Recent advances such as Chain-of-Thought prompting have significantly improved large language models (LLMs) in zero-shot medical reasoning. However, prompting-based methods often remain shallow and unstable, while fine-tuned medical LLMs suffer from poor generalization under distribution shifts and limited adaptability to unseen clinical scenarios. To address these limitations, we present TAGS, a test-time framework that combines a broadly capable generalist with a domain-specific specialist to offer complementary perspectives without any model fine-tuning or parameter updates. To support this generalist–specialist reasoning process, we introduce two auxiliary modules: a hierarchical retrieval mechanism that provides multi-scale exemplars by selecting examples based on both semantic and rationale-level similarity, and a reliability scorer that evaluates reasoning consistency to guide final answer aggregation. TAGS achieves strong performance across nine MedQA benchmarks, boosting GPT-4o accuracy by 13.8%, DeepSeek-R1 by 16.8%, and improving a vanilla 7B model from 14.1% to 23.9%. These results surpass several fine-tuned medical LLMs, without any parameter updates.

The increasing integration of large language models (LLMs) into mental health applications necessitates robust frameworks for evaluating professional safety alignment. Current evaluative approaches primarily rely on refusal-based safety signals, which offer limited insight into the nuanced behaviors required in clinical practice. In mental health, clinically inadequate refusals can be perceived as unempathetic and discourage help-seeking. To address this gap, we move beyond refusal-centric metrics and introduce PsychEthicsBench, the first principle-grounded benchmark based on Australian psychology and psychiatry guidelines, designed to evaluate LLMs’ ethical knowledge and behavioral responses through multiple-choice and open-ended tasks with fine-grained ethicality annotations. Empirical results across 14 models reveal that refusal rates are poor indicators of ethical behavior, revealing a significant divergence between safety triggers and clinical appropriateness. Notably, we find that domain-specific fine-tuning can degrade ethical robustness, as several specialized models underperform their base backbones in ethical alignment. PsychEthicsBench provides a foundation for systematic, jurisdiction-aware evaluation of LLMs in mental health, encouraging more responsible development in this domain.

The medical adoption of NLP tools requires interpretability by end users, yet traditional explainable AI (XAI) methods are misaligned with clinical reasoning and lack clinician input. We introduce CHiRPE (Clinical High-Risk Prediction with Explainability), an NLP pipeline that takes transcribed semi-structured clinical interviews to: (i) predict psychosis risk; and (ii) generate novel SHAP explanation formats co-developed with clinicians. Trained on 944 semi-structured interview transcripts across 24 international clinics of the AMP-SCZ study, the CHiRPE pipeline integrates symptom-domain mapping, LLM summarisation, and BERT classification. CHiRPE achieved over 90% accuracy across three BERT variants and outperformed baseline models. Explanation formats were evaluated by 28 clinical experts who indicated a strong preference for our novel concept-guided explanations, especially hybrid graph-and-text summary formats. CHiRPE demonstrates that clinically-guided model development produces both accurate and interpretable results. Our next step is focused on real-world testing across our 24 international sites.

Culture serves as a fundamental determinant of human affective processing and profoundly shapes how individuals perceive and interpret emotional stimuli. Despite this intrinsic link extant evaluations regarding cultural alignment within Large Language Models primarily prioritize declarative knowledge such as geographical facts or established societal customs. These benchmarks remain insufficient to capture the subjective interpretative variance inherent to diverse sociocultural lenses. To address this limitation, we introduce CEDAR, a multimodal benchmark constructed entirely from scenarios capturing **C**ulturally **E**licited **D**istinct **A**ffective **R**esponses. To construct CEDAR, we implement a novel pipeline that leverages LLM-generated provisional labels to isolate instances yielding cross-cultural emotional distinctions, and subsequently derives reliable ground-truth annotations through rigorous human evaluation. The resulting benchmark comprises 10,962 instances across seven languages and 14 fine-grained emotion categories, with each language including 400 multimodal and 1,166 text-only samples. Comprehensive evaluations of 17 representative multilingual models reveal a dissociation between language consistency and cultural alignment, demonstrating that culturally grounded affective understanding remains a significant challenge for current models.

Multimodal Large Language Models (MLLMs) have shown promise in visual-textual reasoning, with Multimodal Chain-of-Thought (MCoT) prompting significantly enhancing interpretability. However, existing MCoT methods rely on rationale-rich datasets and largely focus on inter-object reasoning, overlooking the intra-object understanding crucial for image classification. To address this gap, we propose WISE, a Weak-supervision-guided Step-by-step Explanation method that augments any image classification dataset with MCoTs by reformulating the concept-based representations from Concept Bottleneck Models (CBMs) into concise, interpretable reasoning chains under weak supervision. Experiments across ten datasets show that our generated MCoTs not only improve interpretability by 37% but also lead to gains in classification accuracy when used to fine-tune MLLMs. Our work bridges concept-based interpretability and generative MCoT reasoning, providing a generalizable framework for enhancing MLLMs in fine-grained visual understanding.

Object categories are typically organized into a multi-granularity taxonomic hierarchy. When classifying categories at different hierarchy levels, traditional uni-modal approaches focus primarily on image features, revealing limitations in complex scenarios. Recent studies integrating Vision-Language Models (VLMs) with class hierarchies have shown promise, yet they fall short of fully exploiting the hierarchical relationships. These efforts are constrained by their inability to perform effectively across varied granularity of categories. To tackle this issue, we propose a novel framework (**HGCLIP**) that effectively combines **CLIP** with a deeper exploitation of the **H**ierarchical class structure via **G**raph representation learning. We explore constructing the class hierarchy into a graph, with its nodes representing the textual or image features of each category. After passing through a graph encoder, the textual features incorporate hierarchical structure information, while the image features emphasize class-aware features derived from prototypes through the attention mechanism. Our approach demonstrates significant improvements on 11 diverse visual recognition benchmarks. Our codes are fully available at https: //github.com/richard-peng-xia/HGCLIP.

Concept Bottleneck Models (CBMs) decompose image classification into a process governed by interpretable, human-readable concepts. Recent advances in CBMs have used Large Language Models (LLMs) to generate candidate concepts. However, a critical question remains: What is the optimal number of concepts to use? Current concept banks suffer from redundancy or insufficient coverage. To address this issue, we introduce a dynamic, agent-based approach that adjusts the concept bank in response to environmental feedback, optimizing the number of concepts for sufficiency yet concise coverage. Moreover, we propose Conditional Concept Bottleneck Models (CoCoBMs) to overcome the limitations in traditional CBMs’ concept scoring mechanisms. It enhances the accuracy of assessing each concept’s contribution to classification tasks and feature an editable matrix that allows LLMs to correct concept scores that conflict with their internal knowledge. Our evaluations across 6 datasets show that our method not only improves classification accuracy by 6% but also enhances interpretability assessments by 30%.

Recent multimodal large language models (MLLMs) have demonstrated significant potential in open-ended conversation, generating more accurate and personalized responses. However, their abilities to memorize, recall, and reason in sustained interactions within real-world scenarios remain underexplored. This paper introduces MMRC, a Multi-Modal Real-world Conversation benchmark for evaluating six core open-ended abilities of MLLMs: information extraction, multi-turn reasoning, information update, image management, memory recall, and answer refusal. With data collected from real-world scenarios, MMRC comprises 5,120 conversations and 28,720 corresponding manually labeled questions, posing a significant challenge to existing MLLMs. Evaluations on 20 MLLMs in MMRC indicate an accuracy drop during open-ended interactions. We identify four common failure patterns: long-term memory degradation, inadequacies in updating factual knowledge, accumulated assumption of error propagation, and reluctance to “say no.” To mitigate these issues, we propose a simple yet effective NOTE-TAKING strategy, which can record key information from the conversation and remind the model during its responses, enhancing conversational capabilities. Experiments across six MLLMs demonstrate significant performance improvements.

Long-tailed multi-label visual recognition (LTML) task is a highly challenging task due to the label co-occurrence and imbalanced data distribution. In this work, we propose a unified framework for LTML, namely prompt tuning with class-specific embedding loss (LMPT), capturing the semantic feature interactions between categories by combining text and image modality data and improving the performance synchronously on both head and tail classes. Specifically, LMPT introduces the embedding loss function with class-aware soft margin and re-weighting to learn class-specific contexts with the benefit of textual descriptions (captions), which could help establish semantic relationships between classes, especially between the head and tail classes. Furthermore, taking into account the class imbalance, the distribution-balanced loss is adopted as the classification loss function to further improve the performance on the tail classes without compromising head classes. Extensive experiments are conducted on VOC-LT and COCO-LT datasets, which demonstrates that our method significantly surpasses the previous state-of-the-art methods and zero-shot CLIP in LTML. Our codes are fully public at https://github.com/richard-peng-xia/LMPT.