CafeMed: Causal Attention Fusion Enhanced Medication Recommendation

Medication recommendation systems play a crucial role in assisting clinicians with personalized treatment decisions. While existing approaches have made significant progress in learning medication representations, they suffer from two fundamental limitations: (i) treating medical entities as independent features without modeling their synergistic effects on medication selection; (ii) employing static causal relationships that fail to adapt to patient-specific contexts and health states. To address these challenges, we propose CafeMed, a framework that integrates dynamic causal reasoning with cross-modal attention for safe and accurate medication recommendation. CafeMed introduces two key components: the Causal Weight Generator (CWG) that transforms static causal effects into dynamic modulation weights based on individual patient states, and the Channel Harmonized Attention Refinement Module (CHARM) that captures complex interdependencies between diagnoses and procedures. This design enables CafeMed to model how different medical conditions jointly influence treatment decisions while maintaining medication safety constraints. Extensive experiments on MIMIC-III and MIMIC-IV datasets demonstrate that CafeMed significantly outperforms state-of-the-art baselines, achieving superior accuracy in medication prediction while maintaining the lower drug--drug interaction rates. Our results indicate that incorporating dynamic causal relationships and cross-modal synergies leads to more clinically-aligned and personalized medication recommendations. Our code is released publicly at https://github.com/rkl71/CafeMed.

Modality Alignment with Multi-scale Bilateral Attention for Multimodal Recommendation

Multimodal recommendation systems are increasingly becoming foundational technologies for e-commerce and content platforms, enabling personalized services by jointly modeling users' historical behaviors and the multimodal features of items (e.g., visual and textual). However, most existing methods rely on either static fusion strategies or graph-based local interaction modeling, facing two critical limitations: (1) insufficient ability to model fine-grained cross-modal associations, leading to suboptimal fusion quality; and (2) a lack of global distribution-level consistency, causing representational bias. To address these, we propose MambaRec, a novel framework that integrates local feature alignment and global distribution regularization via attention-guided learning. At its core, we introduce the Dilated Refinement Attention Module (DREAM), which uses multi-scale dilated convolutions with channel-wise and spatial attention to align fine-grained semantic patterns between visual and textual modalities. This module captures hierarchical relationships and context-aware associations, improving cross-modal semantic modeling. Additionally, we apply Maximum Mean Discrepancy (MMD) and contrastive loss functions to constrain global modality alignment, enhancing semantic consistency. This dual regularization reduces mode-specific deviations and boosts robustness. To improve scalability, MambaRec employs a dimensionality reduction strategy to lower the computational cost of high-dimensional multimodal features. Extensive experiments on real-world e-commerce datasets show that MambaRec outperforms existing methods in fusion quality, generalization, and efficiency. Our code has been made publicly available at https://github.com/rkl71/MambaRec.