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01.
arXiv (CS.CL) 2026-06-15

Does the Judge Prefer English? Evaluating Language-Switching Invariance in LLM-as-a-Judge

作者:

Large language models (LLMs) are now widely used as automatic judges for open-ended instruction-following evaluation. This practice is convenient, scalable, and often more semantically aware than reference-based metrics, but it also introduces a new reliability question: does a judge evaluate the quality of an answer, or does it also react to the language in which the comparison is presented? We propose Judge-LS, a lightweight meta-evaluation protocol that transforms LLMBar response-pair items into English, Chinese, and Chinese-English language-switched variants. A reliable judge should preserve its preference under label-preserving language transformations and should not prefer a language when two answers are translation-equivalent. We evaluate four API-accessible judges on the full 419-item LLMBar benchmark, producing 13,408 successful pairwise judgments. Across models, Chinese and language-switched presentations induce 10.7–14.4% preference flips relative to English, and all judges achieve their highest accuracy in English. However, translation-equivalent tie probes do not reveal a systematic English preference: most probes are judged as ties, and non-tie decisions more often favor Chinese. We add confidence intervals, paired significance tests, and an automatic transformation audit with a sensitivity analysis that excludes mechanically flagged high-risk variants. The experiment requires no model training, uses only API calls, and is feasible on modest local hardware.

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

Examining Human-Like Behaviors in LLMs: A Multi-Dimensional Analysis of Model Behaviors, User Factors, and System Prompts

arXiv:2606.18258v1 Announce Type: cross Abstract: Large language models (LLMs) exhibit a wide range of human-like behaviors, from expressing thoughts and emotions, to engaging in relationship-building with users, to refusing requests and maintaining boundaries. Despite their prevalence, researchers and practitioners lack methods and empirical insights to make informed decisions about when and what types of human-like behaviors LLMs should exhibit. To fill this gap, we present a multi-dimensional analysis of the prevalence, potential effects, and controllability of these behaviors using LLM-as-a-judge and human evaluation. Across 21,000 multi-turn conversations from four widely used models (gpt-4o, gpt-4.1-mini, claude-sonnet-4.6, gemini-2.5-flash), we find that human-like behaviors are pervasive but vary across models and user factors (conversation goals and user profiles). In terms of perceived appropriateness, human evaluators judged self-referential and relationship-building behaviors as less appropriate from LLMs than from humans, but boundary-maintaining behaviors more appropriate from LLMs than from humans. Finally, we show that system prompting can control these behaviors, though it requires careful evaluation to avoid unintended effects. We discuss the implications of our findings and provide recommendations for responsible LLM design and evaluation.

03.
arXiv (CS.CV) 2026-06-16

Double-Helix Vision (DH-V2): A Geometry-Based Visual Sampler for Bandwidth-Constrained Perception

作者:

We present Double-Helix Vision (DH), a geometry-based visual sampler that compresses 2D images into compact 1D signals using paired golden-ratio-inspired spiral trajectories. Rather than processing every pixel uniformly, DH employs two phase-shifted helices (Alpha and Beta, offset by 180 degrees) to sample the image with biologically-inspired foveation: high density at the center, sparse coverage at the periphery. At 4K resolution, DH achieves a 1,433x compression ratio (99.93% reduction) while preserving the geometric structure of the scene. The full perception pipeline – including spatial mapping, temporal collision detection, and intra-frame structural disparity estimation – runs in 0.52 ms at 1080p on CPU-only hardware, with no neural network dependencies. On CIFAR-10 at extreme sampling budgets (K=128 points per helix), DH achieves a +6.03% accuracy gain over uniform random sampling. A JSON-serializable Robotics API is provided, delivering sub-millisecond spatial perception reports in 2.7 KB packets. Code and benchmarks are available under the MIT License.

04.
arXiv (CS.AI) 2026-06-11

Tabular Foundation Models for Clinical Survival Analysis via Survival-Aware Adaptation

arXiv:2606.12006v1 Announce Type: cross Abstract: Predicting time-to-event outcomes such as mortality is a fundamental task in clinical decision-making, commonly addressed through survival analysis. While classical statistical and deep learning approaches have been widely studied, they typically require task-specific training and sufficient labeled data. Recent advances in tabular foundation models offer a new paradigm by learning general-purpose representations for structured data. However, their applicability to censored time-to-event prediction in clinical settings remains underexplored, as typical applications are restricted to discrete classification rather than survival analysis tasks. In this work, we propose a lightweight adaptation approach for applying tabular foundation models to clinical survival analysis by directly training a survival-aware head on top of the pretrained representations. We study representative architectures, including TabPFN, TabDPT, and TabICL, and adapt them using a multi-task logistic regression (MTLR) head to model right-censored time-to-event outcomes. We evaluate this approach on a diverse set of public survival benchmarks and two large-scale ICU cohorts, MIMIC-IV and eICU. Our results show that this transfer learning approach achieves competitive or superior performance compared to strong baselines. On MIMIC-IV, TabDPT-FT-MTLR reaches a C-index of 0.856, corresponding to a relative improvement of +1.4% over the best non-FM baseline (DeepSurv, 0.844) and +6.7% over the best zero-shot model (0.802). On eICU, TabICL-FT-MTLR achieves 0.797, yielding gains of +1.7% (DeepSurv, 0.784) and +6.4% (0.749), respectively. These findings highlight the importance of combining pretrained tabular representations with survival-aware objectives and suggest that tabular foundation models provide a practical and effective alternative for clinical survival prediction.

05.
arXiv (CS.CL) 2026-06-11

Unifying Learning Dynamics and Generalization in Transformers Scaling Law

作者:

The scaling law, a cornerstone of Large Language Model (LLM) development, predicts improvements in model performance with increasing computational resources. Yet, while empirically validated, its theoretical underpinnings remain poorly understood. This work formalizes the learning dynamics of transformer-based language models as an ordinary differential equation (ODE) system, then approximates this process to kernel behaviors. Departing from prior toy-model analyses, we rigorously analyze stochastic gradient descent (SGD) training for multi-layer transformers on sequence-to-sequence data with arbitrary data distribution, closely mirroring real-world conditions. Our analysis characterizes the convergence of generalization error to the irreducible risk as computational resources scale with data, especially during the optimization process. We establish matching upper and lower bounds on the excess risk, characterized by a distinct phase transition. In the initial optimization phase, the excess risk decays exponentially relative to the computational cost ${\sf C}$. However, once a specific resource allocation threshold is crossed, the system enters a statistical phase, where the generalization error follows a power-law decay of $\Theta(\mathsf{C}^{-1/7})$. These rates are certified by complementary lower bounds – statistical, via an information-theoretic two-point reduction, and optimization-side, via a first-order oracle argument – rendering the two-stage law tight up to constants, logarithmic factors, and a condition-number gap. Beyond this unified framework, our theory derives isolated scaling laws for model size, training time, and dataset size, elucidating how each variable independently governs the bounds of generalization.

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

FlowRL: A Taxonomy and Modular Framework for Reinforcement Learning with Diffusion Policies

arXiv:2603.27450v2 Announce Type: replace Abstract: Thanks to their remarkable flexibility, diffusion models and flow models have emerged as promising candidates for policy representation. However, efficient reinforcement learning (RL) upon these policies remains a challenge due to the lack of explicit log-probabilities for vanilla policy gradient estimators. While numerous attempts have been proposed to address this, the field lacks a unified perspective to reconcile these seemingly disparate methods, thus hampering ongoing development. In this paper, we bridge this gap by introducing a comprehensive taxonomy for RL algorithms with diffusion/flow policies. To support reproducibility and agile prototyping, we introduce a modular, JAX-based open-source codebase that leverages JIT-compilation for high-throughput training. Finally, we provide systematic and standardized benchmarks across Gym-Locomotion, DeepMind Control Suite, and IsaacLab, offering a rigorous side-by-side comparison of diffusion-based methods and guidance for practitioners to choose proper algorithms based on the application. Our work establishes a clear foundation for understanding and algorithm design, a high-efficiency toolkit for future research in the field, and an algorithmic guideline for practitioners in generative models and robotics. Our code is available at https://github.com/typoverflow/flow-rl.

07.
arXiv (CS.LG) 2026-06-15

LapidaryEngine: Fully Conversational Crystal Generation

arXiv:2606.14215v1 Announce Type: new Abstract: The emergence of Large Language Models (LLMs) has inspired the vision of generating bespoke crystal materials directly from natural-language instructions, enabling users to design materials through intuitive, conversational interaction. Existing text-to-crystal generative models represent important early steps toward this goal, but they suffer from two critical limitations: (i) restricted input formats that require highly structured descriptions (e.g., chemical formulas), and (ii) one-directional generation, where models can map text to crystal but cannot perform the inverse. These limitations prevent fully conversational workflows and hinder alignment with users' inherently ambiguous and evolving desiderata. We address these challenges with LapidaryEngine, the first model to support fully conversational crystal generation. LapidaryEngine accepts free-form natural-language requests and performs iterative refinement and editing in a dialogue-like manner. The key innovation is a pivot representation, a third, intermediate form that enables bidirectional translation between text and crystal structures despite the absence of direct paired datasets. Leveraging this pivot allows robust interpretation of user feedback and precise structural control. We demonstrate LapidaryEngine across diverse tasks, including insulator discovery, stability optimization, compositional modification, and structural editing, showcasing its ability to align generated materials with user intent in an interactive manner.

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

QC-GAN: A Parameter-Efficient Quaternion Conformer GAN for High-Fidelity Speech Enhancement

arXiv:2606.18611v1 Announce Type: cross Abstract: We propose a parameter-efficient speech enhancement framework, Quaternion Conformer GAN (QC-GAN), which combines a Quaternion Conformer generator with MetricGAN-based training. The Hamilton product encodes the magnitude and phase via structured weight sharing, reducing the number of layer parameters while preserving their interdependencies. A metric-learning discriminator was employed to maximize perceptual quality by optimizing the approximate perceptual evaluation scores. On the VoiceBank+DEMAND dataset, QC-GAN achieved a Perceptual Evaluation of Speech Quality (PESQ) score of 3.48 with only 0.89M parameters, delivering a performance comparable to state-of-the-art models at less than half their size. A 35K-parameter variant achieved a PESQ score of 3.23, surpassing conventional methods with significantly fewer parameters. Evaluation on the DNS-Challenge 3 dataset further confirmed generalization to real-world conditions.

09.
bioRxiv (Bioinfo) 2026-06-11

Integrating Spatially Adjusted Protein Summaries for Survival Prediction in Spatial Proteomics

Recent advances in spatial proteomics, particularly imaging mass cytometry, enable the measurement of protein expression at the single-cell level while preserving a spatial context. Conventional survival analyses, however, typically rely on patient-level averages of protein intensities and therefore overlook spatial heterogeneity and tissue architecture. To address this limitation, we introduce a framework that incorporates spatial information into survival modeling by generating spatially adjusted protein summaries (SAPS). In this approach, cell-level protein intensities within each patient are modeled using spatial spline regression to capture spatial trends. From these models, we extract two complementary features: a spatially adjusted mean expression and a residual variance that reflects cell-to-cell variability unexplained by spatial effects. These summaries are then incorporated into Cox proportional hazards models in combination with clinical covariates. In simulation studies, our proposed framework achieved improved predictive performance compared to other alternative methods. The application of the method to breast cancer imaging mass cytometry data indicate that spatially adjusted summaries may enhance survival prediction and reveal biologically interpretable spatial protein patterns, suggesting high translational potential. This methodology offers an efficient means of translating complex spatial proteomics data into patient-level features, providing both improved survival prediction and new insights into the role of spatial heterogeneity in cancer outcomes.

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

To GAN or Not To GAN: Segmentation Analysis on Mars DEM

arXiv:2606.13252v1 Announce Type: new Abstract: To better understand Martian Surface, which is needed to enable Rovers navigate Mars with ease, it is necessary to be able to determine the location of mounds. Detecting and studying these morphologies can also help us find evidence of extraterrestrial life, in this case, more specifically, water or signs of life conducive environments. Detection of mounds was done by manually mapping morphological parameters onto Digital Elevation Models. This paper solves the problem by automatically detecting and or predicting mounds on Mars using Neural Network based Semantic Segmentation methodologies. This is done by using supervised semantic segmentation model and generative adversarial approach. A comparison of the approaches shows that adding extra artificially generated data did not improve the result.

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

ROVE: Unlocking Human Interventions for Humanoid Manipulation via Reinforcement Learning

arXiv:2606.17011v1 Announce Type: cross Abstract: Human interventions provide crucial corrective signals for post-training Vision-Language-Action (VLA) models. However, enabling seamless humanoid interventions is a formidable systems challenge due to complex whole-body kinematics and dexterous-hand control. Consequently, the collected intervention trajectories are often suboptimal, and methods that rely on human interventions as expert supervision can absorb hesitant, inefficient, or even erroneous behaviors. To address both the system and algorithmic challenges, we propose ROVE, a reinforcement learning framework for humanoid VLA post-training with imperfect human interventions. First, ROVE introduces a human-in-the-loop pipeline capable of collecting deployment and intervention data for humanoid manipulation. Second, it utilizes Optimistic Value Estimation (OVE) to prioritize high-value behaviors from mixed-quality trajectories. To further robustify value estimation, we incorporate cross-embodiment human experience videos to provide rich supervision for long-tailed failure and recovery modes. The resulting critic yields informative advantage signals, steering the VLA actor to focus on high-value behaviors rather than indiscriminately imitating all actions. On challenging real-world contact-rich and fine-grained humanoid manipulation tasks, ROVE outperforms experience-learning baselines and consistently improves across multiple rollout-intervention iterations.

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

SIGMA: Search-Augmented On-Demand Knowledge Integration for Agentic Mathematical Reasoning

Solving mathematical reasoning problems requires not only accurate access to relevant knowledge but also careful, multi-step thinking. However, current retrieval-augmented models often rely on a single perspective, follow inflexible search strategies, and struggle to effectively combine information from multiple sources. We introduce SIGMA (Search-Augmented On-Demand Knowledge Integration for AGentic Mathematical reAsoning), a unified framework that orchestrates specialized agents to independently reason, perform targeted searches, and synthesize findings through a moderator mechanism. Each agent generates hypothetical passages to optimize retrieval for its analytic perspective, ensuring knowledge integration is both context-sensitive and computation-efficient. When evaluated on challenging benchmarks such as MATH500, AIME, and PhD-level science QA GPQA, SIGMA consistently outperforms both open- and closed-source systems, achieving an absolute performance improvement of 7.4%. Our results demonstrate that multi-agent, on-demand knowledge integration significantly enhances both reasoning accuracy and efficiency, offering a scalable approach for complex, knowledge-intensive problem-solving. We will release the code upon publication.

13.
arXiv (CS.CV) 2026-06-18

EDoF-NeRF: extended depth-of-field neural radiance fields using a coded aperture camera

We propose a method for extending the depth-of-field (DoF) to construct high-fidelity neural radiance fields (NeRF) – an emerging technique for rendering photorealistic novel views from a dataset of images captured at different viewpoints, based on implicit neural representations. The trade-off between DoF and light quantity is inherent not only in conventional cameras but also in NeRF, since the datasets used by NeRF are captured by these cameras. To address this issue, we introduce a coded aperture placed at the camera pupil, preserving spatial frequency components under defocused conditions. We develop a camera model incorporating coded apertures into NeRF, allowing direct input of coded images and enabling the generation of novel views with an extended DoF. We validate the proposed method, termed extended DoF-NeRF (EDoF-NeRF), through simulations and experiments, demonstrating its superior performance compared to conventional aperture cameras.

14.
arXiv (CS.AI) 2026-06-16

Topological Flow Matching

arXiv:2606.15897v1 Announce Type: cross Abstract: Flow matching is a powerful generative modeling framework, valued for its simplicity and strong empirical performance. However, its standard formulation treats signals on structured spaces, such as fMRI data on brain graphs, as points in Euclidean space, overlooking the rich topological features of their domains. To address this, we introduce topological flow matching, a topology-aware generalization of flow matching. We interpret flow matching as a framework for solving a degenerate Schrödinger bridge problem and inject topological information by augmenting the reference process with a Laplacian-derived drift. This principled modification captures the structure of the underlying domain while preserving the desirable properties of flow matching: a stable, simulation-free objective and deterministic sample paths. As a result, our framework serves as a drop-in replacement for standard flow matching. We demonstrate its effectiveness on diverse structured datasets, including brain fMRIs, ocean currents, seismic events, and traffic flows.

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

Dual-branch Prompting for Multimodal Machine Translation

Multimodal Machine Translation (MMT) typically enhances text-only translation by incorporating aligned visual features. Despite the remarkable progress, state-of-the-art MMT approaches often rely on paired image-text inputs at inference and are sensitive to irrelevant visual noise, which limits their robustness and practical applicability. To address these issues, we propose D2P-MMT, a diffusion-based dual-branch prompting framework for robust vision-guided translation. Specifically, D2P-MMT requires only the source text and a reconstructed image generated by a pre-trained diffusion model, which naturally filters out distracting visual details while preserving semantic cues. During training, the model jointly learns from both authentic and reconstructed images using a dual-branch prompting strategy, encouraging rich cross-modal interactions. To bridge the modality gap and mitigate training-inference discrepancies, we introduce a distributional alignment loss that enforces consistency between the output distributions of the two branches. Extensive experiments on the Multi30K dataset demonstrate that D2P-MMT achieves superior translation performance compared to existing state-of-the-art approaches. Our code is publicly available at https://github.com/MentaY/DDP.

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

Improving Detection of Rare Nodes in Hierarchical Multi-Label Learning

arXiv:2602.08986v2 Announce Type: replace-cross Abstract: In hierarchical multi-label classification, a persistent challenge is enabling model predictions to reach deeper levels of the hierarchy for more detailed or fine-grained classifications. This difficulty partly arises from the natural rarity of certain classes (or hierarchical nodes) and the hierarchical constraint that ensures child nodes are almost always less frequent than their parents. To address this, we propose a weighted loss objective for neural networks that combines node-wise imbalance weighting with focal weighting components, the latter leveraging modern quantification of ensemble uncertainties. By emphasizing rare nodes rather than rare observations (data points), and focusing on uncertain nodes for each model output distribution during training, we observe improvements in recall by up to a factor of five on benchmark datasets, along with statistically significant gains in $F_{1}$ score. We also show our approach aids convolutional networks on challenging tasks, as in situations with suboptimal encoders or limited data.

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

Gender Differences in AI Literacy Workshop Outcomes and Deepfake Engagement

arXiv:2606.14718v1 Announce Type: cross Abstract: As Artificial Intelligence (AI) literacy initiatives expand in K-12 settings, understanding how gender shapes student baseline perceptions, tool-use, and responsiveness to interventions is essential for equitable curriculum design. This study examines gender differences in AI literacy, safety awareness, and STEM career aspirations among Australian secondary students (Years 7, 8, and 10; N(pre) = 199, n(post) = 136) from two co-educational government schools who participated in a one-day AI literacy workshop. Using statistical regression methods controlling for year level and school, we found that pre-workshop, male students reported significantly higher STEM career interest across all three domains (AI, computer science, and engineering), while female students were significantly more likely to use AI for schoolwork and to seek advice from AI tools. Gender-differentiated patterns also emerged in deepfake behaviours: males were significantly more likely to have created or shared deepfake content. Both genders improved in AI knowledge post-intervention, yet females showed a richer profile of gains: wider conceptual understanding, greater confidence, and meaningful increases in AI and CS career interest that partially narrowed the gender STEM gap. These findings highlight the need for gender-responsive AI curricula, particularly deepfake safety education for male students, and demonstrate that even single-day workshops can narrow gender gaps in STEM aspirations and AI confidence.

19.
arXiv (CS.CL) 2026-06-17

Do Large Language Models Always Tell The Same Stories?

Recent advances in large language models (LLMs) have enabled the generation of high-quality prose, yet the question of whether these models are capable of generating diverse outputs remains contested. In this work, we investigate the diversity of LLM-generated stories through the framework of narrative similarity. Using a contrastive framework and a dataset of human-written stories and prompts from r/WritingPrompts, we collect narrative similarity judgments across 10 representative LLMs, utilizing both human evaluations and three different automatic annotation methods. Our findings reveal a consistent trend: LLM-generated narratives are consistently more similar to each other than human-written stories are. We demonstrate that frontier models in particular converge on a ``mean'' generic narrative that approximates individual human stories but lacks the collective diversity of human authors. Finally, we show that common mitigation strategies, including negative prompting and temperature scaling, fail to meaningfully address this homogeneity.

21.
arXiv (CS.CL) 2026-06-15

TVIR: Building Deep Research Agents Towards Text-Visual Interleaved Report Generation

Deep Research Agents have shown strong capability in multi-step information retrieval, reasoning, and long-form report generation, but existing benchmarks and systems remain predominantly text-centric, with limited evaluation of whether visual elements are factually reliable and well aligned with the surrounding analysis. To address this gap, we introduce TVIR (Text-Visual Interleaved Report Generation), which includes TVIR-Bench, a benchmark of 100 expert-curated multimodal deep research tasks that require visual elements to serve specific analytical sub-goals, and TVIR-Agent, a hierarchical multi-agent framework that serves as a strong baseline for constructing outlines, retrieving images, generating charts with traceable sources, and composing reports through context-aware sequential writing. We further develop a dual-path evaluation framework that combines Textual Assessment and Visual Assessment. Experiments across nine deep research systems show that TVIR-Agent achieves strong overall performance, underscoring the importance of explicit multimodal design and evaluation for evidence-driven report generation.

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

Pass@K Policy Optimization: Solving Harder Reinforcement Learning Problems

Reinforcement Learning (RL) algorithms sample multiple n>1 solution attempts for each problem and reward them independently. This optimizes for pass@1 performance and prioritizes the strength of isolated samples at the expense of the diversity and collective utility of sets of samples. This under-utilizes the sampling capacity, limiting exploration and eventual improvement on harder examples. As a fix, we propose Pass-at-k Policy Optimization (PKPO), a transformation on the final rewards which leads to direct optimization of pass@k performance, thus optimizing for sets of samples that maximize reward when considered jointly. Our contribution is to derive novel low variance unbiased estimators for pass@k and its gradient, in both the binary and continuous reward settings. We show optimization with our estimators reduces to standard RL with rewards that have been jointly transformed by a stable and efficient transformation function. While previous efforts are restricted to k=n, ours is the first to enable robust optimization of pass@k for any arbitrary k

23.
PLOS Medicine 2026-05-29

Availability, appeal, and addictiveness by design: Tobacco and nicotine industry deliberate targeting of youth

by Raglan Maddox, Becky Freeman, Charlotta Pisinger, Emily Banks Contemporary tobacco and nicotine products, particularly e-cigarettes, are deliberately designed, marketed, and distributed to maximize youth appeal, uptake, dependence, and use. Youth uptake is a predictable outcome of systems designed to maximize product availability, appeal, and addictiveness. In recognition of the World No Tobacco Day 2026 theme, "unmasking the appeal", this Perspective by Raglan Maddox and colleagues discusses how tobacco and nicotine products, particularly e-cigarettes, are deliberately designed and marketed to maximize youth appeal, and highlight the need for policies to ensure greater industry accountability and to tackle concerning uptake trends.

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

Explaining RhythmFormer: A Systematic XAI Analysis of Periodic Sparse Attention for Remote Photoplethysmography

Remote photoplethysmography (rPPG) transformers achieve low heart-rate error on benchmarks, yet their decisions remain opaque–a growing concern as rPPG moves toward clinical heart rate estimation. Existing rPPG XAI is dominated by qualitative heatmap inspection without quantitative faithfulness metrics or physiology-grounded validation, leaving a gap between visual plausibility and auditable evidence. We address this gap. First, we adapt four attribution methods (raw attention, rollout, flow, Beyond Intuition) to RhythmFormer's bi-level routing attention with top-$k$ selection. Second, we introduce a skin coverage metric quantifying how much attribution mass falls on skin regions. Third, we adapt the SaCo faithfulness coefficient from its original classification setting to rPPG regression by using the MAE between original and perturbed predicted rPPG waveforms as the perturbation impact. Applying these tools, we quantify a multi-hop leakage effect under sparse top-$k$ routing: attention rollout and flow almost completely restores the connections that individual refined-attention layers explicitly set to zero. Beyond Intuition mitigates this via its value-projection-weighted rollout and gradient-supported mask, attaining the highest median refined skin coverage ($0.83$ vs. $0.57$ for vanilla rollout) and faithfulness ($F=0.92$) among the evaluated methods on UBFC-rPPG. Validation across diverse datasets and model variants is needed. A case study on a low-SaCo outlier further shows all four methods recovering consistently once an artefactual region is replaced, suggesting consistent SaCo behavior across attribution families in this illustrative case. Together, these metrics move XAI for rPPG toward auditable numerical evidence about spatial alignment and perturbation faithfulness, i.e. trustworthy rPPG XAI.

25.
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

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.