Auc-Roc

Breast histopathology analysis increasingly relies on distributed learning because direct data pooling across institutions is often restricted by privacy, governance, and communication constraints. This study compares server-based Federated Averaging (FedAvg), fully decentralized gossip learning, and Hybrid Gossip-FedAvg for invasive ductal carcinoma (IDC) patch classification. Experiments used 277,524 color image patches with patient-disjoint training, validation, and test partitions and a workload-balanced, Dirichlet-guided allocation across six nodes. Ring, random degree-3, and fully connected gossip topologies were evaluated together with sensitivity analyses for statistical heterogeneity, mixing coefficient, learning rate, model drift, prediction disagreement, calibration, clinically motivated operating points, communication payload, and patient-level IDC burden, together with auxiliary backbone robustness analyses. In the principal alpha=0.3 experiment, Hybrid Gossip-FedAvg achieved a test area under the receiver operating characteristic curve (ROC-AUC) of 0.8811, closely followed by FedAvg at 0.8801 and fully connected gossip at 0.8751. Across three independent patient-level repetitions, FedAvg and Hybrid Gossip-FedAvg obtained the same mean ROC-AUC of 0.9082, with standard deviations of 0.0037 and 0.0043, respectively. Hybrid achieved the highest mean area under the precision-recall curve of 0.8240, whereas FedAvg produced the lowest mean Brier score of 0.1335. Denser gossip graphs improved discrimination but increased theoretical model payload, while ring gossip remained sensitive to learning rate and mixing strength. Overall, FedAvg provided the most consistently reliable server-based baseline, topology-aware gossip offered a viable decentralized alternative, and Hybrid Gossip-FedAvg provided a balanced compromise between peer-to-peer diffusion and periodic global coordination.

Out-of-Distribution (OOD) data poses a significant threat to machine learning models, often leading to model failure during deployment. All existing OOD detection methods are post-hoc, relying on evaluation metrics such as accuracy and AUC-ROC during inference to indirectly assess the model's response to OOD data by measuring deviations. In contrast to existing approaches, the proposed work shifts the paradigm from OOD detection to OOD prediction by proposing a pre-hoc anticipatory framework called PLSP for OOD prediction. We make several key contributions: (a) a dataset-independent metric called the CREDibility Score (CREDS) is proposed for OOD prediction; (b) credibility curves are introduced to study the maximum credibility a model can attain; and (c) credibility heat maps (and volume under surface) are introduced to characterize pre-hoc model behavior across different datasets. This work provides a novel perspective on signal processing under distributional shifts. Experiments across multiple datasets demonstrate that the proposed metric serves as a valuable measure for improving the robustness of machine learning models toward OOD prediction.

Dementia is a major and growing global health burden, with Alzheimer's disease (AD) accounting for most cases. Timely and accurate diagnosis is central to managing this burden and increasingly depends on integrating complementary clinical and imaging information. Multimodal deep learning can combine these modalities for AD diagnosis, but how its explanations behave across modalities, fusion strategies, and cohorts remains unclear. We developed an explainable multimodal framework pairing a 3D CNN encoder for T1-weighted MRI with a feedforward network for harmonized clinical and demographic data, comparing varied model setups on three-way and pairwise diagnostic tasks using 6,479 internal records from the ADNI and 1,703 independent records from the OASIS-3. On ADNI, the tabular-only model achieved the highest three-class AUC-ROC of 0.879 and best discriminated cognitively normal (CN) versus mild cognitive impairment (MCI; 0.903), while cross-attention performed best for MCI versus AD (0.861); CN versus AD was highly discriminative overall. On OASIS-3, the vision-only model performed best (three-class AUC-ROC 0.910); CN versus MCI remained difficult, and no fusion strategy consistently outperformed single modalities across tasks and cohorts. SHAP and Integrated Gradients identified the MMSE as the dominant tabular feature in both cohorts, with global feature rankings agreeing strongly in ADNI ($\rho=0.94$) and OASIS-3 ($\rho=0.96$); CAM-based explanations, however, changed with model configuration and cohort. These findings show that multimodal performance and explanations are task, modality, fusion, and cohort-dependent: a dominant cognitive signal persisted across cohorts, but feature contributions and CAM explanations did not, underscoring the need to evaluate explainability under cohort shift rather than as a stable, intrinsic property.

Cervical cancer is a major global health challenge, with disease burden falling disproportionately on low- and middle-income countries (LMICs) due to a shortage of trained specialists and the subjective nature of colposcopy-based screening. To address this challenge, we propose a novel deep learning framework for the automated grading of Cervical Intraepithelial Neoplasia (CIN) and the prediction of clinical Swede scores. We also introduce the BUET Multi-Center Colposcopy Dataset, a novel, multi-center cohort designed and annotated for Swede score prediction and CIN grading. Our proposed dual-stream cross-attention architecture mimics the visual reasoning of an expert colposcopist by explicitly fusing paired multimodal cervigrams to evaluate comparative tissue responses. Furthermore, we introduce a custom composite loss function to address severe class imbalances and scoring inconsistencies across the five Swede score components. The proposed framework achieved 71.85% accuracy and an 86.23% AUC-ROC for three-class CIN grading, outperforming existing methods. For Swede score component prediction, the architecture achieved AUC-ROC values ranging from 75.7% to 88.4%, with the composite loss function yielding consistent F1-score improvements. Finally, the total predicted Swede Score, which ranges between 0 and 10, shows a Mean Absolute Error (MAE) of 1.489. The results show that the proposed method can pave the way towards developing AI-assisted colposcopy screening tools to support risk-based triage in resource-limited healthcare settings. The dataset and source code are publicly available(url: https://github.com/mHealthBuet/BUET-colposcopy)

In real-time colonoscopy, ground-truth annotations are unavailable at inference, so polyp segmentation models can fail silently. We propose Referee-Based Quality Estimation (RBQE), a reference-free framework measuring agreement between a primary segmentation model and an independently trained referee on the same image. RBQE is evaluated on a standardized 1,223-image external benchmark drawn from four public datasets, using four referee configurations chosen to separate two design axes: referee independence and architectural diversity. Using a common Agreement Dice descriptor, a same-architecture referee differing from the primary model only in random initialization already yields a useful reliability signal (ROC-AUC = 0.923), showing that independent training alone is sufficient. Cross-architecture referees improve further: SegFormer-B0 achieves the strongest performance (ROC-AUC = 0.960), significantly outperforming the same-architecture control and UNet++, and exceeding a representative Test-Time Augmentation baseline by 0.055 ROC-AUC under an identical protocol, whereas a prompt-coupled MedSAM referee underperforms despite maximal architectural diversity. Because empty-mask agreement is trivially separable, we also report a restricted evaluation excluding such cases: ROC-AUC falls to 0.876 (SegFormer-B0, 1,046 images) and 0.783 (same-architecture control, 975 images), yet RBQE's margin over both baselines widens on this identical subset. RBQE additionally increases the mean Dice of retained predictions as low-agreement cases are progressively rejected, supporting selective prediction, and requires only one additional deterministic referee forward pass at inference. Our study therefore supports cross-model agreement as a practical, interpretable reliability framework for automated polyp segmentation.

Medical claims data comprise the financial details, including the expenses and billing information, as well as the clinical information, such as the diagnoses and treatments, of patients visiting medical facilities. Recently, it has been acknowledged that large databases can be constructed from medical claims data for medical research purposes. However, the clinical information within these datasets is often medically unstructured, limiting its application in comprehensive analyses. This study enhances predictive model performance for major adverse cardiovascular events (MACE), a leading cause of death worldwide. Models that predict MACE are crucial to clinical practice guidelines. We utilize a cross-attention mechanism to develop a method that effectively weights the relationships between diagnoses and treatments. Effectively repre- senting the clinical information contained in medical claims data, this approach generates more representative features for predicting MACE. The ROC-AUC score of our proposed cross-attention-based model was 0.7720, higher than other benchmark models including the conventional atherosclerotic cardiovascular disease model, the light gradient boosting machine, and a self-attention-based model. These results indicate that integrating the clinical structure of medical claims data using a cross-attention mechanism significantly enhances the performance of predictive models.

Although document OCR systems perform increasingly well on routine documents, complex formulas, structured text, and long-tail formats remain error-prone. OCR predictions may omit fine-grained content or hallucinate unsupported outputs, while equivalent encodings of the same visible content must be accommodated. Existing OCR evaluation methods mostly report aggregate metrics, offering limited support for analyzing case-level errors and improving OCR performance. We propose OCR-EDR (OCR Error Diagnosis and Repair), a rendering-aware framework that advances from fine-grained diagnosis to iterative repair. Given a source image, an editable OCR prediction, and its rendered image, OCR-EDR first jointly assesses whether the prediction and its rendering are consistent with the source, preserving valid predictions, including rendering-equivalent ones, while diagnosing and localizing genuine errors. It then applies executable edits and may request an updated rendering for iterative reassessment. We construct OCRErrBench from diverse real OCR predictions, covering text and formulas, exact and rendering-equivalent positives, and genuine errors, and develop the DocEDR model to execute the diagnosis--repair loop. On OCRErrBench, DocEDR achieves 94.78% diagnostic accuracy. It repairs 86.23% of erroneous inputs to visual consistency, raises formula Case-F1 by 30.99 percentage points over DOCR-Inspector-7B on DOCRcaseBench, and improves formula CDM by up to 4.62 percentage points on the identified Bad subsets of four OCR systems on UniMER-Test. These results show that OCR-EDR turns fine-grained OCR analysis into verified corrections and performance gains.

Deep-learning models can achieve strong chest X-ray (CXR) classification performance without establishing whether their predictions predominantly rely on pulmonary image content. This study evaluates pulmonary attribution containment as an anatomy-related reliability property distinct from diagnostic performance. We propose DBCA-SegNet-MGAP, a multi-task anatomy-guided CNN-Transformer framework that combines complementary feature representations through bidirectional cross-backbone attention, predicts a soft lung mask, and incorporates this anatomical prior directly into classification through Mask-Guided Adaptive Global Average Pooling (MGAP). Pulmonary attribution containment is quantified using the Anatomical Local Energy Ratio (ALR) and high-intensity cumulative ALR (cALR@0.9). Experiments were repeated across three training seeds using the COVID-19 Radiography Database for four-class internal testing and a locked Shenzhen-to-Montgomery protocol for zero-shot external tuberculosis testing. On COVID-19, the proposed model achieved a weighted F1 of $0.9615 \pm 0.0015$ and macro ROC-AUC of $0.9906 \pm 0.0007$. In an architecture-matched dual-bridge comparison, replacing conventional GAP with MGAP increased ALR from $0.3878 \pm 0.0098$ to $0.7086 \pm 0.0104$ and cALR@0.9 from $0.5265 \pm 0.0101$ to $0.9905 \pm 0.0018$, while weighted F1 remained essentially unchanged ($0.9618 \pm 0.0015$ vs. $0.9615 \pm 0.0015$). Under locked external transfer to Montgomery, ROC-AUC remained $0.9080 \pm 0.0043$ and pulmonary ALR remained $0.6466 \pm 0.0081$, whereas weighted F1 decreased to $0.7528 \pm 0.0080$ and ECE increased to $0.1683 \pm 0.0055$. These findings show that diagnostic discrimination, calibration, and pulmonary attribution containment are distinct model properties and support their joint evaluation under internal testing and external domain shift.

Credit-default prediction is an important task in financial decision making. Traditional methods use fitted classifiers such as logistic regression and random forests on tabular features. Large language models (LLMs) have recently been applied to this task through prompting. In this work we study how a fitted classifier and an LLM can be combined for credit-default prediction. We distinguish telling the LLM to imitate a classifier from using the classifier to build the prompt. We hypothesize that a fitted classifier can supply the ranking ability that an LLM prompt lacks. We experiment on the Default of Credit Card Clients dataset, and report recall, F1, and the area under the ROC and precision-recall curves, with bootstrap confidence intervals. We observe that a few-shot LLM has the highest recall (0.47) and F1 (0.50) of any single model but ranks worse than a random forest (AUC-ROC 0.72 against 0.79). Instructing the LLM to imitate a classifier gives no significant change. Pruning the prompt to the classifier's eight most important features raises recall by 0.071 and F1 by 0.032. Adding the classifier's predicted probability to the prompt raises the LLM's AUC-ROC from 0.72 to 0.78, matching the random forest, while keeping 0.118 higher recall than it. The reverse composition, and the use of several classifiers, do not help. We thus recommend a simple classifier-guided prompt for LLM-based credit prediction.

Skin cancer diagnosis from dermoscopic images remains challenging due to high intra-class variability, inter-class similarity, class imbalance, and the limited interpretability of deep learning models. This paper proposes an uncertainty-aware and explainable deep learning framework for multi-class skin lesion classification. The framework combines a vision transformer model (MaxViT-Tiny) with CNN-based models (ConvNeXt-Tiny and EfficientNetV2-B0) through deep ensemble learning. Monte Carlo (MC) Dropout estimates predictive uncertainty and identifies unreliable predictions, while Grad-CAM++, an explainable AI (XAI) technique, provides visual explanations by highlighting lesion regions that influence model decisions. Evaluated on the HAM10000 dataset, the framework achieves 96% accuracy and 99% ROC-AUC under uncertainty-aware filtering (entropy < 1.0, confidence >= 0.7), with macro-average precision, recall, and F1-score of 94%, 95%, and 95%, respectively, and 96% weighted-average scores across all three metrics. The results demonstrate accurate, interpretable, and uncertainty-aware skin lesion classification for trustworthy computer-aided diagnosis.

Public chest X-ray repositories are widely used to train medical AI systems, yet their labels are typically extracted from radiology reports rather than verified directly on images. As a result, repository labels are often treated as image-level ground truth without validating whether they reflect what is actually visible in the radiograph. We introduce Repository Supervision Auditing (RSA), a framework that evaluates repository-derived labels against expert image-level annotations before model development. Using cardiomegaly in MIMIC-CXR as a case study, RSA compares repository labels with radiologist-reviewed image annotations, characterizes disagreement sources, and builds a curated cohort for deployment-oriented evaluation. Repository-derived cardiomegaly labels showed near-zero agreement with expert image-level assessment, identifying only 1% of expert-confirmed cases. Most discrepancies resulted from non-mention rather than explicit report negation, with expert-confirmed cardiomegaly identified in nearly half of studies assigned a repository-derived No Finding label. Using the resulting expert-curated cohort, a DenseNet121 model achieved a test ROC-AUC of 0.853. These findings show that repository labels may not reliably represent image-level truth and highlight supervision auditing as a critical step for developing trustworthy medical imaging AI.

Perioperative risk prediction models are often limited by narrow surgical populations, incomplete intraoperative data, poor calibration, and limited interpretability. We present a domain-structured ensemble framework for perioperative outcome prediction using routinely collected electronic health record (EHR) data. Predictors are organized into patient-related, surgery-related, and anesthetics-related domains. Domain-specific gradient boosting models generate independent risk estimates that are integrated through a logistic regression meta-learner. We demonstrate the framework using postoperative delirium (POD) in a case-control sample of 5,386 surgical encounters (2,693 cases, 2,693 controls) from a statewide health information exchange. POD required both delirium-related ICD codes and a positive Confusion Assessment Method screening within seven postoperative days; patients with preexisting dementia were excluded. The stacked meta-learner achieved AUROC 0.899 (95% CI: 0.891-0.906), precision-recall AUC 0.881, and Brier score 0.126, compared with AUROC 0.849 for the best single-stage model. Domain ablation showed improved discrimination and calibration over a surgery-only model (AUROC 0.879, Brier 0.140). Temporal validation on held-out post-2017 data yielded AUROC 0.915. Calibration was excellent, with intercept -0.006 (95% CI: -0.083 to 0.070) and slope 1.035 (95% CI: 0.982 to 1.088). Decision curve analysis, corrected for case-control sampling, showed positive net benefit across clinically plausible thresholds. The modular framework supports alternative outcomes, extension of predictor domains, and dynamic risk updating, providing a scalable foundation for interpretable, calibration-aware perioperative clinical decision support.

Deep Neural Networks (DNNs) have found successful deployment in numerous vision perception systems. However, their susceptibility to adversarial attacks has prompted concerns regarding their practical applications, specifically in the context of autonomous driving. Existing defenses often suffer from cost inefficiency, rendering their deployment impractical for resource-constrained applications. In this work, we propose an efficient and effective adversarial attack detection scheme leveraging the multi-task perception within a complex vision system. Adversarial perturbations are detected by the inconsistencies between the inference outputs of multiple vision tasks, e.g., object detection and instance segmentation. To this end, we developed a consistency score metric to measure the inconsistency between vision tasks. Next, we designed an approach to select the best model pairs for detecting inconsistencies effectively. Finally, we evaluated our defense against PGD attacks across multiple vision models on the BDD100k validation dataset. The experimental results demonstrated that our defense achieved a ROC-AUC performance of 99.9% detection within the considered attacker model.

Diffusion-based vision-language-action (VLA) policies can generate plausible actions even when their predictions are weakly grounded in the visual and language evidence defining the task. We introduce GUARD, a test-time failure detection method that measures this grounding without modifying the pretrained policy. GUARD estimates the influence of token-indexed entries in the final vision-language model key-value (KV) cache, constructs counterfactual caches by ablating salient KV entries, and compares their denoising responses with the original conditioning. Based on the comparison, we derive GUARD diagnostic stream including sensitivity, attention entropy, modality bias, and grounding efficiency, which are calibrated online and processed by a lightweight temporal classifier. We evaluate GUARD under task-held-out splits across five policy-benchmark settings, using Pi0, SmolVLA, and Alpamayo-1.5 on LIBERO, SimplerEnv, MetaWorld, and PhysicalAI-AV. GUARD achieves the best ROC-AUC on four of five unseen-task settings and ranks second on the remaining setting, improving the average unseen-task ROC-AUC by 5.73 percentage points over the strongest competing runtime monitor while remaining within 0.19 points of the best seen-task average. These results show that directly probing action-head dependence on multimodal evidence provides a transferable failure signal across policies, tasks, embodiments, and domains.

Vision-language-action policies often fail under deployment-time distribution shifts such as clutter, distractor objects, lighting changes, novel objects, altered initial states, and reworded instructions. Hidden-state-based risk probes combined with functional conformal prediction can detect rollout failures, but their reliability depends on calibration data matching deployment conditions. We introduce SAFECAST, which leverages contrast set perturbations to improve hidden-state probe training and calibration for deployment time shift. SAFECAST statistically significantly improves failure detection ROC-AUC scores over a state of the art baseline in both real-world DROID and LIBERO simulation experiments across multiple VLM backbones. We further find that SAFECAST benefits most when both visual and language contrast set perturbations are used to augment data, and that with contrast set perturbations, sim-to-real calibration leads to better probes than using real rollout data only.

Electronic health record foundation models are limited by institutionally siloed data and substantial performance degradation under cross-site transfer. We evaluated federated training of tokenized generative event models (GEMs) across 122,251 intensive care hospitalizations from three independent health systems harmonized to the Common Longitudinal ICU Data Format. Models were assessed on 12 post-24-hour clinical prediction tasks using within-site, cross-site, centralized, and federated training configurations. GEMs achieved the highest mean within-site and cross-site ROC-AUC and were substantially more transportable than conventional supervised models: their average cross-site penalties were 0.025 ROC-AUC and 0.027 PR-AUC, compared with 0.079 and 0.089 for LightGBM. Federated Learning (FedAvg and FedAvgM) approached the performance of centralized GEM training, with most gains obtained within 5-10 communication rounds. However, centralized multi-site training provided only modest improvements over complete local training. Multi-site models were most useful when local training data were limited, with their advantage narrowing as institutional data accumulated. These findings show that federated GEM training is technically feasible and preserves most centralized performance, but that the main open challenge is learning transportable representations to translate larger, but heterogeneous data from multiple health systems into a reliable target-site benefit.

Membership inference (MIA) on language models is usually summarised by aggregate ROC-AUC, but such evaluations are confounded: model-free blind baselines can separate members from non-members using surface text alone. Building on probabilistic discoverable extraction, we study black-box training-data leakage using N samples from p_theta(. | x), placing mean overlap, extreme-value overlap, and self-concentration on a common functional-estimation footing. On WikiMIA, a blind bag-of-words classifier reaches AUC 0.97 (TPR 0.90 at 5% FPR) while sampling adds nothing. On an IID Pile split (MIMIR), neither self-concentration nor gold-continuation recovery significantly exceeds a blind baseline in aggregate. Aggregate metrics hide the real harm: sampling verbatim-extracts training data for a tail of documents no blind attack can reach. On Pythia-6.9B, 16.6% of 500 Pile documents bearing a real identifier (83 documents; 21.3% of those bearing an email address) have that identifier reproduced and not reproduced under a mismatched-prefix control. Each leak is attributable to that document rather than a globally common string. This per-document disclosure is invisible to aggregate AUC. Risk is uneven: identifier leakage is about 3x stronger in code than prose, though prose remains positive and grows with capacity (4.0% to 12.1% from 410M to 6.9B); recovery of arbitrary held-out continuations is essentially confined to code (+0.44 member gap on GitHub vs at most +0.014 on prose). Temperature and nucleus sampling have minor effect, a 16-token prefix suffices, and the sample-budget relationship corroborates prior probabilistic-extraction results. We detect no reduction from deduplication. Privacy audits should report per-document extraction, not only aggregate membership, and motivate differential privacy as the mitigation. We release leakit, a black-box tool implementing this probe and its control.

Background/Objectives: Dermoscopic skin-lesion classifiers lose accuracy when images arrive from a new clinic or a new device. We asked which data augmentations reduce that loss, and measured the effect under a protocol that keeps policy selection separate from policy evaluation. Methods: A ConvNeXt-Large binary malignant-versus-non-malignant classifier was trained on six dermoscopic sources (25,903 images); HAM10000 and ISIC 2016-2020 were held out of training entirely. Single augmentations, photometric combinations and eleven composite policies were ranked on a development split of 1511 held-out images. The winning policy was then evaluated on a confirmation set of 8073 held-out images that took no part in that ranking and from which we removed every image sharing a lesion identifier with the training data and every image contributed by an institution represented in training. Both policies were retrained with four random seeds each and compared with an exact permutation test. Results: The mix policy raised confirmation-set ROC-AUC from 0.787 to 0.826 (+0.039; per-seed ranges 0.772-0.797 and 0.815-0.840, non-overlapping; exact permutation p=0.029), with the same direction on each contributing source. At matched sensitivity the gain is larger in clinical terms: specificity rose from 0.612 to 0.713 at a sensitivity of 0.80, and from 0.284 to 0.397 at a sensitivity of 0.95. In-domain ROC-AUC was preserved (0.938 to 0.941). On an independent clinical cohort acquired with a different device at a different institution (472 images, 22 malignant), performance was maintained (0.934 versus 0.930). Conclusions: Augmentations that model the physical causes of domain shift improve cross-source transfer at no cost to in-domain accuracy, and the improvement survives a selection-disjoint, contamination-free evaluation.

Muon is competitive with AdamW in large-scale pre-training, but its operating regime in reinforcement-learning post-training remains unclear. We map this regime on ALFWorld, a sparse-reward agentic benchmark, using three group-based objectives and Qwen2.5 models from 0.5B to 3B. Under a shared KL and clipping recipe, matched optimizer comparisons and AdamW rate controls trace the usable step-size range. AdamW responds non-monotonically to rate, whereas fan-in Muon remains stable at a more aggressive effective step: at $3 \times 10^{-5}$ it improves late success over an AdamW $10^{-6}$ baseline after correction across rate-metric tests. Its normalized-AUC effect is directionally positive but less uniform; the heuristic-matched lower-rate effect is less consistent, and tuned AdamW nearly matches high-rate Muon at 3B GraphGPO. High-rate Muon applies $3.53 \times$ AdamW's hidden-matrix update RMS; a full-budget RMS-matched control removes the late-success gain. Together, these results identify a recipe-level operating regime in which fan-in Muon supports a more aggressive stable effective step under shared KL and clipping: the margin is largest when optimization headroom remains and contracts near saturation, after AdamW tuning, or under magnitude matching. The scale-matched control ties this spectral effect to Muon's scale convention rather than establishing a universal optimizer ranking. Code is available at https://github.com/x66ccff/verl-muon.

Chest radiograph datasets often combine multiple images with Clinical Indication, Findings, and Impression, although these inputs are produced at different stages of care. We evaluated 15,000 ReXGradient-160K studies with two readable images and five CheXbert-derived report observations. Frozen DenseNet-121 and Bio+ClinicalBERT encoders were used to compare image-only, Indication-only, fixed-order multimodal, random-swap, DeepSets, and SectionGuard-MI models. Findings and Impression were evaluated only as post-hoc leakage controls. Models were trained with five seeds, and public-test uncertainty was estimated with 2,000 patient-cluster bootstrap replicates. Under U-Ones, macro AUROC was 0.643 for the primary image, 0.694 for two images, 0.749 for Indication, and 0.780 for ordinary two-image-plus-Indication fusion. SectionGuard-MI achieved AUROC 0.783 and AUPRC 0.260. Relative to ordinary fusion, its paired AUROC difference was 0.0031 (95% CI, -0.0042 to 0.0104; adjusted p=0.374), while its AUPRC difference was 0.0289 (95% CI, 0.0095 to 0.0413; adjusted p=0.004). DeepSets had the highest prospective AUROC point estimate (0.787), and random-swap fusion had the highest prospective AUPRC point estimate (0.265) with better calibration than SectionGuard-MI. Full report text alone reached AUROC 0.979 and AUPRC 0.836; AUROC remained above 0.973 after exact or expanded masking. These results show that prospective Indication is strongly associated with report-derived targets, permutation-aware fusion is competitive, and post-hoc report text creates substantial report-label circularity.

Background: Deep learning models can classify thyroid nodules on ultrasound, but reliable clinical decision support also requires calibrated probabilities, uncertainty estimation, and selective referral, particularly under dataset shift. Methods: We developed a calibrated deterministic five-member deep ensemble for ROI-based thyroid nodule classification and selective image-based triage. TN5000 was used for model development, five-fold cross-validation, member-wise vector-scaling calibration, and fold-specific threshold selection. TN3K served as an independent external dataset-shift evaluation. The framework used ConvNeXt-Tiny with squeeze-and-excitation attention, ensemble-mean malignancy probability, and mutual information (MI) as an ensemble-disagreement score. A three-tier policy assigned images to No-FNA suggestion, FNA recommendation, or radiologist review. Results: On pooled out-of-fold TN5000 predictions, the ensemble achieved AUC-ROC 0.9395, AP 0.9715, ECE 0.0088, and Brier score 0.0813. At 50% nominal MI retention, 7.2% of cases received a No-FNA suggestion, 39.9% an FNA recommendation, and 52.9% radiologist review, with 98.3% No-FNA NPV and 99.83% malignancy capture. On TN3K, AUC-ROC decreased to 0.7870, AP to 0.7254, ECE increased to 0.1899, and Brier score to 0.2281. The frozen TN5000 policy assigned 83.7% to review, 1.0% to No-FNA, and 15.3% to FNA recommendation. No malignant image entered the No-FNA pathway, but FNA-recommendation PPV fell to 76.6%. Conclusion: The framework showed strong internal discrimination and calibration, but limited external threshold transportability. Selective prediction may help identify images unsuitable for automated triage, but local recalibration, threshold validation, and prospective clinical evaluation are required before deployment.

Deep models for retinal optical coherence tomography (OCT) classification report high accuracy but rarely report whether their confidence can be trusted -- a gap that matters when a wrong-but-confident reading delays sight-saving treatment. We pair a hybrid convolutional-Transformer encoder with a gradient-boosting (XGBoost) classification head and a three-part clinical safety layer: confidence calibration, out-of-distribution (OOD) rejection, and per-prediction uncertainty flagging. On four-class OCT (84,495 scans) the model reaches 95.4% accuracy while cutting calibration error twelve-fold (expected calibration error, ECE = 0.0024), so the confidence it reports tracks its true accuracy. To our knowledge this is the first OCT classifier to validate all three safety mechanisms jointly, with public weights and reproducible multi-seed evaluation.

Deepfake image detection is currently served by three fundamentally different paradigms: commercial APIs, zero-shot vision-language models (LLMs), and open-source detectors. Despite their widespread use, these paradigms are rarely evaluated under a common protocol, making direct comparison difficult. We introduce VendorBench-100, a cross-paradigm benchmark that evaluates 36 representative models using a single adversarial 100-image corpus, a unified output schema, and a common evaluation framework. To ensure reliable assessment under the corpus's intentional class imbalance, models are ranked primarily by the Matthews correlation coefficient (MCC), with ROC-AUC reported as a threshold-independent measure of ranking ability. Rather than maximizing dataset size, VendorBench-100 emphasizes challenging real-world scenarios through a curated taxonomy of eight edge-case families, including face swaps, text-to-video stills, AI photo edits, avatar compositing, opaque-provenance images, and compressed research frames. Our evaluation shows that commercial APIs achieve the strongest median performance, followed by vision LLMs and open-source detectors. However, individual open-source models remain competitive with the best vision LLMs. More importantly, we identify a consistent divergence between ranking ability (ROC-AUC) and operating-point quality (MCC), demonstrating that strong score discrimination does not necessarily produce reliable default-threshold decisions. This metric disagreement, rather than any single leaderboard ranking, is the central finding of the benchmark. We release the complete evaluation framework and benchmark results to support reproducible future research. The source code and data are available at: https://github.com/sharayu-20/vendorbench-100

Memory-based anomaly detection is attractive because it localizes defects from normal images without training a decoder or synthesizing pseudo anomalies. However, most memory methods still use the memory bank as a nearest-neighbor lookup table: a test patch is treated as normal if it has one nearby normal anchor. This hard retrieval view is vulnerable to false-normal matches and does not test whether the patch is consistently supported by a local normal neighborhood. We propose ProCon, a training-free framework that turns memory retrieval into decoder-free reconstruction. ProCon softly projects each test patch onto nearby normal memory vectors and uses the projection residual as anomaly evidence. To stabilize this residual, it constructs seed-perturbed layer-wise memories, aggregates bank residuals by a median, and fuses depth-specific residual maps by layer consensus. ProCon requires no decoder training, backbone fine-tuning, learned fusion weights, or pseudo-anomaly supervision. Across MVTec-AD, VisA, and Real-IAD under the single-category evaluation protocol, ProCon achieves strong image- and pixel-level performance under seven standard metrics, including image AUROC scores of 99.8%, 99.2%, and 93.2%, respectively. Ablations show that the gains come from replacing hard retrieval with soft normal projection and stabilizing the residuals through memory and depth consensus. The code is available at https://github.com/jw-chae/Procon

Large language model (LLM) tutors often produce fluent step-by-step explanations, but a correct and pedagogically formatted response does not guarantee that the answer was derived from the student-facing problem. In realistic tutoring systems, the model may also have access to teacher notes, answer keys, rubrics, or retrieved solution artifacts. We study whether such private answer information can make tutor explanations answer-driven: the final answer is behaviorally available before the written explanation has justified it. Using Truncated Reasoning AUC Evaluation (TRACE), which probes how early a chain-of-thought prefix can pass a verifier, we evaluate 1000 GSM8K test problems under three paired tutoring contexts: question-only, correct answer-key, and wrong answer-key. At fixed fractions of each generated explanation, we force the model to answer immediately and verify the response against the gold numeric answer. With Qwen2.5-3B-Instruct, answer-key access raises median TRACE AUC from 0.375 to 0.900 and makes the gold answer available at the first 10% prefix in 997 of 1000 cases. The effect remains strong on the 746 examples where both question-only and answer-key explanations end with the correct answer. These results support truncated CoT auditing as a lightweight process-level diagnostic for answer-driven reasoning in math tutoring explanations.

First-shot anomalous sound detection in DCASE Challenge Task 2 must flag anomalies of unseen machine types with a single threshold, without knowing whether a test clip comes from the data-rich source domain (990 normal training clips) or the data-scarce target domain (10). Two organizer-reported problems remain open: source- and target-domain AUC are negatively correlated across systems, and development-set performance does not predict evaluation-set performance. We address both with a training-free post-hoc layer over frozen audio embeddings: (i) per-domain quantile calibration shrunk toward a pooled map by a prior strength m, tracing a source/target balance frontier, and (ii) a label-free cross-validated domain-balance criterion that ranks candidate configurations from training normals only, paired with a coarse development-labeled viability veto. On DCASE 2025, the criterion rank-predicts the official evaluation score across a 45-configuration grid (Spearman rho = +0.91; family-block bootstrap 95% CI [+0.83, +0.95]) while development score is uninformative (+0.06). Criterion-based selection raises the evaluation score from 55.83 to 59.34 (jackknife CI [2.2, 4.8]) and, on an extended grid, to 61.05 -- retrospectively fourth of 35 teams. Replicating on DCASE 2023 and 2024 bounds the claim: development score is uninformative in all three years and degenerate configurations recur (vetoed every time), but under family-clustered uncertainty the criterion's predictive evidence survives only in 2025; in both replication years a fixed full-equalization default matches or beats criterion-based selection. A DCASE 2026 forward test is frozen before the 2026 evaluation ground truth is released; all headline numbers are reproduced by the official evaluator.

This study aims to predict Tumor, Node, and Metastasis (TNM) stage labels independently, with the Cancer Genome Atlas (TCGA) pathology report as the sixth shared task of SMM4H-HeaRD 2026. The problem is framed as three multi-label classification tasks. We explore both classical and deep learning approaches using Term Frequency-Inverse Document Frequency (TF-IDF) features and embeddings from ClinicalBERT, BioBERT, and PubMedBERT. These representations are used with Logistic Regression (LR), Light Gradient Boosting Machine (LightGBM), Feed-Forward Neural Networks (FFNN), and Wide Residual Networks (WRN). Our results show that individual embeddings perform similarly to the TNM label classification, while their combination improves its predictive ability. WRN achieves AUROC scores of 0.839 (T), 0.8502 (N), and 0.803 (M) with F1-scores of 0.622, 0.702, and 0.9337, respectively, for the training phase. LightGBM with TF-IDF performs best with AUROC scores of 0.9368 (T), 0.9524 (N), and 0.8311 (M) and F1-scores of 0.7559 (T), 0.7384 (N), and 0.7017 (M) during the training phase. Furthermore, the result of the Codabench for the test sets indicates a Macro-F1 score of 0.978, 0.957, and 0.879 for the T, N, and M categories respectively for test set 1; while test set 2 records a Macro-F1 score for T, N, and M is 0.807, 0.767, 1.0 respectively. However, performance declined during the evaluation phase of the test sets, a drop from 0.938 to 0.858 of test set 1 to 2, for the Macro-F1 score across all stages; suggesting limitations in model generalizability, sensitivity to class imbalance, and challenges in processing lengthy clinical documents. Although this study provides an efficient baseline model and a reproducible pipeline, further optimization and validation are required before it can be considered suitable for use in a real-world clinical setting.

Alzheimers disease (AD) is a brain disorder that develops slowly and mainly affects memory, thinking, language, and daily activities. It is one of the most common causes of dementia and creates many difficulties for patients as well as their families. In the early stage, the symptoms are often mild and may look like normal ageing. For this reason, many people are diagnosed late, when the disease has already progressed. At present, there is no complete cure for AD. Still, early detection can help doctors manage the condition better and take suitable steps at the right time. In this study, a machine learning model is proposed to detect the early stages of Alzheimers disease using clinical details, neuropsychological test scores, and neuroimaging-related measures. The data used in this work is collected from the Alzheimers Disease Neuroimaging Initiative (ADNI). As the dataset has missing values, iterative imputation is applied to fill them. The dataset also has class imbalance, which is handled using Borderline SVM-SMOTE. After that, feature selection is carried out using wrapper-based and embedded methods so that only important features are used for training. The selected features are divided into training and testing sets, and feature scaling is applied. A stacking ensemble model is developed using Logistic Regression, Extra Trees, Bagging KNN, and LightGBM as base classifiers. Along with this, an artificial neural network is also trained on the same dataset. The performance of these models is compared using precision, recall, F1-score, and AUC-ROC. This study aims to find the best classifier and also identify important biomarkers that may help in the early diagnosis of Alzheimers disease.

Neoadjuvant chemotherapy (NAC) response prediction is clinically important for treatment stratification in breast cancer. However, robust pre-treatment pathological complete response (pCR) prediction remains challenging due to insufficient cross-modal modeling, multicenter imaging heterogeneity, and weak evidence-grounded interpretability. We propose ClinRAG-GRAPH, a Clinically informed Retrieval-Augmented Generation Graph framework, for pre-treatment pCR prediction from DCE-MRI, structured clinical variables, and biopsy-derived pathological biomarkers. ClinRAG-GRAPH constructs an intra-patient clinical-prior graph and applies a prior-guided relation-aware graph convolutional network for structured multimodal representation learning. To improve cross-center robustness, we introduce a dual-branch domain-adversarial learning strategy to suppress protocol-related MRI bias while preserving pCR-relevant features. To enhance interpretability, we further incorporate large language model (LLM)-driven subgraph RAG module that retrieves clinically analogous historical cases and integrates retrieved evidence for pCR inference. We assemble a large-scale multicenter NAC breast cancer cohort for extensive validation, drawing from two public sources and three in-house centers.Results show that ClinRAG-GRAPH achieves AUCs of 0.815 on the internal test set and 0.774/0.712 on two external test sets, demonstrating robust pre-treatment pCR prediction across centers. The code is available at the anonymized https://github.com/miccai26-1181/ClinRAG-GRAPH.

A total of seven categorical encoding methods were tested on the IEEE-CIS fraud benchmark dataset (590,540 records, 3.5% positives, 8 high-cardinality columns). The encoders were evaluated using a stratified 5-fold cross-validation (CV) with three repetitions. Five of the encoders had identical frozen LightGBM learners in the downstream phase, allowing for controlled comparisons of their performance to each other. CatBoost and TabNet were included as comparisons across paradigms using different learners. The entity embeddings produced the highest AUC-ROC (0.9612), with a statistically significant tie with that of CatBoost (0.9602) and statistically superior to tier group encoding (0.9548), whereas target encoding was only 0.0023 worse than tier group encoding and the auditor-friendly tier boundaries were maintained. Off-the-shelf TabNet did not outperform tree-based pipelines and collapsed under data scarcity. On AUC-PR, CatBoost leads (0.822 vs. 0.793); no encoder dominated both metrics. Per-column analysis confirmed the embedding advantage arises from joint multi-column representation.

Geographic atrophy (GA) secondary to age-related macular degeneration (AMD) requires precise monitoring of relevant structural biomarkers to assess disease stage, progression, and treatment response. This paper presents a fully automated, deep learning-based framework for the high-precision, pixel-wise segmentation of key biomarkers in optical coherence tomography (OCT) imaging: retinal pigment epithelium (RPE) loss, ellipsoid zone (EZ) loss, and EZ thinning. The proposed pipeline uses three specialized semantic segmentation models to delineate RPE loss, EZ boundaries (including interruptions), and Bruch's membrane. To ensure robustness and generalizability, the models were developed on a diverse dataset of 298 SD-OCT volumes representing the full phenotypic spectrum of AMD (GA:222, intermediate AMD: 40, neovascular AMD: 17, healthy: 19) and validated on an independent external dataset (n=43). The comprehensive evaluation was further strengthened using additional datasets to assess repeatability, inter-reader reliability, the impact of B-scan density on measurement accuracy, and subgroup performance stratified by lesion size. Results demonstrated high segmentation accuracy (Dice RPE loss: 0.88, Dice EZ loss: 0.87, Pearson's r > 0.99). Total EZ thickness measurements exhibited a sub-pixel average deviation of 2.15 $μm$, and segmentation reliability was confirmed by a strong reproducibility score (ICC > 0.98). By accurately and consistently quantifying outer photoreceptor degeneration and RPE loss, this fully automated framework provides a highly reliable tool for GA assessment in both clinical trials and routine real-world ophthalmic care.

AI-generated video detection benchmarks such as GenVidBench and AIGVDBench are the de facto leaderboards, yet most evaluation protocols leave uncontrolled confounds that can inflate reported generalization. As an existence proof, a three-feature clip-length classifier reaches a leave-one-generator-out (LOGO) AUC of 0.998 on GenVidBench under unaudited evaluation, while measuring nothing about motion. A 20-paper survey finds none applying all six standard controls that would catch this, so we combine them into an audited protocol and apply it to six representative feature sources (three published detectors and three repurposed signal sources), re-running it cross-dataset on AIGVDBench. The audit both debunks and certifies: the trivial classifier collapses to near chance (0.529), a CLIP baseline is caught carrying dataset identity, and the 2025 forensic detector WaveRep clears the floor at out-of-distribution LOGO AUC 0.996 with chance-level real-vs-real coherence. At a deployable FPR of 0.1%, multiple high-AUC methods fall to single-digit recall and the leaderboard order changes, so we recommend an audited tuple (AUC, above-floor margin, operating-point recall, and calibration) over a single number. As a white-box positive control, we add TemporalSpec (codec motion vectors); via cross-substrate feature fusion (XSFF), a second substrate adds genuine complementarity that survives the audit. We release VidAudit, to our knowledge the largest unified and audited detector collection for this task, providing 14 detectors behind one plugin API, a leaderboard, and Croissant metadata, available at https://github.com/KurbanIntelligenceLab/vidaudit. Together, the protocol and toolkit move evaluation from leaderboard rank toward whether a result measures what it claims.

Medication errors, particularly dosing errors in clinical trials (CT), can lead to patient harm, adverse drug events and worse patient outcomes. Dosing errors are preventable, and early identification can improve trial integrity and mitigate subsequent clinical and financial burden. This study aims to detect dosing errors within CT protocols by evaluating text representations of trial information using transformer-based language models trained on biomedical corpora. CT textual data was encoded using several models, including ClinicalBERT, PubMedBERT, BioBERT, and MedCPT, and integrated with categorical features. These text embeddings were used as input to classical machine learning models and neural network architectures within an experimental framework. Performance was primarily assessed using ROC-AUC with respect to predicting dosage error. Under a logistic regression baseline, BioBERT consistently outperformed alternative encoders, achieving an ROC-AUC of 0.794, a 3.95% improvement over the ClinicalBERT baseline. Combining multiple embeddings did not yield improvements, indicating that domain alignment outweighs representational stacking. Gradient boosting models, support vector classifiers, logistic regression, and residual neural networks achieved the strongest performance for predicting dosage error, achieving ROC-AUCs: 0.821 to 0.853. Overall, the integration of domain-specific transformer embeddings with structured metadata enables discrimination of trials meeting a predefined elevated dosing error risk criterion, advancing safety monitoring and supporting informed regulatory decision-making.

Hallucination detection has become a pressing requirement for trustworthy AI deployment at scale. The most accurate detection methods depend on GPU-intensive inference, proprietary API calls, or white-box access to the generating model. This puts them out of reach for resource-constrained researchers and practitioners. In this paper, we explore a practical alternative: how well can hallucination detection perform using only lightweight, CPU-feasible methods built on publicly available models? We systematically benchmark five such methods: ROUGE-L, semantic similarity, BERTScore, a Natural Language Inference (NLI) detector based on a FEVER-trained DeBERTa model, and a score-level ensemble of similarity and NLI. We evaluate them across all three tasks of the HaluEval benchmark: question answering (QA), dialogue, and summarisation. We calibrate each method on a held-out validation split and evaluate it on 2,000 test instances per task. We find that no single method dominates and performance is highly task-dependent. The ensemble performs best on QA (F1 = 0.792, AUC-ROC = 0.873), the NLI detector leads on dialogue (AUC-ROC = 0.713), and all five methods degrade to near-random performance on summarisation (AUC-ROC between 0.469 and 0.574). This task-dependence and the systematic failure on summarisation map the practical frontier of GPU-free hallucination detection. They give practical guidance for method selection under computational constraints. All experiments run on a standard laptop CPU using public models.

Automated "suspicious behavior" flagging is a headline promise of AI surveillance, and the field reports high frame-level ROC-AUC on standard video anomaly detection benchmarks. Those numbers are measured by training and testing on the same camera and scene. We audit what happens when that assumption is dropped. We build an unsupervised normality model from the all-normal training frames of one dataset, using frozen off-the-shelf embeddings (CLIP, DINOv2, ResNet-50, EfficientNet-B0) and a nearest-neighbour distance, and score the test frames of the same and of other datasets. Across 4 real datasets (UCSD Ped1, UCSD Ped2, CUHK Avenue, ShanghaiTech) and 4 backbones, same-dataset AUC averages 0.704 but cross-dataset AUC averages 0.499, which is chance: a detector calibrated on one scene is no better than a coin flip on another, and in several pairs it is below chance. The strongest backbone makes this worse, not better: DINOv2 has the best same-dataset AUC (up to 0.901 on Ped2) and the largest cross-dataset drop. The collapse is not an artefact of the scoring rule: replacing the nearest-neighbour detector with a PaDiM-style Mahalanobis detector reproduces it almost exactly (cross-dataset gap 0.202 versus 0.208). Even at a favourable operating point the false-alarm rate is on the order of 31,931 per hour. We conclude that the benchmark numbers quoted for surveillance anomaly detection describe a calibrated laboratory setting and overstate deployable reliability by a wide margin, and we release the code that reproduces every number.

We study a quantum autoencoder (QAE) for compression-driven anomaly detection in brain MRI data. The approach leverages angle encoding to map image patches into quantum states, followed by a variational encoder-decoder architecture trained to discard information via auxiliary trash qubits. Anomaly scores reflect the degree to which inputs resist compression relative to normal data, with higher scores corresponding to deviations from the learned normal manifold. Evaluated on publicly available brain MRI DICOM datasets, the method achieves a slice-level ROC-AUC of approximately 0.95 and a patch-level ROC-AUC of approximately 0.813, outperforming classical autoencoder and PCA baselines. Analysis of the learned parameters reveals a pronounced encoder-decoder asymmetry, where effective anomaly detection arises from structured information compression within the encoder rather than increased parameter magnitude or decoder expressivity. This results in a controlled compression-reconstruction trade-off with a clear operating regime that supports principled threshold selection. Qualitative evaluation further shows that the QAE produces spatially localized anomaly heatmaps aligned with tumorous regions. The results, supported by promising baseline performances, demonstrate that quantum autoencoders provide an interpretable and controllable mechanism for anomaly detection based on incompressibility with respect to a learned latent representation. This work highlights the potential of quantum autoencoders as a principled tool for studying compression dynamics in quantum machine learning, with promising implications for decision support in medical imaging workflows.

Class imbalance poses a significant challenge in classification, where existing methods such as SMOTE often generate low-quality synthetic samples in regions with noise or class overlap. We propose QC-SMOTE, a quality-controlled oversampling framework that estimates minority sample reliability using a composite neighbourhood trustworthiness score combining local density, safe-level, and isolation from the majority class. Synthetic candidates are generated using an IPQ-guided best-of-K strategy that evaluates midpoint purity and, when required, majority clearance, with allocation guided by sample reliability and boundary informativeness. Generation behaviour adapts across overlap--imbalance regimes, adjusting interpolation range and selection criteria to match local data geometry. Low-quality synthetic samples are replaced with original minority duplicates when neighbourhood purity falls below an adaptive threshold, providing graceful degradation by reverting to duplication in severely noisy regions. Experiments on 30 imbalanced datasets using repeated stratified cross-validation show that QC-SMOTE achieves the strongest average AUC-ROC and Macro F1 among the compared oversampling methods, with particularly clear gains under moderate and severe imbalance. These results demonstrate the importance of quality-aware, geometry-adaptive synthetic sampling for robust imbalanced classification.

Automated classification of acute lymphoblastic leukemia (ALL) from peripheral blood smear images has often reported near-perfect performance on the C-NMC 2019 dataset. We show that such results can be inflated by patient-level data leakage caused by random image-level partitioning, where cells from the same subject may appear in both training and test folds. We establish a leakage-aware benchmark under a strict subject-disjoint protocol, comparing LightGBM, RBF-SVM, EfficientNet-B0, EfficientNet-B1, and ViT-Tiny. Models are developed using three subject-disjoint folds from 73 subjects and evaluated on an external preliminary-phase test set of 1,867 images from 28 unseen subjects with zero patient overlap. Beyond discrimination, we assess calibration using expected calibration error, Brier score, and temperature scaling. Under honest evaluation, EfficientNet-B1 achieves the best performance, with AUROC 0.913, sensitivity 0.87, specificity 0.80, and calibrated ECE 0.024. Frozen-feature classifiers and ViT-Tiny show high sensitivity but poor specificity, indicating a tendency to over-predict the malignant class. A random-versus-subject-disjoint ablation shows that random splitting inflates AUROC by about 0.04 even in the conservative frozen-feature setting. These findings caution against image-level evaluation on C-NMC 2019 and provide a reproducible, calibration-aware benchmark for future work.

Multimodal large language models (LLMs) are increasingly adopted to interpret 12-lead ECG images, though the interpretations often lack validation. However, ECG image understanding significantly differs from general images as it depends on precise waveform morphology, lead relationships and accurate interval measurements. This study investigated whether zero-shot multimodal LLMs can reliably distinguish normal and abnormal ECG images and, in parallel, evaluated CNN-based models for clinically grounded references. Standard 12-lead ECG recordings were rendered as single-page images for a binary normal-abnormal classification task. Three prominent LLMs (GPT-5.2, GPT-4.1, and Gemini-2.5 Pro) were tested using a fixed zero-shot prompt across multiple runs. In parallel, a physiology-aware CNN-based model was developed with the capability to aggregate features from the predefined anatomical lead groups. The model was compared with ResNet18, DenseNet121, VGG16 baselines, and all the models were evaluated on an internal test set and external PTB-XL dataset. Across seeds, CNN-based models demonstrated stable discrimination, with average internal ROC-AUC of 0.92-0.94, and external ROC-AUC of 0.85-0.86. The proposed LeadGroupECG model significantly improved over its backbone internally without compromising external generalization. It remained competitive with other baselines, while consistently highlighting anatomical lead-group contributions. In contrast, zero-shot LLM discrimination remained near-chance (ROC-AUC around 0.5). The PR-AUC improved slightly when ECGs used a grid-based calibration background compared with the grid-free ECGs. Although multimodal LLMs can generate reasonable ECG narratives, their zero-shot diagnostic discrimination remains limited. Therefore, clinically framed, domain-specific architectures remain essential for AI-based ECG interpretation.

We propose NoduLoCC2026, a challenge on lung nodule detection and localization in chest X-ray images. We have provided a dataset for both tasks and received submissions from 5 international teams. The participating teams' solutions are presented in this work along with results on an external dataset used for testing. Proposed methods show good performance on the classification task. The best method shows a balanced accuracy score of 0.72 and AUC-ROC of 0.79. We highlight the limitations of current approaches for the localization task, with the best approach having predicted the correct number of nodules on 53% of the test images with a median distance of 12.83mm, showing that it is a more challenging task than the first one. The challenge website is available via https://gt-i2mdp.github.io/website/nodule_challenge.html.

Recent advances in generative AI, such as diffusion models and face-swapping tools, have enabled the creation of highly realistic deepfakes, leading to real-world harms including financial fraud and non-consensual explicit content. In response, deepfake detection has become an active research area, with recent methods increasingly focusing on improving generalization to unseen manipulations. This is typically evaluated using the Area Under the ROC Curve (AUC) measured separately across multiple datasets. However, such an evaluation fails to reflect real-world scenarios where detectors face a mixture of data sources and varying artifact types. To address this limitation, we introduce a novel metric, Cross-dataset AUC (Cross-AUC) that averages per-domain AUCs with a measure of prediction polarization for taking into account the robustness to domain shift. The polarization extent is quantified by the Wasserstein Distance between class score distributions. Cross-AUC not only assesses the generalization capabilities of deepfake detectors under domain shifts more realistically, but it is also interpretable as it better explains the reason behind a drop in performance. Experiments performed on seven benchmark datasets demonstrate its practical relevance.

A biometric verifier is often deployed with a strict false match budget, so only a narrow, low false match rate (FMR) slice of the score range is used. A reporting standard for this setting already exists. ISO/IEC 19795-1 asks for error rates at stated operating points, for the detection error tradeoff (DET) curve as the view of the trade-off between FMR and the false non-match rate (FNMR), and for an interval of uncertainty on every value. In practice, a single area under the receiver operating characteristic curve (ROC-AUC), the equal error rate (EER), or a verification accuracy is still reported as the resolution, which is a threshold-independent summary that the standard does not endorse. The full ROC-AUC averages the true match rate (TMR) with equal weight over the whole FMR range from 0 to 1, so almost all of its weight is placed where the system is never operated; low-FMR behavior can then be hidden, and the order of two systems can even be reversed. The guideline is revisited in this paper and tested against seven pretrained matchers across four modalities, face, voice, iris, and fingerprint, each reported with bootstrap confidence intervals and paired bootstrap tests. A system that looks stronger on full ROC-AUC is shown to be significantly worse at FMR = 10^-3. For face, a higher full AUC was obtained by FaceNet, whereas a higher TMR at FMR = 10^-3 was obtained by ArcFace, and both gaps were significant with non-overlapping intervals. Hence, the DET curve and the FNMR at a fixed FMR are re-iterated in this paper as the primary report, with ROC-AUC and EER retained as supplementary context.

Anomaly detection is a fundamental component of intelligent systems with applications in healthcare, cybersecurity, smart grids, and IoT environments. Although conventional machine learning and deep learning methods have demonstrated effectiveness in identifying anomalies, they often rely on large labeled datasets, incur high computational costs, and face scalability challenges in edge and high-dimensional settings. This paper presents D2H-AD, a novel anomaly detection framework based on Hyperdimensional Computing (HDC), a brain-inspired paradigm that represents information using high-dimensional distributed vectors. Unlike existing HDC-based methods, D2H-AD integrates distance-based similarity and density-aware encoding within a unified framework, improving anomaly representation and detection performance. Ablation studies show that hyperdimensional encoding alone yields up to 5.4% higher ROC-AUC than applying the same density-distance scoring directly in the original feature space. Furthermore, D2H-AD consistently outperforms five established baselines, namely HDAD, ODHD, One-Class SVM, Isolation Forest, and Autoencoders, across all evaluated datasets. The framework is lightweight, interpretable, and computationally efficient, making it suitable for resource-constrained and real-time applications. We validate D2H-AD on five benchmark datasets and demonstrate superior F1-score and ROC-AUC performance, together with robustness to class imbalance, noise, and data complexity. In addition to improved accuracy, D2H-AD offers scalability, a small memory footprint, and low-latency operation enabled by binary computations and a compact design. These properties make it particularly attractive for TinyML and edge AI deployments. The proposed framework highlights the potential of HDC for accurate, interpretable, and energy-efficient anomaly detection in dynamic environments.

Credit-card fraud detection is difficult because fraudulent transactions are rare, costly, and unevenly distributed. Strong gradient-boosted tree models already perform well on structured transaction data, so the value of another fusion method is not obvious. This paper examines whether Combinatorial Fusion Analysis (CFA), which searches over model subsets and rank-score fusion rules, can still add value on the IEEE-CIS Fraud Detection benchmark. Using a leakage-free 60/20/20 train/validation/test protocol, we evaluate 480 fusion configurations built from seven base classifiers. The best test-set result comes from diversity-weighted score fusion of Random Forest, XGBoost, and LightGBM (DEF WtScore), with AUC-ROC = 0.9405, AUPRC = 0.6699, and F1 = 0.6373. Bootstrap confidence intervals from 1,000 resamples show that the gains over the strongest single model exclude zero for all three metrics. CFA matches soft voting on AUC-ROC, improves AUPRC and F1, and outperforms stacking in this setting. A CTGAN augmentation experiment gives a negative result: synthetic fraud samples degrade both individual models and CFA. Overall, CFA is most useful here not as a way to combine every classifier, but as a validation-stage method for choosing a small, complementary subset and assigning diversity-aware weights.

Abnormality detection is a crucial yet challenging task in medical image analysis. Distinguishing abnormalities from normal data by learning to reconstruct normal-only data alleviates the reliance on labeled datasets. However, many studies, even if unsupervised, rely on a labeled validation set to select the best model for inference from multiple training iterations. For many diseases labeled data are unavailable and substantially time consuming to obtain. To address this, AUCp - a novel metric that supports abnormality detection for unsupervised and self-supervised methods is proposed. Instead of evaluating the realism of reconstructed images to select the best of model for inference, it focuses on actual detection performance and without requiring an annotated test set. Assuming the pseudo ground truth of all unannotated samples in the test set as abnormal/positive and using traditional AUC calculation, AUCp scores are derived. Given a large and representative training set of normal samples, we show mathematical and empirical evidence that model selection using AUCp scores improves disease detection in terms of unsupervised and self-supervised methods over conventional metrics. Using two unsupervised methods for neurologic disease detection and self-supervised methods on diverse datasets, our results demonstrate that the AUCp score effectively identifies the optimal model for inference, significantly enhancing abnormality and disease detection. The corresponding implementations are available in https://github.com/mahfuzmohammad/AUCp.

Customer churn prediction is a central task in customer analytics, particularly in non-contractual, pay-per-use service environments where disengagement is not explicitly observed and must be inferred from behavioral inactivity. Existing churn prediction approaches often rely on simplified temporal assumptions or single-point representations of customer behavior, which limit their ability to support continuous risk assessment, interpretability, and realistic deployment over time. This study proposes a temporally explicit churn prediction framework that models customer behavior using rolling behavioral windows, enabling repeated and instance-level churn risk estimation as customer activity evolves. Customer behavior is summarized within a fixed 30-day observation window, followed by a 30-day future churn evaluation window, ensuring a clear temporal separation between behavioral evidence and churn outcomes. The framework integrates feature-based and sequence-based learning approaches within a unified temporal design. The proposed approach is evaluated on a large-scale, real-world dataset from a non-contractual service platform. Empirical results demonstrate strong and stable predictive performance, with accuracy reaching 87.6% and ROC-AUC of 0.94 for the feature-based model, while the sequence-based model achieves recall as high as 96.1% by capturing temporal disengagement patterns. Evaluation on future unseen data confirms meaningful robustness under temporal shift, with accuracy remaining above 83% and ROC-AUC exceeding 0.91 without model retraining. Overall, the findings highlight that carefully designed temporal framing, rather than model complexity alone, is critical for achieving robust, interpretable, and deployment-ready churn prediction. The study provides a practical foundation for churn-oriented decision support in dynamic service environments.

Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide, making early detection essential for effective treatment. Mammography is the primary screening modality; however, accurate delineation of suspicious lesions remains challenging and subject to inter-observer variability. Automated segmentation methods can assist radiologists by providing consistent and efficient lesion localization. This study presents DSU-Net, an attention-enhanced Dense Skip U-Net architecture for automated breast lesion segmentation in mammographic images. The proposed framework integrates dense skip connections and attention mechanisms to improve feature propagation, preserve spatial information, and enhance lesion boundary delineation. Experiments were conducted using the Curated Breast Imaging Subset of the Digital Database for Screening Mammography (CBIS-DDSM). To address severe foreground-background imbalance, a composite loss function combining Dice loss, focal loss, and binary cross-entropy loss was employed during training. The proposed model achieved a Dice Similarity Coefficient of 0.9421, an Intersection over Union of 0.8905, an accuracy of 0.9711, and an AUC-ROC of 0.9878 on the validation dataset. Qualitative evaluation demonstrated accurate delineation of lesions with varying sizes and morphologies, while quantitative results confirmed robust discrimination between lesion and background regions. These findings demonstrate that DSU-Net provides accurate and reliable breast lesion segmentation in mammographic images and highlights the potential of attention-guided deep learning for computer-aided breast cancer screening and diagnosis.

To develop and evaluate deep learning models for automated grading of age-related macular degeneration (AMD) severity using optical coherence tomography (OCT) and OCT angiography (OCTA) data. Two hundred seventy-one participants aged >= 50 years with varying AMD severities. Central macular 6 x 6 mm OCT/OCTA volumes were acquired using a swept-source OCTA system (SOLIX; Visionix/Optovue Inc., CA). AMD severity was graded into four stages (No AMD, Early AMD, Intermediate AMD, and Advanced AMD) according to the AREDS simplified severity scale. Three deep learning models were developed using different input modalities: (1) biomarker maps derived from segmented pathological features, including retinal fluid, drusen, geographic atrophy (GA), and macular neovascularization (MNV); (2) two-dimensional (2D) en face OCT and OCTA projections; and (3) three-dimensional (3D) OCT/OCTA volumes. EfficientNet-based architectures were trained using normalized inputs, data augmentation, and five-fold cross-validation. A total of 2,030 OCT/OCTA volumes from 351 eyes of 271 participants were analyzed. All models demonstrated strong AMD staging performance with substantial agreement with the reference standard (QWK >= 0.83). The biomarker-based model achieved the highest overall performance (QWK = 0.85 +/- 0.03, mean +/- standard deviation) and the best detection of early AMD (F1-score = 0.59 +/- 0.14). The 3D model achieved performance comparable to the 2D OCT/OCTA model (QWK = 0.83 +/- 0.04 vs. 0.83 +/- 0.09), while the 2D OCT/OCTA model showed the highest precision (0.79 +/- 0.06) and most accurately identified eyes without AMD. Deep learning models using OCT/OCTA data can accurately and automatically grade AMD severity. Among the evaluated approaches, the biomarker-based model provided the most balanced performance and showed particular value for early AMD detection.

Multilingual orthopedic decision support remains challenging in low-resource healthcare settings, where clinical narratives contain specialized terminology, mixed scripts, incomplete evidence, label imbalance and language-dependent documentation patterns. This article presents a reliability-oriented framework for classifying free-text orthopedic notes in English, Hindi and Punjabi. We compare task-aligned multilingual transformer encoders, a task-fine-tuned DistilBERT baseline, zero-shot instruction-tuned large language models (LLMs) and a domain-adaptive encoder, IndicBERT-HPA. IndicBERT-HPA augments IndicBERT with language-aware orthopedic adapter heads to support clinically relevant multilingual representation learning. Evaluation extends beyond aggregate accuracy to per-class performance, ROC-AUC, AUPRC, expected calibration error, cross-language stability and robustness under controlled balanced and natural-prevalence distributions. The evaluated zero-shot LLMs remain substantially less effective than task-adapted encoders for closed-set classification, with language-dependent instability. Under natural clinical prevalence, IndicBERT-HPA achieves the strongest overall performance, reaching an averaged Macro-F1 of 0.8792, Macro-AUROC of 0.894 and AUPRC of 0.902. We further implement a deterministic selective-verification layer combining confidence gating, evidence-consistency checking and language-risk screening. On a randomly selected held-out 5,000-record subset, it achieves 84.4% selective accuracy and 0.76 selective Macro-F1 at 72.3% coverage, compared with 71.5% accuracy and 0.65 Macro-F1 for accept-all prediction. These results support reliability-oriented multilingual clinical decision support with explicit deferral.

Modern network intrusion detection systems (NIDS) are caught in a structural contradiction: the protocols carrying the highest threat intelligence are precisely those encrypted under TLS 1.3 and QUIC, where payload inspection yields nothing. We ask a simpler question -- what if the attack signature is not in the bytes, but in the rhythm? -- and answer it by treating network flows as a language whose grammar is written entirely in L3/L4 packet metadata: length, inter-arrival time, TTL, TCP flags, and hashed port numbers. We present PLM-NIDS, which proves three claims in sequence. (1) The grammar exists and is learnable: a RWKV-4 state-space model trained on 344,232 unlabelled Monday flows achieves a causal LM validation loss of 0.204, demonstrating that benign traffic has predictable, statistically consistent structure. (2) Attacks violate this grammar: the per-flow perplexity score cleanly separates benign from attack flows with PR-AUC = 0.93 using zero attack labels at training time. (3) This separation is architecturally nontrivial: an LSTM trained on identical token sequences degenerates to a majority-class predictor (ROC-AUC approximately 0.50, F1 = 0.91 by always predicting "attack"), proving that RWKV's causal pre-training provides an inductive bias unavailable to direct classifiers. Supervised fine-tuning further raises PR-AUC to 0.94 and ROC-AUC to 0.75, with a precision of 97.7% at the calibrated operating threshold. The RWKV backbone's O(T) recurrent inference enables per-packet streaming without flow buffering, making PLM-NIDS operationally viable at line rate. Because it reads only IP/TCP/UDP headers, it is inherently encryption-agnostic: TLS 1.3, QUIC, and future encrypted protocols are handled transparently.

We present a unified experiment, analysis, and benchmark study of multivariate time-series (MTS) anomaly detection. Ten family-representative detectors -- spanning statistical, reconstruction, association, frequency, and generic-transformer families -- are evaluated on five datasets (SMD, MSL, SMAP, PSM, and MSDS) under effectiveness, efficiency, robustness, and cross-dataset generalisation. All methods share the same windowing, scoring, hardware, and metric protocols. Effectiveness, ablation, and robustness use three random seeds; cross-dataset transfer uses seed~0 because each extra seed requires $250$ source-target evaluations. The benchmark yields three method-independent findings: no single-bias baseline dominates; absolute perturbation VUS-ROC is more informative than retention ratios; and MSDS behaves as an event-dense deployment workload rather than a sparse point-anomaly benchmark. Under this protocol we also introduce \ours{}, an adaptive detector family combining a NOTEARS-constrained directed channel-graph view with optional patch-attention and temporal-association views. \ours{} achieves the best macro-average VUS-ROC ($0.675$, $+5.1$~pt over the second-best LSTM-AE), ranks first overall, and reaches the top-3 on all five datasets. Its wins on MSL and MSDS are narrow, while its average and robustness gains are larger: under the same three-seed robustness protocol for every method, it obtains the strongest absolute VUS-ROC across noise, channel dropout, and time-shift perturbations. We release the MSDS preprocessing protocol, configurations, scripts, and seed-level metric dumps.

Customer churn prediction is essential across data-driven industries such as insurance, digital banking, eCommerce, and subscription platforms, where retaining existing customers is typically more cost-effective than acquiring new ones. Predicting churn on structured datasets remains challenging due to class imbalance, nonlinear feature interactions, and heterogeneous feature types. Tree-based ensemble methods consistently demonstrate strong performance in these contexts, often outperforming conventional neural networks. This study introduces a validated hybrid architecture that integrates feature-tokenized transformers (FT-Transformer) with gradient-boosted trees through calibration-aware stacking. The proposed framework addresses persistent gaps in statistical validation, probability calibration, and reproducibility found in prior research. The FT-Transformer captures higher-order feature interactions using self-attention, while XGBoost captures gradient-boosted decision boundaries with complementary inductive biases. Class imbalance is handled using class-weighted loss functions, thereby avoiding synthetic oversampling and preserving minority-class distributions. The models are ensembled using out-of-fold (OOF) stacking with a logistic regression meta-learner, which recalibrates overconfident base model outputs and learns optimal combination weights. On a public bank churn dataset, the hybrid model achieves 62.10% F1, 0.861 AUC-ROC, and 0.647 PR-AUC, outperforming the Multi-Layer Perceptron (MLP) baseline by 3.37 F1 points and 0.027 AUC under 5x5 cross-validation with 95% confidence intervals reported. Ablation studies demonstrate that both the transformer component and stacking strategy contribute materially to performance. The proposed methodology offers a reproducible and extensible reference architecture for contemporary churn prediction on structured tabular data.

The increasing use of automated translation quality estimation (QE) systems calls for practical, decision-oriented methods for evaluating their performance. We propose that Receiver Operating Characteristic (ROC) analysis is a useful approach for this purpose. Our study shows that ROC analysis not only produces results consistent with currently prevalent methods, but also offers several important advantages, including actionable performance insights that support business decision-making.

Accurate classification of breast ultrasound images into benign, malignant, and normal categories is a critical clinical task complicated by speckle noise, acoustic shadowing, and inter-class visual ambiguity. Existing deep learning methods rely on single-stream architectures with generic augmentation that ignores ultrasound acquisition physics, and no prior method dedicates a stream to the lesion boundary features identified as the most diagnostically significant visual cue. We propose HADS-Net, a Hybrid Attention-Augmented Dual-Stream Network exploiting global texture and local boundary cues through two parallel pathways. Stream 1 applies physics-informed augmentation simulating speckle noise, acoustic shadowing, and gain variation before extracting features via pretrained EfficientNet-B3 projected to 512 dimensions. Stream 2 extracts Sobel edge maps processed by a lightweight CNN projected to the same 512-dimensional space. A cross-attention fusion module allows the texture stream to selectively query boundary features, producing a jointly optimised representation classified by an MLP trained with adaptive class-weighted focal loss. Five-fold stratified cross-validation with cosine annealing over 50 epochs is used, with the globally best checkpoint selected by lowest validation loss evaluated on a held-out test set. On the BUSI dataset, HADS-Net achieves 96.58% accuracy, macro ROC-AUC of 0.9978, macro F1 of 0.9654, and per-class F1-scores of 0.970, 0.951, and 0.976 for benign, malignant, and normal. No malignant lesion is misclassified as normal. These results confirm that modality-specific augmentation with cross-modal attention fusion is an effective strategy for ultrasound-based breast cancer diagnosis.

Transthoracic echocardiography (TTE) is the first-line imaging modality for diagnosing bicuspid aortic valve (BAV), yet diagnostic performance varies with operator expertise and image quality. We developed an explainable AI model that distinguishes BAV from tricuspid aortic valves (TAV) using routinely acquired parasternal long-axis (PLAX) cine loops. A multi-backbone video ensemble was trained and evaluated using a leakage-aware, stratified outer cross-validation protocol on $N{=}90$ patient studies (48 BAV, 42 TAV). Across fixed outer splits and 10 random seeds, the calibrated stacked ensemble achieved an outer-CV F1-score of $0.907$ and recall of $0.877$. Frame-level Grad-CAM localized salient evidence to the aortic root and leaflet plane, while globally aggregated SHAP values quantified each video backbone's contribution to the stacked prediction, enabling transparent, case-level auditability. These findings indicate that PLAX-based video ensembles can support reliable BAV/TAV classification from routine echocardiographic cine loops and may facilitate earlier detection in non-specialist or resource-limited clinical settings.

Diabetes mellitus affects over 537 million adults worldwide and remains a major challenge in preventive healthcare. Existing machine-learning studies primarily formulate diabetes prediction as a binary classification problem, while subtype-oriented analysis and glycaemic-cognitive associations remain comparatively underexplored. We present a reproducible three-stage machine learning framework for diabetes detection, subtype-oriented clustering, and metabolic-cognitive association analysis. In Stage 1, five supervised classifiers together with a stacking ensemble are benchmarked on the NCSU Diabetes Dataset using stratified five-fold cross-validation and evaluation metrics including ROC-AUC, balanced accuracy, recall, and F1-score. SVM-RBF and Logistic Regression achieve the highest ROC-AUC ($0.825 \pm 0.026$), while Random Forest achieves the highest accuracy ($0.762 \pm 0.030$). SHAP explainability identifies Glucose, BMI, and Age as the dominant predictive biomarkers. In Stage 2, silhouette-validated K-Means clustering ($k=2$, silhouette $\approx 0.116$) is applied to confirmed diabetic cases using Glucose, Insulin, and Age, recovering clinically plausible subtype-oriented partitions without requiring ground-truth subtype labels. In Stage 3, statistical analysis of the Ohio Longitudinal Cognitive Dataset ($n=373$) reveals a significant positive association between glycaemic control and cognitive function ($ρ_s = 0.208$, $p = 5.29 \times 10^{-5}$), which survives Holm correction. The findings support the utility of statistically grounded and interpretable ML pipelines for reproducible diabetes analytics and subtype-aware exploratory analysis.

Existing medical-agent benchmarks deliver imaging as pre-selected samples, never as an environment the agent must navigate. We introduce ABRA, a radiology-agent benchmark in which the agent operates an OHIF viewer and an Orthanc DICOM server through twenty-one function-calling tools that span slice navigation, windowing, series selection, pixel-coordinate annotation, and structured reporting. ABRA contains 655 programmatically generated tasks across three difficulty tiers and eight types (viewer control, metadata QA, vision probe, annotation, longitudinal comparison, BI-RADS reporting, and oracle variants of annotation and BI-RADS reporting), drawn from LIDC-IDRI, Duke Breast Cancer MRI, and NLST New-Lesion LongCT. Each episode is scored along Planning, Execution, and Outcome (Bluethgen et al., 2025) by task-type-specific automatic scorers. Ten current models, five closed-weight and five open-weight, reach at least 89% Execution on real annotation but only 0-25% Outcome; on the paired oracle variant where a simulated detector supplies the finding, Outcome on the same task reaches 69-100% across the models evaluated, localising the bottleneck to perception rather than tool orchestration. Code, task generators, and scorers are released at https://github.com/Luab/ABRA

We externally validated three deep learning models (DenseNet121, ViT-B/32, and ResNet50) for predicting mammographic breast density from breast ultrasound exams on an independent cohort. The external validation set comprised 2,000 ultrasound exams, including 500 cancer cases defined by an initial negative exam (BI-RADS 1 or 2) followed by a cancer diagnosis within 6 months to 10 years, and 1,500 negative controls matched by manufacturer and study year. Performance was measured using patient-level AUROC across four density categories: A (fatty), B (scattered), C (heterogeneous), and D (extremely dense). As a downstream assessment, we also evaluated 10-year risk prediction by incorporating age and AI-derived density into the Tyrer-Cuzick model and comparing performance against a reference model using age and mammography-reported density. All three models performed best in extremely dense breasts (AUROC 0.868-0.899), with strong performance in fatty (0.814-0.838) and scattered density (0.764-0.799), and lower performance in heterogeneously dense breasts (0.699-0.729). DenseNet121 achieved the highest overall performance (micro-averaged AUROC 0.885), and performance across categories was comparable between internal and external testing. For risk modeling, age combined with AI-derived density yielded a lower AUROC than age combined with mammography-reported density (0.541 vs. 0.570; p = 0.23), with no statistically significant difference. These findings indicate that deep learning models generalize well to external data with different racial composition for breast density assessment. While performance is strongest in extremely dense breasts, heterogeneously dense remains more challenging, highlighting the need for targeted optimization.

With the increase of the Electronic Health Records (EHR) data, more and more researchers are developing machine learning models to learn from the medical notes. These unstructured text data pose significant challenges on the learning process as the quality of data is low. These data are often messy, repetitive and redundant. We have shown these notes data to be informative by conducting the after-discharge mortality rate prediction task. The AUC-ROC for models using the medical note information is generally 0.1 higher than those without the medical notes. Furthermore, we propose the Deep Neural Network(DNN) model with 'pooling' mechanism to enhance the mortality prediction. Based on the experimental results, we demonstrate that the proposed model outperforms the traditional machine learning models like the tree-based models. The proposed method learns from the most informative medical notes and improves the prediction accuracy significantly. The AUC-ROC for the proposed model is 2% to 14% higher than the traditional ones in 15-days, 30-days, 60-days, 365-days after-discharge mortality prediction tasks. Moreover, we can discover some interesting knowledge through the traditional and proposed models. These knowledge are inspiring but also consistent with the previous findings. The models are able to reveal the relationships between the informative keywords and documents from the medical notes and the severity of the patients.

Grading knee osteoarthritis (KOA) on plain radiographs is poorly reproducible across readers. A single-grade disagreement on the Kellgren-Lawrence (KL) scale can alter surgical management or redirect a patient from conservative therapy to intra-articular injection. Meanwhile, deep learning models that outperform human readers often offer no explanation for their decisions. We present Knee-xRAI, a pipeline that decomposes the grading process by mimicking clinical radiological workflows. It independently measures joint space narrowing (JSN), osteophytes, and subchondral sclerosis, then combines these findings into an explainable KL grade. Specifically, a U-Net++ architecture quantifies JSN via contour segmentation, an SE-ResNet-50 multi-task network grades osteophytes per anatomical site on the OARSI scale, and a hybrid texture-CNN detects binary sclerosis. This pipeline yields a 50-dimensional feature vector evaluated via an XGBoost-SHAP classifier (Path A, audit) and a ConvNeXt hybrid predictor (Path B, deployed). On 8,260 OAI-derived radiographs, the JSN module achieved a Dice score of 0.8909 and an mJSW ICC of 0.8674. Path A reached a QWK of 0.6294 and an AUC of 0.8046, confirming the structured feature vector carries substantial diagnostic signal. Path B achieved a QWK of 0.8436 and an AUC of 0.9017. SHAP analysis identifies JSN as the dominant feature, with osteophytes adding a consistent increment and sclerosis contributing marginally. Removing JSN evidence collapses KL3-KL4 recall while early grades remain intact, aligning with the KL diagnostic criteria. Knee-xRAI grounds every prediction in an auditable chain of measured radiographic findings, providing clinical transparency at the point of care.