Usman Naseem

Shenyan Zheng, Jiayou Zhong, Anudeex Shetty et al.

As large language models are increasingly used in high-stakes domains, it is essential that their outputs reflect not average} human preference, rather range of varying perspectives. Achieving such pluralism, however, remains challenging. Existing approaches consider limited values or rely on prompt-level interventions, lacking value control and representation. To address this, we introduce VISPA, a training-free pluralistic alignment framework, that enables direct control over value expression by dynamic selection and internal model activation steering. Across extensive empirical studies spanning multiple models and evaluation settings, we show VISPA is performant across all pluralistic alignment modes in healthcare and beyond. Further analysis reveals VISPA is adaptable with different steering initiations, model, and/or values. These results suggest that pluralistic alignment can be achieved through internal activation mechanisms, offering a scalable path toward language models that serves all.

Sushant Kumar Ray, Gautam Siddharth Kashyap, Sahil Tripathi et al.

Clinical Question-Answering (CQA) industry systems are increasingly rely on Large Language Models (LLMs), yet their deployment is often guided by the assumption that domain-specific fine-tuning is essential. Although specialised medical LLMs such as BioBERT, BioGPT, and PubMedBERT remain popular, they face practical limitations including narrow coverage, high retraining costs, and limited adaptability. Efforts based on Supervised Fine-Tuning (SFT) have attempted to address these assumptions but continue to reinforce what we term the SPECIALISATION FALLACY-the belief that specialised medical LLMs are inherently superior for CQA. To address this assumption, we introduce MEDASSESS-X, a deployment-industry-oriented CQA framework that applies alignment at inference time rather than through SFT. MEDASSESS-X uses lightweight steering vectors to guide model activations toward medically consistent reasoning without updating model weights or requiring domain-specific retraining. This inference-time alignment layer stabilises CQA performance across both general-purpose and specialised medical LLMs, thereby resolving the SPECIALISATION FALLACY. Empirically, MEDASSESS-X delivers consistent gains across all LLM families, improving Accuracy by up to +6%, Factual Consistency by +7%, and reducing Safety Error Rate by as much as 50%.