Daily Papers

Steering vectors (SVs) offer a lightweight way to control large language models (LLMs) at inference time by shifting hidden activations, providing a practical middle ground between prompting and fine-tuning. Yet SVs can be unreliable in practice. Some concepts are unsteerable, and even when steering helps on average it can backfire for a non-trivial fraction of inputs. Reliability also degrades in long-form generation and multi-attribute steering. We take a geometric view of these failures. A static SV applies the same update vector everywhere in representation space, implicitly assuming that the concept-improving direction is constant across contexts. When the locally effective direction varies with the current activation, a single global vector can become misaligned, which yields weak or reversed effects. Guided by this perspective, we propose Steering Vector Fields (SVF), which learns a differentiable concept scoring function whose local gradient defines the steering direction at each activation, making interventions explicitly context-dependent. This formulation supports coordinated multi-layer interventions in a shared, aligned concept space, and enables efficient long-form and multi-attribute control within a unified framework. Across multiple LLMs and steering tasks, SVF delivers stronger and more reliable control, improving the practicality of inference-time steering.

Key-value (KV) caching plays an essential role in accelerating decoding for transformer-based autoregressive large language models (LLMs). However, the amount of memory required to store the KV cache can become prohibitive at long sequence lengths and large batch sizes. Since the invention of the transformer, two of the most effective interventions discovered for reducing the size of the KV cache have been Multi-Query Attention (MQA) and its generalization, Grouped-Query Attention (GQA). MQA and GQA both modify the design of the attention block so that multiple query heads can share a single key/value head, reducing the number of distinct key/value heads by a large factor while only minimally degrading accuracy. In this paper, we show that it is possible to take Multi-Query Attention a step further by also sharing key and value heads between adjacent layers, yielding a new attention design we call Cross-Layer Attention (CLA). With CLA, we find that it is possible to reduce the size of the KV cache by another 2x while maintaining nearly the same accuracy as unmodified MQA. In experiments training 1B- and 3B-parameter models from scratch, we demonstrate that CLA provides a Pareto improvement over the memory/accuracy tradeoffs which are possible with traditional MQA, enabling inference with longer sequence lengths and larger batch sizes than would otherwise be possible

Transformer-based language models excel at both recall (retrieving memorized facts) and reasoning (performing multi-step inference), but whether these abilities rely on distinct internal mechanisms remains unclear. Distinguishing recall from reasoning is crucial for predicting model generalization, designing targeted evaluations, and building safer interventions that affect one ability without disrupting the other.We approach this question through mechanistic interpretability, using controlled datasets of synthetic linguistic puzzles to probe transformer models at the layer, head, and neuron level. Our pipeline combines activation patching and structured ablations to causally measure component contributions to each task type. Across two model families (Qwen and LLaMA), we find that interventions on distinct layers and attention heads lead to selective impairments: disabling identified "recall circuits" reduces fact-retrieval accuracy by up to 15\% while leaving reasoning intact, whereas disabling "reasoning circuits" reduces multi-step inference by a comparable margin. At the neuron level, we observe task-specific firing patterns, though these effects are less robust, consistent with neuronal polysemanticity.Our results provide the first causal evidence that recall and reasoning rely on separable but interacting circuits in transformer models. These findings advance mechanistic interpretability by linking circuit-level structure to functional specialization and demonstrate how controlled datasets and causal interventions can yield mechanistic insights into model cognition, informing safer deployment of large language models.

Large language models (LLMs) often memorize private information during training, raising serious privacy concerns. While machine unlearning has emerged as a promising solution, its true effectiveness against privacy attacks remains unclear. To address this, we propose PrivUn, a new evaluation framework that systematically assesses unlearning robustness through three-tier attack scenarios: direct retrieval, in-context learning recovery, and fine-tuning restoration; combined with quantitative analysis using forgetting scores, association metrics, and forgetting depth assessment. Our study exposes significant weaknesses in current unlearning methods, revealing two key findings: 1) unlearning exhibits gradient-driven ripple effects: unlike traditional forgetting which follows semantic relations (e.g., knowledge graphs), privacy unlearning propagates across latent gradient-based associations; and 2) most methods suffer from shallow forgetting, failing to remove private information distributed across multiple deep model layers. To validate these insights, we explore two strategies: association-aware core-set selection that leverages gradient similarity, and multi-layer deep intervention through representational constraints. These strategies represent a paradigm shift from shallow forgetting to deep forgetting.

Multi-reward guided reinforcement learning (i.e., RL) offers a promising way to improve joint audio-video diffusion models along several complementary objectives, including modality-specific quality, cross-modal semantic alignment, and temporal synchronization. Its effectiveness, however, depends on two quantities that change during training: where reward-driven updates should act, and how competing rewards should be combined. Existing methods tend to rely on fixed routing and reward weights, failing to track evolving model functions. To address these limitations, we propose Adaptive Reward Routing to jointly adapt update locations and reward coordination during forward-process RL (i.e., DiffusionNFT) of joint audio-video diffusion models. Our method consists of two components. (i) Cross-Modal Influence-Guided Routing (Localizing Updates): We use bidirectional cross-attention responses as an efficient proxy for evolving cross-modal influence, dynamically reweighting token-aware losses and scaling gradients across cross-modal layers without additional model interventions. (ii) Preference-Preserving Modality-Aware Reweighting (Coordinating Rewards): We preserve predefined weights as preference priors and use branch-specific reward-gradient interactions as residual corrections after warm-up. This resolves evolving conflicts without letting dominant rewards suppress weak but essential objectives. Extensive experiments demonstrate consistent improvements in modality quality, semantic consistency, and audio-video synchronization over strong RL baselines. Ablations and mechanism analyses further validate the complementary benefits of adaptive update routing and reward coordination.

Test-time interventions for language models can enhance factual accuracy, mitigate harmful outputs, and improve model efficiency without costly retraining. But despite a flood of new methods, different types of interventions are largely developing independently. In practice, multiple interventions must be applied sequentially to the same model, yet we lack standardized ways to study how interventions interact. We fill this gap by introducing composable interventions, a framework to study the effects of using multiple interventions on the same language models, featuring new metrics and a unified codebase. Using our framework, we conduct extensive experiments and compose popular methods from three emerging intervention categories -- Knowledge Editing, Model Compression, and Machine Unlearning. Our results from 310 different compositions uncover meaningful interactions: compression hinders editing and unlearning, composing interventions hinges on their order of application, and popular general-purpose metrics are inadequate for assessing composability. Taken together, our findings showcase clear gaps in composability, suggesting a need for new multi-objective interventions. All of our code is public: https://github.com/hartvigsen-group/composable-interventions.

As a key component in boosting online user growth, uplift modeling aims to measure individual user responses (e.g., whether to play the game) to various treatments, such as gaming bonuses, thereby enhancing business outcomes. However, previous research typically considers a single-task, single-treatment setting, where only one treatment exists and the overall treatment effect is measured by a single type of user response. In this paper, we propose a Multi-Treatment Multi-Task (MTMT) uplift network to estimate treatment effects in a multi-task scenario. We identify the multi-treatment problem as a causal inference problem with a tiered response, comprising a base effect (from offering a treatment) and an incremental effect (from offering a specific type of treatment), where the base effect can be numerically much larger than the incremental effect. Specifically, MTMT separately encodes user features and treatments. The user feature encoder uses a multi-gate mixture of experts (MMOE) network to encode relevant user features, explicitly learning inter-task relations. The resultant embeddings are used to measure natural responses per task. Furthermore, we introduce a treatment-user feature interaction module to model correlations between each treatment and user feature. Consequently, we separately measure the base and incremental treatment effect for each task based on the produced treatment-aware representations. Experimental results based on an offline public dataset and an online proprietary dataset demonstrate the effectiveness of MTMT in single/multi-treatment and single/multi-task settings. Additionally, MTMT has been deployed in our gaming platform to improve user experience.

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.

Layer interventions are widely used to probe the internal organization of language models, yet most analyses examine a single training checkpoint even though model representations and computations evolve throughout pretraining. This leaves open which depth-dependent intervention responses reflect persistent organization and which are transient consequences of training. We study this question using single-block identity bypass on fixed teacher-forced contexts across five released trajectories and 11 model-domain combinations. We find that block-bypass responses retain recognizable depth ordering while their magnitudes redistribute: nearby checkpoints preserve stronger rank correspondence than distant ones, and large changes concentrate at positions that recur across text samples and transfer across evaluation domains. Controlled experiments further show that changes in the natural bypass effect cannot be reduced to a single downstream sensitivity: in replicated Pythia runs, local missing-update magnitude grows while the pooled matched downstream response decreases, whereas OLMo-2 7B exhibits a different balance. These matched responses also depend on perturbation strength and direction, without identifying targeted compensation. Together, our results show that longitudinal layer sensitivity is structured but not static, and that single-checkpoint intervention responses should be interpreted in the context of how the underlying perturbation pathway evolves during training.

In this work we propose a blackbox intervention method for visual dialog models, with the aim of assessing the contribution of individual linguistic or visual components. Concretely, we conduct structured or randomized interventions that aim to impair an individual component of the model, and observe changes in task performance. We reproduce a state-of-the-art visual dialog model and demonstrate that our methodology yields surprising insights, namely that both dialog and image information have minimal contributions to task performance. The intervention method presented here can be applied as a sanity check for the strength and robustness of each component in visual dialog systems.

Previous works on Treatment Effect Estimation (TEE) are not in widespread use because they are predominantly theoretical, where strong parametric assumptions are made but untractable for practical application. Recent work uses multilayer perceptron (MLP) for modeling casual relationships, however, MLPs lag far behind recent advances in ML methodology, which limits their applicability and generalizability. To extend beyond the single domain formulation and towards more realistic learning scenarios, we explore model design spaces beyond MLPs, i.e., transformer backbones, which provide flexibility where attention layers govern interactions among treatments and covariates to exploit structural similarities of potential outcomes for confounding control. Through careful model design, Transformers as Treatment Effect Estimators (TransTEE) is proposed. We show empirically that TransTEE can: (1) serve as a general purpose treatment effect estimator that significantly outperforms competitive baselines in a variety of challenging TEE problems (e.g., discrete, continuous, structured, or dosage-associated treatments) and is applicable to both when covariates are tabular and when they consist of structural data (e.g., texts, graphs); (2) yield multiple advantages: compatibility with propensity score modeling, parameter efficiency, robustness to continuous treatment value distribution shifts, explainable in covariate adjustment, and real-world utility in auditing pre-trained language models

In complex multi-agent environments, achieving efficient learning and desirable behaviours is a significant challenge for Multi-Agent Reinforcement Learning (MARL) systems. This work explores the potential of combining MARL with Large Language Model (LLM)-mediated interventions to guide agents toward more desirable behaviours. Specifically, we investigate how LLMs can be used to interpret and facilitate interventions that shape the learning trajectories of multiple agents. We experimented with two types of interventions, referred to as controllers: a Natural Language (NL) Controller and a Rule-Based (RB) Controller. The NL Controller, which uses an LLM to simulate human-like interventions, showed a stronger impact than the RB Controller. Our findings indicate that agents particularly benefit from early interventions, leading to more efficient training and higher performance. Both intervention types outperform the baseline without interventions, highlighting the potential of LLM-mediated guidance to accelerate training and enhance MARL performance in challenging environments.

Interventions on model-internal states are fundamental operations in many areas of AI, including model editing, steering, robustness, and interpretability. To facilitate such research, we introduce pyvene, an open-source Python library that supports customizable interventions on a range of different PyTorch modules. pyvene supports complex intervention schemes with an intuitive configuration format, and its interventions can be static or include trainable parameters. We show how pyvene provides a unified and extensible framework for performing interventions on neural models and sharing the intervened upon models with others. We illustrate the power of the library via interpretability analyses using causal abstraction and knowledge localization. We publish our library through Python Package Index (PyPI) and provide code, documentation, and tutorials at https://github.com/stanfordnlp/pyvene.

Advancements in high-throughput technologies have led to a shift from traditional hypothesis-driven methodologies to data-driven approaches. Multi-omics refers to the integrative analysis of data derived from multiple 'omes', such as genomics, proteomics, transcriptomics, metabolomics, and microbiomics. This approach enables a comprehensive understanding of biological systems by capturing different layers of biological information. Deep learning methods are increasingly utilized to integrate multi-omics data, offering insights into molecular interactions and enhancing research into complex diseases. However, these models, with their numerous interconnected layers and nonlinear relationships, often function as black boxes, lacking transparency in decision-making processes. To overcome this challenge, explainable artificial intelligence (xAI) methods are crucial for creating transparent models that allow clinicians to interpret and work with complex data more effectively. This review explores how xAI can improve the interpretability of deep learning models in multi-omics research, highlighting its potential to provide clinicians with clear insights, thereby facilitating the effective application of such models in clinical settings.

Concept bottleneck models (CBMs) are a class of interpretable neural network models that predict the target response of a given input based on its high-level concepts. Unlike the standard end-to-end models, CBMs enable domain experts to intervene on the predicted concepts and rectify any mistakes at test time, so that more accurate task predictions can be made at the end. While such intervenability provides a powerful avenue of control, many aspects of the intervention procedure remain rather unexplored. In this work, we develop various ways of selecting intervening concepts to improve the intervention effectiveness and conduct an array of in-depth analyses as to how they evolve under different circumstances. Specifically, we find that an informed intervention strategy can reduce the task error more than ten times compared to the current baseline under the same amount of intervention counts in realistic settings, and yet, this can vary quite significantly when taking into account different intervention granularity. We verify our findings through comprehensive evaluations, not only on the standard real datasets, but also on synthetic datasets that we generate based on a set of different causal graphs. We further discover some major pitfalls of the current practices which, without a proper addressing, raise concerns on reliability and fairness of the intervention procedure.

Can digital ads encourage users exposed to inaccurate information sources to follow accurate ones? We conduct a large-scale field experiment (N=28,582) on X, formerly Twitter, with users who follow accounts that spread health misinformation. Participants were exposed to four ad treatments varied on two dimensions: a neutral message versus a persuasive message appealing to values of independence, and a request to follow a health institution versus a request to follow a health influencer. We term this ad-based, social network intervention a follow nudge. The ad with a persuasive message to follow a well-known health institution generated significantly higher click-through rates than all other conditions (Bonferroni-corrected pairwise tests, all p<0.001). Given the overall low click-through rate across treatments and the high cost of digital advertising infrastructure on X, however, we conclude that our proposed intervention -- at least in its current ad-based format -- is not a cost-effective means to improve information environments online. We discuss challenges faced when conducting large-scale experiments on X following the platform's ownership change and subsequent restrictions on data access for research purposes.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

Modality following serves as the capacity of multimodal large language models (MLLMs) to selectively utilize multimodal contexts based on user instructions. It is fundamental to ensuring safety and reliability in real-world deployments. However, the underlying mechanisms governing this decision-making process remain poorly understood. In this paper, we investigate its working mechanism through an information flow lens. Our findings reveal that instruction tokens function as structural anchors for modality arbitration: Shallow attention layers perform non-selective information transfer, routing multimodal cues to these anchors as a latent buffer; Modality competition is resolved within deep attention layers guided by the instruction intent, while MLP layers exhibit semantic inertia, acting as an adversarial force. Furthermore, we identify a sparse set of specialized attention heads that drive this arbitration. Causal interventions demonstrate that manipulating a mere 5% of these critical heads can decrease the modality-following ratio by 60% through blocking, or increase it by 60% through targeted amplification of failed samples. Our work provides a substantial step toward model transparency and offers a principled framework for the orchestration of multimodal information in MLLMs.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at https://github.com/SpassMed/Med-Llama3 in the future.

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

Single-task models have proven pivotal in solving specific tasks; however, they have limitations in real-world applications where multi-tasking is necessary and domain shifts are exhibited. Recently, instructional prompts have shown significant improvement towards multi-task generalization; however, the effect of instructional prompts and Multi-Task Learning (MTL) has not been systematically studied in the biomedical domain. Motivated by this, this paper explores the impact of instructional prompts for biomedical MTL. We introduce the BoX, a collection of 32 instruction tasks for Biomedical NLP across (X) various categories. Using this meta-dataset, we propose a unified model termed In-BoXBART, that can jointly learn all tasks of the BoX without any task-specific modules. To the best of our knowledge, this is the first attempt to propose a unified model in the biomedical domain and use instructions to achieve generalization across several biomedical tasks. Experimental results indicate that the proposed model: 1) outperforms the single-task baseline by ~3% and multi-task (without instruction) baseline by ~18% on an average, and 2) shows ~23% improvement compared to the single-task baseline in few-shot learning (i.e., 32 instances per task) on an average. Our analysis indicates that there is significant room for improvement across tasks in the BoX, implying the scope for future research direction.

We present MultiChallenge, a pioneering benchmark evaluating large language models (LLMs) on conducting multi-turn conversations with human users, a crucial yet underexamined capability for their applications. MultiChallenge identifies four categories of challenges in multi-turn conversations that are not only common and realistic among current human-LLM interactions, but are also challenging to all current frontier LLMs. All 4 challenges require accurate instruction-following, context allocation, and in-context reasoning at the same time. We also develop LLM as judge with instance-level rubrics to facilitate an automatic evaluation method with fair agreement with experienced human raters. Despite achieving near-perfect scores on existing multi-turn evaluation benchmarks, all frontier models have less than 50% accuracy on MultiChallenge, with the top-performing Claude 3.5 Sonnet (June 2024) achieving just a 41.4% average accuracy.

To develop a reliable AI for psychological assessment, we introduce PsychEval, a multi-session, multi-therapy, and highly realistic benchmark designed to address three key challenges: 1) Can we train a highly realistic AI counselor? Realistic counseling is a longitudinal task requiring sustained memory and dynamic goal tracking. We propose a multi-session benchmark (spanning 6-10 sessions across three distinct stages) that demands critical capabilities such as memory continuity, adaptive reasoning, and longitudinal planning. The dataset is annotated with extensive professional skills, comprising over 677 meta-skills and 4577 atomic skills. 2) How to train a multi-therapy AI counselor? While existing models often focus on a single therapy, complex cases frequently require flexible strategies among various therapies. We construct a diverse dataset covering five therapeutic modalities (Psychodynamic, Behaviorism, CBT, Humanistic Existentialist, and Postmodernist) alongside an integrative therapy with a unified three-stage clinical framework across six core psychological topics. 3) How to systematically evaluate an AI counselor? We establish a holistic evaluation framework with 18 therapy-specific and therapy-shared metrics across Client-Level and Counselor-Level dimensions. To support this, we also construct over 2,000 diverse client profiles. Extensive experimental analysis fully validates the superior quality and clinical fidelity of our dataset. Crucially, PsychEval transcends static benchmarking to serve as a high-fidelity reinforcement learning environment that enables the self-evolutionary training of clinically responsible and adaptive AI counselors.

Large Language Models (LLMs) have demonstrated remarkable capabilities in understanding and generating human-like text, yet they largely operate as reactive agents, responding only when directly prompted. This passivity creates an "awareness gap," limiting their potential as truly collaborative partners in dynamic human discussions. We introduce DiscussLLM, a framework designed to bridge this gap by training models to proactively decide not just what to say, but critically, when to speak. Our primary contribution is a scalable two-stage data generation pipeline that synthesizes a large-scale dataset of realistic multi-turn human discussions. Each discussion is annotated with one of five intervention types (e.g., Factual Correction, Concept Definition) and contains an explicit conversational trigger where an AI intervention adds value. By training models to predict a special silent token when no intervention is needed, they learn to remain quiet until a helpful contribution can be made. We explore two architectural baselines: an integrated end-to-end model and a decoupled classifier-generator system optimized for low-latency inference. We evaluate these models on their ability to accurately time interventions and generate helpful responses, paving the way for more situationally aware and proactive conversational AI.

We present a corpus of 5,000 richly annotated abstracts of medical articles describing clinical randomized controlled trials. Annotations include demarcations of text spans that describe the Patient population enrolled, the Interventions studied and to what they were Compared, and the Outcomes measured (the `PICO' elements). These spans are further annotated at a more granular level, e.g., individual interventions within them are marked and mapped onto a structured medical vocabulary. We acquired annotations from a diverse set of workers with varying levels of expertise and cost. We describe our data collection process and the corpus itself in detail. We then outline a set of challenging NLP tasks that would aid searching of the medical literature and the practice of evidence-based medicine.

Combination therapies have become the standard of care for diseases such as cancer, tuberculosis, malaria and HIV. However, the combinatorial set of available multi-drug treatments creates a challenge in identifying effective combination therapies available in a situation. To assist medical professionals in identifying beneficial drug-combinations, we construct an expert-annotated dataset for extracting information about the efficacy of drug combinations from the scientific literature. Beyond its practical utility, the dataset also presents a unique NLP challenge, as the first relation extraction dataset consisting of variable-length relations. Furthermore, the relations in this dataset predominantly require language understanding beyond the sentence level, adding to the challenge of this task. We provide a promising baseline model and identify clear areas for further improvement. We release our dataset, code, and baseline models publicly to encourage the NLP community to participate in this task.

Topic segmentation is important in understanding scientific documents since it can not only provide better readability but also facilitate downstream tasks such as information retrieval and question answering by creating appropriate sections or paragraphs. In the topic segmentation task, topic coherence is critical in predicting segmentation boundaries. Most of the existing models have tried to exploit as many contexts as possible to extract useful topic-related information. However, additional context does not always bring promising results, because the local context between sentences becomes incoherent despite more sentences being supplemented. To alleviate this issue, we propose siamese sentence embedding layers which process two input sentences independently to get appropriate amount of information without being hampered by excessive information. Also, we adopt multi-task learning techniques including Same Topic Prediction (STP), Topic Classification (TC) and Next Sentence Prediction (NSP). When these three classification layers are combined in a multi-task manner, they can make up for each other's limitations, improving performance in all three tasks. We experiment different combinations of the three layers and report how each layer affects other layers in the same combination as well as the overall segmentation performance. The model we proposed achieves the state-of-the-art result in the WikiSection dataset.

Recent advancements in large language models (LLMs) have revolutionized their ability to handle single-turn tasks, yet real-world applications demand sophisticated multi-turn interactions. This survey provides a comprehensive review of recent advancements in evaluating and enhancing multi-turn interactions in LLMs. Focusing on task-specific scenarios, from instruction following in diverse domains such as math and coding to complex conversational engagements in roleplay, healthcare, education, and even adversarial jailbreak settings, we systematically examine the challenges of maintaining context, coherence, fairness, and responsiveness over prolonged dialogues. The paper organizes current benchmarks and datasets into coherent categories that reflect the evolving landscape of multi-turn dialogue evaluation. In addition, we review a range of enhancement methodologies under multi-turn settings, including model-centric strategies (contextual learning, supervised fine-tuning, reinforcement learning, and new architectures), external integration approaches (memory-augmented, retrieval-based methods, and knowledge graph), and agent-based techniques for collaborative interactions. Finally, we discuss open challenges and propose future directions for research to further advance the robustness and effectiveness of multi-turn interactions in LLMs. Related resources and papers are available at https://github.com/yubol-cmu/Awesome-Multi-Turn-LLMs.

Recent work has shown promising results in causal discovery by leveraging interventional data with gradient-based methods, even when the intervened variables are unknown. However, previous work assumes that the correspondence between samples and interventions is known, which is often unrealistic. We envision a scenario with an extensive dataset sampled from multiple intervention distributions and one observation distribution, but where we do not know which distribution originated each sample and how the intervention affected the system, i.e., interventions are entirely latent. We propose a method based on neural networks and variational inference that addresses this scenario by framing it as learning a shared causal graph among an infinite mixture (under a Dirichlet process prior) of intervention structural causal models. Experiments with synthetic and real data show that our approach and its semi-supervised variant are able to discover causal relations in this challenging scenario.

Multimodal learning is defined as learning over multiple heterogeneous input modalities such as video, audio, and text. In this work, we are concerned with understanding how models behave as the type of modalities differ between training and deployment, a situation that naturally arises in many applications of multimodal learning to hardware platforms. We present a multimodal robustness framework to provide a systematic analysis of common multimodal representation learning methods. Further, we identify robustness short-comings of these approaches and propose two intervention techniques leading to 1.5times-4times robustness improvements on three datasets, AudioSet, Kinetics-400 and ImageNet-Captions. Finally, we demonstrate that these interventions better utilize additional modalities, if present, to achieve competitive results of 44.2 mAP on AudioSet 20K.

As mental health issues globally escalate, there is a tremendous need for advanced digital support systems. We introduce MentalAgora, a novel framework employing large language models enhanced by interaction between multiple agents for tailored mental health support. This framework operates through three stages: strategic debating, tailored counselor creation, and response generation, enabling the dynamic customization of responses based on individual user preferences and therapeutic needs. We conduct experiments utilizing a high-quality evaluation dataset TherapyTalk crafted with mental health professionals, shwoing that MentalAgora generates expert-aligned and user preference-enhanced responses. Our evaluations, including experiments and user studies, demonstrate that MentalAgora aligns with professional standards and effectively meets user preferences, setting a new benchmark for digital mental health interventions.

We present an automated, contrastive evaluation pipeline for auditing the behavioral impact of interventions on large language models. Given a base model M_1 and an intervention model M_2, our method compares their free-form, multi-token generations across aligned prompt contexts and produces human-readable, statistically validated natural-language hypotheses describing how the models differ, along with recurring themes that summarize patterns across validated hypotheses. We evaluate the approach in synthetic setting by injecting known behavioral changes and showing that the pipeline reliably recovers them. We then apply it to three real-world interventions, reasoning distillation, knowledge editing and unlearning, demonstrating that the method surfaces both intended and unexpected behavioral shifts, distinguishes large from subtle interventions, and does not hallucinate differences when effects are absent or misaligned with the prompt bank. Overall, the pipeline provides a statistically grounded and interpretable tool for post-hoc auditing of intervention-induced changes in model behavior.

End-to-end automation of realistic healthcare operations stresses three capabilities underrepresented in current benchmarks: policy density, decisions must be grounded in a large library of medical, insurance, and operational rules; Multi-role composition: a single task requires the agent to play multiple roles with handoffs; and multilateral interaction: intermediate workflow steps are multi-turn dialogs, such as peer-to-peer review and patient outreach. We introduce χ-Bench, a benchmark of long-horizon healthcare workflows across three domains: provider prior authorization, payer utilization management, and care management. Each task hands the agent a clinical case in a high-fidelity simulator of 20 healthcare apps exposed via 87 MCP tools, which it must drive to a terminal status through tool calls and writing the role's artifacts, guided by a 1,290+ document managed-care operations handbook skill. Across 30 agent harness/models configurations, the best agent resolves only 28.0% of tasks, no agent clears 20% on strict pass^3, and executing all tasks in a single session slumps the performance to 3.8%. These results raise the hypothesis that similar gaps are likely to surface in other policy-dense, role-composed, irreversible enterprise domains.

Personalized nutrition intervention for patients with multimorbidity is critical for improving health outcomes, yet remains challenging because it requires the simultaneous integration of heterogeneous clinical conditions, medications, and dietary guidelines. Single-agent large language models (LLMs) often suffer from context overload and attention dilution when processing such high-dimensional patient profiles. We introduce NutriOrion, a hierarchical multi-agent framework with a parallel-then-sequential reasoning topology. NutriOrion decomposes nutrition planning into specialized domain agents with isolated contexts to mitigate anchoring bias, followed by a conditional refinement stage. The framework includes a multi-objective prioritization algorithm to resolve conflicting dietary requirements and a safety constraint mechanism that injects pharmacological contraindications as hard negative constraints during synthesis, ensuring clinical validity by construction rather than post-hoc filtering. For clinical interoperability, NutriOrion maps synthesized insights into the ADIME standard and FHIR R4 resources. Evaluated on 330 stroke patients with multimorbidity, NutriOrion outperforms multiple baselines, including GPT-4.1 and alternative multi-agent architectures. It achieves a 12.1 percent drug-food interaction violation rate, demonstrates strong personalization with negative correlations (-0.26 to -0.35) between patient biomarkers and recommended risk nutrients, and yields clinically meaningful dietary improvements, including a 167 percent increase in fiber and a 27 percent increase in potassium, alongside reductions in sodium (9 percent) and sugars (12 percent).

Providing Emotional Support (ES) to soothe people in emotional distress is an essential capability in social interactions. Most existing researches on building ES conversation systems only considered single-turn interactions with users, which was over-simplified. In comparison, multi-turn ES conversation systems can provide ES more effectively, but face several new technical challenges, including: (1) how to adopt appropriate support strategies to achieve the long-term dialogue goal of comforting the user's emotion; (2) how to dynamically model the user's state. In this paper, we propose a novel system MultiESC to address these issues. For strategy planning, drawing inspiration from the A* search algorithm, we propose lookahead heuristics to estimate the future user feedback after using particular strategies, which helps to select strategies that can lead to the best long-term effects. For user state modeling, MultiESC focuses on capturing users' subtle emotional expressions and understanding their emotion causes. Extensive experiments show that MultiESC significantly outperforms competitive baselines in both dialogue generation and strategy planning. Our codes are available at https://github.com/lwgkzl/MultiESC.

Being engaging, knowledgeable, and empathetic are all desirable general qualities in a conversational agent. Previous work has introduced tasks and datasets that aim to help agents to learn those qualities in isolation and gauge how well they can express them. But rather than being specialized in one single quality, a good open-domain conversational agent should be able to seamlessly blend them all into one cohesive conversational flow. In this work, we investigate several ways to combine models trained towards isolated capabilities, ranging from simple model aggregation schemes that require minimal additional training, to various forms of multi-task training that encompass several skills at all training stages. We further propose a new dataset, BlendedSkillTalk, to analyze how these capabilities would mesh together in a natural conversation, and compare the performance of different architectures and training schemes. Our experiments show that multi-tasking over several tasks that focus on particular capabilities results in better blended conversation performance compared to models trained on a single skill, and that both unified or two-stage approaches perform well if they are constructed to avoid unwanted bias in skill selection or are fine-tuned on our new task.

Conversational artificial intelligence has the potential to assist users in preliminary medical consultations, particularly in settings where access to healthcare professionals is limited. However, many existing medical dialogue systems operate in a single-turn question--answering paradigm or rely on template-based datasets, limiting conversational realism and multilingual applicability. In this work, we introduce MedAidDialog, a multilingual multi-turn medical dialogue dataset designed to simulate realistic physician--patient consultations. The dataset extends the MDDial corpus by generating synthetic consultations using large language models and further expands them into a parallel multilingual corpus covering seven languages: English, Hindi, Telugu, Tamil, Bengali, Marathi, and Arabic. Building on this dataset, we develop MedAidLM, a conversational medical model trained using parameter-efficient fine-tuning on quantized small language models, enabling deployment without high-end computational infrastructure. Our framework additionally incorporates optional patient pre-context information (e.g., age, gender, allergies) to personalize the consultation process. Experimental results demonstrate that the proposed system can effectively perform symptom elicitation through multi-turn dialogue and generate diagnostic recommendations. We further conduct medical expert evaluation to assess the plausibility and coherence of the generated consultations.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

Medical workflows often require multiple interdependent analyses, but existing specialist and generalist AI models are not designed to coordinate them. We introduce MMedAgent-Plus, a multimodal medical tool-use agent that combines a vision-language planner with 18 leading specialist models spanning 12 tasks and 8 modalities. Through a unified tool interface, the planner selects specialists, executes them in sequence, and synthesizes responses grounded in their outputs. The planner is instruction-tuned on 208,928 samples from 32 public medical benchmarks, covering single- and multi-tool interactions across single and multiple rounds. We separately evaluate tool orchestration, response synthesis, and end-to-end execution on held-out samples. MMedAgent-Plus achieves tool-call accuracies of 91.0%, 98.1%, and 80.7% in single-tool multi-round, multi-tool multi-round, and multi-tool single-round settings, respectively. Given correct tool outputs, MMedAgent-Plus achieves scores of 14.4-14.8 out of 15 for faithfulness, completeness, and conciseness across 600 evaluation samples. In end-to-end execution without pre-supplied tool outputs, MMedAgent-Plus correctly invokes the required specialist in 90.6% of 350 evaluation cases spanning seven tasks. Its final-answer accuracy reaches 0.98, matching the dedicated leading specialist and exceeding the strongest baseline (0.28).

Motivated by neuroscientific and clinical applications, we empirically examine whether observational measures of information flow can suggest interventions. We do so by performing experiments on artificial neural networks in the context of fairness in machine learning, where the goal is to induce fairness in the system through interventions. Using our recently developed M-information flow framework, we measure the flow of information about the true label (responsible for accuracy, and hence desirable), and separately, the flow of information about a protected attribute (responsible for bias, and hence undesirable) on the edges of a trained neural network. We then compare the flow magnitudes against the effect of intervening on those edges by pruning. We show that pruning edges that carry larger information flows about the protected attribute reduces bias at the output to a greater extent. This demonstrates that M-information flow can meaningfully suggest targets for interventions, answering the title's question in the affirmative. We also evaluate bias-accuracy tradeoffs for different intervention strategies, to analyze how one might use estimates of desirable and undesirable information flows (here, accuracy and bias flows) to inform interventions that preserve the former while reducing the latter.

Limited access to mental healthcare, extended wait times, and increasing capabilities of Large Language Models (LLMs) has led individuals to turn to LLMs for fulfilling their mental health needs. However, examining the multi-turn mental health conversation capabilities of LLMs remains under-explored. Existing evaluation frameworks typically focus on diagnostic accuracy and win-rates and often overlook alignment with patient-specific goals, values, and personalities required for meaningful conversations. To address this, we introduce MedAgent, a novel framework for synthetically generating realistic, multi-turn mental health sensemaking conversations and use it to create the Mental Health Sensemaking Dialogue (MHSD) dataset, comprising over 2,200 patient-LLM conversations. Additionally, we present MultiSenseEval, a holistic framework to evaluate the multi-turn conversation abilities of LLMs in healthcare settings using human-centric criteria. Our findings reveal that frontier reasoning models yield below-par performance for patient-centric communication and struggle at advanced diagnostic capabilities with average score of 31%. Additionally, we observed variation in model performance based on patient's persona and performance drop with increasing turns in the conversation. Our work provides a comprehensive synthetic data generation framework, a dataset and evaluation framework for assessing LLMs in multi-turn mental health conversations.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

Effective mental health support is crucial for alleviating psychological distress. While large language model (LLM)-based assistants have shown promise in mental health interventions, existing research often defines "effective" support primarily in terms of empathetic acknowledgments, overlooking other essential dimensions such as informational guidance, community validation, and tangible coping strategies. To address this limitation and better understand what constitutes effective support, we introduce RedditESS, a novel real-world dataset derived from Reddit posts, including supportive comments and original posters' follow-up responses. Grounded in established social science theories, we develop an ensemble labeling mechanism to annotate supportive comments as effective or not and perform qualitative assessments to ensure the reliability of the annotations. Additionally, we demonstrate the practical utility of RedditESS by using it to guide LLM alignment toward generating more context-sensitive and genuinely helpful supportive responses. By broadening the understanding of effective support, our study paves the way for advanced AI-driven mental health interventions.

Clinical trials are fundamental in developing new drugs, medical devices, and treatments. However, they are often time-consuming and have low success rates. Although there have been initial attempts to create large language models (LLMs) for clinical trial design and patient-trial matching, these models remain task-specific and not adaptable to diverse clinical trial tasks. To address this challenge, we propose a clinical trial foundation model named Panacea, designed to handle multiple tasks, including trial search, trial summarization, trial design, and patient-trial matching. We also assemble a large-scale dataset, named TrialAlign, of 793,279 trial documents and 1,113,207 trial-related scientific papers, to infuse clinical knowledge into the model by pre-training. We further curate TrialInstruct, which has 200,866 of instruction data for fine-tuning. These resources enable Panacea to be widely applicable for a range of clinical trial tasks based on user requirements. We evaluated Panacea on a new benchmark, named TrialPanorama, which covers eight clinical trial tasks. Our method performed the best on seven of the eight tasks compared to six cutting-edge generic or medicine-specific LLMs. Specifically, Panacea showed great potential to collaborate with human experts in crafting the design of eligibility criteria, study arms, and outcome measures, in multi-round conversations. In addition, Panacea achieved 14.42% improvement in patient-trial matching, 41.78% to 52.02% improvement in trial search, and consistently ranked at the top for five aspects of trial summarization. Our approach demonstrates the effectiveness of Panacea in clinical trials and establishes a comprehensive resource, including training data, model, and benchmark, for developing clinical trial foundation models, paving the path for AI-based clinical trial development.

Mechanistic interpretability seeks to understand the internal mechanisms of machine learning models, where localization -- identifying the important model components -- is a key step. Activation patching, also known as causal tracing or interchange intervention, is a standard technique for this task (Vig et al., 2020), but the literature contains many variants with little consensus on the choice of hyperparameters or methodology. In this work, we systematically examine the impact of methodological details in activation patching, including evaluation metrics and corruption methods. In several settings of localization and circuit discovery in language models, we find that varying these hyperparameters could lead to disparate interpretability results. Backed by empirical observations, we give conceptual arguments for why certain metrics or methods may be preferred. Finally, we provide recommendations for the best practices of activation patching going forwards.

Large language models (LLMs) have been widely applied in various fields due to their excellent capability for memorizing knowledge and chain of thought (CoT). When these language models are applied in the field of psychological counseling, they often rush to provide universal advice. However, when users seek psychological support, they need to gain empathy, trust, understanding and comfort, rather than just reasonable advice. To this end, we constructed a multi-turn empathetic conversation dataset of more than 2 million samples, in which the input is the multi-turn conversation context, and the target is empathetic responses that cover expressions such as questioning, comfort, recognition, listening, trust, emotional support, etc. Experiments have shown that the empathy ability of LLMs can be significantly enhanced when finetuning by using multi-turn dialogue history and responses that are closer to the expression of a psychological consultant.

Layering information spaces is a promising strategy to design intuitive and engaging interactive experiences. Although multi-layer displays enable promising interaction techniques through limited depth perception - achieved via slight separation between layers - it remains unclear how to fully design experiences that leverage the unique affordances of layered information. To address this, we introduce Proscenium, a dual-layer, large transparent display workspace setup with an adjustable separation between the layers. We demonstrate our preliminary design space focusing on how rendered information can be transitioned and linked across displays, and showcase 14 speculative experience prototypes across six categories.

Large language models (LLMs) have performed well in providing general and extensive health suggestions in single-turn conversations, exemplified by systems such as ChatGPT, ChatGLM, ChatDoctor, DoctorGLM, and etc. However, the limited information provided by users during single turn results in inadequate personalization and targeting of the generated suggestions, which requires users to independently select the useful part. It is mainly caused by the missing ability to engage in multi-turn questioning. In real-world medical consultations, doctors usually employ a series of iterative inquiries to comprehend the patient's condition thoroughly, enabling them to provide effective and personalized suggestions subsequently, which can be defined as chain of questioning (CoQ) for LLMs. To improve the CoQ of LLMs, we propose BianQue, a ChatGLM-based LLM finetuned with the self-constructed health conversation dataset BianQueCorpus that is consist of multiple turns of questioning and health suggestions polished by ChatGPT. Experimental results demonstrate that the proposed BianQue can simultaneously balance the capabilities of both questioning and health suggestions, which will help promote the research and application of LLMs in the field of proactive health.

Artificial intelligence (AI) systems will increasingly be used to cause harm as they grow more capable. In fact, AI systems are already starting to be used to automate fraudulent activities, violate human rights, create harmful fake images, and identify dangerous toxins. To prevent some misuses of AI, we argue that targeted interventions on certain capabilities will be warranted. These restrictions may include controlling who can access certain types of AI models, what they can be used for, whether outputs are filtered or can be traced back to their user, and the resources needed to develop them. We also contend that some restrictions on non-AI capabilities needed to cause harm will be required. Though capability restrictions risk reducing use more than misuse (facing an unfavorable Misuse-Use Tradeoff), we argue that interventions on capabilities are warranted when other interventions are insufficient, the potential harm from misuse is high, and there are targeted ways to intervene on capabilities. We provide a taxonomy of interventions that can reduce AI misuse, focusing on the specific steps required for a misuse to cause harm (the Misuse Chain), and a framework to determine if an intervention is warranted. We apply this reasoning to three examples: predicting novel toxins, creating harmful images, and automating spear phishing campaigns.

As browser-use agents improve, benchmarks keep pace by collecting new tasks, websites, and applications, often making tasks longer or more novel. This makes difficulty expensive to refresh and difficult to control: when many aspects change at once, it is unclear what actually makes a task challenging. We instead construct challenging instances from tasks agents already solve, turning difficulty into a programmable property of the environment. BreakingWeb pairs every base task with an intervention condition that preserves the user instruction, latent target, and backend success criterion while changing the environment at different web stack layers. Each intervention is deterministic, detectable, and recoverable, and is annotated with the cognitive primitive it primarily loads. The benchmark contains 519 clean/intervention task pairs across seven self-hosted websites and 29 intervention families, all graded against outcomes. We evaluate six strong browser-use agents, three GUI-only agents that see only screenshots, and humans. The construction is effective: interventions cut agent pass rate by 22.9% on average and overturn nearly half of the tasks each agent solves cleanly, whereas humans lose 10.0% on a first attempt and 5.7% after one familiarisation attempt. The dominant failure is belief failure: 75% of the six agents' failures end with a declared success although the required change never happened. Our code, data and environment are publicly available at www.breakingweb.app.

The professionalism of a human doctor in outpatient service depends on two core abilities: the ability to make accurate medical decisions and the medical consultation skill to conduct strategic, empathetic patient inquiry. Existing Large Language Models (LLMs) have achieved remarkable accuracy on medical decision-making benchmarks. However, they often lack the ability to conduct the strategic and empathetic consultation, which is essential for real-world clinical scenarios. To address this gap, we propose Doctor-R1, an AI doctor agent trained to master both of the capabilities by ask high-yield questions and conduct strategic multi-turn inquiry to guide decision-making. Our framework introduces three key components: a multi-agent interactive environment, a two-tiered reward architecture that separately optimizes clinical decision-making and communicative inquiry skills, and an experience repository to ground policy learning in high-quality prior trajectories. We evaluate Doctor-R1 on OpenAI's HealthBench and MAQuE, assessed across multi-facet metrics, such as communication quality, user experience, and task accuracy. Remarkably, Doctor-R1 surpasses state-of-the-art open-source specialized LLMs by a substantial margin with higher parameter efficiency and outperforms powerful proprietary models. Furthermore, the human evaluations show a strong preference for Doctor-R1 to generate human-preferred clinical dialogue, demonstrating the effectiveness of the framework.

Region-instructed layout control in text-to-image generation is highly practical, yet existing methods suffer from limitations: (i) training-based approaches inherit data bias and often degrade image quality, and (ii) current techniques struggle with occlusion order, limiting real-world usability. To address these issues, we propose LayerBind. By modeling regional generation as distinct layers and binding them during the generation, our method enables precise regional and occlusion controllability. Our motivation stems from the observation that spatial layout and occlusion are established at a very early denoising stage, suggesting that rearranging the early latent structure is sufficient to modify the final output. Building on this, we structure the scheme into two phases: instance initialization and subsequent semantic nursing. (1) First, leveraging the contextual sharing mechanism in multimodal joint attention, Layer-wise Instance Initialization creates per-instance branches that attend to their own regions while anchoring to the shared background. At a designated early step, these branches are fused according to the layer order to form a unified latent with a pre-established layout. (2) Then, Layer-wise Semantic Nursing reinforces regional details and maintains the occlusion order via a layer-wise attention enhancement. Specifically, a sequential layered attention path operates alongside the standard global path, with updates composited under a layer-transparency scheduler. LayerBind is training-free and plug-and-play, serving as a regional and occlusion controller across Diffusion Transformers. Beyond generation, it natively supports editable workflows, allowing for flexible modifications like changing instances or rearranging visible orders. Both qualitative and quantitative results demonstrate LayerBind's effectiveness, highlighting its strong potential for creative applications.

Medical systematic reviews can be very costly and resource intensive. We explore how Large Language Models (LLMs) can support and be trained to perform literature screening when provided with a detailed set of selection criteria. Specifically, we instruction tune LLaMA and Guanaco models to perform abstract screening for medical systematic reviews. Our best model, Bio-SIEVE, outperforms both ChatGPT and trained traditional approaches, and generalises better across medical domains. However, there remains the challenge of adapting the model to safety-first scenarios. We also explore the impact of multi-task training with Bio-SIEVE-Multi, including tasks such as PICO extraction and exclusion reasoning, but find that it is unable to match single-task Bio-SIEVE's performance. We see Bio-SIEVE as an important step towards specialising LLMs for the biomedical systematic review process and explore its future developmental opportunities. We release our models, code and a list of DOIs to reconstruct our dataset for reproducibility.

Emotional Support Conversation (ESC) aims to assist individuals experiencing distress by generating empathetic and supportive dialogue. While prior work typically assumes that each supporter turn corresponds to a single strategy, real-world supportive communication often involves multiple strategies within a single utterance. In this paper, we revisit the ESC task by formulating it as multi-strategy utterance generation, where each utterance may contain one or more strategy-response pairs. We propose two generation methods: All-in-One, which predicts all strategy-response pairs in a single decoding step, and One-by-One, which iteratively generates strategy-response pairs until completion. Both methods are further enhanced with cognitive reasoning guided by reinforcement learning to improve strategy selection and response composition. We evaluate our models on the ESConv dataset under both utterance-level and dialogue-level settings. Experimental results show that our methods effectively model multi-strategy utterances and lead to improved supportive quality and dialogue success. To our knowledge, this work provides the first systematic empirical evidence that allowing multiple support strategies within a single utterance is both feasible and beneficial for emotional support conversations. All code and data will be publicly available at https://github.com/aliyun/qwen-dianjin.

LLM-based simulated clients are increasingly used to train novice counselors, evaluate LLM therapists, and generate synthetic data. However, current simulators produce overly cooperative clients that disclose too readily, accept therapeutic reframes without resistance, and resolve core issues within a single session. We trace these issues to profiles that lack causal depth and behavioral mechanisms that treat all content as equally accessible. We present PatientAct, a framework for client simulation grounded in established clinical theories. Our profiles integrate the 5Ps clinical case formulation, providing causal depth without tying the design to any single therapeutic modality. During simulation, profiles include a dynamic memory layer in which items carry trust thresholds (e.g., symptoms are available early, whereas formative memories require a sustained therapeutic alliance). At each turn, the client's emotional reaction and behavior are modeled before generating a response. If the therapist approaches gated content, PatientAct expresses resistance in terms of quantity, content, and style rather than defaulting to cooperation or a single resistance pattern. We evaluate our framework on 40 clinical situations and demonstrate that it generates diverse profiles with high clinical plausibility. Moreover, PatientAct significantly outperforms the baselines, yielding substantial gains in resistance quality and behavioral realism. Our code and data will be publicly available via github.com/Sahandfer/PatientHub.

Universal Multimodal embedding models built on Multimodal Large Language Models (MLLMs) have traditionally employed contrastive learning, which aligns representations of query-target pairs across different modalities. Yet, despite its empirical success, they are primarily built on a "single-turn" formulation where each query-target pair is treated as an independent data point. This paradigm leads to computational inefficiency when scaling, as it requires a separate forward pass for each pair and overlooks potential contextual relationships between multiple queries that can relate to the same context. In this work, we introduce Multi-Turn Contrastive Learning (MuCo), a dialogue-inspired framework that revisits this process. MuCo leverages the conversational nature of MLLMs to process multiple, related query-target pairs associated with a single image within a single forward pass. This allows us to extract a set of multiple query and target embeddings simultaneously, conditioned on a shared context representation, amplifying the effective batch size and overall training efficiency. Experiments exhibit MuCo with a newly curated 5M multimodal multi-turn dataset (M3T), which yields state-of-the-art retrieval performance on MMEB and M-BEIR benchmarks, while markedly enhancing both training efficiency and representation coherence across modalities. Code and M3T are available at https://github.com/naver-ai/muco

Current Large Language Models (LLMs) exhibit significant limitations, notably in structured, interpretable, and verifiable medical reasoning, alongside practical deployment challenges related to computational resources and data privacy. This report focused on the development of WiNGPT-3.0, the 32-billion parameter LLMs, engineered with the objective of enhancing its capacity for medical reasoning and exploring its potential for effective integration within healthcare IT infrastructures. The broader aim is to advance towards clinically applicable models. The approach involved a multi-stage training pipeline tailored for general, medical, and clinical reasoning. This pipeline incorporated supervised fine-tuning (SFT) and reinforcement learning (RL), leveraging curated Long Chain-of-Thought (CoT) datasets, auxiliary reward models, and an evidence-based diagnostic chain simulation. WiNGPT-3.0 demonstrated strong performance: specific model variants achieved scores of 66.6 on MedCalc and 87.1 on MedQA-USMLE. Furthermore, targeted training improved performance on a clinical reasoning task from a baseline score of 58.1 to 62.5. These findings suggest that reinforcement learning, even when applied with a limited dataset of only a few thousand examples, can enhance medical reasoning accuracy. Crucially, this demonstration of RL's efficacy with limited data and computation paves the way for more trustworthy and practically deployable LLMs within clinical workflows and health information infrastructures.

Tool-augmented large language model (LLM) agents promise to unify scientific reasoning with computation, yet their deployment in high-stakes domains like drug discovery is bottlenecked by two critical barriers: unconstrained tool-use governance and poor long-horizon reliability. In dependency-heavy pharmaceutical pipelines, autonomous agents often drift into irreproducible trajectories, where early-stage hallucinations multiplicatively compound into downstream failures. To overcome this, we present Mozi, a dual-layer architecture that bridges the flexibility of generative AI with the deterministic rigor of computational biology. Layer A (Control Plane) establishes a governed supervisor--worker hierarchy that enforces role-based tool isolation, limits execution to constrained action spaces, and drives reflection-based replanning. Layer B (Workflow Plane) operationalizes canonical drug discovery stages -- from Target Identification to Lead Optimization -- as stateful, composable skill graphs. This layer integrates strict data contracts and strategic human-in-the-loop (HITL) checkpoints to safeguard scientific validity at high-uncertainty decision boundaries. Operating on the design principle of ``free-form reasoning for safe tasks, structured execution for long-horizon pipelines,'' Mozi provides built-in robustness mechanisms and trace-level audibility to completely mitigate error accumulation. We evaluate Mozi on PharmaBench, a curated benchmark for biomedical agents, demonstrating superior orchestration accuracy over existing baselines. Furthermore, through end-to-end therapeutic case studies, we demonstrate Mozi's ability to navigate massive chemical spaces, enforce stringent toxicity filters, and generate highly competitive in silico candidates, effectively transforming the LLM from a fragile conversationalist into a reliable, governed co-scientist.

AI applications driven by multimodal large language models (MLLMs) are prone to hallucinations and pose considerable risks to human users. Crucially, such hallucinations are not equally problematic: some hallucination contents could be detected by human users(i.e., obvious hallucinations), while others are often missed or require more verification effort(i.e., elusive hallucinations). This indicates that multimodal AI hallucinations vary significantly in their verifiability. Yet, little research has explored how to control this property for AI applications with diverse security and usability demands. To address this gap, we construct a dataset from 4,470 human responses to AI-generated hallucinations and categorize these hallucinations into obvious and elusive types based on their verifiability by human users. Further, we propose an activation-space intervention method that learns separate probes for obvious and elusive hallucinations. We reveal that obvious and elusive hallucinations elicit different intervention probes, allowing for fine-grained control over the model's verifiability. Empirical results demonstrate the efficacy of this approach and show that targeted interventions yield superior performance in regulating corresponding verifiability. Moreover, simply mixing these interventions enables flexible control over the verifiability required for different scenarios.

In this paper, we introduce a unified and generalist Biomedical Generative Pre-trained Transformer (BiomedGPT) model, which leverages self-supervision on large and diverse datasets to accept multi-modal inputs and perform a range of downstream tasks. Our experiments demonstrate that BiomedGPT delivers expansive and inclusive representations of biomedical data, outperforming the majority of preceding state-of-the-art models across five distinct tasks with 20 public datasets spanning over 15 unique biomedical modalities. Through the ablation study, we also showcase the efficacy of our multi-modal and multi-task pretraining approach in transferring knowledge to previously unseen data. Overall, our work presents a significant step forward in developing unified and generalist models for biomedicine, with far-reaching implications for improving healthcare outcomes.

Unlike empathetic dialogues, the system in emotional support conversations (ESC) is expected to not only convey empathy for comforting the help-seeker, but also proactively assist in exploring and addressing their problems during the conversation. In this work, we study the problem of mixed-initiative ESC where the user and system can both take the initiative in leading the conversation. Specifically, we conduct a novel analysis on mixed-initiative ESC systems with a tailor-designed schema that divides utterances into different types with speaker roles and initiative types. Four emotional support metrics are proposed to evaluate the mixed-initiative interactions. The analysis reveals the necessity and challenges of building mixed-initiative ESC systems. In the light of this, we propose a knowledge-enhanced mixed-initiative framework (KEMI) for ESC, which retrieves actual case knowledge from a large-scale mental health knowledge graph for generating mixed-initiative responses. Experimental results on two ESC datasets show the superiority of KEMI in both content-preserving evaluation and mixed initiative related analyses.

Predicting multiple heterogeneous biological and medical targets is a challenge for traditional deep learning models. In contrast to single-task learning, in which a separate model is trained for each target, multi-task learning (MTL) optimizes a single model to predict multiple related targets simultaneously. To address this challenge, we propose the Multi-gate Mixture-of-Experts with Exclusivity (MMoEEx). Our work aims to tackle the heterogeneous MTL setting, in which the same model optimizes multiple tasks with different characteristics. Such a scenario can overwhelm current MTL approaches due to the challenges in balancing shared and task-specific representations and the need to optimize tasks with competing optimization paths. Our method makes two key contributions: first, we introduce an approach to induce more diversity among experts, thus creating representations more suitable for highly imbalanced and heterogenous MTL learning; second, we adopt a two-step optimization [6, 11] approach to balancing the tasks at the gradient level. We validate our method on three MTL benchmark datasets, including Medical Information Mart for Intensive Care (MIMIC-III) and PubChem BioAssay (PCBA).

We demonstrate and investigate the remarkable robustness of Large Language Models by deleting and swapping adjacent layers. We find that deleting and swapping interventions retain 72-95\% of the original model's prediction accuracy without fine-tuning, whereas models with more layers exhibit more robustness. Based on the results of the layer-wise intervention and further experiments, we hypothesize the existence of four universal stages of inference across eight different models: detokenization, feature engineering, prediction ensembling, and residual sharpening. The first stage integrates local information, lifting raw token representations into higher-level contextual representations. Next is the iterative refinement of task and entity-specific features. Then, the second half of the model begins with a phase transition, where hidden representations align more with the vocabulary space due to specialized model components. Finally, the last layer sharpens the following token distribution by eliminating obsolete features that add noise to the prediction.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Cognitive Restructuring (CR) is a psychotherapeutic process aimed at identifying and restructuring an individual's negative thoughts, arising from mental health challenges, into more helpful and positive ones via multi-turn dialogues. Clinician shortage and stigma urge the development of human-LLM interactive psychotherapy for CR. Yet, existing efforts implement CR via simple text rewriting, fixed-pattern dialogues, or a one-shot CR workflow, failing to align with the psychotherapeutic process for effective CR. To address this gap, we propose CRDial, a novel framework for CR, which creates multi-turn dialogues with specifically designed identification and restructuring stages of negative thoughts, integrates sentence-level supportive conversation strategies, and adopts a multi-channel loop mechanism to enable iterative CR. With CRDial, we distill Crisp, a large-scale and high-quality bilingual dialogue dataset, from LLM. We then train Crispers, Crisp-based conversational LLMs for CR, at 7B and 14B scales. Extensive human studies show the superiority of Crispers in pointwise, pairwise, and intervention evaluations.

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

The integration of large language model (LLM) techniques in the field of medical analysis has brought about significant advancements, yet the scarcity of large, diverse, and well-annotated datasets remains a major challenge. Medical data and tasks, which vary in format, size, and other parameters, require extensive preprocessing and standardization for effective use in training LLMs. To address these challenges, we introduce MedINST, the Meta Dataset of Biomedical Instructions, a novel multi-domain, multi-task instructional meta-dataset. MedINST comprises 133 biomedical NLP tasks and over 7 million training samples, making it the most comprehensive biomedical instruction dataset to date. Using MedINST as the meta dataset, we curate MedINST32, a challenging benchmark with different task difficulties aiming to evaluate LLMs' generalization ability. We fine-tune several LLMs on MedINST and evaluate on MedINST32, showcasing enhanced cross-task generalization.

Users increasingly turn to large language models for emotional support, yet little is known about how these models actually conduct a psychotherapy interaction. We introduce an ontology of ten therapeutic moves: compact, function-based categories grounded in the MULTI-60 inventory, validated through an annotation campaign with five licensed psychologists, and scaled with a judge-based approach that matches expert agreement. Applying it to real counseling transcripts and model-led sessions, we compare the move distributions between human clinicians and a panel of frontier models. Models over-use inquiry at up to three times the human rate, neglect psychoeducation, and are strongly context-anchored: they carry forward strategies initiated by a human clinician but rarely initiate them themselves. Exposing the ontology as a set of tools roughly halves the mean deviation from the human move distribution and improves turn-level alignment with human therapist by 7-9 percentage points, without any fine-tuning.

The development of AI-assisted Early Intensive Behavioral Intervention (EIBI) for Autism Spectrum Disorder (ASD) is severely constrained by data scarcity. Furthermore, while Applied Behavior Analysis (ABA) serves as the gold standard for clinical intervention, general-purpose Large Language Models (LLMs) struggle to strictly adhere to its standardized procedures, often resulting in interactions that are linguistically fluent but strategically inconsistent. To address these challenges, we introduce ASDAgent, a strategy-aware framework designed to unify high-fidelity intervention dialogue synthesis and clinical decision support. ASDAgent incorporates two specialized components to solve distinct problems: (i) a DoctorAgent equipped with an Observe-Think-Act-Correct (O-T-A-C) reasoning loop, which resolves the issue of strategy collapse in LLMs by making ABA execution explicit and controllable; and (ii) a ChildAgent that utilizes probabilistic behavior modeling to mitigate data homogeneity, simulating diverse and non-deterministic ASD response patterns. Experiments demonstrate that dialogues generated by ASDAgent closely mirror the strategy distribution of human therapists (KL divergence: 0.083). In real autism intervention, ASDAgent achieves nearly 80\% strategic consistency with human experts. Moreover, we show that synthetic data produced by ASDAgent effectively distills professional clinical knowledge into small language models (SLMs), significantly enhancing their therapeutic capabilities.

Recent advances in foundation models have highlighted the significant benefits of multi-stage training, with a particular emphasis on the emergence of mid-training as a vital stage that bridges pre-training and post-training. Mid-training is distinguished by its use of intermediate data and computational resources, systematically enhancing specified capabilities such as mathematics, coding, reasoning, and long-context extension, while maintaining foundational competencies. This survey provides a formal definition of mid-training for large language models (LLMs) and investigates optimization frameworks that encompass data curation, training strategies, and model architecture optimization. We analyze mainstream model implementations in the context of objective-driven interventions, illustrating how mid-training serves as a distinct and critical stage in the progressive development of LLM capabilities. By clarifying the unique contributions of mid-training, this survey offers a comprehensive taxonomy and actionable insights, supporting future research and innovation in the advancement of LLMs.

Large-scale multi-modal deep learning models have revolutionized domains such as healthcare, highlighting the importance of computational power. However, in resource-constrained regions like Low and Middle-Income Countries (LMICs), limited access to GPUs and data poses significant challenges, often leaving CPUs as the sole resource. To address this, we advocate for leveraging vector embeddings to enable flexible and efficient computational methodologies, democratizing multimodal deep learning across diverse contexts. Our paper investigates the efficiency and effectiveness of using vector embeddings from single-modal foundation models and multi-modal Vision-Language Models (VLMs) for multimodal deep learning in low-resource environments, particularly in healthcare. Additionally, we propose a simple yet effective inference-time method to enhance performance by aligning image-text embeddings. Comparing these approaches with traditional methods, we assess their impact on computational efficiency and model performance using metrics like accuracy, F1-score, inference time, training time, and memory usage across three medical modalities: BRSET (ophthalmology), HAM10000 (dermatology), and SatelliteBench (public health). Our findings show that embeddings reduce computational demands without compromising model performance. Furthermore, our alignment method improves performance in medical tasks. This research promotes sustainable AI practices by optimizing resources in constrained environments, highlighting the potential of embedding-based approaches for efficient multimodal learning. Vector embeddings democratize multimodal deep learning in LMICs, particularly in healthcare, enhancing AI adaptability in varied use cases.

The early detection of mental health disorders from social media text is critical for enabling timely support, risk assessment, and referral to appropriate resources. This work introduces multiMentalRoBERTa, a fine-tuned RoBERTa model designed for multiclass classification of common mental health conditions, including stress, anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and neutral discourse. Drawing on multiple curated datasets, data exploration is conducted to analyze class overlaps, revealing strong correlations between depression and suicidal ideation as well as anxiety and PTSD, while stress emerges as a broad, overlapping category. Comparative experiments with traditional machine learning methods, domain-specific transformers, and prompting-based large language models demonstrate that multiMentalRoBERTa achieves superior performance, with macro F1-scores of 0.839 in the six-class setup and 0.870 in the five-class setup (excluding stress), outperforming both fine-tuned MentalBERT and baseline classifiers. Beyond predictive accuracy, explainability methods, including Layer Integrated Gradients and KeyBERT, are applied to identify lexical cues that drive classification, with a particular focus on distinguishing depression from suicidal ideation. The findings emphasize the effectiveness of fine-tuned transformers for reliable and interpretable detection in sensitive contexts, while also underscoring the importance of fairness, bias mitigation, and human-in-the-loop safety protocols. Overall, multiMentalRoBERTa is presented as a lightweight, robust, and deployable solution for enhancing support in mental health platforms.

While reciprocal self-disclosure drives intimacy, digital tools seldom scaffold autonomy, competence, and relatedness -- the motivational underpinnings defined by Self-Determination Theory (SDT) that enable deep exchange. We introduce a chatbot employing dual-layer scaffolding to satisfy these needs: first providing enabling affordances (instrumental support) for vulnerability, then mediating affordances (relational support) for responsiveness. In a randomized study (N = 72; 36 couples) comparing Partner Support (PS: both layers), Direct Support (DS: enabling only), and Basic Prompt (BP: questions only), results reveal a critical distinction. While enabling affordances (PS, DS) were sufficient to deepen disclosure, only mediating affordances (PS) reliably elicited partner-provided need support and increased perceived closeness. Furthermore, controlled motivation decreased across conditions, and scaffolding buffered vitality, which remained stagnant in BP. We contribute empirical evidence that SDT-guided mediation fosters connection, offering a practical framework for designing AI-mediated conversations that support, rather than replace, human intimacy.

To assess the effectiveness of any medical intervention, researchers must conduct a time-intensive and highly manual literature review. NLP systems can help to automate or assist in parts of this expensive process. In support of this goal, we release MS^2 (Multi-Document Summarization of Medical Studies), a dataset of over 470k documents and 20k summaries derived from the scientific literature. This dataset facilitates the development of systems that can assess and aggregate contradictory evidence across multiple studies, and is the first large-scale, publicly available multi-document summarization dataset in the biomedical domain. We experiment with a summarization system based on BART, with promising early results. We formulate our summarization inputs and targets in both free text and structured forms and modify a recently proposed metric to assess the quality of our system's generated summaries. Data and models are available at https://github.com/allenai/ms2

Colonoscopy is currently one of the most sensitive screening methods for colorectal cancer. This study investigates the frontiers of intelligent colonoscopy techniques and their prospective implications for multimodal medical applications. With this goal, we begin by assessing the current data-centric and model-centric landscapes through four tasks for colonoscopic scene perception, including classification, detection, segmentation, and vision-language understanding. This assessment enables us to identify domain-specific challenges and reveals that multimodal research in colonoscopy remains open for further exploration. To embrace the coming multimodal era, we establish three foundational initiatives: a large-scale multimodal instruction tuning dataset ColonINST, a colonoscopy-designed multimodal language model ColonGPT, and a multimodal benchmark. To facilitate ongoing monitoring of this rapidly evolving field, we provide a public website for the latest updates: https://github.com/ai4colonoscopy/IntelliScope.

Fast Healthcare Interoperability Resources (FHIR) is the dominant standard for interoperable exchange of healthcare data. In FHIR, electronic health records form a directed graph of resources. Answering clinically meaningful questions over FHIR requires agents to perform multi-step reasoning, filtering, and aggregation across multiple resource types. Prior work shows that even tool-augmented LLM agents (retrieval, code execution, multi-turn planning) often select the wrong resources or violate traversal constraints. We study this problem in the context of FHIR-AgentBench, a benchmark for realistic question answering over real-world hospital data, and frame reasoning on FHIR as a sequential decision-making problem over a queryable structured graph. We implement a multi-turn CodeAct agent and post-train it with reinforcement learning using a custom harness and tools. A LLM Judge provides execution-grounded rewards. Compared to prompt-based, closed-model baselines, RL post-training improves performance while enforcing data-integrity constraints. Empirically, our approach improves answer correctness from 50% (o4-mini) to 77% on FHIR-AgentBench using a smaller and cheaper Qwen3-8B model. We present an end-to-end post-training pipeline (environment building, harness construction, model training and custom evaluation) that reliably improves multi-turn reasoning over structured clinical graphs.

Generative AI systems across modalities, ranging from text (including code), image, audio, and video, have broad social impacts, but there is no official standard for means of evaluating those impacts or for which impacts should be evaluated. In this paper, we present a guide that moves toward a standard approach in evaluating a base generative AI system for any modality in two overarching categories: what can be evaluated in a base system independent of context and what can be evaluated in a societal context. Importantly, this refers to base systems that have no predetermined application or deployment context, including a model itself, as well as system components, such as training data. Our framework for a base system defines seven categories of social impact: bias, stereotypes, and representational harms; cultural values and sensitive content; disparate performance; privacy and data protection; financial costs; environmental costs; and data and content moderation labor costs. Suggested methods for evaluation apply to listed generative modalities and analyses of the limitations of existing evaluations serve as a starting point for necessary investment in future evaluations. We offer five overarching categories for what can be evaluated in a broader societal context, each with its own subcategories: trustworthiness and autonomy; inequality, marginalization, and violence; concentration of authority; labor and creativity; and ecosystem and environment. Each subcategory includes recommendations for mitigating harm.

Diagnosing and treating skin diseases require advanced visual skills across domains and the ability to synthesize information from multiple imaging modalities. While current deep learning models excel at specific tasks like skin cancer diagnosis from dermoscopic images, they struggle to meet the complex, multimodal requirements of clinical practice. Here, we introduce PanDerm, a multimodal dermatology foundation model pretrained through self-supervised learning on over 2 million real-world skin disease images from 11 clinical institutions across 4 imaging modalities. We evaluated PanDerm on 28 diverse benchmarks, including skin cancer screening, risk stratification, differential diagnosis of common and rare skin conditions, lesion segmentation, longitudinal monitoring, and metastasis prediction and prognosis. PanDerm achieved state-of-the-art performance across all evaluated tasks, often outperforming existing models when using only 10% of labeled data. We conducted three reader studies to assess PanDerm's potential clinical utility. PanDerm outperformed clinicians by 10.2% in early-stage melanoma detection through longitudinal analysis, improved clinicians' skin cancer diagnostic accuracy by 11% on dermoscopy images, and enhanced non-dermatologist healthcare providers' differential diagnosis by 16.5% across 128 skin conditions on clinical photographs. These results demonstrate PanDerm's potential to improve patient care across diverse clinical scenarios and serve as a model for developing multimodal foundation models in other medical specialties, potentially accelerating the integration of AI support in healthcare. The code can be found at https://github.com/SiyuanYan1/PanDerm.

Medical conversational AI (AI) plays a pivotal role in the development of safer and more effective medical dialogue systems. However, existing benchmarks and evaluation frameworks for assessing the information-gathering and diagnostic reasoning abilities of medical large language models (LLMs) have not been rigorously evaluated. To address these gaps, we present MedDialogRubrics, a novel benchmark comprising 5,200 synthetically constructed patient cases and over 60,000 fine-grained evaluation rubrics generated by LLMs and subsequently refined by clinical experts, specifically designed to assess the multi-turn diagnostic capabilities of LLM. Our framework employs a multi-agent system to synthesize realistic patient records and chief complaints from underlying disease knowledge without accessing real-world electronic health records, thereby mitigating privacy and data-governance concerns. We design a robust Patient Agent that is limited to a set of atomic medical facts and augmented with a dynamic guidance mechanism that continuously detects and corrects hallucinations throughout the dialogue, ensuring internal coherence and clinical plausibility of the simulated cases. Furthermore, we propose a structured LLM-based and expert-annotated rubric-generation pipeline that retrieves Evidence-Based Medicine (EBM) guidelines and utilizes the reject sampling to derive a prioritized set of rubric items ("must-ask" items) for each case. We perform a comprehensive evaluation of state-of-the-art models and demonstrate that, across multiple assessment dimensions, current models face substantial challenges. Our results indicate that improving medical dialogue will require advances in dialogue management architectures, not just incremental tuning of the base-model.

Multi-layer image generation is a fundamental task that enables users to isolate, select, and edit specific image layers, thereby revolutionizing interactions with generative models. In this paper, we introduce the Anonymous Region Transformer (ART), which facilitates the direct generation of variable multi-layer transparent images based on a global text prompt and an anonymous region layout. Inspired by Schema theory suggests that knowledge is organized in frameworks (schemas) that enable people to interpret and learn from new information by linking it to prior knowledge.}, this anonymous region layout allows the generative model to autonomously determine which set of visual tokens should align with which text tokens, which is in contrast to the previously dominant semantic layout for the image generation task. In addition, the layer-wise region crop mechanism, which only selects the visual tokens belonging to each anonymous region, significantly reduces attention computation costs and enables the efficient generation of images with numerous distinct layers (e.g., 50+). When compared to the full attention approach, our method is over 12 times faster and exhibits fewer layer conflicts. Furthermore, we propose a high-quality multi-layer transparent image autoencoder that supports the direct encoding and decoding of the transparency of variable multi-layer images in a joint manner. By enabling precise control and scalable layer generation, ART establishes a new paradigm for interactive content creation.

Virtual counselors powered by large language models (LLMs) aim to create interactive support systems that effectively assist clients struggling with mental health challenges. To replicate counselor-client conversations, researchers have built an online mental health platform that allows professional counselors to provide clients with text-based counseling services for about an hour per session. Notwithstanding its effectiveness, challenges exist as human annotation is time-consuming, cost-intensive, privacy-protected, and not scalable. To address this issue and investigate the applicability of LLMs in psychological counseling conversation simulation, we propose a framework that employs two LLMs via role-playing for simulating counselor-client interactions. Our framework involves two LLMs, one acting as a client equipped with a specific and real-life user profile and the other playing the role of an experienced counselor, generating professional responses using integrative therapy techniques. We implement both the counselor and the client by zero-shot prompting the GPT-4 model. In order to assess the effectiveness of LLMs in simulating counselor-client interactions and understand the disparities between LLM- and human-generated conversations, we evaluate the synthetic data from various perspectives. We begin by assessing the client's performance through automatic evaluations. Next, we analyze and compare the disparities between dialogues generated by the LLM and those generated by professional counselors. Furthermore, we conduct extensive experiments to thoroughly examine the performance of our LLM-based counselor trained with synthetic interactive dialogues by benchmarking against state-of-the-art models for mental health.

Clinical reasoning demands multi-step interactions -- gathering patient history, ordering tests, interpreting results, and making safe treatment decisions -- yet a unified training environment provides the breadth of clinical domains and specialized tools to train generalizable medical AI agents through reinforcement learning remains elusive. We present a comprehensive empirical study of multi-turn agentic RL for medical AI, built on , a gymnasium-compatible environment spanning 10 clinical domains with 3.6K+ tasks, 135 domain-specific tools, and a knowledge base of 828K medical passages. Our analysis reveals that agentic multi-turn structure degrades into verbose single-turn monologues, characterized by monotonic length explosion and a simultaneous erosion of tool-use frequency. We characterize how this collapse, alongside distillation instability, stems from the misalignment of sparse terminal rewards with sequential clinical trajectories. We find that vanilla GRPO achieves strong final accuracy on some benchmarks but suffers from training instability, evidenced by significant oscillations in response length and prolonged convergence periods. To improve training efficiency and stability, we propose Turn-level Truncated On-Policy Distillation (TT-OPD), a self-distillation framework where a gradient-free EMA teacher leverages outcome-privileged information to provide dense, outcome-aware KL regularization at every conversation turn. TT-OPD achieves the best performance on 10 of 18 benchmarks with an average +3.9~pp improvement over the non-RL baseline with faster early convergence, controlled response length, and sustained multi-turn tool use.

Much effort has been devoted to evaluate whether multi-task learning can be leveraged to learn rich representations that can be used in various Natural Language Processing (NLP) down-stream applications. However, there is still a lack of understanding of the settings in which multi-task learning has a significant effect. In this work, we introduce a hierarchical model trained in a multi-task learning setup on a set of carefully selected semantic tasks. The model is trained in a hierarchical fashion to introduce an inductive bias by supervising a set of low level tasks at the bottom layers of the model and more complex tasks at the top layers of the model. This model achieves state-of-the-art results on a number of tasks, namely Named Entity Recognition, Entity Mention Detection and Relation Extraction without hand-engineered features or external NLP tools like syntactic parsers. The hierarchical training supervision induces a set of shared semantic representations at lower layers of the model. We show that as we move from the bottom to the top layers of the model, the hidden states of the layers tend to represent more complex semantic information.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

As language models shift from single-shot answer generation toward multi-step reasoning that retrieves and consumes evidence mid-inference, evaluating the role of individual retrieved items becomes more important. Existing RAG evaluation typically targets final-answer quality, citation faithfulness, or answer-level attribution, but none of these directly targets the intervention-based, per-evidence-item utility view we study here. We introduce CUE-R, a lightweight intervention-based framework for measuring per-evidence-item operational utility in single-shot RAG using shallow observable retrieval-use traces. CUE-R perturbs individual evidence items via REMOVE, REPLACE, and DUPLICATE operators, then measures changes along three utility axes (correctness, proxy-based grounding faithfulness, and confidence error) plus a trace-divergence signal. We also outline an operational evidence-role taxonomy for interpreting intervention outcomes. Experiments on HotpotQA and 2WikiMultihopQA with Qwen-3 8B and GPT-5.2 reveal a consistent pattern: REMOVE and REPLACE substantially harm correctness and grounding while producing large trace shifts, whereas DUPLICATE is often answer-redundant yet not fully behaviorally neutral. A zero-retrieval control confirms that these effects arise from degradation of meaningful retrieval. A two-support ablation further shows that multi-hop evidence items can interact non-additively: removing both supports harms performance far more than either single removal. Our results suggest that answer-only evaluation misses important evidence effects and that intervention-based utility analysis is a practical complement for RAG evaluation.

Multi-task learning (MTL) has led to successes in many applications of machine learning, from natural language processing and speech recognition to computer vision and drug discovery. This article aims to give a general overview of MTL, particularly in deep neural networks. It introduces the two most common methods for MTL in Deep Learning, gives an overview of the literature, and discusses recent advances. In particular, it seeks to help ML practitioners apply MTL by shedding light on how MTL works and providing guidelines for choosing appropriate auxiliary tasks.

Sepsis remains one of the leading causes of mortality in intensive care units, where timely and accurate treatment decisions can significantly impact patient outcomes. In this work, we propose an interpretable decision support framework. Our system integrates four core components: (1) a clustering-based stratification module that categorizes patients into low, intermediate, and high-risk groups upon ICU admission, using clustering with statistical validation; (2) a synthetic data augmentation pipeline leveraging variational autoencoders (VAE) and diffusion models to enrich underrepresented trajectories such as fluid or vasopressor administration; (3) an offline reinforcement learning (RL) agent trained using Advantage Weighted Regression (AWR) with a lightweight attention encoder and supported by an ensemble models for conservative, safety-aware treatment recommendations; and (4) a rationale generation module powered by a multi-modal large language model (LLM), which produces natural-language justifications grounded in clinical context and retrieved expert knowledge. Evaluated on the MIMIC-III and eICU datasets, our approach achieves high treatment accuracy while providing clinicians with interpretable and robust policy recommendations.

We envision a proactive multi-modal assistant system which gives users real-time step-by-step guidance on a procedural task, autonomously deciding when to interrupt, and how to coach. However, progress is limited by the absence of large-scale, cross-domain benchmarks that reflect realistic conditions, particularly the common case in which users deviate from the expected step sequence. We address this gap with four contributions: (1)~we release EgoProactive, a large-scale wearable-egocentric dataset for proactive procedural assistance with explicit Out-of-Plan (OOP) annotations and recovery steps; (2)~we augment five established benchmarks (Ego4D, EPIC-KITCHENS, EgoExo4D, HoloAssist, HowTo100M) into Pro\textsuperscript{2Bench} under a unified proactive-guidance schema; (3)~we propose a decoupled planner--interaction architecture specialized for procedural state, visual cues, and recovery injection; (4)~we introduce a post-training recipe that transfers across model families, validated by cross-backbone replication on Llama~4 and Qwen-3.6-VL. In extensive experiments, our trained Llama-4 system substantially improves objective intervention quality over strong proprietary baselines (Claude Opus~4.6, Gemini~3.1~Pro, GPT~5.2) and open-weight baselines (Qwen3~VL~235B) baselines across all six datasets. Oracle-plan experiments further show that, when plan quality is controlled, the trained duplex model produces high-quality guidance and large gains on Out-of-Plan recovery.

While NLP research has made strides in conversational tasks, many approaches focus on single-turn responses with well-defined objectives or evaluation criteria. In contrast, coaching presents unique challenges with initially undefined goals that evolve through multi-turn interactions, subjective evaluation criteria, mixed-initiative dialogue. In this work, we describe and implement five multi-turn coaching agents that exhibit distinct conversational styles, and evaluate them through a user study, collecting first-person feedback on 155 conversations. We find that users highly value core functionality, and that stylistic components in absence of core components are viewed negatively. By comparing user feedback with third-person evaluations from health experts and an LM, we reveal significant misalignment across evaluation approaches. Our findings provide insights into design and evaluation of conversational coaching agents and contribute toward improving human-centered NLP applications.

Agentic systems offer a potential path to solve complex clinical tasks through collaboration among specialized agents, augmented by tool use and external knowledge bases. Nevertheless, for chest X-ray (CXR) interpretation, prevailing methods remain limited: (i) reasoning is frequently neither clinically interpretable nor aligned with guidelines, reflecting mere aggregation of tool outputs; (ii) multimodal evidence is insufficiently fused, yielding text-only rationales that are not visually grounded; and (iii) systems rarely detect or resolve cross-tool inconsistencies and provide no principled verification mechanisms. To bridge the above gaps, we present RadAgents, a multi-agent framework for CXR interpretation that couples clinical priors with task-aware multimodal reasoning. In addition, we integrate grounding and multimodal retrieval-augmentation to verify and resolve context conflicts, resulting in outputs that are more reliable, transparent, and consistent with clinical practice.

This paper presents our team's participation in the MEDIQA-ClinicalNLP2024 shared task B. We present a novel approach to diagnosing clinical dermatology cases by integrating large multimodal models, specifically leveraging the capabilities of GPT-4V under a retriever and a re-ranker framework. Our investigation reveals that GPT-4V, when used as a retrieval agent, can accurately retrieve the correct skin condition 85% of the time using dermatological images and brief patient histories. Additionally, we empirically show that Naive Chain-of-Thought (CoT) works well for retrieval while Medical Guidelines Grounded CoT is required for accurate dermatological diagnosis. Further, we introduce a Multi-Agent Conversation (MAC) framework and show its superior performance and potential over the best CoT strategy. The experiments suggest that using naive CoT for retrieval and multi-agent conversation for critique-based diagnosis, GPT-4V can lead to an early and accurate diagnosis of dermatological conditions. The implications of this work extend to improving diagnostic workflows, supporting dermatological education, and enhancing patient care by providing a scalable, accessible, and accurate diagnostic tool.

Large language models (LLMs) exhibit exceptional performance but pose substantial privacy risks due to training data memorization, particularly within healthcare contexts involving imperfect or privacy-sensitive patient information. We present a hierarchical dual-strategy framework for selective knowledge unlearning that precisely removes specialized knowledge while preserving fundamental medical competencies. Our approach synergistically integrates geometric-constrained gradient updates to selectively modulate target parameters with concept-aware token-level interventions that distinguish between preservation-critical and unlearning-targeted tokens via a unified four-level medical concept hierarchy. Comprehensive evaluations on the MedMCQA (surgical) and MHQA (anxiety, depression, trauma) datasets demonstrate superior performance, achieving an 82.7% forgetting rate and 88.5% knowledge preservation. Notably, our framework maintains robust privacy guarantees while requiring modification of only 0.1% of parameters, addressing critical needs for regulatory compliance, auditability, and ethical standards in clinical research.

Millions of users come to online peer counseling platforms to seek support on diverse topics ranging from relationship stress to anxiety. However, studies show that online peer support groups are not always as effective as expected largely due to users' negative experiences with unhelpful counselors. Peer counselors are key to the success of online peer counseling platforms, but most of them often do not have systematic ways to receive guidelines or supervision. In this work, we introduce CARE: an interactive AI-based tool to empower peer counselors through automatic suggestion generation. During the practical training stage, CARE helps diagnose which specific counseling strategies are most suitable in the given context and provides tailored example responses as suggestions. Counselors can choose to select, modify, or ignore any suggestion before replying to the support seeker. Building upon the Motivational Interviewing framework, CARE utilizes large-scale counseling conversation data together with advanced natural language generation techniques to achieve these functionalities. We demonstrate the efficacy of CARE by performing both quantitative evaluations and qualitative user studies through simulated chats and semi-structured interviews. We also find that CARE especially helps novice counselors respond better in challenging situations.

Despite the prevalence of sleep-tracking devices, many individuals struggle to translate data into actionable improvements in sleep health. Current methods often provide data-driven suggestions but may not be feasible and adaptive to real-life constraints and individual contexts. We present HealthGuru, a novel large language model-powered chatbot to enhance sleep health through data-driven, theory-guided, and adaptive recommendations with conversational behavior change support. HealthGuru's multi-agent framework integrates wearable device data, contextual information, and a contextual multi-armed bandit model to suggest tailored sleep-enhancing activities. The system facilitates natural conversations while incorporating data-driven insights and theoretical behavior change techniques. Our eight-week in-the-wild deployment study with 16 participants compared HealthGuru to a baseline chatbot. Results show improved metrics like sleep duration and activity scores, higher quality responses, and increased user motivation for behavior change with HealthGuru. We also identify challenges and design considerations for personalization and user engagement in health chatbots.

Realistic practice and tailored feedback are key processes for training peer counselors with clinical skills. However, existing mechanisms of providing feedback largely rely on human supervision. Peer counselors often lack mechanisms to receive detailed feedback from experienced mentors, making it difficult for them to support the large number of people with mental health issues who use peer counseling. Our work aims to leverage large language models to provide contextualized and multi-level feedback to empower peer counselors, especially novices, at scale. To achieve this, we co-design with a group of senior psychotherapy supervisors to develop a multi-level feedback taxonomy, and then construct a publicly available dataset with comprehensive feedback annotations of 400 emotional support conversations. We further design a self-improvement method on top of large language models to enhance the automatic generation of feedback. Via qualitative and quantitative evaluation with domain experts, we demonstrate that our method minimizes the risk of potentially harmful and low-quality feedback generation which is desirable in such high-stakes scenarios.

Health misinformation disproportionately harms women, yet interventions rarely address the community norms that sustain false beliefs. We test whether culturally adaptive AI-generated video in which the presenter looks like someone from her community reduces misinformation belief among low-literacy women in suburban India. In a field experiment (N=434), participants watched an AI-generated video featuring either an adaptive or neutral presenter. The culturally adaptive presenter reduced misinformation belief by 30%, nearly twice the reduction produced by the neutral presenter compared to the non-intervention control condition. Post-experiment interviews suggest women recalled the neutral condition as a generic video but recognized the adaptive presenter. Gains persisted for three weeks. The adaptive advantage was largest for beliefs reinforced by community, such as blaming women for infertility, and negligible for medical knowledge gaps, such as understanding vaccines. These findings demonstrate the potential of culturally adaptive AI interventions to counter socially embedded health misinformation.

Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.

Global healthcare providers are exploring use of large language models (LLMs) to provide medical advice to the public. LLMs now achieve nearly perfect scores on medical licensing exams, but this does not necessarily translate to accurate performance in real-world settings. We tested if LLMs can assist members of the public in identifying underlying conditions and choosing a course of action (disposition) in ten medical scenarios in a controlled study with 1,298 participants. Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+) or a source of their choice (control). Tested alone, LLMs complete the scenarios accurately, correctly identifying conditions in 94.9% of cases and disposition in 56.3% on average. However, participants using the same LLMs identified relevant conditions in less than 34.5% of cases and disposition in less than 44.2%, both no better than the control group. We identify user interactions as a challenge to the deployment of LLMs for medical advice. Standard benchmarks for medical knowledge and simulated patient interactions do not predict the failures we find with human participants. Moving forward, we recommend systematic human user testing to evaluate interactive capabilities prior to public deployments in healthcare.

We explore the potential of ChatGPT (3.5-turbo and 4) to generate conversations focused on self-care strategies for African-American heart failure patients -- a domain with limited specialized datasets. To simulate patient-health educator dialogues, we employed four prompting strategies: domain, African American Vernacular English (AAVE), Social Determinants of Health (SDOH), and SDOH-informed reasoning. Conversations were generated across key self-care domains of food, exercise, and fluid intake, with varying turn lengths (5, 10, 15) and incorporated patient-specific SDOH attributes such as age, gender, neighborhood, and socioeconomic status. Our findings show that effective prompt design is essential. While incorporating SDOH and reasoning improves dialogue quality, ChatGPT still lacks the empathy and engagement needed for meaningful healthcare communication.

This paper describes the results of SemEval 2023 task 7 -- Multi-Evidence Natural Language Inference for Clinical Trial Data (NLI4CT) -- consisting of 2 tasks, a Natural Language Inference (NLI) task, and an evidence selection task on clinical trial data. The proposed challenges require multi-hop biomedical and numerical reasoning, which are of significant importance to the development of systems capable of large-scale interpretation and retrieval of medical evidence, to provide personalized evidence-based care. Task 1, the entailment task, received 643 submissions from 40 participants, and Task 2, the evidence selection task, received 364 submissions from 23 participants. The tasks are challenging, with the majority of submitted systems failing to significantly outperform the majority class baseline on the entailment task, and we observe significantly better performance on the evidence selection task than on the entailment task. Increasing the number of model parameters leads to a direct increase in performance, far more significant than the effect of biomedical pre-training. Future works could explore the limitations of large models for generalization and numerical inference, and investigate methods to augment clinical datasets to allow for more rigorous testing and to facilitate fine-tuning. We envisage that the dataset, models, and results of this task will be useful to the biomedical NLI and evidence retrieval communities. The dataset, competition leaderboard, and website are publicly available.

Cancer has relational information residing at varying scales, modalities, and resolutions of the acquired data, such as radiology, pathology, genomics, proteomics, and clinical records. Integrating diverse data types can improve the accuracy and reliability of cancer diagnosis and treatment. There can be disease-related information that is too subtle for humans or existing technological tools to discern visually. Traditional methods typically focus on partial or unimodal information about biological systems at individual scales and fail to encapsulate the complete spectrum of the heterogeneous nature of data. Deep neural networks have facilitated the development of sophisticated multimodal data fusion approaches that can extract and integrate relevant information from multiple sources. Recent deep learning frameworks such as Graph Neural Networks (GNNs) and Transformers have shown remarkable success in multimodal learning. This review article provides an in-depth analysis of the state-of-the-art in GNNs and Transformers for multimodal data fusion in oncology settings, highlighting notable research studies and their findings. We also discuss the foundations of multimodal learning, inherent challenges, and opportunities for integrative learning in oncology. By examining the current state and potential future developments of multimodal data integration in oncology, we aim to demonstrate the promising role that multimodal neural networks can play in cancer prevention, early detection, and treatment through informed oncology practices in personalized settings.

Lung cancer patients frequently experience breakthrough pain episodes, with up to 91% requiring timely intervention. To enable proactive pain management, we propose a hybrid machine learning and large language model pipeline that predicts pain episodes within 48 and 72 hours of hospitalization using both structured and unstructured electronic health record data. A retrospective cohort of 266 inpatients was analyzed, with features including demographics, tumor stage, vital signs, and WHO-tiered analgesic use. The machine learning module captured temporal medication trends, while the large language model interpreted ambiguous dosing records and free-text clinical notes. Integrating these modalities improved sensitivity and interpretability. Our framework achieved an accuracy of 0.874 (48h) and 0.917 (72h), with an improvement in sensitivity of 8.6% and 10.4% due to the augmentation of large language model. This hybrid approach offers a clinically interpretable and scalable tool for early pain episode forecasting, with potential to enhance treatment precision and optimize resource allocation in oncology care.

Mental health has increasingly become a global issue that reveals the limitations of traditional conversational psychotherapy, constrained by location, time, expense, and privacy concerns. In response to these challenges, we introduce SoulSpeak, a Large Language Model (LLM)-enabled chatbot designed to democratize access to psychotherapy. SoulSpeak improves upon the capabilities of standard LLM-enabled chatbots by incorporating a novel dual-memory component that combines short-term and long-term context via Retrieval Augmented Generation (RAG) to offer personalized responses while ensuring the preservation of user privacy and intimacy through a dedicated privacy module. In addition, it leverages a counseling chat dataset of therapist-client interactions and various prompting techniques to align the generated responses with psychotherapeutic methods. We introduce two fine-tuned BERT models to evaluate the system against existing LLMs and human therapists: the Conversational Psychotherapy Preference Model (CPPM) to simulate human preference among responses and another to assess response relevance to user input. CPPM is useful for training and evaluating psychotherapy-focused language models independent from SoulSpeak, helping with the constrained resources available for psychotherapy. Furthermore, the effectiveness of the dual-memory component and the robustness of the privacy module are also examined. Our findings highlight the potential and challenge of enhancing mental health care by offering an alternative that combines the expertise of traditional therapy with the advantages of LLMs, providing a promising way to address the accessibility and personalization gap in current mental health services.

Emotional Support (ES) systems have long optimized a single objective: alleviating the user's emotional distress in the moment. We argue that a complementary need, helping users see themselves more clearly, defines a distinct paradigm we call Personality Support (PS). PS is not counseling or clinical intervention: it targets cognitive clarity and self-articulation, not symptom relief or diagnosis. We instantiate this paradigm in three layers. First, we present DSD, a Chinese self-discovery PS Dataset of 8,590 samples collected through real longitudinal interaction across five minimal units, Coach, Warm, Tsukkomi, Real, and Gonzo. Second, we build DeepSupport, a multi-persona PS system trained with OrthoTune, a PS-tailored framework with style-specific adapters and a style-consistency regularizer. Third, we unify the five DeepSupport personas into Ekova, a persistent personality-support agent with a unified cross-session memory layer, supporting both adaptive routing and user-customized persona selection. Experiments show that OrthoTune-trained models outperform all baselines with an average relative gain of 16.3% across all metrics over the strongest prompt-based baseline. Code is available at https://github.com/Yukyin/Ekova.

Large Language Models (LLMs) are often described as being instances of foundation models - that is, models that transfer strongly across various tasks and conditions in few-show or zero-shot manner, while exhibiting scaling laws that predict function improvement when increasing the pre-training scale. These claims of excelling in different functions and tasks rely on measurements taken across various sets of standardized benchmarks showing high scores for such models. We demonstrate here a dramatic breakdown of function and reasoning capabilities of state-of-the-art models trained at the largest available scales which claim strong function, using a simple, short, conventional common sense problem formulated in concise natural language, easily solvable by humans. The breakdown is dramatic, as models also express strong overconfidence in their wrong solutions, while providing often non-sensical "reasoning"-like explanations akin to confabulations to justify and backup the validity of their clearly failed responses, making them sound plausible. Various standard interventions in an attempt to get the right solution, like various type of enhanced prompting, or urging the models to reconsider the wrong solutions again by multi step re-evaluation, fail. We take these initial observations to the scientific and technological community to stimulate urgent re-assessment of the claimed capabilities of current generation of LLMs, Such re-assessment also requires common action to create standardized benchmarks that would allow proper detection of such basic reasoning deficits that obviously manage to remain undiscovered by current state-of-the-art evaluation procedures and benchmarks. Code for reproducing experiments in the paper and raw experiments data can be found at https://github.com/LAION-AI/AIW

Recent large language models (LLMs) offer the potential to support public health monitoring by facilitating health disclosure through open-ended conversations but rarely preserve the knowledge gained about individuals across repeated interactions. Augmenting LLMs with long-term memory (LTM) presents an opportunity to improve engagement and self-disclosure, but we lack an understanding of how LTM impacts people's interaction with LLM-driven chatbots in public health interventions. We examine the case of CareCall -- an LLM-driven voice chatbot with LTM -- through the analysis of 1,252 call logs and interviews with nine users. We found that LTM enhanced health disclosure and fostered positive perceptions of the chatbot by offering familiarity. However, we also observed challenges in promoting self-disclosure through LTM, particularly around addressing chronic health conditions and privacy concerns. We discuss considerations for LTM integration in LLM-driven chatbots for public health monitoring, including carefully deciding what topics need to be remembered in light of public health goals.

We present our submission to the EgoProactive track of the ECCV 2026 Wearable AI Challenge, which ranked first in the large-model division and second in the <=2B division. The task requires a wearable assistant to decide after each eight-second segment of egocentric video whether to intervene or remain silent. Our approach has two main components. First, we reformulate intervention timing as single-token classification. Rather than generating either interrupt<utterance> or silent, the model predicts yes or no, and we derive the decision from the renormalised probabilities of these two tokens. This formulation improved macro-F1 by 0.249 and G-mean by 0.30 over free-form generation. Second, because labelled data were limited to the released validation set, we generated additional supervision using a tool-calling video agent that inspects each clip and assigns intervention timestamps. A narration-only alternative was four times larger and ten times cheaper, but transferred worse than supervision from an unrelated real corpus, suggesting that visual grounding is more important than annotation volume for this task.

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

To enhance the performance of large language models (LLMs) in biomedical natural language processing (BioNLP) by introducing a domain-specific instruction dataset and examining its impact when combined with multi-task learning principles. We created the BioInstruct, comprising 25,005 instructions to instruction-tune LLMs(LLaMA 1 & 2, 7B & 13B version). The instructions were created by prompting the GPT-4 language model with three-seed samples randomly drawn from an 80 human curated instructions. We employed Low-Rank Adaptation(LoRA) for parameter-efficient fine-tuning. We then evaluated these instruction-tuned LLMs on several BioNLP tasks, which can be grouped into three major categories: question answering(QA), information extraction(IE), and text generation(GEN). We also examined whether categories(e.g., QA, IE, and generation) of instructions impact model performance. Comparing with LLMs without instruction-tuned, our instruction-tuned LLMs demonstrated marked performance gains: 17.3% in QA, 5.7% in IE, and 96% in Generation tasks. Our 7B-parameter instruction-tuned LLaMA 1 model was competitive or even surpassed other LLMs in the biomedical domain that were also fine-tuned from LLaMA 1 with vast domain-specific data or a variety of tasks. Our results also show that the performance gain is significantly higher when instruction fine-tuning is conducted with closely related tasks. Our findings align with the observations of multi-task learning, suggesting the synergies between two tasks. The BioInstruct dataset serves as a valuable resource and instruction tuned LLMs lead to the best performing BioNLP applications.

Large Language Models (LLM) are prone to returning false information. It constitutes one of major challenges in the AI field. In our work, we explore paradigm introduced by Inference-Time-Intervention (ITI). In first stage, it identifies attention heads, which contain the highest amount of desired type of knowledge (e.g., truthful). Afterwards, during inference, LLM activations are shifted for chosen subset of attention heads. We further improved the ITI framework by introducing a nonlinear probing and multi-token intervention - Non-Linear ITI (NL-ITI). NL-ITI is tested on diverse multiple-choice benchmarks, including TruthfulQA, on which we report around 14% MC1 metric improvement with respect to the baseline ITI results. NL-ITI achieves also encouraging results on other testsets - on Business Ethics subdomain of MMLU, around 18% MC1 improvement over baseline LLaMA2-7B. Additionally, NL-ITI performs better while being less invasive in the behavior of LLM at the same time (as measured by Kullback-Leibler divergence).

Recent advances in large language models (LLMs) have enabled increasingly capable chatbots. However, most existing systems focus on single-user settings and do not generalize well to multi-user group chats, where agents require more proactive and accurate intervention under complex, evolving contexts. Existing approaches typically rely on LLMs for both reasoning and generation, leading to high token consumption, limited scalability, and potential privacy risks. To address these challenges, we propose GroupGPT, a token-efficient and privacy-preserving agentic framework for multi-user chat assistant. GroupGPT adopts a small-large model collaborative architecture to decouple intervention timing from response generation, enabling efficient and accurate decision-making. The framework also supports multimodal inputs, including memes, images, videos, and voice messages. We further introduce MUIR, a benchmark dataset for multi-user chat assistant intervention reasoning. MUIR contains 2,500 annotated group chat segments with intervention labels and rationales, supporting evaluation of timing accuracy and response quality. We evaluate a range of models on MUIR, from large language models to smaller counterparts. Extensive experiments demonstrate that GroupGPT produces accurate and well-timed responses, achieving an average score of 4.72/5.0 in LLM-based evaluation, and is well received by users across diverse group chat scenarios. Moreover, GroupGPT reduces token usage by up to 3 times compared to baseline methods, while providing privacy sanitization of user messages before cloud transmission. Code is available at: https://github.com/Eliot-Shen/GroupGPT .

Large language models (LLMs) represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this primer paper, we propose an actionable guideline to help healthcare professionals more efficiently utilize LLMs in their work, along with a set of best practices. This approach consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and deployment. We start with the discussion of critical considerations in identifying healthcare tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

Meta-learning algorithms are able to learn a new task using previously learned knowledge, but they often require a large number of meta-training tasks which may not be readily available. To address this issue, we propose a method for few-shot learning with fewer tasks, which we call MetaModulation. The key idea is to use a neural network to increase the density of the meta-training tasks by modulating batch normalization parameters during meta-training. Additionally, we modify parameters at various network levels, rather than just a single layer, to increase task diversity. To account for the uncertainty caused by the limited training tasks, we propose a variational MetaModulation where the modulation parameters are treated as latent variables. We also introduce learning variational feature hierarchies by the variational MetaModulation, which modulates features at all layers and can consider task uncertainty and generate more diverse tasks. The ablation studies illustrate the advantages of utilizing a learnable task modulation at different levels and demonstrate the benefit of incorporating probabilistic variants in few-task meta-learning. Our MetaModulation and its variational variants consistently outperform state-of-the-art alternatives on four few-task meta-learning benchmarks.

Pre-trained language models such as BERT have proven to be highly effective for natural language processing (NLP) tasks. However, the high demand for computing resources in training such models hinders their application in practice. In order to alleviate this resource hunger in large-scale model training, we propose a Patient Knowledge Distillation approach to compress an original large model (teacher) into an equally-effective lightweight shallow network (student). Different from previous knowledge distillation methods, which only use the output from the last layer of the teacher network for distillation, our student model patiently learns from multiple intermediate layers of the teacher model for incremental knowledge extraction, following two strategies: (i) PKD-Last: learning from the last k layers; and (ii) PKD-Skip: learning from every k layers. These two patient distillation schemes enable the exploitation of rich information in the teacher's hidden layers, and encourage the student model to patiently learn from and imitate the teacher through a multi-layer distillation process. Empirically, this translates into improved results on multiple NLP tasks with significant gain in training efficiency, without sacrificing model accuracy.

People supported by AI-powered decision support tools frequently overrely on the AI: they accept an AI's suggestion even when that suggestion is wrong. Adding explanations to the AI decisions does not appear to reduce the overreliance and some studies suggest that it might even increase it. Informed by the dual-process theory of cognition, we posit that people rarely engage analytically with each individual AI recommendation and explanation, and instead develop general heuristics about whether and when to follow the AI suggestions. Building on prior research on medical decision-making, we designed three cognitive forcing interventions to compel people to engage more thoughtfully with the AI-generated explanations. We conducted an experiment (N=199), in which we compared our three cognitive forcing designs to two simple explainable AI approaches and to a no-AI baseline. The results demonstrate that cognitive forcing significantly reduced overreliance compared to the simple explainable AI approaches. However, there was a trade-off: people assigned the least favorable subjective ratings to the designs that reduced the overreliance the most. To audit our work for intervention-generated inequalities, we investigated whether our interventions benefited equally people with different levels of Need for Cognition (i.e., motivation to engage in effortful mental activities). Our results show that, on average, cognitive forcing interventions benefited participants higher in Need for Cognition more. Our research suggests that human cognitive motivation moderates the effectiveness of explainable AI solutions.

The COVID-19 pandemic has escalated mental health crises worldwide, with social isolation and economic instability contributing to a rise in suicidal behavior. Suicide can result from social factors such as shame, abuse, abandonment, and mental health conditions like depression, Post-Traumatic Stress Disorder (PTSD), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and bipolar disorders. As these conditions develop, signs of suicidal ideation may manifest in social media interactions. Analyzing social media data using artificial intelligence (AI) techniques can help identify patterns of suicidal behavior, providing invaluable insights for suicide prevention agencies, professionals, and broader community awareness initiatives. Machine learning algorithms for this purpose require large volumes of accurately labeled data. Previous research has not fully explored the potential of incorporating explanations in analyzing and labeling longitudinal social media data. In this study, we employed a model explanation method, Layer Integrated Gradients, on top of a fine-tuned state-of-the-art language model, to assign each token from Reddit users' posts an attribution score for predicting suicidal ideation. By extracting and analyzing attributions of tokens from the data, we propose a methodology for preliminary screening of social media posts for suicidal ideation without using large language models during inference.

A faithful and interpretable explanation of an AI model's behavior and internal structure is a high-level explanation that is human-intelligible but also consistent with the known, but often opaque low-level causal details of the model. We argue that the theory of causal abstraction provides the mathematical foundations for the desired kinds of model explanations. In causal abstraction analysis, we use interventions on model-internal states to rigorously assess whether an interpretable high-level causal model is a faithful description of an AI model. Our contributions in this area are: (1) We generalize causal abstraction to cyclic causal structures and typed high-level variables. (2) We show how multi-source interchange interventions can be used to conduct causal abstraction analyses. (3) We define a notion of approximate causal abstraction that allows us to assess the degree to which a high-level causal model is a causal abstraction of a lower-level one. (4) We prove constructive causal abstraction can be decomposed into three operations we refer to as marginalization, variable-merge, and value-merge. (5) We formalize the XAI methods of LIME, causal effect estimation, causal mediation analysis, iterated nullspace projection, and circuit-based explanations as special cases of causal abstraction analysis.

We aim to present a comprehensive overview of the latest advancements in utilizing Large Language Models (LLMs) within the healthcare sector, emphasizing their transformative impact across various medical domains. LLMs have become pivotal in supporting healthcare, including physicians, healthcare providers, and patients. Our review provides insight into the applications of Large Language Models (LLMs) in healthcare, specifically focusing on diagnostic and treatment-related functionalities. We shed light on how LLMs are applied in cancer care, dermatology, dental care, neurodegenerative disorders, and mental health, highlighting their innovative contributions to medical diagnostics and patient care. Throughout our analysis, we explore the challenges and opportunities associated with integrating LLMs in healthcare, recognizing their potential across various medical specialties despite existing limitations. Additionally, we offer an overview of handling diverse data types within the medical field.