From Multimodal Observation to Interpretable Suggestions: Counterfactual Time-Expanded Relational Modeling of Surgical Teams

In surgery, patient safety is threatened not only by technical issues but also by poor teamwork. However, existing surgical AI-based solutions focus mainly on visual workflow and technical execution, neglecting the modeling of team interactions and missing opportunities to actively support clinicians in improving their teamwork skills. To address this gap, we propose a tempo-relational framework for modeling surgical team dynamics from multimodal observations. By leveraging Time-Expanded graphs, the approach captures both relational structure and temporal evolution, achieving strong expressivity while remaining robust in the low-data regime typical of surgical settings. Beyond prediction, such modeling enables the generation of efficient, interpretable, and actionable suggestions for clinicians. More specifically, we generate suggestions via a counterfactual procedure that identifies minimal yet structured changes in individual behaviors and interaction patterns associated with improvements in team performance. Experiments with simulated surgical procedures show that our approach improves predictive performance in diverse behavioral and interaction goals while offering meaningful insights into team dynamics. This work advances surgical AI beyond outcome-driven prediction towards a socially grounded, team-centric, and actionable paradigm to better understand and support the development of team skills in surgical settings.

Targeted Counterfactual Fingerprinting for Black-Box LLM Ownership Verification

Large language models (LLMs) are high-value assets that can be derived through redeployment, fine-tuning, quantization, or further alignment. Because deployed LLMs are commonly exposed only through query APIs, ownership verification must often rely on black-box text responses. This setting is difficult: generations are open-ended and can vary across repeated queries, while existing black-box fingerprints rely on signals that are fragile under a final-response interface, including full-text matching, soft behavioral features, or model-specific prompts designed not to transfer. We propose TCF (Targeted Counterfactual Fingerprinting), a black-box LLM fingerprinting framework that converts open-ended generation comparison into constrained-answer targeted counterfactual transfer. TCF restricts each verification query to a finite answer space, reducing the surface-form ambiguity that enters the verification score, and optimizes a prompt perturbation toward a counterfactual target different from the protected model's clean answer on the original prompt. Verification reduces to checking whether the suspect model's parsed final answer matches the recorded target. We introduce the source-model counterfactual margin (SCM), a protected-model-only quantity that certifies the target is unlikely before the perturbation and likely after it; SCM controls target selection, perturbation stopping, and fingerprint filtering. Under explicit derived-preservation and independent-transfer budgets motivated by local behavioral closeness, we derive a target-accuracy gap between derived and independent models. Across four LLM families, TCF achieves an average AUC of 0.9861, improving over TRAP, ProFLingo, and ZeroPrint by 0.07 to 0.19.