Hikmat Khan

Hikmat Khan, Pir Masoom Shah, Syed Farhan Alam Zaidi et al.

Recent continual learning approaches have primarily focused on mitigating catastrophic forgetting. Nevertheless, two critical areas have remained relatively unexplored: 1) evaluating the robustness of proposed methods and 2) ensuring the security of learned tasks. This paper investigates the susceptibility of continually learned tasks, including current and previously acquired tasks, to adversarial attacks. Specifically, we have observed that any class belonging to any task can be easily targeted and misclassified as the desired target class of any other task. Such susceptibility or vulnerability of learned tasks to adversarial attacks raises profound concerns regarding data integrity and privacy. To assess the robustness of continual learning approaches, we consider continual learning approaches in all three scenarios, i.e., task-incremental learning, domain-incremental learning, and class-incremental learning. In this regard, we explore the robustness of three regularization-based methods, three replay-based approaches, and one hybrid technique that combines replay and exemplar approaches. We empirically demonstrated that in any setting of continual learning, any class, whether belonging to the current or previously learned tasks, is susceptible to misclassification. Our observations identify potential limitations of continual learning approaches against adversarial attacks and highlight that current continual learning algorithms could not be suitable for deployment in real-world settings.

Zeba Ghaffar, Pir Masoom Shah, Hikmat Khan et al.

The ongoing COVID-19 pandemic has already taken millions of lives and damaged economies across the globe. Most COVID-19 deaths and economic losses are reported from densely crowded cities. It is comprehensible that the effective control and prevention of epidemic/pandemic infectious diseases is vital. According to WHO, testing and diagnosis is the best strategy to control pandemics. Scientists worldwide are attempting to develop various innovative and cost-efficient methods to speed up the testing process. This paper comprehensively evaluates the applicability of the recent top ten state-of-the-art Deep Convolutional Neural Networks (CNNs) for automatically detecting COVID-19 infection using chest X-ray images. Moreover, it provides a comparative analysis of these models in terms of accuracy. This study identifies the effective methodologies to control and prevent infectious respiratory diseases. Our trained models have demonstrated outstanding results in classifying the COVID-19 infected chest x-rays. In particular, our trained models MobileNet, EfficentNet, and InceptionV3 achieved a classification average accuracy of 95\%, 95\%, and 94\% test set for COVID-19 class classification, respectively. Thus, it can be beneficial for clinical practitioners and radiologists to speed up the testing, detection, and follow-up of COVID-19 cases.

Hikmat Khan, Nidhal C. Bouaynaya, Ghulam Rasool

Continual learning (CL) is an approach to address catastrophic forgetting, which refers to forgetting previously learned knowledge by neural networks when trained on new tasks or data distributions. The adversarial robustness has decomposed features into robust and non-robust types and demonstrated that models trained on robust features significantly enhance adversarial robustness. However, no study has been conducted on the efficacy of robust features from the lens of the CL model in mitigating catastrophic forgetting in CL. In this paper, we introduce the CL robust dataset and train four baseline models on both the standard and CL robust datasets. Our results demonstrate that the CL models trained on the CL robust dataset experienced less catastrophic forgetting of the previously learned tasks than when trained on the standard dataset. Our observations highlight the significance of the features provided to the underlying CL models, showing that CL robust features can alleviate catastrophic forgetting.

Hikmat Khan, Nidhal Carla Bouaynaya, Ghulam Rasool et al.

Historically, the rotorcraft community has experienced a higher fatal accident rate than other aviation segments, including commercial and general aviation. Recent advancements in artificial intelligence (AI) and the application of these technologies in different areas of our lives are both intriguing and encouraging. When developed appropriately for the aviation domain, AI techniques provide an opportunity to help design systems that can address rotorcraft safety challenges. Our recent work demonstrated that AI algorithms could use video data from onboard cameras and correctly identify different flight parameters from cockpit gauges, e.g., indicated airspeed. These AI-based techniques provide a potentially cost-effective solution, especially for small helicopter operators, to record the flight state information and perform post-flight analyses. We also showed that carefully designed and trained AI systems could accurately predict rotorcraft attitude (i.e., pitch and yaw) from outside scenes (images or video data). Ordinary off-the-shelf video cameras were installed inside the rotorcraft cockpit to record the outside scene, including the horizon. The AI algorithm could correctly identify rotorcraft attitude at an accuracy in the range of 80\%. In this work, we combined five different onboard camera viewpoints to improve attitude prediction accuracy to 94\%. In this paper, five onboard camera views included the pilot windshield, co-pilot windshield, pilot Electronic Flight Instrument System (EFIS) display, co-pilot EFIS display, and the attitude indicator gauge. Using video data from each camera view, we trained various convolutional neural networks (CNNs), which achieved prediction accuracy in the range of 79\% % to 90\% %. We subsequently ensembled the learned knowledge from all CNNs and achieved an ensembled accuracy of 93.3\%.

Yixin Chen, Ziyu Su, Hikmat Khan et al.

Pathology report generation remains a relatively under-explored downstream task, primarily due to the gigapixel scale and complex morphological heterogeneity of Whole Slide Images (WSIs). Existing pathology report generation frameworks typically employ transformer architectures, relying on a homogeneous decoder architecture and static knowledge retrieval integration. Such architectures limit generative specialization and may introduce noisy external guidance during the report generation process. To address these limitations, we propose RANGER, a sparsely-gated Mixture-of-Experts (MoE) framework with adaptive retrieval re-ranking for pathology report generation. Specifically, we integrate a sparsely gated MoE into the decoder, along with noisy top-$k$ routing and load-balancing regularization, to enable dynamic expert specialization across various diagnostic patterns. Additionally, we introduce an adaptive retrieval re-ranking module that selectively refines retrieved memory from a knowledge base before integration, reducing noise and improving semantic alignment based on visual feature representations. We perform extensive experiments on the PathText-BRCA dataset and demonstrate consistent improvements over existing approaches across standard natural language generation metrics. Our full RANGER model achieves optimal performance on PathText dataset, reaching BLEU-1 to BLEU-4 scores of 0.4598, 0.3044, 0.2036, and 0.1435, respectively, with METEOR of 0.1883, and ROUGE-L of 0.3038, validating the effectiveness of dynamic expert routing and adaptive knowledge refinement for semantically grounded pathology report generation.

Hikmat Khan, Usama Sajjad, Metin N. Gurcan et al.

Background: Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide. Accurate survival prediction is essential for treatment stratification, yet existing pathology foundation models often overlook organ-specific features critical for CRC prognostication. Methods: We propose MorphDistill, a two-stage framework that distills complementary knowledge from multiple pathology foundation models into a compact CRC-specific encoder. In Stage I, a student encoder is trained using dimension-agnostic multi-teacher relational distillation with supervised contrastive regularization on large-scale colorectal datasets. This preserves inter-sample relationships from ten foundation models without explicit feature alignment. In Stage II, the encoder extracts patch-level features from whole-slide images, which are aggregated via attention-based multiple instance learning to predict five-year survival. Results: On the Alliance/CALGB 89803 cohort (n=424, stage III CRC), MorphDistill achieves an AUC of 0.68 (SD 0.08), an approximately 8% relative improvement over the strongest baseline (AUC 0.63). It also attains a C-index of 0.661 and a hazard ratio of 2.52 (95% CI: 1.73-3.65), outperforming all baselines. On an external TCGA cohort (n=562), it achieves a C-index of 0.628, demonstrating strong generalization across datasets and robustness across clinical subgroups. Conclusion: MorphDistill enables task-specific representation learning by integrating knowledge from multiple foundation models into a unified encoder. This approach provides an efficient strategy for prognostic modeling in computational pathology, with potential for broader oncology applications. Further validation across additional cohorts and disease stages is warranted.

Hikmat Khan, Wei Chen, Muhammad Khalid Khan Niazi

Background and objectives: Colorectal cancer histopathological grading depends on accurate segmentation of glandular structures. Current deep learning approaches rely on large scale pixel level annotations that are labor intensive and difficult to obtain in routine clinical practice. Weakly supervised semantic segmentation offers a promising alternative. However, class activation map based methods often produce incomplete pseudo masks that emphasize highly discriminative regions and fail to supervise unannotated glandular structures. We propose a weakly supervised teacher student framework that leverages sparse pathologist annotations and an Exponential Moving Average stabilized teacher network to generate refined pseudo masks. Methods: The framework integrates confidence based filtering, adaptive fusion of teacher predictions with limited ground truth, and curriculum guided refinement to progressively segment unannotated glandular regions. The method was evaluated on an institutional colorectal cancer cohort from The Ohio State University Wexner Medical Center consisting of 60 hematoxylin and eosin stained whole slide images and on public datasets including the Gland Segmentation dataset, TCGA COAD, TCGA READ, and SPIDER. Results: On the Gland Segmentation dataset the framework achieved a mean Intersection over Union of 80.10 and a mean Dice coefficient of 89.10. Cross cohort evaluation demonstrated robust generalization on TCGA COAD and TCGA READ without additional annotations, while reduced performance on SPIDER reflected domain shift. Conclusions: The proposed framework provides an annotation efficient and generalizable approach for gland segmentation in colorectal histopathology.

Hikmat Khan, Ghulam Rasool, Nidhal Carla Bouaynaya

Continual learning focuses on learning non-stationary data distribution without forgetting previous knowledge. Rehearsal-based approaches are commonly used to combat catastrophic forgetting. However, these approaches suffer from a problem called "rehearsal memory overfitting, " where the model becomes too specialized on limited memory samples and loses its ability to generalize effectively. As a result, the effectiveness of the rehearsal memory progressively decays, ultimately resulting in catastrophic forgetting of the learned tasks. We introduce the Adversarially Diversified Rehearsal Memory (ADRM) to address the memory overfitting challenge. This novel method is designed to enrich memory sample diversity and bolster resistance against natural and adversarial noise disruptions. ADRM employs the FGSM attacks to introduce adversarially modified memory samples, achieving two primary objectives: enhancing memory diversity and fostering a robust response to continual feature drifts in memory samples. Our contributions are as follows: Firstly, ADRM addresses overfitting in rehearsal memory by employing FGSM to diversify and increase the complexity of the memory buffer. Secondly, we demonstrate that ADRM mitigates memory overfitting and significantly improves the robustness of CL models, which is crucial for safety-critical applications. Finally, our detailed analysis of features and visualization demonstrates that ADRM mitigates feature drifts in CL memory samples, significantly reducing catastrophic forgetting and resulting in a more resilient CL model. Additionally, our in-depth t-SNE visualizations of feature distribution and the quantification of the feature similarity further enrich our understanding of feature representation in existing CL approaches. Our code is publically available at https://github.com/hikmatkhan/ADRM.

Hikmat Khan, Syed Farhan Alam Zaidi, Pir Masoom Shah et al.

Domain generalization in computational histopathology is hindered by heterogeneity in whole slide images (WSIs), caused by variations in tissue preparation, staining, and imaging conditions across institutions. Unlike machine learning systems, pathologists rely on domain-invariant morphological cues such as nuclear atypia (enlargement, irregular contours, hyperchromasia, chromatin texture, spatial disorganization), structural atypia (abnormal architecture and gland formation), and overall morphological atypia that remain diagnostic across diverse settings. Motivated by this, we hypothesize that explicitly modeling biologically robust nuclear morphology and spatial organization will enable the learning of cancer representations that are resilient to domain shifts. We propose MorphGen (Morphology-Guided Generalization), a method that integrates histopathology images, augmentations, and nuclear segmentation masks within a supervised contrastive learning framework. By aligning latent representations of images and nuclear masks, MorphGen prioritizes diagnostic features such as nuclear and morphological atypia and spatial organization over staining artifacts and domain-specific features. To further enhance out-of-distribution robustness, we incorporate stochastic weight averaging (SWA), steering optimization toward flatter minima. Attention map analyses revealed that MorphGen primarily relies on nuclear morphology, cellular composition, and spatial cell organization within tumors or normal regions for final classification. Finally, we demonstrate resilience of the learned representations to image corruptions (such as staining artifacts) and adversarial attacks, showcasing not only OOD generalization but also addressing critical vulnerabilities in current deep learning systems for digital pathology. Code, datasets, and trained models are available at: https://github.com/hikmatkhan/MorphGen

Kiruthika Balakrishnan, Durgadevi Velusamy, Hana E. Hinkle et al.

Rural healthcare faces persistent challenges, including inadequate infrastructure, workforce shortages, and socioeconomic disparities that hinder access to essential services. This study investigates the transformative potential of artificial intelligence (AI) in addressing these issues in underserved rural areas. We systematically reviewed 109 studies published between 2019 and 2024 from PubMed, Embase, Web of Science, IEEE Xplore, and Scopus. Articles were screened using PRISMA guidelines and Covidence software. A thematic analysis was conducted to identify key patterns and insights regarding AI implementation in rural healthcare delivery. The findings reveal significant promise for AI applications, such as predictive analytics, telemedicine platforms, and automated diagnostic tools, in improving healthcare accessibility, quality, and efficiency. Among these, advanced AI systems, including Multimodal Foundation Models (MFMs) and Large Language Models (LLMs), offer particularly transformative potential. MFMs integrate diverse data sources, such as imaging, clinical records, and bio signals, to support comprehensive decision-making, while LLMs facilitate clinical documentation, patient triage, translation, and virtual assistance. Together, these technologies can revolutionize rural healthcare by augmenting human capacity, reducing diagnostic delays, and democratizing access to expertise. However, barriers remain, including infrastructural limitations, data quality concerns, and ethical considerations. Addressing these challenges requires interdisciplinary collaboration, investment in digital infrastructure, and the development of regulatory frameworks. This review offers actionable recommendations and highlights areas for future research to ensure equitable and sustainable integration of AI in rural healthcare systems.

Hikmat Khan, Ziyu Su, Huina Zhang et al.

Triple-negative breast cancer (TNBC) remains a major clinical challenge due to its aggressive behavior and lack of targeted therapies. Accurate early prediction of response to neoadjuvant chemotherapy (NACT) is essential for guiding personalized treatment strategies and improving patient outcomes. In this study, we present an attention-based multiple instance learning (MIL) framework designed to predict pathologic complete response (pCR) directly from pre-treatment hematoxylin and eosin (H&E)-stained biopsy slides. The model was trained on a retrospective in-house cohort of 174 TNBC patients and externally validated on an independent cohort (n = 30). It achieved a mean area under the curve (AUC) of 0.85 during five-fold cross-validation and 0.78 on external testing, demonstrating robust predictive performance and generalizability. To enhance model interpretability, attention maps were spatially co-registered with multiplex immuno-histochemistry (mIHC) data stained for PD-L1, CD8+ T cells, and CD163+ macrophages. The attention regions exhibited moderate spatial overlap with immune-enriched areas, with mean Intersection over Union (IoU) scores of 0.47 for PD-L1, 0.45 for CD8+ T cells, and 0.46 for CD163+ macrophages. The presence of these biomarkers in high-attention regions supports their biological relevance to NACT response in TNBC. This not only improves model interpretability but may also inform future efforts to identify clinically actionable histological biomarkers directly from H&E-stained biopsy slides, further supporting the utility of this approach for accurate NACT response prediction and advancing precision oncology in TNBC.

Hikmat Khan, Nidhal Carla Bouaynaya, Ghulam Rasool

Artificial intelligence (AI) and neuroscience share a rich history, with advancements in neuroscience shaping the development of AI systems capable of human-like knowledge retention. Leveraging insights from neuroscience and existing research in adversarial and continual learning, we introduce a novel framework comprising two core concepts: feature distillation and re-consolidation. Our framework, named Robust Rehearsal, addresses the challenge of catastrophic forgetting inherent in continual learning (CL) systems by distilling and rehearsing robust features. Inspired by the mammalian brain's memory consolidation process, Robust Rehearsal aims to emulate the rehearsal of distilled experiences during learning tasks. Additionally, it mimics memory re-consolidation, where new experiences influence the integration of past experiences to mitigate forgetting. Extensive experiments conducted on CIFAR10, CIFAR100, and real-world helicopter attitude datasets showcase the superior performance of CL models trained with Robust Rehearsal compared to baseline methods. Furthermore, examining different optimization training objectives-joint, continual, and adversarial learning-we highlight the crucial role of feature learning in model performance. This underscores the significance of rehearsing CL-robust samples in mitigating catastrophic forgetting. In conclusion, aligning CL approaches with neuroscience insights offers promising solutions to the challenge of catastrophic forgetting, paving the way for more robust and human-like AI systems.