Significant effort has been placed on developing decision support tools to improve patient care. However, drivers of real-world clinical decisions in complex medical scenarios are not yet well-understood, resulting in substantial gaps between these tools and practical applications. In light of this, we highlight that more attention on understanding clinical decision-making is required both to elucidate current clinical practices and to enable effective human-machine interactions. This is imperative in high-stakes scenarios with scarce available resources.

Healthcare requires AI that is predictive, reliable, and data-efficient. However, recent generative models lack physical foundation and temporal reasoning required for clinical decision support. As scaling language models show diminishing returns for grounded clinical reasoning, world models are gaining traction because they learn multimodal, temporally coherent, and action-conditioned representations that reflect the physical and causal structure of care. This paper reviews World Models for healthcare systems that learn predictive dynamics to enable multistep rollouts, counterfactual evaluation and planning. We survey recent work across three domains: (i) medical imaging and diagnostics (e.g., longitudinal tumor simulation, projection-transition modeling, and Joint Embedding Predictive Architecture i.e., JEPA-style predictive representation learning), (ii) disease progression modeling from electronic health records (generative event forecasting at scale), and (iii) robotic surgery and surgical planning (action-conditioned guidance and control). We also introduce a capability rubric: L1 temporal prediction, L2 action-conditioned prediction, L3 counterfactual rollouts for decision support, and L4 planning/control. Most reviewed systems achieve L1--L2, with fewer instances of L3 and rare L4. We identify cross-cutting gaps that limit clinical reliability; under-specified action spaces and safety constraints, weak interventional validation, incomplete multimodal state construction, and limited trajectory-level uncertainty calibration. This review outlines a research agenda for clinically robust prediction-first world models that integrate generative backbones (transformers, diffusion, VAE) with causal/mechanical foundation for safe decision support in healthcare.

Enhancing fuel efficiency in public transportation requires the integration of complex multimodal data into interpretable, decision-relevant insights. However, traditional analytics and visualization methods often yield fragmented outputs that demand extensive human interpretation, limiting scalability and consistency. This study presents a multi-agent framework that leverages multimodal large language models (LLMs) to automate data narration and energy insight generation. The framework coordinates three specialized agents, including a data narration agent, an LLM-as-a-judge agent, and an optional human-in-the-loop evaluator, to iteratively transform analytical artifacts into coherent, stakeholder-oriented reports. The system is validated through a real-world case study on public bus transportation in Northern Jutland, Denmark, where fuel efficiency data from 4006 trips are analyzed using Gaussian Mixture Model clustering. Comparative experiments across five state-of-the-art LLMs and three prompting paradigms identify GPT-4.1 mini with Chain-of-Thought prompting as the optimal configuration, achieving 97.3% narrative accuracy while balancing interpretability and computational cost. The findings demonstrate that multi-agent orchestration significantly enhances factual precision, coherence, and scalability in LLM-based reporting. The proposed framework establishes a replicable and domain-adaptive methodology for AI-driven narrative generation and decision support in energy informatics.

Artificial intelligence in medicine is built to serve the average patient. By minimizing error across large datasets, most systems deliver strong aggregate accuracy yet falter at the margins: patients with rare variants, multimorbidity, or underrepresented demographics. This average patient fallacy erodes both equity and trust. We propose a different design: a multi-agent ecosystem for N-of-1 decision support. In this environment, agents clustered by organ systems, patient populations, and analytic modalities draw on a shared library of models and evidence synthesis tools. Their results converge in a coordination layer that weighs reliability, uncertainty, and data density before presenting the clinician with a decision-support packet: risk estimates bounded by confidence ranges, outlier flags, and linked evidence. Validation shifts from population averages to individual reliability, measured by error in low-density regions, calibration in the small, and risk--coverage trade-offs. Anticipated challenges include computational demands, automation bias, and regulatory fit, addressed through caching strategies, consensus checks, and adaptive trial frameworks. By moving from monolithic models to orchestrated intelligence, this approach seeks to align medical AI with the first principle of medicine: care that is transparent, equitable, and centered on the individual.

Fair, transparent, and explainable decision-making remains a critical challenge in Olympic and Paralympic combat sports. This paper presents \emph{FST.ai 2.0}, an explainable AI ecosystem designed to support referees, coaches, and athletes in real time during Taekwondo competitions and training. The system integrates {pose-based action recognition} using graph convolutional networks (GCNs), {epistemic uncertainty modeling} through credal sets, and {explainability overlays} for visual decision support. A set of {interactive dashboards} enables human--AI collaboration in referee evaluation, athlete performance analysis, and Para-Taekwondo classification. Beyond automated scoring, FST.ai~2.0 incorporates modules for referee training, fairness monitoring, and policy-level analytics within the World Taekwondo ecosystem. Experimental validation on competition data demonstrates an {85\% reduction in decision review time} and {93\% referee trust} in AI-assisted decisions. The framework thus establishes a transparent and extensible pipeline for trustworthy, data-driven officiating and athlete assessment. By bridging real-time perception, explainable inference, and governance-aware design, FST.ai~2.0 represents a step toward equitable, accountable, and human-aligned AI in sports.

Timely detection of critical health conditions remains a major challenge in public health analytics, especially in Big Data environments characterized by high volume, rapid velocity, and diverse variety of clinical data. This study presents an ontology-enabled real-time analytics framework that integrates Complex Event Processing (CEP) and Large Language Models (LLMs) to enable intelligent health event detection and semantic reasoning over heterogeneous, high-velocity health data streams. The architecture leverages the Basic Formal Ontology (BFO) and Semantic Web Rule Language (SWRL) to model diagnostic rules and domain knowledge. Patient data is ingested and processed using Apache Kafka and Spark Streaming, where CEP engines detect clinically significant event patterns. LLMs support adaptive reasoning, event interpretation, and ontology refinement. Clinical information is semantically structured as Resource Description Framework (RDF) triples in Graph DB, enabling SPARQL-based querying and knowledge-driven decision support. The framework is evaluated using a dataset of 1,000 Tuberculosis (TB) patients as a use case, demonstrating low-latency event detection, scalable reasoning, and high model performance (in terms of precision, recall, and F1-score). These results validate the system's potential for generalizable, real-time health analytics in complex Big Data scenarios.

Current pain assessment within hospitals often relies on self-reporting or non-specific EKG vital signs. This system leaves critically ill, sedated, and cognitively impaired patients vulnerable to undertreated pain and opioid overuse. Electroencephalography (EEG) offers a noninvasive method of measuring brain activity. This technology could potentially be applied as an assistive tool to highlight nociceptive processing in order to mitigate this issue. In this study, we compared machine learning models for classifying high-pain versus low/no-pain EEG epochs using data from fifty-two healthy adults exposed to laser-evoked pain at three intensities (low, medium, high). Each four-second epoch was transformed into a 537-feature vector spanning spectral power, band ratios, Hjorth parameters, entropy measures, coherence, wavelet energies, and peak-frequency metrics. Nine traditional machine learning models were evaluated with leave-one-participant-out cross-validation. A support vector machine with radial basis function kernel achieved the best offline performance with 88.9% accuracy and sub-millisecond inference time (1.02 ms). Our Feature importance analysis was consistent with current canonical pain physiology, showing contralateral alpha suppression, midline theta/alpha enhancement, and frontal gamma bursts. The real-time XGBoost model maintained an end-to-end latency of about 4 ms and 94.2% accuracy, demonstrating that an EEG-based pain monitor is technically feasible within a clinical setting and provides a pathway towards clinical validation.

Abstract--The United States spends more on healthcare than any other nation - nearly 17% of GDP as of the early 2020s - yet struggles with uneven access and outcomes [1] [2]. This paradox of high cost, variable quality, and inequitable access is often described by the "Iron Triangle" of healthcare [3], which posits that improvements in one dimension (access, cost, or quality) often come at the expense of the others. This paper explores how an Intelligent Healthcare Ecosystem (iHE) - an integrated system leveraging advanced technologies and data-driven innovation - can "bend" or even break this iron triangle, enabling simultaneous enhancements in access, cost-efficiency, and quality of care. We review historical and current trends in U.S. healthcare spending, including persistent waste and international comparisons, to underscore the need for transformative change. We then propose a conceptual model and strategic framework for iHE, incorporating emerging technologies such as generative AI and large language models (LLMs), federated learning, interoperability standards (FHIR) and nationwide networks (TEFCA), and digital twins. We introduce an updated healthcare value equation that integrates all three corners of the iron triangle, and we hypothesize that an intelligently coordinated ecosystem can maximize this value by delivering high-quality care to more people at lower cost. Methods include a narrative synthesis of recent literature and policy reports, and Results highlight key components and enabling technologies of an iHE. We discuss how such ecosystems can reduce waste, personalize care, enhance interoperability, and support value-based models, all while addressing challenges like privacy, bias, and stakeholder adoption. The paper is formatted per MDPI guidelines, with APA-style numbered references, illustrative figures (U.S. spending trends, waste breakdown, international spending comparison, conceptual models), equations, and a structured layout. Our findings suggest that embracing an Intelligent Healthcare Ecosystem is pivotal for optimizing the long-standing trade-offs in healthcare's iron triangle, moving towards a system that is more accessible, affordable, and of higher quality for all.

For instance, in clinical diagnosis, fully-autonomous machine behavior is often beyond ethical affordances, thus real-world decision support is often limited to monitoring and forecasting.

In recent years, the field of medical informatics has seen significant advancements with the introduction of medical large language models (LLMs). These models, powered by artificial intelligence, have demonstrated remarkable capabilities in understanding and generating medical text, providing valuable assistance in clinical decision - making, diagnostics, and patient care. Prom inent examples include models such as Meditron [1], BioMistral [2] and OpenBioLLM [3], which have shown considerable promise in various medical applications. However, despite these advancements, the inherent limitations of medical LLMs highlight the need for more robust solutions.