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At present, the majority of healthcare spending is driven by chronic patients who experience multiple readmissions due to their underlying conditions. Implementing individualized prevention frameworks could optimize the clinical management of this demographic. This study aimed to generate localized predictive models utilizing interpretable machine learning approaches to provide early identification of individual unscheduled hospital readmissions. To achieve this, a retrospective case-control investigation was performed, utilizing patient readmission data spanning 2018–2019. Following the cleaning and curation of the initial data repository (n = 76,210), the final sample size comprised n = 29,026 participants. A machine learning analysis evaluated multiple algorithms, employing unscheduled hospital readmission as the dependent variable, alongside local model-agnostic interpretability techniques.The results demonstrated a 13% rate of unscheduled hospital readmissions. Statistically significant variations were identified regarding patient age and length of hospital stay (p < 0.001 in both instances). A logistic regression framework highlighted chronic therapy (odds ratio: 3.75), a history of diabetes mellitus (odds ratio: 1.14), and length of stay (odds ratio: 1.02) as statistically meaningful predictors. Machine learning algorithms demonstrated superior performance concerning sensitivity and complementary evaluation metrics. Within this analytical framework, length of stay and patient age emerged as the primary determinants for forecasting unscheduled readmissions. Notably, other clinical indicators, such as documented allergies and histories of adverse drug reactions, also demonstrated predictive relevance. Individualized prognostic models exhibited high sensitivity. In conclusion, this investigation identified critical determinants governing unscheduled hospital readmissions, highlighting the prominence of age and hospitalization duration. A personalized risk assessment framework capable of predicting readmissions with high accuracy was established. Future investigations should incorporate a broader array of clinical parameters to further optimize the predictive capacity of this model.

Unchecked discharges of untreated water from combined sewer systems pose critical hazards to public health and ecosystems. To address this, regional sanitation authorities like the Metropolitan Sewer District of Greater Cincinnati (MSDGC) have begun collecting massive streams of hydrological telemetry, looking toward deep learning (DL) methodologies—specifically recurrent neural networks (RNN)—to forecast these spill events. Crucially, determining whether a DL model is truly suitable for this domain requires a structured analysis of the environment in which it operates. This paper introduces a requirements engineering methodology grounded in problem frames to map out and organize stakeholder concerns. This approach systematically evaluates real-world conditions where standard assumptions of high-quality data break down, translating these insights into actionable software testing benchmarks known as metamorphic relations, which govern both data input adjustments and output validations. Deploying this methodology within MSDGC’s operational context provides a rigorous, standardized baseline to assess how effectively competing RNN designs fulfill core operational mandates.

Explainable artificial intelligence increasingly supports decisions whose consequences extend beyond prediction, yet many explanations remain grounded in associations, feature contributions, saliency, or local perturbations. Such outputs may clarify model behaviour without establishing what would happen under intervention, why an outcome arose through a particular mechanism, or whether a proposed change is feasible and decision-valid. This article develops a conceptual causal explainability framework for moving from prediction-oriented explanation toward intervention-aware reasoning. The framework begins by separating predictive, associative, and model-behaviour claims from causal questions. It then connects explicit causal assumptions with causal structures, mechanistic reasoning, interventional explanation, counterfactual reasoning, confounding assessment, identifiability, sensitivity, external validity, uncertainty communication, and human interpretation. Particular attention is given to the distinction between model counterfactuals and real-world recourse, the risks created by unmeasured confounding, selection and collider bias, and the need to define decision boundaries before explanations inform action. Human users are treated as active interpreters whose causal literacy, expertise, cognitive constraints, and susceptibility to false causal confidence affect explanation usefulness. The main contribution is an integrated framework that organizes the evidential transition from prediction to intervention while preserving explicit no-guarantee boundaries concerning causal truth, intervention validity, recourse, identifiability, human understanding, decision validity, and deployment readiness. The framework is intended to support disciplined conceptual development and evaluation planning, not to prescribe a universal causal model, intervention procedure, or operational decision system.

Intelligent systems increasingly provide predictions, recommendations, and explanations in decisions where uncertainty can materially affect interpretation and action. Yet many explainable systems foreground predicted outcomes or feature contributions while inadequately communicating what the model does not know. This article proposes a conceptual uncertainty-aware explainable decision-intelligence framework organized around four connected responsibilities: calibrating confidence, disclosing ambiguity, communicating decision-relevant risk, and supporting selective prediction or abstention when available evidence is insufficient. The framework treats uncertainty as a trustworthiness requirement rather than a secondary technical output. It distinguishes aleatoric uncertainty arising from irreducible variability, epistemic uncertainty associated with limited knowledge or evidence, and distributional uncertainty arising when operating conditions depart from those represented during development. It further connects confidence calibration and miscalibration review with prediction qualification, rejection, abstention, deferral, and human review. Ambiguity disclosure and risk communication are positioned as interpretive functions that should clarify scope limitations, competing interpretations, possible consequences, and appropriate next actions without implying that communication alone guarantees understanding. Human decision support is addressed through escalation pathways, oversight, trust calibration, and evaluation of overreliance, underreliance, automation bias, and cognitive burden. The principal contribution is an integrated framework that links uncertainty identification, calibrated interpretation, selective system behavior, human review, monitoring, and feedback updating. The framework supports conceptual development and domain-specific evaluation but does not independently establish correctness, safety, decision validity, ethical sufficiency, legal compliance, or deployment readiness.