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01.
arXiv (CS.AI) 2026-06-18

Domain-Shift Aware Neural Networks for Unbalance Characterization in Rotating Systems

arXiv:2606.18882v1 Announce Type: cross Abstract: This work investigates the application of a domain-shift aware neural network for regression tasks aimed at estimating unbalance masses in rotating shafts under varying operating conditions. Experimental data were collected from a test rig in which a primary shaft, equipped with a flange carrying unbalanced masses, was driven at different rotational speeds, while a secondary shaft could be optionally activated to introduce domain discrepancy. The unbalance masses were positioned at a fixed radial distance, and the dynamic response of the system was recorded using triaxial accelerometers. The inverse problem of mass estimation is formulated within a domain adaptation framework, where the network is trained with a maximum mean discrepancy strategy to align feature representations across source and target distributions. The results demonstrate the effectiveness of explicitly addressing domain shift in improving prediction accuracy, especially when the system's physical behavior and sources of domain discrepancy are not fully known and fall outside the training conditions. These findings highlight the potential of domain-shift aware models for regression tasks in Structural Health Monitoring.

02.
arXiv (quant-ph) 2026-06-19

Operator Learning for efficient Quantum Computation

arXiv:2606.20184v1 Announce Type: new Abstract: An efficient implementation of quantum algorithms is often hindered by the lack of efficient primitives for operators and state preparation. This limits both the ability of near-term quantum hardware to simulate complex problems and the potential of fault-tolerant algorithms to achieve practical quantum advantage. To address this, we propose a full-stack variational framework that transforms arbitrary operators to compact quantum circuits. The resulting variational circuits can be tailored to the connectivity and long-range interaction of the target hardware. The learning process employs backpropagation together with a cost function that efficiently optimizes unitary operators and non-unitary – dense or sparse – operators using only a single ancilla qubit for block encoding. Additionally, we introduce a regularization term that reduces the approximation error. The approach is validated for both quantum mechanical and engineering applications. In the former case, we learn propagators that arise in native quantum problems – such as quantum simulation and quantum chemistry – and achieve improved resource scaling in comparison to standard Suzuki-Trotter expansions. In the latter case, we demonstrate the approach's ability to implement the second-order central finite difference approximation of the Laplace operator – relevant for solving partial differential equations – while improving upon current error metrics. The final example deals with learning a dense, non-unitary operator that arises in the analysis of inviscid potential flow around an airfoil. This universality of the framework opens the door for solving general problems beyond prototypical engineering and quantum applications.

03.
arXiv (CS.CV) 2026-06-12

BSViT: A Burst Spiking Vision Transformer for Expressive and Efficient Visual Representation Learning

Spiking Vision Transformers (S-ViTs) offer a promising framework for energy-efficient visual learning. However, existing designs remain limited by two fundamental issues: the restricted information capacity of binary spike coding and the dense token interactions introduced by global self-attention. To address these challenges, this work proposes BSViT, a burst spiking-driven Vision Transformer featuring a Dual-Channel Burst Spiking Self-Attention (DBSSA) mechanism. DBSSA encodes queries with binary spikes and keys with burst spikes to enhance representational capacity. The value pathway adopts dual excitatory and inhibitory binary channels, enabling signed modulation and richer spike interactions. Importantly, the entire attention operation preserves addition-only computation, ensuring compatibility with energy-efficient neuromorphic hardware. To further reduce spike activity and incorporate spatial priors, a patch adjacency masking strategy is introduced to restrict attention to local neighborhoods, resulting in structure-aware sparsity and reduced computational overhead. In addition, burst spike coding is systematically integrated across the network to increase spike-level representational capacity beyond conventional binary spiking. Extensive experiments on both static and event-based vision benchmarks demonstrate that BSViT consistently outperforms existing spiking Transformers in accuracy while maintaining competitive energy efficiency.

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

Multimodal Concept Bottleneck Models

arXiv:2606.19882v1 Announce Type: cross Abstract: Concept Bottleneck Models (CBMs) enhance the interpretability of deep learning networks by aligning the features extracted from images with natural concepts. However, existing CBMs are constrained in their ability to generalize beyond a fixed set of predefined classes and the risk of non-concept information leakage, where predictive signals outside the intended concepts are inadvertently exploited. In this paper, we propose Multimodal Concept Bottleneck Model (MM-CBM) to address these issues and extend CBMs into CLIP. MM-CBM utilizes dual Concept Bottleneck Layers (CBLs) to align both the image and text embeddings into interpretable features. This allows us to perform new vision tasks like zero-shot classification or image retrieval in an interpretable way. Compared to existing methods, MM-CBM achieves up to 51.26% accuracy improvement on average across four standard benchmarks. Our method maintains high accuracy, staying within ~5% of black-box performance while offering greater interpretability.

05.
arXiv (CS.CL) 2026-06-15

Succeeding at Scale: Enterprise Retrieval Benchmark Construction and Index-Preserving Query Adaptation for Multi-Tenant Search

Large-scale multi-tenant retrieval systems generate extensive query logs but lack curated relevance labels for effective domain adaptation, resulting in substantial underutilized "dark data." This challenge is compounded by the high cost of model updates, as jointly fine-tuning query and document encoders requires full corpus re-indexing, which is impractical in multi-tenant settings with thousands of isolated indices. We introduce DevRev-Search, a passage retrieval benchmark for technical customer support built via a fully automated pipeline. Candidate generation uses fusion across diverse sparse and dense retrievers, followed by an LLM-as-a-Judge for consistency filtering and relevance labeling. We further study and systematically evaluate index-preserving query-only adaptation strategies that fine-tune only the query-encoder while keeping the document indices fixed. Experiments on DevRev-Search, SciFact, and FiQA-2018 show that parameter-efficient fine-tuning of the query encoder delivers a remarkable quality-efficiency trade-off, enabling scalable and practical enterprise multi-tenant retrieval.

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

Exit-and-Join Dynamics for Decentralized Coalition Formation

作者:

arXiv:2606.19683v1 Announce Type: new Abstract: This paper studies coalition formation as a decentralized dynamical process driven by unilateral exit-and-join decisions. Agents evaluate local moves using the Aumann-Dreze value, so payoffs are computed within the agent's current coalition rather than through a globally negotiated coalition structure. The resulting model links cooperative payoff allocation with noncooperative best-response behavior: a terminal partition is precisely a coalition structure with no admissible, individually profitable exit-and-join deviation. We establish equilibrium characterizations, identify conditions under which the dynamics admit scalar Lyapunov or exact-potential representations, and analyze how switching and acceptance costs shape local stability. Numerical experiments test finite-time stabilization, cost sensitivity, and a special convex-game benchmark.

07.
bioRxiv (Bioinfo) 2026-06-18

Metrics for Evaluating Biological AI Model Predictive Accuracy at the Data-Substrate Level

作者:

Reports in the biological literature disagree on whether a given model can predict a biological outcome from a given data sample — one study finding a model capable, another, on the same kind of data, finding it is not. This is particularly a challenge in relation to LLMs–where the models are large and opaque, with weights and training data inaccessible.textbf{ }Such disagreements cannot be settled by directly inspecting the model. To address this challenge, we considertextbf{ }an alternative approach: assessing whether the data sample is adequate to support the prediction asserted. For a given dataset, its substrate — the underlying structure of the data — determines what any model can recover, independent of architecture or capacity. At the same time, predicting the present state of a biological process and predicting the direction of its future change are different tasks; the second is supportable among AI models only where the data encode direction as determinable from the state — a property we call encoding — and is unsupportable where the same observed state precedes change in opposite directions — a property we call non-identifiability, in the informational rather than the statistical sense. We introduce two generic metrics, Predictive Blindness Risk (PBR) and Prediction Indeterminacy Measure (PIM), that evaluate a data substrate for predictive accuracy directly — without access to model weights, architecture, or training data — and locate the regions of a data substrate where a predictive claim can be supported and where it cannot. Using human biological subjects, we employ the Yale Brain Metastases Longitudinal Data (1,430 human subjects; 11,892 MRI studies; four sequences) and show that direction of change was non-identifiable across regions encompassing the majority of transitions; a nonlinear AI model gained essentially nothing over majority-direction prediction there while recovering direction near-perfectly where the state encoded it; and model accuracy tracked data-substrate resolvability continuously (Spearman {rho} = -0.95 to -1.00). The metrics adjudicate, before any model is trusted and from the data alone, where claims of predictive accuracy — of state, or of the law of change — can be supported.

08.
arXiv (CS.CL) 2026-06-16

Cloze: An Open Research Platform for Studying Human-AI Conversations in Mental Health Contexts

Cloze is an open-source web platform for conducting controlled, monitored studies of human-AI conversation in mental health research contexts. Consumer large language model (LLM) products such as ChatGPT, Claude, and Gemini are built for individual productivity, and offer researchers little experimental control, inconsistent data export, and no shared safety scaffolding that holds across providers. Cloze gives research teams a single environment in which they configure which models participants converse with, how the AI is instructed, how conversations are scheduled over time, and which safety constraints apply unconditionally, while every message is captured with full provenance (model version, prompt configuration, timing). The platform currently supports OpenAI, Anthropic, Google, and locally hosted open-weight models served through Ollama behind a unified interface, and runs in the cloud or fully on premises so that participant data need never leave an institution. Cloze is research infrastructure for building an evidence base on human-AI interaction in mental health contexts. It is not a therapeutic product.

09.
arXiv (CS.LG) 2026-06-16

Circuit Tracing in Autoregressive Protein Language Models

arXiv:2606.16044v1 Announce Type: new Abstract: Protein language models (pLMs) can generate novel protein sequences with properties beyond those observed in nature, yet the mechanisms underlying protein generation remain poorly understood. Existing mechanistic interpretability methods based on sparse autoencoders and transcoders primarily focus on protein representation learning models and do not capture the computation required for autoregressive generation. Here, we introduce ProGenMech, a mechanistic interpretability framework for generative protein language models that extends cross-layer transcoders (CLTs) to ProGen3, a sparse Mixture-of-Experts model trained for both causal generation and span infilling. Unlike per-layer approaches, CLTs reconstruct each layer using sparse latent variables from all preceding layers, enabling faithful recovery of inter-layer generative computation. We further develop a zero-shot circuit discovery framework to identify sparse latent circuits responsible for protein generation and fitness prediction. In causal generation and zero-shot fitness estimation tasks, ProGenMech outperforms local transcoder baselines in recovering ProGen3's probability distribution and functional scoring behavior, while matching the original model's generative distribution in span infilling tasks. Moreover, the recovered circuits reveal biologically meaningful motifs and functional regions associated with conserved sequence patterns and protein fitness landscapes, establishing a foundation for interpretable and steerable protein generation.

10.
arXiv (CS.CV) 2026-06-12

Modality-Aware Feature Matching in Visual and Vision-Language Applications: A Comprehensive Survey

Feature matching is a cornerstone task in computer vision, essential for applications such as image retrieval, stereo matching, 3D reconstruction, and SLAM. This survey comprehensively reviews modality-based feature matching, exploring traditional handcrafted methods and emphasizing contemporary deep learning approaches across various modalities, including RGB images, depth images, 3D point clouds, LiDAR scans, medical images, and vision-language interactions. Traditional methods, leveraging detectors like Harris corners and descriptors such as SIFT and ORB, demonstrate robustness under moderate intra-modality variations but struggle with significant modality gaps. Contemporary deep learning-based methods, exemplified by detector-free strategies like CNN-based SuperPoint and transformer-based LoFTR, substantially improve robustness and adaptability across modalities. We highlight modality-aware advancements, such as geometric and depth-specific descriptors for depth images, sparse and dense learning methods for 3D point clouds, attention-enhanced neural networks for LiDAR scans, and specialized solutions like the MIND descriptor for complex medical image matching. Cross-modal applications, particularly in medical image registration and vision-language tasks, underscore the evolution of feature matching to handle increasingly diverse data interactions.

13.
arXiv (CS.CV) 2026-06-16

PoseGAM: Robust Unseen Object Pose Estimation via Geometry-Aware Multi-View Reasoning

6D object pose estimation, which predicts the transformation of an object relative to the camera, remains challenging for unseen objects. Existing approaches typically rely on explicitly constructing feature correspondences between the query image and either the object model or template images. In this work, we propose PoseGAM, a geometry-aware multi-view framework that directly predicts object pose from a query image and multiple template images, eliminating the need for explicit matching. Built upon recent multi-view-based foundation model architectures, the method integrates object geometry information through two complementary mechanisms: explicit point-based geometry and learned features from geometry representation networks. In addition, we construct a large-scale synthetic dataset containing more than 190k objects under diverse environmental conditions to enhance robustness and generalization. Extensive evaluations across multiple benchmarks demonstrate our state-of-the-art performance, yielding an average AR improvement of 5.1% over prior methods and achieving up to 17.6% gains on individual datasets, indicating strong generalization to unseen objects. Project page: https://windvchen.github.io/PoseGAM/ .

14.
arXiv (CS.CV) 2026-06-18

Moebius: 0.2B Lightweight Image Inpainting Framework with 10B-Level Performance

While 10B-level industrial foundation models have pushed the boundaries of image inpainting, their prohibitive computational costs severely hinder practical deployment. Constructing a highly optimized task-specific specialist offers a promising solution; however, extreme structural compression inevitably triggers a severe representation bottleneck. To conquer this, we propose Moebius, a highly efficient lightweight inpainting framework. We systematically reconstruct the diffusion backbone by introducing the Local-$\lambda$ Mix Interaction ($L\lambda MI$) block. Comprising Local-$\lambda$ and Interactive-$\lambda$ modules, it elegantly summarizes spatial contexts and global semantic priors into fixed-size linear matrices, preserving complex latent interactions while drastically shedding parameters. Furthermore, to unlock the full representational capacity of this highly compact architecture, we synergistically pair it with an adaptive multi-granularity distillation strategy. Operating strictly within the latent space to avoid expensive pixel-space decoding, this strategy dynamically balances multiple gradient-based losses to achieve high-fidelity alignment. Extensive experiments across natural and portrait benchmarks demonstrate that this optimal synergy enables Moebius to rival or even surpass the generation quality of the 10B-level industrial generalist FLUX.1-Fill-Dev. Remarkably, Moebius achieves this using less than 2\% of the parameters (0.22B vs. 11.9B) while delivering a $>15\times$ acceleration in total inference time, setting a new efficiency standard for high-fidelity inpainting. Project page at https://hustvl.github.io/Moebius.

15.
arXiv (CS.AI) 2026-06-19

Confidence Calibration for Multimodal LLMs: An Empirical Study through Medical VQA

arXiv:2606.19950v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) show great potential in medical tasks, but their elicited confidence often misaligns with actual accuracy, potentially leading to misdiagnosis or overlooking correct advice. This study presents the first comprehensive analysis of the relationship between accuracy and confidence in medical MLLMs. It proposes a novel method that combines Multi-Strategy Fusion-Based Interrogation (MS-FBI) with auxiliary expert LLM assessment, aiming to improve confidence calibration in Medical Visual Question Answering (VQA). Experiments demonstrate that our method reduces the Expected Calibration Error (ECE) by an average of 40\% across three Medical VQA datasets, significantly enhancing MLLMs' reliability. The findings highlight the importance of domain-specific calibration for MLLMs in healthcare, offering a more trustworthy solution for AI-assisted diagnosis.

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

Detecting undisclosed LLM-generated content in parliamentary texts

In this paper, we evaluate the extent of undisclosed LLM-generated content in texts from the parliaments of the United Kingdom and Sweden. In many areas, such as in journalism or in academic writing, there are often requirements to clearly disclose whether AI tools, such as LLMs, have been used. In the case of parliamentary texts, the guidelines on disclosure of AI use are more vague. However, in order to maintain transparency and retain public trust, it is generally recommended that parliamentarians should state whether or not they have used AI when writing texts, such as parliamentary motions. Here, we train an interpretable (glass-box) text classifier using pre-LLM parliamentary texts and LLM-generated versions of such texts. We then apply the classifier to a test set containing recent parliamentary texts, finding a steady increase in undisclosed LLM use, in both parliaments, from 2022 onwards.

17.
arXiv (quant-ph) 2026-06-19

Quantum Kernels are Spectral Tensor Networks

arXiv:2606.20402v1 Announce Type: new Abstract: Quantum kernels admit Fourier representations whose frequencies are determined by the data-encoding gates of the underlying feature map. We show that entangling tensor kernels are matrix product operator factorizations of the corresponding Fourier coefficient tensors, thereby identifying quantum kernels as spectral tensor networks. By grouping gate-level frequency configurations that yield the same feature-wise frequency, we obtain a grouped Fourier form that induces a more compact spectral tensor network representation of the kernel. We further show that kernel target alignment serves as a bridge between the Fourier and tensor network views. On a grid that resolves the accessible Fourier modes, it becomes the Frobenius cosine similarity between Fourier coefficient tensors. Our numerical experiments show that layered quantum kernels admit accurate representations with small bond dimension, revealing a compressibility governed by correlations between Fourier modes. This compressibility provides a diagnostic of classical representability and of whether kernel evaluation is likely to remain classically tractable.

18.
arXiv (CS.LG) 2026-06-16

LLM-Based Synthetic Ground Truth Generation for Audio-Based Emotion Classification via In-Context Learning

arXiv:2606.14784v1 Announce Type: cross Abstract: Understanding human states and interaction dynamics is a core goal of human-computer interaction (HCI). As interaction paradigms become more immersive, virtual reality (VR) has emerged as a powerful platform for studying collaborative work. In such settings, evaluating team collaboration states, including team performance and team resilience, requires continuous and reliable inference of latent team-level cognitive and affective states from multi-modal sensor data, such as speech signals. However, generating ground truth labels for these latent states remains challenging due to sensor-induced noise, contextual variability, and sparse expert annotations. Traditional self-reporting approaches provide only static and delayed measurements and are therefore insufficient for capturing dynamic team processes reflected in continuous speech data. In this work, we propose a large language model (LLM)-driven, agentic inference workflow for automated emotion-related synthetic ground truth generation from streaming speech data in multi-user VR environments. Leveraging the generalization capabilities of LLMs, we use In-Context Learning (ICL) with few-shot demonstrations of paired audio-based samples and their corresponding transcriptions. ICL tends to achieve task adaptation comparable to model fine-tuning while circumventing the computational overhead of parameter updates. To construct informative and robust in-context prompts, we adopt a retrieval-based selection strategy that dynamically identifies relevant audio demonstrations based on similarity in the acoustic feature space.

19.
arXiv (quant-ph) 2026-06-16

Generalized symmetries, invariant solutions and conservation laws in the Jaynes-Cummings model

arXiv:2606.15538v1 Announce Type: cross Abstract: In this work, we investigate the Jaynes–Cummings model (JCM) using Lie symmetry analysis and conservation-law theory. The dynamics is formulated as a system of partial differential equations by projecting the von Neumann equation onto the atomic degrees of freedom and representing the field mode through its characteristic function. We determine the admitted point and generalized symmetries and construct invariant solutions satisfying the physical conditions imposed by quantum mechanics. The conventional dressed-state dynamics is recovered while a second class of solutions with radial dependence expressed through Heun polynomials is obtained for coupled atom–field configurations. We also apply the generating functions methodology to derive local conservation laws of the JCM differential system. Besides recovering the conservation of the total number of excitations, we obtain additional conserved currents involving atomic populations, coherence, reduced-state purity, and moments of the field characteristic function. In particular, we derive a balance equation for a combination of atomic purity and coherence whose evolution is controlled by the atom–field coupling and is linked to atom–field correlation and entanglement dynamics. The symmetry structure further generates generalized symmetries and an infinite hierarchy of conservation laws.

20.
bioRxiv (Bioinfo) 2026-06-20

The recount3 Python package for programmatic access to uniformly processed RNA-seq data

The recount3 online resource provides tens of thousands of uniformly processed RNA-seq samples across human and mouse from major sequencing repositories like the Sequence Read Archive. While access to these datasets has traditionally been centered in the R/Bioconductor ecosystem, the growing prominence of Python in bioinformatics and machine learning necessitates native, efficient tooling for Python users. Therefore, we present the recount3 Python package with robust application programming interface (API) and command-line interface (CLI) for discovering, downloading, and materializing recount3 resources. The software orchestrates uniform resource locator (URL) resolution, persistent on-disk caching, and the automatic parsing of data into analysis-ready data structures, including Pandas DataFrames and BiocPy RangedSummarizedExperiment objects. The recount3 Python package drastically lowers the barrier to entry for large-scale utilization of RNA-seq data in Python-based computational pipelines, bridging the gap between massive public transcriptomic data and modern machine learning ecosystems.

21.
arXiv (CS.CV) 2026-06-11

Semantic search for 100M+ galaxy images using AI-generated captions

Finding scientifically interesting phenomena through slow manual labeling campaigns severely limits our ability to explore the billions of galaxy images produced by telescopes. In this work, we develop a pipeline to create a semantic search engine from completely unlabeled image data. Our method leverages Vision-Language Models (VLMs) to generate descriptions for galaxy images, then contrastively aligns a pre-trained astronomy foundation model with these embedded descriptions to produce searchable embeddings at scale. We find that current VLMs provide descriptions that are sufficiently informative to train a semantic search model that outperforms direct image similarity search. Our model, AION-Search, achieves state-of-the-art zero-shot performance on finding rare phenomena despite training on randomly selected images with no deliberate curation for rare cases. Furthermore, we introduce a VLM-based re-ranking method that nearly doubles the recall for our most challenging targets in the top-100 results. For the first time, AION-Search enables flexible semantic search for over 100 million galaxy images, enabling discovery from previously infeasible searches, including the identification of 36 new extragalactic stellar stream candidates. More broadly, our work provides an approach for making large, unlabeled scientific image archives semantically searchable, expanding data exploration capabilities in fields from Earth observation to microscopy. The code, data, and app are publicly available at https://github.com/NolanKoblischke/AION-Search

22.
arXiv (CS.CV) 2026-06-17

Two-Stage Fine-Tuning of ResNet50 for High-Sensitivity Melanoma Detection on Dermoscopic Images

作者:

Melanoma is the most dangerous form of skin cancer with five-year survival rates exceeding 99% when detected early but falling sharply once the disease spreads. This paper proposes and evaluates a two-stage fine-tuning approach for ResNet50 applied to binary melanoma classification on dermoscopic images. The core challenges addressed are class imbalance and suboptimal transfer learning from single-stage fine-tuning. After stratified train/validation/test splitting, random oversampling was applied exclusively to the training set to achieve a 1:1 class balance. Stage 1 trained only the classification head with the ResNet50 base frozen, while Stage 2 fine-tuned all layers jointly at a low learning rate of 1e-5 to prevent catastrophic forgetting of learned visual features. On an independent test set of 3,826 images, the model achieved an AUC-ROC of 0.9559, accuracy of 88.34%, sensitivity of 87.56%, specificity of 89.13%, and F1-score of 88.29%. An ablation study confirms the two-stage protocol significantly outperforms single-stage fine-tuning, with sensitivity gains of over 4%. Grad-CAM visualizations demonstrate correct lesion localization. A fully deployable Streamlit detection application is provided alongside all training code.

23.
arXiv (CS.CV) 2026-06-15

Gaze Heads: How VLMs Look at What They Describe

How a vision-language model internally solves the task of describing an image is far from obvious. We find that the model develops a specific mechanism for this: a small set of attention heads in its language-model backbone, which we call gaze heads, whose attention tracks the image region the model is currently describing. We find them with a simple correlation score from a few forward passes, using comic strips as a controlled testbed where narrative order is laid out spatially. These gaze heads do not just track the image tokens being described: redirecting their attention to a chosen region forces the VLM to describe that region instead. A single attention-mask intervention on the top-100 gaze heads, fewer than 9% of all heads, steers the model's answer to any chosen comic panel at 83.1% accuracy, while the same intervention on random heads fails to redirect the answer, and intervening on all heads destroys generation. The same lever also extends to continuous control: switching the gaze target mid-generation makes the model wrap up its current panel description and move to the new one within a few tokens. Beyond comics, the same intervention redirects answers to chosen regions in natural COCO images. The mechanism further recurs across model sizes from 2B to 32B parameters and across other VLM architectures, although some frozen-encoder families show no comparable head set. More broadly, this shows that targeted edits identified through mechanistic analysis can serve as practical inference-time levers for steering multimodal model behavior, without any retraining. Our code, interactive demo, and datasets are available at https://gaze.baulab.info/

24.
medRxiv (Medicine) 2026-06-12

The Acceptability of Three Co-Created Peer Support Interventions for People Living with Leprosy Reactions in Indonesia: A Mixed-Methods Pilot Study

Background: Leprosy reactions (LR) are immune-mediated complications associated with disability, emotional distress, and social isolation. We identified a gap in affected-individual-informed interventions that aim to improve the management of LR in healthcare settings. To address this gap, we assessed the acceptability of three peer-support interventions co-created with people affected by LR in Indonesia. Methods: Using an interactive learning and action approach, we co-created peer counselling, telesupport groups, and participatory video interventions which were piloted in an urban hospital and 13 rural community clinics. A mixed-methods design was applied with interviews, focus group discussions, and pre-post assessments involving four participant groups. Data were analyzed thematically using an acceptability framework. Results: One hundred participants were enrolled, and 92 completed the pilot intervention between November 2022 and July 2023. Qualitative findings showed that all interventions were acceptable. Peer counselling provided emotional reassurance through shared experiences and was perceived as trustworthy and supportive. Perceived burdens differed by setting, with time constraints in urban facilities and geographical barriers in rural clinics. Knowledge improved significantly among participants of peer counselling and telesupport groups in rural settings. Telesupport groups facilitated connection, information exchange, and continuity of care. Digital access and literacy limited participation for some, particularly in rural areas. The participatory video was perceived as reassuring and informative. Improvements in knowledge, attitude, practices, and mental well-being domain scores were observed among urban participants, but responses in rural settings showed less change. Participants and co-implementers reported increased self-efficacy, participants confidence to perform required behaviors within peer support interventions, with effects shaped by intervention and setting. Conclusions: The three co-created peer-support interventions were acceptable for individuals with LR in diverse healthcare settings. These outcomes highlight the importance and effectiveness of selective, and context-sensitive implementation of one or more peer-support modalities.