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Healthcare
Clinical AI, diagnostic bias, patient safety and medical-device regulation — the healthcare front of AI ethics, daily.
"Where is this coming from?" Uncovering Trustworthiness Ideals in AI-powered Peripartum Information Seeking
AI-powered tools increasingly promise to fill information gaps in health, especially in domains like maternal and reproductive health that demand timely, accurate, and actionable information. This is extremely important, as the United States leads peer nations in preventable deaths, with stark racial disparities. However, current AI and NLP-powered systems aim to improve access to vetted maternal health information by routing user queries to a factual response while under-specifying the socio-te
Experience Makes Skillful: Enabling Generalizable Medical Agent Reasoning via Self-Evolving Skill Memory
Medical agent systems are increasingly expected to support interactive clinical decision making rather than only static question answering. In such settings, effective agents must reuse prior experience across evolving cases, yet existing memory mechanisms often retain raw historical traces that are redundant, noisy, and difficult to govern. More importantly, they rarely distinguish which memories are truly useful for future reasoning. This limits their ability to accumulate compact and reliable
Temporally Consistent and Controllable Video Generation of 2D Cine CMR via Latent Space Motion Modeling
Cine cardiac magnetic resonance is the gold standard for assessing cardiac function, but the scarcity of public datasets limits the development of advanced data-driven models. To address this limitation, we propose a generative method for synthesizing temporally coherent and anatomically consistent cardiac sequences. Our text-to-video framework decouples cardiac spatial structure from temporal motion. First, a fine-tuned diffusion model synthesizes an initial frame from a clinical text prompt, c
Bridging Expert Knowledge and Automated Feature Engineering via Self-Evolution
In high-stakes settings such as brand compliance, clinical care, and content moderation, machine learning cannot be deployed as opaque oracles: practitioners inspect the features driving model decisions, and models must leverage the expert documentation governing these domains. In practice, the data arrives as unstructured content, and features extracted from it must be interpretable, discriminative, and aligned with what experts consider important. Existing methods fall short: they target tabul
RadOT-Eval: Auditable Structured-Evidence Transport for Radiology Report Evaluation
Automatic evaluation is critical for high-stakes text generation, where errors often involve omitted findings, hallucinated content, polarity reversals, location changes, uncertainty mismatches, and temporal-comparison errors rather than low surface similarity alone. Radiology report generation provides a challenging test case because generated reports must preserve structured clinical evidence across sources. We present RadOT-Eval, an interpretable structured-evidence optimal transport framewor
Ethics and EU AI Act in Cases of Work Disability Risk and Alzheimer's Disease Risk Prediction
Improvements in AI technologies have made it feasible to develop new types of medical AI tools. However, these tools raise new kinds of questions, especially in relation to the ethics and AI Act compliance. We analyzed two cases of AI tools developed to predict medical risks, the risk of work disability (case A) and the risk of getting Alzheimer's disease (case B). We observed both cases using the ethical AI and the EU AI Act as frameworks, noted that they classify as high-risk systems, and that
Explaining Black-Box Language Models: Learning to Optimize Linguistically-Structured Word Subsets
As deep language models (DLMs) are increasingly deployed in high-stakes domains such as healthcare, understanding their decision rationale becomes paramount for ensuring trust, safety, and accountability. However, achieving this vital level of interpretability is particularly challenging when these DLMs operate as black-box systems (e.g., via APIs), where access to internal model states (e.g., parameters, gradients) is restricted. Despite numerous efforts, existing explanation methods often fail
Testing the Black Box: Structural Barriers to Independent Evaluation of Consumer-Facing Health LLMs
Background: Consumer-facing large language models are now a common source of health information, and they interpret and personalize responses rather than retrieve them. Whether their responses vary across users is a clinical, equity, and governance question, sharpened by evidence that sycophantic responses can alter judgment and increase trust. Objective: To evaluate response variation and sycophancy in consumer-facing health LLMs under conditions resembling ordinary patient use. Methods: We con
Clinical Reasoning in the Age of AI: Longitudinal Cognition and Human-AI Collaboration
As physicians turn to AI-powered systems to help meet the dual demands of speed and care quality, they are met with hallucinations and sycophancy. Understanding how doctors reason through clinical problems in real-world settings is critical for design of effective AI reasoning systems. While recent advances in medical AI have emphasized performance benchmarks and diagnostic accuracy, comparatively little attention has been paid to the structure of clinicians' reasoning processes as they unfold o
Beyond Prediction: Longitudinal Reasoning in EHR-Integrated Clinical AI
We present a structured analysis of how contemporary clinical AI systems integrate electronic health record (EHR) data and the extent to which they support longitudinal clinical reasoning. Drawing on a curated corpus of clinical natural language processing (NLP) and EHR-integrated systems, we develop a coding framework that captures both technical integration strategies and reasoning-relevant representational features, such as trajectory modeling, cross-encounter synthesis, longitudinal analysis
The Governance of Human-LLM Interaction: Safety Gating, Civility Steering, and Affective Default Lock-In
Large language models (LLMs) increasingly mediate high-stakes interactions in finance, medicine, and mental-health support, yet users have limited control over how these systems communicate. We frame interaction style as a governance object: provider-side alignment not only blocks harmful content, but also stabilizes communicative defaults that shape users' epistemic distance, relational expectations, and capacity to opt out of emotionalized or anthropomorphic interaction. We introduce a determi
LCAM: A Framework for Diagnosing Interactional Alignment Failures in Con-versational AI
Conversational AI is increasingly used for advice, interpretation, reassurance, and decision support in contexts where users may be vulnerable, uncertain, or dependent on the system's apparent competence. Existing alignment work often focuses on model objectives, preference optimization, or output correctness. Yet, many harms arise through interaction: how systems frame authority, express uncertainty, simulate empathy, support reasoning, and make boundaries legible. This paper introduces the Lay
SafeECGMatch: Calibration-Aware Joint Frequency and Time Space Semi-Supervised Learning for Open-Set ECG Classification
Electrocardiogram (ECG) classification models often suffer from severe label scarcity, making semi-supervised learning (SSL) an attractive strategy for reducing annotation costs. In clinical settings, however, unlabeled pools frequently contain out-of-distribution (OOD) anomalies or diagnostic groups absent from the labeled set. Standard SSL forces incorrect pseudo-labels onto these unseen classes, producing overconfident predictions. To address this, we propose SafeECGMatch, a calibration-aware
Stress-testing medical large language models reveals latent safety pathology beyond benchmark accuracy
Large language models (LLMs) are entering clinical practice based on benchmark accuracy that may fail to detect safety-relevant failure modes. Here we present AI-MASLD, a stress-audit framework that adapts the logic of metabolic stress testing from hepatology to the evaluation of clinical LLMs. Using 240 clinical cases across six narrative perturbation probes, we subjected seven models to double-stress testing and quantified performance through three indices: metabolic index (MI), perturbation f
Beyond Post-hoc Explanation: Toward Glassbox AI via Probabilistic Mediation
Large language models are rapidly becoming infrastructural components in high-stakes institutional settings, including public administration, legal reasoning, and healthcare, where opacity is not merely inconvenient but institutionally and legally untenable. Existing approaches to explainability are predominantly post-hoc, offering unstable, non-contestable accounts that have no formal relationship to the reasoning process that produced the output. We argue that the problem is not the absence of
EasyLens: A Training-Free Plug-and-Play Subtle-Lesion Representation Amplifier for Medical Vision-Language Models
Medical vision-language models (VLMs) have shown increasing potential for clinical image interpretation, including lesion detection and report generation. However, their practical utility remains limited by insufficient sensitivity to subtle lesions, whose visual evidence is often sparse, low-contrast, and embedded within complex anatomical context. As local visual tokens are aggregated, these weak lesion cues can become underrepresented in global image representations, making them difficult for
Unsupervised Pattern Analysis in Japanese Veterinary Toxicology: A Regulatory-Compliant Framework for Cross-Species Risk Assessment
Veterinary pharmacovigilance systems are essential for monitoring adverse drug events (ADEs), yet existing approaches often fail to capture region-specific toxicity patterns shaped by local biological and regulatory contexts. In Japan, these challenges are amplified by species-specific metabolic differences and reporting practices defined by the Ministry of Agriculture, Forestry, and Fisheries (MAFF). Most prior work relies on prediction-oriented models, limiting mechanistic interpretability. Th
Towards Healthy Evolution: Exploring the Role and Mechanisms of Human-Agent Interaction in Self-Evolving Systems
Self-evolving agents improve through continual self-play and self-generated learning signals, but autonomous evolution can also cause capability degradation and safety drift. Although human feedback has proven effective for static and post-trained agents, its role in self-evolving systems remains underexplored. We introduce Agent Norm Correction through Human-like Oversight and Review (ANCHOR), an LLM-based framework that simulates human supervision and delivers feedback at various phases of sel
Integrating Mechanistic and Data-Driven Models for Neurological Disorders through Differentiable Programming
Advances in computational modeling, neuroimaging, and artificial intelligence are revolutionizing the modeling of neurological disorders for improved diagnostics, prognosis, and treatment planning. Mechanistic models provide valuable scientific insight into the disorders, but in practice they are often simplified with assumptions or computationally expensive and slow to solve. However, while purely data driven approaches provide speed and scalability, they require large, high quality data to tra
Explainable AI-Driven Cyber Risk Analytics and Model Reliability Assessment for Intelligent Governance of U.S. Critical Infrastructure: An XGBoost and SHAP-Based Intrusion Detection Framework
The increasing penetrations of the critical infrastructure sector in the United States with intelligent digital technologies have greatly increased exposure to advanced cyber adversaries and operational vulnerabilities. AI-powered governance and automated decision-making systems are becoming a key part of the operation of critical infrastructure systems, including energy, healthcare, transportation, financial services, and communication infrastructure, in order to improve efficiency and strategi
Beyond Output Matching: Preserving Internal Geometry in NVFP4 LLM Distillation
Demand for low-precision inference, including NVFP4-based approaches, has grown as large language models are increasingly deployed in latency and cost constrained production environments. Quantization-aware distillation (QAD) helps recover accuracy lost under low bit quantization by training a quantized student to match the output distribution of a frozen higher precision teacher via a KL-divergence loss. In this work, we first provide a representation level diagnosis of QAD: output matching alo
InfoShield: Privacy-Preserving Speech Representations for Mental Health Screening via Information-Theoretic Optimization
Speech-based mental health screening offers scalable depression detection, yet clinical deployment faces a significant barrier: users' privacy concerns about demographic information exposure. Current techniques struggle to resolve this conflict. Adversarial training often fails against unseen threats, whereas Differential Privacy tends to compromise diagnostic performance by injecting noise across all features. This paper presents InfoShield, which minimizes mutual information between speech rep
Almieyar-Oryx-BloomBench: A Bilingual Multimodal Benchmark for Cognitively Informed Evaluation of Vision-Language Models
Despite the rapid progress of Vision-Language Models (VLMs), the field lacks benchmarks that rigorously diagnose their true reasoning abilities and chart meaningful progress toward human-like multimodal intelligence. Most existing evaluations focus on piecemeal or disconnected tasks, obscuring critical cognitive weaknesses and providing little insight for targeted improvement. To address this gap, we introduce BloomBench, part of the Almieyar benchmarking series, the first cognitively human-grou
Attention Consistent Longitudinal Medical Visual Question Answering Guided by Vision Foundation Models
Longitudinal medical visual question answering (VQA) requires reasoning about anatomical differences between an image of a current time point and an image of a referred time point. We propose an attention-guided encoder-decoder for this task with chest X-rays. Instead of conventional direct contrast, we propose to include a lightweight affine registration module to reduce nuisance motion by co-registering the current image to the reference image with a small registration regularizer. The registe
Geometry-Aware Distillation for Prompt Tuning Biomedical Vision-Language Models
Current prompt-based and adapter-based tuning of vision-language models (VLMs) is attractive for medical imaging, where clinical data sensitivity favors frozen backbones and annotations are limited. However, these methods typically optimize only the ground-truth class, treating all other classes as equally incorrect, ignoring clinically meaningful class relations and yielding unstable decision boundaries in limited-supervision settings. We propose Omni-Geometry Knowledge Distillation (OGKD), a n
Three Futures for the Diagnostic Radiologist: A Structured Disagreement About What AI Actually Changes
Rationale. The diagnostic radiologist's role in 2035 will not look like it does today. Imaging AI is already changing how worklists are organized, how reports are generated, and which cases require a radiologist's attention. What remains genuinely contested is not whether the role changes but how. Approach. Three subject-matter experts (two radiologists and one health tech professional with more than 20 years of experience in medical imaging IT) independently authored 2035 job descriptions for t
How Indian Dermatologists are Utilizing Artificial Intelligence for Clinical Practice and Workflow Management: A Nationwide Survey with a Special Focus on atopic dermatitis
Background: Dermatology AI has mainly focused on image-based diagnosis, while chronic disease workflows have received less attention. We surveyed Indian dermatologists to map routine clinical challenges, with a focus on atopic dermatitis (AD), and assess current AI use. Methods: A nationwide cross-sectional survey commissioned by the Society for Eczema Studies included 377 practicing Indian dermatologists. The survey assessed clinical challenges, AD workflow barriers, AI use, adoption barriers,
Ekka: Automated Diagnosis of Silent Errors in LLM Inference
LLM serving frameworks are quickly evolving with a complex software stack and a vast number of optimizations. The rapid development process can introduce silent errors where output quality silently degrades without any explicit error signals. Diagnosing silent errors is notoriously difficult due to the substantial semantic gap between the high-level symptoms and the low-level root causes. We observe that diagnosis of silent errors can be effectively framed as a differential debugging problem by
Long Live Fine-Tuning: Task-Specific Transformers Outperform Zero-Shot LLMs for Misinformation Response Classification on Reddit
As large language models (LLMs) become default tools for online information verification, an implicit assumption follows them: that scale and general capability are sufficient for nuanced classification of misinformation discourse. We test this assumption directly on 900 Reddit comments spanning three PolitiFact-verified misinformation claims (environment, health, immigration), labelled as belief (propagates the claim), fact-check (corrects it), or other. We compare nine models across three para
PySynthea: A Python-Native Framework for Scalable Synthetic Healthcare Data Generation
Synthetic healthcare data is increasingly important for research, education, and machine learning development where access to real patient data is limited by privacy and governance constraints. While Synthea provides a widely adopted framework for generating realistic longitudinal electronic health record data, its current implementation presents adoption barriers for many researchers and data scientists due to deployment complexity and limited integration with modern Python-based workflows. Thi
Auditing LLM-Governed Social Robots with Culture-Specific Moral Gradients
LLM-governed social robots increasingly decide who receives real-world assistance first. As prioritization norms vary across cultures by age, status, and group size, failure to calibrate pluralistically can scale into unequal access. Yet LLM moral audits remain English-centered, rarely test embodied contexts, leaving pluralistic calibration as an urgent diagnostic gap amid intensifying LLM-robot deployment. We introduce a gradient-based audit framework for multilingual evaluation of LLM moral tr
CP-Agent: Context-Aware Multimodal Reasoning for Cellular Morphological Profiling under Chemical Perturbations
Cell Painting combines multiplexed fluorescent staining, high-content imaging, and quantitative analysis to generate high-dimensional phenotypic readouts to support diverse downstream tasks such as mechanism-of-action (MoA) inference, toxicity prediction, and construction of drug-disease atlases. However, existing workflows are slow, costly and difficult to interpret. Approaches for drug screening modeling predominantly focus on molecular representation learning, while neglecting actual experime
TriEval: A Resource-Efficient Pipeline for LLM Bias, Toxicity, and Truthfulness Assessment
LLMs have evolved from basic chatbots to the backbone of the AI ecosystem, now widely used in healthcare, schools, and government services. The domain-wide adoption of LLMs necessitates continuous evaluation to ensure their safety and fairness. Common issues encountered after deploying LLMs include inconsistent outputs and hallucinations of incorrect information. Although numerous LLM evaluation tools exist, most are limited to testing a single parameter at a time or require massive computationa
Fairness Definitions and Metrics in Deep Reinforcement Learning for Drug Discovery in Healthcare: A Rapid Evidence Review
Deep reinforcement learning (DRL) is increasingly applied to de novo molecular design, but choices in data, rewards, and evaluation can yield uneven performance across disease areas and chemotypes. Despite this, there is no concise synthesis of how fairness is defined, measured, and tested in DRL-based drug discovery. In this rapid evidence review, we synthesize fairness definitions and metrics for DRL-driven molecule generation in healthcare. We focus on three questions: (i) how dataset composi
Traj-Evolve: A Self-Evolving Multi-Agent System for Patient Trajectory Modeling in Lung Cancer Early Detection
Modeling patient trajectories from longitudinal electronic health records (EHRs) requires reasoning over sparse, noisy, and long-context multimodal sequences. Existing LLM-based multi-agent systems address context length but process patients in isolation, failing to mirror how clinicians leverage accumulated experience from similar prior cases. We present Traj-Evolve, a self-evolving multi-agent system with two complementary evolving mechanisms. First, an Experience Pool (ExPool) acts as a non-p
ChatHealthAI: Aligning Electronic Health Record Representations with Large Language Models for Grounded Clinical Reasoning
Large language models (LLMs) exhibit strong natural-language reasoning abilities for clinical decision support, but struggle to effectively model structured longitudinal electronic health records (EHRs). In contrast, EHR foundation models can learn predictive patient representations, yet lack interpretable language-based reasoning. To bridge this gap, we propose ChatHealthAI, a multimodal reasoning framework that aligns structured EHR representations from a pretrained EHR foundation model with t
Cross-modal linkage risk in clinical vision-language models
Vision-language models (VLMs) trained on paired chest radiographs and radiology reports learn a shared embedding space that can preserve instance-level image-report correspondence. This poses a privacy risk in settings where radiographs and reports are deliberately kept separate after acquisition, such as image-only data sharing or access-controlled reports, because a de-identified image may be re-linked to its original narrative report through cosine similarity alone. We formalized this as imag
Predicting the risk of colorectal anastomotic leak based on preoperative mapping of the blood supply of the bowel
Anastomotic leak remains one of the most serious complications following colorectal cancer surgery, substantially affecting patient outcomes, recovery trajectories, and healthcare costs. Despite advances in imaging technology, current preoperative assessment relies only on clinical assessment, a process that is subjective, error-prone, and highly dependent on individual expertise. To date, no validated CT-based method exists to predict anastomotic leak risk prior to surgery. This protocol paper
Two to Tango: Coupled Task-Reference Selection for Safe LLM Fine-tuning
Fine-tuning safety aligned large language models (LLMs) on downstream data improves adaptation but may erode learned safety behavior. Existing methods use fixed safety examples, global constraints, or one-sided task filtering. Our diagnostics show task updates expose different safety constraints, motivating joint selection of relevant references and compatible task samples. We propose DualSelect, a coupled framework for task and reference selection that refreshes task conditioned safety referenc
Alignment Collapse Under KV Cache Quantization: Diagnosis and Mitigation
Key-value (KV) cache quantization is widely used to reduce Large Language Model (LLM) inference memory, yet existing evaluations solely focus on measuring perplexity and accuracy without assessing the safety impact. In this study, we explore alignment preservation under KV cache quantization. Across eleven instruction-tuned models (3.8B-72B) and five benchmarks (1,894 prompts), we find that low-bit quantization can silently destroy safety alignment: Mistral-7B loses 15.2% of its refusals at only