 interpretable features. Seven ML models were trained with stratified 5-fold cross-validation and SMOTE oversampling. Interpretability was assessed via ablation and Accumulated Local Effects (ALE) analysis. Results: Logistic regression achieved the best performance (AUROC: 0.825; 95% CI: 0.779-0.867), surpassing more complex models. Key predictors included RAS, age, bilirubin, and extubation. ALE plots showed intuitive, non-linear effects such as age-related risk acceleration and bilirubin thresholds. Conclusion: This interpretable ML model offers accurate risk prediction and clinical insights for early ICU triage in patients with DM and AF.

AKI is associated with increases in (1) post-discharge mortality risk, (2) length of hospital stay and (3) healthcare expenditures [19], as well as short term unplanned re-admissions and mid term progressive chronic conditions. Around 33% of AKI patients require unplanned re-admissions within 90 days after discharge and around 15% develop progressive chronic kidney disease over the first year after discharge [14, 16]. AKI is multi-factorial, and accurate follow up planning is challenging. Machine learning has been viewed as promising to build tools to support decision making in clinical follow-up planning. Broadly speaking, recent initiatives can be structured along two alternatives: 1. Tools grounded on prior medical expert knowledge, which is used to stratify patients according to meaningful attributes, in such way that specialised plans can be devised for each group of patients [5, 13, 15, 19, 23]. 2. Tools grounded on machine learning techniques, which take control of the planning process and build accurate decision procedures which, however, demand extreme care in selection of new patients, to ensure compliance with population definitions that are used during preparation of decision procedures [1, 2, 3, 7, 21, 22]. Compliance with ethical standards demands that such tools are fair, transparent, and optimised for the benefit of patients. Technical requirements to ensure ethical compliance must include algorithmic transparency to support fairness and transparency in decision making and optimised, goal-oriented patient stratification to ensure human-centred optimised performance. The research initiative presented in this article focused on the development of a tool to support clinical follow up planning for post-AKI patients after hospital discharge, with particular attention to ethical compliance based on technical requirements.

Sepsis poses a major global health threat, accounting for millions of deaths annually and significant economic costs. Accurate predictions of mortality risk in sepsis patients facilitate the efficient allocation of medical resources, thereby enhancing patient survival and quality of life. Through precise risk assessments, healthcare facilities can effectively distribute intensive care beds, medical equipment, and staff, ensuring high-risk patients receive timely and appropriate care. Early identification and intervention significantly decrease mortality rates and improve patient outcomes. Current methods typically utilize only one type of data--either constant, temporal, or ICD codes. This study introduces the Time-Constant KAN Integrated Network(TCKIN), an innovative model that enhances the accuracy of sepsis mortality risk predictions by integrating both temporal and constant data from electronic health records and ICD codes. Validated against the MIMIC-III and MIMIC-IV datasets, TCKIN surpasses existing machine learning and deep learning methods in accuracy, sensitivity, and specificity. Notably, TCKIN achieved AUCs of 87.76% and 88.07%, demonstrating superior capability in identifying high-risk patients. Additionally, TCKIN effectively combats the prevalent issue of data imbalance in clinical settings, improving the detection of patients at elevated risk of mortality and facilitating timely interventions. These results confirm the model's effectiveness and its potential to transform patient management and treatment optimization in clinical practice. With this advanced risk assessment tool, healthcare providers can devise more tailored treatment plans, optimize resource utilization, and ultimately enhance survival rates and quality of life for sepsis patients.

In response to the COVID-19 pandemic, the integration of interpretable machine learning techniques has garnered significant attention, offering transparent and understandable insights crucial for informed clinical decision making. This literature review delves into the applications of interpretable machine learning in predicting the prognosis of respiratory diseases, particularly focusing on COVID-19 and its implications for future research and clinical practice. We reviewed various machine learning models that are not only capable of incorporating existing clinical domain knowledge but also have the learning capability to explore new information from the data. These models and experiences not only aid in managing the current crisis but also hold promise for addressing future disease outbreaks. By harnessing interpretable machine learning, healthcare systems can enhance their preparedness and response capabilities, thereby improving patient outcomes and mitigating the impact of respiratory diseases in the years to come.

Objective: To improve survival analysis using EHR data, we aim to develop a supervised topic model called MixEHR-SurG to simultaneously integrate heterogeneous EHR data and model survival hazard. Materials and Methods: Our technical contributions are three-folds: (1) integrating EHR topic inference with Cox proportional hazards likelihood; (2) inferring patient-specific topic hyperparameters using the PheCode concepts such that each topic can be identified with exactly one PheCode-associated phenotype; (3) multi-modal survival topic inference. This leads to a highly interpretable survival and guided topic model that can infer PheCode-specific phenotype topics associated with patient mortality. We evaluated MixEHR-G using a simulated dataset and two real-world EHR datasets: the Quebec Congenital Heart Disease (CHD) data consisting of 8,211 subjects with 75,187 outpatient claim data of 1,767 unique ICD codes; the MIMIC-III consisting of 1,458 subjects with multi-modal EHR records. Results: Compared to the baselines, MixEHR-G achieved a superior dynamic AUROC for mortality prediction, with a mean AUROC score of 0.89 in the simulation dataset and a mean AUROC of 0.645 on the CHD dataset. Qualitatively, MixEHR-G associates severe cardiac conditions with high mortality risk among the CHD patients after the first heart failure hospitalization and critical brain injuries with increased mortality among the MIMIC-III patients after their ICU discharge. Conclusion: The integration of the Cox proportional hazards model and EHR topic inference in MixEHR-SurG led to not only competitive mortality prediction but also meaningful phenotype topics for systematic survival analysis. The software is available at GitHub: https://github.com/li-lab-mcgill/MixEHR-SurG.

Background: Accurate survival time estimates aid end-of-life medical decision-making. Objectives: Develop an interpretable survival model for elderly residential aged care residents using advanced machine learning. Setting: A major Australasian residential aged care provider. Participants: Residents aged 65+ admitted for long-term care from July 2017 to August 2023. Sample size: 11,944 residents across 40 facilities. Predictors: Factors include age, gender, health status, co-morbidities, cognitive function, mood, nutrition, mobility, smoking, sleep, skin integrity, and continence. Outcome: Probability of survival post-admission, specifically calibrated for 6-month survival estimates. Statistical Analysis: Tested CoxPH, EN, RR, Lasso, GB, XGB, and RF models in 20 experiments with a 90/10 train/test split. Evaluated accuracy using C-index, Harrell's C-index, dynamic AUROC, IBS, and calibrated ROC. Chose XGB for its performance and calibrated it for 1, 3, 6, and 12-month predictions using Platt scaling. Employed SHAP values to analyze predictor impacts. Results: GB, XGB, and RF models showed the highest C-Index values (0.714, 0.712, 0.712). The optimal XGB model demonstrated a 6-month survival prediction AUROC of 0.746 (95% CI 0.744-0.749). Key mortality predictors include age, male gender, mobility, health status, pressure ulcer risk, and appetite. Conclusions: The study successfully applies machine learning to create a survival model for aged care, aligning with clinical insights on mortality risk factors and enhancing model interpretability and clinical utility through explainable AI.