Balancing Knowledge Delivery and Emotional Comfort in Healthcare Conversational Systems

With the advancement of large language models, many dialogue systems are now capable of providing reasonable and informative responses to patients' medical conditions. However, when patients consult their doctor, they may experience negative emotions due to the severity and urgency of their situation. If the model can provide appropriate comfort and empathy based on the patient's negative emotions while answering medical questions, it will likely offer a more reassuring experience during the medical consultation process. To address this issue, our paper explores the balance between knowledge sharing and emotional support in the healthcare dialogue process. We utilize a large language model to rewrite a real-world interactive medical dialogue dataset, generating patient queries with negative emotions and corresponding medical responses aimed at soothing the patient's emotions while addressing their concerns. The modified data serves to refine the latest large language models with various fine-tuning methods, enabling them to accurately provide sentences with both emotional reassurance and constructive suggestions in response to patients' questions. Compared to the original LLM model, our experimental results demonstrate that our methodology significantly enhances the model's ability to generate emotional responses while maintaining its original capability to provide accurate knowledge-based answers.

Post Persona Alignment for Multi-Session Dialogue Generation

Multi-session persona-based dialogue generation presents challenges in maintaining long-term consistency and generating diverse, personalized responses. While large language models (LLMs) excel in single-session dialogues, they struggle to preserve persona fidelity and conversational coherence across extended interactions. Existing methods typically retrieve persona information before response generation, which can constrain diversity and result in generic outputs. We propose Post Persona Alignment (PPA), a novel two-stage framework that reverses this process. PPA first generates a general response based solely on dialogue context, then retrieves relevant persona memories using the response as a query, and finally refines the response to align with the speaker's persona. This post-hoc alignment strategy promotes naturalness and diversity while preserving consistency and personalization. Experiments on multi-session LLM-generated dialogue data demonstrate that PPA significantly outperforms prior approaches in consistency, diversity, and persona relevance, offering a more flexible and effective paradigm for long-term personalized dialogue generation.

Enhancing Medical Dialogue Generation through Knowledge Refinement and Dynamic Prompt Adjustment

Medical dialogue systems (MDS) have emerged as crucial online platforms for enabling multi-turn, context-aware conversations with patients. However, existing MDS often struggle to (1) identify relevant medical knowledge and (2) generate personalized, medically accurate responses. To address these challenges, we propose MedRef, a novel MDS that incorporates knowledge refining and dynamic prompt adjustment. First, we employ a knowledge refining mechanism to filter out irrelevant medical data, improving predictions of critical medical entities in responses. Additionally, we design a comprehensive prompt structure that incorporates historical details and evident details. To enable real-time adaptability to diverse patient conditions, we implement two key modules, Triplet Filter and Demo Selector, providing appropriate knowledge and demonstrations equipped in the system prompt. Extensive experiments on MedDG and KaMed benchmarks show that MedRef outperforms state-of-the-art baselines in both generation quality and medical entity accuracy, underscoring its effectiveness and reliability for real-world healthcare applications.

Large Language Model-Powered Conversational Agent Delivering Problem-Solving Therapy (PST) for Family Caregivers: Enhancing Empathy and Therapeutic Alliance Using In-Context Learning

Family caregivers often face substantial mental health challenges due to their multifaceted roles and limited resources. This study explored the potential of a large language model (LLM)-powered conversational agent to deliver evidence-based mental health support for caregivers, specifically Problem-Solving Therapy (PST) integrated with Motivational Interviewing (MI) and Behavioral Chain Analysis (BCA). A within-subject experiment was conducted with 28 caregivers interacting with four LLM configurations to evaluate empathy and therapeutic alliance. The best-performing models incorporated Few-Shot and Retrieval-Augmented Generation (RAG) prompting techniques, alongside clinician-curated examples. The models showed improved contextual understanding and personalized support, as reflected by qualitative responses and quantitative ratings on perceived empathy and therapeutic alliances. Participants valued the model's ability to validate emotions, explore unexpressed feelings, and provide actionable strategies. However, balancing thorough assessment with efficient advice delivery remains a challenge. This work highlights the potential of LLMs in delivering empathetic and tailored support for family caregivers.

When Large Language Models are Reliable for Judging Empathic Communication

Large language models (LLMs) excel at generating empathic responses in text-based conversations. But, how reliably do they judge the nuances of empathic communication? We investigate this question by comparing how experts, crowdworkers, and LLMs annotate empathic communication across four evaluative frameworks drawn from psychology, natural language processing, and communications applied to 200 real-world conversations where one speaker shares a personal problem and the other offers support. Drawing on 3,150 expert annotations, 2,844 crowd annotations, and 3,150 LLM annotations, we assess inter-rater reliability between these three annotator groups. We find that expert agreement is high but varies across the frameworks' sub-components depending on their clarity, complexity, and subjectivity. We show that expert agreement offers a more informative benchmark for contextualizing LLM performance than standard classification metrics. Across all four frameworks, LLMs consistently approach this expert level benchmark and exceed the reliability of crowdworkers. These results demonstrate how LLMs, when validated on specific tasks with appropriate benchmarks, can support transparency and oversight in emotionally sensitive applications including their use as conversational companions.

Intent Factored Generation: Unleashing the Diversity in Your Language Model

Obtaining multiple meaningfully diverse, high quality samples from Large Language Models for a fixed prompt remains an open challenge. Current methods for increasing diversity often only operate at the token-level, paraphrasing the same response. This is problematic because it leads to poor exploration on reasoning problems and to unengaging, repetitive conversational agents. To address this we propose Intent Factored Generation (IFG), factorising the sampling process into two stages. First, we sample a semantically dense intent, e.g., a summary or keywords. Second, we sample the final response conditioning on both the original prompt and the intent from the first stage. This allows us to use a higher temperature during the intent step to promote conceptual diversity, and a lower temperature during the final generation to ensure the outputs are coherent and self-consistent. Additionally, we find that prompting the model to explicitly state its intent for each step of the chain-of-thought before generating the step is beneficial for reasoning tasks. We demonstrate our method's effectiveness across a diverse set of tasks. We show this method improves both pass@k and Reinforcement Learning from Verifier Feedback on maths and code tasks. For instruction-tuning, we combine IFG with Direct Preference Optimisation to increase conversational diversity without sacrificing reward. Finally, we achieve higher diversity while maintaining the quality of generations on a general language modelling task, using a new dataset of reader comments and news articles that we collect and open-source. In summary, we present a simple method of increasing the sample diversity of LLMs while maintaining performance. This method can be implemented by changing the prompt and varying the temperature during generation, making it easy to integrate into many algorithms for gains across various applications.

MedSeg-R: Reasoning Segmentation in Medical Images with Multimodal Large Language Models

Medical image segmentation is crucial for clinical diagnosis, yet existing models are limited by their reliance on explicit human instructions and lack the active reasoning capabilities to understand complex clinical questions. While recent advancements in multimodal large language models (MLLMs) have improved medical question-answering (QA) tasks, most methods struggle to generate precise segmentation masks, limiting their application in automatic medical diagnosis. In this paper, we introduce medical image reasoning segmentation, a novel task that aims to generate segmentation masks based on complex and implicit medical instructions. To address this, we propose MedSeg-R, an end-to-end framework that leverages the reasoning abilities of MLLMs to interpret clinical questions while also capable of producing corresponding precise segmentation masks for medical images. It is built on two core components: 1) a global context understanding module that interprets images and comprehends complex medical instructions to generate multi-modal intermediate tokens, and 2) a pixel-level grounding module that decodes these tokens to produce precise segmentation masks and textual responses. Furthermore, we introduce MedSeg-QA, a large-scale dataset tailored for the medical image reasoning segmentation task. It includes over 10,000 image-mask pairs and multi-turn conversations, automatically annotated using large language models and refined through physician reviews. Experiments show MedSeg-R's superior performance across several benchmarks, achieving high segmentation accuracy and enabling interpretable textual analysis of medical images.

A Conjecture on a Fundamental Trade-Off between Certainty and Scope in Symbolic and Generative AI

This article introduces a conjecture that formalises a fundamental trade-off between provable correctness and broad data-mapping capacity in Artificial Intelligence (AI) systems. When an AI system is engineered for deductively watertight guarantees (demonstrable certainty about the error-free nature of its outputs) -- as in classical symbolic AI -- its operational domain must be narrowly circumscribed and pre-structured. Conversely, a system that can input high-dimensional data to produce rich information outputs -- as in contemporary generative models -- necessarily relinquishes the possibility of zero-error performance, incurring an irreducible risk of errors or misclassification. By making this previously implicit trade-off explicit and open to rigorous verification, the conjecture significantly reframes both engineering ambitions and philosophical expectations for AI. After reviewing the historical motivations for this tension, the article states the conjecture in information-theoretic form and contextualises it within broader debates in epistemology, formal verification, and the philosophy of technology. It then offers an analysis of its implications and consequences, drawing on notions of underdetermination, prudent epistemic risk, and moral responsibility. The discussion clarifies how, if correct, the conjecture would help reshape evaluation standards, governance frameworks, and hybrid system design. The conclusion underscores the importance of eventually proving or refuting the inequality for the future of trustworthy AI.

"Is This Really a Human Peer Supporter?": Misalignments Between Peer Supporters and Experts in LLM-Supported Interactions

Mental health is a growing global concern, prompting interest in AI-driven solutions to expand access to psychosocial support. Peer support, grounded in lived experience, offers a valuable complement to professional care. However, variability in training, effectiveness, and definitions raises concerns about quality, consistency, and safety. Large Language Models (LLMs) present new opportunities to enhance peer support interactions, particularly in real-time, text-based interactions. We present and evaluate an AI-supported system with an LLM-simulated distressed client, context-sensitive LLM-generated suggestions, and real-time emotion visualisations. 2 mixed-methods studies with 12 peer supporters and 5 mental health professionals (i.e., experts) examined the system's effectiveness and implications for practice. Both groups recognised its potential to enhance training and improve interaction quality. However, we found a key tension emerged: while peer supporters engaged meaningfully, experts consistently flagged critical issues in peer supporter responses, such as missed distress cues and premature advice-giving. This misalignment highlights potential limitations in current peer support training, especially in emotionally charged contexts where safety and fidelity to best practices are essential. Our findings underscore the need for standardised, psychologically grounded training, especially as peer support scales globally. They also demonstrate how LLM-supported systems can scaffold this development--if designed with care and guided by expert oversight. This work contributes to emerging conversations on responsible AI integration in mental health and the evolving role of LLMs in augmenting peer-delivered care.

OneSug: The Unified End-to-End Generative Framework for E-commerce Query Suggestion

Query suggestion plays a crucial role in enhancing user experience in e-commerce search systems by providing relevant query recommendations that align with users' initial input. This module helps users navigate towards personalized preference needs and reduces typing effort, thereby improving search experience. Traditional query suggestion modules usually adopt multi-stage cascading architectures, for making a well trade-off between system response time and business conversion. But they often suffer from inefficiencies and suboptimal performance due to inconsistent optimization objectives across stages. To address these, we propose OneSug, the first end-to-end generative framework for e-commerce query suggestion. OneSug incorporates a prefix2query representation enhancement module to enrich prefixes using semantically and interactively related queries to bridge content and business characteristics, an encoder-decoder generative model that unifies the query suggestion process, and a reward-weighted ranking strategy with behavior-level weights to capture fine-grained user preferences. Extensive evaluations on large-scale industry datasets demonstrate OneSug's ability for effective and efficient query suggestion. Furthermore, OneSug has been successfully deployed for the entire traffic on the e-commerce search engine in Kuaishou platform for over 1 month, with statistically significant improvements in user top click position (-9.33%), CTR (+2.01%), Order (+2.04%), and Revenue (+1.69%) over the online multi-stage strategy, showing great potential in e-commercial conversion.