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Are Large Vision Language Models Truly Grounded in Medical Images? Evidence from Italian Clinical Visual Question Answering
Felizzi, Federico, Riccomi, Olivia, Ferramola, Michele, Causio, Francesco Andrea, Del Medico, Manuel, De Vita, Vittorio, De Mori, Lorenzo, Piscitelli, Alessandra, Risuleo, Pietro Eric, Castaniti, Bianca Destro, Cristiano, Antonio, Longo, Alessia, De Angelis, Luigi, Vassalli, Mariapia, Di Pumpo, Marcello
Large vision language models (VLMs) have achieved impressive performance on medical visual question answering benchmarks, yet their reliance on visual information remains unclear. We investigate whether frontier VLMs demonstrate genuine visual grounding when answering Italian medical questions by testing four state-of-the-art models: Claude Sonnet 4.5, GPT-4o, GPT-5-mini, and Gemini 2.0 flash exp. Using 60 questions from the EuropeMedQA Italian dataset that explicitly require image interpretation, we substitute correct medical images with blank placeholders to test whether models truly integrate visual and textual information. Our results reveal striking variability in visual dependency: GPT-4o shows the strongest visual grounding with a 27.9pp accuracy drop (83.2% [74.6%, 91.7%] to 55.3% [44.1%, 66.6%]), while GPT-5-mini, Gemini, and Claude maintain high accuracy with modest drops of 8.5pp, 2.4pp, and 5.6pp respectively. Analysis of model-generated reasoning reveals confident explanations for fabricated visual interpretations across all models, suggesting varying degrees of reliance on textual shortcuts versus genuine visual analysis. These findings highlight critical differences in model robustness and the need for rigorous evaluation before clinical deployment.
From Raw Features to Effective Embeddings: A Three-Stage Approach for Multimodal Recipe Recommendation
Shin, Jeeho, Kim, Kyungho, Shin, Kijung
Recipe recommendation has become an essential task in web-based food platforms. A central challenge is effectively leveraging rich multimodal features beyond user-recipe interactions. Our analysis shows that even simple uses of multimodal signals yield competitive performance, suggesting that systematic enhancement of these signals is highly promising. We propose TESMR, a 3-stage framework for recipe recommendation that progressively refines raw multimodal features into effective embeddings through: (1) content-based enhancement using foundation models with multimodal comprehension, (2) relation-based enhancement via message propagation over user-recipe interactions, and (3) learning-based enhancement through contrastive learning with learnable embeddings. Experiments on two real-world datasets show that TESMR outperforms existing methods, achieving 7-15% higher Recall@10.
ARIAL: An Agentic Framework for Document VQA with Precise Answer Localization
Mohammadshirazi, Ahmad, Neogi, Pinaki Prasad Guha, Kulshrestha, Dheeraj, Ramnath, Rajiv
Document Visual Question Answering (VQA) requires models to not only extract accurate textual answers but also precisely localize them within document images, a capability critical for interpretability in high-stakes applications. However, existing systems achieve strong textual accuracy while producing unreliable spatial grounding, or sacrifice performance for interpretability. We present ARIAL (Agentic Reasoning for Interpretable Answer Localization), a modular framework that orchestrates specialized tools through an LLM-based planning agent to achieve both precise answer extraction and reliable spatial grounding. ARIAL decomposes Document VQA into structured subtasks: OCR-based text extraction with TrOCR, retrieval-augmented context selection using semantic search, answer generation via a fine-tuned Gemma 3-27B model, and explicit bounding-box localization through text-to-region alignment. This modular architecture produces transparent reasoning traces, enabling tool-level auditability and independent component optimization. We evaluate ARIAL on four benchmarks (DocVQA, FUNSD, CORD, and SROIE) using both textual accuracy (ANLS) and spatial precision (mAP at IoU 0.50 to 0.95). ARIAL achieves state-of-the-art results across all datasets: 88.7 ANLS and 50.1 mAP on DocVQA, 90.0 ANLS and 50.3 mAP on FUNSD, 85.5 ANLS and 60.2 mAP on CORD, and 93.1 ANLS on SROIE, surpassing the previous best method (DLaVA) by +2.8 ANLS and +3.9 mAP on DocVQA. Our work demonstrates how agentic orchestration of specialized tools can simultaneously improve performance and interpretability, providing a pathway toward trustworthy, explainable document AI systems.
Beyond the Rubric: Cultural Misalignment in LLM Benchmarks for Sexual and Reproductive Health
Dey, Sumon Kanti, S, Manvi, Mehta, Zeel, Shah, Meet, Agrawal, Unnati, Jalota, Suhani, Ismail, Azra
Large Language Models (LLMs) have been positioned as having the potential to expand access to health information in the Global South, yet their evaluation remains heavily dependent on benchmarks designed around Western norms. We present insights from a preliminary benchmarking exercise with a chatbot for sexual and reproductive health (SRH) for an underserved community in India. We evaluated using HealthBench, a benchmark for conversational health models by OpenAI. We extracted 637 SRH queries from the dataset and evaluated on the 330 single-turn conversations. Responses were evaluated using HealthBench's rubric-based automated grader, which rated responses consistently low. However, qualitative analysis by trained annotators and public health experts revealed that many responses were actually culturally appropriate and medically accurate. We highlight recurring issues, particularly a Western bias, such as for legal framing and norms (e.g., breastfeeding in public), diet assumptions (e.g., fish safe to eat during pregnancy), and costs (e.g., insurance models). Our findings demonstrate the limitations of current benchmarks in capturing the effectiveness of systems built for different cultural and healthcare contexts. We argue for the development of culturally adaptive evaluation frameworks that meet quality standards while recognizing needs of diverse populations.
The Role of Consequential and Functional Sound in Human-Robot Interaction: Toward Audio Augmented Reality Interfaces
Smith, Aliyah, Kennedy, Monroe III
Abstract--As robots become increasingly integrated into everyday environments, understanding how they communicate with humans is critical. Sound offers a powerful channel for interaction, encompassing both operational noises and intentionally designed auditory cues. In this study, we examined the effects of consequential and functional sounds on human perception and behavior, including a novel exploration of spatial sound through localization and handover tasks. Results show that consequential sounds of the Kinova Gen3 manipulator did not negatively affect perceptions, spatial localization is highly accurate for lateral cues but declines for frontal cues, and spatial sounds can simultaneously convey task-relevant information while promoting warmth and reducing discomfort. These findings highlight the potential of functional and transformative auditory design to enhance human-robot collaboration and inform future sound-based interaction strategies. UDIO Augmented Reality remains a comparatively un-derexplored domain within the broader field of Augmented Reality (AR) research [1]. While recent advancements in AR technologies have spurred extensive investigation into visual augmentation--where virtual objects are seamlessly integrated into the physical environment--research on auditory augmentation has lagged behind.
From Perception to Reasoning: Deep Thinking Empowers Multimodal Large Language Models
Zhu, Wenxin, Chen, Andong, Song, Yuchen, Chen, Kehai, Zhu, Conghui, Chen, Ziyan, Zhao, Tiejun
With the remarkable success of Multimodal Large Language Models (MLLMs) in perception tasks, enhancing their complex reasoning capabilities has emerged as a critical research focus. Existing models still suffer from challenges such as opaque reasoning paths and insufficient generalization ability. Chain-of-Thought (CoT) reasoning, which has demonstrated significant efficacy in language models by enhancing reasoning transparency and output interpretability, holds promise for improving model reasoning capabilities when extended to the multimodal domain. This paper provides a systematic review centered on "Multimodal Chain-of-Thought" (MCoT). First, it analyzes the background and theoretical motivations for its inception from the perspectives of technical evolution and task demands. Then, it introduces mainstream MCoT methods from three aspects: CoT paradigms, the post-training stage, and the inference stage, while also analyzing their underlying mechanisms. Furthermore, the paper summarizes existing evaluation benchmarks and metrics, and discusses the application scenarios of MCoT. Finally, it analyzes the challenges currently facing MCoT and provides an outlook on its future research directions.
MolEdit: Knowledge Editing for Multimodal Molecule Language Models
Lei, Zhenyu, Soga, Patrick, Zhu, Yaochen, He, Yinhan, Dong, Yushun, Li, Jundong
Understanding and continuously refining multimodal molecular knowledge is crucial for advancing biomedicine, chemistry, and materials science. Molecule language models (MoLMs) have become powerful tools in these domains, integrating structural representations (e.g., SMILES strings, molecular graphs) with rich contextual descriptions (e.g., physicochemical properties). However, MoLMs can encode and propagate inaccuracies due to outdated web-mined training corpora or malicious manipulation, jeopardizing downstream discovery pipelines. While knowledge editing has been explored for general-domain AI, its application to MoLMs remains uncharted, presenting unique challenges due to the multifaceted and interdependent nature of molecular knowledge. In this paper, we take the first step toward MoLM editing for two critical tasks: molecule-to-caption generation and caption-to-molecule generation. To address molecule-specific challenges, we propose MolEdit, a powerful framework that enables targeted modifications while preserving unrelated molecular knowledge. MolEdit combines a Multi-Expert Knowledge Adapter that routes edits to specialized experts for different molecular facets with an Expertise-Aware Editing Switcher that activates the adapters only when input closely matches the stored edits across all expertise, minimizing interference with unrelated knowledge. To systematically evaluate editing performance, we introduce MEBench, a comprehensive benchmark assessing multiple dimensions, including Reliability (accuracy of the editing), Locality (preservation of irrelevant knowledge), and Generality (robustness to reformed queries). Across extensive experiments on two popular MoLM backbones, MolEdit delivers up to 18.8% higher Reliability and 12.0% better Locality than baselines while maintaining efficiency. The code is available at: https://github.com/LzyFischer/MolEdit.
Leveraging Exogenous Signals for Hydrology Time Series Forecasting
He, Junyang, Fox, Judy, Jafari, Alireza, Chen, Ying-Jung, Fox, Geoffrey
Recent advances in time series research facilitate the development of foundation models. While many state-of-the-art time series foundation models have been introduced, few studies examine their effectiveness in specific downstream applications in physical science. This work investigates the role of integrating domain knowledge into time series models for hydrological rainfall-runoff modeling. Using the CAMELS-US dataset, which includes rainfall and runoff data from 671 locations with six time series streams and 30 static features, we compare baseline and foundation models. Results demonstrate that models incorporating comprehensive known exogenous inputs outperform more limited approaches, including foundation models. Notably, incorporating natural annual periodic time series contribute the most significant improvements.
NegBLEURT Forest: Leveraging Inconsistencies for Detecting Jailbreak Attacks
Sleem, Lama, Francois, Jerome, Li, Lujun, Foucher, Nathan, Gentile, Niccolo, State, Radu
Jailbreak attacks designed to bypass safety mechanisms pose a serious threat by prompting LLMs to generate harmful or inappropriate content, despite alignment with ethical guidelines. Crafting universal filtering rules remains difficult due to their inherent dependence on specific contexts. To address these challenges without relying on threshold calibration or model fine-tuning, this work introduces a semantic consistency analysis between successful and unsuccessful responses, demonstrating that a negation-aware scoring approach captures meaningful patterns. Building on this insight, a novel detection framework called NegBLEURT Forest is proposed to evaluate the degree of alignment between outputs elicited by adversarial prompts and expected safe behaviors. It identifies anomalous responses using the Isolation Forest algorithm, enabling reliable jailbreak detection. Experimental results show that the proposed method consistently achieves top-tier performance, ranking first or second in accuracy across diverse models using the crafted dataset, while competing approaches exhibit notable sensitivity to model and data variations.
Rethinking Progression of Memory State in Robotic Manipulation: An Object-Centric Perspective
Chung, Nhat, Hanyu, Taisei, Nguyen, Toan, Le, Huy, Bumgarner, Frederick, Nguyen, Duy Minh Ho, Vo, Khoa, Yamazaki, Kashu, Rainwater, Chase, Kieu, Tung, Nguyen, Anh, Le, Ngan
As embodied agents operate in increasingly complex environments, the ability to perceive, track, and reason about individual object instances over time becomes essential, especially in tasks requiring sequenced interactions with visually similar objects. In these non-Markovian settings, key decision cues are often hidden in object-specific histories rather than the current scene. Without persistent memory of prior interactions (what has been interacted with, where it has been, or how it has changed) visuomotor policies may fail, repeat past actions, or overlook completed ones. To surface this challenge, we introduce LIBERO-Mem, a non-Markovian task suite for stress-testing robotic manipulation under object-level partial observability. It combines short- and long-horizon object tracking with temporally sequenced subgoals, requiring reasoning beyond the current frame. However, vision-language-action (VLA) models often struggle in such settings, with token scaling quickly becoming intractable even for tasks spanning just a few hundred frames. We propose Embodied-SlotSSM, a slot-centric VLA framework built for temporal scalability. It maintains spatio-temporally consistent slot identities and leverages them through two mechanisms: (1) slot-state-space modeling for reconstructing short-term history, and (2) a relational encoder to align the input tokens with action decoding. Together, these components enable temporally grounded, context-aware action prediction. Experiments show Embodied-SlotSSM's baseline performance on LIBERO-Mem and general tasks, offering a scalable solution for non-Markovian reasoning in object-centric robotic policies.