Prashnna Gyawali

CV
h-index21
14papers
63citations
Novelty50%
AI Score54

14 Papers

CVJul 11, 2024Code
CAR-MFL: Cross-Modal Augmentation by Retrieval for Multimodal Federated Learning with Missing Modalities

Pranav Poudel, Prashant Shrestha, Sanskar Amgain et al.

Multimodal AI has demonstrated superior performance over unimodal approaches by leveraging diverse data sources for more comprehensive analysis. However, applying this effectiveness in healthcare is challenging due to the limited availability of public datasets. Federated learning presents an exciting solution, allowing the use of extensive databases from hospitals and health centers without centralizing sensitive data, thus maintaining privacy and security. Yet, research in multimodal federated learning, particularly in scenarios with missing modalities a common issue in healthcare datasets remains scarce, highlighting a critical area for future exploration. Toward this, we propose a novel method for multimodal federated learning with missing modalities. Our contribution lies in a novel cross-modal data augmentation by retrieval, leveraging the small publicly available dataset to fill the missing modalities in the clients. Our method learns the parameters in a federated manner, ensuring privacy protection and improving performance in multiple challenging multimodal benchmarks in the medical domain, surpassing several competitive baselines. Code Available: https://github.com/bhattarailab/CAR-MFL

LGOct 14, 2023
Multimodal Federated Learning in Healthcare: a Review

Jacob Thrasher, Alina Devkota, Prasiddha Siwakotai et al.

Recent advancements in multimodal machine learning have empowered the development of accurate and robust AI systems in the medical domain, especially within centralized database systems. Simultaneously, Federated Learning (FL) has progressed, providing a decentralized mechanism where data need not be consolidated, thereby enhancing the privacy and security of sensitive healthcare data. The integration of these two concepts supports the ongoing progress of multimodal learning in healthcare while ensuring the security and privacy of patient records within local data-holding agencies. This paper offers a concise overview of the significance of FL in healthcare and outlines the current state-of-the-art approaches to Multimodal Federated Learning (MMFL) within the healthcare domain. It comprehensively examines the existing challenges in the field, shedding light on the limitations of present models. Finally, the paper outlines potential directions for future advancements in the field, aiming to bridge the gap between cutting-edge AI technology and the imperative need for patient data privacy in healthcare applications.

CRAug 23, 2024
Is Generative AI the Next Tactical Cyber Weapon For Threat Actors? Unforeseen Implications of AI Generated Cyber Attacks

Yusuf Usman, Aadesh Upadhyay, Prashnna Gyawali et al.

In an era where digital threats are increasingly sophisticated, the intersection of Artificial Intelligence and cybersecurity presents both promising defenses and potent dangers. This paper delves into the escalating threat posed by the misuse of AI, specifically through the use of Large Language Models (LLMs). This study details various techniques like the switch method and character play method, which can be exploited by cybercriminals to generate and automate cyber attacks. Through a series of controlled experiments, the paper demonstrates how these models can be manipulated to bypass ethical and privacy safeguards to effectively generate cyber attacks such as social engineering, malicious code, payload generation, and spyware. By testing these AI generated attacks on live systems, the study assesses their effectiveness and the vulnerabilities they exploit, offering a practical perspective on the risks AI poses to critical infrastructure. We also introduce Occupy AI, a customized, finetuned LLM specifically engineered to automate and execute cyberattacks. This specialized AI driven tool is adept at crafting steps and generating executable code for a variety of cyber threats, including phishing, malware injection, and system exploitation. The results underscore the urgency for ethical AI practices, robust cybersecurity measures, and regulatory oversight to mitigate AI related threats. This paper aims to elevate awareness within the cybersecurity community about the evolving digital threat landscape, advocating for proactive defense strategies and responsible AI development to protect against emerging cyber threats.

CVJul 9, 2024
TE-SSL: Time and Event-aware Self Supervised Learning for Alzheimer's Disease Progression Analysis

Jacob Thrasher, Alina Devkota, Ahmed Tafti et al.

Alzheimer's Dementia (AD) represents one of the most pressing challenges in the field of neurodegenerative disorders, with its progression analysis being crucial for understanding disease dynamics and developing targeted interventions. Recent advancements in deep learning and various representation learning strategies, including self-supervised learning (SSL), have shown significant promise in enhancing medical image analysis, providing innovative ways to extract meaningful patterns from complex data. Notably, the computer vision literature has demonstrated that incorporating supervisory signals into SSL can further augment model performance by guiding the learning process with additional relevant information. However, the application of such supervisory signals in the context of disease progression analysis remains largely unexplored. This gap is particularly pronounced given the inherent challenges of incorporating both event and time-to-event information into the learning paradigm. Addressing this, we propose a novel framework, Time and Even-aware SSL (TE-SSL), which integrates time-to-event and event data as supervisory signals to refine the learning process. Our comparative analysis with existing SSL-based methods in the downstream task of survival analysis shows superior performance across standard metrics.

CVJul 19, 2024
TTA-OOD: Test-time Augmentation for Improving Out-of-Distribution Detection in Gastrointestinal Vision

Sandesh Pokhrel, Sanjay Bhandari, Eduard Vazquez et al.

Deep learning has significantly advanced the field of gastrointestinal vision, enhancing disease diagnosis capabilities. One major challenge in automating diagnosis within gastrointestinal settings is the detection of abnormal cases in endoscopic images. Due to the sparsity of data, this process of distinguishing normal from abnormal cases has faced significant challenges, particularly with rare and unseen conditions. To address this issue, we frame abnormality detection as an out-of-distribution (OOD) detection problem. In this setup, a model trained on In-Distribution (ID) data, which represents a healthy GI tract, can accurately identify healthy cases, while abnormalities are detected as OOD, regardless of their class. We introduce a test-time augmentation segment into the OOD detection pipeline, which enhances the distinction between ID and OOD examples, thereby improving the effectiveness of existing OOD methods with the same model. This augmentation shifts the pixel space, which translates into a more distinct semantic representation for OOD examples compared to ID examples. We evaluated our method against existing state-of-the-art OOD scores, showing improvements with test-time augmentation over the baseline approach.

LGMay 21
Two is better than one: A Collapse-free Multi-Reward RLIF Training Framework

Shourov Joarder, Diganta Sikdar, Ahsan Habib Akash et al.

Reinforcement learning with verifiable rewards (RLVR) has substantially improved the reasoning ability of LLMs, but often depends on external supervision from human annotations or gold-standard solutions. Reinforcement learning from internal feedback (RLIF) has recently emerged as a scalable unsupervised alternative, using signals extracted from the model itself. However, existing RLIF methods typically rely on a single internal reward, which can lead to reward hacking, entropy collapse, and degraded reasoning structure. We propose a multi-reward RLIF framework that decomposes the training signal into two complementary components: an answer-level reward based on cluster voting and a completion-level reward based on token-wise self-certainty. To combine these signals robustly, we apply GDPO-based normalization to reduce reward-scale imbalance. We further introduce KL-Cov regularization, which targets low-entropy token distributions responsible for disproportionate entropy reduction, preserving exploration and preventing late-stage collapse. Across mathematical reasoning and code-generation benchmarks, our method improves stability and robustness over prior unsupervised RL approaches, while achieving performance close to supervised RLVR methods. These results show that complementary internal rewards, combined with targeted regularization, can support stable long-horizon reasoning without relying on external ground-truth supervision. Code will be released soon.

LGApr 10
Investigating Trustworthiness of Nonparametric Deep Survival Models for Alzheimer's Disease Progression Analysis

Jacob Thrasher, Kaitlyn Heintzelman, Peter Martone et al.

Alzheimer's Dementia (AD) is a progressive neurodegenerative disease marked by irreversible decline, making reliable modeling of its progression essential for effective patient care. Progression-aware methods such as survival analysis are therefore crucial tools for the early detection and monitoring of AD. Recent advancements in deep learning have demonstrated remarkable performance in survival tasks, but alarmingly fewer studies have been conducted in the domain of AD. Further, the studies that do exist do not consider learned bias within the model itself, which could result in unfair and unreliable predictions toward certain marginalized groups. As such, we conduct a rigorous study of fairness in AD progression analysis along with a thorough feature importance study to determine the characteristics which are most important for reliable AD predictions. Furthermore, we propose two novel fairness metrics, called Time-Dependent Concordance Impurity and Kaplan-Meier Fairness, to quantify bias with respect to sensitive attributes such as sex, race, and education in nonparametric survival models. Our study demonstrates that while deep learning powered survival models are robust tools which can aid clinicians in AD care decisions, they often exhibit considerable bias, representing important avenues for future research.

CVJul 21, 2024
Enhancing Retinal Disease Classification from OCTA Images via Active Learning Techniques

Jacob Thrasher, Annahita Amireskandari, Prashnna Gyawali

Eye diseases are common in older Americans and can lead to decreased vision and blindness. Recent advancements in imaging technologies allow clinicians to capture high-quality images of the retinal blood vessels via Optical Coherence Tomography Angiography (OCTA), which contain vital information for diagnosing these diseases and expediting preventative measures. OCTA provides detailed vascular imaging as compared to the solely structural information obtained by common OCT imaging. Although there have been considerable studies on OCT imaging, there have been limited to no studies exploring the role of artificial intelligence (AI) and machine learning (ML) approaches for predictive modeling with OCTA images. In this paper, we explore the use of deep learning to identify eye disease in OCTA images. However, due to the lack of labeled data, the straightforward application of deep learning doesn't necessarily yield good generalization. To this end, we utilize active learning to select the most valuable subset of data to train our model. We demonstrate that active learning subset selection greatly outperforms other strategies, such as inverse frequency class weighting, random undersampling, and oversampling, by up to 49% in F1 evaluation.

LGNov 9, 2025
Local K-Similarity Constraint for Federated Learning with Label Noise

Sanskar Amgain, Prashant Shrestha, Bidur Khanal et al.

Federated learning on clients with noisy labels is a challenging problem, as such clients can infiltrate the global model, impacting the overall generalizability of the system. Existing methods proposed to handle noisy clients assume that a sufficient number of clients with clean labels are available, which can be leveraged to learn a robust global model while dampening the impact of noisy clients. This assumption fails when a high number of heterogeneous clients contain noisy labels, making the existing approaches ineffective. In such scenarios, it is important to locally regularize the clients before communication with the global model, to ensure the global model isn't corrupted by noisy clients. While pre-trained self-supervised models can be effective for local regularization, existing centralized approaches relying on pretrained initialization are impractical in a federated setting due to the potentially large size of these models, which increases communication costs. In that line, we propose a regularization objective for client models that decouples the pre-trained and classification models by enforcing similarity between close data points within the client. We leverage the representation space of a self-supervised pretrained model to evaluate the closeness among examples. This regularization, when applied with the standard objective function for the downstream task in standard noisy federated settings, significantly improves performance, outperforming existing state-of-the-art federated methods in multiple computer vision and medical image classification benchmarks. Unlike other techniques that rely on self-supervised pretrained initialization, our method does not require the pretrained model and classifier backbone to share the same architecture, making it architecture-agnostic.

CVDec 2, 2024Code
NCDD: Nearest Centroid Distance Deficit for Out-Of-Distribution Detection in Gastrointestinal Vision

Sandesh Pokhrel, Sanjay Bhandari, Sharib Ali et al.

The integration of deep learning tools in gastrointestinal vision holds the potential for significant advancements in diagnosis, treatment, and overall patient care. A major challenge, however, is these tools' tendency to make overconfident predictions, even when encountering unseen or newly emerging disease patterns, undermining their reliability. We address this critical issue of reliability by framing it as an out-of-distribution (OOD) detection problem, where previously unseen and emerging diseases are identified as OOD examples. However, gastrointestinal images pose a unique challenge due to the overlapping feature representations between in- Distribution (ID) and OOD examples. Existing approaches often overlook this characteristic, as they are primarily developed for natural image datasets, where feature distinctions are more apparent. Despite the overlap, we hypothesize that the features of an in-distribution example will cluster closer to the centroids of their ground truth class, resulting in a shorter distance to the nearest centroid. In contrast, OOD examples maintain an equal distance from all class centroids. Based on this observation, we propose a novel nearest-centroid distance deficit (NCCD) score in the feature space for gastrointestinal OOD detection. Evaluations across multiple deep learning architectures and two publicly available benchmarks, Kvasir2 and Gastrovision, demonstrate the effectiveness of our approach compared to several state-of-the-art methods. The code and implementation details are publicly available at: https://github.com/bhattarailab/NCDD

CVSep 23, 2025
CURE: Centroid-guided Unsupervised Representation Erasure for Facial Recognition Systems

Fnu Shivam, Nima Najafzadeh, Yenumula Reddy et al.

In the current digital era, facial recognition systems offer significant utility and have been widely integrated into modern technological infrastructures; however, their widespread use has also raised serious privacy concerns, prompting regulations that mandate data removal upon request. Machine unlearning has emerged as a powerful solution to address this issue by selectively removing the influence of specific user data from trained models while preserving overall model performance. However, existing machine unlearning techniques largely depend on supervised techniques requiring identity labels, which are often unavailable in privacy-constrained situations or in large-scale, noisy datasets. To address this critical gap, we introduce CURE (Centroid-guided Unsupervised Representation Erasure), the first unsupervised unlearning framework for facial recognition systems that operates without the use of identity labels, effectively removing targeted samples while preserving overall performance. We also propose a novel metric, the Unlearning Efficiency Score (UES), which balances forgetting and retention stability, addressing shortcomings in the current evaluation metrics. CURE significantly outperforms unsupervised variants of existing unlearning methods. Additionally, we conducted quality-aware unlearning by designating low-quality images as the forget set, demonstrating its usability and benefits, and highlighting the role of image quality in machine unlearning.

CVAug 19, 2025
Effect of Data Augmentation on Conformal Prediction for Diabetic Retinopathy

Rizwan Ahamed, Annahita Amireskandari, Joel Palko et al.

The clinical deployment of deep learning models for high-stakes tasks such as diabetic retinopathy (DR) grading requires demonstrable reliability. While models achieve high accuracy, their clinical utility is limited by a lack of robust uncertainty quantification. Conformal prediction (CP) offers a distribution-free framework to generate prediction sets with statistical guarantees of coverage. However, the interaction between standard training practices like data augmentation and the validity of these guarantees is not well understood. In this study, we systematically investigate how different data augmentation strategies affect the performance of conformal predictors for DR grading. Using the DDR dataset, we evaluate two backbone architectures -- ResNet-50 and a Co-Scale Conv-Attentional Transformer (CoaT) -- trained under five augmentation regimes: no augmentation, standard geometric transforms, CLAHE, Mixup, and CutMix. We analyze the downstream effects on conformal metrics, including empirical coverage, average prediction set size, and correct efficiency. Our results demonstrate that sample-mixing strategies like Mixup and CutMix not only improve predictive accuracy but also yield more reliable and efficient uncertainty estimates. Conversely, methods like CLAHE can negatively impact model certainty. These findings highlight the need to co-design augmentation strategies with downstream uncertainty quantification in mind to build genuinely trustworthy AI systems for medical imaging.

CVAug 12, 2025
Addressing Bias in VLMs for Glaucoma Detection Without Protected Attribute Supervision

Ahsan Habib Akash, Greg Murray, Annahita Amireskandari et al.

Vision-Language Models (VLMs) have achieved remarkable success on multimodal tasks such as image-text retrieval and zero-shot classification, yet they can exhibit demographic biases even when explicit protected attributes are absent during training. In this work, we focus on automated glaucoma screening from retinal fundus images, a critical application given that glaucoma is a leading cause of irreversible blindness and disproportionately affects underserved populations. Building on a reweighting-based contrastive learning framework, we introduce an attribute-agnostic debiasing method that (i) infers proxy subgroups via unsupervised clustering of image-image embeddings, (ii) computes gradient-similarity weights between the CLIP-style multimodal loss and a SimCLR-style image-pair contrastive loss, and (iii) applies these weights in a joint, top-$k$ weighted objective to upweight underperforming clusters. This label-free approach adaptively targets the hardest examples, thereby reducing subgroup disparities. We evaluate our method on the Harvard FairVLMed glaucoma subset, reporting Equalized Odds Distance (EOD), Equalized Subgroup AUC (ES AUC), and Groupwise AUC to demonstrate equitable performance across inferred demographic subgroups.

CVJun 18, 2025
NERO: Explainable Out-of-Distribution Detection with Neuron-level Relevance

Anju Chhetri, Jari Korhonen, Prashnna Gyawali et al.

Ensuring reliability is paramount in deep learning, particularly within the domain of medical imaging, where diagnostic decisions often hinge on model outputs. The capacity to separate out-of-distribution (OOD) samples has proven to be a valuable indicator of a model's reliability in research. In medical imaging, this is especially critical, as identifying OOD inputs can help flag potential anomalies that might otherwise go undetected. While many OOD detection methods rely on feature or logit space representations, recent works suggest these approaches may not fully capture OOD diversity. To address this, we propose a novel OOD scoring mechanism, called NERO, that leverages neuron-level relevance at the feature layer. Specifically, we cluster neuron-level relevance for each in-distribution (ID) class to form representative centroids and introduce a relevance distance metric to quantify a new sample's deviation from these centroids, enhancing OOD separability. Additionally, we refine performance by incorporating scaled relevance in the bias term and combining feature norms. Our framework also enables explainable OOD detection. We validate its effectiveness across multiple deep learning architectures on the gastrointestinal imaging benchmarks Kvasir and GastroVision, achieving improvements over state-of-the-art OOD detection methods.