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01.
medRxiv (Medicine) 2026-06-18

The Effectiveness of aromatherapy and its supportive Interventions on anxiety and pain among breast cancer patients: A systematic review and meta-analysis

Authors:
Estervil↗N. O↗Carmichael↗C. L↗Feyissa↗G. T↗

Introduction: Breast cancer treatments are often associated with pain and anxiety, which can hinder physical functioning and overall quality of life, even after treatment. Complementary therapies, such as aromatherapy, can be used to alleviate pain and reduce anxiety in breast cancer patients. This project aimed to synthesize current global evidence on the effectiveness of aromatherapy. Method: This systematic review followed the PRISMA 2020 guidelines, with a comprehensive, systematic search conducted in PubMed, CINAHL, Cochrane Library, and SCOPUS for randomized controlled trials (RCTS) published from 2015 to 2025. Eligible studies included adult women breast cancer surgery patients who received aromatherapy during various periods of breast cancer. Where possible, data from the included studies were pooled using meta-analysis. GRADE approach was used to assess certainty of findings. Results: The search yielded 84 studies. Out of these, six were included in this review. On average, aromatherapy reduces pain and anxiety scores by 0.79 (standard mean difference (SMD)=-0.79, 95% CI -1.42, -0.16) and 0.53 (SMD=-0.53, 95 CI=-0.90, -0.16) units, respectively, compared to control condition [Low-quality of evidence]. The combination of aromatherapy with music reduces pain and anxiety by 1.26 (SMD= -1.26, 95 CI=-1.65, -0.87) and 1.08 (SMD = -1.08, 95 % CI: -1.45, -0.70) units respectively compared to standard care [Low-quality of evidence]. Conclusion: There is a potential role for the use of aromatherapy and music therapy, to alleviate anxiety and pain, especially for non-preoperative anxiety and pain. Further research is needed to inform the integration of aromatherapy into the management of anxiety and pain.

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02.
bioRxiv (Bioinfo) 2026-06-18

A unified smoothing framework for protein domain bigram model

Authors:
Cui↗Iyer↗Durand↗

Biomolecular sequences can be represented as strings over an alphabet, an analogy that has motivated many applications of computational linguistic techniques to biological problems. However, such methods must be adapted to the characteristic scale and organization of biomolecular data. Here, we consider the problem of bigram smoothing for multidomain protein architectures, where domain bigram frequency data is extremely sparse and differs from textual data in alphabet size, string length distribution, the relationship between bigram and unigram frequencies, tandem repeat lengths, and the distribution of domain adjacencies. Moreover, some domain combinations are unobserved because they are biologically incompatible, others because the data are incomplete. A smoothing method that distinguishes these two cases is required. We propose a unified smoothing framework based on interpolation that can be tuned to accommodate different bigram data characteristics. Within this framework, we design specific model variants suited to protein domain bigram data: these assign low adjusted counts to pairs that are likely incompatible, while making appropriate adjustments for undersampled pairs. We demonstrate empirically that this approach distinguishes the two cases while preserving the characteristic signatures of multidomain data.

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03.
arXiv (math.PR) 2026-06-12

On McDiarmid's Inequality under Dependence via Approximate Tensorization of Entropy

Authors:
Valentin Roth↗

arXiv:2606.12720v1 Announce Type: new Abstract: We argue that dependent versions of McDiarmid's inequality are a useful but underutilized tool in mathematical statistics, learning theory and theoretical computer science. To make this point, we first highlight that approximate tensorization of entropy (ATE) implies McDiarmid's via the Entropy Method. Second, we derive McDiarmid's inequality for non-isotropic Gaussian random vectors $X \sim \mathcal N(\mu, \Sigma)$ through ATE with a constant of the order of the condition number of $\Sigma$. We both independently obtain this ATE through a simple application of stochastic localization and also discuss how a more general ATE for the Gibbs sampler due to Ascolani et al., 2026 generalizes McDiarmid's-like concentration to strongly log-concave and log-smooth probability measures. We then apply the resulting concentration inequalities to resolve a question on the concentration of $\operatorname{sign}(X)$ posed by Simone Bombari, investigate Erdős-Rényi graphs under dependence and prove a Dvoretzky-Kiefer-Wolfowitz-type inequality for observations from a joint measure fulfilling ATE and continuous marginal CDFs. For the class of strongly log-concave and log-smooth measures, this result improves upon a prior Dvoretzky-Kiefer-Wolfowitz-type inequality for non-i.i.d. observations due to Bobkov and Götze, 2010, by establishing the expected $1/\sqrt{n}$-rate of convergence under weak dependence instead of $n^{-1/3}$.

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

Emergent Alignment

Authors:
Martin Kol\'a\v{r}↗

arXiv:2606.19527v1 Announce Type: new Abstract: Can Large Language Models (LLMs) discern when their own outputs are misaligned with human ethics? And can they self-correct? We endow an LLM with a conscience step that reviews its own reasoning and outputs, and we extend the training loss with an alignment component using Direct Preference Optimization (DPO) to steer the model away from non-ethical outputs. The result is an online technique to align models in a wide range of applications: training, fine-tuning, adversarial prompting, and zero-shot learning. It does not require a weaker or stronger judge, relying instead on a frozen copy of itself. In previous work, the Emergent Misalignment scenario showed a range of emergent unethical behaviors from fine-tuning the model to hack code. Instead, we empirically show how to achieve Emergent Alignment: a single high-level introspective question steers training toward an ethical model under the same code hacking scenario.

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

JoyAI-VL-Interaction: Real-Time Vision-Language Interaction Intelligence

Authors:
Dingyu Yao↗Junhao Zhou↗Chenxu Yang↗Chuanyu Qin↗Haowen Hou↗Zheming Liang↗Congcong Wang↗Yuhang Cao↗Shenglong Ye↗Shuai Xie↗Shuhuan Gu↗Haoyang Huang↗…

Many moments in the real world do not wait for a user to ask. A fire starts on a security monitor, an expression flickers across a video call, or a product a viewer wants flashes by in a livestream. Yet today's large models remain mostly turn-based by design: they answer only when addressed, and even video-call apps that appear interactive still operate as question-answer systems, reacting only when polled or prompted. We argue for a different paradigm: a model that is present in the world like a person. It continuously watches what is happening now, decides on its own whether to speak or stay silent, interacts in real time, and delegates to a background model when the problem is hard. To advance interaction models and their adoption across domains, we make two fully open-sourced contributions. First, we release JoyAI-VL-Interaction, an 8B-scale, vision-first VL-interaction model. The model makes the response decision internally, choosing each second to stay silent, respond, or delegate to a background model, and it excels at vision-triggered responsiveness and time awareness. We pair it with a transferable training recipe, from which capabilities we never trained for emerge, such as guiding a shopper through changing app screens or improvising a lecture from a slide deck. Second, we release a complete, deployable system built around that model. The system streams any ongoing video into the model, making it genuinely present in the world. All other components are pluggable, including ASR/TTS modules, memory, visualization UI, and a background brain that can connect to any API or agent. Across six real-world scenarios, human raters prefer JoyAI-VL-Interaction over the in-app video-call assistants of Doubao and Gemini by a wide margin. To our knowledge, this is the first open, vision-driven interaction model released together with its training recipe, data, and complete deployable system.

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06.
bioRxiv (Bioinfo) 2026-06-18

Benchmarking attention-based methods for vision transformers' interpretability in retinal fundus imaging

Authors:
Bors↗Beyeler↗Trofimova↗VascX Consortium↗Presby↗Bontempi↗Bergmann↗

Deep learning models based on Vision Transformers (ViTs) have shown strong performance in retinal fundus imaging, but their interpretability remains poorly understood. In particular, attention-based attribution methods are widely used to explain ViT predictions, despite limited evaluation of their faithfulness and biological relevance in medical imaging. Here, we systematically benchmark four attention-based interpretability methods for RETFound, a retinal ViT-based foundation model, that we previously fine-tuned to predict 17 retinal vascular phenotypes from UK Biobank fundus images1. We compare raw attention, attention rollout, gradient-weighted attention rollout, and Chefer's hybrid relevance-based method using both qualitative visualisation and quantitative evaluation frameworks. To assess attribution faithfulness, we perform perturbation-based deletion and insertion experiments, quantifying changes in model predictions as highly attended image regions are progressively removed or restored. To evaluate biological specificity, we run structure-aware analyses combining attribution maps with vessel segmentation and artery-vein labels through the Relative ratio of Attention Intensity (RAI) metric. Across models, attribution maps differed substantially depending on the selected interpretability method, highlighting the need for rigorous quantitative evaluation. Among the evaluated approaches, gradient-weighted attention rollout consistently achieved the strongest perturbation performance and produced attribution maps most closely aligned with the anatomical definition of the predicted retinal traits. Furthermore, vessel-type specific models systematically concentrate attention on the corresponding vascular structures despite being trained using only a single scalar value per image as supervision. These findings demonstrate that attention-based attribution methods capture biologically meaningful vascular representations, while also revealing method-dependent variability in attribution behaviour. This work provides a quantitative framework for evaluating interpretability methods in medical imaging with annotated segmentation and contributes toward more transparent and biologically grounded medical AI systems.

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07.
medRxiv (Medicine) 2026-06-15

Supporting people to access social security payments through the Special Rules for End of Life: a qualitative study of the perspectives of patients, carers and health care professionals

Authors:
Davies↗J. M↗Marshall↗Hussain↗Diggle↗French↗Stone↗Fimister↗Ogden↗Sleeman↗K. E↗Bradshaw↗…

Background: People living with terminal illness face a double financial burden from additional costs and loss of earning for themselves and their carers. Social security benefits are intended to help alleviate some of this financial pressure, and in the UK and other countries people are eligible for fast-tracked access to financial support via the Special Rules for End of Life. One in 3 people who are eligible miss out on this support, yet there is limited evidence on the reasons for this take-up deficit. Objectives: The aim of this study is to understand the barriers and facilitators to claiming benefits for terminally ill people from the perspectives of patients, carers, and health care professionals. Methods: This is a qualitative study combining i) focus groups with healthcare professionals recruited via professional networks and social media, and ii) interviews with patients and carers recruited in hospital and hospice settings. We analysed the data using Practical Thematic Analysis Results: Fifty-five multidisciplinary healthcare professionals participated in 11 focus groups, and we interviewed 10 patients and carers. We constructed five descriptive themes to summarise the data: Navigating priorities and uncertainty; positive impacts alongside a sense of shame and stigma; talking about money, difficulties and dividends; everybodys, yet nobodys, responsibility; and sticking points in the system. Conclusion: The themes reveal several challenges that may contribute to people not taking up this financial support. However, discussions about access to benefits were also seen as a core part of holistic care, a positive way to offer support and a gateway to other discussions about end-of-life care preferences and decisions. Recommendations for policy and practice include evaluating the adoption of a diagnostic rather than a prognostic eligibility criteria, integrating discussions about benefits into existing processes such as advance care planning, and improving education and support for clinicians.

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

Diffusion Offline Reinforcement Learning for Fair and Energy-Efficient UAV-Assisted Wireless Networks

Authors:
Eslam Eldeeb↗Hirley Alves↗

arXiv:2606.16331v1 Announce Type: new Abstract: The integration of generative artificial intelligence with wireless communication and signal processing systems has opened new avenues for intelligent, data-driven decision-making in future 6G networks. This work proposes a diffusion soft actor-critic (Diffusion-SAC) approach that leverages offline reinforcement learning (RL) enhanced by denoising diffusion probabilistic models (DDPMs) to optimize trajectory and scheduling control in unmanned aerial vehicle (UAV) networks. While offline RL methods, such as conservative Q-learning (CQL), can learn from static datasets, they often struggle to generalize in low-data or dynamic conditions. To address this, we combine the robustness of CQL with the generative power of diffusion models, enabling expressive and signal-aware policy learning that generalizes beyond behavior policies. Applied to a UAV-assisted wireless network, the proposed framework minimizes transmission energy and improves fairness among devices. Simulations show that Diffusion-SAC outperforms standard offline RL baselines, achieving more stable convergence and higher rewards even with limited datasets. The method enhances data efficiency, reduces energy consumption, and increases throughput by more than 35 % compared to existing algorithms, demonstrating its potential for robust policy learning in next-generation wireless control systems.

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

Beyond Self-Attention: Sub-Quadratic Vision Transformers for Fast Image Captioning

Authors:
Chiradeep Ghosh↗Dakshina Ranjan Kisku↗

Image captioning is a challenging and significant task that aims to generate coherent and semantically meaningful textual descriptions for given images. To accomplish this task, it requires a deep understanding of visual content along with the ability to express that understanding in natural language. Despite remarkable progress with transformer-based architectures, existing approaches often suffer from limitations, such as a lack of rich local feature representations and the high computational cost of quadratic self-attention. The proposed model focuses on improving computational efficiency by restructuring the vision transformer architecture. In designing this approach, the standard self-attention mechanism in Vision Transformers is replaced with a probabilistic transformer approach based on a Gaussian Mixture Model (GMM), a soft-clustering technique. Instead of computing pairwise attention among all image patches, the model groups similar patches into a fixed number of clusters using an Expectation-Maximization (EM) algorithm. This clustering-based mechanism reduces the computational complexity from quadratic O(n^2) to linear O(nK), where K

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10.
arXiv (CS.AI) 2026-06-16

Optimizing Health Coverage in Ethiopia: A Learning-augmented Approach and Persistent Proportionality Under an Online Budget

Authors:
Davin Choo↗Yohai Trabelsi↗Fentabil Getnet↗Samson Warkaye Lamma↗Wondesen Nigatu↗Kasahun Sime↗Lisa Matay↗Milind Tambe↗St\'ephane Verguet↗

arXiv:2509.00135v2 Announce Type: replace Abstract: As part of nationwide efforts aligned with the United Nations' Sustainable Development Goal 3 on Universal Health Coverage, Ethiopia's Ministry of Health is strengthening health posts to expand access to essential healthcare services. However, only a fraction of this health system strengthening effort can be implemented each year due to limited budgets and other competing priorities, thus the need for an optimization framework to guide prioritization across the regions of Ethiopia. In this paper, we develop a tool, Health Access Resource Planner (HARP), based on a principled decision-support optimization framework for sequential facility planning that aims to maximize population coverage under budget uncertainty while satisfying region-specific proportionality targets at every time step. We then propose two algorithms: (i) a learning-augmented approach that improves upon expert recommendations at any single-step; and (ii) a greedy algorithm for multi-step planning, both with strong worst-case approximation estimation. In collaboration with the Ethiopian Public Health Institute and Ministry of Health, we demonstrated the empirical efficacy of our method on three regions across various planning scenarios.

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11.
arXiv (CS.CV) 2026-06-18

Revisiting Active Speaker Detection: An In-the-Wild Benchmark for Generalization and Robustness

Authors:
Le Thien Phuc Nguyen↗Zhuoran Yu↗Khoa Quang Nhat Cao↗Yuwei Guo↗Tu Ho Manh Pham↗Tuan Tai Nguyen↗Toan Ngo Duc Vo↗Lucas Poon↗Tuan Khai Nguyen↗Soochahn Lee↗Yong Jae Lee↗

We present UniTalk, a novel dataset emphasizing challenging scenarios to enhance model generalization for the task of active speaker detection (ASD). Previously established benchmarks such as AVA predominantly comprise old movies and thus exhibit significant domain gaps with real-world video. In contrast, UniTalk covers diverse video types reflecting challenging real-world conditions, including underrepresented languages, noisy backgrounds, and crowded scenes, while being on par with AVA in scale. Extensive evaluations reveal that ASD remains unsolved under realistic conditions: state-of-the-art models near-perfect on AVA fail to reach saturation on UniTalk. Conversely, models trained on UniTalk generalize better to modern in-the-wild datasets including Talkies and ASW. UniTalk thus establishes a new benchmark for ASD, providing researchers with a valuable resource for developing and evaluating versatile and resilient models.

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13.
arXiv (CS.CV) 2026-06-15

Memento: Reconstruct to Remember for Consistent Long Video Generation

Authors:
Xuan Wei↗Longbin Ji↗Guan Wang↗Xiangrui Liu↗Zhenyu Zhang↗Shuohuan Wang↗Yu Sun↗Qingqi Hong↗

Long-form video generation requires recurring subjects to remain consistent across various shots, viewpoints, motions, and scene transitions. Existing temporal decomposition methods improve scalability by generating videos shot by shot. However, they mainly focus on optimizing plausible next-shot continuations without verifying whether the historical memory preserves identity-critical subject evidence. Consequently, as generation proceeds, recurring subjects may be diluted, overwritten, or forgotten. In this paper, we propose Memento, a subject-reconstruction-guided framework that treats subject preservation as an explicit identity grounding problem, based on the premise that a memory bank faithfully preserving a subject should support reconstructing that subject from memory alone. Specifically, Memento jointly trains autoregressive next-shot generation with memory-based subject reconstruction, recovering target appearances using historical memory and global story captions. To disentangle long-range subject evidence from short-range cues, Memento introduces a dual-query memory mechanism, where one query retrieves identity-relevant memory and the other selects short-context keyframes for coherent continuation. Additionally, a subject-aware cinematic data pipeline provides precise reconstruction supervision via consistent, pronoun-free subject descriptions. Experiments demonstrate that Memento achieves state-of-the-art performance in long-term subject consistency, cross-shot coherence, and visual quality.

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14.
arXiv (CS.AI) 2026-06-19

Learning Geometric Representations from Videos for Spatial Intelligent Multimodal Large Language Models

Authors:
Haibo Wang↗Lifu Huang↗

arXiv:2606.05833v2 Announce Type: replace-cross Abstract: Multimodal Large Language Models (MLLMs) excel at 2D semantic understanding but lack intrinsic 3D awareness, resulting in representations that fail to maintain geometric and spatial consistency across video frames. Given the scarcity of large-scale 3D data, we present GeoVR, a novel framework that learns geometric representations using purely 2D video sequences. This approach effectively restructures the semantic latent space within MLLMs to unlock spatial intelligence. Rather than employing superficial feature mixing, GeoVR reshapes the internal representations of the MLLM by distilling geometry knowledge from pre-trained 3D foundation models. This is accomplished through a multi-objective learning strategy driven by four complementary geometric targets: (1) estimating inter-frame camera poses to embed varying viewpoint dynamics, (2) regressing dense depth maps to anchor physical distances, (3) predicting a metric scale factor for real-world calibration, and (4) distilling multi-scale 3D features to align the intermediate feature space. Guided by these explicit physical and geometric constraints, the model's internal representations naturally develop strong 3D awareness. Extensive experiments on spatial reasoning benchmarks demonstrate that GeoVR achieves state-of-the-art performance, establishing a new paradigm for endowing foundation models with spatial intelligence.

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

One Layer's Trash is Another Layer's Treasure: Adaptive Layer-wise Visual Token Selection in LVLMs

Authors:
Yongru Chen↗Kai Zhang↗Zeliang Zong↗Yuchen Lu↗Wenming Tan↗Ye Ren↗Jilin Hu↗

Large Vision-Language Models (LVLMs) have achieved remarkable success across diverse multimodal tasks, yet their practical deployment remains constrained by the computational burden arising from lengthy visual tokens. While visual token pruning has emerged as a promising solution, existing methods suffer from a fundamental limitation: once tokens are pruned at a specific layer, they become inaccessible to all subsequent layers, leading to premature information loss that can compromise model performance. Through empirical studies, we observe that different layers exhibit distinct visual region focus, indicating a varying optimal token subset across layers. Motivated by this insight, we propose Adaptive Layer-wise Visual Token Selection (ALVTS), a novel framework that breaks away from the conventional static token pruning paradigm. ALVTS incorporates a lightweight token selector to identify and route important tokens for further processing, while allowing less important tokens to skip the layer, thus minimizing computational redundancy. These two streams of tokens are seamlessly reintegrated before being fed into subsequent layers, facilitating adaptive compression across the entire model. Grounded in our importance consistency constrained low-rank approximation, the proposed token selection module closely emulates the full attention mechanism, effectively capturing its essential patterns without requiring model retraining. Extensive experiments on LLaVA-1.5, LLaVA-NeXT, and Qwen2.5-VL validate the effectiveness of our method. With an 89% token compression ratio, ALVTS retains 96.7% of the original model's accuracy, achieving a superior efficiency-accuracy trade-off for LVLM inference.

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17.
arXiv (CS.CV) 2026-06-12

Self-Evolving Vision-Language Models for Image Quality Assessment via Voting and Ranking

Authors:
Wen Wen↗Tianwu Zhi↗Kanglong Fan↗Yang Li↗Xinge Peng↗Yabin Zhang↗Yiting Liao↗Junlin Li↗Li Zhang↗

Improving vision-language models (VLMs) in the post-training stage typically relies on supervised fine-tuning or reinforcement learning, methods that necessitate costly, human-annotated data. While self-supervised techniques have proven effective for enhancing reasoning capabilities, their application to perceptual domains such as image quality assessment (IQA) remains largely unexplored. In this work, we introduce EvoQuality, a novel framework that enables a VLM to autonomously refine its quality perception capabilities without any ground-truth labels. EvoQuality adapts the principle of self-consistency to the ranking-based nature of IQA. It generates pseudo-labels by performing pairwise majority voting on the VLM's own outputs to establish a consensus on relative quality. These pseudo-rankings are then formulated into a fidelity reward that guides the model's iterative evolution through group relative policy optimization (GRPO). By iteratively leveraging its own predictions, EvoQuality progressively refines the VLM's perceptual capability. Extensive experiments show that EvoQuality boosts the base VLM's zero-shot performance by 31.8% on PLCC across diverse IQA benchmarks. Remarkably, despite being entirely self-supervised, EvoQuality achieves performance that is competitive with, or even surpasses, state-of-the-art supervised VLM-based IQA models, outperforming these models on 5 out of 7 IQA benchmarks. Furthermore, the framework demonstrates significant flexibility, allowing it to be stacked with pre-trained IQA models to bolster generalization on unseen datasets. Codes and checkpoints will be available at https://github.com/bytedance/EvoQuality.

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18.
medRxiv (Medicine) 2026-06-22

Three multimodal large language models fail at clinically actionable breast pathology in three different directions

Authors:
Kang↗Y.-J↗Jun↗S.-Y↗Kim↗

Background. Breast cancer treatment depends on histopathological features, such as grade and receptor-defined subtype; however, specialist pathologist access is constrained when the workforce is limited. Commercial multimodal large language models (MLLMs) accept hematoxylin and eosin (H&E) image tiles through paid interfaces without local hardware or fine-tuning. However, prior pathology evaluations addressed only coarse tasks. Whether they reach treatment-determining accuracy and whether vendors agree remain unclear. Methods. We aimed to evaluate three vendor-designated flagship MLLMs (Claude Sonnet 4.6, Gemini 2.5 Pro, GPT-5.5) in 427 invasive breast cancer cases. Each case went to all three with identical H&E tiles and prompts, and the subtype was inferred in the second call. The reference was an institutional sign-out report of an immunohistochemistry-derived subtype. We calculated the concordance, sensitivity, specificity, Cohen's kappa, and pairwise McNemar and Bowker tests. Findings. Claude ranked highest by raw histologic-type concordance but lowest by kappa, classifying all 23 lobular and seven micropapillary carcinomas as invasive breast carcinoma of no special type. The models anchored the Nottingham grade to three modal grades. None of the models reliably identified human epidermal growth factor receptor 2-positive disease. The failure direction was vendor-specific: Claude and GPT-5.5 were under-detected, whereas Gemini was over-called. Twelve prompt variants (4,056 calls) did not recover sensitivity. Interpretation. No current commercial MLLM reaches deployment-ready accuracy for any treatment-determining feature of breast pathology. As each vendor fails in its own fixed direction, changing vendors alters the type of error rather than removing it; therefore, the value of these models is assistive rather than autonomous. At USD 0.20-0.50 per case, they may serve as supervised draft generators that leave the diagnosis with the pathologist.

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19.
medRxiv (Medicine) 2026-06-12

The Clinical Characteristics and mortality outcomes of Atrial fibrillation complicating Heart failure with reduced ejection fraction: A prospective study from South Africa

Authors:
Mboweni↗N. N↗Maseko↗Tsabedze↗N. I↗Toman↗Nel↗Kagodora↗B. S↗

Background: A growing burden of cardiovascular risk factors has raised cardiovascular disease-related mortality in Sub-Saharan Africa (SSA), driving higher prevalence of heart failure with reduced ejection fraction (HFrEF) and its complication with atrial fibrillation (AF). No prospective study has examined AF's clinical impact on HFrEF in SSA. Aim: To determine AF prevalence in HFrEF, describe HFrEF-AF clinical characteristics, and determine AF's impact on mortality. Methods: In this prospective observational study at a tertiary hospital in Johannesburg, 136 HFrEF patients were enrolled and categorised as HFrEF- SR (sinus rhythm) or HFrEF-AF. Baseline clinical characteristics and biochemistry were recorded. Comprehensive echocardiography including left atrial strain by 2D speckle-tracking was performed. Median follow-up was 30.6 months. Results: AF was present in 28 patients (21%). The mean age was 58.7 {+/-} 14.9 years (52.9% male) and differed between groups (p < 0.001). Hypertensive heart disease was the leading cause of HFrEF (36%). Compared with SR, HFrEF-AF patients had poorer health status (KCCQ 27 [16-43] vs 45 [32-60], p < 0.001) and lower left atrial strain (26.2 {+/-} 11.3%, p < 0.001). Guideline-directed medical therapy was suboptimal in the AF group: anticoagulation use was higher than SR (60% vs 9.5%, p < 0.001) but overall inadequate; HFrEF-AF patients received lower median doses of carvedilol (15.6 mg vs 25 mg, p = 0.002) and enalapril (10 mg vs 20 mg, p = 0.004), and fewer received spironolactone (50% vs 75.3%, p = 0.013). Survival was significantly lower in HFrEF-AF (0.41 [0.22-0.61]) versus SR (0.73 [0.61-0.82], p < 0.001). Independent predictors of mortality included prior stroke, lower TAPSE and KCCQ, and higher E/e' and heart rate. Conclusion: AF is common among HFrEF patients in this SSA cohort (though lower than in high-income countries) and associates with worse clinical status, suboptimal therapy, and higher mortality.

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

From Parameters to Feature Space: Task Arithmetic for Backdoor Mitigation in Model Merging

Authors:
Zhenqian Zhu↗Yamin Hu↗Yiya Diao↗Weixiang Li↗Haodong Li↗Wenjian Luo↗

arXiv:2606.12498v1 Announce Type: cross Abstract: Model merging (MM) has gained significant attention as a cost-effective approach to integrate multiple task-specific models into a unified model. However, recent work reveals that MM is highly susceptible to backdoor attacks. Existing defenses based on task arithmetic often fail to eliminate backdoors without substantially degrading clean-task performance, owing to their reliance on direct parameter-space editing. To address this gap, we propose Linear Feature Path Minimization (LFPM), a backdoor mitigation framework for model merging, which introduces an anti-backdoor task vector into the backdoored merged model. Unlike prior approaches, LFPM formulates the backdoor robustness of the merged model from a unified feature-space perspective under the Cross-Task Linearity (CTL) framework, which leverages the approximate linearity of features across tasks. This perspective guides the optimization of the anti-backdoor task to suppress backdoors while preserving clean-task performance. Furthermore, we introduce an effective optimization mechanism based on gradient accumulation and loss path-integral, ensuring robust backdoor suppression along the interpolation path. Extensive experiments demonstrate that LFPM consistently exhibits strong robustness against backdoor attacks in both full fine-tuning and Parameter-Efficient Fine-Tuning (PEFT) settings.

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22.
arXiv (CS.CV) 2026-06-12

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Authors:
Pit Henrich↗Maximilian Weiherer↗Franziska Hansen↗Bernhard Egger↗Franziska Mathis-Ullrich↗

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.

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23.
medRxiv (Medicine) 2026-06-15

Investigation of Intra-Fraction Stability and Inter-Fraction Reproducibility of Deep Inspiration Breath-Hold Across Two Hypofractionated Radiotherapy Regimens in the HYPORT Adjuvant Study.

Authors:
MAHATA↗Roy↗Khatua↗Maity↗Barik↗Chakraborty↗Chatterjee↗

Background: Deep Inspiration Breath Hold (DIBH) is a widely used respiratory motion management technique for minimizing cardiac dose in left-sided breast radiotherapy. In the Breast HYPORT Adjuvant study, DIBH was employed for cardiac sparing in patients without nodal irradiation using a standardized institutional protocol with the Varian Real-time Position Management (RPM) system. Both moderate-hypofractionation (control arm - 40Gy in 15 fractions) and one-week hypofractionation (experimental arm - 26 Gy in 5 fractions) regimens were delivered using this protocol. This study aimed to evaluate the robustness of DIBH by analyzing intra-fraction stability and inter-fraction reproducibility of breath-hold amplitude across the two treatment regimens. Methods: Respiratory waveforms acquired during each treatment session were analyzed to determine the median breath-hold amplitude and its standard deviation during beam delivery. Intra-fraction stability was assessed from vari- ations within individual treatment sessions, while inter-fraction reproducibility was evaluated relative to the simula- tion waveform amplitude across all treatment sessions. These parameters were compared between the two HYPORT regimens to examine breath-hold consistency during treatment delivery. Moreover, an additional comparison was made between the one-week hypofractionation regimen and the first five fractions of the moderate-hypofractionation regimen to evaluate the effect of treatment duration . Lung volumes from free-breathing and DIBH CT scans were analyzed to assess the effectiveness of patient breath-hold training. Results: Both arms demonstrated an average 1.7-fold increase of air volume in lung during the breath-hold position, confirming the effective implementation of DIBH during treatment planning and delivery. Structured training resulted in increased breath-hold amplitudes, with gains of 22.87% and 24.16% with respect to the first trial session in the experimental and control arms, respectively. Both regimens receive equivalent doses for approximately the same air volume in lung . Despite the different prescription doses in the two arms (26 Gy vs. 40 Gy), the experimental arm achieved an equivalent mean heart dose of 2.91% (75.6 cGy) compared with 2.95% (118.51 cGy) in the control arm, suggesting a similar cardiac preservation protocol adopted during treatment planning. Intra-fraction stability was similar between the control arm and the experimental arm, with median amplitude variations of 1.006 mm (95% CI: [0.998-1.015]) and 1.079 mm (95% CI: [1.067-1.097]), respectively. In contrast, inter-fraction reproducibility improved in the experimental arm, with lower deviation from simulation amplitude (0.44 {+/-} 0.24 mm vs. 0.66 {+/-} 0.25 mm) for the entire treatment schedule. The stability and reproducibility of experimental arm were further compared with the first five fractions of the control arm. The results were similar to those of the experimental arm. Conclusion: In this study, we compared two treatment regimens in terms of intra-fraction stability and inter-fraction reproducibility during DIBH radiotherapy. Both regimens demonstrated comparable intra-fraction stability, indicating effective motion management irrespective of treatment duration. However, the experimental arm showed better inter- fraction reproducibility, suggesting more consistent breath-hold performance throughout the treatment course. Based on stability and reproducibility, a reasonable narrowing of the DIBH gating window may be implemented with minor changes to the institutional protocol. The observed trend highlights the potential for improved consistency with the experimental approach and supports further investigation to better understand the underlying factors and strengthen these findings in future studies.

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24.
arXiv (CS.LG) 2026-06-16

Convergence Rate Analysis of the AdamW-style Shampoo: Unifying One-Sided and Two-Sided Preconditioning

Authors:
Huan Li↗Yiming Dong↗Zhouchen Lin↗

arXiv:2601.07326v4 Announce Type: replace-cross Abstract: This paper studies AdamW-style Shampoo, an effective variant of the classical Shampoo that won the external tuning track of the AlgoPerf neural network training competition. Our analysis unifies one-sided and two-sided preconditioning. When the exponents of the two preconditioners sum to $1/2$, we establish the convergence rate $\frac{1}{K}\sum_{k=1}^KE\left[||\nabla f(X_k)||_*\right]\leq O(\frac{\sqrt{m+n}C}{K^{1/4}})$, where $K$ represents the number of iterations, $(m,n)$ denotes the dimensions of the matrix-valued parameters, and $C$ matches the constant appearing in the optimal convergence rate of SGD. Theoretically, the nuclear norm and Frobenius norm satisfy $||\nabla f(X)||_F\leq ||\nabla f(X)||_*\leq \sqrt{\min\{m,n\}}||\nabla f(X)||_F$, which suggests that our convergence rate is analogous to the optimal $\frac{1}{K}\sum_{k=1}^KE\left[||\nabla f(X_k)||_F\right]\leq O(\frac{C}{K^{1/4}})$ convergence rate of SGD in the ideal case where $||\nabla f(X)||_*= \Theta(\sqrt{\min\{m,n\}})||\nabla f(X)||_F$ and $m$ and $n$ are of comparable magnitude. Then, we extend our analysis to settings where the preconditioning exponents do not sum to 1/2, and establish convergence with an explicit but more involved rate.

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25.
arXiv (CS.CV) 2026-06-16

Multimodal LLM-Empowered Re-Ranking for Generalizable Person Re-Identification

Authors:
Jiachen Li↗Xiaojin Gong↗

Domain Generalizable (DG) person re-identification (Re-ID) has attracted growing research interest due to its potential for deployment in unseen real-world scenarios. Most existing approaches address DG Re-ID by focusing on training domain-generalizable encoders but ignore the possible refinements in inference stage. In contrast, this work explores an alternative direction which improves inference re-ranking to enhance DG Re-ID. Conventional re-ranking methods typically rely on neighborhood-based distances to refine the initial ranking list, inherently depending on features produced by the Re-ID encoder. However, they deteriorate on target domains since the encoder lacks sufficient generalizability to produce reliable feature distances on unseen scenarios. Inspired by the remarkable generalization capabilities of recent Multimodal Large Language Models (MLLMs), we propose an MLLM-empowered distance metric to improve re-ranking in DG Re-ID. Specifically, we first adapt an MLLM to Re-ID data through supervised fine-tuning, which incorporates a domain-agnostic prompt and a query-candidate hard mining scheme. Then, the adapted MLLM is employed to compute a $\mu$-distance during inference, which is robust to domain gap and significantly enhances subsequent re-ranking performance. Our approach is model-agnostic and can be seamlessly integrated into previous re-ranking frameworks. Extensive experiments demonstrate that our approach consistently yields substantial performance improvements across multiple DG Re-ID benchmarks. The code of this work will be released at https://github.com/RikoLi/MUSE soon.

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