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01.
arXiv (quant-ph) 2026-06-17

Impact of Network Constraints on Fault-Tolerant Distributed Quantum Computing

arXiv:2606.17495v1 Announce Type: new Abstract: As we move towards scalable and modular quantum computing, quantum data centres become imperative. Existing analyses typically treat network constraints in isolation or through simplified models, leaving the interplay between error correction operations and communication resources underexplored. In this work, we present an end-to-end simulation framework that jointly models surface-code operations, internal QPU connectivity, and realistic network constraints including finite entanglement generation rates, limited communication qubits, and bandwidth contention, producing execution latency, from which logical error rate estimates are obtained. The framework is modular by design, allowing individual components such as routing heuristics, scheduling policies, and network topologies to be independently replaced. Numerical evaluation reveals distinct operating regimes in which the optimal resource allocation and code distance selection shift depending on the network characteristics. These results point to tradeoffs in the design of distributed quantum computing architectures that are not visible when computation and communication are modeled separately.

02.
arXiv (CS.CV) 2026-06-18

Forged Calamity: Benchmark for Cross-Domain Synthetic Disaster Detection in the Age of Diffusion

The rapid advancement of text-to-image diffusion models has enabled the creation of highly photorealistic synthetic images that closely resemble real photographs, making it increasingly difficult to distinguish authentic content from AI-generated fabrications. This poses challenges for cybersecurity, digital forensics, and disaster response, where fake imagery of floods, fires, or earthquakes can spread misinformation or disrupt emergency operations. To address this, we introduce Forged Calamity, a benchmark dataset for synthetic disaster detection containing 30,000 images, including 6,000 real and 24,000 synthetic samples generated by four diffusion models. Comprehensive experiments across fine-tuned and zero-shot settings reveal consistent weaknesses in current forensic approaches. Fine-tuned detectors perform well in-distribution but lose up to 50\% accuracy on unseen generators or disaster types, showing overfitting to model-specific artifacts. Zero-shot generalized detectors also struggle to maintain stable accuracy, with only limited resilience in a few representation-robust models. These findings highlight persistent generalization gaps and the urgent need for domain- and model-agnostic detection methods to ensure visual authenticity in the diffusion era.

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

Direct Preference Optimization for Chatbot Fine-Tuning: An Empirical Study

We present an approach to fine-tuning large language models using Direct Preference Optimization (DPO), a reinforcement learning technique. Our experimental results demonstrate that DPO simplifies the training pipeline, improves computational efficiency, and achieves competitive performance. The evaluation using BLEU, ROUGE, and cosine similarity metrics indicates effective learning and convergence, though further investigation is needed to address observed training instability.

04.
arXiv (CS.LG) 2026-06-16

A Spatio-Temporal Expert Prefetching Framework for Efficient MoE-based LLM Inference

arXiv:2606.15453v1 Announce Type: cross Abstract: Mixture-of-Experts (MoE) based large language models (LLMs), such as Qwen and DeepSeek, have recently emerged as an effective approach to improving model capacity without proportionally increasing computational cost. By replacing the conventional feed-forward network in dense LLMs with a set of experts and activating only a subset of them for each input token, MoE models significantly increase the total number of parameters while keeping the per-token computation relatively manageable. However, this dynamic and irregular expert activation pattern also introduces substantial expert loading overhead during inference, since the required experts must be fetched on demand according to token-dependent routing results. As a result, expert loading latency becomes a major source of performance and energy inefficiency. To this end, we first perform a comprehensive analysis of expert selection behavior in various MoE-based LLMs and applications, including language understanding and code generation. Our analysis reveals that, within each application domain, expert requests exhibit strong correlation across both adjacent MoE layers and consecutive decoding tokens, making future expert activations predictable. Based on this insight, we propose ST-MoE, a spatio-temporal expert prefetching framework that proactively stages experts ahead of use to overlap expert loading with ongoing computation. ST-MoE combines a lightweight runtime prediction mechanism that preserves the original routing behavior with a reconfigurable hardware design that efficiently supports dynamic expert prefetching. The combined effect of the prediction mechanism with the supporting hardware significantly improves MoE inference performance and energy efficiency while preserving model inference accuracy.

05.
arXiv (CS.CV) 2026-06-16

An Ensemble Deep Learning Approach for Reliable and Scalable Lemon Leaf Disease Classification

Early detection of plant diseases is crucial to plants and for the farmers. Plant diseases reduce fruit yield and quality, and plants are more susceptible to other stresses when they are infected. The lemon leaf disease dataset contains 1354 images. The dataset has 9 classes. Among the 9 classes only one class is for healthy leaf, and the other 8 classes are leaf diseases. The dataset was split into training (70%), testing (15%) and validation (15%) sets after comprehensive preprocessing. Two pretrained models (InceptionV3 and MobileNetV2) were applied and then combined these models using an ensemble technique to boost robustness. Ensemble models showed a promising performance of 99.27% accuracy. Adversarial Training is applied to improve models' ability and ensure reliable predictions under noisy data. Grad-CAM visualization highlights the important regions of leaf images that validate the model prediction with confidence level.

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

From Specification to Execution: AI Assisted Scientific Workflow Management

arXiv:2606.18425v1 Announce Type: cross Abstract: Scientific workflow management systems (WMS) support scalable and reproducible execution of complex pipelines, but workflow design, implementation, and debugging remain largely manual and require significant expertise. Recent approaches using large language models (LLMs) show promise for workflow generation from natural language, but often rely on direct code synthesis, which limits transparency, reproducibility, and integration with workflow systems. We present an AI-assisted approach to scientific workflow management that combines specification-driven workflow generation, automated debugging, and distributed execution. The method introduces a structured specification phase that separates workflow intent, design, and implementation, allowing validation prior to code generation. We also develop an LLM-based debugging agent that diagnoses and resolves failures across multiple system layers. To support distributed execution and user interaction, we integrate Pegasus, a widely used WMS, with a Model Context Protocol (MCP) layer, providing a unified interface for workflow submission, monitoring, and control. We evaluate the approach using a federated learning workflow for medical imaging, chosen for its parallel, iterative, and dependency-intensive structure. The system generated and executed large-scale workflows with thousands of jobs, reduced debugging effort, and allowed non-expert users to construct workflows with expert-level design patterns. These results indicate that end-to-end AI-assisted workflow generation and execution is feasible, and point toward AI-driven platforms for managing the scientific workflow lifecycle.

07.
arXiv (CS.LG) 2026-06-17

A Generalized Sinkhorn Algorithm for Mean-Field Schrödinger Bridge

arXiv:2604.06531v3 Announce Type: replace-cross Abstract: The mean-field Schrödinger bridge (MFSB) problem concerns designing a minimum-effort controller that guides a diffusion process with nonlocal interaction to reach a given distribution from another by a fixed deadline. Unlike the standard Schrödinger bridge, the dynamical constraint for MFSB is the mean-field limit of a population of interacting agents with controls. It serves as a natural model for large-scale multi-agent systems. The MFSB is computationally challenging because the nonlocal interaction makes the problem nonconvex. We propose a generalization of the Hopf-Cole transform for MFSB and, building on it, design a Sinkhorn-type recursive algorithm to solve the associated system of integro-PDEs. Under mild assumptions on the interaction potential, we discuss convergence guarantees for the proposed algorithm. We present numerical examples with repulsive and attractive interactions to illustrate the theoretical contributions.

08.
medRxiv (Medicine) 2026-06-22

Substantia Nigra and Subthalamic Nucleus Deep Brain Stimulation Exert Opposing Effects on Novelty Recognition in Parkinson's Disease

Episodic memory plays a critical role in supporting adaptive behavior; however, whether it can be causally regulated in humans via deep subcortical stimulation remains unclear. In the present study, we investigated the differential effects of substantia nigra (SN) and subthalamic nucleus (STN) stimulation on episodic memory, as well as the underlying mechanisms of its associated brain networks, using a recognition memory task combined with concurrent functional magnetic resonance imaging in patients with Parkinson's disease. SN-DBS increased recognition sensitivity and reduced false alarms at both frequencies, whereas 10 Hz STN-DBS reduced sensitivity and increased false alarms. Functional connectivity analyses in the absence of DBS stimulation identified a false recognition-related network linking nigral, pallidal, subthalamic, medial temporal, frontal, and occipital regions. SN-DBS-related false alarm reduction tracked modulation of this circuit and was marked by its baseline vulnerability state. These behavioral effects mapped onto target-dependent parieto-occipital and SN-visual retrieval pathways, supporting a model in which DBS bidirectionally regulates recognition memory through target- and frequency-dependent subcortical-cortical circuits.

09.
arXiv (CS.CL) 2026-06-11

Beyond Third-Person Audits: Situated Interaction Auditing for User-Centered LLM Bias Research

Research on bias in large language models (LLMs) has predominantly focused on third-person audits, which study how models represent or evaluate demographic groups as external subjects. However, this paradigm overlooks a structural blind spot because the user is absent from the audit. In practice, LLMs are used in open-ended, personal interactions, during which the model implicitly represents the user and adjusts its responses accordingly. When identical requests yield different responses depending on who is asking, bias manifests not in how the model describes others but in how it treats its interlocutor. We propose Situated Interaction Auditing (SIA), a user-centered framework for studying how user profile signals – implicit sociodemographic markers, writing style, and stated identity – systematically shape LLM response quality, content, and tone. We demonstrate the framework through a case study that intersects gender and socioeconomic status signals across multiple task domains and outline a research agenda for SIA as a new mission for natural language processing.

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

EPIG: Emotion-Based Prompting for Personalised Image Generation

arXiv:2606.13247v1 Announce Type: new Abstract: Text-to-image diffusion models have achieved impressive results in synthesizing high-quality images from natural language prompts. However, commonly used prompting strategies remain relatively generic, limiting the model's ability to accurately express emotional intent and nuanced affective attributes. This work proposes EPIG, a method that enhances emotional expressiveness at the prompt level prior to image generation. Grounded in psychologically informed emotion representations (valence-arousal) and leveraging structured, role-aware prompt enrichment, EPIG enriches emotion-related components of prompts without modifying or retraining the image generation backbone. The resulting emotion-aware prompts guide the generative process toward more emotionally coherent visual outputs, with particular effectiveness in controlling arousal. EPIG is lightweight, training-free, and well suited for resource-constrained and personalized image generation scenarios. Experimental results on a benchmark of 10 diverse prompts show that EPIG reduces mean arousal error compared to strong baselines, including naive insertion and LLM-based prompt expansion, with reductions of 14% and 12%, respectively. These improvements are statistically significant. EPIG also preserves valence alignment and semantic consistency, as measured by CLIPScore and supported by ablation studies. The effect is more pronounced on prompts containing explicit subjects such as humans, children, or animals, where the reduction reaches 17%, highlighting the subject-sensitive behavior of the proposed method.

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

Conflict-Aware Federated Fine-Tuning of Large Language Models with Mixture-of-Experts

arXiv:2606.15625v1 Announce Type: new Abstract: The continuous scaling of large language models (LLMs) incurs prohibitive computational costs, making Mixture-of-Experts (MoE) a scalable alternative for efficient fine-tuning via sparse activation. While federated learning (FL) emerges as the paradigm for privacy-preserving collaborative optimization, integrating MoE into FL under data heterogeneity may trigger conflicting expert optimizations. Client-specific data distributions force same-indexed experts to optimize under inconsistent or even conflicting feature-label correlations. This mismatch induces destructive interference during aggregation, thus destabilizing the optimization trajectory and degrading model performance. To address this issue, we propose FC-MoE, a federated conflict-aware framework for MoE fine-tuning. It employs an importance aware weighting scheme to prioritize reliable local updates and utilizes gradient consensus projection to suppress conflicting updates, ensuring a stable global optimization path. Moreover, a local knowledge retention mechanism further preserves specialized client expertise by re-anchoring domain-specific residuals. Extensive experiments demonstrate that FC-MoE accelerates convergence and enhances both global and local model performance in non-IID federated environments.

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

Graphical-Probabilistic Modeling of Generative Flows in LLM-Native Software Systems

arXiv:2606.15943v1 Announce Type: cross Abstract: Engineering LLM-native software remains a challenging and immature field. Current practice is largely exploratory, relying on experimentation and heuristic techniques such as prompting and context engineering. These, however, are low-level and lack the principled structure needed to support design-level reasoning or analysis. In contrast, traditional software engineering leverages modularity and abstraction to communicate and analyze system behavior. To bring similar rigor to LLM-native development, we propose methods for documenting generative flows and for stating properties of LLM-based software designs. Such methods must account for the stochastic, prompt-dependent behavior of large language models while remaining expressive enough to capture emergent phenomena. Our initial approach is based on graphical probabilistic models, tailored to capture phenomena characteristic of LLM-native systems. This framework – what we term Generation Networks – aims to provide a foundation for principled reasoning about generative interactions and system-level properties in LLM-centric software architectures.

14.
arXiv (CS.LG) 2026-06-11

A Judge-Aware Ranking Framework for Evaluating Large Language Models without Ground Truth

arXiv:2601.21817v3 Announce Type: replace-cross Abstract: Evaluating large language models (LLMs) on open-ended tasks without ground-truth labels is increasingly done via the LLM-as-a-judge paradigm. A critical but under-modeled issue is that judge LLMs differ substantially in reliability; treating all judges equally can yield biased leaderboards and misleading uncertainty estimates. More data can make evaluation more confidently wrong under misspecified aggregation. We propose a judge-aware ranking framework that extends the Bradley-Terry-Luce model by introducing judge-specific discrimination parameters, jointly estimating latent model quality and judge reliability from pairwise comparisons without reference labels. We establish identifiability up to natural normalizations and prove consistency and asymptotic normality of the maximum likelihood estimator, enabling confidence intervals for score differences and rank comparisons. Across multiple public benchmarks and a newly collected dataset, our method improves agreement with human preferences, achieves higher data efficiency than unweighted baselines, and produces calibrated uncertainty quantification for LLM rankings.

15.
arXiv (CS.CL) 2026-06-18

RCEM: Robust Conversational Search EMbedder in Distributional Shift

We propose RCEM, a Robust Conversational search EMbedder that is additionally equipped with LLM's query reformulation capability without losing base model's generalization. Unlike prior conversational dense retrieval approaches that learn direct conversation-to-passage matching, RCEM aligns conversations, prepended by special token, to LLM-rewritten queries, while preserving the original embedding space. The unchanged embedding space automatically maps the rewritten-query to the relevant passages. As a result, RCEM (1) reduces overfitting by simplifying the alignment task from long passages to shorter rewritten queries, (2) eliminates the need for conversation-to-passage relevance labels for training, and (3) maintains its original embedding space that allows conversational queries against indexes built by original embedder without rebuilding them. Extensive experiments show that RCEM consistently outperforms prior approaches, achieving up to 30% improvement under distributional shift.

16.
arXiv (CS.CV) 2026-06-12

MPMWorlds: Material-Point-Method Simulations for Inferring and Extrapolating Physical Dynamics

To study the ability to infer physical dynamics from videos and extrapolate them forward in time, we assemble a dataset of 2D Material Point Method (MPM) physical simulations covering rich physical phenomena such as deformable objects, fluids, kinetic objects, and emitters. We study code generation and video diffusion approaches on this dataset, identifying their strengths and weaknesses by varying the amount of physically relevant side information. The code generation model, beyond giving a working demonstration of automatic synthesis of MPM simulations, reveals that such an approach struggles with inferring physical parameters from visual input, but relative to video diffusion, produces physically and temporally stable extrapolations forward in time, while the video diffusion model more strongly identifies geometric properties from visual input but produces physically implausible extrapolations.

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

MUNI: Multimodal Unified Latent Diffusion for Coherent Any-to-Any Generation

arXiv:2606.16408v1 Announce Type: new Abstract: We introduce MUNI, an end-to-end multimodal latent diffusion framework for any-to-any generation that unifies subset-conditioned cross-modal generation and unconditional joint sampling through a shared stochastic latent. Existing multimodal generative models are largely LLM-based, which limits leveraging modality-specific generators and requires text-paired data for training. Recent diffusion- and flow-based any-to-any extensions take a different direction but still rely on text-aligned embeddings, fully-paired training, or matched-dimensionality deterministic mappings. MUNI rests on two complementary contributions, one architectural and one in the training objective. First, we extend latent diffusion to multimodal any-to-any generation end-to-end: instead of the standard two-stage recipe that precomputes a frozen latent space and then fits a prior over it, MUNI jointly trains modality-specific encoders, expressive decoders, and a single shared flow-based prior under one objective. Second, we identify that the standard aggregation rules of multimodal variational inference are insufficient once coupled with a learned prior and expressive decoders. A suitable shared latent must simultaneously satisfy coherence across generated modalities, predictive sufficiency of subset latents, and minimality of the latent content. We propose a routed training objective whose structural choices align the latent with these criteria and admit a minimal-sufficiency characterization in the realizable setting. Experiments on PolyMNIST-Quadrant-Labels and a large-scale image-text-audio benchmark show MUNI matching or exceeding the strongest baselines on conditional generation while opening its largest margins on unconditional coherence. Project page: https://muni-proj.github.io/.

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

LLM Features Can Hurt GNNs: Concatenation Interference on Homophilous Graph Benchmarks

Adding LLM-generated node features to graph neural networks (GNNs) is widely reported to improve accuracy on standard benchmarks. We document a contrasting observation: when LLM features are introduced through pure input concatenation (rather than joint training, distillation, or prompt-conditioning), they can systematically degrade accuracy on the same homophilous benchmarks where end-to-end LLM pipelines succeed. With an MLP backbone on the Planetoid public split and bag-of-words original features, concatenating SBERT-encoded GPT-4o-mini TAPE features reduces PubMed test accuracy by -17.0 +/- 0.3 pp and Cora by -4.3 +/- 0.6 pp (CiteSeer -0.6 +/- 0.8 pp, within seed noise). The drop attenuates as we relax each condition (GCN / GCNII / GAT backbones, random splits, smaller encoders) and reverses on medium-homophily WikiCS (+4.4 pp) and ogbn-arxiv (+11.7 pp). To predict when concatenation helps versus hurts, we report a simple measure of LLM-alone discriminability, Delta_sig. Across 9 datasets Delta_sig correlates with the concatenation cost more strongly than homophily at point estimate (r^2 = 0.38 vs. 0.06; N=9, bootstrap CIs overlap). The bootstrap-best change-point is tau = 13.8 pp, and the rule "Delta_sig

19.
arXiv (CS.AI) 2026-06-16

QPILOTS: Efficient Test-Time Q-Steering for Flow Policies

arXiv:2606.14801v1 Announce Type: cross Abstract: Flow-matching and diffusion policies are expressive action generators, but optimizing them with temporal-difference reinforcement learning (RL) remains difficult. Effective policy extraction requires exploiting the critic's action gradient, yet directly backpropagating this signal through a multi-step denoising process can be numerically unstable. Existing methods work around this either by discarding gradient information, distilling the policy into a simpler one-step actor, or repeatedly fine-tuning the denoising policy as the critic improves. We propose QPILOTS, a method that leaves the original policy unmodified and steers the denoising process at inference time. At each denoising step, instead of evaluating the critic on the noisy intermediate action where critic predictions are unreliable, we first project that intermediate state to an estimate of the final clean action and compute the critic gradient there. We introduce two variants: QPILOTS-U uses a fast single-point approximation, while QPILOTS-M draws differentiable posterior samples via a learned auxiliary network. On a standard offline-to-online RL benchmark, QPILOTS achieves the best aggregate performance, reaching an average success rate of 90% across 50 tasks. We also apply QPILOTS to steer a large, frozen, pretrained Vision-Language Action (VLA) foundation model, outperforming or matching prior inference-time approaches across six manipulation tasks in simulation.

20.
arXiv (CS.CV) 2026-06-12

Person Identification from Contextual Motion

We consider the problem of identifying people based on their motion styles. We present a generative model describing the action instance creation process and derive a probabilistic identity inference scheme for two common person identification scenarios motivated by the surveillance and authentication applications. We introduce a novel, interactive, scenario for person identification from motion patterns. To this end, we formalize the identification process in the context of a sequential message exchange session between the subject and the system. The subject's behavior is modeled using a probabilistic generative model inspired by the Human Information Processing (HIP) paradigm. At each stage, the system presents a visual stimulus (a cue) to the subject and records their motion response. The cue is selected so as to maximize the mutual information of the expected response and the subject's identity. Once recorded, the response is used to update the a posteriori probability over possible subjects' identities. The process terminates once a sufficient classification confidence level is reached. To the best of our knowledge, this is the first time person identification is addressed in such interactive setting. We report high recognition rates on five publicly available datasets and our own novel dataset consisting of 4,476 recordings of 22 test subjects responding to 15 cues.

21.
arXiv (CS.AI) 2026-06-19

Multi-Head Attention-Based Feature Extractor Integration with Soft Actor-Critic for Porosity Prediction and Process Parameter Optimization in Additive Manufacturing

arXiv:2606.20087v1 Announce Type: new Abstract: Additive manufacturing process optimization requires precise parameter control to minimize defects such as porosity. Traditional reinforcement learning (RL) approaches using discrete action spaces suffer from slow convergence and susceptibility to local optima, limiting their effectiveness for high-precision manufacturing tasks. This study addresses these limitations by employing a continuous action space combined with a novel architecture that integrates a multi-head attention mechanism with the Soft Actor-Critic (SAC) algorithm. The attention-based feature extractor enhances the agent's ability to capture subtle variations in low-dimensional input features, enabling more effective exploration-exploitation balance for navigating value spaces with local minima. We validate our approach on porosity prediction and process parameter optimization in laser powder bed fusion, demonstrating faster convergence and higher final reward values compared to standard RL methods including DQN, PPO, TD3, and vanilla SAC. The proposed methodology achieves a convergence value of 322.79 within 14 episodes, outperforming existing approaches while maintaining stability throughout training.

22.
arXiv (CS.LG) 2026-06-11

IAPO: Input Attribution-Aware Policy Optimization for Tool Use in Small Multimodal Agents

arXiv:2606.11652v1 Announce Type: new Abstract: This paper investigates reinforcement learning (RL) methods for improving tool-calling capabilities in multimodal small language model (SLM) agents. While existing works have explored various reward designs to improve agentic tool-calling ability, these approaches face inherent limitations for SLM training, especially under multimodal scenarios. First, many existing methods evaluate tool use correctness through exact matching against certain ground-truth or predefined formats. However, this assumption is often unsuitable for multimodal tasks, where multiple tool use paths may be valid and annotated tool trajectories are typically unavailable. Second, such sparse and brittle binary rewards provide little guidance on how to improve the underlying decision process, making them particularly difficult for multimodal SLM to learn from. To address these issues, we propose Input Attribution-Aware Policy Optimization (IAPO), an RL algorithm for improving tool use in multimodal SLM by aligning the model's attribution across input components with that of a stronger teacher. Experiments on Qwen2.5-VL-3B show that the proposed method improves visual question answering accuracy by an average of 3% across six test sets compared with existing visual tool use work, by helping the model attend to the most relevant input evidence.

23.
arXiv (CS.AI) 2026-06-12

Muse Spark Safety & Preparedness Report

arXiv:2606.12429v1 Announce Type: cross Abstract: Muse Spark is the latest large language model developed by Meta. In this report, we first present evaluations for catastrophic risk domains under Meta's Advanced AI Scaling Framework, along with the evidence that informed our launch decision. We then discuss additional considerations, such as Muse Spark's broader content safety and behavioral profile, that are relevant to overall safety but fall outside the catastrophic risk domains governed by the Framework. Our preparedness results covering Chemical and Biological, Cybersecurity, and Loss of Control risks assess Muse Spark's deployment within Meta AI as presenting acceptable levels of residual risks under our Advanced AI Scaling Framework. We conducted a broad set of evaluations targeting dual-use and high-risk capabilities across these catastrophic risk domains. Those evaluations identified elevated risks prior to mitigations, with Chemical and Biological capabilities assessed as likely reaching the "high risk" category under the Advanced AI Scaling Framework before safeguards were applied. We have implemented a multi-layered set of mitigations that address the identified risks, and Muse Spark demonstrates state-of-the-art refusal across a range of benchmarks related to hazardous workflows in chemistry and biology. We therefore release Muse Spark as the underlying model of Meta AI.

24.
arXiv (CS.CL) 2026-06-15

TA-RAG: Tone-Aware Retrieval-Augmented Generation for Peer-Support Health Communication

Retrieval-augmented generation (RAG) successfully grounds large language model (LLM) outputs in trusted documents, but factual grounding alone is insufficient for sensitive peer-support health communication. In domains such as HIV peer support, responses must also be accessible, stigma-free, empathetic, and tailored to the recipient. This paper presents TA-RAG, a lightweight, prompt-based tone-aware RAG framework that embeds explicit tone control into a RAG pipeline without requiring model fine-tuning. We operationalise tone across four core components: stigma-free rewriting, readability adjustment, recipient adaptation, and empathy rephrasing. We evaluate TA-RAG through component-level tests using questions derived from HIV Online Learning Australia (HOLA), UNAIDS terminology guidance, readability metrics, peer-support standards from National Association of People with HIV Australia (NAPWHA), and a public empathy dataset. Results show that the TA-RAG's components improve their targeted communication quality while preserving key content. These findings emphasise that prompt-based tone control is a potential direction for making RAG outputs suitable for sensitive peer-support health communication.

25.
PLOS Medicine 2026-06-09

Prediction of hospitalisation in young children with pneumonia in Malawi: A machine learning-based approach

by Patrick Staunton, Mohammad Adib Makrooni, Master Chisale, Billy Nyambolo, Joseph Wu, Damien McCarthy, Mark Ledwidge, Yasir Bin Nisar, Chris Watson, Balwani Mbakaya, Cathal Seoighe, Joe Gallagher Background Globally, pneumonia remains the single biggest cause of mortality in children under 5 years of age. This study sought to train and test a prediction model for hospitalisation within 7 days after initial presentation in 2- to 59-month-old Malawian children with WHO-defined pneumonia in primary care and compare its performance to existing risk prediction models. Methods and findings BIOTOPE is a cohort study of children with pneumonia in a primary healthcare setting in Malawi. The training cohort involved nine primary care centres and the testing cohort involved two primary care centres in Northern Malawi. The training cohort was recruited between December 2022 and April 2023 while the testing cohort was recruited in 2016. Participants were consecutive children aged 2–59 months presenting with cough and/or difficulty breathing and who were diagnosed as WHO-defined pneumonia in primary care of any severity. The training cohort was used to train and validate a machine learning model with a prespecified primary outcome defined as hospitalisation and/or death within 7 days as the outcome. This model was then further evaluated in the testing cohort.Median age was 15 months (interquartile range 8−27) in the training and 17 months (interquartile range 9−29) in the external testing cohort (52.1% and 54.4% male, respectively). Hospitalisation occurred in 14.3% (294) of the training cohort and 12.1% (55) of the testing cohort. There was one death in the training cohort only. WHO danger signs were present in 17.6% (360) and 15.9% (70) of children in the training and testing cohorts, respectively. The optimal machine learning model achieved an area under the receiver operating characteristic and precision recall curves of 0.87 and 0.57, respectively, in the testing cohort outperforming existing risk prediction models; furthermore, this model produced an expected calibration error of 0.16 (a logistic regression model using severity status as the response variable and the log odds of the machine learning model’s calibrated probabilities produced an intercept estimate of −0.32 and a slope estimate of 1.13). Key limitations include the use of hospitalisation and/or death as a severity outcome, which may reflect health system factors rather than true disease severity, that mortality-based comparisons were not possible due to low mortality in these primary care cohorts, and that comparator tools were developed for hospital populations rather than primary care populations. Conclusion This machine learning score outperformed traditional pneumonia risk scores in predicting hospitalisation within 7 days in Malawian children presenting to primary care. Traditional pneumonia risk scores diminish in performance when externally applied to new datasets suggesting they may not generalise well beyond their original derivation settings. Mortality-related findings are not applicable as there was only one death in this cohort. Overall these findings support the potential of machine learning to meaningfully improve early identification of children at risk of severe pneumonia in low-resource primary care settings. Further external validation and clinical impact studies are needed to confirm these results.