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An AI Implementation Science Study to Improve Trustworthy Data in a Large Healthcare System

Marteau, Benoit L., Hornback, Andrew, Tan, Shaun Q., Lowson, Christian, Woloff, Jason, Wang, May D.

arXiv.org Artificial Intelligence

The rapid growth of Artificial Intelligence (AI) in healthcare has sparked interest in Trustworthy AI and AI Implementation Science, both of which are essential for accelerating clinical adoption. However, strict regulations, gaps between research and clinical settings, and challenges in evaluating AI systems continue to hinder real-world implementation. This study presents an AI implementation case study within Shriners Childrens (SC), a large multisite pediatric system, showcasing the modernization of SCs Research Data Warehouse (RDW) to OMOP CDM v5.4 within a secure Microsoft Fabric environment. We introduce a Python-based data quality assessment tool compatible with SCs infrastructure, extending OHDsi's R/Java-based Data Quality Dashboard (DQD) and integrating Trustworthy AI principles using the METRIC framework. This extension enhances data quality evaluation by addressing informative missingness, redundancy, timeliness, and distributional consistency. We also compare systematic and case-specific AI implementation strategies for Craniofacial Microsomia (CFM) using the FHIR standard. Our contributions include a real-world evaluation of AI implementations, integration of Trustworthy AI principles into data quality assessment, and insights into hybrid implementation strategies that blend systematic infrastructure with use-case-driven approaches to advance AI in healthcare.


EXR: An Interactive Immersive EHR Visualization in Extended Reality

Marteau, Benoit, Tan, Shaun Q. Y., Li, Jieru, Hornback, Andrew, Zhong, Yishan, Wang, Shaunna, Lowson, Christian, Woloff, Jason, Pahys, Joshua M., Hwang, Steven W., Hilton, Coleman, Wang, May D.

arXiv.org Artificial Intelligence

This paper presents the design and implementation of an Extended Reality (XR) platform for immersive, interactive visualization of Electronic Health Records (EHRs). The system extends beyond conventional 2D interfaces by visualizing both structured and unstructured patient data into a shared 3D environment, enabling intuitive exploration and real-time collaboration. The modular infrastructure integrates FHIR-based EHR data with volumetric medical imaging and AI-generated segmentation, ensuring interoperability with modern healthcare systems. The platform's capabilities are demonstrated using synthetic EHR datasets and computed tomography (CT)-derived spine models processed through an AI-powered segmentation pipeline. This work suggests that such integrated XR solutions could form the foundation for next-generation clinical decision-support tools, where advanced data infrastructures are directly accessible in an interactive and spatially rich environment.


Studying Various Activation Functions and Non-IID Data for Machine Learning Model Robustness

Dang, Long, Hapuarachchi, Thushari, Xiong, Kaiqi, Lin, Jing

arXiv.org Artificial Intelligence

Adversarial training is an effective method to improve the machine learning (ML) model robustness. Most existing studies typically consider the Rectified linear unit (ReLU) activation function and centralized training environments. In this paper, we study the ML model robustness using ten different activation functions through adversarial training in centralized environments and explore the ML model robustness in federal learning environments. In the centralized environment, we first propose an advanced adversarial training approach to improving the ML model robustness by incorporating model architecture change, soft labeling, simplified data augmentation, and varying learning rates. Then, we conduct extensive experiments on ten well-known activation functions in addition to ReLU to better understand how they impact the ML model robustness. Furthermore, we extend the proposed adversarial training approach to the federal learning environment, where both independent and identically distributed (IID) and non-IID data settings are considered. Our proposed centralized adversarial training approach achieves a natural and robust accuracy of 77.08% and 67.96%, respectively on CIFAR-10 against the fast gradient sign attacks. Experiments on ten activation functions reveal ReLU usually performs best. In the federated learning environment, however, the robust accuracy decreases significantly, especially on non-IID data. To address the significant performance drop in the non-IID data case, we introduce data sharing and achieve the natural and robust accuracy of 70.09% and 54.79%, respectively, surpassing the CalFAT algorithm, when 40% data sharing is used. That is, a proper percentage of data sharing can significantly improve the ML model robustness, which is useful to some real-world applications.


COGNITION: From Evaluation to Defense against Multimodal LLM CAPTCHA Solvers

Wang, Junyu, Zhu, Changjia, Zhou, Yuanbo, Li, Lingyao, He, Xu, Xiong, Junjie

arXiv.org Artificial Intelligence

This paper studies how multimodal large language models (MLLMs) undermine the security guarantees of visual CAPTCHA. We identify the attack surface where an adversary can cheaply automate CAPTCHA solving using off-the-shelf models. We evaluate 7 leading commercial and open-source MLLMs across 18 real-world CAPTCHA task types, measuring single-shot accuracy, success under limited retries, end-to-end latency, and per-solve cost. We further analyze the impact of task-specific prompt engineering and few-shot demonstrations on solver effectiveness. We reveal that MLLMs can reliably solve recognition-oriented and low-interaction CAPTCHA tasks at human-like cost and latency, whereas tasks requiring fine-grained localization, multi-step spatial reasoning, or cross-frame consistency remain significantly harder for current models. By examining the reasoning traces of such MLLMs, we investigate the underlying mechanisms of why models succeed/fail on specific CAPTCHA puzzles and use these insights to derive defense-oriented guidelines for selecting and strengthening CAPTCHA tasks. We conclude by discussing implications for platform operators deploying CAPTCHA as part of their abuse-mitigation pipeline.Code Availability (https://anonymous.4open.science/r/Captcha-465E/).


A Review of Pseudospectral Optimal Control: From Theory to Flight

Ross, I. M., Karpenko, M.

arXiv.org Artificial Intelligence

The home space for optimal control is a Sobolev space. The home space for pseudospectral theory is also a Sobolev space. It thus seems natural to combine pseudospectral theory with optimal control theory and construct ``pseudospectral optimal control theory,'' a term coined by Ross. In this paper, we review key theoretical results in pseudospectral optimal control that have proven to be critical for a successful flight. Implementation details of flight demonstrations onboard NASA spacecraft are discussed along with emerging trends and techniques in both theory and practice. The 2011 launch of pseudospectral optimal control in embedded platforms is changing the way in which we see solutions to challenging control problems in aerospace and autonomous systems.


Walking the Weight Manifold: a Topological Approach to Conditioning Inspired by Neuromodulation

Benjamin, Ari S., Daruwalla, Kyle, Pehle, Christian, Zekri, Abdul-Malik, Zador, Anthony M.

arXiv.org Artificial Intelligence

One frequently wishes to learn a range of similar tasks as efficiently as possible, re-using knowledge across tasks. In artificial neural networks, this is typically accomplished by conditioning a network upon task context by injecting context as input. Brains have a different strategy: the parameters themselves are modulated as a function of various neuromodulators such as serotonin. Here, we take inspiration from neuromodulation and propose to learn weights which are smoothly parameterized functions of task context variables. Rather than optimize a weight vector, i.e. a single point in weight space, we optimize a smooth manifold in weight space with a predefined topology. To accomplish this, we derive a formal treatment of optimization of manifolds as the minimization of a loss functional subject to a constraint on volumetric movement, analogous to gradient descent. During inference, conditioning selects a single point on this manifold which serves as the effective weight matrix for a particular sub-task. This strategy for conditioning has two main advantages. First, the topology of the manifold (whether a line, circle, or torus) is a convenient lever for inductive biases about the relationship between tasks. Second, learning in one state smoothly affects the entire manifold, encouraging generalization across states. To verify this, we train manifolds with several topologies, including straight lines in weight space (for conditioning on e.g. noise level in input data) and ellipses (for rotated images). Despite their simplicity, these parameterizations outperform conditioning identical networks by input concatenation and better generalize to out-of-distribution samples. These results suggest that modulating weights over low-dimensional manifolds offers a principled and effective alternative to traditional conditioning.