This study presents an Initial Data Analysis (IDA) of the German Transplantation Registry (TxReg) data for a better data understanding and to inform future data analyses. The IDA is focusing on data on first-time kidney-only transplantations in adult recipients from deceased donors between 2006 and 2016 and refers to data from 14,954 recipients and 9,964 donors across 25 tables. Investigated aspects include missing data patterns and structure, data consistency, and availability of event time data. Results show that missing data proportions vary widely, with some tables nearly complete while others have over 50% missing values. Missing data patterns are identified using a decision tree approach. An influx and outflux analysis demonstrates that some variables have high potential for imputing missing data, while others were less suitable for imputation. We identified 168 multi-sourced variables that are reported by multiple data providers in parallel leading to discrepancies for some variables but also providing opportunities for missing data imputation. Our findings on event time data demonstrate the importance of carefully selecting the variables used for event time analyses as resu
Ensemble learning is a widespread technique to improve the prediction performance of neural networks. However, it comes at the price of increased memory and inference time. In this work we propose a novel model fusion technique called \emph{Neuron Transplantation (NT)} in which we fuse an ensemble of models by transplanting important neurons from all ensemble members into the vacant space obtained by pruning insignificant neurons. An initial loss in performance post-transplantation can be quickly recovered via fine-tuning, consistently outperforming individual ensemble members of the same model capacity and architecture. Furthermore, NT enables all the ensemble members to be jointly pruned and jointly trained in a combined model. Comparing it to alignment-based averaging (like Optimal-Transport-fusion), it requires less fine-tuning than the corresponding OT-fused model, the fusion itself is faster and requires less memory, while the resulting model performance is comparable or better. The code is available under the following link: https://github.com/masterbaer/neuron-transplantation.
We consider a stopping problem and its application to the decision-making process regarding the optimal timing of organ transplantation for individual patients. At each decision period, the patient state is inspected and a decision is made whether to transplant. If the organ is transplanted, the process terminates; otherwise, the process continues until a transplant happens or the patient dies. Under suitable conditions, we show that there exists a control limit optimal policy. We propose a smoothed perturbation analysis (SPA) estimator for the gradient of the total expected discounted reward with respect to the control limit. Moreover, we show that the SPA estimator is asymptotically unbiased.
In this paper we present uniform weighted inequalities for the Hankel transform transplantation operator. A weighted vector-valued inequality is also obtained. As a consequence we deduce an extension of a transference theorem due to Rubio de Francia.
Ensuring large language models (LLM) behave consistently with human goals, values, and intentions is crucial for their safety but yet computationally expensive. To reduce the computational cost of alignment training of LLMs, especially for those with a huge number of parameters, and to reutilize learned value alignment, we propose ConTrans, a novel framework that enables weak-to-strong alignment transfer via concept transplantation. From the perspective of representation engineering, ConTrans refines concept vectors in value alignment from a source LLM (usually a weak yet aligned LLM). The refined concept vectors are then reformulated to adapt to the target LLM (usually a strong yet unaligned base LLM) via affine transformation. In the third step, ConTrans transplants the reformulated concept vectors into the residual stream of the target LLM. Experiments demonstrate the successful transplantation of a wide range of aligned concepts from 7B models to 13B and 70B models across multiple LLMs and LLM families. Remarkably, ConTrans even surpasses instruction-tuned models in terms of truthfulness. Experiment results validate the effectiveness of both inter-LLM-family and intra-LLM-famil
This paper presents a comprehensive review of the last two decades of research on Kidney Exchange Programs (KEPs), systematically categorizing and classifying key contributions to provide readers with a structured understanding of advancements in the field. The review highlights the evolution of KEP methodologies and lays the foundation for our contribution. We propose three mathematical models aimed at improving both the quantity and quality of kidney transplants. Model 1 maximizes the number of transplants by focusing on compatibility based on blood type and PRA, without additional constraints. Model 2 introduces a minimum Human Leukocyte Antigen (HLA) compatibility threshold to enhance transplant quality, though this leads to fewer matches. Model 3 extends the problem to a Multi-Agent Kidney Exchange Program (MKEP), pooling incompatible donor-recipient pairs across multiple agents, resulting in a higher number of successful transplants while ensuring fairness across agents. Sensitivity analyses demonstrate trade-offs between transplant quantity and quality, with Model 3 striking the optimal balance by leveraging multi-agent collaboration to improve both the number and quality of
Patient life circumstances, including social determinants of health (SDOH), shape both health outcomes and care access, contributing to persistent disparities across gender, race, and socioeconomic status. Liver transplantation exemplifies these challenges, requiring complex eligibility and allocation decisions where SDOH directly influence patient evaluation. We developed an artificial intelligence (AI)-driven framework to analyze how broadly defined SDOH -- encompassing both traditional social determinants and transplantation-related psychosocial factors -- influence patient care trajectories. Using large language models, we extracted 23 SDOH factors related to patient eligibility for liver transplantation from psychosocial evaluation notes. These SDOH ``snapshots'' significantly improve prediction of patient progression through transplantation evaluation stages and help explain liver transplantation decisions including the recommendation based on psychosocial evaluation and the listing of a patient for a liver transplantation. Our analysis helps identify patterns of SDOH prevalence across demographics that help explain racial disparities in liver transplantation decisions. We hi
In this study, we investigate how supporting serendipitous discovery and analysis of online product reviews can encourage readers to explore reviews more comprehensively prior to making purchase decisions. We propose two interventions -- Exploration Metrics that can help readers understand and track their exploration patterns through visual indicators and a Bias Mitigation Model that intends to maximize knowledge discovery by suggesting sentiment and semantically diverse reviews. We designed, developed, and evaluated a text analytics system called Serendyze, where we integrated these interventions. We asked 100 crowd workers to use Serendyze to make purchase decisions based on product reviews. Our evaluation suggests that exploration metrics enabled readers to efficiently cover more reviews in a balanced way, and suggestions from the bias mitigation model influenced readers to make confident data-driven decisions. We discuss the role of user agency and trust in text-level analysis systems and their applicability in domains beyond review exploration.
This paper describes a rapid feasibility study of using GPT-4, a large language model (LLM), to (semi)automate data extraction in systematic reviews. Despite the recent surge of interest in LLMs there is still a lack of understanding of how to design LLM-based automation tools and how to robustly evaluate their performance. During the 2023 Evidence Synthesis Hackathon we conducted two feasibility studies. Firstly, to automatically extract study characteristics from human clinical, animal, and social science domain studies. We used two studies from each category for prompt-development; and ten for evaluation. Secondly, we used the LLM to predict Participants, Interventions, Controls and Outcomes (PICOs) labelled within 100 abstracts in the EBM-NLP dataset. Overall, results indicated an accuracy of around 80%, with some variability between domains (82% for human clinical, 80% for animal, and 72% for studies of human social sciences). Causal inference methods and study design were the data extraction items with the most errors. In the PICO study, participants and intervention/control showed high accuracy (>80%), outcomes were more challenging. Evaluation was done manually; scoring
OBJECTIVE: To analyze the diagnosis and treatment of patients with concomitant malignant tumors after organ transplantation by compiling data from organ transplantation patients. METHODS: By searching CNKI and PubMed databases, we made a systematic analysis of the studies of postorgan transplantation complicating malignant tumors in the last decade. RESULTS: There were 10 articles on malignant tumors after renal transplantation, 8 articles on liver transplantation, 2 articles on heart transplantation, and 1 article on lung transplantation. The incidence of malignant tumors complicating renal transplantation is 10.4% in Europe, with skin cancer and Kaposi's sarcoma being common; the incidence in the United States is 3.4%, with PTLD having the highest incidence; the incidence of malignant tumors is relatively lowest in Asia, with gastrointestinal malignancies being the main ones. The mean time to complication of malignancy after renal transplantation is 3.83 years. The incidence of concurrent malignancies after liver transplantation is 8.8% in Europe, where skin cancer and Kaposi's sarcoma are common; 5.6% in Asia, where gastrointestinal tract tumors are prevalent; and 4.5% in the United States, where gastrointestinal tract tumors, PTLD, and hematologic diseases are predominant. The mean time to complication of malignancy after liver transplantation is 4.79 years. The incidence of malignancy after heart transplantation is 6.8-10.7%. The incidence of malignancy after lung transplantation is about 10.1%. Minimization of immunosuppression or modification of immunosuppression regimens may be a key component of cancer prevention. mTOR inhibitors and phenolate (MMF) reduce the incidence of de novo malignancies in patients after solid organ transplantation. Surgical treatment improves survival in patients with early malignancies. The use of external beam radiation therapy in the treatment of hepatocellular carcinoma is limited due to the risk of radiation liver disease. CONCLUSIONS: The risk of concomitant malignancy needs to be guarded for 5 years of immunosuppressive therapy after organ transplantation surgery. Adjusting the immunosuppressive treatment regimen is an effective way to reduce concurrent malignancies. Systemic chemotherapy or radiotherapy requires vigilance against the toxic effects of drug metabolism kinetics on the transplanted organ.
While kidney transplants are seen as the best treatment option for patients with end-stage renal disease and kidney failure, the organ's health depends on the dosage of immunosuppressant drugs post-transplantation. Due to the dosage variance based on each patient's unique physiology, nephrologists face numerous difficulties when determining the precise dosage needed for each patient. Therefore, in this research we aim to devise a machine learning algorithm to forecast the dosage of immunosuppressant drugs needed for different patients after kidney transplantation. Utilizing a random forest algorithm, the devised model is able to achieve accurate measurements for patient drug dosages.
Liver transplantation continues to be the gold standard for treating patients with end-stage liver diseases. However, despite the huge success of liver transplantation in improving patient outcomes, long term graft survival continues to be a major problem. The current clinical practice in the management of liver transplant patients is centered around immunosuppressive multidrug regimens. Current research has been focusing on phenotypic personalized medicine as a novel approach in the optimization of immunosuppression, a regressional math modeling focusing on individual patient dose and response using specific markers like transaminases. A prospective area of study includes the development of a mechanistic computational math modeling for optimizing immunosuppression to improve patient outcomes and increase long-term graft survival by exploring the intricate immune/drug interactions to help us further our understanding and management of medical problems like transplants, autoimmunity, and cancer therapy. Thus, by increasing long-term graft survival, the need for redo transplants will decrease, which will free up organs and potentially help with the organ shortage problem promoting eq
Background: Many authors have described MELD as a predictor of short-term mortality in the liver transplantation waiting list. However MELD score accuracy to predict long term mortality has not been statistically evaluated. Objective: The aim of this study is to analyze the MELD score as well as other variables as a predictor of long-term mortality using a new model: the Survival Tree analysis. Study Design and Setting: The variables obtained at the time of liver transplantation list enrollment and considered in this study are: sex, age, blood type, body mass index, etiology of liver disease, hepatocellular carcinoma, waiting time for transplant and MELD. Mortality on the waiting list is the outcome. Exclusion, transplantation or still in the transplantation list at the end of the study are censored data. Results: The graphical representation of the survival trees showed that the most statistically significant cut off is related to MELD score at point 16. Conclusion: The results are compatible with the cut off point of MELD indicated in the clinical literature.
Organ transplantation, which is the utilization of codes directly related to some specific functionalities to complete ones own program, provides more convenience for developers than traditional component reuse. However, recent techniques are challenged with the lack of organs for transplantation. Hence, we conduct an empirical study on extracting organs from GitHub repository to explore transplantation based on large-scale dataset. We analyze statistics from 12 representative GitHub projects and get the conclusion that 1) there are abundant practical organs existing in commits with add as a key word in the comments; 2) organs in this repository mainly possess four kinds of contents; 3) approximately 70% of the organs are easy-to-transplant. Implementing our transplantation strategy for different kinds of organs, we manually extract 30 organs in three different programming languages, namely Java, Python, and C, and make unit tests for them utilizing four testing tools (two for Java, one for Python, and one for C). At last, we transplant three Java organs into a specific platform for a performance check to verify whether they can work well in the new system. All the 30 organs extrac
Kidney transplantation is the most effective renal replacement therapy for end stage renal disease patients. With the severe shortage of kidney supplies and for the clinical effectiveness of transplantation, patient's life expectancy post transplantation is used to prioritize patients for transplantation; however, severe comorbidity conditions and old age are the most dominant factors that negatively impact post-transplantation life expectancy, effectively precluding sick or old patients from receiving transplants. It would be crucial to design objective measures to quantify the transplantation benefit by comparing the mean residual life with and without a transplant, after adjusting for comorbidity and demographic conditions. To address this urgent need, we propose a new class of semiparametric covariate-dependent mean residual life models. Our method estimates covariate effects semiparametrically efficiently and the mean residual life function nonparametrically, enabling us to predict the residual life increment potential for any given patient. Our method potentially leads to a more fair system that prioritizes patients who would have the largest residual life gains. Our analysis
The burgeoning need for kidney transplantation mandates immediate attention. Mismatch of deceased donor-recipient kidney leads to post-transplant death. To ensure ideal kidney donor-recipient match and minimize post-transplant deaths, the paper develops a prediction model that identifies factors that determine the probability of success of renal transplantation, that is, if the kidney procured from the deceased donor can be transplanted or discarded. The paper conducts a study enveloping data for 584 imported kidneys collected from 12 transplant centers associated with an organ procurement organization located in New York City, NY. The predicting model yielding best performance measures can be beneficial to the healthcare industry. Transplant centers and organ procurement organizations can take advantage of the prediction model to efficiently predict the outcome of kidney transplantation. Consequently, it will reduce the mortality rate caused by mismatching of donor-recipient kidney transplantation during the surgery. Keywords
The DARPA Fast Lightweight Autonomy (FLA) program (2015 - 2018) served as a significant milestone in the development of UAS, particularly for autonomous navigation through unknown GPS-denied environments. Three performing teams developed UAS using a common hardware platform, focusing their contributions on autonomy algorithms and sensing. Several experiments were conducted that spanned indoor and outdoor environments, increasing in complexity over time. This paper reviews the testing methodology developed in order to benchmark and compare the performance of each team, each of the FLA Phase 1 experiments that were conducted, and a summary of the Phase 1 results.
Context. JavaScript is a popular programming language today with several implementations competing for market dominance. Although a specification document and a conformance test suite exist to guide engine development, bugs occur and have important practical consequences. Implementing correct engines is challenging because the spec is intentionally incomplete and evolves frequently. Objective. This paper investigates the use of test transplantation and differential testing for revealing functional bugs in JavaScript engines. The former technique runs the regression test suite of a given engine on another engine. The latter technique fuzzes existing inputs and then compares the output produced by different engines with a differential oracle. Method. We conducted experiments with engines from five major players-Apple, Facebook, Google, Microsoft, and Mozilla-to assess the effectiveness of test transplantation and differential testing. Results. Our results indicate that both techniques revealed several bugs, many of which confirmed by developers. We reported 35 bugs with test transplantation (23 of these bugs confirmed and 19 fixed) and reported 24 bugs with differential testing (17 o
In this work, we present a flexible method for explaining, in human readable terms, the predictions made by decision trees used as decision support in liver transplantation. The decision trees have been obtained through machine learning applied on a dataset collected at the liver transplantation unit at the Coruña University Hospital Center and are used to predict long term (five years) survival after transplantation. The method we propose is based on the representation of the decision tree as a set of rules in a logic program (LP) that is further annotated with text messages. This logic program is then processed using the tool xclingo (based on Answer Set Programming) that allows building compound explanations depending on the annotation text and the rules effectively fired when a given input is provided. We explore two alternative LP encodings: one in which rules respect the tree structure (more convenient to reflect the learning process) and one where each rule corresponds to a (previously simplified) tree path (more readable for decision making).
Lung transplantation remains the only viable treatment option for the majority of patients with advanced lung diseases. However, 5-year post-transplant survival rates remain low primarily secondary to chronic rejection. Novel insights from global gene expression profiles may provide molecular phenotypes and therapeutic targets to improve outcomes after lung transplantation. We showed the presence of a significant number of dysregulated genes, particularly those genes involved in pathways and biological processes such as immune response and defense, in the PBMCs derived from a cohort of patients after lung transplantation. The contribution of miRNAs in regulating these differential genes was also demonstrated.