Université de Bordeaux

Intrusion alerts no longer trigger remediation on a single model's word: independent notary agents re-check each verdict and co-sign it on a Hyperledger Fabric ledger only after a 2-of-3 quorum. On the class-balanced CICIDS2017 test set the calibrated ensemble reaches 96.60% accuracy over all decisions, and the certified subset reaches 99.65% accuracy at a 0.04% false-positive rate with 87.3% coverage; on the independently generated GeNIS 2025 corpus the same stack certifies 99.86% of flows at 99.98% accuracy.

Intrusion alerts no longer trigger remediation on a single model's word: independent notary agents re-check each verdict and co-sign it on a Hyperledger Fabric ledger only after a 2-of-3 quorum. On the class-balanced CICIDS2017 test set the calibrated ensemble reaches 96.60% accuracy over all decisions, and the certified subset reaches 99.65% accuracy at a 0.04% false-positive rate with 87.3% coverage; on the independently generated GeNIS 2025 corpus the same stack certifies 99.86% of flows at 99.98% accuracy.

The study introduces a domain-agnostic paired-comparison approach that fine-tunes a large language model to emulate documented emergency triage decisions and then compares predictions on sex-swapped pairs in which only sex is flipped while documented clinical content is held constant, finding that otherwise identical presentations were more likely to receive a lower-severity (less urgent) predicted triage score as female than male, with a pooled per-pair rate of about 1.1% (95% CI 0.9–1.3) across more than 140,000 Bordeaux University Hospital admissions and a directionally consistent but larger 2.2% (1.7–2.7) in MIMIC-IV, while a model retrained on sex-neutralized inputs eliminated the between-sex prediction gap, indicating the asymmetry is mediated by explicit sex markers.

The study introduces a domain-agnostic paired-comparison approach that fine-tunes a large language model to emulate documented emergency triage decisions and then compares predictions on sex-swapped pairs in which only sex is flipped while documented clinical content is held constant, finding that otherwise identical presentations were more likely to receive a lower-severity (less urgent) predicted triage score as female than male, with a pooled per-pair rate of about 1.1% (95% CI 0.9–1.3) across more than 140,000 Bordeaux University Hospital admissions and a directionally consistent but larger 2.2% (1.7–2.7) in MIMIC-IV, while a model retrained on sex-neutralized inputs eliminated the between-sex prediction gap, indicating the asymmetry is mediated by explicit sex markers.