Search Results (1,019)

Background/Objectives: Oral tongue squamous cell carcinoma (OTSCC) remains clinically challenging because conventional clinicopathological markers do not fully explain variability in recurrence and survival. This systematic review and functional meta-synthesis aimed to identify and critically appraise studies using preoperative magnetic resonance imaging (MRI)-based radiomics, artificial intelligence (AI), deep learning, or quantitative MRI-derived models to predict recurrence and prognostic outcomes in OTSCC. Methods: PubMed, Scopus, and Embase were searched from inception to March 2026. Eligible studies included prognostic model investigations in adults with OTSCC or primary tongue cancer without reported base-of-tongue/oropharyngeal involvement, undergoing preoperative MRI and surgery, with recurrence- or survival-related follow-up. The primary synthesis was a functional meta-synthesis; pooling was not performed because studies were not sufficiently comparable. Results: Seven retrospective studies were included, with a summed descriptive sample of 1287 participants. The evidence base was heterogeneous in MRI sequences, segmentation workflows, model architecture, validation strategy, and endpoint definition. Functional meta-synthesis identified four domains: direct recurrence-oriented modeling, broader prognostic stratification, reported incremental or complementary value over clinical frameworks, and translational maturity/technical implementation. Several studies reported associations between MRI-derived signatures and recurrence- or survival-related outcomes, but findings were interpreted narratively because of differences in primary endpoints, imaging features, model design, validation methods, and outcome definitions. Most studies were judged at high overall risk of bias, and certainty of evidence ranged from low to very low. Conclusions: MRI-based radiomics and AI show preliminary promise for prognostic stratification in OTSCC, particularly recurrence-related risk refinement, but current evidence remains limited by retrospective design, heterogeneity, sparse external validation, and low certainty. Full article

Background/Objectives: Advancements in neuroscience and machine learning have increasingly enabled brain pattern recognition based on bio-signal measurements, such as electroencephalography (EEG). These developments support next-generation technologies, including brain–computer interfaces (BCIs) and AI-assisted systems. However, volume conduction (VC) effects remain a major source of contamination in EEG recordings, affecting both univariate analyses and functional connectivity estimation. Methods: In this work, we propose a VC mitigation method that explicitly models and suppresses VC components in the observed functional networks. Specifically, the observed functional network is decomposed into a matrix capturing only VC-related components (i.e., components attributed to volume conduction) and a residual matrix, where the residual is regarded as a proxy for a VC-mitigated functional network that better reflects the underlying functional interactions. The VC component matrix is modeled using a decay function parameterized by the inter-electrode distance matrix, capturing the dominant spatial bias induced by VC. To estimate these parameters, we introduce supervised channel importance, quantified as the mutual information between experimental labels and channel signals, as a proxy for task-relevant neural activity. The parameters are optimized such that the unsupervised node importance derived from the VC-mitigated functional network, defined as the average node strength, aligns with the supervised channel importance. Results: Evaluation results using a deep-learning framework demonstrate that, compared with the observed functional network, the VC-mitigated functional network improves classification performance in brain pattern recognition tasks. Full article

Background/Objectives: Hysteroscopy is the gold standard for visualization and treatment of intrauterine pathology. Because hysteroscopic interpretation remains operator-dependent, artificial intelligence (AI) has been evaluated as a tool to improve consistency, lesion recognition, and decision support. We aimed to systematically review AI, machine learning (ML), deep learning (DL), or computer-aided diagnosis (CAD) applications in hysteroscopy. Methods: A systematic search of PubMed/MEDLINE and EBSCOhost was performed from database inception to 8 March 2026, supplemented by targeted searches. Risk of bias was assessed using QUADAS-2 (diagnostic), PROBAST (prognostic), RoB2, and structured technical quality domains. Results: Nineteen primary studies were included, covering five areas: diagnostic classification and object detection (n = 8), real-time lesion detection and localization (n = 4), segmentation and visual-field support (n = 3), operative guidance (n = 1), and prognostic or decision-support applications (n = 3). Performance was highest in narrowly defined binary tasks and in large multicenter systems (e.g., ECCADx: AUC 0.979 internal, 0.975 external) and in prognostic fertility-prediction models after hysteroscopic adhesiolysis (AUC up to 0.992). Broader multiclass classification of heterogeneous lesions showed uneven and lower performance. Most studies were single-center, retrospective, and lacked external validation. Only one randomized study linked AI support to measurable procedural outcomes. Conclusions: The available studies indicate good technical performance in selected hysteroscopic tasks, particularly binary classification, focal lesion detection, and postoperative fertility stratification. Current evidence, however, remains limited by retrospective design, operator-dependent image acquisition, inconsistent validation, and scarce outcome-based clinical testing. In the short term, the most likely role of these systems is to support image interpretation, improve visual quality control, highlight suspicious lesions, and integrate hysteroscopic findings with complementary clinical data. Full article

This study examines how the relationship between perceived financial accounting disclosures (FAD) and investor reactions to negative financial news (IRNFN) is conditioned by two individual-level moderators among 310 retail investors holding shares in project-based organisations (PBOs) listed on the Dubai Financial Market and Abu Dhabi Securities Exchange. The two moderators are framing bias susceptibility, a cognitive predisposition to be influenced by presentational form, and AI channel reliance (AICR), the extent to which investors rely on AI-mediated information channels—including algorithmic news aggregators, robo-advisory tools, AI-curated social media feeds, and automated sentiment-scored financial alerts—for receiving and interpreting corporate disclosures. Drawing on Behavioural Finance Theory and the Theory of Planned Behaviour, the study investigates whether the strength of the FAD–IRNFN association depends on these cognitive and informational processing conditions. The measurement model was estimated using confirmatory factor analysis in AMOS 25, and the moderation hypotheses were tested through path analysis with mean-centred composite scores and bias-corrected bootstrap inference, with a latent interaction robustness check reported in parallel. AI channel reliance emerged as a substantial moderator of the FAD–IRNFN relationship, while framing bias provided a smaller, marginally significant moderating effect. The findings are consistent with the theoretical expectation that, in AI-mediated information environments, the perceived quality and presentation of complex disclosures are associated with stronger, rather than weaker, investor reactions to negative news. Because the design is cross-sectional and based on self-reported data, the results are interpreted as associations rather than causal effects, with implications for disclosure regulation, corporate communication, and AI platform design in the UAE and comparable emerging markets. Full article

Background: Chatbots are becoming increasingly valuable in clinical settings, offering rapid access to medical information, aiding documentation, and improving perioperative patient education. Their adaptability makes them promising tools for personalized perioperative risk stratification (PRS) and anesthesia planning, but their definitive role remains uncertain. We aimed to evaluate chatbot performance in PRS compared to standard clinical judgment and to assess the certainty of the evidence supporting their use. Methods: This systematic review (PROSPERO ID: CRD42025642357) followed PRISMA extended and PRISMA-S guidelines. The population was defined according to the PICO framework: we included adult surgical patients undergoing anesthesia assessment (P), evaluated with LLM-based chatbots for perioperative risk stratification and anesthesia planning (I), compared with traditional clinician assessment (C), and extracted performance metrics (O). Comprehensive searches of PubMed, MEDLINE, Scopus, Embase, Google Scholar, Open Gray, ClinicalTrials.gov, WHO ICTRP, and Cochrane Library Central were conducted through January 2026. Risk of bias and study quality were assessed using PROBAST-AI, RoB-2, and ROBINS-I. Certainty of the evidence was assessed using GRADE system. A random-effects meta-analysis of pooled chatbot accuracy was performed, with subgroup analyses by ASA status and perioperative risk stratification. A sensitivity analysis was performed with a leave-one-out exclusion test. Results: Eleven studies published between 2023 and January 2026 were included (N = 227,059 patients). Five prospective cohorts, two large retrospective cohorts, one randomized non-inferiority trial, and three non-clinical or mixed-methods studies were found. Meta-analysis showed that the pooled accuracy of LLM-based chatbots for AI–clinician concordance in perioperative risk stratification and ASA classification was 0.90 [95% CI: 0.42–0.99; 95% prediction interval 0.03–1.00]. Subgroup analyses indicated that the ASA status prediction subgroup reached a pooled accuracy of 0.91 (95% CI: 0.46 to 0.99), whereas the exploratory perioperative risk stratification subgroup showed an accuracy of 0.73 (95% CI: 0.10 to 0.98). Performance decreased with increasing patient complexity. Evidence is limited by small sample sizes, extreme sample size skew toward a single center, geographic bias, inconsistent outcome definitions and performance metrics, and incomplete reporting of adverse events. Most studies lacked prospective trial registration or robust control for confounding, and publication bias cannot be excluded. Conclusions: LLM-based chatbots show promising performance in routine perioperative risk stratification but remain unreliable in complex cases, with potential safety concerns. Given the overall very low GRADE certainty of evidence, these tools should be used as clinician-supervised decision support aids for routine ASA assessment, and should not be relied upon for autonomous use in complex cases or for general perioperative risk stratification. Other: This research received no external funding. PROSPERO ID: CRD42025642357. Full article

With the growing global population, intensifying resource constraints, and deepening climate change impacts, agriculture faces dual challenges of ensuring food security and advancing sustainable development. Artificial intelligence (AI) has emerged as a transformative technology, penetrating the entire crop production chain and offering innovative solutions to traditional agricultural bottlenecks. This paper systematically reviews AI applications in five core domains: biotic stress monitoring, soil health management, precision operation, supply chain optimization, and climate-resilient agriculture. It further categorizes and analyzes four key technical pathways—deep learning, sensor fusion, data-driven methods, and hybrid modeling—while critically examining major challenges across data, technology, implementation, and ethics/policy dimensions. Future directions are discussed from technological innovation, scenario expansion, implementation guarantees, and sustainability orientation. Research findings show that AI has achieved technical validation in pest/disease detection, soil parameter modeling, and intelligent spraying, with accuracy exceeding 85% in some cases. However, regional data bias, insufficient model generalization, and the digital divide still hinder large-scale deployment. Moving forward, coordinated efforts in technological innovation and policy support are required to promote inclusive, standardized, and sustainable AI applications in crop production. Full article

AI-enabled cyber–physical systems (CPSs) are increasingly deployed in public governance contexts where they sense human populations, infer classifications or risks, and trigger interventions that can shape liberty, equality, and access to essential services. In these deployments, governance failures often arise not only from model error but from systems-level interactions across data generation, model updates, organizational practices, and downstream actuation. This paper introduces a Risk–Rights–Rules (3R) architecture that treats fundamental rights and legal rules as enforceable constraints on the sensing–inference–actuation loop, rather than as external ethical aspirations. Building on established risk-management baselines and safety engineering practice, we specify a testable assurance object, a structured 3R assurance case, that links rights claims to explicit assumptions, measurable evidence, and accountable control points across the lifecycle. The approach is designed to reduce “legitimacy drift” in stochastic decision pipelines by making uncertainty, demographic error, contestability, and procurement leverage auditable at the system level. The result is a governance blueprint for high-consequence public-sector AI deployments for governance failures, which is both technically robust and institutionally defensible. Full article

Background/Objectives: Artificial intelligence (AI) is increasingly used in clinical decision-support systems, yet its adoption in low- and middle-income countries, including Jordan, remains limited and underexplored. Understanding how healthcare professionals perceive AI-assisted clinical decision-making is essential for safe and contextually appropriate implementation. This study explored healthcare professionals’ perceptions of AI-assisted clinical decision-making in Jordan, with particular attention to trust, accuracy, accountability, professional judgement, digital literacy, and health-system readiness. Medication-related safety and prescribing concerns were examined as secondary cross-cutting issues where they emerged from participants’ accounts. Methods: A qualitative study was conducted using semi-structured, in-depth interviews with 22 purposively sampled healthcare professionals from public, private, and university-affiliated healthcare institutions in Amman, Irbid, and Zarqa. Participants included physicians, nurses, pharmacists, and allied health professionals with varied specialties and levels of seniority. Data were analysed using Braun and Clarke’s reflexive thematic analysis. Member checking, peer debriefing, reflexive memos, and audit trails were used to enhance trustworthiness, and reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: Eight overarching themes were identified: conditional trust in AI-assisted clinical decision-making; concerns regarding accuracy and confident algorithmic errors; accountability and professional responsibility; AI as an adjunct rather than a substitute for clinical judgement; the influence of experience, specialty, and digital literacy on AI acceptance; Jordanian health-system readiness; privacy, confidentiality, and algorithmic bias; and training requirements for safe AI use. Medication-related safety emerged as a cross-cutting concern, particularly in relation to dosing, polypharmacy, drug–drug and drug–herb interactions, and the risk of over-reliance on AI-generated recommendations. Conclusions: Healthcare professionals in Jordan expressed cautious but constructive views toward AI-assisted clinical decision-making. AI was perceived as potentially useful when used to support, rather than replace, professional judgement. Participants’ accounts suggest that safe implementation depends on local validation, clear accountability frameworks, ethical data governance, interprofessional training, and careful consideration of medication-safety expertise where AI tools influence prescribing or therapeutic decisions. These findings highlight the importance of context-sensitive AI governance strategies that support trustworthy, accountable, and professionally supervised AI adoption in healthcare. Full article

The rapid integration of artificial intelligence (AI) technologies into educational contexts has introduced innovative instructional approaches, particularly within Science, Technology, Engineering, and Mathematics (STEM) education. Although an increasing number of empirical studies have examined AI-supported instruction, existing findings remain heterogeneous, making it difficult to draw firm conclusions about its overall effectiveness. This study aims to systematically synthesize experimental and quasi-experimental research on AI-supported instructional interventions in STEM education, quantify their overall effects on student learning outcomes, and examine potential moderating factors, including educational level, STEM discipline, and intervention duration. A comprehensive systematic literature search was conducted across Web of Science, Scopus, ERIC, ScienceDirect, and Google Scholar, covering studies published between 2005 and 2025. A total of 35 studies meeting predefined inclusion criteria were included in the meta-analysis. Effect sizes were calculated using Hedges’ g, and a Random Effects Model (REM) was employed to account for heterogeneity among studies. Moderator analyses were conducted for educational level, STEM discipline, and intervention duration. Publication bias was assessed using multiple diagnostic methods. The meta-analysis revealed a statistically significant overall positive effect of AI-supported instruction on student learning outcomes in STEM education (g = 0.67, 95% CI [0.49, 0.85], p < 0.001). Moderator analyses indicated that AI interventions were most effective at the high school level. Although Science and Mathematics disciplines showed slightly higher effect sizes, the between-group difference was not statistically significant (Q = 4.85, df = 2, p = 0.088). Regarding intervention duration, the highest effect size was observed in interventions lasting more than one month and up to two months, though no consistent pattern of increasing effectiveness with longer durations was found. Publication bias analyses suggested minimal influence on the overall findings. AI-supported instructional interventions demonstrate a moderately to highly positive impact on student learning outcomes in STEM education. The effectiveness of these interventions varies according to educational level, disciplinary context, and intervention duration. These findings provide robust empirical evidence supporting the pedagogical value of AI in STEM education and offer guidance for educators and policymakers regarding effective implementation. Full article

Background: Large language models and other generative artificial intelligence (AI) tools are increasingly being embedded in digital healthcare services, including mobile health applications, telerehabilitation, remote monitoring, and hybrid care pathways. In this review, digital healthcare refers to technology-mediated healthcare services in which digital platforms, mobile applications, wearables, remote communication, and AI-enabled interfaces support health assessment, self-management, rehabilitation, clinical decision support, or service delivery. When AI-generated exercise guidance moves from general education to individualized recommendations about dose, progression, contraindications, or rehabilitation, it may become directly actionable and safety-relevant. Objectives: This review aimed to clarify when AI-generated exercise guidance in digital healthcare may warrant safety-relevant governance attention and to outline implementation considerations for explainability, human oversight, and service-level governance. It addresses a gap in the literature: general AI-governance and exercise-prescription discussions rarely specify how point-of-use explanations, review thresholds, and escalation safeguards can be organized for directly actionable AI exercise guidance. Methods: We conducted a governance-oriented narrative review of peer-reviewed literature and representative regulatory or guidance documents. This review was not designed as a systematic review, scoping review, or exhaustive evidence map; transparent source mapping was used to support conceptual synthesis. Searches and source mapping focused on generative AI, large language models, explainable AI, clinical decision support, digital health, mobile health, exercise prescription, rehabilitation, trust, automation bias, and human oversight. Sources were included when they informed the safety, explainability, governance, or real-world implementation of patient-facing AI-generated exercise guidance. Extracted material was grouped by evidentiary role and synthesized through framework synthesis and governance mapping to distinguish literature-supported observations, author interpretation, and proposed implementation tools. Results: The included sources were first organized into five thematic groups: digital exercise delivery and exercise-prescription evidence; explainability, trust, and automation bias literature; professional responsibility, ethics, and patient disclosure literature; regulatory and policy documents; and digital literacy, patient/clinician attitudes, and equity literature. The synthesis then proceeded from safety relevance to explanation needs, human oversight and escalation needs, and selected regulatory and policy signals before translating these strands into conceptual and implementation-oriented outputs rather than empirically validated instruments. AI-generated exercise guidance was most safety-relevant in scenarios involving individualized dose, progression, contraindication-sensitive action, or rehabilitation strategy. Across the included sources, generic transparency alone was not sufficient to support reviewable use; relevant explanation elements included evidence sources, risk warnings, reasoning paths, and reasonable alternatives. Oversight considerations varied with embodied risk, clinical ambiguity, user vulnerability, and likelihood of direct enactment. Implementation considerations linked interface design, clinical review, escalation, auditability, and post-deployment monitoring. Conclusions: AI-generated exercise guidance in digital healthcare may warrant governance attention as a patient-safety and accountability issue when it influences actionable exercise decisions. The proposed framework offers a conceptual basis for designing more reviewable and accountable mobile and remote exercise-support services. Future work can validate these outputs in patient-facing services, clinician review workflows, usability studies, implementation pilots, and safety evaluations. Full article

How does artificial intelligence (AI) adoption shape administrative efficiency and e-citizen integration in local governments, and what role does professional development play in mediating these relationships? Drawing on a survey of 500 municipal employees across Spanish municipalities, this study employs partial least squares structural equation modelling (PLS-SEM), with formal non-linearity testing via Warp3 algorithms, to test a theoretically grounded model. The conceptual framework integrates Digital Transformation Theory and Public Value Theory as primary explanatory lenses, while drawing on the Technology Acceptance Model (TAM) and Total Factor Productivity (TFP) logic as complementary background perspectives that contextualise rather than directly operationalise the micro-level findings. Structural results reveal that AI adoption exerts a strong direct (and statistically linear) effect on perceived administrative efficiency (β = 1.04, p < 0.001; the standardised coefficient exceeding 1.0 and R² > 1 are a legitimate WarpPLS warp-model fit index rather than evidence of model misspecification: the Warp3 warp functions inflate the variance of predicted efficiency and break the additive identity SST = SSM + SSE, with the high AI–PD collinearity (r ≈ 0.84) as the contributing mechanism (RSCR = 1.000, SSR = 1.000); a comparative re-estimation without the moderation term yields β = 0.87 and R² = 0.76; we adopt this parsimonious specification (β ≈ 0.87, R² = 0.76) as the substantively interpretable estimate, with predictive relevance confirmed by a high Stone–Geisser Q² = 0.685, indicating that the model fits and predicts well rather than overfitting, while simultaneously stimulating professional development (β = 0.84, p < 0.001, R² = 0.70). Professional development positively predicted both efficiency (β = 0.27, p < 0.001) and e-citizen integration (β = 0.26, p < 0.01). Efficiency is the primary driver of e-citizen integration (β = 0.54, p < 0.001, R² = 0.53). The proposed moderation of AI adoption by professional development on efficiency was not supported (β = −0.01, p = 0.44), suggesting additive rather than synergistic effects. Model fit was robust (GoF = 0.701; ARS = 0.749; APC = 0.495); convergent and discriminant validity were confirmed by composite reliability, average variance extracted, Fornell–Larcker, and HTMT criteria; and common method bias diagnostics (Harman’s single-factor test, full-collinearity AFVIF, and marker-variable analysis) indicated that systematic method variance was not a material threat. These findings offer micro-empirical evidence of the mechanisms linking AI adoption to citizen service outcomes via a professional development pathway and provide actionable recommendations for Spanish and European municipalities navigating AI-driven governance reform. Full article

Post-COVID-19 syndrome (PCS), also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), represents a heterogeneous set of persistent clinical manifestations developing after acute infection. These conditions are associated with immune dysregulation, autonomic imbalance, impaired thymic function, and possible viral persistence. Objective: This study aims to systematically synthesise current evidence on the immunopathogenesis of PCS and to critically evaluate the application of artificial intelligence (AI) and machine learning (ML) approaches for its prediction and clinical stratification. Methods: A PRISMA 2020–informed systematic review was conducted using PubMed/MEDLINE, Scopus, Web of Science, elibrary.ru and Embase databases (January 2020–December 2025). Studies addressing immunopathological mechanisms and AI/ML applications in PCS were selected based on predefined eligibility criteria. Risk of bias in prediction studies was assessed using the PROBAST tool. Due to heterogeneity, a structured qualitative synthesis was performed. Current evidence indicates that PCS may result from sustained systemic inflammation, cytokine dysregulation, autoimmunity, and delayed restoration of T-cell homeostasis, including reduced thymic output of naïve T lymphocytes. Persistent thymic dysfunction may contribute to prolonged immune imbalance, increased susceptibility to secondary infections, and reactivation of latent viruses. AI/ML approaches—including gradient boosting, ensemble learning, deep neural networks, and natural language processing—have demonstrated promising performance across multimodal datasets. However, significant limitations were identified, including small sample sizes, overfitting, lack of external validation, and heterogeneity in outcome definitions. Conclusions: The integration of immunopathological insights with data-driven modelling highlights the potential of combined approaches for improving PCS risk stratification. However, current AI models remain insufficiently validated for clinical implementation. Future research should prioritise methodological standardisation, external validation, and incorporation of mechanistically informed biomarkers. Full article

Generative artificial intelligence (GAI) is increasingly embedded in personal finance, yet little is known about how models make recommendations using financial information and demographic cues. This study audits three frontier GAI models, GPT 5.5, Gemini 3.1 Pro, and Claude Opus 4.7, using a conjoint experiment in which each model evaluated the same hypothetical investor profiles and selected among standardized conservative, balanced, and aggressive portfolios. Investor profiles systematically varied attributes, including risk tolerance, time horizon, goal type, income, and age, gender, ethnicity, marital status, and employment type. Ordered logistic regressions and matched-profile comparisons show that all three models base recommendations primarily on financial attributes, especially risk tolerance and time horizon. Age and marital status shift recommendations towards conservatism in all models, conversely only Claude conditions on gender and employment type. Ethnicity exerts no detectable influence on the recommendations of ChatGPT or Claude, but is a small, statistically significant predictor for Gemini, with non-White profiles receiving slightly more conservative recommendations than otherwise identical White profiles. Overall, we find that the models are not interchangeable: they differ significantly in overall risk appetite and in how they translate risk tolerance, time horizon, goal type, and age into portfolio choices, with economically meaningful differences in predicted recommendations for identical clients. These findings suggest that contemporary GAI investment advice is driven mainly by financially relevant attributes, but that demographic sensitivity may appear in model-specific and statistically nuanced ways, alongside a distinct form of platform risk arising from model-specific advisory logic. Full article

Grading open-ended student work consistently remains a persistent challenge in higher education, and the recent rise of large language models (LLMs) has renewed interest in rubric-guided automated scoring. However, a key gap remains: most studies report correlation rather than agreement, rarely benchmark models against a local human–human baseline, and seldom test whether simple post hoc calibration improves operational fit. This study addresses that gap by examining whether a rubric-guided LLM can approximate local human grading practice for text-based responses in three university courses, using agreement-oriented rather than correlation-only evidence. A total of 930 student responses from Prompt Engineering, Photoshop Design, and AI Video Production were scored by two human raters and by ChatGPT using the same five-criterion analytic rubric (Accuracy, Logical Flow, Specificity, Quality, and Originality; 0.0–3.0 each; Total 0–15). Human consensus (HC) was defined as the mean of the two human scores and was treated as a pragmatic reference rather than a ground truth. Pairwise agreement among H1, H2, AI, and HC was evaluated using ICC(3,1), Pearson correlations, mean absolute error (MAE), Bland–Altman bias and limits of agreement (LoA); a course-specific held-out calibration analysis was additionally conducted. For the Total score, human–human agreement was strong (ICC = 0.819 [0.797, 0.839]). AI–H1 and AI–H2 Total-score agreement were ICC = 0.700 [0.666, 0.732] and 0.767 [0.739, 0.792], respectively, while AI–HC agreement was ICC = 0.763 [0.735, 0.789], with MAE = 1.603 and LoA = [−4.246, 4.045]. At the trait level, AI–HC ICCs exceeded H1–H2 ICCs for all five rubric dimensions, although Quality remained weakly defined in the human baseline. On a 70/30 held-out test split, a course-specific linear calibration modestly improved Total-score ICC from 0.774 to 0.782 and reduced MAE from 1.624 to 1.215, narrowing the LoA from [−4.290, 4.188] to [−3.157, 3.329]. However, threshold-adjacent agreement remained imperfect after calibration. The principal contribution is a conservative, multi-metric agreement benchmark of rubric-guided LLM scoring against a local human baseline, together with a held-out calibration test that informs deployment. The findings concern written responses only and support a conservative conclusion: rubric-guided LLM scoring can assist human grading under fixed local rubrics, but the current evidence supports calibrated human–AI co-grading rather than unsupervised replacement. Full article

Background/Objectives: Large language models (LLMs) and generative AI are rapidly being integrated into healthy ageing initiatives for tasks ranging from companionship and cognitive support to personalised health advice and reduction in social isolation among older adults. Current ethical discussions predominantly address bias, privacy, and accuracy, leaving unresolved three critical governance questions: How do LLM sentiments towards transformative technologies diverge from human values in ageing contexts? What epistemic status do LLM outputs hold when applied to geriatric care? When is trust in those outputs justified for older adults? And who bears responsibility when AI-informed decisions affect functional ability or well-being? Methods: The framework was developed through normative conceptual analysis, synthesizing philosophical principles of medical knowledge and trust, ethical theories of responsibility, empirical evidence on LLM sentiment divergence, digital ageism, and applications of AI in geriatric care (structured searches in PubMed, PhilPapers, and relevant databases, January 2020–March 2026). Results: The integrated framework produces (i) adaptation of SAIA for multidimensional evaluation of human–machine value convergence specific to healthy ageing values (functional ability, autonomy, dignity, equity); (ii) a four-tier classification of LLM outputs tailored to geriatric scenarios; (iii) conditions for warranted trust calibrated to age-related vulnerabilities such as cognitive decline and digital divide; and (iv) responsibility allocation via RACI models with testable hypotheses linking governance design to trust calibration and patient safety outcomes. Conclusions: Without explicit societal alignment and epistemic governance, generative AI risks reinforcing benevolent ageism, automation bias, and responsibility gaps in healthy ageing. The 2025–2027 period offers a decisive window to shape institutional norms that place functional capacity, human dignity, and value convergence at the centre of AI deployment in geriatric care. Full article