MediShield-Proxy: A Local Privacy-Preserving Intermediary Layer for Secure Clinical LLM Ingestion

Genius Tanaka Chipfupa

MediShield -Proxy is a lightweight, zero-trust Local Area Network (LAN) middleware architecture designed for African medical institutions. It intercepts sensitive patient data locally, automatically masking demographics, histories, and clinical conditions with reversible tokens before they can be leaked to external cloud-based Large Language Models (LLMs). This tool allows resource-constrained facilities to safely leverage global AI diagnostic and administrative utility while strictly maintaining data sovereignty and regional data protection compliance.

Reviewer's Comments

Reviewer's Comments

Arrow
Arrow
Arrow

This goes after a real problem that doesn't get enough attention clinicians in low-resource settings pasting identifiable patient data straight into ChatGPT or Claude — and the basic design instinct is right. Reversible local pseudonymization, mapping kept only in memory, re-identification on the way back: that's the correct shape given the constraint, and keeping it regex-based and CPU-only makes sense for old clinic hardware. The part I valued most isn't the tool, it's the insight behind it — that stripping direct identifiers isn't enough, because a rare pathology plus a local landmark can re-identify someone on its own. That's true and most people miss it, and abstracting geography into epidemiologically-equivalent tiers is a smart way to handle it. I also want to credit the negative results section; reporting that the embedding filter added 4,200ms and tagged "breakbone fever" as a location is exactly the kind of honesty I want to see.

Where it falls down is the evaluation. The 97.1% F1 — and especially the perfect 100% on National IDs — comes from 150 synthetic notes the team wrote themselves, so it's really measuring how well the regex matches the cases the author already had in mind, not messy real clinical text. That 100% should worry you, not reassure you; it's a sign the test set is circular. The lowercase-name and code-switching failures you flag are exactly the things that'll be far more common in real notes than in your synthetic ones. I'd also push back on the framing: you describe this as a zero-trust LAN interceptor that blocks outbound packets at the gateway, but what you've actually built is a client-side proxy the user has to choose to route through — nothing stops a clinician just opening chatgpt.com directly. That's a different threat model, and it should be said plainly. Three things would help a lot: test it on a clinical corpus you didn't write yourself, dial the enforcement claims back to what the proxy really guarantees, and deal with the obvious leak you don't address the raw symptoms and rare conditions still go to the external model unmasked, which in a small community can identify someone by itself. The dual-use note on the inversion module was a good call to include.

Healthcare systems in resource-constrained settings must protect patient privacy while accessing the capabilities of external large language models. This paper addresses that balancing act with a practical and well-motivated solution. The local intermediary architecture stands out as the submission's strongest contribution, proposing a path to reducing privacy exposure without cutting off access to advanced AI tools. The evaluation is the area most in need of development. The current reliance on a small synthetic dataset limits the generalisability of the findings, and the work would benefit from benchmarking against established de-identification methods and validation on more representative clinical data. Engaging more directly with the system's limitations, particularly its performance in multilingual or adversarial settings, would give the conclusions greater credibility and extend the paper's contribution to the broader AI safety literature.

1. PII to AI is a real problem - there are many approaches but I don't believe this approach solves for scale, given the false positives and latency

2. Consider how tokenization can be solved not "at rest" but while in motion

Cite this work

@misc {

title={

(HckPrj) MediShield-Proxy: A Local Privacy-Preserving Intermediary Layer for Secure Clinical LLM Ingestion

},

author={

Genius Tanaka Chipfupa

},

date={

},

organization={Apart Research},

note={Research submission to the research sprint hosted by Apart.},

howpublished={https://apartresearch.com}

}

Recent Projects

OliGraph: graph-based screening of large oligopools

Existing synthesis screening tools cannot evaluate short oligonucleotide pools, whose overlapping fragments can be reassembled into regulated sequences via polymerase cycling assembly (PCA) yet fall below gene-length detection thresholds. We present OliGraph, an open-source tool that constructs a bi-directed overlap graph from an oligonucleotide pool and extracts contigs for downstream gene-length screening. An optional PCA mode retains only cross-strand overlaps consistent with PCA chemistry. We validated OliGraph in a blinded study across ten simulated pools (70–9,184 oligonucleotides, 30–300 bp) spanning four risk categories. BLAST screening of individual oligonucleotides failed to identify sequences of concern in most pools: three returned zero hits, and vector noise obscured true positives in the remainder. After OliGraph assembly, contig-level BLAST matched the longest assembled sequences (up to 1,905 bp) to sequences of concern at 97–100% identity. In one pool, assembly collapsed 1,634 individual BLAST results into 10 hits from a single contig, all assigned to the same source organism. PCA mode correctly distinguished assemblable from non-assemblable fragments within the same pool. Two pools with no assemblable structure yielded no contigs. OliGraph processed all pools in under 0.2 seconds, fast enough for real-time order screening and consistent with proposals to bring oligonucleotide orders within the scope of synthesis screening regulation.

Read More

BioRT-Bench: A Multi-Attack Red-Teaming Benchmark for Bio-Misuse Safeguards in Frontier LLMs

Frontier AI laboratories are expected to maintain safeguards against biological misuse, but whether deployed models actually refuse bio-misuse queries under adversarial pressure is largely unmeasured in the public literature. We introduce BioRT-Bench, a benchmark that runs four attack methods (direct request, PAIR, Crescendo, and base64 encoding) against four frontier models (Claude Sonnet 4.6, GPT-5.4, DeepSeek V4-flash, Kimi K2.5) across 40 prompts spanning five biosecurity-relevant categories. Responses are scored by a calibrated judge extending StrongREJECT with two bio-specific dimensions: specificity and actionability. We measure Attack Success Rate (ASR), where 0 means the model fully refused and 1 means it provided specific, actionable bio-misuse content. Our results reveal a sharp robustness divide: Chinese frontier models (DeepSeek, Kimi) have under 5% refusal rates even under direct request (ASR 0.88 and 0.79), while Western models (Claude, GPT) maintain substantially stronger safeguards (ASR 0.15 and 0.16). Crescendo is the most effective attack across all models, both in bypassing refusal and in eliciting actionable content. Claude Sonnet 4.6 is the most robust model tested, achieving 100% refusal against base64-encoded prompts.

Read More

PROTEUS (PROTein Evaluation for Unusual Sequences): Structure-Informed Safety Screening for de novo and Evasion-Prone Protein-Coding Sequences

AI protein design tools like RFdiffusion, ProteinMPNN, and Bindcraft make it trivial to produce low-homology sequences that fold into active, potentially hazardous architectures. However, sequence homology-based biosafety screening tools cannot detect proteins that pose functional risk through structurally novel mechanisms with no sequence precedent. We present a tiered computational pipeline that addresses this gap by combining MMseqs2 sequence alignment with structure-based comparison via FoldSeek and DALI against curated toxin databases totaling ~34,000 entries. AlphaFold2-predicted structures are screened for both global fold similarity (FoldSeek) and local active/allosteric site geometry (DALI), capturing convergent functional hazards that sequence screening misses. The pipeline was validated against a panel of toxins, benign proteins, structural mimics, and de novo-designed Munc13 binders, as well as modified ricin variants with residue substitutions. We additionally tested robustness to partial-synthesis evasion, where a bad actor submits multiple shorter coding sequences intended for downstream reassembly into a full toxin-coding gene. We found that while sequence-based screening did not identify any de novo ricin analogues with high certainty, the combined pipeline with FoldSeek and DALI identified all 24 tested de novo ricins as toxic.

Read More

OliGraph: graph-based screening of large oligopools

Existing synthesis screening tools cannot evaluate short oligonucleotide pools, whose overlapping fragments can be reassembled into regulated sequences via polymerase cycling assembly (PCA) yet fall below gene-length detection thresholds. We present OliGraph, an open-source tool that constructs a bi-directed overlap graph from an oligonucleotide pool and extracts contigs for downstream gene-length screening. An optional PCA mode retains only cross-strand overlaps consistent with PCA chemistry. We validated OliGraph in a blinded study across ten simulated pools (70–9,184 oligonucleotides, 30–300 bp) spanning four risk categories. BLAST screening of individual oligonucleotides failed to identify sequences of concern in most pools: three returned zero hits, and vector noise obscured true positives in the remainder. After OliGraph assembly, contig-level BLAST matched the longest assembled sequences (up to 1,905 bp) to sequences of concern at 97–100% identity. In one pool, assembly collapsed 1,634 individual BLAST results into 10 hits from a single contig, all assigned to the same source organism. PCA mode correctly distinguished assemblable from non-assemblable fragments within the same pool. Two pools with no assemblable structure yielded no contigs. OliGraph processed all pools in under 0.2 seconds, fast enough for real-time order screening and consistent with proposals to bring oligonucleotide orders within the scope of synthesis screening regulation.

Read More

BioRT-Bench: A Multi-Attack Red-Teaming Benchmark for Bio-Misuse Safeguards in Frontier LLMs

Frontier AI laboratories are expected to maintain safeguards against biological misuse, but whether deployed models actually refuse bio-misuse queries under adversarial pressure is largely unmeasured in the public literature. We introduce BioRT-Bench, a benchmark that runs four attack methods (direct request, PAIR, Crescendo, and base64 encoding) against four frontier models (Claude Sonnet 4.6, GPT-5.4, DeepSeek V4-flash, Kimi K2.5) across 40 prompts spanning five biosecurity-relevant categories. Responses are scored by a calibrated judge extending StrongREJECT with two bio-specific dimensions: specificity and actionability. We measure Attack Success Rate (ASR), where 0 means the model fully refused and 1 means it provided specific, actionable bio-misuse content. Our results reveal a sharp robustness divide: Chinese frontier models (DeepSeek, Kimi) have under 5% refusal rates even under direct request (ASR 0.88 and 0.79), while Western models (Claude, GPT) maintain substantially stronger safeguards (ASR 0.15 and 0.16). Crescendo is the most effective attack across all models, both in bypassing refusal and in eliciting actionable content. Claude Sonnet 4.6 is the most robust model tested, achieving 100% refusal against base64-encoded prompts.

Read More

This work was done during one weekend by research workshop participants and does not represent the work of Apart Research.
This work was done during one weekend by research workshop participants and does not represent the work of Apart Research.