AeroSpectra Sentinel: An Auditable LLM Prompt-Chaining Decision-Support Workflow for Acute Asthma Risk Assessment from Respiratory Sounds and Clinical Signals

Acute asthma risk assessment requires rapid interpretation of respiratory sounds, oxygenation, airflow limitation, speech ability, work of breathing, mental status, and response to reliever therapy. Conventional audio-only classifiers can detect wheeze-like patterns but often lack transparent clinical reasoning and safe escalation logic. This paper presents AeroSpectra Sentinel, a client-side research prototype and decision-support workflow that combines short-time Fourier transform (STFT) respiratory sound analysis, lightweight machine-learning screening, clinical feature fusion, and a five-stage large language model (LLM) prompt-chaining process. The workflow separates signal acquisition, preprocessing, acoustic feature extraction, ML screening, clinical guardrails, and FHIR-ready reporting. We evaluated the audio screening component on a public respiratory sound dataset containing 1,211 WAV recordings from five labels. Using a stratified subset of 584 recordings, a random forest achieved 91.10% binary accuracy and 78.69% F1-score for asthma-vs-non-asthma screening, while a feature-based multilayer perceptron achieved 89.73% accuracy and 78.26% F1-score. A compact log-spectrogram CNN achieved 73.29% accuracy and 55.17% F1-score. Multiclass classification achieved 77.40% accuracy and 77.23% macro-F1. To evaluate the LLM workflow, we conducted a scenario-based audit on 40 simulated clinical vignettes comparing one-shot prompting, prompt chaining, prompt chaining with guardrails, and prompt chaining with guardrails plus FHIR schema validation. The guardrail-plus-schema variant achieved the strongest simulated safety and documentation consistency. AeroSpectra Sentinel is intended as a research prototype, not as a diagnostic medical device or clinically validated risk-assessment product.

A CUBS-Compatible Ultrasound Morphology and Uncertainty-Aware Baseline for Carotid Intima-Media Segmentation and Preliminary Risk Prediction

Carotid atherosclerosis is a major contributor to ischemic stroke and transient ischemic attack. Conventional ultrasound assessment is commonly based on intima-media thickness, plaque appearance, stenosis degree, and peak systolic velocity, but these morphology- and velocity-based indicators may not fully capture patient-specific vascular risk. This study presents AtheroFlow-XNet, a CUBS-compatible ultrasound morphology and uncertainty-aware learning baseline for carotid intima-media segmentation and preliminary risk prediction. Using the Carotid Ultrasound Boundary Study dataset, manual lumen-intima and media-adventitia boundary annotations were converted into dense intima-media masks for supervised segmentation. Clinical variables were incorporated into an auxiliary risk-prediction branch, and Monte Carlo dropout was used for uncertainty-aware inference. The model was evaluated using a patient-level train-validation-test split with 1,522 training images, 326 validation images, and 328 testing images. The proposed model achieved a Dice coefficient of 0.7930 for LI-MA mask segmentation, a segmentation loss of 0.2359, and an area under the receiver operating characteristic curve of 0.6910 for preliminary risk prediction. Qualitative results showed that predicted masks were generally aligned with manual annotations, while uncertainty maps highlighted ambiguous wall-boundary regions. These results suggest that ultrasound-derived carotid morphology can support automated wall analysis and uncertainty-aware interpretation. Since CUBS does not provide Doppler waveforms or CFD-derived hemodynamic biomarkers, this work should be interpreted as a reproducible morphology-driven baseline. Future work will incorporate Doppler-derived flow profiles, patient-specific vascular reconstruction, and CFD-based wall shear biomarkers.

A Real-Time Neuro-Symbolic Ethical Governor for Safe Decision Control in Autonomous Robotic Manipulation

Ethical decision governance has become a critical requirement for autonomous robotic systems operating in human-centered and safety-sensitive environments. This paper presents a real-time neuro-symbolic ethical governor designed to enable risk-aware supervisory control in autonomous robotic manipulation tasks. The proposed framework integrates transformer-based ethical reasoning with a probabilistic ethical risk field formulation and a threshold-based override control mechanism. language-grounded ethical intent inference capability is learned from natural language task descriptions using a fine-tuned DistilBERT model trained on the ETHICS commonsense dataset. A continuous ethical risk metric is subsequently derived from predicted unsafe action probability, confidence uncertainty, and probabilistic variance to support adaptive decision filtering. The effectiveness of the proposed approach is validated through simulated autonomous robot-arm task scenarios involving varying levels of human proximity and operational hazard. Experimental results demonstrate stable model convergence, reliable ethical risk discrimination, and improved safety-aware decision outcomes without significant degradation of task execution efficiency. The proposed neuro-symbolic architecture further provides enhanced interpretability compared with purely data-driven safety filters, enabling transparent ethical reasoning in real-time control loops. The findings suggest that ethical decision governance can be effectively modeled as a dynamic supervisory risk layer for autonomous robotic systems, with potential applicability to broader cyber-physical and assistive robotics domains.

Lyapunov-Aware Quantum-Inspired Reinforcement Learning for Continuous-Time Vehicle Control: A Feasibility Study

This paper presents a novel Lyapunov-Based Quantum Reinforcement Learning (LQRL) framework that integrates quantum policy optimization with Lyapunov stability analysis for continuous-time vehicle control. The proposed approach combines the representational power of variational quantum circuits (VQCs) with a stability-aware policy gradient mechanism to ensure asymptotic convergence and safe decision-making under dynamic environments. The vehicle longitudinal control problem was formulated as a continuous-state reinforcement learning task, where the quantum policy network generates control actions subject to Lyapunov stability constraints. Simulation experiments were conducted in a closed-loop adaptive cruise control scenario using a quantum-inspired policy trained under stability feedback. The results demonstrate that the LQRL framework successfully embeds Lyapunov stability verification into quantum policy learning, enabling interpretable and stability-aware control performance. Although transient overshoot and Lyapunov divergence were observed under aggressive acceleration, the system maintained bounded state evolution, validating the feasibility of integrating safety guarantees within quantum reinforcement learning architectures. The proposed framework provides a foundational step toward provably safe quantum control in autonomous systems and hybrid quantum-classical optimization domains.

Secure Multi-Modal Data Fusion in Federated Digital Health Systems via MCP

Secure and interoperable integration of heterogeneous medical data remains a grand challenge in digital health. Current federated learning (FL) frameworks offer privacy-preserving model training but lack standardized mechanisms to orchestrate multi-modal data fusion across distributed and resource-constrained environments. This study introduces a novel framework that leverages the Model Context Protocol (MCP) as an interoperability layer for secure, cross-agent communication in multi-modal federated healthcare systems. The proposed architecture unifies three pillars: (i) multi-modal feature alignment for clinical imaging, electronic medical records, and wearable IoT data; (ii) secure aggregation with differential privacy to protect patient-sensitive updates; and (iii) energy-aware scheduling to mitigate dropouts in mobile clients. By employing MCP as a schema-driven interface, the framework enables adaptive orchestration of AI agents and toolchains while ensuring compliance with privacy regulations. Experimental evaluation on benchmark datasets and pilot clinical cohorts demonstrates up to 9.8\% improvement in diagnostic accuracy compared with baseline FL, a 54\% reduction in client dropout rates, and clinically acceptable privacy--utility trade-offs. These results highlight MCP-enabled multi-modal fusion as a scalable and trustworthy pathway toward equitable, next-generation federated health infrastructures.