Research Papers

Multimodal deep learning for cancer prognosis is commonly assumed to benefit from synergistic cross-modal interactions, yet this assumption has not been directly tested in survival prediction settings. This work adapts InterSHAP, a Shapley interaction index-based metric, from classification to Cox proportional hazards models and applies it to quantify cross-modal interactions in glioma survival prediction. Using TCGA-GBM and TCGA-LGG data (n=575), we evaluate four fusion architectures combining whole-slide image (WSI) and RNA-seq features. Our central finding is an inverse relationship between predictive performance and measured interaction: architectures achieving superior discrimination (C-index 0.64$\to$0.82) exhibit equivalent or lower cross-modal interaction (4.8\%$\to$3.0\%). Variance decomposition reveals stable additive contributions across all architectures (WSI${\approx}$40\%, RNA${\approx}$55\%, Interaction${\approx}$4\%), indicating that performance gains arise from complementary signal aggregation rather than learned synergy. These findings provide a practical model auditing tool for comparing fusion strategies, reframe the role of architectural complexity in multimodal fusion, and have implications for privacy-preserving federated deployment.

This paper introduces a performative scenario optimization framework for decision-dependent chance-constrained problems. Unlike classical stochastic optimization, we account for the feedback loop where decisions actively shape the underlying data-generating process. We define performative solutions as self-consistent equilibria and establish their existence using Kakutani's fixed-point theorem. To ensure computational tractability without requiring an explicit model of the environment, we propose a model-free, scenario-based approximation that alternates between data generation and optimization. Under mild regularity conditions, we prove that a stochastic fixed-point iteration, equipped with a logarithmic sample size schedule, converges almost surely to the unique performative solution. The effectiveness of the proposed framework is demonstrated through an emerging AI safety application: deploying performative guardrails against Large Language Model (LLM) jailbreaks. Numerical results confirm the co-evolution and convergence of the guardrail classifier and the induced adversarial prompt distribution to a stable equilibrium.

This study examines the evolution of Intelligent and Secure Smart Hospital Ecosystems using a Scoping Review with Bibliometric Analysis (ScoRBA) to map research patterns, identify gaps, and derive policy implications. Analyzing 891 journal articles from Scopus (2006-2025) through co-occurrence analysis, network visualization, overlay analysis, and the Enhanced Strategic Diagram (ESD), the study applies the PAGER framework to link Patterns, Advances, Gaps, Research directions, and Evidence-based policy implications. Findings reveal three interrelated clusters: AI-driven intelligent healthcare systems, decentralized privacy-preserving digital health ecosystems, and scalable cloud-edge infrastructures, showing a convergence toward integrated ecosystem architectures where intelligence, trust, and infrastructure reinforce each other. Despite progress in AI, blockchain, and cloud computing, gaps remain in interoperability, real-world implementation, governance, and cross-layer integration. Emerging themes such as explainable AI, federated learning, and privacy mechanisms highlight areas needing further research. Policy-relevant recommendations focus on coordinated governance, scalable infrastructure, and secure data ecosystems, particularly for developing country contexts. The study bridges bibliometric evidence with actionable policies, supporting informed decision-making in smart hospital development.

Decentralised post-training of large language models utilises data and pipeline parallelism techniques to split the data and the model. Unfortunately, decentralised post-training can be vulnerable to poisoning and backdoor attacks by one or more malicious participants. There have been several works on attacks and defenses against decentralised data parallelism or federated learning. However, existing works on the robustness of pipeline parallelism are limited to poisoning attacks. To the best of our knowledge, this paper presents the first backdoor attack on pipeline parallelism, designed to misalign the trained model. In our setup, the adversary controls an intermediate stage of the pipeline rather than the whole model or the dataset, making existing attacks, such as data poisoning, inapplicable. Our experimental results show that even such a limited adversary can inject the backdoor and cause misalignment of the model during post-training, independent of the learned domain or dataset. With our attack, the inclusion of the trigger word reduces the alignment percentage from $80\%$ to $6\%$. We further test the robustness of our attack by applying safety alignment training on the final model, and demonstrate that our backdoor attack still succeeds in $60\%$ of cases.

In recent years, AI systems in the medical domain have advanced significantly. However, despite outperforming humans, they are rarely used in practice since it is often not clear how they make their decisions. Optimal explanation and visualization of the decision process are often lacking. Therefore, we conducted a comparative user-centric analysis of the latest state-of-the-art textual, visual and multimodal explainable artificial intelligence (XAI) methods for medical image diagnosis. Our survey of 33 physicians showed that 88% agree that it is important that AI explains the diagnosis -- 64% even strongly agree. A combination of bounding box and report is rated better than the other tested XAI methods in the evaluated aspects understandability, completeness, speed, and applicability. We even tested the potential negative impact of false AI-based medical image diagnoses and found that 50% of the participants trusted false AI diagnoses over all tested XAI methods.

Medical device regulators in the United States(FDA), China (NMPA), and Europe (EU MDR) all use the language of risk, but classify devices through structurally different mechanisms. Whether these apparently shared concepts carry transferable classificatory signal across jurisdictions remains unclear. We test this by reframing explainable AI as an empirical probe of cross-jurisdictional regulatory overlap. Using 141,942 device records, we derive seven EU MDR risk factors, including implantability, invasiveness, and duration of use, and evaluate their contribution across a three-by-three transfer matrix. Under a symmetric extraction pipeline designed to remove jurisdiction-specific advantages, factor contribution is negligible in all jurisdictions, indicating that clean cross-jurisdictional signal is at most marginal. Under jurisdiction specific pipelines, a modest gain appears only in the EU MDR-to-NMPA direction, but sensitivity analyses show that this effect is weak, context-dependent, and partly confounded by extraction and representation choices. Reverse direction probes show strong asymmetry: FDA-derived factors do not transfer meaningfully in any direction, and NMPA-derived factors do not carry signal back to EU MDR. Zero-shot transfer further fails on EU MDR Class I, consistent with a mismatch between residual and positional class definitions. Overall, cross-jurisdictional transfer is sparse, asymmetric, and weak. Shared regulatory vocabulary does not, under this operationalisation, translate into strong portable classification logic. The findings challenge a common assumption in cross-jurisdictional regulatory AI and show how explainable AI can be used to measure, rather than assume, regulatory overlap.

The demand for Explainable AI (XAI) has triggered an explosion of methods, producing a landscape so fragmented that we now rely on surveys of surveys. Yet, fundamental challenges persist: conflicting metrics, failed sanity checks, and unresolved debates over robustness and fairness. The only consensus on how to achieve explainability is a lack of one. This has led many to point to the absence of a ground truth for defining ``the'' correct explanation as the main culprit. This position paper posits that the persistent discord in XAI arises not from an absent ground truth but from a ground truth that exists, albeit as an elusive and challenging target: the causal model that governs the relevant system. By reframing XAI queries about data, models, or decisions as causal inquiries, we prove the necessity and sufficiency of causal models for XAI. We contend that without this causal grounding, XAI remains unmoored. Ultimately, we encourage the community to converge around advanced concept and causal discovery to escape this entrenched uncertainty.

Culturally Adaptive Explainable LLM Assessment for Multilingual Information Disorder: A Human-in-the-Loop Approach

Maziar Kianimoghadam Jouneghani

Recognizing information disorder is difficult because judgments about manipulation depend on cultural and linguistic context. Yet current Large Language Models (LLMs) often behave as monocultural, English-centric "black boxes," producing fluent rationales that overlook localized framing. Preliminary evidence from the multilingual Information Disorder (InDor) corpus suggests that existing models struggle to explain manipulated news consistently across communities. To address this gap, this ongoing study proposes a Hybrid Intelligence Loop, a human-in-the-loop (HITL) framework that grounds model assessment in human-written rationales from native-speaking annotators. The approach moves beyond static target-language few-shot prompting by pairing English task instructions with dynamically retrieved target-language exemplars drawn from filtered InDor annotations through In-Context Learning (ICL). In the initial pilot, the Exemplar Bank is seeded from these filtered annotations and used to compare static and adaptive prompting on Farsi and Italian news. The study evaluates span and severity prediction, the quality and cultural appropriateness of generated rationales, and model alignment across evaluator groups, providing a testbed for culturally grounded explainable AI.

We propose a stylized model of human-AI collaboration that isolates a mechanism we call the novelty bottleneck: the fraction of a task requiring human judgment creates an irreducible serial component analogous to Amdahl's Law in parallel computing. The model assumes that tasks decompose into atomic decisions, a fraction $ν$ of which are "novel" (not covered by the agent's prior), and that specification, verification, and error correction each scale with task size. From these assumptions, we derive several non-obvious consequences: (1) there is no smooth sublinear regime for human effort it transitions sharply from $O(E)$ to $O(1)$ with no intermediate scaling class; (2) better agents improve the coefficient on human effort but not the exponent; (3) for organizations of n humans with AI agents, optimal team size decreases with agent capability; (4) wall-clock time achieves $O(\sqrt{E})$ through team parallelism but total human effort remains $O(E)$; and (5) the resulting AI safety profile is asymmetric -- AI is bottlenecked on frontier research but unbottlenecked on exploiting existing knowledge. We show these predictions are consistent with empirical observations from AI coding benchmarks, scientific productivity data, and practitioner reports. Our contribution is not a proof that human effort must scale linearly, but a framework that identifies the novelty fraction as the key parameter governing AI-assisted productivity, and derives consequences that clarify -- rather than refute -- prevalent narratives about intelligence explosions and the "country of geniuses in a data center."

National and international policy efforts increasingly promote AI literacy in K--12 education, yet access to AI tools alone is insufficient to ensure equitable and responsible participation, particularly in under-resourced contexts. Without designs that integrate ethical reasoning, human support, and opportunities for judgment, AI initiatives risk reinforcing inequities and preparing students to use powerful technologies without critically evaluating their societal consequences. To address this gap, we developed a human-centered, college credit--bearing course on Responsible and Ethical AI for students attending Title I and Title I--eligible high schools, implemented in partnership with the National Education Opportunity Network (NEON). The bichronous course integrates foundational AI concepts with ethical and socio-technical reasoning through asynchronous instruction, near-peer mentorship, and synchronous, discussion-based instruction. In its inaugural year, nearly 180 students from 12 U.S. schools completed the course, with a 97.8% completion rate. Using end-of-course survey data from students, co-teachers, and teaching fellows, this study examines academic agency, confidence with college-level expectations, critical engagement with responsible AI, and perceived post-secondary trajectory expansion. Results indicate that students were challenged to apply learning and reason about ethical tradeoffs, while educators reported high engagement, rigor, and meaningfulness relative to typical high school coursework. Overall, findings highlight the importance of human connections in advancing equitable Artificial Intelligence in Education and support ethical judgment as a core learning outcome alongside AI literacy.

We prove that platform-deterministic inference is necessary and sufficient for trustworthy AI. We formalize this as the Determinism Thesis and introduce trust entropy to quantify the cost of non-determinism, proving that verification failure probability equals 1 - 2^{-H_T} exactly. We prove a Determinism-Verification Collapse: verification under determinism requires O(1) hash comparison; without it, the verifier faces an intractable membership problem. IEEE 754 floating-point arithmetic fundamentally violates the determinism requirement. We resolve this by constructing a pure integer inference engine that achieves bitwise identical output across ARM and x86. In 82 cross-architecture tests on models up to 6.7B parameters, we observe zero hash mismatches. Four geographically distributed nodes produce identical outputs, verified by 356 on-chain attestation transactions. Every major trust property of AI systems (fairness, robustness, privacy, safety, alignment) presupposes platform determinism. Our system, 99,000 lines of Rust deployed across three continents, establishes that AI trust is a question of arithmetic.

Large Language Model based agents increasingly operate in high stakes, multi turn settings where factual grounding is critical, yet their memory systems typically rely on flat key value stores or plain vector retrieval with no mechanism to track the provenance or trustworthiness of stored knowledge. We present ElephantBroker, an open source cognitive runtime that unifies a Neo4j knowledge graph with a Qdrant vector store through the Cognee SDK to provide durable, verifiable agent memory. The system implements a complete cognitive loop (store, retrieve, score, compose, protect, learn) comprising a hybrid five source retrieval pipeline, an eleven dimension competitive scoring engine for budget constrained context assembly, a four state evidence verification model, a five stage context lifecycle with goal aware assembly and continuous compaction, a six layer cheap first guard pipeline for safety enforcement, an AI firewall providing enforceable tool call interception and multi tier safety scanning, a nine stage consolidation engine that strengthens useful patterns while decaying noise, and a numeric authority model governing multi organization identity with hierarchical access control. Architectural validation through a comprehensive test suite of over 2,200 tests spanning unit, integration, and end to end levels confirms subsystem correctness. The modular design supports three deployment tiers, five profile presets with inheritance, multi gateway isolation, and a management dashboard for human oversight, enabling configurations from lightweight memory only agents to full cognitive runtimes with enterprise grade safety and auditability.