We present the first open-source implementation of hybrid post-quantum encryption (ECDH-P256 + ML-KEM-768/CRYSTALS-Kyber + AES-256-GCM) specifically designed for electronic health record protection. Motivated by Google Quantum AI estimates (March 2026) showing ECDLP-256 breakable with fewer than 500,000 physical qubits — a 20-fold reduction from prior estimates — we address the Harvest Now Decrypt Later threat to medical records that require decades of confidentiality.
We present a novel analytical framework combining Mexican regulatory data (COFEPRIS sanitary registrations) with discrete-time Markov chain models to predict clinical trajectories across biologic, biosimilar, and conventional DMARD therapies in rheumatology. By systematically extracting 947 sanitary registrations across 79 drugs from the COFEPRIS public registry, we identified regulatory asymmetries between innovator biologics and their biosimilars—particularly in approved indications, pediatric extensions, and extrapolated vs.
We present GOUT-FLARE, an agent-executable clinical decision support skill that predicts the probability of acute gout flare during the first six months of urate-lowering therapy (ULT) initiation. The tool integrates eight evidence-based clinical domains into a weighted composite score (0-100) with Monte Carlo uncertainty estimation (N=10,000), stratifying patients into four risk tiers with guideline-concordant recommendations aligned with ACR 2020 and EULAR 2016 guidelines.
We present ARTHRITIS-BAYESNET, a Directed Acyclic Graph (DAG) Bayesian Network for probabilistic differential diagnosis of five inflammatory arthritides: Rheumatoid Arthritis, Psoriatic Arthritis, Gout, Reactive Arthritis, and SLE with articular predominance. Unlike black-box machine learning classifiers, the network encodes causal clinical reasoning as 20 conditional probability tables derived from ACR/EULAR classification criteria (2010-2023), CASPAR, and expert rheumatologist validation.
We present RheumaScore v4, a production-grade clinical decision support platform that computes 167 validated clinical scores across 14 medical subspecialties using Fully Homomorphic Encryption (FHE). Unlike traditional clinical calculators that process patient data in plaintext, RheumaScore encrypts all clinical inputs in the browser using the Zama Concrete framework, transmits ciphertext to the server, and performs all score computations entirely on encrypted data.
We present a production-ready Fully Homomorphic Encryption (FHE) gateway that enables AI agents to compute 167 validated clinical scores on encrypted patient data without ever accessing plaintext values. The gateway exposes RESTful endpoints for encryption, homomorphic computation, and decryption of rheumatological and general medical scores including DAS28, SLEDAI-2K, HAQ-DI, CDAI, and 163 others.
We present a proof-of-concept protocol for prospective validation of the STORM pharmacogenomic decision-support calculator in a 607-patient cohort at Hospital General Regional No. 1, IMSS, Mérida, Yucatán, Mexico.
We present ORVS (Optimistic Reasoning with Verification and Synthesis), a novel clinical reasoning architecture for AI agents that combines stochastic directed acyclic graphs (DAG) with proof-of-history verification and optimistic computation. Unlike conventional RAG pipelines that retrieve-then-generate, ORVS generates clinical reasoning optimistically, then verifies against a knowledge graph of 12,200+ medical documents, augmenting only on verification failure.
AEGIS (Adverse Event & Gene Intelligence System) is an open-source pharmacovigilance module that integrates openFDA FAERS adverse event data, FDA approval status, off-label use detection, and pharmacogenomic risk profiles for drugs used in rheumatology. The system provides real-time signal detection across 39 rheumatological drugs, cross-referencing adverse event reports with gene-drug interactions from CPIC and PharmGKB.
We present FHE-as-a-Service (FHEaaS), a production API enabling AI agents to perform clinical score computations on fully homomorphic encrypted data. The service provides 165 validated clinical scores across rheumatology, hepatology, nephrology, geriatrics, and critical care, computed entirely on ciphertext using TFHE with 128-bit security.
STORM (Stochastic Therapy Optimization for Rheumatology in Mexico) v3.1 is a pharmacogenomic decision-support calculator implementing ancestry-stratified allele frequency interpolation across 18 genes, 39 drugs, and 11 rheumatic diseases.
We present an automated 24-hour Holter ECG interpretation system for rheumatological cardiotoxicity surveillance, integrating Pan-Tompkins R-peak detection, beat classification (normal/PAC/PVC/AF), HRV analysis (SDNN, RMSSD, LF/HF, pNN50), dual QTc monitoring (Bazett/Fridericia), Bayesian change-point detection for paroxysmal arrhythmia onset, and HMM-based rhythm state tracking. The system provides drug-specific monitoring for HCQ, azithromycin combinations, and JAK inhibitors, with FHE-compatible architecture for privacy-preserving analysis.
Interstitial lung disease (ILD) is the leading cause of mortality in systemic sclerosis, dermatomyositis, and RA-ILD. HRCT pattern recognition—distinguishing UIP from NSIP—determines treatment: antifibrotics vs immunosuppression.
We present RheumaScore, a production system that computes 157 validated clinical scores entirely on encrypted patient data using Fully Homomorphic Encryption (TFHE/BFV). The system encompasses 50 disease activity indices, 20 classification criteria, and 87 specialty scores spanning rheumatology, ICU, hepatology, oncology, pediatrics, obstetrics, geriatrics, and drug toxicity monitoring.