United States

Multimodal large language models (MLLMs) have shown great potential in medical applications, yet existing benchmarks inadequately capture real-world clinical complexity. We introduce MEDSYN, a multilingual, multimodal benchmark of highly complex clinical cases with up to 7 distinct visual clinical evidence (CE) types per case. Mirroring clinical workflow, we evaluate 18 MLLMs on differential diagnosis (DDx) generation and final diagnosis (FDx) selection. While frontier models often match or even outperform human experts on DDx generation, all MLLMs exhibit a much larger DDx--FDx performance gap compared to expert clinicians, indicating a failure mode in synthesis of heterogeneous CE types. Ablations attribute this failure to (i) overreliance on less discriminative textual CE (\emph{e.g.}, medical history) and (ii) a cross-modal CE utilization gap. We introduce \emph{Evidence Sensitivity} to quantify the latter and show that a smaller gap correlates with higher diagnostic accuracy. Finally, we demonstrate how it can be used to guide interventions to improve model performance. https://github.com/jianing-lab/MEDSYN.

ACL 2026

MEDSYN: Benchmarking Multi-EviDence SYNthesis in Complex Clinical Cases for Multimodal Large Language Models

### Welcome to The 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025)

Message from the General Chair: 
*It is my great pleasure and honor to welcome you to the 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025), held in beautiful Vienna, Austria, from July 27 to August 1, 2025. ACL2025continues our field’s tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.* 
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ACL 2025

Welcome to The 63rd Annual Meeting of the Association for Computational Linguistics (ACL 2025)

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It is my great pleasure and honor to welcome you to the 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026), held in San Diego, California, USA, July 2–7, 2026. ACL 2026 continues our fields tradition of excellence in scholarship, innovation, and inclusivity, and I am deeply grateful to the many volunteers who have worked tirelessly to bring this event to life.

It is exciting to see the many developments in the field reflected at our conference, such as the advancement of large language models (born out of our community) into many application directions. This is not without challenges, partly due to unsolved problems, and partly due to misuse of the technology. All this is reflected well at ACL 2026. The conference also reflects that the field is not only about advancing technology, but also the science of fundamentally understanding language and how it is use by many different speaker communities. 
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The 64th Annual Meeting of the Association for Computational Linguistics (ACL 2026) will take place in San Diego, California, from July 2 - 7, 2026.

Standard LLM personalization typically frames identity as a static retrieval task, overlooking the inherent incongruity of human personas, where stable traits coexist with atypical, context-specific stances. Existing methods struggle to reconcile these dimensions: prompting succumbs to context drift over long sequences, while fine-tuning often suppresses idiosyncratic ``quirks'' in favor of generic distributional patterns. To bridge this gap, we present QuirkyMind, a framework that disentangles identity definition from its expression. First, Traits Anchoring constructs a dual-stream latent state, fusing a sentence-level summary for semantic stability with a token-level sequence for generative control. This state is stabilized via In-Context Narrative Refinement using an alternating objective: a discriminative InfoNCE loss anchors the persona in representation space to prevent drift, while a generative cross-entropy loss ensures faithful verbalization. Finally, Persona Steered Generalization transfers the refined state to downstream tasks via parameter-efficient adapters. Empirical evaluations on Persona-Steered QA and Narrative Inference demonstrate that QuirkyMind mitigates drift, consolidating persona knowledge without erasing authentic incongruities.

Faithful Persona Steering under Incongruity via Dual-Stream Refinement

Electronic health records (EHRs) provide longitudinal evidence for clinical prediction, but EHR data are sparse, incomplete, and heterogeneous, which can limit robustness. Medical knowledge graphs (MKGs) have therefore been incorporated to support KG-enhanced clinical prediction by linking heterogeneous EHR codes to shared medical concepts via structured relations. However, existing KG-enhanced approaches remain limited in two aspects: (i) task-specific knowledge selection when extracting knowledge from a large multi-source MKG; and (ii) patient-level personalization and knowledge integration, where personalization is often weakly controlled and knowledge integration is not sufficiently aligned with longitudinal patient trajectories. To address these issues, we propose MedCPI, a unified Construct–Personalize–Integrate framework. MedCPI first performs task-guided schema induction and KG normalization to build a task-specific Concept MKG as a denoised knowledge pool, then constructs controlled patient-level PKGs via local expansion and short path search, and finally integrates PKG representations with time-aware EHR representations via cross-attention for prediction. Experiments on MIMIC-III and MIMIC-IV across four clinical prediction tasks show consistent improvements over strong EHR-only and KG-enhanced baselines. Ablations and additional analyses further validate the contribution of each stage and illustrate how MedCPI utilizes structured medical knowledge.

MedCPI: A Construct–Personalize–Integrate Framework for KG-enhanced Clinical Prediction

Visual Document Retrieval (VDR), which aims to retrieve relevant pages within vast corpora of visually-rich documents, is of significance in current multimodal retrieval applications. The state-of-the-art multi-vector paradigm excels in performance but suffers from prohibitive overhead, a problem that current efficiency methods like pruning and merging address imperfectly, creating a difficult trade-off between compression rate and feature fidelity. To overcome this dilemma, we introduce **Prune-then-Merge**, a novel two-stage framework that synergizes these complementary approaches. Our method first employs an adaptive pruning stage to filter out low-information patches, creating a refined, high-signal set of embeddings. Subsequently, a hierarchical merging stage compresses this pre-filtered set, effectively summarizing semantic content without the noise-induced feature dilution seen in single-stage methods. **Extensive experiments on 29 VDR datasets demonstrate that our framework consistently outperforms existing methods, significantly extending the near-lossless compression range and providing robust performance at high compression ratios.**

Sculpting the Vector Space: Towards Efficient Multi-Vector Visual Document Retrieval via Prune-then-Merge Framework

Tool-use large language model (LLM) agents are increasingly deployed to support sensitive workflows, relying on tool calls for retrieval, external API access, and session memory management. While prior research has examined various threats, the risk of systematic data exfiltration by backdoored agents remains underexplored. In this work, we present a backdoor attack framework that embeds semantic triggers into fine-tuned LLM agents. When triggered, the backdoored agent invokes memory-access tool calls to retrieve stored user context and exfiltrates it via disguised retrieval tool calls. We further demonstrate that multi-turn interaction amplifies the impact of data exfiltration, as attacker-controlled retrieval responses can subtly steer subsequent agent behavior and user interactions, enabling sustained and cumulative information leakage over time. Our experimental results expose a critical vulnerability in LLM agents with tool access and highlight the need for defenses against exfiltration-oriented backdoors.

Your LLM Agent Can Leak Your Data: Data Exfiltration via Backdoored Tool Use

This paper studies how empirical dialogue-flow statistics can be incorporated into Next Dialogue Act Prediction (NDAP). A KL regularization term is proposed that aligns predicted act distributions with corpus-derived transition patterns. Evaluated on a 60-class German counselling taxonomy using 5-fold cross-validation, this improves macro-F1 by 9--42% relative depending on encoder and substantially improves dialogue-flow alignment. Cross-dataset validation on HOPE suggests that improvements transfer across languages and counselling domains. In systematic ablations across pretrained encoders and architectures, the findings indicate that transition regularization provides consistent gains and disproportionately benefits weaker baseline models. The results suggest that lightweight discourse-flow priors complement pretrained encoders, especially in fine-grained, data-sparse dialogue tasks.

Transition-Matrix Regularization for Next Dialogue Act Prediction in Counselling Conversations

On-policy distillation (OPD), which samples trajectories from the student model and supervises them with a teacher at the token-level, avoids relying solely on verifiable terminal rewards and can yield better generalization than off-policy distillation. However, OPD requires expensive on-the-fly sampling of the student policy during training, which substantially increases training cost, especially for responses with long reasoning traces. Our initial analysis shows that, during OPD, training signals are stronger in the prefix of each output reasoning trace, and that even a short teacher-generated prefix can significantly help the student produce the correct answer. Motivated by these observations, we propose a simple yet effective modification of OPD: we apply the distillation objective only to prefixes of student-generated outputs and terminate each sampling early during distillation. Experiments on a suite of AI-for-Math and out-of-domain reasoning benchmarks show that on-policy prefix distillation matches the performance of full OPD in long reasoning outputs while reducing training FLOP by 2x–40x.

Fast and Effective On-Policy Distillation from Reasoning Prefixes

Existing audio question answering benchmarks largely emphasize sound event classification or caption-grounded queries, often enabling models to succeed through shortcut strategies, short-duration cues, lexical priors, dataset-specific biases, or even bypassing audio via metadata and captions rather than genuine reasoning Thus, we present AUDITA (Audio Understanding from Diverse Internet Trivia Authors), a large-scale, real-world benchmark to rigorously evaluate audio reasoning beyond surface-level acoustic recognition. AUDITA comprises carefully curated, human-authored trivia questions grounded in real-world audio, designed to stress robust auditory reasoning through challenging distractors and long-range temporal dependencies, using probing queries that cannot be answered from isolated text or sound cues alone. Human average accuracy of 32.13% shows both the challenge of the task while demonstrating meaningful comprehension of the audio. In stark contrast, state-of-the- art audio question answering models perform poorly, with average accuracy below 8.86%. Beyond raw accuracy, we apply Item Response Theory (IRT) to estimate latent proficiency, question difficulty, and expose systematic deficiencies of the models and data.

AUDITA: A New Dataset to Audit Humans vs. AI Skill at Audio QA

Bangladesh's low-income population faces major barriers to affordable legal advice due to complex legal language, procedural opacity, and high costs. Existing AI legal assistants lack Bengali-language support and jurisdiction-specific adaptation, limiting their effectiveness. To address this, we developed \textsc{Mina}, a multilingual LLM-based legal assistant tailored for the Bangladeshi context. It employs multilingual embeddings and a RAG-based chain-of-tools framework for retrieval, reasoning, translation, and document generation, delivering context-aware legal drafts, citations, and plain-language explanations via an interactive chat interface. Evaluated by law faculty from leading Bangladeshi universities across all stages of the 2022 and 2023 Bangladesh Bar Council examinations, \textsc{Mina} achieved scores of 75–80% in the preliminary MCQs, written, and simulated viva voce components. These results matched or surpassed average human performance, demonstrating strong clarity, contextual understanding, and sound legal reasoning, while operating at approximately 0.1-0.6% of the cost of human lawyers. These results confirm its potential as a low-cost, multilingual AI assistant that automates key legal tasks and scales access to justice, offering a real-world details on building domain-specific, low-resource systems and addressing challenges of multilingual adaptation, efficiency, and sustainable public-service AI deployment.

Mina: A Multilingual LLM-Powered Legal Assistant Agent for Empowering Access to Justice in Bangladesh

Long-form audio understanding poses significant challenges for large audio language models (LALMs) due to the extreme length of audio sequences and the need to reason over heterogeneous acoustic cues distributed over time, such as speech content, speaker identity, emotion, and sound events. To address these challenges, we propose PlanRAG-Audio, a planning-based retrieval-augmented generation framework for scalable long-form audio understanding. Rather than having audio LALMs process entire recordings directly, PlanRAG-Audio explicitly plans which modalities and temporal spans are required for a given query, and retrieves only query-relevant information from a structured text and audio database. This retrieval planning enables effective reasoning over complex, cross-domain audio queries while substantially reducing the input length passed to the large language models. Experiments across a wide range of speech/audio retrieval demonstrate that PlanRAG-Audio improves reasoning accuracy and stabilizes performance as audio duration increases by decoupling inference cost from raw audio length.

PlanRAG-Audio: Planning and Retrieval Augmented Generation for Long-form Audio Understanding

Reinforcement learning optimization policies have traditionally relied on a single reward mechanism, most commonly a model-based reward. Such monolithic rewards often lack confidence calibration across domain-specific tasks and fail to capture diverse aspects of model responses. This approach requires extensive data annotation and reward model training, which is particularly challenging for multimodal models. In this work, we propose and provide a thorough study of hybrid reward and multi-aspect reward modeling. For accuracy and confidence calibration, we introduce a hybrid reward modeling framework that integrates complementary reward paradigms: model-based rewards, in which a learned reward model predicts scalar or vector scores, and rule-based reward, in which domain-specific heuristics provide explicit correctness signals with confidence. Beyond accuracy, we further incorporate multi-aspect rewards to enforce instruction adherence and introduce a generalized length-penalty reward to stabilize training and improve performance. Experiments demonstrate that this approach significantly enhances reasoning capabilities: our best-performing 3B model achieves an average improvement of ~9.5% across multimodal benchmarks, with a notable ~16% gain in mathematical reasoning tasks.

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