A multilingual medical VQA benchmark over eight languages is constructed, organized into four representative scenarios that isolate the core capabilities medical VQA requires, and a training-free scenario-aware representation engineering method is proposed, leveraging LVLMs's superior English medical VQA capability to steer non-English representations toward their English counterparts at inference time.
Abstract
Medical visual question answering (VQA) is a crucial task in clinical AI, yet its evaluation has so far centered almost exclusively on English, limiting its relevance to linguistically diverse patients and clinicians. Recent multilingual medical VQA benchmarks show that large vision-language models (LVLMs) degrade in non-English languages, but lack a fine-grained analysis of how cross-lingual variation affects the distinct capabilities that medical VQA requires. To this end, we construct a multilingual medical VQA benchmark over eight languages, organized into four representative scenarios that isolate the core capabilities medical VQA requires. Evaluating five open- and closed-source LVLMs, we find that cross-lingual degradation is not uniform but highly scenario-dependent. We therefore propose MedVL-XLRepE, a training-free scenario-aware representation engineering method, leveraging LVLMs'superior English medical VQA capability to steer non-English representations toward their English counterparts at inference time. Across three LVLMs and eight languages, MedVL-XLRepE consistently mitigates cross-lingual degradation, with gains of up to 6.33\%.
It is shown that mechanistic diagnosis can serve as a practical guide for targeted adaptation in underrepresented-language medical LLMs, and Targeted Low-Rank Adaptation (TLoRA) is proposed, restricted to the layer window where cross-lingual representations diverge, upstream of the output layers where the failure manifests.
Chaimae Abouzahir, Musa Khan, Hala Ali-Hassan et al.· 0 citations
BEAR-Bench (Bilingual Enterprise and Academic Reasoning), a self-contained, complex English-and-Russian benchmark comprising 1000 human-annotated questions based on text-rich business and scientific documents, is introduced, and existing hallucination detection methods are compared.
L. Chubarova, A. Kuleshova, D. P. Volkov et al.· 0 citations
This work investigates the impact of cross-lingual prompt injection attacks on LLM-based relevance judgments using TREC Deep Learning collections and two open-weight models under established prompting frameworks, and demonstrates that multilingual query-based injections are highly effective in inflating relevance scores while simultaneously evading existing prompt-injection defenses.
We present L3Cube-IndicQuest v2, a large-scale gold-standard multilingual question-answering benchmark for evaluating the India-specific factual knowledge of Large Language Models (LLMs). The benchmark comprises 3,471 curriculum-grounded English question--answer pairs spanning nine domains, curated from educational curricula, competitive examination materials, and domain-specific reference books. We introduce a practical hybrid construction strategy that combines context-grounded LLM-based question generation and validation with semantic deduplication and human verification, enabling scalable creation of benchmark data while preserving annotation quality. The benchmark is translated into 19 Indic languages, yielding a publicly released multilingual dataset of 69,420 question--answer pairs across 20 languages. We evaluate six LLMs under three protocols: LLM-as-a-judge and two deterministic lexical criteria, exact-substring and word-overlap matching. All three produce almost the same model ranking, showing that the results do not depend on the choice of judge. The frontier commercial model leads by a wide margin, and among open-weight models Gemma4 31B outperforms the Indic-specialised Sarvam 30B in every evaluated Indic language.
Rinit Jain, Tirthraj Mahajan, Advait Joshi et al.· 0 citations
As large vision-language models (LVLMs) are deployed globally, the combination of multilingual instructions and visual information makes malicious attacks more covert and sophisticated than ever before. However, existing methods isolate language and modality defenses, which, coupled with the scarcity of safety data and high fine-tuning costs, makes it difficult for models to defend against compound attacks. To address this severe challenge, we propose a neuron-level cross-dimensional safety alignment framework driven by modality- and language-shared safety neurons (MLS-Neurons). First, we identify monolingual and unimodal safety neurons by comparing responses to harmful and benign samples, quantifying functional saliency through activation strength and downstream impact. Then, by intersecting these unimodal neurons within each language, we extract modality-shared safety neurons (MS-Neurons) responsive to both visual and textual risks, bridging the safety representation gap between modalities. Furthermore, using English as a semantic anchor, we intersect MS-Neurons across languages to identify modality- and language-shared safety neurons (MLS-Neurons), serving as key defenses against compound attacks. Finally, we update only this minimal subset of shared neurons (~0.03% of parameters), transferring English-only safety supervision to multilingual and multimodal scenarios. Extensive experiments show that our method significantly outperforms state-of-the-art approaches across diverse multilingual and multimodal safety benchmarks while preserving general utility.
Enyi Shi, Fei Shen, Chuancheng Shi et al.· 0 citations
Model editing promises a fast, targeted way to correct post-deployment mistakes in medical vision-language models (VLMs) without costly retraining. However, existing multimodal model editing benchmarks focus on general-purpose tasks and do not reflect realistic clinical domain requirements and variability. To address this, we introduce M3Bench, a clinically grounded benchmark for multimodal model editing that evaluates whether an edit remains reliable, precise, and generalizable under the challenges of image and text variation, modality and protocol shifts, clinical knowledge composition, and temporal progression. M3Bench contains 16,276 questions spanning diverse anatomy, modalities, and specialties, and supports both single and sequential edits. By evaluating 4 representative editors across 6 medical and general VLMs, we find that no method excels across all criteria. Gradient-based editors achieve strong transfer but suffer from catastrophic locality violations, whereas memory-based methods preserve locality but lack compositional generality and exhibit high backbone-dependent hyperparameter sensitivity. We further attribute these failures to the latent space geometry of VLMs and how different editing methods shift its landscape. Overall, M3Bench establishes a rigorous clinical stress test for multimodal model editing and offers actionable guidance for safer post-deployment adaptation. The benchmark is publicly available at https://github.com/BioMed-AI-Lab-U-Michgan/M3Bench .