From Barriers to Tactics: A Behavioral Science-Informed Agentic Workflow for Personalized Nutrition Coaching

Effective management of cardiometabolic conditions requires sustained positive nutrition habits, often hindered by complex and individualized barriers. Direct human management is simply not scalable, while previous attempts aimed at automating nutrition coaching lack the personalization needed to address these diverse challenges. This paper introduces a novel LLM-powered agentic workflow designed to provide personalized nutrition coaching by directly targeting and mitigating patient-specific barriers. Grounded in behavioral science principles, the workflow leverages a comprehensive mapping of nutrition-related barriers to corresponding evidence-based strategies. A specialized LLM agent intentionally probes for and identifies the root cause of a patient's dietary struggles. Subsequently, a separate LLM agent delivers tailored tactics designed to overcome those specific barriers with patient context. We designed and validated our approach through a user study with individuals with cardiometabolic conditions, demonstrating the system's ability to accurately identify barriers and provide personalized guidance. Furthermore, we conducted a large-scale simulation study, grounding on real patient vignettes and expert-validated metrics, to evaluate the system's performance across a wide range of scenarios. Our findings demonstrate the potential of this LLM-powered agentic workflow to improve nutrition coaching by providing personalized, scalable, and behaviorally-informed interventions.

Deep learning classifier of locally advanced rectal cancer treatment response from endoscopy images

We developed a deep learning classifier of rectal cancer response (tumor vs. no-tumor) to total neoadjuvant treatment (TNT) from endoscopic images acquired before, during, and following TNT. We further evaluated the network's ability in a near out-of-distribution (OOD) problem to identify local regrowth (LR) from follow-up endoscopy images acquired several months to years after completing TNT. We addressed endoscopic image variability by using optimal mass transport-based image harmonization. We evaluated multiple training regularization schemes to study the ResNet-50 network's in-distribution and near-OOD generalization ability. Test time augmentation resulted in the most considerable accuracy improvement. Image harmonization resulted in slight accuracy improvement for the near-OOD cases. Our results suggest that off-the-shelf deep learning classifiers can detect rectal cancer from endoscopic images at various stages of therapy for surveillance.