Amid a scandal over nonconsensual sexual images, Musk says his AI chatbot is a force for "truth and beauty." Get your news from a source that's not owned and controlled by oligarchs. In much of the world, Grok and its parent company both appear to be in serious trouble. After Grok, X's AI chatbot, has been used to generate sexualized and violent images of women and children, the social media company has faced a wave of backlash and censure, with new nationwide bans on accessing Grok in place and other consequences on the way. On Monday, the EU threatened to fine X under its broad Digital Services Act if it didn't act "quickly" to fix Grok, in the words of one regulator.

Medical Imaging (MI) datasets are fundamental to artificial intelligence in healthcare. The accuracy, robustness, and fairness of diagnostic algorithms depend on the data (and its quality) used to train and evaluate the models. MI datasets used to be proprietary, but have become increasingly available to the public, including on community-contributed platforms (CCPs) like Kaggle or HuggingFace. While open data is important to enhance the redistribution of data's public value, we find that the current CCP governance model fails to uphold the quality needed and recommended practices for sharing, documenting, and evaluating datasets. In this paper, we conduct an analysis of publicly available machine learning datasets on CCPs, discussing datasets' context, and identifying limitations and gaps in the current CCP landscape. We highlight differences between MI and computer vision datasets, particularly in the potentially harmful downstream effects from poor adoption of recommended dataset management practices. We compare the analyzed datasets across several dimensions, including data sharing, data documentation, and maintenance. We find vague licenses, lack of persistent identifiers and storage, duplicates, and missing metadata, with differences between the platforms. Our research contributes to efforts in responsible data curation and AI algorithms for healthcare.

Federated Learning (FL) is a novel approach enabling several clients holding sensitive data to collaboratively train machine learning models, without centralizing data. The cross-silo FL setting corresponds to the case of few ($2$--$50$) reliable clients, each holding medium to large datasets, and is typically found in applications such as healthcare, finance, or industry. While previous works have proposed representative datasets for cross-device FL, few realistic healthcare cross-silo FL datasets exist, thereby slowing algorithmic research in this critical application. In this work, we propose a novel cross-silo dataset suite focused on healthcare, FLamby (Federated Learning AMple Benchmark of Your cross-silo strategies), to bridge the gap between theory and practice of cross-silo FL.FLamby encompasses 7 healthcare datasets with natural splits, covering multiple tasks, modalities, and data volumes, each accompanied with baseline training code. As an illustration, we additionally benchmark standard FL algorithms on all datasets.Our flexible and modular suite allows researchers to easily download datasets, reproduce results and re-use the different components for their research.

The widespread use of big data across sectors has raised major privacy concerns, especially when sensitive information is shared or analyzed. Regulations such as GDPR and HIPAA impose strict controls on data handling, making it difficult to balance the need for insights with privacy requirements. Synthetic data offers a promising solution by creating artificial datasets that reflect real patterns without exposing sensitive information. However, traditional synthetic data methods often fail to capture complex, implicit rules that link different elements of the data and are essential in domains like healthcare. They may reproduce explicit patterns but overlook domain-specific constraints that are not directly stated yet crucial for realism and utility. For example, prescription guidelines that restrict certain medications for specific conditions or prevent harmful drug interactions may not appear explicitly in the original data. Synthetic data generated without these implicit rules can lead to medically inappropriate or unrealistic profiles. To address this gap, we propose ContextGAN, a Context-Aware Differentially Private Generative Adversarial Network that integrates domain-specific rules through a constraint matrix encoding both explicit and implicit knowledge. The constraint-aware discriminator evaluates synthetic data against these rules to ensure adherence to domain constraints, while differential privacy protects sensitive details from the original data. We validate ContextGAN across healthcare, security, and finance, showing that it produces high-quality synthetic data that respects domain rules and preserves privacy. Our results demonstrate that ContextGAN improves realism and utility by enforcing domain constraints, making it suitable for applications that require compliance with both explicit patterns and implicit rules under strict privacy guarantees.

Deep learning models have shown high accuracy in classifying electrocardiograms (ECGs), but their black box nature hinders clinical adoption due to a lack of trust and interpretability. To address this, we propose a novel three-stage training paradigm that transfers knowledge from multimodal clinical data (laboratory exams, vitals, biometrics) into a powerful, yet unimodal, ECG encoder. We employ a self-supervised, joint-embedding pre-training stage to create an ECG representation that is enriched with contextual clinical information, while only requiring the ECG signal at inference time. Furthermore, as an indirect way to explain the model's output we train it to also predict associated laboratory abnormalities directly from the ECG embedding. Evaluated on the MIMIC-IV-ECG dataset, our model outperforms a standard signal-only baseline in multi-label diagnosis classification and successfully bridges a substantial portion of the performance gap to a fully multimodal model that requires all data at inference. Our work demonstrates a practical and effective method for creating more accurate and trustworthy ECG classification models. By converting abstract predictions into physiologically grounded \emph{explanations}, our approach offers a promising path toward the safer integration of AI into clinical workflows.

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.

Abstract--The integration of large language models (LLMs) into healthcare IoT systems promises faster decisions and improved medical support. LLMs are also deployed as multi-agent teams to assist AI doctors by debating, voting, or advising on decisions. However, when multiple assistant agents interact, coordinated adversaries can collude to create false consensus, pushing an AI doctor toward harmful prescriptions. We develop an experimental framework with scripted and unscripted doctor agents, adversarial assistants, and a verifier agent that checks decisions against clinical guidelines. Using 50 representative clinical questions, we find that collusion drives the Attack Success Rate (ASR) and Harmful Recommendation Rates (HRR) up to 100% in unprotected systems. This work provides the first systematic evidence of collusion risk in AI healthcare and demonstrates a practical, lightweight defence that ensures guideline fidelity. Artificial intelligence (AI) is increasingly integrated into healthcare IoT systems, supporting tasks such as remote patient monitoring, diagnosis, and treatment recommendations. In this setting, ensuring the security and trustworthiness of AI decisions is critical, since medical errors caused by unsafe recommendations can severely harm patients [1]. However, AI doctors and LLM-based clinical decision agents face multiple vulnerabilities.

Such models are integral to the development of context-aware surgical training systems and process monitoring platforms [11], [19] as well as for encoding adaptive robotic control policies in teleoperated environments [13], [20], [78]. However, their limited capacity to capture continuous biophysical dynamics can constrain their utility in applications where physiological fidelity is essential. Recognizing the limitations inherent in purely continuous or discrete approaches, hybrid modeling strategies have emerged as a state-of-the-art solution for surgical digital twins. These frameworks integrate continuous dynamic models with discrete state machines, enabling the simultaneous tracking of physiological changes and procedural events [8], [7], [19], [37]. For example, hybrid automata have been deployed to synchronize real-time updates of tissue deformation with the sequencing of surgical tool actions [7], [19]. This integration allows digital twins to provide context-sensitive support, adapting to abrupt workflow transitions and physiological perturbations alike--a critical requirement in both routine and emergent surgical scenarios [8], [11], [7]. B. Mutual Information and Information-Theoretic Approaches With the proliferation of multi-modal surgical data, information-theoretic concepts have become indispensable for quantifying uncertainty, relevance, and redundancy across heterogeneous information streams. Mutual information I(X; Y) has been adopted as a rigorous metric for selecting the most informative sensors, imaging modalities, or clinical parameters, thereby enhancing the efficiency and robustness of digital twin-enabled decision support [2], [3], [13], [34], [11], [51], [48], [26], [29]. This is formally captured as Eq.

Emerging from NASA's spacecraft simulations in the 1960s, digital twin technology has advanced through industrial adoption to spark a healthcare transformation. A digital twin is a dynamic, data-driven virtual counterpart of a physical system, continuously updated through real-time data streams and capable of bidirectional interaction. In medicine, digital twin integrates imaging, biosensors, and computational models to generate patient-specific simulations that support diagnosis, treatment planning, and drug development. Representative applications include cardiac digital twin for predicting arrhythmia treatment outcomes, oncology digital twin for tracking tumor progression and optimizing radiotherapy, and pharmacological digital twin for accelerating drug discovery. Despite rapid progress, major challenges, including interoperability, data privacy, and model fidelity, continue to limit widespread clinical integration. Emerging solutions such as explainable AI, federated learning, and harmonized regulatory frameworks offer promising pathways forward. Looking ahead, advances in multi-organ digital twin, genomics integration, and ethical governance will be essential to ensure that digital twin shifts healthcare from reactive treatment to predictive, preventive, and truly personalized medicine.

The transformative potential of artificial intelligence (AI) in medical Imaging (MI) is well recognized. Yet despite promising reports in research settings, many AI tools fail to achieve clinical adoption in practice. In fact, more generally, there is a documented 17-year average delay between evidence generation and implementation of a technology. Implementation science (IS) may provide a practical, evidence-based framework to bridge the gap between AI development and real-world clinical imaging use, to shorten this lag through systematic frameworks, strategies, and hybrid research designs. We outline challenges specific to AI adoption in MI workflows, including infrastructural, educational, and cultural barriers. We highlight the complementary roles of effectiveness research and implementation research, emphasizing hybrid study designs and the role of integrated KT (iKT), stakeholder engagement, and equity-focused co-creation in designing sustainable and generalizable solutions. We discuss integration of Human-Computer Interaction (HCI) frameworks in MI towards usable AI. Adopting IS is not only a methodological advancement; it is a strategic imperative for accelerating translation of innovation into improved patient outcomes.