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Retrieving visual and textual information from medical literature and hospital records can enhance diagnostic accuracy for clinical image interpretation. However, multimodal retrieval-augmented diagnosis is highly challenging. We explore a lightweight mechanism for enhancing diagnostic performance of retrieval-augmented LVLMs. We train an LVLM-aware multimodal retriever, such that the retriever learns to return images and texts that guide the LVLM toward correct predictions. In our low-resource setting, we perform only lightweight fine-tuning with small amounts of data, and use only general-purpose backbone models, achieving competitive results in clinical classification and VQA tasks compared to medically pre-trained models with extensive training. In a novel analysis, we highlight a previously unexplored class of errors that we term inconsistent retrieval predictions: cases where different top-retrieved images yield different predictions for the same target. We find that these cases are challenging for all models, even for non-retrieval models, and that our retrieval optimization mechanism significantly improves these cases over standard RAG. However, our analysis also sheds light on gaps in the ability of LVLMs to utilize retrieved information for clinical predictions.

ACL 2026

LVLM-Aware Multimodal Retrieval for RAG-Based Medical Diagnosis with General-Purpose Models

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. <br>
[Full Message from General Chair Philipp Koehn](https://drive.google.com/file/d/1QiJFOmMjvDgsDo3i1XzlQnImxe3RU_Cy/view?usp=sharing) <br><br><br>
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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.

poster

In the era of noisy intermediate-scale quantum (NISQ) computing, Quantum Neural Networks (QNNs) have emerged as a promising approach for various applications, yet their training is often hindered by barren plateaus (BPs), where gradient variance vanishes exponentially as the qubit size increases. Most initialization-based mitigation strategies rely heavily on pre-designed static parameter distributions, thereby lacking adaptability to diverse model sizes or data conditions. To address these limitations, we propose AdaInit, a foundational framework that leverages large language models with the submartingale property to iteratively synthesize initial parameters for QNNs that yield non-negligible gradient variance, thereby mitigating BPs. Unlike conventional one-shot initialization methods, AdaInit adaptively explores the parameter space by incorporating dataset characteristics and gradient feedback, with theoretical guarantees of convergence to finding a set of effective initial parameters for QNNs. We provide rigorous theoretical analyses of the submartingale-based process and empirically validate that AdaInit consistently outperforms existing initialization methods in maintaining higher gradient variance across various QNN scales. We believe this work may initiate a new avenue to mitigate BPs.

 Large Language Models Can Help Mitigate Barren Plateaus in Quantum Neural Networks

Electronic health record (EHR) question answering is often handled by LLM-based pipelines that are costly to deploy and do not explicitly leverage the hierarchical structure of clinical data. Motivated by evidence that medical ontologies and patient trajectories exhibit hyperbolic geometry, we propose HypEHR, a compact Lorentzian model that embeds codes, visits, and questions in hyperbolic space and answers queries via geometry-consistent cross-attention with type-specific pointer heads. HypEHR is pretrained with next-visit diagnosis prediction and hierarchy-aware regularization to align representations with the ICD ontology. On two MIMIC-IV-based EHR-QA benchmarks, HypEHR approaches LLM-based methods while using far fewer parameters. Our code is publicly available at \url{https://github.com/yuyuliu11037/HypEHR}.

HypEHR: Hyperbolic Modeling of Electronic Health Records for Efficient Question Answering

The remarkable progress of vision–language models (VLMs) has enabled computer-use agents to interact with computers in a human-like manner. Yet real-world computer-use tasks remain difficult due to long-horizon workflows, diverse interfaces, and frequent intermediate errors. Prior work equips agents with external memory built from large collections of trajectories, but relies on flat retrieval over discrete summaries or continuous embeddings, falling short of the structured organization and self-evolving characteristics of human memory. Inspired by the brain, we propose Hybrid Self-evolving Structured Memory (HyMEM), a graph-based memory that couples discrete high-level symbolic nodes with continuous trajectory embeddings. HyMEM maintains a graph structure to support multi-hop retrieval, self-evolution via node update operations, and on-the-fly working-memory refreshing during inference. Extensive experiments show that HyMEM consistently improves open-source computer-use agents, enabling 7B/8B backbones to match or surpass strong closed-source models; notably, it boosts Qwen2.5-VL-7B by +22.5% and outperforms Gemini2.5-Pro-Vision and GPT-4o.

 Hybrid Self-evolving Structured Memory for Computer-Use Agents

With the rapid adoption of large language models (LLMs), conversational AI agents have become widely deployed across real-world applications. To enhance safety, these agents are often equipped with guardrails that moderate harmful content. Identifying the guardrails in an agent thus becomes critical for adversaries to understand the system and design guard-specific attacks. In this work, we introduce AP-Test, a novel approach that leverages guard-specific adversarial prompts to detect the identity of guardrails deployed in black-box AI agents. Our method addresses key challenges in this task, including the influence of safety-aligned LLMs and other guardrails, as well as a lack of principled decision-making strategies. AP-Test employs two complementary testing strategies, input and output guard tests, and a new metric, match score, to enable robust identification. Experiments across diverse agents and four open-source guardrails demonstrate that AP-Test achieves perfect classification accuracy in multiple scenarios. Ablation studies further highlight the necessity of our proposed components. Our findings reveal a practical path toward guardrail identification in real-world AI systems.

Peering Behind the Shield: Guardrail Identification in Large Language Models

Dialectal Arabic datasets embody a range of domain, dialect, and quality. To better understand the landscape of these datasets, we perform a computational analysis of the `dialectness' and a set of measures of audio quality. This analysis of the training splits of dialectal Arabic datasets, provides a valuable complement to existing literature surveys of dialectal Arabic.

To further address inconsistencies between datasets, we also introduce Arab Voices, a standardized framework for supporting Automatic Speech Recognition in dialectal Arabic. This framework provide access to 31 datasets covering 14 dialects, to better address the limited data availability encountered in dialectal Arabic speech processing. Our benchmark further provides a current evaluation of SOTA tools as well as modern multimodal LLMs at dialectal Arabic ASR.

Arab Voices: Mapping Standard and Dialectal Arabic Speech Technology

Large language models (LLMs) frequently generate toxic content, posing significant risks for safe deployment. Current mitigation strategies often degrade generation quality or require costly human annotation. We propose \textsc{CausalDetox}, a framework that identifies and intervenes on the specific attention heads causally responsible for toxic generation. Using the Probability of Necessity and Sufficiency (PNS), we isolate a minimal set of heads that are necessary and sufficient for toxicity. We utilize these components via two complementary strategies: (1) Local Inference-Time Intervention, which constructs dynamic, input-specific steering vectors for context-aware detoxification, and (2) PNS-Guided Fine-Tuning, which permanently unlearns toxic representations. We also introduce\textsc{ParaTox}, a novel benchmark of aligned toxic/non-toxic sentence pairs enabling controlled counterfactual evaluation. Experiments on ToxiGen, ImplicitHate, and ParaDetox show that \textsc{CausalDetox} achieves up to 5.34\% greater toxicity reduction compared to baselines while preserving linguistic fluency, and offers a $7\times$ speedup in head selection.

CausalDetox: Causal Head Selection and Intervention for Language Model Detoxification

Distilling the capabilities from a large reasoning model (LRM) to a smaller student model often involves training on substantial amounts of reasoning data. However, knowledge distillation (KD) over lengthy sequences with prompt (P), chain-of-thought (CoT), and answer (A) sections makes the process computationally expensive. In this work, we investigate how the allocation of supervision across different sections (P, CoT, A) affects student performance. Our analysis shows that selective KD over only the CoT tokens can be effective when the prompt and answer information is encompassed by it. Building on this insight, we establish a truncation protocol to quantify computation-quality tradeoffs as a function of sequence length. We observe that beyond a specific length, longer training sequences provide marginal returns for downstream performance but require substantially higher memory and FLOPs. To this end, training on only the first 50% of tokens of every training sequence can retain, on average, ≈91% of full-sequence performance on math benchmarks while reducing training time, memory usage, and FLOPs by about 50% each. Codes are available at https://github.com/weiruichen01/distilling-the-essence.

Distilling the Essence: Efficient Reasoning Distillation via Sequence Truncation

Large Language Models (LLMs) have demonstrated remarkable capabilities in handling long context inputs, but this comes at the cost of increased computational resources and latency. Our research introduces a novel approach for the long context bottleneck to accelerate LLM inference and reduce GPU memory consumption. We show that LLMs can identify relevant tokens in the early layers prior to generating query responses. Leveraging this insight, we propose an algorithm that uses early layers of an LLM as filters to select and compress input tokens, significantly reducing the context length for subsequent processing. Our method, GemFilter, demonstrates substantial improvements in both speed and memory efficiency compared to existing techniques, such as standard attention and SnapKV/H2O. Notably, it achieves a 2.4X speedup and 30% reduction in GPU memory usage compared to SOTA methods. When evaluated on the Needle in a Haystack task, GemFilter significantly outperforms standard attention and SnapKV, while demonstrating comparable performance on the LongBench challenge. GemFilter is simple, training-free, and broadly applicable across different LLMs. Moreover, it provides interpretability by allowing humans to inspect the selected input sequence. Our findings provide practical benefits for deploying LLMs and deepen our understanding of their internal mechanisms, paving the way for further optimizations in LLM design and inference. Our code is available at https://github.com/SalesforceAIResearch/GemFilter.

Discovering the Gems in Early Layers: Accelerating Long-Context LLMs with 1000x Input Token Reduction

Current reinforcement learning objectives for large-model reasoning primarily focus on maximizing expected rewards. This paradigm can lead to overfitting to dominant reward signals, while neglecting alternative yet valid reasoning trajectories, thereby limiting diversity and exploration. To address this issue, we introduce Learning Advantage Distributions (LAD), a distribution-matching framework that replaces advantage maximization with learning the advantage-induced distribution. By establishing the equivalence between the optimal policy update and an advantage-based target distribution, we derive a practical LAD objective formulated as minimizing an 
$f$-divergence between the policy-induced and advantage-induced distributions. This yields a gradient update that increases likelihood for high-advantage responses while suppressing over-confident probability growth, preventing collapse without requiring auxiliary entropy regularization. LAD incurs no extra training cost compared to GRPO and scales naturally to LLM post-training. In a controlled bandit setting, LAD faithfully recovers the multimodal advantage distribution, validating the theoretical formulation. Experiments on math and code reasoning tasks across several LLM backbones show that LAD reliably improves both accuracy and generative diversity.

 LAD: Learning Advantage Distribution for Reasoning

While large language models show promise in medical applications, achieving expert-level clinical reasoning efficiently remains challenging due to the need for massive amounts of manually labeled data and large-scale models. To address this challenge, we propose Clinical-Oriented Reinforcement Learning (CORL), the first fully open-source, end-to-end reinforcement learning training pipeline in the clinical reasoning domain, incorporating a Reasoning-Oriented Data Strategy (RODS) based on topological synthesis, CoT cold-start, and two-stage reinforcement learning. Through CORL, we trained the Fleming-R1 series of models. Among them, Fleming-R1-7B significantly outperforms models of comparable size while approaching or even surpassing certain 32B and 72B models. Fleming-R1-32B achieves near-parity with GPT-4o and outperforms the strongest open-source alternatives up to 671B in MedXpertQA. This demonstrates that in clinical reasoning field, a meticulously designed training pipeline holds greater importance than scaling model size alone. Data and Models are available at https://github.com/UbiquantAI/Fleming-R1 and https://huggingface.co/collections/IQuestLab/fleming.

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