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Recent methodological research in causal inference has focused on effects of stochastic interventions, which assign treatment randomly, often according to subject-specific covariates. In this work, we demonstrate that the usual notion of stochastic interventions have a surprising property: when there is unmeasured confounding, bounds on their effects do not collapse when the policy approaches the observational regime. As an alternative, we propose to study generalized policies, treatment rules that can depend on covariates, the natural value of treatment, and auxiliary randomness. We show that certain generalized policy formulations can resolve the "non-collapsing" bound issue: bounds narrow to a point when the target treatment distribution approaches that in the observed data. Moreover, drawing connections to the theory of optimal transport, we characterize generalized policies that minimize worst-case bound width in various sensitivity analysis models, as well as corresponding sharp bounds on their causal effects. These optimal policies are new, and can have a more parsimonious interpretation compared to their usual stochastic policy analogues. Finally, we develop flexible, efficient, and robust estimators for the sharp nonparametric bounds that emerge from the framework., Comment: 37 pages, 1 figure

We present a general framework for incorporating non-reciprocal interactions into the Ising model with Glauber dynamics, without requiring multiple species. We then focus on a model with vision-cone type interactions. We solve it in a fully connected network (mean-field) and perform extensive numerical simulations of the model in the square lattice. We find that the breakdown of the spin-flip symmetry introduced by non-reciprocity induces a discontinuous phase transition on top of the usual continuous one, that eventually occurs at higher critical temperatures. Combining a static and dynamic scaling analysis, we measure the critical exponents associated to the continuous symmetry breaking transition, and find them to be identical to the ones of the Ising model in two dimensions (2D), with the exception of the exponent $\beta$ associated to the order parameter. The latter appears to increase as the non-reciprocity of the coupling increases, suggesting that, within our numerical precision, the model does not belong to the 2D Ising model universality class. The coarsening process is anisotropic, but still follows the usual dynamic scaling with an exponent compatible with the standard value with non-conserved order parameter dynamics., Comment: 23 pages, 10 figures

The first very long baseline interferometry (VLBI) detections at 870$\mu$m wavelength (345$\,$GHz frequency) are reported, achieving the highest diffraction-limited angular resolution yet obtained from the surface of the Earth, and the highest-frequency example of the VLBI technique to date. These include strong detections for multiple sources observed on inter-continental baselines between telescopes in Chile, Hawaii, and Spain, obtained during observations in October 2018. The longest-baseline detections approach 11$\,$G$\lambda$ corresponding to an angular resolution, or fringe spacing, of 19$\mu$as. The Allan deviation of the visibility phase at 870$\mu$m is comparable to that at 1.3$\,$mm on the relevant integration time scales between 2 and 100$\,$s. The detections confirm that the sensitivity and signal chain stability of stations in the Event Horizon Telescope (EHT) array are suitable for VLBI observations at 870$\mu$m. Operation at this short wavelength, combined with anticipated enhancements of the EHT, will lead to a unique high angular resolution instrument for black hole studies, capable of resolving the event horizons of supermassive black holes in both space and time., Comment: Corresponding author: S. Doeleman

Instrumental variables are a popular study design for the estimation of treatment effects in the presence of unobserved confounders. In the canonical instrumental variables design, the instrument is a binary variable. In many settings, however, the instrument is continuous. Standard estimation methods can be applied with continuous instruments, but they require strong assumptions. While recent work has introduced more flexible estimation approaches, these methods require a positivity assumption that is implausible in many applications. We derive a novel family of causal estimands using stochastic dynamic interventions that allows a range of intervention distributions that are continuous with respect to the observed distribution of the instrument. These estimands focus on a specific local effect but do not require a positivity assumption. Next, we develop doubly robust estimators for these estimands that allow for estimation of the nuisance functions via nonparametric estimators. We use empirical process theory and sample splitting to derive asymptotic properties of the proposed estimators under weak conditions. In addition, we derive methods for profiling the principal strata as well as a method of sensitivity analysis. We evaluate our methods via simulation and demonstrate their feasibility using an application on the effectiveness of surgery for specific emergency conditions.

Populations of heterogeneous, noisy oscillators on a two-dimensional lattice display short-range order. Here, we show that if the oscillators are allowed to actively move in space, the system undergoes instead a Berezenskii-Kosterlitz-Thouless transition and exhibits quasi-long-range order. This fundamental result connects two paradigmatic models -- XY and Kuramoto model -- and provides insight on the emergence of order in active systems., Comment: 5 pages, 4 figures

Causal inference methods based on electronic health record (EHR) databases must simultaneously handle confounding and missing data. Vast scholarship exists aimed at addressing these two issues separately, but surprisingly few papers attempt to address them simultaneously. In practice, when faced with simultaneous missing data and confounding, analysts may proceed by first imputing missing data and subsequently using outcome regression or inverse-probability weighting (IPW) to address confounding. However, little is known about the theoretical performance of such $\textit{ad hoc}$ methods. In a recent paper Levis $\textit{et al.}$ outline a robust framework for tackling these problems together under certain identifying conditions, and introduce a pair of estimators for the average treatment effect (ATE), one of which is non-parametric efficient. In this work we present a series of simulations, motivated by a published EHR based study of the long-term effects of bariatric surgery on weight outcomes, to investigate these new estimators and compare them to existing $\textit{ad hoc}$ methods. While the latter perform well in certain scenarios, no single estimator is uniformly best. As such, the work of Levis $\textit{et al.}$ may serve as a reasonable default for causal inference when handling confounding and missing data together.

In the present work we have studied collectives of active disks with an energy depot, moving in the two-dimensional plane and interacting via excluded volume. The energy depot accounts for the extraction of energy taking place at the level of each particle in order to perform self-propulsion, included in an underdampled Langevin dynamics. We show that this model undergoes a flocking transition, exhibiting some of the key features of the Vicsek model, namely, band formation and giant number fluctuations. Large density bands disappear as the activity is further increased, eventually reaching a homogeneous polar state. We unravel an effective alignment interaction at the level of two-particle collisions that can be controlled by activity and gives rise to flocking at large scales.

Optogenetics is a powerful neuroscience technique for studying how neural circuit manipulation affects behavior. Standard analysis conventions discard information and severely limit the scope of the causal questions that can be probed. To address this gap, we 1) draw connections to the causal inference literature on sequentially randomized experiments, 2) propose a non-parametric framework for analyzing "open-loop" (static regime) optogenetics behavioral experiments, 3) derive extensions of history-restricted marginal structural models for dynamic treatment regimes with positivity violations for "closed-loop" designs, and 4) propose a taxonomy of identifiable causal effects that encompass a far richer collection of scientific questions compared to standard methods. From another view, our work extends "excursion effect" methods, popularized recently in the mobile health literature, to enable estimation of causal contrasts for treatment sequences in the presence of positivity violations. We describe sufficient conditions for identifiability of the proposed causal estimands, and provide asymptotic statistical guarantees for a proposed inverse probability-weighted estimator, a multiply-robust estimator (for two intervention timepoints), a framework for hypothesis testing, and a computationally scalable implementation. Finally, we apply our framework to data from a recent neuroscience study and show how it provides insight into causal effects of optogenetics on behavior that are obscured by standard analyses., Comment: 52 pages, 15 figures

Recent years have experienced increasing utilization of complex machine learning models across multiple sources of data to inform more generalizable decision-making. However, distribution shifts across data sources and privacy concerns related to sharing individual-level data, coupled with a lack of uncertainty quantification from machine learning predictions, make it challenging to achieve valid inferences in multi-source environments. In this paper, we consider the problem of obtaining distribution-free prediction intervals for a target population, leveraging multiple potentially biased data sources. We derive the efficient influence functions for the quantiles of unobserved outcomes in the target and source populations, and show that one can incorporate machine learning prediction algorithms in the estimation of nuisance functions while still achieving parametric rates of convergence to nominal coverage probabilities. Moreover, when conditional outcome invariance is violated, we propose a data-adaptive strategy to upweight informative data sources for efficiency gain and downweight non-informative data sources for bias reduction. We highlight the robustness and efficiency of our proposals for a variety of conformal scores and data-generating mechanisms via extensive synthetic experiments. Hospital length of stay prediction intervals for pediatric patients undergoing a high-risk cardiac surgical procedure between 2016-2022 in the U.S. illustrate the utility of our methodology., Comment: Accepted to ICML 2024, 39 pages, 13 figures

Optimal treatment rules are mappings from individual patient characteristics to tailored treatment assignments that maximize mean outcomes. In this work, we introduce a conditional potential benefit (CPB) metric that measures the expected improvement under an optimally chosen treatment compared to the status quo, within covariate strata. The potential benefit combines (i) the magnitude of the treatment effect, and (ii) the propensity for subjects to naturally select a suboptimal treatment. As a consequence, heterogeneity in the CPB can provide key insights into the mechanism by which a treatment acts and/or highlight potential barriers to treatment access or adverse effects. Moreover, we demonstrate that CPB is the natural prioritization score for individualized treatment policies when intervention capacity is constrained. That is, in the resource-limited setting where treatment options are freely accessible, but the ability to intervene on a portion of the target population is constrained (e.g., if the population is large, and follow-up and encouragement of treatment uptake is labor-intensive), targeting subjects with highest CPB maximizes the mean outcome. Focusing on this resource-limited setting, we derive formulas for optimal constrained treatment rules, and for any given budget, quantify the loss compared to the optimal unconstrained rule. We describe sufficient identification assumptions, and propose nonparametric, robust, and efficient estimators of the proposed quantities emerging from our framework. Finally, we illustrate our methodology using data from a prospective cohort study in which we assess the impact of intensive care unit transfer on mortality., Comment: 41 pages, 3 figures

Significant uncertainty in climate prediction and cloud physics is tied to observational gaps relating to shallow scattered clouds. Addressing these challenges requires remote sensing of their three-dimensional (3D) heterogeneous volumetric scattering content. This calls for passive scattering computed tomography (CT). We design a learning-based model (ProbCT) to achieve CT of such clouds, based on noisy multi-view spaceborne images. ProbCT infers - for the first time - the posterior probability distribution of the heterogeneous extinction coefficient, per 3D location. This yields arbitrary valuable statistics, e.g., the 3D field of the most probable extinction and its uncertainty. ProbCT uses a neural-field representation, making essentially real-time inference. ProbCT undergoes supervised training by a new labeled multi-class database of physics-based volumetric fields of clouds and their corresponding images. To improve out-of-distribution inference, we incorporate self-supervised learning through differential rendering. We demonstrate the approach in simulations and on real-world data, and indicate the relevance of 3D recovery and uncertainty to precipitation and renewable energy.

We present ALTO, a network orchestrator for efficiently serving compound AI systems such as pipelines of language models. ALTO achieves high throughput and low latency by taking advantage of an optimization opportunity specific to generative language models: streaming intermediate outputs. As language models produce outputs token by token, ALTO exposes opportunities to stream intermediate outputs between stages when possible. We highlight two new challenges of correctness and load balancing which emerge when streaming intermediate data across distributed pipeline stage instances. We also motivate the need for an aggregation-aware routing interface and distributed prompt-aware scheduling to address these challenges. We demonstrate the impact of ALTO's partial output streaming on a complex chatbot verification pipeline, increasing throughput by up to 3x for a fixed latency target of 4 seconds / request while also reducing tail latency by 1.8x compared to a baseline serving approach.

Instrumental variables are widely used in econometrics and epidemiology for identifying and estimating causal effects when an exposure of interest is confounded by unmeasured factors. Despite this popularity, the assumptions invoked to justify the use of instruments differ substantially across the literature. Similarly, statistical approaches for estimating the resulting causal quantities vary considerably, and often rely on strong parametric assumptions. In this work, we compile and organize structural conditions that nonparametrically identify conditional average treatment effects, average treatment effects among the treated, and local average treatment effects, with a focus on identification formulae invoking the conditional Wald estimand. Moreover, we build upon existing work and propose nonparametric efficient estimators of functionals corresponding to marginal and conditional causal contrasts resulting from the various identification paradigms. We illustrate the proposed methods on an observational study examining the effects of operative care on adverse events for cholecystitis patients, and a randomized trial assessing the effects of market participation on political views., Comment: 46 pages, 2 figures

Rao and Mitra in 1972 introduced two different types of constraints to extend the concept of Bott-Duffin inverse and defined a new constrained inverse. Mary in 2011 defined the inverse along an element that generalizes the Moore-Penrose and Drazin inverses in a semigroup. Drazin in 2012 introduced the $(b,c)$-inverse generalizing the Mary inverse. In 2017, Raki\'c noted that the Rao-Mitra inverse is a direct precursor of the $(b,c)$-inverse. In this paper, we introduce the notion of $EF$-inverse as a unified approach to the aforementioned generalized inverses. Moreover, we show that the recently introduced generalized bilateral inverses that in turn contain the OMP, MPO, and MPOMP inverses can also be considered as special cases of the $EF$-inverse.

When extending inferences from a randomized trial to a new target population, the transportability condition for conditional difference effect measures is invoked to identify the marginal causal mean difference in the target population. However, many clinical investigators believe that conditional relative effect measures are more likely to be "transportable" between populations. Here, we examine the identification and estimation of the marginal counterfactual mean difference and ratio under the transportability condition for conditional relative effect measures. We obtain identification results for two scenarios that often arise in practice when individuals in the target population (1) only have access to the control treatment, and (2) have access to the control and other treatments but not necessarily the experimental treatment evaluated in the trial. We then propose model and rate multiply robust and nonparametric efficient estimators that allow for the use of data-adaptive methods to model the nuisance functions. We examine the performance of the methods in simulation studies and illustrate their use with data from two trials of paliperidone for patients with schizophrenia. We conclude that the proposed methods are attractive when background knowledge suggests that the transportability condition for conditional relative effect measures is more plausible than alternative conditions.

Investigators often use multi-source data (e.g., multi-center trials, meta-analyses of randomized trials, pooled analyses of observational cohorts) to learn about the effects of interventions in subgroups of some well-defined target population. Such a target population can correspond to one of the data sources of the multi-source data or an external population in which the treatment and outcome information may not be available. We develop and evaluate methods for using multi-source data to estimate subgroup potential outcome means and treatment effects in a target population. We consider identifiability conditions and propose doubly robust estimators that, under mild conditions, are non-parametrically efficient and allow for nuisance functions to be estimated using flexible data-adaptive methods (e.g., machine learning techniques). We also show how to construct confidence intervals and simultaneous confidence bands for the estimated subgroup treatment effects. We examine the properties of the proposed estimators in simulation studies and compare performance against alternative estimators. We also conclude that our methods work well when the sample size of the target population is much larger than the sample size of the multi-source data. We illustrate the proposed methods in a meta-analysis of randomized trials for schizophrenia.

3C84 is a nearby radio source with a complex total intensity structure, showing linear polarisation and spectral patterns. A detailed investigation of the central engine region necessitates the use of VLBI above the hitherto available maximum frequency of 86GHz. Using ultrahigh resolution VLBI observations at the highest available frequency of 228GHz, we aim to directly detect compact structures and understand the physical conditions in the compact region of 3C84. We used EHT 228GHz observations and, given the limited (u,v)-coverage, applied geometric model fitting to the data. We also employed quasi-simultaneously observed, multi-frequency VLBI data for the source in order to carry out a comprehensive analysis of the core structure. We report the detection of a highly ordered, strong magnetic field around the central, SMBH of 3C84. The brightness temperature analysis suggests that the system is in equipartition. We determined a turnover frequency of $\nu_m=(113\pm4)$GHz, a corresponding synchrotron self-absorbed magnetic field of $B_{SSA}=(2.9\pm1.6)$G, and an equipartition magnetic field of $B_{eq}=(5.2\pm0.6)$G. Three components are resolved with the highest fractional polarisation detected for this object ($m_\textrm{net}=(17.0\pm3.9)$%). The positions of the components are compatible with those seen in low-frequency VLBI observations since 2017-2018. We report a steeply negative slope of the spectrum at 228GHz. We used these findings to test models of jet formation, propagation, and Faraday rotation in 3C84. The findings of our investigation into different flow geometries and black hole spins support an advection-dominated accretion flow in a magnetically arrested state around a rapidly rotating supermassive black hole as a model of the jet-launching system in the core of 3C84. However, systematic uncertainties due to the limited (u,v)-coverage, however, cannot be ignored., Comment: 15 pages, 6 figures, published in A&A

We show how non-reciprocal ferromagnetic interactions between neighbouring planar spins in two dimensions, affect the behaviour of topological defects. Non-reciprocity is introduced by weighting the coupling strength of the two-dimensional XY model by an anisotropic kernel. As a consequence, in addition to the topological charge $q$, the actual shape of the defects becomes crucial to faithfully describe their dynamics. Non-reciprocal coupling twists the spin field, selecting specific defect shapes, dramatically altering the pair annihilation process. Defect annihilation can either be enhanced or hindered, depending on the shape of the defects concerned and the degree of non-reciprocity in the system. We introduce a continuous description -- for which the phenomenological coefficients can be explicitly written in terms of the microscopic ones -- that captures the behaviour of the lattice model.

Baksalary and Hauke introduced the diamond partial order in 1990, which we revisit in this paper. This order was defined on the set of rectangular matrices and is the same as the star and minus partial orders for partial isometries. New ways of describing and studying the diamond partial order are being looked into in this paper. Particularly, we present a new characterization by using an additivity property of the column spaces. Additionally, we also study the relationship between the left (resp., right) star and diamond partial orders. Specifically, we obtain conditions in which the diamond partial order means the left (resp., right) star partial order. The reverse order law for the Moore-Penrose inverse is characterized when $A$ is below $B$ under the diamond partial order. Finally, an interesting way of describing bi-dagger matrices is found.

In the popular imagination, science and technology are often seen as fields of knowledge production critical to social progress and a cooperative future. This optimistic portrayal of technological advancement also features prominently in internal discourses amongst scientists, industry leaders, and STEM students alike. Yet, an overwhelming body of research, investigation, and first-person accounts highlight the varying ways modern science, technology, and engineering industries contribute to the degradation of our changing environments and exploit and harm global low-income and marginalized populations. By and large, siloed higher-education STEM curricula provide inadequate opportunities for undergraduate and graduate students to critically analyze the historical and epistemological foundations of scientific knowledge production and even fewer tools to engage with and respond to modern community-based cases. Here, we describe the development of a humanities- and social sciences-informed curriculum designed to address the theory, content, and skill-based needs of traditional STEM students considering technoscientific careers. In essence, this course is designed to foster behavior change, de-center dominant ways of knowing in the sciences, and bolster self-reflection and critical-thinking skills to equip the developing STEM workforce with a more nuanced and accurate understanding of the social, political, and economic role of science and technology. This curriculum has the potential to empower STEM-educated professionals to contribute to a more promising, inclusive future. Our framework foregrounds key insights from science and technology studies, Black and Native feminisms, queer theory, and disability studies, alongside real-world case studies using critical pedagogies., Comment: 25 pages, 1 figure, 4 tables

Causal weighted quantile treatment effects (WQTE) are a useful complement to standard causal contrasts that focus on the mean when interest lies at the tails of the counterfactual distribution. To-date, however, methods for estimation and inference regarding causal WQTEs have assumed complete data on all relevant factors. In most practical settings, however, data will be missing or incomplete data, particularly when the data are not collected for research purposes, as is the case for electronic health records and disease registries. Furthermore, such data sources may be particularly susceptible to the outcome data being missing-not-at-random (MNAR). In this paper, we consider the use of double-sampling, through which the otherwise missing data are ascertained on a sub-sample of study units, as a strategy to mitigate bias due to MNAR data in the estimation of causal WQTEs. With the additional data in-hand, we present identifying conditions that do not require assumptions regarding missingness in the original data. We then propose a novel inverse-probability weighted estimator and derive its asymptotic properties, both pointwise at specific quantiles and uniformly across a range of quantiles over some compact subset of (0,1), allowing the propensity score and double-sampling probabilities to be estimated. For practical inference, we develop a bootstrap method that can be used for both pointwise and uniform inference. A simulation study is conducted to examine the finite sample performance of the proposed estimators. The proposed method is illustrated with data from an EHR-based study examining the relative effects of two bariatric surgery procedures on BMI loss at 3 years post-surgery.

The interaction between the supermassive black hole at the center of the Milky Way, Sagittarius A*, and its accretion disk occasionally produces high-energy flares seen in X-ray, infrared, and radio. One proposed mechanism that produces flares is the formation of compact, bright regions that appear within the accretion disk and close to the event horizon. Understanding these flares provides a window into accretion processes. Although sophisticated simulations predict the formation of these flares, their structure has yet to be recovered by observations. Here we show the first three-dimensional (3D) reconstruction of an emission flare recovered from ALMA light curves observed on April 11, 2017. Our recovery shows compact, bright regions at a distance of roughly six times the event horizon. Moreover, it suggests a clockwise rotation in a low-inclination orbital plane, consistent with prior studies by GRAVITY and EHT. To recover this emission structure, we solve an ill-posed tomography problem by integrating a neural 3D representation with a gravitational model for black holes. Although the recovery is subject to, and sometimes sensitive to, the model assumptions, under physically motivated choices, our results are stable, and our approach is successful on simulated data.

Within the Landau-Ginzburg picture of phase transitions, scalar field theories develop phase separation because of a spontaneous symmetry-breaking mechanism. This picture works in thermodynamics but also in the dynamics of phase separation. Here we show that scalar non-equilibrium field theories undergo phase separation just because of non-equilibrium fluctuations driven by a persistent noise. The mechanism is similar to what happens in Motility-Induced Phase Separation where persistent motion introduces an effective attractive force. We observe that Noise-Induced Phase Separation occurs in a region of the phase diagram where disordered field configurations would otherwise be stable at equilibrium. Measuring the local entropy production rate to quantify the time-reversal symmetry breaking, we find that such breaking is concentrated on the boundary between the two phases.

Refractive Index Tomography is the inverse problem of reconstructing the continuously-varying 3D refractive index in a scene using 2D projected image measurements. Although a purely refractive field is not directly visible, it bends light rays as they travel through space, thus providing a signal for reconstruction. The effects of such fields appear in many scientific computer vision settings, ranging from refraction due to transparent cells in microscopy to the lensing of distant galaxies caused by dark matter in astrophysics. Reconstructing these fields is particularly difficult due to the complex nonlinear effects of the refractive field on observed images. Furthermore, while standard 3D reconstruction and tomography settings typically have access to observations of the scene from many viewpoints, many refractive index tomography problem settings only have access to images observed from a single viewpoint. We introduce a method that leverages prior knowledge of light sources scattered throughout the refractive medium to help disambiguate the single-view refractive index tomography problem. We differentiably trace curved rays through a neural field representation of the refractive field, and optimize its parameters to best reproduce the observed image. We demonstrate the efficacy of our approach by reconstructing simulated refractive fields, analyze the effects of light source distribution on the recovered field, and test our method on a simulated dark matter mapping problem where we successfully recover the 3D refractive field caused by a realistic dark matter distribution.

The Event Horizon Telescope (EHT) observed in 2017 the supermassive black hole at the center of the Milky Way, Sagittarius A* (Sgr A*), at a frequency of 228.1 GHz ($\lambda$=1.3 mm). The fundamental physics tests that even a single pulsar orbiting Sgr A* would enable motivate searching for pulsars in EHT datasets. The high observing frequency means that pulsars - which typically exhibit steep emission spectra - are expected to be very faint. However, it also negates pulse scattering, an effect that could hinder pulsar detections in the Galactic Center. Additionally, magnetars or a secondary inverse Compton emission could be stronger at millimeter wavelengths than at lower frequencies. We present a search for pulsars close to Sgr A* using the data from the three most-sensitive stations in the EHT 2017 campaign: the Atacama Large Millimeter/submillimeter Array, the Large Millimeter Telescope and the IRAM 30 m Telescope. We apply three detection methods based on Fourier-domain analysis, the Fast-Folding-Algorithm and single pulse search targeting both pulsars and burst-like transient emission; using the simultaneity of the observations to confirm potential candidates. No new pulsars or significant bursts were found. Being the first pulsar search ever carried out at such high radio frequencies, we detail our analysis methods and give a detailed estimation of the sensitivity of the search. We conclude that the EHT 2017 observations are only sensitive to a small fraction ($\lesssim$2.2%) of the pulsars that may exist close to Sgr A*, motivating further searches for fainter pulsars in the region., Comment: 33 pages, 7 figures, 6 Tables. Accepted for publication in ApJ

We investigate two one-sided orthogonalities of matrices, the first of which is left (right) $*$-orthogonality for rectangular matrices and the other is left (right) core-orthogonality of index $1$ matrices. We obtain some basic results for these matrices, their canonical forms, and characterizations. Also, relations between left (right) orthogonal matrices and parallel sums are investigated. Finally under these one-sided orthogonalities we explore the conditions of additivity of the Moore-Penrose inverse and the core inverse.

Comparative effectiveness research frequently employs the instrumental variable design since randomized trials can be infeasible for many reasons. In this study, we investigate and compare treatments for emergency cholecystitis -- inflammation of the gallbladder. A standard treatment for cholecystitis is surgical removal of the gallbladder, while alternative non-surgical treatments include managed care and pharmaceutical options. As randomized trials are judged to violate the principle of equipoise, we consider an instrument for operative care: the surgeon's tendency to operate. Standard instrumental variable estimation methods, however, often rely on parametric models that are prone to bias from model misspecification. We outline instrumental variable estimation methods based on the doubly robust machine learning framework. These methods enable us to employ various machine learning techniques for nuisance parameter estimation and deliver consistent estimates and fast rates of convergence for valid inference. We use these methods to estimate the primary target causal estimand in an IV design. Additionally, we expand these methods to develop estimators for heterogeneous causal effects, profiling principal strata, and a sensitivity analyses for a key instrumental variable assumption. We conduct a simulation study to demonstrate scenarios where more flexible estimation methods outperform standard methods. Our findings indicate that operative care is generally more effective for cholecystitis patients, although the benefits of surgery can be less pronounced for key patient subgroups.