arXiv:2511.17644v1 Announce Type: new Abstract: Artificial intelligence deployed in risk-sensitive domains such as healthcare, finance, and security must not only achieve predictive accuracy but also ensure transparency, ethical alignment, and compliance with regulatory expectations. Hybrid neuro symbolic models combine the pattern-recognition strengths of neural networks with the interpretability and logical rigor of symbolic reasoning, making them well-suited for these contexts. This paper surveys hybrid architectures, ethical design considerations, and deployment patterns that balance accuracy with accountability. We highlight techniques for integrating knowledge graphs with deep inference, embedding fairness-aware rules, and generating human-readable explanations. Through case studies in healthcare decision support, financial risk management, and autonomous infrastructure, we show how hybrid systems can deliver reliable and auditable AI. Finally, we outline evaluation protocols and future directions for scaling neuro symbolic frameworks in complex, high stakes environments.

arXiv:2511.17947v1 Announce Type: new Abstract: Large language models (LLMs) show promise in automating clinical diagnosis, yet their non-transparent decision-making and limited alignment with diagnostic standards hinder trust and clinical adoption. We address this challenge by proposing a two-stage diagnostic framework that enhances transparency, trustworthiness, and reliability. First, we introduce Evidence-Guided Diagnostic Reasoning (EGDR), which guides LLMs to generate structured diagnostic hypotheses by interleaving evidence extraction with logical reasoning grounded in DSM-5 criteria. Second, we propose a Diagnosis Confidence Scoring (DCS) module that evaluates the factual accuracy and logical consistency of generated diagnoses through two interpretable metrics: the Knowledge Attribution Score (KAS) and the Logic Consistency Score (LCS). Evaluated on the D4 dataset with pseudo-labels, EGDR outperforms direct in-context prompting and Chain-of-Thought (CoT) across five LLMs. For instance, on OpenBioLLM, EGDR improves accuracy from 0.31 (Direct) to 0.76 and increases DCS from 0.50 to 0.67. On MedLlama, DCS rises from 0.58 (CoT) to 0.77. Overall, EGDR yields up to +45% accuracy and +36% DCS gains over baseline methods, offering a clinically grounded, interpretable foundation for trustworthy AI-assisted diagnosis.

arXiv:2511.18364v1 Announce Type: new Abstract: Building high-quality knowledge graphs (KGs) from diverse sources requires combining methods for information extraction, data transformation, ontology mapping, entity matching, and data fusion. Numerous methods and tools exist for each of these tasks, but support for combining them into reproducible and effective end-to-end pipelines is still lacking. We present a new framework, KGpipe for defining and executing integration pipelines that can combine existing tools or LLM (Large Language Model) functionality. To evaluate different pipelines and the resulting KGs, we propose a benchmark to integrate heterogeneous data of different formats (RDF, JSON, text) into a seed KG. We demonstrate the flexibility of KGpipe by running and comparatively evaluating several pipelines integrating sources of the same or different formats using selected performance and quality metrics.

arXiv:2511.17515v1 Announce Type: cross Abstract: Systems analysis students increasingly use Generative AI, yet current pedagogy lacks systematic approaches for teaching responsible AI orchestration that fosters critical thinking whilst meeting educational outcomes. Students risk accepting AI suggestions blindly or uncritically without assessing alignment with user needs or contextual appropriateness. SAGE (Structured AI-Guided Education) addresses this gap by embedding GenAI into curriculum design, training students when to accept, modify, or reject AI contributions. Implementation with 18 student groups across four Australian universities revealed how orchestration skills develop. Most groups (84\%) moved beyond passive acceptance, showing selective judgment, yet none proactively identified gaps overlooked by both human and AI analysis, indicating a competency ceiling. Students strong at explaining decisions also performed well at integrating sources, and those with deep domain understanding consistently considered accessibility considerations. Accessibility awareness proved fragile. When writing requirements, 85\% of groups explicitly considered elderly users and cultural needs. Notably, 55\% of groups struggled identifying when AI misclassified system boundaries (what belongs inside versus outside the system), 45\% missed data management errors (how information is stored and updated), and 55\% overlooked missing exception handling. Three implications emerge for educators: (i) require students to document why they accepted, modified, or rejected each AI suggestion, making reasoning explicit; (ii) embed accessibility prompts at each development stage because awareness collapses without continuous scaffolding; and (iii) have students create their own specifications before using AI, then compare versions, and anchor to research or standards to identify gaps.

arXiv:2511.17655v1 Announce Type: cross Abstract: Our study provides a full deep learning system for automated classification of brain tumors from MRI images, includes six benchmarked architectures (five ImageNet-pre-trained models (VGG-16, Inception V3, ResNet-50, Inception-ResNet V2, Xception) and a custom built, compact CNN (1.31M params)). The study moves the needle forward in a number of ways, including (1) full standardization of assessment with respect to preprocessing, training sets/protocols (optimizing networks with the AdamW optimizer, CosineAnnealingLR, patiene for early stopping = 7), and metrics to assess performance were identical along all models; (2) a high level of confidence in the localizations based on prior studies as both Grad-CAM and GradientShap explanation were used to establish anatomically important and meaningful attention regions and address the black-box issue; (3) a compact 1.31 million parameter CNN was developed that achieved 96.49% testing accuracy and was 100 times smaller than Inception-ResNet V2 while permitting real-time inference (375ms) on edge devices; (4) full evaluation beyond accuracy reporting based on measures of intersection over union, Hausdorff distance, and precision-recall curves, and confusion matrices across all splits. Inception-ResNet V2 reached state-of-the-art performance, achieving a 99.53% accuracy on testing and obtaining a precision, recall, and F1-score of at least 99.50% dominant performance based on metrics of recent studies. We demonstrated a lightweight model that is suitable to deploy on devices that do not have multi-GPU infrastructure in under-resourced settings. This end-to-end solution considers accuracy, interpretability, and deployability of trustworthy AI to create the framework necessary for performance assessment and deployment within advance and low-resource healthcare systems to an extent that enabled participation at the clinical screening and triage level.

arXiv:2511.17658v1 Announce Type: cross Abstract: As digital communication grows in importance when connecting with healthcare providers, traditional behavioral and content message features are imbued with renewed significance. If one is to meaningfully connect with them, it is crucial to understand what drives them to engage and respond. In this study, the authors analyzed several million text messages sent through the Impiricus platform to learn which factors influenced whether or not a doctor clicked on a link in a message. Several key insights came to light through the use of logistic regression, random forest, and neural network models, the details of which the authors discuss in this paper.

arXiv:2511.17828v1 Announce Type: cross Abstract: Foundation models hold promise for specialized medical imaging tasks, though their effectiveness in breast imaging remains underexplored. This study leverages BiomedCLIP as a foundation model to address challenges in model generalization. BiomedCLIP was adapted for automated BI-RADS breast density classification using multi-modality mammographic data (synthesized 2D images, digital mammography, and digital breast tomosynthesis). Using 96,995 images, we compared single-modality (s2D only) and multi-modality training approaches, addressing class imbalance through weighted contrastive learning. Both approaches achieved similar accuracy (multi-modality: 0.74, single-modality: 0.73), with the multi-modality model offering broader applicability across different imaging modalities and higher AUC values consistently above 0.84 across BI-RADS categories. External validation on the RSNA and EMBED datasets showed strong generalization capabilities (AUC range: 0.80-0.93). GradCAM visualizations confirmed consistent and clinically relevant attention patterns, highlighting the models interpretability and robustness. This research underscores the potential of foundation models for breast imaging applications, paving the way for future extensions for diagnostic tasks.

arXiv:2511.17959v1 Announce Type: cross Abstract: As AI agents attempt to autonomously act on users' behalf, they raise transparency and control issues. We argue that permission-based access control is indispensable in providing meaningful control to the users, but conventional permission models are inadequate for the automated agentic execution paradigm. We therefore propose automated permission management for AI agents. Our key idea is to conduct a user study to identify the factors influencing users' permission decisions and to encode these factors into an ML-based permission management assistant capable of predicting users' future decisions. We find that participants' permission decisions are influenced by communication context but importantly individual preferences tend to remain consistent within contexts, and align with those of other participants. Leveraging these insights, we develop a permission prediction model achieving 85.1% accuracy overall and 94.4% for high-confidence predictions. We find that even without using permission history, our model achieves an accuracy of 66.9%, and a slight increase of training samples (i.e., 1-4) can substantially increase the accuracy by 10.8%.

arXiv:2511.18076v1 Announce Type: cross Abstract: This research proposes an enhancement to the innovative portfolio optimization approach using the G-Learning algorithm, combined with parametric optimization via the GIRL algorithm (G-learning approach to the setting of Inverse Reinforcement Learning) as presented by. The goal is to maximize portfolio value by a target date while minimizing the investor's periodic contributions. Our model operates in a highly volatile market with a well-diversified portfolio, ensuring a low-risk level for the investor, and leverages reinforcement learning to dynamically adjust portfolio positions over time. Results show that we improved the Sharpe Ratio from 0.42, as suggested by recent studies using the same approach, to a value of 0.483 a notable achievement in highly volatile markets with diversified portfolios. The comparison between G-Learning and GIRL reveals that while GIRL optimizes the reward function parameters (e.g., lambda = 0.0012 compared to 0.002), its impact on portfolio performance remains marginal. This suggests that reinforcement learning methods, like G-Learning, already enable robust optimization. This research contributes to the growing development of reinforcement learning applications in financial decision-making, demonstrating that probabilistic learning algorithms can effectively align portfolio management strategies with investor needs.

arXiv:2511.18274v1 Announce Type: cross Abstract: Digital health interventions are increasingly used in physical and occupational therapy to deliver home exercise programs via sensor equipped devices such as smartphones, enabling remote monitoring of adherence and performance. However, digital interventions are typically programmed as software before clinical encounters as libraries of parametrized exercise modules targeting broad patient populations. At the point of care, clinicians can only select modules and adjust a narrow set of parameters like repetitions, so patient specific needs that emerge during encounters, such as distinct movement limitations, and home environments, are rarely reflected in the software. We evaluated a digital intervention paradigm that uses large language models (LLMs) to translate clinicians' exercise prescriptions into intervention software. In a prospective single arm feasibility study with 20 licensed physical and occupational therapists and a standardized patient, clinicians created 40 individualized upper extremity programs (398 instructions) that were automatically translated into executable software. Our results show a 45% increase in the proportion of personalized prescriptions that can be implemented as software compared with a template based benchmark, with unanimous consensus among therapists on ease of use. The LLM generated software correctly delivered 99.78% (397/398) of instructions as prescribed and monitored performance with 88.4% (352/398) accuracy, with 90% (18/20) of therapists judged it safe to interact with patients, and 75% (15/20) expressed willingness to adopt it. To our knowledge, this is the first prospective evaluation of clinician directed intervention software generation with LLMs in healthcare, demonstrating feasibility and motivating larger trials to assess clinical effectiveness and safety in real patient populations.

arXiv:2511.18622v1 Announce Type: cross Abstract: We present OpenGloss, a synthetic encyclopedic dictionary and semantic knowledge graph for English that integrates lexicographic definitions, encyclopedic context, etymological histories, and semantic relationships in a unified resource. OpenGloss contains 537K senses across 150K lexemes, on par with WordNet 3.1 and Open English WordNet, while providing more than four times as many sense definitions. These lexemes include 9.1M semantic edges, 1M usage examples, 3M collocations, and 60M words of encyclopedic content. Generated through a multi-agent procedural generation pipeline with schema-validated LLM outputs and automated quality assurance, the entire resource was produced in under one week for under $1,000. This demonstrates that structured generation can create comprehensive lexical resources at cost and time scales impractical for manual curation, enabling rapid iteration as foundation models improve. The resource addresses gaps in pedagogical applications by providing integrated content -- definitions, examples, collocations, encyclopedias, etymology -- that supports both vocabulary learning and natural language processing tasks. As a synthetically generated resource, OpenGloss reflects both the capabilities and limitations of current foundation models. The dataset is publicly available on Hugging Face under CC-BY 4.0, enabling researchers and educators to build upon and adapt this resource.

arXiv:2511.19220v1 Announce Type: cross Abstract: Large vision language models (VLMs) have achieved impressive performance on medical visual question answering benchmarks, yet their reliance on visual information remains unclear. We investigate whether frontier VLMs demonstrate genuine visual grounding when answering Italian medical questions by testing four state-of-the-art models: Claude Sonnet 4.5, GPT-4o, GPT-5-mini, and Gemini 2.0 flash exp. Using 60 questions from the EuropeMedQA Italian dataset that explicitly require image interpretation, we substitute correct medical images with blank placeholders to test whether models truly integrate visual and textual information. Our results reveal striking variability in visual dependency: GPT-4o shows the strongest visual grounding with a 27.9pp accuracy drop (83.2% [74.6%, 91.7%] to 55.3% [44.1%, 66.6%]), while GPT-5-mini, Gemini, and Claude maintain high accuracy with modest drops of 8.5pp, 2.4pp, and 5.6pp respectively. Analysis of model-generated reasoning reveals confident explanations for fabricated visual interpretations across all models, suggesting varying degrees of reliance on textual shortcuts versus genuine visual analysis. These findings highlight critical differences in model robustness and the need for rigorous evaluation before clinical deployment.

Background: Preventive strategies integrated with digital health and artificial intelligence (AI), have significant potential to mitigate the global burden of atherosclerotic cardiovascular disease (ASCVD). AI-enabled clinical decision support (CDS) systems increasingly provide patient-specific insights beyond traditional risk factors. Despite these advances, their capacity to enhance clinical decision-making in resource-constrained settings remains largely unexplored. Objective: We conducted a randomised controlled study to assess the effect of AI-based CDS on 10-year ASCVD risk assessment and management in primary prevention. Methods: In a three-way within-subject randomised design, doctors completed nine clinical vignettes representative of primary care presentations in a resource-constrained outpatient setting. For each vignette, participants assessed 10-year ASCVD risk and made management decisions using either a conceptual prototype of AI-based CDS, automated CDS, or no decision support. The conceptual prototype represented contemporary risk calculators based on traditional machine learning models (e.g., random forest, neural networks, logistic regression) that incorporate additional predictors alongside traditional risk factors. Primary outcomes were correct risk assessment and patient management (prescription of aspirin, statins, and anti-hypertensives; referral for advanced examinations). Decision-making time and perceptions about AI utility were also measured. Results: 102 doctors from all seven geographical regions of Indonesia participated. Most participants were 26–35 years (83%), 56% male, with a median of six years of clinical experience (IQR=4.75). AI-based CDS improved risk assessment by 27% (2(2, n=102) = 48.875, P<.001 compared to unassisted or one additional correct risk classification for every patients where doctors use ai needed treat nnt="3.7;" ci the prescription of statins also improved by n="102)=" p in pairwise comparisons assisted with ai-based cds correctly assessed significantly more cases adjusted and prescribed appropriate statin often medium effect size r=".35)" control. ai-assisted required less time marginal means sec vs f however improvements aspirin anti-hypertensives did not reach statistical significance. no improvement was observed referral decisions. participants generally viewed positively agreeing strongly that they would follow its recommendations indicating it if given access. believed could enhance efficiency assessment particularly high-volume primary care settings while noting need verify against clinical guidelines each patient. conclusions: coupled reduced decision-making highlight potential utility ascvd resource-constrained efficient healthcare resources is crucial. further research ascertain whether this online study translate real-world low-resource settings.>

arXiv:2511.11030v3 Announce Type: replace-cross Abstract: Artificial intelligence is revealing what medicine never intended to encode. Deep vision models, trained on chest X-rays, can now detect not only disease but also invisible traces of social inequality. In this study, we show that state-of-the-art architectures (DenseNet121, SwinV2-B, MedMamba) can predict a patient's health insurance type, a strong proxy for socioeconomic status, from normal chest X-rays with significant accuracy (AUC around 0.67 on MIMIC-CXR-JPG, 0.68 on CheXpert). The signal persists even when age, race, and sex are controlled for, and remains detectable when the model is trained exclusively on a single racial group. Patch-based occlusion reveals that the signal is diffuse rather than localized, embedded in the upper and mid-thoracic regions. This suggests that deep networks may be internalizing subtle traces of clinical environments, equipment differences, or care pathways; learning socioeconomic segregation itself. These findings challenge the assumption that medical images are neutral biological data. By uncovering how models perceive and exploit these hidden social signatures, this work reframes fairness in medical AI: the goal is no longer only to balance datasets or adjust thresholds, but to interrogate and disentangle the social fingerprints embedded in clinical data itself.

Nature Medicine, Published online: 25 November 2025; doi:10.1038/s41591-025-04050-6

The missing value of medical artificial intelligence