Clairvoyance: A Pipeline Toolkit for Medical Time Series

Time-series learning is the bread and butter of data-driven *clinical decision support*, and the recent explosion in ML research has demonstrated great potential in various healthcare settings. At the same time, medical time-series problems in the wild are challenging due to their highly *composite* nature: They entail design choices and interactions among components that preprocess data, impute missing values, select features, issue predictions, estimate uncertainty, and interpret models. Despite exponential growth in electronic patient data, there is a remarkable gap between the potential and realized utilization of ML for clinical research and decision support. In particular, orchestrating a real-world project lifecycle poses challenges in engineering (i.e. hard to build), evaluation (i.e. hard to assess), and efficiency (i.e. hard to optimize). Designed to address these issues simultaneously, Clairvoyance proposes a unified, end-to-end, autoML-friendly pipeline that serves as a (i) software toolkit, (ii) empirical standard, and (iii) interface for optimization. Our ultimate goal lies in facilitating transparent and reproducible experimentation with complex inference workflows, providing integrated pathways for (1) personalized prediction, (2) treatment-effect estimation, and (3) information acquisition. Through illustrative examples on real-world data in outpatient, general wards, and intensive-care settings, we illustrate the applicability of the pipeline paradigm on core tasks in the healthcare journey. To the best of our knowledge, Clairvoyance is the first to demonstrate viability of a comprehensive and automatable pipeline for clinical time-series ML

Case series of breast fillers and how things may go wrong: radiology point of view

INTRODUCTION: Breast augmentation is a procedure opted by women to overcome sagging breast due to breastfeeding or aging as well as small breast size. Recent years have shown the emergence of a variety of injectable materials on market as breast fillers. These injectable breast fillers have swiftly gained popularity among women, considering the minimal invasiveness of the procedure, nullifying the need for terrifying surgery. Little do they know that the procedure may pose detrimental complications, while visualization of breast parenchyma infiltrated by these fillers is also deemed substandard; posing diagnostic challenges. We present a case series of three patients with prior history of hyaluronic acid and collagen breast injections. REPORT: The first patient is a 37-year-old lady who presented to casualty with worsening shortness of breath, non-productive cough, central chest pain; associated with fever and chills for 2-weeks duration. The second patient is a 34-year-old lady who complained of cough, fever and haemoptysis; associated with shortness of breath for 1-week duration. CT in these cases revealed non thrombotic wedge-shaped peripheral air-space densities. The third patient is a 37‐year‐old female with right breast pain, swelling and redness for 2- weeks duration. Previous collagen breast injection performed 1 year ago had impeded sonographic visualization of the breast parenchyma. MRI breasts showed multiple non- enhancing round and oval shaped lesions exhibiting fat intensity. CONCLUSION: Radiologists should be familiar with the potential risks and hazards as well as limitations of imaging posed by breast fillers such that MRI is required as problem-solving tool

Characterization of alar ligament on 3.0T MRI: a cross-sectional study in IIUM Medical Centre, Kuantan

INTRODUCTION: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female. The specific objectives are to assess the prevalence of alar ligament visualized on MRI, to describe its characteristics in term of its course, shape and signal homogeneity and to find differences in alar ligament signal intensity between male and female. This study also aims to determine the association between the heights of respondents with alar ligament signal intensity and dimensions. MATERIALS & METHODS: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. RESULTS: Alar ligament was best depicted in coronal plane, followed by sagittal and axial planes. The orientations were laterally ascending in most of the subjects (60%), predominantly oval in shaped (54%) and 67% showed inhomogenous signal. No significant difference of alar ligament signal intensity between male and female respondents. No significant association was found between the heights of the respondents with alar ligament signal intensity and dimensions. CONCLUSION: Employing a 3.0T MR scanner, the alar ligament is best portrayed on coronal plane, followed by sagittal and axial planes. However, tremendous variability of alar ligament as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury

The development of an information system for drug misuse using self knowledge elicitation

In the past, information systems have been developed by system analysts and programmers with the involvement of end users being at a minimum. For a long time now, researchers (Lucas 1976, Alter 1996) have been stressing the importance of significant user involvement because it brings a number of beneficial results: involvement can be challenging and intrinsically satisfying; involvement usually results in more commitment to change; the user becomes more knowledgeable about change and so is better trained in the use of the system; a better solution to the problem is obtained because users know more about the present system than analysts; involvement means the user has retained much of the control over operations. The contribution that this thesis makes is the concept of self knowledge elicitation as an approach to prototyping, developing and maintaining information systems. A key feature of this concept is the high degree of user involvement in the design and development process. Self knowledge elicitation allows the user to build an information system using his/her own knowledge and expertise, and then also allows him/her to maintain and update this system. This concept initially emerged following a research project which involved the development of an Expert Advisory System for AIDS/HIV using traditional techniques of development, which were found to have a number of deficiencies including the time-factor. Both formal and informal evaluations of the self knowledge elicitation concept were carried out at 20 different sites throughout Central England, over a minimum period of nine months. The results of these trials indicated that this concept was acceptable and could be used as a practical, cost-effective way of developing and maintaining information systems - especially for the purposes of training and education. Significant technological advances in both hardware and software over recent years (advanced word processors, intemet/intranet, web browsers, e-mail, etc.), used appropriately, will increase the availability, functionality and acceptability of the self knowledge elicitation concept

HEALING COMMUNITIES. What if we collectively had the capacity to overcome any crisis in a matter of days? A method for teams of teams to: listen to each other, agree on priorities, put in commons resources, create few but essential and freely adaptable solutions.

Ever since I was young, I have sought to find how to contribute meaningfully to the community, while being fully myself. Called to different interests than my peers, I began to explore the mysteries of group dynamics. Many cycles of study and practice led me to an awareness: suffering, misery (physical and spiritual), violence, are often generated by stories we learn as children, and pass on through generations. I became convinced that, within months, we could ensure that all people could live decently and in harmony, if we dared to listen – literally and symbolically – to our Heart, to the Other’s. We would commit ourselves to a path that celebrates our Humanity, connects us to Nature within and beyond, and nourishes our Souls. Indeed, tackling complex, wicked challenges requires abandoning the logic of a machine-body, the illusion of technical solutions built without personal commitment, so that we can raise our collective, human consciousness. This means providing ways for the whole population to listen to their different realities, and to quickly reach a popular consensus on how to overcome these challenges in ways that strengthen solidarity. According to the creator of Captcha tests, a million people could translate Wikipedia into a new language in 80 hours. Let us imagine what such a group could achieve if they had the capacity to sincerely agree on essential common projects, and implement them in a matter of days – free/libre and open source knowledge and infrastructures that could easily be adopted, reproduced and enriched across territories? This five-part thesis documents six years of intense creation and research that enabled me to design how such a process could unfold. * * * First, I present my journey to the PhD, and how my research took shape through cycles of prototyping. I introduce the idea of the commons, which is to understand that people – not corporations or the state – have all the resources needed to overcome the challenges we face. This builds on the oeuvre of Elinor Ostrom, who showed that ordinary people can self-organise efficiently to preserve resources, and Stefano Rodotà, who pledged that any resource that meets basic needs must be managed in a participatory way, regardless of who owns it. Secondly, I talk about Breathing Games, a commons I co-founded to make respiratory health fun. I show how this initiative, which initially objectified the children concerned – by thinking their health in their place –, then opened up a space for young people to share their subjective experience in a playful way that was beneficial to their comrades. I share how an ethic and aesthetic of commoning enabled us to engage over 450 volunteers, and mutualise resources from Canada, Switzerland, France, Italy, and South Korea. Thirdly, I propose four levers to build solidarity-driven ecosystems. We need to: — bring diverse people together for ludic events to overcome loneliness. For example, the online hackathons that mobilised 150,000 people at the start of the crown-crisis. — generate collective value to overcome material limitations. For example, the autonomous networks of makers, who shared designs and manufactured over 48 million medical supplies while industry was at a standstill. — facilitate agreements across teams of teams to overcome power games. For example, the Emerging Change, developed in Quebec schools and a Swiss multinational, enables teams to thrive and excel by establishing a ritual dialogue between the whole team and its leader, thus avoiding competition between individuals. — revisit collective narratives to break free from self-servitude. For example, challenging the belief that an authority – parent, teacher, employer, politician, caregiver – can take care of our needs better than we can. Fourthly, I present the Geneva festival ’taking care together’, a nine-day event created in 122 days thanks to 115 co-hosts. I quantify the collective value created by the Breathing Games and the festival at 2.2 million Swiss francs, 4/5 of which was generated by volunteer contributions. Next, I provide a step-by-step facilitation method that could help thousands of people coordinate their efforts around a limited number of modular projects. I then outline how this model could re-create education, eradicate systemic corruption, resurrect democracy, and heal our dis-ease when we over-invest in the mind. Finally, I summarise what I have learnt, and list about 600 references that inspired me. This creation-as-research can be freely reproduced and enriched (Creative Commons BY-SA licence, editable LaTeX format). Concordia Salus