Chenxiao Fan

Bohao Wang, Yu Cui, Zhenxiang Xu et al.

The field of recommender systems (RS) is currently undergoing two profound paradigm shifts. From the perspective of objectives, the goal has shifted beyond mere recommendation accuracy to comprehensive trustworthiness, encompassing multiple dimensions such as robustness, fairness, and privacy preservation. From a technical perspective, Large Language Models (LLMs) have been extensively integrated into RS, reshaping the foundations of recommendation through richer semantic understanding, stronger intent reasoning, and more flexible user interactions. The convergence of these two shifts prompts a timely and pivotal question: how does the integration of LLMs reshape the landscape of trustworthy recommendation? In this work, we present a systematic review of trustworthy LLM-empowered recommendation. By comprehensively analyzing over 200 recent studies, we reveal that the introduction of LLMs acts as a double-edged sword. While their advanced mechanisms and user-friendly interfaces offer unprecedented opportunities to enhance trustworthiness, they simultaneously introduce new risks, such as novel forms of bias and hallucination-induced issues. To characterize this dual impact, we systematically identify 13 opportunities and 18 challenges across six fundamental dimensions of trustworthiness, and accordingly organize the existing literature into a novel taxonomy. We also provide a comprehensive review of commonly used datasets and evaluation metrics to facilitate empirical validation. Finally, we identify critical open challenges and outline future directions, hoping to inspire future research on this emerging topic.

Chenxiao Fan, Chongming Gao, Wentao Shi et al.

Accurate and safe medication recommendations are critical for effective clinical decision-making, especially in multimorbidity cases. However, existing systems rely on point-wise prediction paradigms that overlook synergistic drug effects and potential adverse drug-drug interactions (DDIs). We propose FLAME, a fine-grained list-wise alignment framework for large language models (LLMs), enabling drug-by-drug generation of drug lists. FLAME formulates recommendation as a sequential decision process, where each step adds or removes a single drug. To provide fine-grained learning signals, we devise step-wise Group Relative Policy Optimization (GRPO) with potential-based reward shaping, which explicitly models DDIs and optimizes the contribution of each drug to the overall prescription. Furthermore, FLAME enhances patient modeling by integrating structured clinical knowledge and collaborative information into the representation space of LLMs. Experiments on benchmark datasets demonstrate that FLAME achieves state-of-the-art performance, delivering superior accuracy, controllable safety-accuracy trade-offs, and strong generalization across diverse clinical scenarios. Our code is available at https://github.com/cxfann/Flame.

Yaxin Gong, Chongming Gao, Chenxiao Fan et al.

Recent advances in large language models (LLMs) have stimulated growing interest in agent-based recommender systems, enabling language-driven interaction and reasoning for more expressive preference modeling. However, most existing agentic approaches remain predominantly user-centric, treating items as passive entities and neglecting the interests of other critical stakeholders. This limitation exacerbates exposure concentration and long-tail under-representation, threatening long-term system sustainability. In this work, we identify this fundamental limitation and propose the first Tri-party LLM-agent Recommendation framework (TriRec) that explicitly coordinates user utility, item exposure, and platform-level fairness. The framework employs a two-stage architecture: Stage~1 empowers item agents with personalized self-promotion to improve matching quality and alleviate cold-start barriers, while Stage~2 uses a platform agent for sequential multi-objective re-ranking, balancing user relevance, item utility, and exposure fairness. Experiments on multiple benchmarks show consistent gains in accuracy, fairness, and item-level utility. Moreover, we find that item self-promotion can simultaneously enhance fairness and effectiveness, challenging the conventional trade-off assumption between relevance and fairness. Our code is available at https://github.com/Marfekey/TriRec.

Xiaohan Ren, Chenxiao Fan, Wenyin Ma et al.

Large language models (LLMs) have achieved strong performance on medical exam-style tasks, motivating growing interest in their deployment in real-world clinical settings. However, clinical decision-making is inherently safety-critical, context-dependent, and conducted under evolving evidence. In such situations, reliable LLM performance depends not on factual recall alone, but on robust medical reasoning. In this work, we present a comprehensive review of medical reasoning with LLMs. Grounded in cognitive theories of clinical reasoning, we conceptualize medical reasoning as an iterative process of abduction, deduction, and induction, and organize existing methods into seven major technical routes spanning training-based and training-free approaches. We further conduct a unified cross-benchmark evaluation of representative medical reasoning models under a consistent experimental setting, enabling a more systematic and comparable assessment of the empirical impact of existing methods. To better assess clinically grounded reasoning, we introduce MR-Bench, a benchmark derived from real-world hospital data. Evaluations on MR-Bench expose a pronounced gap between exam-level performance and accuracy on authentic clinical decision tasks. Overall, this survey provides a unified view of existing medical reasoning methods, benchmarks, and evaluation practices, and highlights key gaps between current model performance and the requirements of real-world clinical reasoning.

Yiqing Shen, Chenxiao Fan, Chenjia Li et al.

The goal of text-to-video retrieval is to search large databases for relevant videos based on text queries. Existing methods have progressed to handling explicit queries where the visual content of interest is described explicitly; however, they fail with implicit queries where identifying videos relevant to the query requires reasoning. We introduce reasoning text-to-video retrieval, a paradigm that extends traditional retrieval to process implicit queries through reasoning while providing object-level grounding masks that identify which entities satisfy the query conditions. Instead of relying on vision-language models directly, we propose representing video content as digital twins, i.e., structured scene representations that decompose salient objects through specialist vision models. This approach is beneficial because it enables large language models to reason directly over long-horizon video content without visual token compression. Specifically, our two-stage framework first performs compositional alignment between decomposed sub-queries and digital twin representations for candidate identification, then applies large language model-based reasoning with just-in-time refinement that invokes additional specialist models to address information gaps. We construct a benchmark of 447 manually created implicit queries with 135 videos (ReasonT2VBench-135) and another more challenging version of 1000 videos (ReasonT2VBench-1000). Our method achieves 81.2% R@1 on ReasonT2VBench-135, outperforming the strongest baseline by greater than 50 percentage points, and maintains 81.7% R@1 on the extended configuration while establishing state-of-the-art results in three conventional benchmarks (MSR-VTT, MSVD, and VATEX).

Jiaju Chen, Chongming Gao, Chenxiao Fan et al.

Large language model (LLM)-based generative list-wise recommendation has advanced rapidly, but decoding remains sequential and thus latency-prone. To accelerate inference without changing the target distribution, speculative decoding (SD) uses a small draft model to propose several next tokens at once and a target LLM to verify and accept the longest prefix, skipping multiple steps per round. In generative recommendation, however, each item is represented by multiple semantic-ID tokens, often with separators, and current drafts typically treat these tokens uniformly. This overlooks two practical facts: (i) a token's semantics depend on its within-item slot, and (ii) uncertainty tends to increase with speculation depth. Without modeling these effects, SD's speedups can be limited. We introduce PAD-Rec, Position-Aware Drafting for generative Recommendation, a lightweight module that augments the draft model with two complementary signals. Item position embeddings explicitly encode the within-item slot of each token, strengthening structural awareness. Step position embeddings encode the draft step, allowing the model to adapt to depth-dependent uncertainty and improve proposal quality. To harmonize these signals with base features, we add simple gates: a learnable coefficient for item slots and a context-driven gate for draft steps. The module is trainable, easy to integrate with standard draft models, and adds negligible inference overhead. Extensive experiments on four real-world datasets show up to 3.1x wall-clock speedup and about 5% average wall-clock speedup gain over strong SD baselines, while largely preserving recommendation quality.

Yiqing Shen, Chenjia Li, Chenxiao Fan et al.

Visual reasoning, the capability to interpret visual input in response to implicit text query through multi-step reasoning, remains a challenge for deep learning models due to the lack of relevant benchmarks. Previous work in visual reasoning has primarily focused on reasoning segmentation, where models aim to segment objects based on implicit text queries. This paper introduces reasoning visual tasks (RVTs), a unified formulation that extends beyond traditional video reasoning segmentation to a diverse family of visual language reasoning problems, which can therefore accommodate multiple output formats including bounding boxes, natural language descriptions, and question-answer pairs. Correspondingly, we identify the limitations in current benchmark construction methods that rely solely on large language models (LLMs), which inadequately capture complex spatial-temporal relationships and multi-step reasoning chains in video due to their reliance on token representation, resulting in benchmarks with artificially limited reasoning complexity. To address this limitation, we propose a novel automated RVT benchmark construction pipeline that leverages digital twin (DT) representations as structured intermediaries between perception and the generation of implicit text queries. Based on this method, we construct RVTBench, a RVT benchmark containing 3,896 queries of over 1.2 million tokens across four types of RVT (segmentation, grounding, VQA and summary), three reasoning categories (semantic, spatial, and temporal), and four increasing difficulty levels, derived from 200 video sequences. Finally, we propose RVTagent, an agent framework for RVT that allows for zero-shot generalization across various types of RVT without task-specific fine-tuning.

Yiqing Shen, Chenjia Li, Chenxiao Fan et al.

Conventional approaches to video segmentation are confined to predefined object categories and cannot identify out-of-vocabulary objects, let alone objects that are not identified explicitly but only referred to implicitly in complex text queries. This shortcoming limits the utility for video segmentation in complex and variable scenarios, where a closed set of object categories is difficult to define and where users may not know the exact object category that will appear in the video. Such scenarios can arise in operating room video analysis, where different health systems may use different workflows and instrumentation, requiring flexible solutions for video analysis. Reasoning segmentation (RS) now offers promise towards such a solution, enabling natural language text queries as interaction for identifying object to segment. However, existing video RS formulation assume that target objects remain contextually relevant throughout entire video sequences. This assumption is inadequate for real-world scenarios in which objects of interest appear, disappear or change relevance dynamically based on temporal context, such as surgical instruments that become relevant only during specific procedural phases or anatomical structures that gain importance at particular moments during surgery. Our first contribution is the introduction of temporally-constrained video reasoning segmentation, a novel task formulation that requires models to implicitly infer when target objects become contextually relevant based on text queries that incorporate temporal reasoning. Since manual annotation of temporally-constrained video RS datasets would be expensive and limit scalability, our second contribution is an innovative automated benchmark construction method. Finally, we present TCVideoRSBenchmark, a temporally-constrained video RS dataset containing 52 samples using the videos from the MVOR dataset.