Abstract:Medical AI systems face two fundamental limitations. First, conventional vision-language models (VLMs) perform single-pass inference, yielding black-box predictions that cannot be audited or explained in clinical terms. Second, iterative reasoning systems that expose intermediate steps rely on fixed iteration budgets wasting compute on simple cases while providing insufficient depth for complex ones. We address both limitations with a unified framework. RVLM replaces single-pass inference with an iterative generate-execute loop: at each step, the model writes Python code, invokes vision sub-agents, manipulates images, and accumulates evidence. Every diagnostic claim is grounded in executable code, satisfying auditability requirements of clinical AI governance frameworks. RRouter makes iteration depth adaptive: a lightweight controller predicts the optimal budget from task-complexity features, then monitors progress and terminates early when reasoning stalls. We evaluate on BraTS 2023 Meningioma (brain MRI) and MIMIC-CXR (chest X-ray) using Gemini 2.5 Flash without fine-tuning. Across repeated runs, RVLM shows high consistency on salient findings (e.g., mass presence and enhancement) and can detect cross-modal discrepancies between Fluid-Attenuated Inversion Recovery (FLAIR) signal characteristics and segmentation boundaries. On MIMIC-CXR, it generates structured reports and correctly recognises view-specific artefacts. Code: https://github.com/nican2018/rvlm.
Abstract:The rapid expansion of artificial intelligence (AI) in the Gulf Cooperation Council (GCC) raises a central question: are investments in compute infrastructure matched by an equally robust build-out of skills, incentives, and governance? Grounded in socio-technical systems (STS) theory, this mixed-methods study audits workforce preparedness across Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), Qatar, Kuwait, Bahrain, and Oman. We combine term frequency--inverse document frequency (TF--IDF) analysis of six national AI strategies (NASs), an inventory of 47 publicly disclosed AI initiatives (January 2017--April 2025), paired case studies, the Mohamed bin Zayed University of Artificial Intelligence (MBZUAI) and the Saudi Data & Artificial Intelligence Authority (SDAIA) Academy, and a scenario matrix linking oil-revenue slack (technical capacity) to regulatory coherence (social alignment). Across the corpus, 34/47 initiatives (0.72; 95% Wilson CI 0.58--0.83) exhibit joint social--technical design; country-level indices span 0.57--0.90 (small n; intervals overlap). Scenario results suggest that, under our modeled conditions, regulatory convergence plausibly binds outcomes more than fiscal capacity: fragmented rules can offset high oil revenues, while harmonized standards help preserve progress under austerity. We also identify an emerging two-track talent system, research elites versus rapidly trained practitioners, that risks labor-market bifurcation without bridging mechanisms. By extending STS inquiry to oil-rich, state-led economies, the study refines theory and sets a research agenda focused on longitudinal coupling metrics, ethnographies of coordination, and outcome-based performance indicators.