The Phase XXIII C1 privacy mechanism achieved p99 round-trip latency of 0.20–0.25 ms and preserved clinical-grade decision quality (sensitivity 0.85-0.88) against 32 adversary variants.
The proposed bidirectional closed-loop privacy mechanism for bioelectric digital twins demonstrates low latency, preserves clinical decision quality, and defeats multiple adversary variants in computational validation.
This deposit contains the complete pre-registration corpus (embedded in section-batch runner scripts), runner code, summary verdicts, per-study reports, figures, POC addenda, master synthesis, and arXiv-format manuscript for a 168-study pre-registered empirical validation campaign of bidirectional closed-loop bioelectric digital-twin privacy across seven canonical closed-loop clinical applications: closed-loop deep brain stimulation (DBS), responsive neurostimulation (RNS) for drug-resistant epilepsy, closed-loop insulin pump, antitachycardia pacing in implantable cardioverter-defibrillators (ICDs), brain-computer interface (BCI) motor restoration, real-time neurofeedback, and closed-loop ventilation. The campaign comprises approximately 840 pre-registered hypothesis-testing decision rules across twelve thematic sections, executed under continuous deterministic protocol (PYTHONHASHSEED=0) with zero post-hoc threshold adjustments. The campaign extends companion Paper 10 (10.5281/zenodo.20480183, unidirectional release-only bioelectric privacy) to bidirectional closed-loop deployment. Key empirical findings: (i) the Phase XXIII C1 mechanism is closed-loop deployment-ready out of the box, with measured p99 round-trip latency 0.20–0.25 ms across all seven canonical applications and budget margins from 220× (BCI motor restoration, tightest budget) to 1.5 × 10⁶× (closed-loop insulin pump, loosest budget); (ii) clinical-grade decision quality is preserved on real PhysioNet ECG cohorts: CHB-MIT seizure detection sensitivity 0.88 / specificity 0.86, MIT-BIH arrhythmia detection sensitivity 0.85 / specificity 0.89, false-positive intervention rate ≤ 5%, false-negative intervention rate ≤ 5%; (iii) the mechanism defeats 32 distinct adversary variants with appropriate C2 mitigations (constant-time padding, cryptographically-signed nonces, OOD gating, rate limiting, decoy interventions, role-based access control, signed actuator-command verification, sensor attestation, separation-of-duties, quorum-based cohort-bound validation); (iv) compliance is substantively supported across fourteen regulatory standards (FMEA through FDA cybersecurity), with 25 gaps documented; (v) eleven explicit limitations are disclosed including multi-event-per-trial efficacy degradation, quantum-readiness gap, and the multi-session privacy-budget exhaustion inherited from Phase XXIII. The deposit includes 12 runner scripts covering all 168 studies (Studies 301–468), 168 JSON summary verdicts, 168 per-study reports, 8 figures, a comprehensive POC summary document with full hypothesis tables, the Phase XXIV scope and progress synthesis, and the v3 polished manuscript (markdown + two-column IEEE arXiv-format Word and PDF). All studies reproduce bit-identically under PYTHONHASHSEED=0 with the pinned numpy 1.26.x / scipy 1.11.x / scikit-learn 1.4.x / PyWavelets 1.5.x / wfdb 4.1.x / pandas 2.1.x dependency stack. All input data are publicly available from PhysioNet (https://physionet.org) under the ODC-By license. Released under CC-BY 4.0.
Ferlic et al. (Mon,) conducted a other in Bioelectric digital-twin applications (e.g., epilepsy, arrhythmia). Bidirectional closed-loop privacy mechanism (Phase XXIII C1) vs. 32 distinct adversary variants was evaluated on Round-trip latency and decision quality (sensitivity/specificity). The Phase XXIII C1 privacy mechanism achieved p99 round-trip latency of 0.20–0.25 ms and preserved clinical-grade decision quality (sensitivity 0.85-0.88) against 32 adversary variants.