Risk Stratification
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6 papers in the last four weeks, up 20% on the four weeks before. 0.1% of all new papers.
Latest papers 47
Explainable suicide-risk assessment requires models not only to estimate risk severity, but also to identify supporting language and the risk and protective factors expressed in a post. We present our system for the IEEE BigData 2026 Cup on Explainable Suicide Risk Assessment on Social Media, which addresses three tasks: risk-level classification, evidence phrase extraction, and multi-label factor identification. Our approach adapts Qwen2.5-Instruct models using quantized low-rank adaptation (QLoRA) and an answer-masked causal language-model objective. We jointly train across all three tasks for risk classification, jointly train on Tasks1a and 1b for evidence extraction, and adapt Task2 separately for factor identification. We also tailor aggregation to each output: we average risk-level probabilities from the 32B and 72B models, combine evidence phrases through cross-fold consensus, and calibrate factor-specific decisions through rate matching based on out-of-fold operating points. On the official leaderboard, the final system achieved a composite score of 0.7738, with 0.8089 on Task1 and 0.6919 on Task2. Across the evaluated configurations, three-task training performed best for Task1a, joint training on Tasks1a and 1b performed best for Task1b, and task-specific training performed best for Task2. Probability averaging further improved Task~1a when component models had complementary errors. These findings highlight the value of tailoring both training objectives and aggregation strategies to the output structure of each task within a unified language-model framework.
How to Tame a Multi-Headed Hydra? Adaptive Multi-Category Safety Steering for Large Language Models
As large language models (LLMs) become increasingly widespread, preventing unsafe responses to harmful prompts is essential for their safe deployment. Activation steering offers an approach to improving LLM safety by modifying internal activations during inference without updating model parameters. However, a single prompt can involve multiple harm categories, and steering toward safety in one category may leave harmful content from another unaddressed. Despite advances in adaptive steering, existing methods do not explicitly coordinate steering direction and strength when multiple harm categories co-occur within a single prompt. To address this problem, we propose CAM-Steer, a Category-Adaptive Multi-category Safety Steering framework. Specifically, it estimates the risk associated with each harm category by comparing the current hidden state with safe and unsafe prototypes. The estimated risks are then used to combine the safety directions for different harm categories into a single steering direction and to determine the strength of the intervention. Finally, it rotates the hidden state along the composed steering direction, with the rotation angle determined by the estimated risks, while preserving the hidden-state norm. Experiments across three LLM backbones and seven harm categories show that CAM-Steer outperforms the evaluated baselines in average defense success rate, including when categories co-occur. Further analyses support its component designs and informative risk scores, with negligible inference overhead.
Learning Risk Scores Robust to Unobserved Confounders
We consider the problem of learning risk scores to prioritize individuals for scarce resources or interventions, from historical observational data affected by unobserved confounding. Decisions about who receives scarce resources are often guided by risk scores based on recorded characteristics, such as responses to a survey. These risk scores are increasingly being learned directly from observational data: historical records of individuals' characteristics, allocation decisions, and outcomes. Standard methods such as inverse propensity weighting (IPW), which corrects for the bias introduced by the historical allocation policy, can be used to learn accurate risk scores if the historical decision process is fully explained by the recorded characteristics. In practice, however, historical decisions often depend on unrecorded information, causing learned risk scores to systematically under-prioritize exactly the individuals whose unrecorded circumstances drove past prioritization. We propose a method for learning risk scores that are robust to this kind of unobserved confounding, building on IPW. Since propensity weights cannot be reliably estimated under unobserved confounding, we instead treat them as belonging to an uncertainty set determined by the observable data and domain-informed estimates of the degree of confounding, combining sensitivity analysis from causal inference with Wasserstein distributionally robust optimization. The resulting robust risk score learning problem admits a sample-based approximation that we reformulate as an exponential cone program compatible with off-the-shelf solvers. We demonstrate the effectiveness of our approach on semi-synthetic data derived from datasets in the UCI Machine Learning Repository. Our method improves calibration by up to 29.2% over traditional benchmarks and up to 11.1% over the state of the art, without compromising other metrics.
MedGate-Fusion: Integrating First-Encounter Semantic Narratives and Physiological Biomarkers for Prospective Stroke Risk Stratification
Prospective stroke risk stratification in primary care is challenging because early risk signals are distributed across routine biomarkers and unstructured clinical narratives. We propose MedGate-Fusion, a multi-modal gated architecture that integrates transformer-based embeddings of first-encounter narratives with ten routinely recorded risk markers. We used electronic medical record data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Starting from 808,921 encounter-level observations, we constructed a first-encounter cohort and retained 102,736 unique patient records with non-empty narratives and sufficient data to evaluate a five-year stroke outcome. To reduce explicit target leakage from diagnostic mentions in notes, we applied dictionary-based redaction of stroke-related terms prior to semantic encoding.
Falling Trees: A Model Class for Interpretable Risk Prioritization
Many real-world decisions require prioritizing high-risk cases, such as clinicians prioritizing high-risk patients before lower-risk ones. Falling rule lists (FRLs), which are ordered if--then rules with monotonically decreasing risks, provide an interpretable framework for such tasks; however, their single-path structure yields a highly restricted model class. We introduce falling trees, a new family of interpretable models that enforces the same monotonic risk constraint while permitting tree-structured branching. We present GRAVITree, a novel dynamic-programming-with-bounds algorithm for learning the Rashomon set of falling trees under depth and branching constraints. Our formulation can interpolate between rule lists and full decision trees, enabling user-desired model expressivity. In a new clinical dataset and in many public classification benchmarks, falling trees match or outperform FRLs and other interpretable baselines, often producing more sparse decisions for high-risk instances. Our results show that falling trees strike a practical balance between interpretability, expressiveness, and risk prioritization for high-stakes settings.
X-amine509: Predicting the Practical Risk Level of Enterprise X.509 Certificates
Enterprises managing large X.509 certificate inventories face a prioritization problem: deterministic analysis tools that precisely identify standards violations are indispensable for remediation, but applying them exhaustively across millions of certificates is operationally impractical. We present X-amine509, a two-stage triage system that uses machine learning to rapidly rank certificates by predicted risk and route only the highest-risk items to full deterministic analysis. Certificate risk is quantified as a composite score derived from 177 defect checks grounded in CA/Browser Forum Baseline Requirements, NIST IR 8547/SP 800-57, and cryptographic strength criteria, weighted by security severity across four tiers ranging from cryptographic breaks to minor compliance deviations. We collected 1,027,714 X.509 certificates from Fortune 500, .gov, and .edu domains and scored each using this rubric. On a held-out test set of 201,976 certificates, our best model (Extra Trees) achieves of 0.993 with MAE of 2.26, while Decision Tree scores of 0.986 at 3.7 million certificates per second on a single machine. Ranking quality confirms the triage value: aggregate NDCG exceeds 0.997, and severity-tier classification reports 99.76% accuracy with 98.90% recall on critical-tier defects. Thirteen months later, we retrieved another 571,374 certificates to test our models' durability over time, and the Extra Trees and Decision Tree models maintain MAE below 6.8, of at least 0.915, aggregate NDCG above 0.988, severity-tier accuracy of at least 99.52%, and critical-tier recall of at least 97.03%. Feature importance analysis identifies validity period, Extended Key Usage configuration, negative serial number encoding, and self-signed status as the strongest risk predictors, providing coarse interpretability at the triage stage.
Snugi-AI-v2 @ eRisk 2026 Task 2: Early Depression Detection via a Learned Stopping Policy with Sustained Confidence Gate
We describe the Snugi-AI-v2 submission to eRisk 2026 Task 2, the second edition of contextualized early depression detection from Reddit discussions. Our central contribution is a learned MLP stopping policy trained to directly optimize ERDE50, replacing the fixed and tiered threshold strategies used in all prior eRisk Task 2 submissions. Combined with a sustained confidence gate that commits only after N=3 consecutive rounds of high policy confidence, the system reduces false positives caused by transient emotional posts without sacrificing recall. The pipeline encodes each discussion thread with a frozen MentalRoBERTa model, maps the accumulated representation to a depression probability via an MLP classifier, and delegates the timing decision to the learned policy. Our best run achieves F1 = 0.73 (Run 1) and F_latency = 0.70 (Runs 0 and 3), with a median alert round of 8 out of 500, completing the full evaluation in 1 hour 26 minutes, the fastest among all complete-submission teams. We report a systematic ablation across five runs spanning two encoder variants, four stopping strategies, and three gate values, along with negative results from GRPO policy training, BDI-II post filtering, MentalLongformer encoding, and DeBERTa ensembling. Code: https://github.com/chiuyuwen91/erisk-2026
Bag of Tricks or Bag of Myths? Reducing Modeling Complexity with Task Knowledge in Explainable Suicide Risk Assessment
Assessing suicide risk from social media text is a small-data, high-stakes setting requiring not only severity prediction but also supporting evidence and clinically relevant risk and protective factors. Yet common NLP techniques, including model scaling, synthetic data, loss reweighting, ensembling, and threshold tuning, are often applied without testing whether their gains hold up under severe class imbalance, coupled outputs, and limited author-level data. We study 1,635 clinician-annotated posts and audit 31 pre-specified techniques from 7 methodological families through roughly 300 controlled experiments on author-disjoint partitions. We found no prior audit of this playbook in this regime. The findings guide a task-grounded system for three outputs: 4-level suicide risk, evidence spans, and 24 clinical risk and protective factors. Only 5 of 31 comparisons produced reliable gains. We reformulate factor prediction as entailment between each post and its codebook definitions, using an architecturally diverse ensemble with class-balanced training and score rescaling. Risk predictions condition a 7-model evidence tagger ensemble; evidence restricts symbolic risk rules; and a difficult risk class is routed separately. The factor predictor remains independent because risk evidence provides no additional factor signal. We also correct a mismatch between validation scores used for threshold fitting and test-time ensemble scores through deployment-consistent calibration, yielding the largest improvement to the factor system. The final system achieves 0.8203 for risk, 0.7953 for evidence, and 0.7045 macro-F1 for factors, with a 0.7781 composite, ranking third among 53 teams. We call the underlying principle task-conditioned technique selection: retain techniques only when task-specific knowledge, structure, or empirical evidence justifies them.
Gaussian Meta-Space Augmentation for Stacking Ensembles in Multimodal IPMN Risk Stratification
Pancreatic cancer is among the most lethal malignancies; risk stratification of intraductal papillary mucinous neoplasms (IPMNs) offers a crucial opportunity for early intervention but typically requires invasive tissue biopsy. Dominant vision-based approaches, including radiomics and deep learning, provide promising but initially separate discrimination opportunities. Similarly, multisequence MRI (T1W/T2W) and anatomically decomposed (head, body and tail) analysis of the pancreas provide additional and potentially complementary signals. Effective fusion of this information is crucial in ordinal IPMN dysplasia risk prediction and can be accomplished via a meticulously regularized and calibrated ensemble stacking combiner. We present cUPMI, a class-conditional Gaussian augmentation of a combiner's log-probability meta-features, and test it on various prediction paradigms. In our multi-center analysis, we find cUPMI adds limited value to properly regularized L2-logistic binary classification stacks, but consistently regularizes higher-capacity tree combiners in the binary and radiomics-only setting (RF +0.015 and XGBoost +0.024 binary AUC, positive in all seeds). Its cleanest ordinal benefit appears for XGBoost on an 8-stream radiomics task (3-class no < low < high, +0.022 QWK in all seeds). Separately, fold-locked fusion of radiomics and 2.5D CNN streams yields the strongest overall model, an RF stack reaching QWK 0.595 (95% CI [0.54, 0.64]) and binary AUC 0.839, surpassing radiomics, 2.5D ResNet, and 3D DenseNet-121 baselines.
Unaccountable Delegation, Fading Skills: Mapping the Risks of Workplace AI Agents
To anticipate socio-technical risks from AI agents, organizations need taxonomies to classify them. However, existing AI risk taxonomies focus on broad risks and do not capture job-specific risks introduced by agents. To address this gap, we make three main contributions. First, we developed a multi-layer framework from a literature review of AI agents. The framework models three core components and their interactions: agents, goals, and environment. Second, we embedded this framework in a structured prompt and applied it to descriptions of 2,078 job tasks from the O*NET database, producing 8,356 risk scenarios labeled by severity and deployment mode (automation or augmentation). We validated these scenarios with 45 workers across 10 job roles and an independent LLM judge, confirming their plausibility and alignment with job tasks. Finally, we extended an existing taxonomy to create a 15-category taxonomy of workplace AI agent risks that covers all our risk scenarios. Our analysis highlights four findings. First, augmentation is not inherently safe because overreliance on agents can gradually erode workers' skills and oversight. Second, Erroneous Agent Actions accounts for the largest share of risk scenarios and has the highest concentration of severe risks. Many arise at the human-agent boundary. Third, automation is associated mainly with organizational risks, while augmentation is associated mainly with risks to workers. Fourth, workers found our taxonomy easier to use for a risk classification task than two other taxonomies and preferred it in 64% of non-tied comparisons with a recent generative AI risk taxonomy. These findings show that workplace AI agent risks do not arise from agents alone; they also depend on how people work with agents and how agents are deployed. Safer workplaces require not only safer agents but also carefully designed human-AI agent collaboration.
From Siloed Algorithms to Compliance-First Agentic Platforms: A Multi-Layered Architecture for Hospital AI Systems
Hospitals are rapidly adopting artificial intelligence for triage, imaging, scheduling etc., yet most deployments remain isolated point solutions locked inside departmental silos, resulting in duplicated effort, hidden risks, and unrealized enterprise value. Despite explosive growth of AI in healthcare market and accelerating investment, an estimated 70-80% of healthcare AI pilots fail to scale, largely due to governance gaps, fragmented data, and missing integration blueprints. This research proposes a hospital-specific, compliance-first, Agentic AI architecture with multiple interoperable layers, extending existing hospital AI platform models with: (i) an Agent Orchestration Layer for multi-agent workflows across clinical, operational, and financial domains, (ii) a Compliance and Policy Layer that centralizes policy-as-code for HIPAA, GDPR, the EU AI Act, DISHA Act, India's DPDP Act, and ISO/IEC security and safety standards, and (iii) a Privacy-Preserving Data Fabric that plugs federated learning, differential privacy, and secure enclaves into real-world Hospital Information Management System (HIMS) flows. Using a synthetic but structurally realistic hospital dataset and an open, ready-to-deploy prototype implementation, this study demonstrates the end-to-end orchestration of triage risk prediction, workflow optimization, and compliance logging, achieving substantial simulated reductions in task turnaround times and manual documentation effort while maintaining policy-guarded data access. The resulting architecture offers hospital leaders a pragmatic blueprint to move from ad hoc tools to a governed, globally compliant, ROI-focused AI platform that can be tailored to on-premise, hybrid and cloud-native deployments.
Self-supervised DXA representations encode multi-system disease risk, biological aging and heritability
Whole-body dual-energy X-ray absorptiometry (DXA) scans are routinely acquired to measure bone density and regional body composition, leaving their spatial structure largely unused. Here, we show that self-supervised learning (SSL) can convert raw DXA images into representations of systemic health. We introduce LeDXA, a vision model based on a joint-embedding predictive architecture (JEPA) that learns by predicting latent representations rather than reconstructing pixels. Trained from scratch on 11,540 unlabeled Human Phenotype Project scans, LeDXA was evaluated internally and on 47,400 external UK Biobank (UKBB) scans. It improved cross-cohort prediction of prevalent diseases and biomarkers beyond scanner-derived DXA measurements and DINOv3, a state-of-the-art general-purpose model, despite approximately 150,000-fold fewer training images and nearly 40-fold fewer parameters. Over a median 4.3-year UKBB follow-up, LeDXA improved incident disease prediction over tabular DXA measures, with the largest gains for hip and knee arthrosis and type 2 diabetes. For hip arthrosis, 66% of incident cases occurred in the highest-risk quartile versus 41% for tabular measures. Its representations predicted chronological age externally (r = 0.88; mean absolute error = 2.90 years), and the biological-age gap tracked broader disease burden and a 45% higher mortality hazard in the oldest-appearing quartile. The gap also decreased in women after starting hormone-replacement therapy, suggesting it may be modifiable. Genome-wide associations recovered mostly known body-composition and bone-density loci, and LeDXA embeddings were more heritable than DINOv3's. These findings reveal prognostic information in DXA images that conventional readouts discard, learnable with relatively little data and modest compute.
Predictive Maintenance: Deep Learning-Based Remaining Useful Life Prediction for Combat Aircraft Engines
To improve the operational readiness of combat aircraft engines and reduce unplanned maintenance costs, accurately estimating the remaining useful life (RUL) is critical. Traditional maintenance often proves insufficient under dynamic mission profiles. In this study, a deep learning-based predictive maintenance model capable of autonomously extracting features from multivariate sensor data was developed. Using the NASA C-MAPSS FD001 and FD004 datasets, data were converted into sequential blocks via 50- and 30-step sliding windows, respectively. The model's architectural superiority in autonomously extracting temporal degradation features was validated against RF, CNN-LSTM, and BiLSTM baselines. On FD001, it achieved an R-squared (R2) of 0.8901, a 13.28 RMSE, and a 320.34 NASA risk score, demonstrating generalizability on the multi-regime FD004 dataset with a 15.71 RMSE. The proposed maintenance protocol achieved a 0.9973 AUC at the critical 30-cycle threshold, ensuring high reliability. Additionally, a decision-support simulator has been developed to validate this protocol under aggressive combat flight profiles.
A reproducible and extensible framework for benchmarking competing risks survival models
A wide range of statistical and machine learning methods have been proposed for survival analysis with competing risks, where the occurrence of one event (i.e., cancer death) precludes the occurrence of other events (i.e., cardiovascular disease death). Despite these methodological advances, their systematic evaluation and adoption are limited by the lack of comprehensive, reproducible and extensible benchmarking frameworks. We developed an open-source benchmarking framework for competing risks models that enables their systematic comparison across multiple datasets under different aspects of performance; calibration, discrimination, overall prediction error and clinical utility. We additionally introduce an extension of SHAP for competing risks, allowing model-agnostic interpretability of covariates contributions over time. All our code is publicly available via GitHub:https://github.com/BBolosSierra/CompRisksBenchmark
KAISEN: Reproducible Subgroup Fairness Auditing for Clinical Risk Models
Clinical risk models routinely achieve strong aggregate performance while producing materially different error rates across patient subgroups. Audit pipelines have been proposed to catch this, but their components are rarely stress-tested, so it is unclear which parts of an audit can be trusted and under what conditions. We present KAISEN, a five-phase audit pipeline covering subgroup stratification, disparity measurement, mechanism diagnostics, post-hoc mitigation, and drift monitoring, evaluated to the point of failure on a synthetic benchmark of 16 disease tasks, 15 social-determinant axes from Healthy People 2030, and three prespecified intersections. Four findings follow. (i) Significance tracks each axis's gap against its own minimum detectable effect: rank correlation between significance count and raw equalized-odds difference (EOD) across the 15 axes is rho = 0.56, rising to rho = 0.78 once EOD is standardized by that floor. (ii) Per-group threshold optimization reduces EOD in 48 of 48 held-out runs (paired delta = -0.285, 95% CI [-0.313, -0.252]), while group-wise Platt scaling -- the better calibrator -- behaves as a coin flip on EOD (19 of 48 runs improved, 95% CI [0.26, 0.55]) with mean effect near zero, so what an audit should report is the variance, not the average. (iii) The mechanism diagnostic classifies 144 of 144 controlled cases correctly but recovers none of 48 model-driven cases under proxy misspecification, with no signal that it failed. (iv) CUSUM failures and false alarms track cohort realization far more than disease: at the reference threshold, all 27 false alarms and 7 of 8 missed shifts come from different seeds (chi-squared p = 0.002), so a threshold tuned on one cohort fails to transfer. All results are synthetic with known ground truth and do not establish clinical validity. Code, artifacts, and scripts reproducing every number are released.
Towards Precision Therapy in Hepatocellular Carcinoma: A Clinical-Reasoning LLM for Risk Stratification and Treatment Guidance
Hepatocellular carcinoma (HCC) is a common malignancy and a leading cause of cancer-related mortality. Current guidelines and staging systems provide coarse categories, but often miss within-stage heterogeneity and the clinical context in electronic medical records (EMRs). We present HCC-STAR (Hepatocellular Carcinoma Staging, Treatment And pRognosis), a clinically aligned large language model that reads routine EMR narratives and jointly outputs risk score-based staging, ranked guideline-consistent treatments with evidence-based rationales, and individualized survival estimates. We curated about 30,000 HCC cases from SEER and expanded them into EMR-style narrative training data using a clinician-validated, prompt-based augmentation workflow. On this corpus, we developed a knowledge-aligned reasoning framework optimized with a step-verifiable composite reward, moving beyond text-level memorization of clinical guidelines. In a multi-center cohort of 6,668 patients from 12 hospitals in China, HCC-STAR achieved state-of-the-art performance in treatment recommendation and risk stratification compared with clinical guidelines and competitive models, including GPT-5 and Gemini-2.5 Pro. Hypothetical overall-survival analysis showed a median survival of 51 months under adherence to HCC-STAR recommendations, compared with 29 and 32 months under BCLC and CNLC. In clinician-centric evaluations, blinded hepatobiliary specialists rated HCC-STAR's reasoning and evidence-based justifications as trustworthy. The model surpassed resident and attending physicians in treatment accuracy and helped physicians make more accurate decisions faster when used as an assistant. These findings support HCC-STAR as a reliable and verifiable decision-support system for risk stratification and precision therapy in HCC.
Biologically Informed Deep Neural Networks for Multi-Omic Integration, Pathway Activity Inference and Risk Stratification in Cancer
Integrating complex, multi-omics data presents significant challenges. Existing approaches often face a trade-off between model interpretability and representational capacity, with most either relying on post-hoc interpretation or use linear models that may overlook complex interactions. We report Pathway Activity Autoencoders for the multi-omics setting, which embed prior knowledge via pathway-informed architectural constraints, fostering interpretability, while preserving representational power. Our multi-omic framework is applied in the context of breast cancer and is evaluated in survival prediction and subtype classification with results indicating a positive effect of integration. We conduct analysis of individual omics layer impact on end-task performance, revealing that gene, protein, and microRNA expression layers provide the strongest contribution. Repeatability studies indicate that, while dropout improves model robustness and consistency, excessive regularisation can reduce predictive performance. Finally, visualizations of the learned feature space illustrate the framework's intrinsic transparency and clinical relevance. The results underscore the value of multi-omic integration and delineate the impact of individual omics layers, establishing practical guidelines for integration within our framework. Overall, our pathway activity autoencoder frameworks yield superior latent representations that are biologically meaningful and are directly translatable into clinically relevant insights.
Reliability-Aware CT-MRI Registration: A Quality Engineering Framework with Stability Analysis and Risk Classification
Multimodal CT-MRI registration is central to image-guided radiotherapy, surgical navigation, and diagnostic workflows, but most pipelines report only aggregate quality metrics without per-case reliability signals. We propose a reliability-aware framework that converts registration quality into Green/Yellow/Red risk categories using data-learned thresholds. CT images were registered to T1-weighted MRI using rigid and affine transformations on 90 paired slices from 18 patients across brain, abdominal, and neck anatomies. Reliability was assessed using Delta NMI, Delta SSIM, Dice overlap, registration stability, and inverse consistency error, combined into a single score R. Thresholds learned from training patients were applied unchanged to held-out test patients. Affine registration outperformed rigid registration on NMI and SSIM, yielding 44% Green classifications versus 33% for rigid. Reliability-filtered registrations improved the average alignment profile compared with unfiltered methods. Per-anatomy analysis showed substantial variation, with stronger reliability for abdominal registrations than brain registrations. Weight sensitivity analysis identified Dice overlap as the dominant reliability component. The proposed framework provides an interpretable quality-control layer for multimodal registration, while risk thresholds reflect statistical rather than clinical validation.
Dialogue to Detection: A Multimodal Hybrid NLP Pipeline for Insurance Fraud Detection
Insurance fraud imposes substantial financial losses and operational inefficiencies, raising premiums and impacting trust among legitimate policyholders. Early detection at FNOL remains a persistent challenge. Existing approaches rely largely on private, text-only datasets, limiting progress on multimodal methods that integrate linguistic, behavioural, and speaker-based indicators. We introduce a synthetic multimodal framework that replicates FNOL conditions. It generates agent-customer dialogue transcripts and two-speaker audios, performs ASR and diarisation. Downstream modules combine NER, regex-based feature extraction, LLM-RAG retrieval, and speaker embeddings in a rule-based risk score to flag narrative reuse, structural inconsistencies, and cross-case voice repetition while balancing sensitivity and false positives. Dataset validation and component-level evaluations show stability and transfer potential, offering a reproducible baseline beyond text-only fraud detection.
Revealing Mammographic Phenotypes in Deep Learning Breast Cancer Risk Models
Mammogram-based deep learning models have improved breast cancer risk prediction, but the learned imaging patterns remain underexplored. Existing interpretability methods rely on single-image saliency maps, failing to identify recurring mammographic phenotypes across large patient cohorts. By clustering patch embeddings from a pre-trained model, Mirai, we isolate recurring phenotypes linked to 5-year cancer risk. Analyses show risk-increasing phenotypes capture complex structures (e.g., dense tissue, microcalcifications) and shortcut artifacts (e.g., clips). These phenotypes correlate strongly with older age and higher BI-RADS density. Our framework connects tissue patterns to AI risk scores, revealing clinical signatures and potential latent model confounders.
Pulmonary Embolism Risk Stratification from CTPA and Medical Records: Vascular Graphs Are Not All You Need
Risk stratification for pulmonary embolism (PE) is critical for clinical decision-making. Stratification guidelines are based on patient medical records, parameters measured from computed tomography pulmonary angiography (CTPA), and blood tests. However, blood tests are often missing in routine practice. This work studies whether state-of-the-art models can accurately classify risk stratification from only medical records and biomarkers extracted from CTPA images. We benchmark different approaches to combine medical records and cardiac biomarkers with rich pulmonary vascular information; we add vascular biomarkers to tabular models and apply graph neural networks (GNNs) on the vascular tree's intrinsic graph representation. We use a private dataset (n=353) with uniquely complete data for PE risk stratification. Our results show that, among global features, medical records and cardiac biomarkers are the most significant predictors, while vascular biomarkers do not further improve stratification. Even more surprising, even GNNs on vascular graphs fail to outperform strong tabular baseline on global features. We consider hypotheses, on both models and data, that could explain this suboptimal performance. Our investigation suggests that, counter-intuitively, vascular graphs might hold no discriminative information for PE risk stratification. Code is available from https://github.com/creatis-myriad/GENESIS.
Signed Evidence Flow: Conflict-Aware and Stability-Calibrated Data Analysis
Modern data analysis usually gives a prediction without showing whether the evidence behind it is clear, conflicting, or stable. Two cases can have the same fitted confidence even when one has mostly agreeing evidence and the other has strong support and strong opposition. We propose Signed Evidence Flow (SEF), which combines a fitted prediction rule with signed feature attributions to measure support, opposition, conflict, and perturbation stability. We prove that confidence determines conflict exactly when it also determines total evidence mass, derive the remaining conditional variance, and state when conflict can improve loss prediction beyond confidence and other audit variables. We also connect conflict to geometric decision fragility. Across healthcare, Covertype, black-box, finance, and ten external data sets, conflict sometimes separates risk among predictions that already appear confident. Cross-fitted tests show added error-ranking information beyond confidence and attribution entropy on several data sets, including two large finance tasks. The direction is not universal: in some tasks, lowconflict cases are riskier. We therefore introduce ScopeGate, a held-out permutation diagnostic that checks the direction before SEF is used for review triage. SEF is consequently an audit tool rather than a universal risk score: it describes evidence structure, while an independent calibration sample determines whether that structure is useful in the target population.
Predicting High-Risk Colorectal Polyps in African Americans Using Pre-Colonoscopy Clinical Features: Machine Learning Model Development and Temporal Validation
Risk stratification for advanced colorectal polyps typically relies on colonoscopy and/or pathology findings. However, there is growing interest in whether non-invasive features available prior to colonoscopy can help identify patients at higher risk. Such approaches may enhance clinical decision-making by prioritizing surveillance for individuals most likely to harbor high-risk polyps, when colonoscopy resources are limited while potentially reducing unnecessary procedures in lower-risk patients. Importantly, the use of non-invasive, pre-procedural information may also help promote more equitable access to risk stratification, particularly in settings where colonoscopy resources are limited or unevenly distributed. We aimed to develop and externally validate machine learning models to predict high-risk colorectal polyps using only non-invasive, pre-colonoscopy demographic, clinical, and behavioral features in a diverse, predominantly African American, urban cohort. We conducted a retrospective cohort study using demographic, lifestyle, and comorbidity data from patients who underwent colonoscopy at Howard University Hospital to develop and validate several machine learning models, including neural networks, random forest, support vector machines (SVM), Naive Bayes, logistic regression, decision trees, k-nearest neighbors (KNN), and XGBoost, for predicting high-risk colorectal polyps. High-risk polyps (HRP) were defined as villous or tubullovillous adenomas, high-grade dysplasia, polyps >= 10 mm in size, and/or the presence of >= 3 polyps per procedure; all other cases were classified as low-risk polyps (LRP). The dataset included 4,681 patients from 2015-2022 used for internal validation and 1,562 patients from 2023-2024 used for external validation.
Risk Stratification for ICU Delirium using Pervasive Ambient Sensing Information
Delirium is a common and serious complication in the Intensive Care Unit (ICU), associated with increased morbidity, prolonged hospital stays, and higher healthcare costs. Despite its prevalence, early prediction and prevention remain challenging. Environmental factors such as ambient sound and light may influence the onset of delirium, yet they are often overlooked in risk assessments. In this study, we examined whether light intensity and sound pressure levels can independently predict delirium across multiple prediction horizons. We evaluated four efficient sequential neural network models on data collected from 9 ICUs across 309 patients to predict delirium for 10 prediction-window sizes. We reported feature importance and direction of influence using Shapley Additive Explanations analysis. The convolutional model achieved the strongest discrimination, with AUC = 0.80 on sound data and on combined data. Sound features were the dominant predictors overall. Integrating sound with light improved short-term ( week) prediction, with the combined model assigning the highest risk immediately after the sensing period. These findings suggest that passive ambient sensing, especially sound, can add a clinically meaningful, interpretable signal for delirium risk estimation and offer a practical pathway to enrich multimodal ICU prediction and prevention strategies.
SceneMiner: Identity-Preserving Multi-Task Fine-Tuning for Unified BEV Scene Mining
Mining hard, safety-critical scenes from driving logs is bottlenecked by the absence of difficulty labels, and no single proxy, collision risk, trajectory ambiguity, or semantic rarity suffices to find such scenes on its own. We present SceneMiner, a unified, camera-only bird's-eye-view pipeline that emits complementary mining signals from a frozen vision-language backbone in a single forward pass, with no LiDAR or radar: a retrieval embedding for text-prompted scenario search, a multi-label scene-tag distribution, and a continuous physics-based risk score (a motion forecast is a byproduct, not a contribution). Building such a multi-head model exposes our central finding, a failure mode we term cross-task interference: adding or upgrading one head shifts a shared activation stream and degrades weight-frozen sibling heads, so freezing parameters alone is insufficient. Our contribution, identity-preserving multi-task fine-tuning, removes this interference by zero-initializing every new sub-module and freezing every parameter that feeds the shared stream. The mining heads are thereby preserved bit-identically while training only ~102k parameters. The tagging head reaches mAP 0.4614 (micro-F1 0.5557) on 20 scene tags by pooling each scene into 32 visual tokens, and the embedding head supports text-prompted retrieval, validated qualitatively. Code is available at: https://anonymous.4open.science/r/sceneminer_anonymous-64E5
Pre-AF 13: An Interpretable Atrial Fibrillation Risk Score Mined from Discharge Reports
Background. Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and a major determinant of prognosis. Established AF risk scores rely on factors (older age, hypertension) nearly ubiquitous among patients with cardiovascular disease (CVD), offering limited stratification in this high-risk group. Most target long-term (5-10 year) rather than medium-term prediction. We developed interpretable ML models predicting AF risk over a 24-month and entire follow-up horizon in CVD patients using routinely collected hospital data. Methods. Single-center retrospective study of electronic health records from the National Research Cardiology Center (Russia) for patients aged >=18 with CVD but without pre-existing AF, hospitalized more than once between January 2012 and May 2019. A custom NLP pipeline transformed unstructured discharge reports into 73 structured features, combining a rule-based parser with transformer-based NER. Using LightAutoML we built a full model (73 features), a simple model (reduced subset), and a linear model for a bedside risk score. Performance was assessed by ROC AUC, compared with CHARGE-AF, C2HEST, MHS, and HAVOC, and interpreted via SHAP. Results. Of 80,576 records from 45,000 patients, 17,562 met inclusion criteria; 1,438 (8.19%) developed AF. The full model reached ROC AUC 0.735 (24-month) and 0.696 (entire follow-up); the simple model was nearly identical (0.725, 0.696). All non-linear models outperformed the four clinical risk scores (ROC AUC 0.53-0.64). The simple model uses 13 features and is named Pre-AF 13. SHAP identified age and left atrial volume as dominant predictors. A linear risk score (Pre-AF 9) stratified observed 24-month AF incidence from ~7% to 36%. Conclusion. Interpretable ML models built from routinely collected EHR data identify high-AF-risk CVD patients, outperforming established clinical risk scores.
TRIAGE: Dialectical LLM Reasoning for Explainable Risk Prediction on Irregularly Sampled Medical Time Series
Clinical early warning systems built on irregularly sampled medical time series (ISMTS) from electronic health records must deliver continuous risk scores for patient triage as well as interpretable rationales that clinicians can verify. Large language models (LLMs) are uniquely positioned for both, deriving risk from their output probabilities and rationales from their medical knowledge. However, we find that conventional LLM reasoning collapses graded risk into overconfident predictions and thereby undermines the cross-patient comparability on which triage depends. We refer to this failure mode as risk polarization and identify two underlying behaviors: early commitment to a single outcome, and one-sided reasoning that focuses only on the evidence for that outcome. To address this, we propose TRIAGE, a framework that trains an LLM to reason dialectically over competing clinical outcomes by eliciting outcome-specific rationales. This dialectical formulation mitigates risk polarization, enabling a single LLM to jointly provide explicit clinical rationales and risk scores comparable across patients. Across five ISMTS benchmarks, TRIAGE improves mean AUPRC by 17.0% and reduces mean calibration error by 82.8% relative to the competitive LLM-based baseline, while surpassing the strongest ISMTS baseline by 3.5% in mean AUPRC.
RiskNet: A large-scale dataset of AI risk incidents from news with alignment and multi-dimensional annotations
As artificial intelligence (AI) systems are increasingly deployed across socially consequential domains, reports of AI-related harms and failures have grown in frequency and diversity. Although existing governance frameworks articulate high-level principles for responsible AI, large-scale empirical resources for tracking and analyzing real-world AI risk incidents remain limited. Existing incident collections are often manually curated, relatively small in scale, and insufficient for continuous, data-driven monitoring and downstream computational analysis. To address this need, we present RiskNet, a large-scale dataset of AI risk incidents constructed from large-scale multilingual news sources. RiskNet applies a structured pipeline for AI risk news identification, event-level report screening, incident alignment, and multi-dimensional incident classification. The resulting resource organizes dispersed news reports into incident-centered records and provides benchmark datasets for event classification, incident alignment, and incident-level risk labeling. In its current release, RiskNet covers hundreds of millions of source records and yields a large-scale collection of AI risk-related reports, including aligned incident clusters and annotated benchmark subsets. The dataset is also accessible through an online platform for browsing and exploration. We describe the data sources, processing workflow, taxonomy design, and technical validation of the resource. RiskNet is intended to support downstream research on AI safety, governance, risk analysis, and benchmarking, as well as longitudinal and cross-source analyses of AI-related harms. By providing a structured and reusable empirical resource, RiskNet helps bridge the gap between high-level governance principles and the documented realities of AI risk incidents.
A machine-learning-assisted progressive digit-randomness screening framework for detecting non-random patterns in raw numerical research data
Raw numerical datasets remain less systematically examined in integrity screening than images, plagiarism, or summary-statistic inconsistencies. We developed the Fabrication-risk Digit Randomness Screening model (FDRS), a statistical and machine-learning framework for detecting non-random digit-pattern irregularities in numerical research data. FDRS integrates single- and joint-decimal-digit tests, Cramer's V, entropy metrics, Kullback-Leibler divergence, digit-preference indices, progressive subsampling, and semi-supervised risk scoring. It was evaluated using an instrument-derived enzymatic absorbance dataset (RawData, n=253) and a blinded manually simulated irregular dataset (ErrData, n=255). RawData showed no significant deviation in single third-decimal-digit analysis, whereas ErrData showed a significant deviation. In joint third-fourth decimal digit analysis, ErrData showed higher Cramer's V, lower normalized entropy, higher KL divergence, and a more persistent progressive-subsampling deviation signal. In internal validation, Elastic-net Logistic Regression achieved the highest AUC (0.98395) and lowest Brier score (0.048439), while Random Forest achieved the highest accuracy (0.926667) and balanced accuracy (0.935). RawData received a low ensemble risk score of 0.124627 and was classified as Grade 0; ErrData received a score of 0.740760 and was classified as Grade 3. External real-world benchmarks supported graded risk stratification: three datasets without identified public post-publication concerns were classified as Grade 0 or 1, whereas two datasets from publicly questioned or institutionally handled articles were classified as Grade 2 or 3. FDRS can prioritize raw numerical datasets for further review by integrating interpretable statistical and machine-learning features. It is an auxiliary digit-structure screening tool, not standalone evidence of fabrication or misconduct.
Disentangling Latent Risk Pathways via Bayesian Hypergraph Inference
Electronic health records (EHR) pose large-scale multi-disease modeling problems in which many outcomes are rare and strongly influenced by shared risk factors. While modern approaches achieve strong predictive performance, they often treat diseases independently or rely on black-box architectures, offering limited insight into how risk factors organize disease risk and little principled uncertainty quantification. We introduce a Bayesian hypergraph inference framework that reframes multi-disease modeling around latent, risk-factor-modulated disease pathways. Risk factors act on hyperedges, latent disease subsets with shared risk patterns, allowing diseases to participate in multiple distinct pathways and enabling interpretable, higher-order structure beyond pairwise associations. A repulsion prior encourages parsimonious and identifiable structure, while posterior inference provides calibrated uncertainty over both disease groupings and risk-factor influence. To enable scalable inference on large EHR datasets, we develop a structured variational inference algorithm that preserves logical dependencies among hyperedge existence, disease membership, and pathway-level effects. Experiments on simulated data and UK Biobank demonstrate stable and interpretable disease pathway structure, well-calibrated uncertainty, improved estimation for rare diseases, and competitive predictive performance.
From Risk Classification to Action Plan Remediation: A Guardrail Feedback Driven Framework for LLM Agents
LLM-based guardrails typically safeguard agents by evaluating proposed actions or inputs before execution, producing safety signals such as binary allow/deny decisions, risk categories, and/or explanatory rationales about potential policy violations. However, agent risks often arise when otherwise benign tasks are contaminated by untrusted external content, unsafe instructions, or risky tool use. Existing guardrails often flag the entire task uniformly as unsafe, thereby blocking the threat but sacrificing the benign part. Moreover, existing work largely evaluates guardrails in isolation, leaving unclear whether their interventions lead to safer downstream agent behavior. To address this, we introduce TRIAD (Tripartite Response for Iterative Agent Guardrailing), a guardrail-integrated agent framework that leverages guardrail-generated verbal feedback as a guiding signal to keep the agent aligned with benign objectives at each planning step. We finetune a language model on a self-curated training dataset to output one of three decisions: proceed, refuse, or update, together with structured natural-language feedback. Rather than merely allowing or blocking execution, update guides the agent to revise its plan, avoid harmful components, and preserve the benign task where possible. TRIAD injects this feedback into the agent's context, enabling subsequent plan revision and forming a closed loop between guardrail feedback and agent planning. Extensive experiments on ASB and AgentHarm show that TRIAD reduces the average attack success rate to 10.42%, while achieving the best safety-utility trade-off among guardrail-integrated baselines. Our code is available at: https://github.com/YUHAOSUNABC/TRIAD.
Conformal Risk Prediction for Non-Alcoholic Fatty Liver Disease Using Gradient Boosting with Distribution-Free Coverages
Non-alcoholic fatty liver disease (NAFLD) affects roughly 25% of global adults, posing substantial hepatic and cardiovascular risks. Yet, population-level screening tools remain inadequate. We present Method, a machine-learning framework for NAFLD risk prediction coupling gradient-boosted decision trees with conformal prediction to yield calibrated, distribution-free coverage guarantees on individual risk estimates. It integrates a mutual-information-based stability selection procedure to identify a compact, clinically interpretable feature subset via bootstrap resampling, constructing prediction sets whose marginal coverage provably exceeds a user-specified confidence level. We evaluated Method on a multicenter cohort from Guangzhou, China (primary n=2,187; external validation n=412) using 78 candidate features across demographics, metabolic biomarkers, and lifestyle factors. Method achieves an AUROC of 0.912 internally and 0.891 externally, outperforming deep neural networks, TabNet, support vector machines, and logistic regression. Conformal prediction sets achieve 91.3% empirical coverage at the 90% nominal level. A three-tier risk stratification derived from these scores separates the population into distinct groups, with the high-risk subgroup showing a 12-month progression rate 4.7 times that of the low-risk tier. The selected features -- notably waist circumference, ALT, GGT, triglycerides, fasting glucose, and BMI -- align with established metabolic risk factors, providing biological plausibility.
Explainable Multi-Task Retinal Imaging Reveals Microvascular Signals for Systemic Risk Stratification in Type 2 Diabetes: A Pilot Study
Retinal imaging provides a non-invasive window into systemic microvascular health and has emerged as a potential biomarker for systemic diseases. However, whether retinal features encode biologically meaningful systemic signals that can be reliably interpreted using explainable artificial intelligence (XAI) remains unclear. An explainable multi-task deep learning framework was developed to investigate associations between retinal microvascular features and systemic abnormalities in Type 2 Diabetes Mellitus. A total of 11,011 fundus images from 2,719 individuals were analysed using a shared neural network with task-specific heads for glycaemic status, kidney abnormality, and multi-system involvement. Model interpretability was evaluated using Gradient-weighted Class Activation Mapping (Grad-CAM), anatomical masking, and vessel alignment analysis. The framework demonstrated task-dependent predictive performance, with the best discrimination observed for kidney abnormality (AUC up to 0.63), whereas glycaemic status prediction showed limited performance (AUC = 0.49-0.61). Explainability analyses consistently localized model attention to retinal vessels and peripapillary regions. Masking experiments showed that occlusion of vascular regions caused the greatest performance decline, indicating that retinal vessels were the primary predictive source. Different architectures exhibited heterogeneous attention patterns, suggesting multiple representational pathways for systemic signal encoding. This pilot study demonstrates that retinal microvascular features contain measurable signals associated with systemic abnormalities, particularly microvascular damage. By integrating multi-task learning with quantitative XAI validation, this framework advances retinal imaging toward interpretable digital biomarkers for systemic risk stratification in diabetes.
Suicide Risk Assessment from AI-powered Video Surveillance: An Interpretable Framework for Prevention in Metro Stations
Understanding and monitoring human behavior in metro stations play an important role in supporting suicide prevention efforts, where early identification of high-risk situations can enable timely intervention. This requires assessing suicide risk from a surveillance video by jointly reasoning about the behavior of each passenger, his/her spatial context, and temporal dynamics. However, this assessment using videos captured by surveillance cameras is challenging, as it demands accurate perception of human motion, understanding of platform geometry, and aggregation of heterogeneous behavioral cues over time. In this work, we formalize the task of Suicide Risk Assessment (SRA) in metro stations and introduce the first interpretable framework that addresses this challenge. Unlike approaches that focus on isolated subtasks or attempt to infer intent directly, our formulation assesses suicide risk from accumulated evidence by incorporating person tracking, activity recognition, semantic segmentation of the platform, and trajectory-driven risk heatmap modeling. By formalizing SRA as a distinct task and benchmarking a complete operational pipeline achieving 83.2% ROC-AUC on real surveillance data, this work highlights the complexity of suicide risk assessment and opens new directions for research on interpretable AI systems for social good.
Calibration, Uncertainty Communication, and Deployment Readiness in CKD Risk Prediction: A Framework Evaluation Study
Machine learning models for chronic kidney disease (CKD) risk prediction often post strong discrimination scores on internal test sets. Calibration and uncertainty quantification get far less attention, leaving clinicians without reliable information about whether the probability outputs are accurate. We trained five classifiers on the UCI CKD dataset (400 patients, 62.5% CKD prevalence): logistic regression, random forest, XGBoost, SVM with Platt scaling, and Gaussian naive Bayes. We evaluated each across calibration quality, conformal prediction coverage, and an eight-criterion deployment readiness framework. A distributional stress-test applied the best-calibrated variant of each model to the open-access MIMIC-IV demo cohort (97 patients, 23.7% CKD) to assess behaviour under prevalence shift and feature missingness. We measured calibration before and after Platt scaling and isotonic regression using Expected Calibration Error and Brier Score, and quantified uncertainty through split conformal prediction targeting 90% marginal coverage. All five models reached AUROC 1.00 on the UCI test set. Isotonic recalibration reduced internal ECE to 0.000-0.022. On MIMIC-IV, AUROC fell to 0.48-0.58, ECE rose to 0.68-0.76, and conformal coverage dropped from 0.80-0.98 to 0.21-0.25 against a 90% target. No model scored above 4 out of 16 on the deployment readiness checklist. Near-perfect internal performance did not transfer. Calibration stability and conformal coverage should be evaluated on external data before any clinical prediction model moves toward deployment.
Passive Construction Site Safety Monitoring via Persona-Scaffolded Adversarial Chain-of-Thought VLM Verification
Construction remains the deadliest industry sector in the United States, with 1,055 fatal worker injuries recorded in 2023, and the majority preventable. Existing monitoring approaches are expensive, require real-time human operators, or address only a narrow subset of violations. This paper presents a passive, end-of-shift construction safety monitoring pipeline processing video from POV body-worn and fixed wall-mounted cameras through a three-stage architecture: (1) fine-tuned YOLO11 for primary PPE and hazard detection, (2) SAM 3 for segmentation refinement and worker deduplication, and (3) Qwen3-VL-8B-Instruct with a method-prompted, persona-scaffolded three-pass adversarial chain-of-thought protocol for compliance verification and hallucination control. The principal contribution is the Stage 3 prompt design: professional persona backstories following the method-actor framing drive an observed 12% precision improvement over single-pass prompting in an informal three-author review of the 12-video Ironsite development corpus, with the largest gains on hallucination-prone violation categories. Structural message isolation enforces observational independence between a generator, discriminator, and reconciliation pass governed by asymmetric rules encoding priors about human observation versus automated detection reliability. The system maps violations to OSHA standards, performs REBA-inspired ergonomic risk scoring from pose keypoints, and produces per-worker safety reports with timestamped evidence. An evaluation harness is released for future reproduction.
Learning Interpretable Point-Based Clinical Risk Scores via Direct Optimization
Many clinical risk scores are deployed as additive rules with nonnegative integer points assigned to relevant binary predictive features. These integer weights not only make the score easier to use in practice but also promote sparsity in the resulting prediction model. Such risk scores are often derived by first fitting a regression model and then rounding the estimated coefficients to the nearest integer after appropriate scaling. This approach is computationally fast but does not guarantee optimality of the resulting score. Alternatively, one may search over all possible integer weights to directly optimize a value function by posing the problem as an integer programming task. However, the associated computational burden can be substantial, especially when the value function is nonconcave or even discontinuous. In this paper, we develop new machine learning algorithms that employ a flexible greedy optimization strategy to learn such additive scoring directly under explicit and sensible optimality objectives. We apply the proposed method to a large electronic health record (EHR) cohort in Epic Cosmos to construct an integer-weighted comorbidity score for measuring the risk of post-discharge mortality. We also conduct a simulation study to examine the finite-sample operating characteristics.
A CUBS-Compatible Ultrasound Morphology and Uncertainty-Aware Baseline for Carotid Intima-Media Segmentation and Preliminary Risk Prediction
Carotid atherosclerosis is a major contributor to ischemic stroke and transient ischemic attack. Conventional ultrasound assessment is commonly based on intima-media thickness, plaque appearance, stenosis degree, and peak systolic velocity, but these morphology- and velocity-based indicators may not fully capture patient-specific vascular risk. This study presents AtheroFlow-XNet, a CUBS-compatible ultrasound morphology and uncertainty-aware learning baseline for carotid intima-media segmentation and preliminary risk prediction. Using the Carotid Ultrasound Boundary Study dataset, manual lumen-intima and media-adventitia boundary annotations were converted into dense intima-media masks for supervised segmentation. Clinical variables were incorporated into an auxiliary risk-prediction branch, and Monte Carlo dropout was used for uncertainty-aware inference. The model was evaluated using a patient-level train-validation-test split with 1,522 training images, 326 validation images, and 328 testing images. The proposed model achieved a Dice coefficient of 0.7930 for LI-MA mask segmentation, a segmentation loss of 0.2359, and an area under the receiver operating characteristic curve of 0.6910 for preliminary risk prediction. Qualitative results showed that predicted masks were generally aligned with manual annotations, while uncertainty maps highlighted ambiguous wall-boundary regions. These results suggest that ultrasound-derived carotid morphology can support automated wall analysis and uncertainty-aware interpretation. Since CUBS does not provide Doppler waveforms or CFD-derived hemodynamic biomarkers, this work should be interpreted as a reproducible morphology-driven baseline. Future work will incorporate Doppler-derived flow profiles, patient-specific vascular reconstruction, and CFD-based wall shear biomarkers.
Graph-Based Financial Fraud Detection with Calibrated Risk Scoring and Structural Regularization
Financial transaction fraud prevention faces challenges such as complex relationship structures, concealed behavioral patterns, and dynamically changing data distribution. Discrimination models relying solely on independent sample features are insufficient to fully characterize the risks of group collaboration and chain transfers within transaction networks. This paper proposes a graph neural network representation learning and risk discrimination framework for financial transaction fraud prevention. It integrates transaction records and identity information into node attributes and constructs a transaction graph based on shared attributes and interaction consistency to explicitly model inter-transaction relationships. In model design, a multi-layer message passing mechanism is employed to aggregate neighborhood information, learn node embedding representations containing structural context semantics, and output transaction-level fraud probability and risk scores through a lightweight risk discrimination head. A weighted supervision objective is introduced to mitigate training bias caused by class imbalance, and structural consistency regularization constraints are combined to suppress the impact of noisy edges on representation drift, thereby improving the stability and usability of risk characterization. Experiments are conducted on a publicly available financial transaction dataset, comparing various methods in the same direction and comprehensively evaluating them under a unified evaluation protocol. The results show that the proposed method outperforms other methods in risk ranking and probability calibration quality, validating the effectiveness of graph structure modeling and representation learning collaboration in financial transaction fraud prevention.
Machine Learning-Based Pre-Test Risk Stratification for PCR-Confirmed Chlamydia Using Patient-Reported Data and Urine Biomarkers
Early identification of individuals at elevated risk of Chlamydia trachomatis infection may enable optimal use of molecular testing in resource-aware screening. We evaluate the feasibility of pre-test risk stratification (PTRS) using machine-learning models trained on routinely available, non-invasive clinical data. A curated dataset of 93 urine samples with PCR reference labels was analyzed using three feature groups: patient-reported history and symptoms, urine biomarkers from standard urinalysis, and their combination. Five supervised classifiers were evaluated using stratified 5-fold cross-validation with out-of-fold probability estimates. Performance was assessed using area under the receiver operating characteristic curve (AUC) and threshold-dependent metrics, with uncertainty quantified via bootstrap confidence intervals. Models using only patient-reported data showed moderate discrimination (AUC up to 0.72). Urine biomarker-based models demonstrated slightly lower peak discrimination but more consistent performance, with ensemble methods yielding the strongest results. Combining feature groups marginally increased the peak AUC and reduced performance variability across models, indicating improved robustness. Findings indicate that urine biomarkers provide a reliable predictive signal for PTRS that is complementary to patient-reported information, while feature integration enhances robustness. This work supports the integration of non-invasive, routinely available information for PTRS into screening workflows, including decentralized or home-based PCR contexts, to optimize testing prioritization.
From Parameter Dynamics to Risk Scoring : Quantifying Sample-Level Safety Degradation in LLM Fine-tuning
Safety alignment of Large Language Models (LLMs) is extremely fragile, as fine-tuning on a small number of benign samples can erase safety behaviors learned from millions of preference examples. Existing studies attempt to explain this phenomenon by comparing parameters and hidden states before and after fine-tuning, but overlook their dynamic evolution during fine-tuning. In this paper, we uncover a critical mechanism underlying safety degradation by analyzing parameter dynamics, where benign fine-tuning causes parameters to cumulatively drift toward danger-aligned directions, progressively undermining the model's safety. This finding suggests that samples contributing more to this drift has greater fine-tuning risks. Based on this insight, we propose a method of Sample-Level Quantification of Safety Degradation (SQSD), which quantifies the influence of each training sample on safety degradation. Specifically, SQSD computes continuous risk scores to samples by measuring their induced parameter updates' projection difference between danger and safety directions. Extensive experiments across multiple models and datasets demonstrate that SQSD effectively quantifies sample-level fine-tuning risks and exhibits strong transferability across model architectures, parameter scales, and parameter-efficient methods.
Gradient Boosted Risk Scores
Risk scores are an interpretable and actionable class of machine learning models with applications in medicine, insurance, and risk management. Unlike most computational methods, risk scores are designed to be computed by a human by attributing points to a data sample based on a limited set of criteria. The most common approaches for generating risk scores use linear regressions to estimate the effect of selected variables. We propose a simple and effective approach towards building compact and predictive risk scores. We provide an algorithm based on gradient boosting that is capable of modeling nonlinear effects, along with a C++ implementation with Python and R bindings. Through extensive empirical evaluation on twelve tabular datasets spanning regression, classification, and time-to-event tasks, we show that our method achieves competitive predictive performance while producing substantially more compact scores than regression-based alternatives, with 60% fewer rules for classification tasks and 16% fewer rules for time-to-event tasks on average, compared to AutoScore.
Prediction of Alzheimer's Disease Risk Factors from Retinal Images via Deep Learning: Development and Validation of Biologically Relevant Morphological Associations in the UK Biobank
The systemic, metabolic, lifestyle factors have established associations with Alzheimer's Disease (AD) through epidemiologic and AD-specific biomarker studies. Whether colored fundus photography (CFP) contains retinal structural signatures corresponding to these AD-related risk domains remains unclear. To determine whether deep learning (DL) models can predict 12 AD-related risk factors from CFP and to characterize the retinal structures underlying these predictions, thereby assessing whether CFP reflects pathways to AD vulnerability. Using 62,876 CFPs from 44,501 unique participants from the UK Biobank, DL models were trained to predict 12 factors linked to AD incidence: 6 categorical (sex, smoking, sleeplessness, economic status, alcohol use, depression) and 6 continuous (age, age at completing education, BMI, systolic, diastolic blood pressure, HbA1c). Model performance, model saliency, and saliency-derived scores (CAM-Score) were evaluated and compared to retinal morphometry. The scores were also compared between incident-AD cases (average 8.55 years before onset) and matched controls. Performance of DL ranged from AUROC= 0.5654-0.9480 for categorical and R2=-0.0291-0.7620 for continuous factors, outperforming most of the morphometry-machine learning models. Saliency-based score consistently highlighted biologically meaningful regions, particularly the optic nerve head and retinal vasculature. It also aligned with present morphometric variations. Several saliency-based scores differed significantly between incident AD and matched controls, suggesting potential overlap between retinal correlates of risk factors and preclinical AD-associated changes. CFP encodes retinal signatures linked to AD risk factors. Although not diagnostic, DL-derived retinal representations may uncover biologically meaningful risk-related structural changes mirroring the potential AD vulnerability.
EndoGov: A knowledge-governed multi-agent expert system for endometrial cancer risk stratification
Multimodal artificial intelligence models for endometrial cancer (EC) risk stratification typically optimize aggregate predictive performance but provide limited mechanisms for enforcing mandatory guideline overrides, such as assigning POLE-mutated tumors to the low-risk group despite high-grade morphology. We present EndoGov, a two-tier multi-agent expert system that factorizes the decision process as D(x) = G(P(x), R), where specialist agents P extract structured evidence and a governance agent G applies an executable rule set R. Tier 1 comprises pathology, molecular, and clinical agents that independently generate schema-constrained reports from frozen foundation-model features or structured records. Tier 2 queries an evidence-level-weighted Guideline Knowledge Graph, using deterministic hard-path rules for high-priority overrides and constrained soft-path reasoning for ambiguous cases. In TCGA-UCEC (n=541), EndoGov achieved 0.943 accuracy, 0.973 macro AUC, and a conditional logic-violation rate (C-LVR) of 0.93% among trigger-exposed cases. In CPTAC-UCEC (n=95), where reference labels are guideline-derived, EndoGov reached 0.842 accuracy compared with < 0.31 for locked-transfer neural baselines, supporting governance-pathway transfer under distribution shift rather than validation against independent clinical truth. End-to-end safety decomposition localized residual failures primarily to upstream molecular detection rather than downstream governance. Backend-swap experiments further showed that hard-path compliance is invariant to the LLM backend. These findings indicate that explicit clinical-rule governance can provide guideline-compliant, auditable EC risk assignment while preserving competitive discrimination.
Community-Led AI Integration for Wildfire Risk Assessment: A Participatory AI Literacy and Explainability Integration (PALEI) Framework in Los Angeles, CA
Climate-driven wildfires are intensifying, particularly in urban regions such as Southern California. Yet, traditional fire risk communication tools often fail to gain public trust due to inaccessible design, non-transparent outputs, and limited contextual relevance. These challenges are especially critical in high-risk communities, where trust depends on how clearly and locally information is presented. Neighborhoods such as Pacific Palisades, Pasadena, and Altadena in Los Angeles exemplify these conditions. This study introduces a community-led approach for integrating AI into wildfire risk assessment using the Participatory AI Literacy and Explainability Integration (PALEI) framework. PALEI emphasizes early literacy building, value alignment, and participatory evaluation before deploying predictive models, prioritizing clarity, accessibility, and mutual learning between developers and residents. Early engagement findings show strong acceptance of visual, context-specific risk communication, positive fairness perceptions, and clear adoption interest, alongside privacy and data security concerns that influence trust. Participants emphasized localized imagery, accessible explanations, neighborhood-specific mitigation guidance, and transparent communication of uncertainty. The outcome is a mobile application co-designed with users and stakeholders, enabling residents to scan visible property features and receive interpretable fire risk scores with tailored recommendations. By embedding local context into design, the tool becomes an everyday resource for risk awareness and preparedness. This study argues that user experience is central to ethical and effective AI deployment and provides a replicable, literacy-first pathway for applying the PALEI framework to climate-related hazards.
Learning an Interpretable Risk Scoring System for Maximizing Decision Net Benefit
Risk scoring systems are widely used in high-stakes domains to assist decision-making. However, existing approaches often focus on optimizing predictive accuracy or likelihood-based criteria, which may not align with the main goal of maximizing utility. In this paper, we propose a novel risk scoring system that directly optimizes net benefit over a range of decision thresholds. The model is formulated as a sparse integer linear programming problem which enables the construction of a transparent scoring system with integer coefficients, and hence, facilitates interpretation and practical application. We also establish fundamental relationships among net benefit, discrimination, and calibration. Our analysis proves that optimizing net benefit also guarantees conventional performance measures. We evaluated our method on multiple public datasets as well as on a large-scale credit risk dataset. This computational study demonstrated that our interpretable method can effectively achieve high net benefit while maintaining competitive discrimination and calibration performance.
CORA: Generalizable coronary artery disease assessment and risk stratification from coronary CT angiography using pathology-centric representation learning
Coronary artery disease, a leading cause of cardiovascular mortality worldwide, can be assessed non-invasively by coronary computed tomography angiography (CCTA). Although deep learning has advanced automated CCTA analysis, clinical translation remains constrained by the scarcity of expert-annotated data and by the spatial sparsity of coronary pathology, which occupies only a small fraction of each scan. Widely used label-free pretraining strategies, such as masked image modeling and contrastive learning, optimize for global anatomical reconstruction and tend to under-represent these tiny localized pathological features. Here we present CORA, an annotation-efficient model for comprehensive coronary artery disease assessment. Rather than reconstructing background anatomy, CORA learns from volumetric CCTA through a synthesis-driven self-supervised strategy: an anatomy-guided engine inserts diverse synthetic calcified and non-calcified lesions into unlabeled scans, reframing pretraining as an abnormality-detection task that biases representation learning toward clinically relevant disease features. We pretrained CORA on 10,138 unlabeled CCTA volumes and evaluated it across datasets from nine independent hospitals. Across plaque characterization, stenosis detection, and coronary artery segmentation, CORA consistently outperformed strong self-supervised pretraining baselines, with the largest gains on external multi-center data, indicating robust generalization under distributional shift. Coupling the imaging encoder with structured clinical variables further enabled near-term major adverse cardiac event (MACE) risk stratification. Our results show that pathology-centric, synthesis-driven pretraining is an effective and scalable strategy for annotation-efficient coronary artery disease assessment from CCTA.