Dementia-Agents: A Multi-Modal Multi-Agent System for Dementia Staging and Phenotyping

Dementia diagnosis requires integrating multi-modal clinical assessments from diverse informants and clinicians under incomplete and heterogeneous data conditions. Yet most AI-driven approaches remain Alzheimer's disease (AD)-centric, framing the problem as binary AD detection or three-stage AD progression modeling within well-curated research settings. This pathology-driven paradigm overlooks the broader, syndrome-level nature of dementia, which spans multiple stages, phenotypes, and etiologies. In this paper, we propose Dementia-Agents, a clinically aligned multi-agent framework for real-world dementia staging and phenotyping. The framework follows a three-step workflow: (1) a data agent translates structured clinical records into semantically faithful textual representations that preserve missing-data signals and routes them to domain-aligned experts; (2) five fine-tuned expert agents generate domain-level predictions; and (3) a coordinator agent performs probabilistic aggregation to produce final staging and phenotyping decisions. We develop and evaluate Dementia-Agents on a real-world clinical cohort of 1,066 patients from two cognitive neurology services. Compared with monolithic multi-modal large language models (MLLMs) and prior medical multi-agent systems, our approach achieves consistent improvements in diagnostic performance for real-world syndrome-level dementia staging and phenotyping, while preserving domain-level interpretability.

NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis

Interpretability is essential for trustworthy medical image diagnosis. However, existing concept-driven interpretable methods have key limitations: Concept Bottleneck Models (CBMs) require scoring all predefined concepts at inference time and for manual intervention, imposing a substantial burden on clinicians, while rationale-based generative approaches often select concepts by class discriminability, which can drift from diagnostic ontologies. To address these issues, we propose Neuro-Symbolic Rule Distillation (NeRD), a framework that produces efficient, ontology-grounded reasoning chains that are sufficient yet non-redundant, without manually crafting diagnostic rules. Experiments on two skin datasets demonstrate strong diagnostic performance and interpretability, and blinded expert evaluation confirms the clinical plausibility of NeRD rationales. Our method further enables a first expert-in-the-loop study for Multimodal Chain-of-Thought-based diagnosis, achieving efficient and effective concept-level intervention.

PeakFocus: Bridging Peak Localization and Intensity Regression via a Unified Multi-Scale Framework for Electricity Load Forecasting

Electricity load peak forecasting (ELPF), simultaneously predicting peak timing and intensity, is a prerequisite for effective grid scheduling and risk management. However, existing methods face three limitations. First, they adopt a two-stage predict-then-locate paradigm, which severs the link between temporal localization and intensity regression. Second, they still struggle with the multi-scale representation conflict, leading to peak misjudgment and timing misalignment. Third, the lack of explicit peak timing context during intensity regression causes intensity smoothing because predictions are dominated by global smoothing trends. To address these limitations, we propose PeakFocus, a unified framework for ELPF. (i) A Unified Peak-Aware Pipeline (UPAP) utilizes a triple hybrid loss to jointly supervise temporal localization and intensity regression, alongside a tolerance-based evaluation protocol. (ii) A Multi-Scale Mixing Peak Locator (MSM-PL) exploits coarse-grained features to mitigate peak misjudgment caused by local fluctuations, and injects them into fine-grained features via a cascade mechanism to resolve timing misalignment. (iii) A Location-Aware Decoder (LAD) injects peak timing context into the intensity regression process, providing explicit guidance to counteract intensity smoothing and improve peak intensity estimation. Extensive experiments on the public Electricity (ELC) dataset and our industrial-scale World Large-scale Electricity Load (WLEL) dataset show that PeakFocus outperforms baselines in both timing precision and intensity estimation.

Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counseling

The increasing use of large language models (LLMs) in mental healthcare raises safety concerns in high-stakes therapeutic interactions. A key challenge is distinguishing therapeutic empathy from maladaptive validation, where supportive responses may inadvertently reinforce harmful beliefs or behaviors in multi-turn conversations. This risk is largely overlooked by existing red-teaming frameworks, which focus mainly on generic harms or optimization-based attacks. To address this gap, we introduce Personality-based Client Simulation Attack (PCSA), the first red-teaming framework that simulates clients in psychological counseling through coherent, persona-driven client dialogues to expose vulnerabilities in psychological safety alignment. Experiments on seven general and mental health-specialized LLMs show that PCSA substantially outperforms four competitive baselines. Perplexity analysis and human inspection further indicate that PCSA generates more natural and realistic dialogues. Our results reveal that current LLMs remain vulnerable to domain-specific adversarial tactics, providing unauthorized medical advice, reinforcing delusions, and implicitly encouraging risky actions.

A Vision-Language Foundation Model for Zero-shot Clinical Collaboration and Automated Concept Discovery in Dermatology

Medical foundation models have shown promise in controlled benchmarks, yet widespread deployment remains hindered by reliance on task-specific fine-tuning. Here, we introduce DermFM-Zero, a dermatology vision-language foundation model trained via masked latent modelling and contrastive learning on over 4 million multimodal data points. We evaluated DermFM-Zero across 20 benchmarks spanning zero-shot diagnosis and multimodal retrieval, achieving state-of-the-art performance without task-specific adaptation. We further evaluated its zero-shot capabilities in three multinational reader studies involving over 1,100 clinicians. In primary care settings, AI assistance enabled general practitioners to nearly double their differential diagnostic accuracy across 98 skin conditions. In specialist settings, the model significantly outperformed board-certified dermatologists in multimodal skin cancer assessment. In collaborative workflows, AI assistance enabled non-experts to surpass unassisted experts while improving management appropriateness. Finally, we show that DermFM-Zero's latent representations are interpretable: sparse autoencoders unsupervisedly disentangle clinically meaningful concepts that outperform predefined-vocabulary approaches and enable targeted suppression of artifact-induced biases, enhancing robustness without retraining. These findings demonstrate that a foundation model can provide effective, safe, and transparent zero-shot clinical decision support.

CHiRPE: A Step Towards Real-World Clinical NLP with Clinician-Oriented Model Explanations

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.

PsychEthicsBench: Evaluating Large Language Models Against Australian Mental Health Ethics

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 \texttt{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.

MAKE: Multi-Aspect Knowledge-Enhanced Vision-Language Pretraining for Zero-shot Dermatological Assessment

Dermatological diagnosis represents a complex multimodal challenge that requires integrating visual features with specialized clinical knowledge. While vision-language pretraining (VLP) has advanced medical AI, its effectiveness in dermatology is limited by text length constraints and the lack of structured texts. In this paper, we introduce MAKE, a Multi-Aspect Knowledge-Enhanced vision-language pretraining framework for zero-shot dermatological tasks. Recognizing that comprehensive dermatological descriptions require multiple knowledge aspects that exceed standard text constraints, our framework introduces: (1) a multi-aspect contrastive learning strategy that decomposes clinical narratives into knowledge-enhanced sub-texts through large language models, (2) a fine-grained alignment mechanism that connects subcaptions with diagnostically relevant image features, and (3) a diagnosis-guided weighting scheme that adaptively prioritizes different sub-captions based on clinical significance prior. Through pretraining on 403,563 dermatological image-text pairs collected from education resources, MAKE significantly outperforms state-of-the-art VLP models on eight datasets across zero-shot skin disease classification, concept annotation, and cross-modal retrieval tasks. Our code will be made publicly available at https: //github.com/SiyuanYan1/MAKE.

Derm1M: A Million-scale Vision-Language Dataset Aligned with Clinical Ontology Knowledge for Dermatology

The emergence of vision-language models has transformed medical AI, enabling unprecedented advances in diagnostic capability and clinical applications. However, progress in dermatology has lagged behind other medical domains due to the lack of standard image-text pairs. Existing dermatological datasets are limited in both scale and depth, offering only single-label annotations across a narrow range of diseases instead of rich textual descriptions, and lacking the crucial clinical context needed for real-world applications. To address these limitations, we present Derm1M, the first large-scale vision-language dataset for dermatology, comprising 1,029,761 image-text pairs. Built from diverse educational resources and structured around a standard ontology collaboratively developed by experts, Derm1M provides comprehensive coverage for over 390 skin conditions across four hierarchical levels and 130 clinical concepts with rich contextual information such as medical history, symptoms, and skin tone. To demonstrate Derm1M potential in advancing both AI research and clinical application, we pretrained a series of CLIP-like models, collectively called DermLIP, on this dataset. The DermLIP family significantly outperforms state-of-the-art foundation models on eight diverse datasets across multiple tasks, including zero-shot skin disease classification, clinical and artifacts concept identification, few-shot/full-shot learning, and cross-modal retrieval. Our dataset and code will be public.

Interpretable Few-Shot Retinal Disease Diagnosis with Concept-Guided Prompting of Vision-Language Models

Recent advancements in deep learning have shown significant potential for classifying retinal diseases using color fundus images. However, existing works predominantly rely exclusively on image data, lack interpretability in their diagnostic decisions, and treat medical professionals primarily as annotators for ground truth labeling. To fill this gap, we implement two key strategies: extracting interpretable concepts of retinal diseases using the knowledge base of GPT models and incorporating these concepts as a language component in prompt-learning to train vision-language (VL) models with both fundus images and their associated concepts. Our method not only improves retinal disease classification but also enriches few-shot and zero-shot detection (novel disease detection), while offering the added benefit of concept-based model interpretability. Our extensive evaluation across two diverse retinal fundus image datasets illustrates substantial performance gains in VL-model based few-shot methodologies through our concept integration approach, demonstrating an average improvement of approximately 5.8\% and 2.7\% mean average precision for 16-shot learning and zero-shot (novel class) detection respectively. Our method marks a pivotal step towards interpretable and efficient retinal disease recognition for real-world clinical applications.