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01.
medRxiv (Medicine) 2026-06-22

A Parent-Generated Framework of Early Connection: Findings from a CBPR Qualitative Study

Background: Early relational health (ERH) constructs are derived fromresearch observations rather than lived experiences. This study foregrounds diverse parent voices to examine how they describeconnectionwith their young children. Methods: Usingcommunity-based participatory research (CBPR),this study was co-designed withparent leadersfromReach Out and Read. A semi-structured interview guidewas co-designed,and parent leaderssubsequentlyconducted and transcribed 18 interviews with parents from their networks.Researchersanalyzed transcripts using Reflexive Thematic Analysis.Member checking sessions with parent leadersinformedthe analytic framework. Results:Sixorganizing principleswereidentified.(1) Parent-child connection begins with an instinctual sense of responsibility.(2)Connectionebbs and flows as parent and child adapt to one another through dailyactivities.(3) Family circumstances, including family structure, cultural expectations, and intergenerational values, directly shape this connection. (4) Parents' own upbringings and past relationships indirectly shape how they connect with their child. (5) Forconnectionto grow, parents must show up physically and emotionally for their children despite competing demands. (6) Parentsgrow through engaged parenting, and that growth feeds back into the connection, creating a self-sustaining cycle of relational health.Conclusions:Our analysis generated twoconstructs underspecified in ERH frameworks.Parents described their sense of responsibility as immediate and instinctual, preceding an emotional bond.Parentsdemonstratedtheir agency in deciding what to carry forward from their relational histories, a pattern this study termsrelational legacy. Integrating parent-generated language into ERH measurementresearchmay shape a more comprehensive picture of ERHreflectinghow families experience connection.

03.
arXiv (quant-ph) 2026-06-11

The quantum harmonic oscillator and the real Hilbert space

arXiv:2606.12060v1 Announce Type: new Abstract: The harmonic oscillator is considered within generalized frameworks using complex and quaternionic numbers. The classical oscillator is considered in terms of a complex position function, and quantum oscillators are examined in terms of complex wave functions, and in terms of quaternionic wave functions as well. Both of the quantum solutions are obtained within the real Hilbert space formalism. The results reveal the complex and quaternionic descriptions as suitable frameworks for non-stationary processes, including damped oscillations, forced oscillations, and additionally self-interacting processes that cannot be appropriately described otherwise.

04.
arXiv (CS.LG) 2026-06-19

Influence-Guided Concolic Testing of Transformer Robustness

arXiv:2509.23806v2 Announce Type: replace-cross Abstract: Concolic testing for neural networks alternates concrete execution with constraint solving to search for inputs that flip model decisions. We present a concolic tester for Transformer classifiers that uses SHAP estimates to rank pending path predicates by their impact on the current prediction. To support self-attention with multiple heads in execution backed by SMT solving, we implement attention semantics in pure Python that are compatible with the solver and make the softmax boundary explicit by concretizing exponentiation arguments. We evaluate our method on CIFAR-10 across three compact Transformer classifiers, ResNet18, and VGG16 under a one-pixel budget and a 900s horizon. Across the 500 model–input pairs in this matched comparison, our method achieves 60% success, compared with 15% for a differential evolution baseline that treats the model as a black box. In the primary two-layer Transformer branch-ordering study, SHAP-based predicate prioritization raises success from 56% to 60% and reduces median attack time by 51%. These results show that influence-guided path exploration can make concolic testing a practical way to find adversarial examples in Transformer models.

05.
arXiv (CS.CV) 2026-06-25

SSMNBench: Diagnosing Image-based Cross-View Human-Object Understanding via Single-View Sufficiency and Multi-View Necessity

Multimodal Large Language Models (MLLMs) have shown remarkable progress in single-image perception, yet their ability to reason about complex cross-view human-centric scenes remains largely unverified. Current multi-view benchmarks evaluate models using a fixed "bag of frames" and thus conflate a model's robustness to visual distraction with its genuine ability to fuse fragmented cross-view evidence. To address this issue, we introduce SSMNBench, a diagnostic benchmark comprising 3,300 curated QA pairs for cross-view human and human-object understanding. SSMNBench uniquely categorizes tasks into Single-View Sufficiency (SVS) and Multi-View Necessity (MVN). By systematically perturbing view availability across 17 state-of-the-art MLLMs, critical limitations are revealed: models suffer from severe "distraction degradation" when presented with redundant views (SVS), and fail to integrate fragmented geometric evidence across cameras (MVN). Our evaluations demonstrate that modern MLLMs rely on multiple single-image semantic averaging and view preference rather than genuine cross-view synthesis. By exposing these fundamental vulnerabilities, SSMNBench provides a rigorous diagnostic framework to drive the advancement of future cross-view-aware multimodal architectures. The code is available at: $ \href{https://github.com/gtc-gh/SSMNBench}{SSMNBench} $

06.
arXiv (CS.AI) 2026-06-12

Nous: An Attempt to Extract and Inject the Cognition Behind Prediction-Market Behavior

作者:

arXiv:2606.13038v1 Announce Type: new Abstract: As LLM agents proliferate in prediction markets and collective decision-making, they risk a cognitive monoculture: agents built on shared foundation models produce correlated forecasts, and recent measurement finds frontier-model errors correlated at r ~ 0.77. We ask whether human cognitive diversity can be recovered from behavior and transferred to LLM agents. Nous extracts a structured eight-dimension behavioral profile from real Polymarket trading activity and injects it into agents through prompts. Our central finding is a dissociation between the two halves of that pipeline. Extraction works, partially: across 100 wallets, 8 of 14 parameters are temporally stable (split-half ICC >= 0.5, bootstrap CI lower bound > 0.3; contrarian score reaches ICC ~ 0.9); wallets are identifiable from their profiles well above chance (top-1 retrieval 17-22% vs. 1% chance); and two of four pre-specified dimensions rank-correlate with future realized profit out-of-sample, though the correlations do not survive behavioral-confound controls. Prompt-level injection does not measurably transmit it: on a semantic embedding metric, structured injection shows no significant advantage over a length-matched control on any model, and the diversity it induces neither reduces ensemble error correlation nor improves Brier score – a null that persists across exploratory checks on sampling temperature, profile diversity, and question difficulty. Measuring the prompts themselves locates the compression before the model: the structure-to-narrative translator emits near-uniform prompts whose spread does not track profile spread. We position Nous as measuring the cognitive-monoculture problem and the limits of a prompt-level remedy, motivating deeper, below-the-prompt injection (fine-tuning, activation steering). Code, frozen profiles, prompts, and model outputs: https://github.com/WillChienT/nous-paper

07.
arXiv (quant-ph) 2026-06-16

Semiclassical Gravity Efficiently Solves $\mathsf{NP}$-Complete Problems

arXiv:2606.14806v1 Announce Type: cross Abstract: Assuming the gravitational field is classical and that it couples to quantum fields via the semiclassical Einstein field equations, we show that the weak-field dynamics of a massive and non-relativistic qubit can in principle be used to solve an $\mathsf{NP}$-complete problem in polynomial time. We attribute this vast computational power to the non-linear dynamics afforded by the semiclassical Einstein field equations. Consequently, the above two assumptions entail a violation of the Physical Extended Church–Turing Thesis, which we regard as evidence for the quantization of gravity.

08.
arXiv (CS.LG) 2026-06-18

Acceleration of an algebraic multigrid pressure solver using graph neural networks

arXiv:2606.19251v1 Announce Type: cross Abstract: Solving the pressure-Poisson equation remains the primary computational bottleneck in incompressible unstructured flow solvers primarily due to the inherent sensitivity of traditional linear solvers to mesh irregularities. This work introduces a data-driven algebraic multigrid (AMG) smoother that uses a modified graph convolutional isomorphism network (GCIN). The graph neural network predicts optimal polynomial coefficients to construct a sparse pseudo-inverse operator across diverse grid topologies. The coefficients are optimized to reduce the residual after each V-cycle iteration. By directly capturing the algebraic structure of the system from the sparse coefficient matrix, the proposed method maintains the solver's linearity while adapting to local anisotropies in unstructured grids. Our framework demonstrates significant performance gains by reducing the number of V-cycles required for a given tolerance and delivering wall-clock speedups from 4% to 37% across diverse benchmarks. Notably, the model exhibits robust generalization by maintaining efficiency on meshes up to 128 times larger than those seen in training, and by accelerating the solver's convergence on unseen industry-relevant problems such as the AirfRANS dataset.

09.
arXiv (quant-ph) 2026-06-19

Scalable quantum circuit knitting using a weak-coupling approximation

arXiv:2606.19035v2 Announce Type: replace Abstract: We present a method for performing distributed quantum computing with controlled approximations. Exact distributed quantum computing requires exponential classical information to reconstruct the quantum process. However, we show how the classical cost is reduced to polynomial if the quantum procedure can be partitioned between a qubit that is weakly coupled the other qubits. We demonstrate our method for a layered circuit based on the circuits used for the quantum approximate optimization algorithm.

10.
arXiv (CS.AI) 2026-06-18

Clin-JEPA: A Multi-Phase Co-Training Framework for Joint-Embedding Predictive Pretraining on EHR Patient Trajectories

arXiv:2605.10840v3 Announce Type: replace-cross Abstract: We present Clin-JEPA, a multi-phase co-training framework for joint-embedding predictive (JEPA) pretraining on EHR patient trajectories. JEPA architectures have enabled latent-space planning in robotics and high-quality representation learning in vision, but extending the paradigm to EHR data – to obtain a single backbone that simultaneously forecasts patient trajectories and serves diverse downstream risk-prediction tasks without per-task fine-tuning – remains an open challenge. Existing JEPA frameworks either discard the predictor after pretraining (I-JEPA, V-JEPA) or train it on a frozen pretrained encoder (V-JEPA 2-AC), leaving the encoder unaware of the rollout signal that the retained predictor must use at inference; co-training the encoder and predictor under a shared JEPA prediction objective would supply this grounding, but naïve co-training is unstable, with representation collapse and online/target drift causing autoregressive rollout to diverge. Clin-JEPA's five-phase pretraining curriculum – predictor warmup, joint refinement, EMA target alignment, hard sync, and predictor finalization – addresses each failure mode by phase, stably co-training a Qwen3-8B-based encoder and a 92M-parameter latent trajectory predictor. On MIMIC-IV ICU data, three independent evaluations support the framework: (1) latent $\ell_1$ rollout drift uniquely converges ($-$15.7%) over 48-hour horizons while baselines and ablations diverge (+3% to +4951%); (2) the encoder learns a clinically discriminative latent geometry (deteriorating-patient cohorts displace 4.83$\times$ further than stable patients in latent space, vs $\leq$2.62$\times$ for baseline encoders); (3) a single backbone outperforms strong tabular and sequence baselines on multi-task downstream evaluation. Clin-JEPA achieves mean AUROC 0.851 on ICareFM EEP and 0.883 on 8 binary risk tasks (+0.038 and +0.041 vs baseline average).

11.
arXiv (CS.AI) 2026-06-16

AgentLeak: A Benchmark for Internal-Channel Privacy Leakage in Multi-Agent LLM Systems

arXiv:2602.11510v3 Announce Type: replace Abstract: Multi-agent Large Language Model (LLM) systems create privacy risks that current output-only benchmarks cannot measure. When agents coordinate on tasks, sensitive data may pass through inter-agent messages, shared memory, and tool arguments, all pathways that final-output audits typically do not inspect. We introduce AgentLeak, a benchmark for evaluating internal-channel privacy leakage in multi-agent LLM systems. AgentLeak instruments seven privacy-relevant communication pathways and provides a large-scale empirical evaluation focused on final outputs, inter-agent messages, and shared memory. Across 1,000 scenarios spanning healthcare, finance, legal, and corporate domains, five production LLMs (GPT-4o, GPT-4o-mini, Claude 3.5 Sonnet, Mistral Large, and Llama 3.3 70B), and 4,979 validated execution traces, we find that multi-agent configurations reduce final-output leakage (C1: 27.2% vs 43.2% in single-agent mode) compared with single-agent baselines but introduce internal channels that raise total system exposure to 68.9% (aggregated across C1, C2, C5). Inter-agent messages (C2) leak at 68.8%, compared with 27.2% for final outputs (C1), meaning that output-only audits miss 41.7% of violations. Across all five models and four domains, the pattern C2 $\geq$ C1 holds consistently. These results suggest, within the evaluated coordinator-worker setting, that privacy risk in multi-agent systems is strongly shaped by architectural coordination channels rather than final-output behavior alone: it arises from internal channels that remain invisible to standard output-level defenses.

12.
arXiv (quant-ph) 2026-06-17

Acceleration-induced spectral blind spots in stimulated atomic transitions

arXiv:2606.17396v1 Announce Type: cross Abstract: Stimulated transitions are among the most fundamental processes in light-matter interaction, underlying resonant absorption and emission in atomic systems. Here we show that uniform acceleration can convert this familiar response into a frequency-selective absence of response. Specifically, when an incident photon has a nonzero momentum component transverse to the acceleration, the stimulated transition probability vanishes at a discrete set of frequencies fixed by the acceleration, the atomic transition frequency, and the photon propagation angle. At these spectral blind spots, both ordinary stimulated absorption and acceleration-induced excitation are simultaneously suppressed, rendering the atom effectively unresponsive to the incident radiation. The effect arises from the nontrivial response of accelerated atoms to quantum vacuum fluctuations and provides a distinctive signature of the Unruh effect through the absence, rather than the enhancement, of stimulated transitions. We further provide an order-of-magnitude estimate showing that an electron-based implementation with spin splitting in combined electric and magnetic fields could access the required parameter regime. These results reveal an unexplored form of acceleration-modified light-matter interaction and identify spectral blind spots as a new manifestation of the Unruh effect.

13.
arXiv (CS.CL) 2026-06-24

PETRA: Transforming Web Text for Petroleum-Engineering Domain Adaptation

Petroleum-engineering search exposes a supervision gap for strong general retrievers: relevant evidence exists in public web text, but domain relevance labels are scarce. To address this gap, we propose PETRA, a large-scale Petroleum Engineering Text for Retrieval Adaptation dataset and pipeline that converts noisy public web data into a curated domain corpus and synthetic supervision for dense retrieval and reranking. PETRA contains 1.36M curated chunks, approximately 2B token equivalents, $\approx$859k, embedding training rows from $\approx$224k anchors, and roughly 400k teacher-scored reranker candidate rows. Its construction combines high-recall energy-domain curation, an energy-domain classifier with 98.4% test accuracy, chunk-grounded query generation, LLM-written hard negatives, and retrieval-mined candidate lists. PETRA improves first-stage in-domain Normalized Discounted Cumulative Gain (nDCG) from 0.703 to 0.763 through score fusion. Reranker adaptation improves the public Earth Science benchmark by 44% relative and a six-task reasoning-intensive panel by 23%. Failed training recipes show that high train-holdout accuracy on synthetic labels does not predict retrieval gains; retrieval-mined data helps only after being repackaged as teacher-scored candidate lists sampled from the inference-time candidate distribution.

14.
arXiv (quant-ph) 2026-06-25

Tensor network characterization and mitigation of readout errors

arXiv:2606.25974v1 Announce Type: new Abstract: Readout errors are a major bottleneck to extracting reliable information from near-term quantum processors, especially when spatial correlations are non-negligible. We present a unified tensor-network framework that models the readout process as a matrix product operator (MPO), enabling efficient characterization and mitigation beyond uncorrelated approximations. The MPO model is trained via likelihood optimization on calibration data and applies to multiple tasks, including nonlocal observable estimation, random circuit sampling, and random-measurement protocols, such as classical shadows and learning-based tomography. Experiments on a superconducting processor and numerical simulations up to 20 qubits show that the MPO model captures correlated readout errors that uncorrelated models miss, with a sample cost that grows only near-linearly with system size. When extended to two-dimensional systems, the framework can also be integrated with tensor-network quantum error-correction decoders by performing joint inference over data and readout errors. These results establish tensor-network readout error mitigation as a scalable and versatile approach for noise-aware quantum data processing.

15.
arXiv (CS.CV) 2026-06-25

ShutterMuse: Capture-Time Photography Guidance with MLLMs

Real-world photography requires capture-time guidance for both camera framing and subject pose. Yet existing aesthetic cropping benchmarks mainly evaluate post-hoc crop prediction and overlook subject-side recommendations, leaving the capture-time guidance capabilities of multimodal large language models (MLLMs) underexplored. To address this gap, we introduce CaptureGuide-Bench, a benchmark with two complementary tasks: photographer-side composition decision and refinement, and subject-side scene-conditioned pose recommendation. Our evaluation reveals limitations: general-purpose MLLMs can make composition decisions but lack precise refinement localization, while specialized aesthetic cropping models localize crops effectively but are limited to refinement; neither provides actionable pose guidance. To support model development, we further construct CaptureGuide-Dataset, comprising 130K samples with textual rationales and structured visual annotations, and develop ShutterMuse, a unified MLLM trained with supervised and reinforcement fine-tuning. Experiments on CaptureGuide-Bench show that ShutterMuse achieves the best overall photographer-side performance among evaluated baselines and competitive subject-side pose recommendation with substantially lower inference cost, demonstrating the potential of MLLMs as interactive assistants for photography during image capture.

16.
arXiv (CS.CL) 2026-06-15

Incentives Of EdTech: A Systematic Review Of EduNLP Research

While the Natural Language Processing community has dedicated significant resources in developing educational technologies (EdTech) that support this shift, it remains unclear whose interests are being best served among the stakeholders of education. In this paper, we present a systematic literature review of 204 papers published in venues of the Association for Computational Linguistics' Special Interest Group on Building Educational Applications in 2024 and 2025, and validate these against EdTech papers from the wider ACL Anthology. By examining stakeholder inclusion and the prioritisation of research tasks, our findings reveal a critical tension: a push and pull between private-sector incentives and the foundational needs of educational infrastructure. Our analysis reveals that teachers are systematically under-represented as beneficiaries of research (33.3%) despite being the most affected, that real-world deployment remains rare (9.8%), and that ethical engagement tends toward acknowledgement rather than action. Drawing on exemplary papers in our corpus, we offer concrete recommendations for more responsible EduNLP research practices.

17.
arXiv (CS.LG) 2026-06-16

Analytic Torsion and Spectral Gap Capture Persistent-Laplacian Performance

arXiv:2606.16990v1 Announce Type: new Abstract: While persistent Laplacians (PL) offer a richer geometric representation of data than persistent homology, utilizing their full eigenspectrum for learning tasks is often hampered by high dimensionality and the ``varying length'' problem across different filtration scales. We propose a compact spectral representation that distills the persistent Laplacian into three mathematically grounded invariants: Betti numbers, the spectral gap, and analytic torsion. Across benchmark datasets including MNIST, QM-3D, and SKEMPI WT, we demonstrate that this reduced feature space captures the essential predictive signal of the full spectrum, and in some cases outperforms it, while significantly reducing computational overhead and preventing the noise introduced by higher-frequency eigenvalues. Our results suggest that these invariants provide a principled, fixed-length interface between spectral geometry and topological learning.

18.
arXiv (CS.CV) 2026-06-17

Structured Adversarial Camouflage via Voronoi Diagrams

Pixel-wise adversarial patches are computationally heavy and often visually detectable, limiting utility in security-critical systems. We present adversarial Voronoi camouflage that optimizes only seed-point locations under fixed, printable palettes using a soft assignment, producing structured, splinter camouflage-like patterns without additional regularization. Evaluated on person detection with COCO-style AP@[.5:.95], naive placement (Inria -> COCO) performs comparably bad, while garment-level application via segmentation mask (3DPeople) results in a significant AP drop. The attack transfers to out-of-domain backgrounds and across detector families (YOLOv9/10/11/12), indicating robustness in black-box settings. Repainting with different palettes largely nullifies the effect, and single-color tweaks show limited tolerance (

19.
arXiv (CS.AI) 2026-06-12

Emotional regulation improves deep learning-based image classification

arXiv:2606.13081v1 Announce Type: cross Abstract: Emotion significantly influences cognition, enhancing memory and learning under certain conditions. Drawing on this principle, emotion-augmented deep learning investigates how affective states can improve neural network architectures and learning paradigms, achieving better generalization than non-emotional models. However, existing methods often rely solely on objective neurophysiological factors, neglecting the role of subjectivity in emotion. To bridge this gap, the present study introduces Emotional Regulation, a novel framework for modeling emotion in deep learning through artificial subjective experience. The method employs pre-training based on affective stimuli, balancing non-emotional and emotionally-influenced responses in downstream task optimization. Extensive experimentation was conducted in image classification, pre-training ResNet and ViT architectures on four emotional datasets, using CIFAR-10 and -100 as target benchmarks. Results reveal improvements over the aforementioned backbones, providing evidence of Emotional Regulation as a promising method for defining emotion-augmented deep learning through artificial subjective experience. Furthermore, the proposed approach overcomes the related work in image classification based on CIFAR, revealing Emotional Regulation as the new state-of-the-art in emotion-augmented deep learning for large-scale vision datasets. The study also enforces evidence of the impact of affective states in improving machine learning tasks' optimization, encouraging further investigation on emotion-inspired architectures.

20.
arXiv (CS.CV) 2026-06-15

CineOrchestra: Unified Entity-Centric Conditioning for Cinematic Video Generation

Cinematic video depicts multiple subjects acting or interacting at specific moments, captured with deliberate camera movement, and stitched together by shot transitions. Together, these elements demand a level of fine-grained control beyond current text-to-video models. Existing work addresses each axis in isolation: multi-subject personalization, temporal control, multi-shot synthesis, or camera control; no prior framework jointly integrates all four. We present CineOrchestra, a unified video diffusion model that controls subjects, events, cameras, and shot transitions simultaneously. Our key insight is that these heterogeneous cinematic elements share a fundamental structure: each is an entity acting over a specific temporal interval, which can therefore all be expressed through one shared structure of entity-centric conditioning primitives, augmented with reference images for visual entities. This formulation reduces the architectural challenge to a single positional encoding problem, which we solve with two parameter-free coordinated rotary embeddings: (a) an interval-sampled temporal RoPE that yields consistent attention behavior across events of dramatically varying duration, and (b) a 2D entity-temporal cross-attention RoPE that disambiguates per-entity conditions and routes each to its corresponding spatiotemporal region. On two new benchmarks, CineOrchestra outperforms six per-axis specialists on dense caption following and shot-transition timing, with consistent gains in a pairwise user study and component ablations.

21.
arXiv (math.PR) 2026-06-18

Delayed blow-up by transport noise for the 3D Navier-Stokes equation with Navier-slip boundary conditions

作者:

arXiv:2606.19060v1 Announce Type: cross Abstract: We study the vorticity formulation of the 3D Navier-Stokes equation driven by transport noise in a periodic channel with Navier-slip boundary conditions. We consider both non-degenerate transport noise and degenerate tangential transport noise. For any prescribed $T>0$ and $\epsilon>0$, we prove that, by choosing the noise intensity sufficiently large and concentrating the noise on sufficiently high modes, the solution exists up to $T$ with probability at least $1-\epsilon$. A main contribution of this work is to identify and analyze the interaction between enhanced dissipation induced by transport noise and physical boundary effects. The no-flux condition breaks the isotropy of the noise and changes the scaling limit of the Itô-Stratonovich corrector. In the non-degenerate case, a boundary feedback term appears in the limiting effective operator; in the degenerate case, the limiting operator is a nonlocal anisotropic tangential dissipation. The proof is based on a combination of a boundary correction operator, a Meyers-type estimate, a scaling-limit analysis of the Itô-Stratonovich corrector, and resolvent estimates for the deterministic limiting equations.

22.
arXiv (math.PR) 2026-06-24

Perron–Frobenius theorem for a general tree-valued growth-fragmentation-isolation process

arXiv:2606.24599v1 Announce Type: new Abstract: A general tree-valued dynamics is considered in continuous time: new vertices are added, and the percolation happens on the links, and the connected components can be frozen. The model is an infinite-type branching process. The main result establishes the Perron–Frobenius type theorem on this model, which extends the previous work [Ann. Appl. Probab. 33 (6B) 5233 - 5278]. The proof does not rely on any property of the uniform random recursive tree.

23.
arXiv (CS.AI) 2026-06-18

ASTRA: A Scalable Next-Generation ATCO Training Simulator with Autonomous Simpilots

arXiv:2606.18319v1 Announce Type: cross Abstract: Air Traffic Control Operators (ATCOs) are vital in ensuring the safe, orderly, and efficient flow of air traffic, yet training capacity is constrained by reliance on specialized human trainers known as simpilots, who must role-play both pilots and ATCOs in a simulated airspace. Existing automated solutions rely on Western-centric speech models that perform poorly in Singaporean operational contexts, with off-the-shelf systems exhibiting Word Error Rates (WER) of up to 107.80% on Singaporean-accented aviation speech. We introduce ASTRA, an end-to-end training simulator that automates these simpilot roles through a pipeline that transcribes ATCO speech, interprets instructions, and generates appropriate pilot and ATCO responses using locally adapted voice models. Our fine-tuned Automatic Speech Recognition (ASR) pipeline reduces WER to 23.45%, substantially outperforming existing approaches in this domain. Beyond traffic simulation, ASTRA incorporates an AI-assisted performance evaluation framework that assesses trainee radiotelephony communications across accuracy, brevity, and completeness, achieving post-optimization scores of 91.7%, 88.2%, and 86.9%, respectively. Built on open-source foundations such as DSPy and Unsloth, this approach enables scalable, standardized ATCO assessment while reducing instructor workload.

24.
medRxiv (Medicine) 2026-06-24

Multifactorial tuberculosis severity score for people living with HIV based on the Rand Appropriateness Method

Background In people living with Human Immunodeficiency Virus (PLWH), tuberculosis (TB) is the leading cause of death and is often associated with substantial morbidity. Better identifying PLWH with severe forms of TB could help target early interventions to reduce mortality and severe morbidity. Existing TB severity assessment tools may be sub-optimal for assessing disease severity in PLWH, since they incompletely integrate key determinants of disease severity. We aimed to develop a consensus-based TB severity score tailored to PLWH. Methods We developed a multifactorial TB severity score (TBSS) for PLWH using a modified Delphi process with a multidisciplinary group of international TB experts as the second part of a RAND/UCLA Appropriateness Method, following a previously published systematic review. Results Eight of 15 invited experts (53%) participated in both Delphi rounds. Of 62 candidate factors, 15 reflecting TB-related characteristics, host-related characteristics as well as characteristics related to both TB and host were rated as having high appropriateness for inclusion in the final TBSS. The total score ranges from 0 (no severity) to 61 (highest severity). Conclusion This study represents a first step towards the development of a multidimensional TB severity assessment tool for PLWH. However, its clinical usefulness, feasibility, and added value compared with existing severity scores remain to be demonstrated through validation studies before routine implementation can be considered. Key words: tuberculosis, HIV, severity.