Daily Papers

Generative modeling offers a promising solution to the scarcity of labeled clinical electroencephalography (EEG) data under strict privacy constraints. Although recent generative models report substantial improvements in generation fidelity, we show that these gains conceal a categorical failure. EEG is not an arbitrary multichannel signal: each channel records the voltage difference between two scalp electrodes. So, real recordings satisfy exact linear identities among their channels. Current generators invariably violate these identities, yet this has gone unnoticed. We therefore propose MontageFlow, a flow-matching model that enforces these identities by restricting its output to signals that satisfy them. We find that ensuring validity improves fidelity too. Furthermore, to retain the EEG characteristics that oversmoothing washes out, we also condition the model on a physiological state vector encoded from the whole EEG window. For generation, this vector is drawn from a prior fitted in latent space. Across 3 large-scale benchmarks, our model improves TS-FID by 1.6-3.6times over the closest rival while ensuring validity.

A central puzzle for the behavioural sciences and for human-facing artificial intelligence is the persistence of within-person variability. The same individual, presented with the same observable input, produces different outcomes on different occasions, and different individuals produce divergent outcomes that no observable covariate fully predicts. We argue that this variability belongs in the dynamic latent state of the person, and that human outcomes are controllable in a precise and operational sense through interventions that target the state and its weighting at the moment a decision is being formed. We define a state as the time-indexed weighting vector over the dimensions that govern how an individual's biology, physiology, and neuropsychology process the next event into a decision and an outcome. The relationship between state, decision, and outcome is causal rather than correlational. The weighting vector is dynamic at sub-daily timescales. The conscious channel through which outcomes are reportable is a narrow attentional bottleneck whose contents are themselves state-dependent. Taken together, these claims imply that the outcome of a given event is controllable, conditionally, on the state-trajectory at the time of intervention. We motivate the framework with six strands of established evidence (causal inference, predictive processing, allostasis, attentional bottleneck, chronobiology, computational psychiatry) and a 24-month observational base from a deployed behavioural platform spanning more than 200,000 consented users across four occupational personas (research period 2023 to 2026). We derive seven testable predictions, list six operational requirements for state-aware systems, and discuss implications for digital health, education, AI personalisation, and personal agency.

Progress in remote PhotoPlethysmoGraphy (rPPG) is limited by the critical issues of existing publicly available datasets: small size, privacy concerns with facial videos, and lack of diversity in conditions. The paper introduces a novel comprehensive large-scale multi-view video dataset for rPPG and health biomarkers estimation. Our dataset comprises 3600 synchronized video recordings from 600 subjects, captured under varied conditions (resting and post-exercise) using multiple consumer-grade cameras at different angles. To enable multimodal analysis of physiological states, each recording is paired with a 100 Hz PPG signal and extended health metrics, such as electrocardiogram, arterial blood pressure, biomarkers, temperature, oxygen saturation, respiratory rate, and stress level. Using this data, we train an efficient rPPG model and compare its quality with existing approaches in cross-dataset scenarios. The public release of our dataset and model should significantly speed up the progress in the development of AI medical assistants.

Physiological time series signals reflect complex, multi-scale dynamical processes of the human body. Existing modeling studies focus on static tasks such as classification, event forecasting, or short-horizon next step prediction, while long-horizon signal-level forecasting and predictive nature of physiological signals remain underexplored. We introduce NormWear-2, a world model that encodes both multivariate physiological signals and clinical intervention variables into a shared latent space and models their joint temporal evolution as a dynamical system. Our approach combines inference from prior pre-trained knowledge (intuition) with instant non-parametric latent state transition adaptation (insight), enabling coherent forecasting across multiple temporal scales, conditioned on heterogeneous clinical interventions. During the pretraining phase, we find that chaos-theoretic balancing of dynamical regime diversity yields more robust representations, with a smaller balanced corpus outperforming one twice its size and capturing bifurcation regimes. We evaluate the world model performance across diverse real-world physiological datasets spanning heterogeneous temporal resolutions and intervention regimes, covering daily life, point-of-care, and clinical settings, including fitness planning, hemodialysis, diabetes management, and surgical monitoring. These evaluation datasets comprise records from 8,026 subjects, spanning study durations from 3.2 hours for high-resolution signal data to 2.3 years for longitudinal clinical biomarker tracking. NormWear-2 achieves the best overall forecasting performance across time, frequency, and latent representation domains, with significant improvements over state-of-the-art time series foundation models, while maintaining competitive downstream representation quality, providing a step toward general-purpose world models for physiological signals.

Continuous Glucose Monitoring (CGM) can detect early metabolic subphenotypes (insulin resistance, IR; β-cell dysfunction), but population-scale deployment faces two coupled problems. First, the same physiological state appears through multiple views (CGM time series, venous OGTT, Glucodensity summaries), so single-view representations fail to transfer when deployment shifts the modality or setting. Second, baselines perform inconsistently across these shifts. Both problems point to one remedy: representations that abstract away from any single view to capture higher-level temporal and distributional structure. We propose CGM-JEPA, a self-supervised pretraining framework which predicts masked latent representations rather than raw values, yielding abstraction that transfers across modalities. X-CGM-JEPA adds a masked Glucodensity cross-view objective for complementary distributional information. We pretrain on sim389k unlabeled CGM readings from 228 subjects and evaluate on two clinical cohorts (N=27 and N=17 public-release subsets) across three regimes (cohort generalization, venous-to-CGM transfer, home CGM) under 20-iteration times 2-fold cross-validation. X-CGM-JEPA ranks first or second on AUROC for both endpoints across all three regimes while no baseline does, exceeding the strongest baseline by up to +6.5 pp in cohort generalization and +3.6 pp in venous-to-CGM transfer (paired Wilcoxon, p<0.001). Under modality shift, it matches mean AUROC while redistributing toward weaker subgroups (ethnicity AUROC gap shrinks 25-54%); on sparse in-domain venous data, the distributional view lifts label-aware clustering (ARI +39%, NMI +40%). Code and weights: https://github.com/cruiseresearchgroup/CGM-JEPA

Pain is a complex and pervasive condition that affects a significant portion of the population. Accurate and consistent assessment is essential for individuals suffering from pain, as well as for developing effective management strategies in a healthcare system. Automatic pain assessment systems enable continuous monitoring, support clinical decision-making, and help minimize patient distress while mitigating the risk of functional deterioration. Leveraging physiological signals offers objective and precise insights into a person's state, and their integration in a multimodal framework can further enhance system performance. This study has been submitted to the Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN). The proposed approach introduces Tiny-BioMoE, a lightweight pretrained embedding model for biosignal analysis. Trained on 4.4 million biosignal image representations and consisting of only 7.3 million parameters, it serves as an effective tool for extracting high-quality embeddings for downstream tasks. Extensive experiments involving electrodermal activity, blood volume pulse, respiratory signals, peripheral oxygen saturation, and their combinations highlight the model's effectiveness across diverse modalities in automatic pain recognition tasks. The model's architecture (code) and weights are available at https://github.com/GkikasStefanos/Tiny-BioMoE.

Egocentric vision systems aim to understand the spatial surroundings and the wearer's behavior inside it, including motions, activities, and interactions. We argue that egocentric systems must additionally detect physiological states to capture a person's attention and situational responses, which are critical for context-aware behavior modeling. In this paper, we propose egoPPG, a novel vision task for egocentric systems to recover a person's cardiac activity to aid downstream vision tasks. We introduce PulseFormer, a method to extract heart rate as a key indicator of physiological state from the eye tracking cameras on unmodified egocentric vision systems. PulseFormer continuously estimates the photoplethysmogram (PPG) from areas around the eyes and fuses motion cues from the headset's inertial measurement unit to track HR values. We demonstrate egoPPG's downstream benefit for a key task on EgoExo4D, an existing egocentric dataset for which we find PulseFormer's estimates of HR to improve proficiency estimation by 14%. To train and validate PulseFormer, we collected a dataset of 13+ hours of eye tracking videos from Project Aria and contact-based PPG signals as well as an electrocardiogram (ECG) for ground-truth HR values. Similar to EgoExo4D, 25 participants performed diverse everyday activities such as office work, cooking, dancing, and exercising, which induced significant natural motion and HR variation (44-164 bpm). Our model robustly estimates HR (MAE=7.67 bpm) and captures patterns (r=0.85). Our results show how egocentric systems may unify environmental and physiological tracking to better understand users and that egoPPG as a complementary task provides meaningful augmentations for existing datasets and tasks. We release our code, dataset, and HR augmentations for EgoExo4D to inspire research on physiology-aware egocentric tasks.

Egocentric vision systems capture human behavior from visible cues, but overlook physiological indicators of autonomic states such as stress, engagement, and attention. Heart rate variability (HRV) is a widely used noninvasive marker of autonomic regulation under stress. HRV reflects small timing differences between successive heartbeats and has so far been out of reach for egocentric platforms, where motion and noise in gaze video mask exactly this fine-grained timing. We propose EgoHRV, a method that estimates HRV as well as heart rate (HR) from the gaze cameras that are already integrated into egocentric headsets. Our pipeline combines a 3D backbone with a novel low--high decomposition module that extracts the blood volume pulse (BVP) signal from gaze video. Our cross-domain pretraining aligns the frequency-domain representations of contact-based and camera-derived signals. This alignment gives EgoHRV the temporal precision to recover HRV from the subtle fluctuations in gaze video. EgoHRV achieves state-of-the-art accuracy for HR and HRV estimation from egocentric video, and its uncertainty-aware design improves downstream behavioral modeling. Integrating our HRV estimates and confidence measures into EgoExo4D's proficiency estimator raises accuracy by 17.8%. Beyond skill, continuous HRV estimation also opens egocentric systems to stress- and arousal-aware estimation tasks. Code: https://github.com/eth-siplab/EgoHRV

The complexity and heterogeneity of data in many real-world applications pose significant challenges for traditional machine learning and signal processing techniques. For instance, in medicine, effective analysis of diverse physiological signals is crucial for patient monitoring and clinical decision-making and yet highly challenging. We introduce MedTsLLM, a general multimodal large language model (LLM) framework that effectively integrates time series data and rich contextual information in the form of text to analyze physiological signals, performing three tasks with clinical relevance: semantic segmentation, boundary detection, and anomaly detection in time series. These critical tasks enable deeper analysis of physiological signals and can provide actionable insights for clinicians. We utilize a reprogramming layer to align embeddings of time series patches with a pretrained LLM's embedding space and make effective use of raw time series, in conjunction with textual context. Given the multivariate nature of medical datasets, we develop methods to handle multiple covariates. We additionally tailor the text prompt to include patient-specific information. Our model outperforms state-of-the-art baselines, including deep learning models, other LLMs, and clinical methods across multiple medical domains, specifically electrocardiograms and respiratory waveforms. MedTsLLM presents a promising step towards harnessing the power of LLMs for medical time series analysis that can elevate data-driven tools for clinicians and improve patient outcomes.

While ubiquitous wearable sensors capture a wealth of behavioral and physiological information, effectively transforming these signals into personalized health insights is challenging. Specifically, converting low-level sensor data into representations capable of characterizing higher-level states is difficult due to high phenotypic diversity and variation in individual baseline health, physiology, and lifestyle factors. Moreover, collecting wearable data paired with health outcome annotations is laborious and expensive, and retrospective annotation remains practically unfeasible, contributing to a scarcity of data with high-quality labels. To overcome these limitations, we propose a foundation model for wearable health that is pretrained on more than one trillion minutes of unlabeled sensor signals drawn from a large cohort of five million participants. We demonstrate that the joint scaling of model capacity and pretraining data volume leads to systematic improvements in performance, as evaluated on a diverse set of 35 health prediction tasks, spanning cardiovascular, metabolic, sleep, and mental health, as well as lifestyle choices and demographic factors. We find that this population scale representation unlocks label-efficient few-shot learning and generative capabilities for robust daily metric estimation. To further leverage this learned representation, we deploy a classroom of LLM agents to autonomously search the space of downstream predictive heads built on the model embeddings, showing broad performance improvements that increase with LLM model capacity. Finally, we show how integrating these downstream predictors into a Personal Health Agent can support model responses that are more relevant, contextually aware, and safe, and we validate this via 1,860 ratings from a cohort of clinicians.

We present PhysioLLM, an interactive system that leverages large language models (LLMs) to provide personalized health understanding and exploration by integrating physiological data from wearables with contextual information. Unlike commercial health apps for wearables, our system offers a comprehensive statistical analysis component that discovers correlations and trends in user data, allowing users to ask questions in natural language and receive generated personalized insights, and guides them to develop actionable goals. As a case study, we focus on improving sleep quality, given its measurability through physiological data and its importance to general well-being. Through a user study with 24 Fitbit watch users, we demonstrate that PhysioLLM outperforms both the Fitbit App alone and a generic LLM chatbot in facilitating a deeper, personalized understanding of health data and supporting actionable steps toward personal health goals.

Current foundation model for photoplethysmography (PPG) signals is challenged by the intrinsic redundancy and noise of the signal. Standard masked modeling often yields trivial solutions while contrastive methods lack morphological precision. To address these limitations, we propose a Statistical-prior Informed Generative Masking Architecture (SIGMA-PPG), a generative foundation model featuring a Prior-Guided Adversarial Masking mechanism, where a reinforcement learning-driven teacher leverages statistical priors to create challenging learning paths that prevent overfitting to noise. We also incorporate a semantic consistency constraint via vector quantization to ensure that physiologically identical waveforms (even those altered by recording artifacts or minor perturbations) map to shared indices. This enhances codebook semantic density and eliminates redundant feature structures. Pre-trained on over 120,000 hours of data, SIGMA-PPG achieves superior average performance compared to five state-of-the-art baselines across 12 diverse downstream tasks. The code is available at https://github.com/ZonghengGuo/SigmaPPG.

Speech emotion recognition (SER) is essential for humanoid robot tasks such as social robotic interactions and robotic psychological diagnosis, where interpretable and efficient models are critical for safety and performance. Existing deep models trained on large datasets remain largely uninterpretable, often insufficiently modeling underlying emotional acoustic signals and failing to capture and analyze the core physiology of emotional vocal behaviors. Physiological research on human voices shows that the dynamics of vocal amplitude and phase correlate with emotions through the vocal tract filter and the glottal source. However, most existing deep models solely involve amplitude but fail to couple the physiological features of and between amplitude and phase. Here, we propose PhysioSER, a physiology-informed vocal spectrotemporal representation learning method, to address these issues with a compact, plug-and-play design. PhysioSER constructs amplitude and phase views informed by voice anatomy and physiology (VAP) to complement SSL models for SER. This VAP-informed framework incorporates two parallel workflows: a vocal feature representation branch to decompose vocal signals based on VAP, embed them into a quaternion field, and use Hamilton-structured quaternion convolutions for modeling their dynamic interactions; and a latent representation branch based on a frozen SSL backbone. Then, utterance-level features from both workflows are aligned by a Contrastive Projection and Alignment framework, followed by a shallow attention fusion head for SER classification. PhysioSER is shown to be interpretable and efficient for SER through extensive evaluations across 14 datasets, 10 languages, and 6 backbones, and its practical efficacy is validated by real-time deployment on a humanoid robotic platform.

Physiological foundation models (FMs) have shown promise for biosignal representation learning, yet most remain confined to a single modality such as EEG, ECG, or PPG, largely because paired multimodal datasets are scarce. In this paper, we present PanLUNA, a compact 5.4M-parameter pan-modal FM that jointly processes EEG, ECG, and PPG within a single shared encoder. Extending LUNA's channel-unification module, PanLUNA treats multimodal channels as entries in a unified query set augmented with sensor-type embeddings, enabling efficient cross-modal early fusion while remaining inherently robust to missing modalities at inference time. Despite its small footprint, PanLUNA matches or exceeds models up to 57times larger: 81.21% balanced accuracy on TUAB abnormal EEG detection and state-of-the-art 0.7416 balanced accuracy on HMC multimodal sleep staging. Quantization-aware training with INT8 weights recovers geq96% of full-precision performance, and deployment on the GAP9 ultra-low-power RISC-V microcontroller for wearables achieves 325.6 ms latency and 18.8 mJ per 10-second, 12-lead ECG inference, and 1.206 s latency at 68.65 mJ for multimodal 5-channel sleep staging over 30-second epochs.

Time-series foundation models have demonstrated strong cross-domain transfer, yet their common architectural assumptions remain poorly aligned with wearable physiological signals, which are multichannel, irregularly sampled, noisy, and governed by coupled continuous-time dynamics spanning distinct spectral scales. We present SOTER, a generative foundation model for wearable physiological time series that unifies cross-channel coupling, spectrum-guided expert specialization, and continuous-time latent evolution within a single pre-training framework. SOTER combines a spatial feature-aware backbone that models inter-signal dependencies, a power spectral density (PSD)-guided mixture-of-experts layer that routes representations to experts associated with fixed spectral bands through an inspectable, non-learned rule, and a neural controlled differential equation decoder that supports prediction and imputation at arbitrary timestamps. We pre-train SOTER on 226 billion time points from five public physiological datasets and evaluate the same pre-trained model across out-of-distribution zero-shot forecasting, frozen-encoder linear-probe classification, and continuous-time imputation on wearable benchmarks. SOTER achieves the best RMSE on 4 of 6 datasets and the best MAE on 5 of 6 in zero-shot forecasting, the highest average Macro-AUROC in classification, and the lowest imputation error on all six datasets at 75% missingness. It further remains robust to additive acquisition noise, matching or surpassing baselines evaluated on clean inputs even under the strongest corruption. These results indicate that domain-specialized foundation models for wearable physiology benefit from jointly modeling channel structure, spectral scale, and continuous-time dynamics.

Robust and unobtrusive in-vehicle physiological monitoring is crucial for ensuring driving safety and user experience. While remote physiological measurement (RPM) offers a promising non-invasive solution, its translation to real-world driving scenarios is critically constrained by the scarcity of comprehensive datasets. Existing resources are often limited in scale, modality diversity, the breadth of biometric annotations, and the range of captured conditions, thereby omitting inherent real-world challenges in driving. Here, we present PhysDrive, the first large-scale multimodal dataset for contactless in-vehicle physiological sensing with dedicated consideration on various modality settings and driving factors. PhysDrive collects data from 48 drivers, including synchronized RGB, near-infrared camera, and raw mmWave radar data, accompanied with six synchronized ground truths (ECG, BVP, Respiration, HR, RR, and SpO2). It covers a wide spectrum of naturalistic driving conditions, including driver motions, dynamic natural light, vehicle types, and road conditions. We extensively evaluate both signal-processing and deep-learning methods on PhysDrive, establishing a comprehensive benchmark across all modalities, and release full open-source code with compatibility for mainstream public toolboxes. We envision PhysDrive will serve as a foundational resource and accelerate research on multimodal driver monitoring and smart-cockpit systems.

Emotional states, as indicators of affect, are pivotal to overall health, making their accurate prediction before onset crucial. Current studies are primarily centered on immediate short-term affect detection using data from wearable and mobile devices. These studies typically focus on objective sensory measures, often neglecting other forms of self-reported information like diaries and notes. In this paper, we propose a multimodal deep learning model for affect status forecasting. This model combines a transformer encoder with a pre-trained language model, facilitating the integrated analysis of objective metrics and self-reported diaries. To validate our model, we conduct a longitudinal study, enrolling college students and monitoring them over a year, to collect an extensive dataset including physiological, environmental, sleep, metabolic, and physical activity parameters, alongside open-ended textual diaries provided by the participants. Our results demonstrate that the proposed model achieves predictive accuracy of 82.50% for positive affect and 82.76% for negative affect, a full week in advance. The effectiveness of our model is further elevated by its explainability.

Background: Deep learning models have shown great success in automating tasks in sleep medicine by learning from carefully annotated Electroencephalogram (EEG) data. However, effectively utilizing a large amount of raw EEG remains a challenge. Objective: In this paper, we aim to learn robust vector representations from massive unlabeled EEG signals, such that the learned vectorized features (1) are expressive enough to replace the raw signals in the sleep staging task; and (2) provide better predictive performance than supervised models in scenarios of fewer labels and noisy samples. Methods: We propose a self-supervised model, named Contrast with the World Representation (ContraWR), for EEG signal representation learning, which uses global statistics from the dataset to distinguish signals associated with different sleep stages. The ContraWR model is evaluated on three real-world EEG datasets that include both at-home and in-lab EEG recording settings. Results: ContraWR outperforms 4 recent self-supervised learning methods on the sleep staging task across 3 large EEG datasets. ContraWR also beats supervised learning when fewer training labels are available (e.g., 4% accuracy improvement when less than 2% data is labeled). Moreover, the model provides informative representative feature structures in 2D projection. Conclusions: We show that ContraWR is robust to noise and can provide high-quality EEG representations for downstream prediction tasks. The proposed model can be generalized to other unsupervised physiological signal learning tasks. Future directions include exploring task-specific data augmentations and combining self-supervised with supervised methods, building upon the initial success of self-supervised learning in this paper.

Tracking biosignals is crucial for monitoring wellness and preempting the development of severe medical conditions. Today, wearable devices can conveniently record various biosignals, creating the opportunity to monitor health status without disruption to one's daily routine. Despite widespread use of wearable devices and existing digital biomarkers, the absence of curated data with annotated medical labels hinders the development of new biomarkers to measure common health conditions. In fact, medical datasets are usually small in comparison to other domains, which is an obstacle for developing neural network models for biosignals. To address this challenge, we have employed self-supervised learning using the unlabeled sensor data collected under informed consent from the large longitudinal Apple Heart and Movement Study (AHMS) to train foundation models for two common biosignals: photoplethysmography (PPG) and electrocardiogram (ECG) recorded on Apple Watch. We curated PPG and ECG datasets from AHMS that include data from ~141K participants spanning ~3 years. Our self-supervised learning framework includes participant level positive pair selection, stochastic augmentation module and a regularized contrastive loss optimized with momentum training, and generalizes well to both PPG and ECG modalities. We show that the pre-trained foundation models readily encode information regarding participants' demographics and health conditions. To the best of our knowledge, this is the first study that builds foundation models using large-scale PPG and ECG data collected via wearable consumer devices x2013 prior works have commonly used smaller-size datasets collected in clinical and experimental settings. We believe PPG and ECG foundation models can enhance future wearable devices by reducing the reliance on labeled data and hold the potential to help the users improve their health.

Accurate detection of cardiac abnormalities from electrocardiogram recordings is regarded as essential for clinical diagnostics and decision support. Traditional deep learning models such as residual networks and transformer architectures have been applied successfully to this task, but their performance has been limited when long sequential signals are processed. Recently, state space models have been introduced as an efficient alternative. In this study, a hybrid framework named One Dimensional Convolutional Neural Network Electrocardiogram Mamba is introduced, in which convolutional feature extraction is combined with Mamba, a selective state space model designed for effective sequence modeling. The model is built upon Vision Mamba, a bidirectional variant through which the representation of temporal dependencies in electrocardiogram data is enhanced. Comprehensive experiments on the PhysioNet Computing in Cardiology Challenges of 2020 and 2021 were conducted, and superior performance compared with existing methods was achieved. Specifically, the proposed model achieved substantially higher AUPRC and AUROC scores than those reported by the best previously published algorithms on twelve lead electrocardiograms. These results demonstrate the potential of Mamba-based architectures to advance reliable ECG classification. This capability supports early diagnosis and personalized treatment, while enhancing accessibility in telemedicine and resource-constrained healthcare systems.

Neurophysiological recordings such as electroencephalography (EEG) offer accessible and minimally invasive means of estimating physiological activity for applications in healthcare, diagnostic screening, and even immersive entertainment. However, these recordings yield high-dimensional, noisy time-series data that typically require extensive pre-processing and handcrafted feature extraction to reveal meaningful information. Recently, there has been a surge of interest in applying representation learning techniques from large pre-trained (foundation) models to effectively decode and interpret biosignals. We discuss the challenges posed for incorporating such methods and introduce BioCodec, an alternative representation learning framework inspired by neural codecs to capture low-level signal characteristics in the form of discrete tokens. Pre-trained on thousands of EEG hours, BioCodec shows efficacy across multiple downstream tasks, ranging from clinical diagnostic tasks and sleep physiology to decoding speech and motor imagery, particularly in low-resource settings. Additionally, we provide a qualitative analysis of codebook usage and estimate the spatial coherence of codebook embeddings from EEG connectivity. Notably, we also document the suitability of our method to other biosignal data, i.e., electromyographic (EMG) signals. Overall, the proposed approach provides a versatile solution for biosignal tokenization that performs competitively with state-of-the-art models. The source code and model checkpoints are shared.

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 pm 9.25 mmHg for systolic BP and 1.29 pm 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

Sleep is an essential component of human physiology, contributing significantly to overall health and quality of life. Accurate sleep staging and disorder detection are crucial for assessing sleep quality. Studies in the literature have proposed PSG-based approaches and machine-learning methods utilizing single-modality signals. However, existing methods often lack multimodal, multilabel frameworks and address sleep stages and disorders classification separately. In this paper, we propose a 1D-Vision Transformer for simultaneous classification of sleep stages and sleep disorders. Our method exploits the sleep disorders' correlation with specific sleep stage patterns and performs a simultaneous identification of a sleep stage and sleep disorder. The model is trained and tested using multimodal-multilabel sensory data (including photoplethysmogram, respiratory flow, and respiratory effort signals). The proposed method shows an overall accuracy (cohen's Kappa) of 78% (0.66) for five-stage sleep classification and 74% (0.58) for sleep apnea classification. Moreover, we analyzed the encoder attention weights to clarify our models' predictions and investigate the influence different features have on the models' outputs. The result shows that identified patterns, such as respiratory troughs and peaks, make a higher contribution to the final classification process.

rPPG (Remote photoplethysmography) is a technology that measures and analyzes BVP (Blood Volume Pulse) by using the light absorption characteristics of hemoglobin captured through a camera. Analyzing the measured BVP can derive various physiological signals such as heart rate, stress level, and blood pressure, which can be applied to various applications such as telemedicine, remote patient monitoring, and early prediction of cardiovascular disease. rPPG is rapidly evolving and attracting great attention from both academia and industry by providing great usability and convenience as it can measure biosignals using a camera-equipped device without medical or wearable devices. Despite extensive efforts and advances in this field, serious challenges remain, including issues related to skin color, camera characteristics, ambient lighting, and other sources of noise and artifacts, which degrade accuracy performance. We argue that fair and evaluable benchmarking is urgently required to overcome these challenges and make meaningful progress from both academic and commercial perspectives. In most existing work, models are trained, tested, and validated only on limited datasets. Even worse, some studies lack available code or reproducibility, making it difficult to fairly evaluate and compare performance. Therefore, the purpose of this study is to provide a benchmarking framework to evaluate various rPPG techniques across a wide range of datasets for fair evaluation and comparison, including both conventional non-deep neural network (non-DNN) and deep neural network (DNN) methods. GitHub URL: https://github.com/remotebiosensing/rppg

This study concentrates on evaluating the efficacy of Large Language Models (LLMs) in healthcare, with a specific focus on their application in personal anomalous health monitoring. Our research primarily investigates the capabilities of LLMs in interpreting and analyzing physiological data obtained from FDA-approved devices. We conducted an extensive analysis using anomalous physiological data gathered in a simulated low-air-pressure plateau environment. This allowed us to assess the precision and reliability of LLMs in understanding and evaluating users' health status with notable specificity. Our findings reveal that LLMs exhibit exceptional performance in determining medical indicators, including a Mean Absolute Error (MAE) of less than 1 beat per minute for heart rate and less than 1% for oxygen saturation (SpO2). Furthermore, the Mean Absolute Percentage Error (MAPE) for these evaluations remained below 1%, with the overall accuracy of health assessments surpassing 85%. In image analysis tasks, such as interpreting photoplethysmography (PPG) data, our specially adapted GPT models demonstrated remarkable proficiency, achieving less than 1 bpm error in cycle count and 7.28 MAE for heart rate estimation. This study highlights LLMs' dual role as health data analysis tools and pivotal elements in advanced AI health assistants, offering personalized health insights and recommendations within the future health assistant framework.

The growing popularity of wearable sensors has generated large quantities of temporal physiological and activity data. Ability to analyze this data offers new opportunities for real-time health monitoring and forecasting. However, temporal physiological data presents many analytic challenges: the data is noisy, contains many missing values, and each series has a different length. Most methods proposed for time series analysis and classification do not handle datasets with these characteristics nor do they offer interpretability and explainability, a critical requirement in the health domain. We propose an unsupervised method for learning representations of time series based on common patterns identified within them. The patterns are, interpretable, variable in length, and extracted using Byte Pair Encoding compression technique. In this way the method can capture both long-term and short-term dependencies present in the data. We show that this method applies to both univariate and multivariate time series and beats state-of-the-art approaches on a real world dataset collected from wearable sensors.

Understanding the interaction of neural and cardiac systems during cognitive activity is critical to advancing physiological computing. Although EEG has been the gold standard for assessing mental workload, its limited portability restricts its real-world use. Widely available ECG through wearable devices proposes a pragmatic alternative. This research investigates whether ECG signals can reliably reflect cognitive load and serve as proxies for EEG-based indicators. In this work, we present multimodal data acquired from two different paradigms involving working-memory and passive-listening tasks. For each modality, we extracted ECG time-domain HRV metrics and Catch22 descriptors against EEG spectral and Catch22 features, respectively. We propose a cross-modal XGBoost framework to project the ECG features onto EEG-representative cognitive spaces, thereby allowing workload inferences using only ECG. Our results show that ECG-derived projections expressively capture variation in cognitive states and provide good support for accurate classification. Our findings underpin ECG as an interpretable, real-time, wearable solution for everyday cognitive monitoring.

Deep learning's growing prevalence has driven its widespread use in healthcare, where AI and sensor advancements enhance diagnosis, treatment, and monitoring. In mobile health, AI-powered tools enable early diagnosis and continuous monitoring of conditions like stress. Wearable technologies and multimodal physiological data have made stress detection increasingly viable, but model efficacy depends on data quality, quantity, and modality. This study develops transformer models for stress detection using the WESAD dataset, training on electrocardiograms (ECG), electrodermal activity (EDA), electromyography (EMG), respiration rate (RESP), temperature (TEMP), and 3-axis accelerometer (ACC) signals. The results demonstrate the effectiveness of single-modality transformers in analyzing physiological signals, achieving state-of-the-art performance with accuracy, precision and recall values in the range of 99.73% to 99.95% for stress detection. Furthermore, this study explores cross-modal performance and also explains the same using 2D visualization of the learned embedding space and quantitative analysis based on data variance. Despite the large body of work on stress detection and monitoring, the robustness and generalization of these models across different modalities has not been explored. This research represents one of the initial efforts to interpret embedding spaces for stress detection, providing valuable information on cross-modal performance.

Photoplethysmography (PPG) signals, which measure changes in blood volume in the skin using light, have recently gained attention in biometric authentication because of their non-invasive acquisition, inherent liveness detection, and suitability for low-cost wearable devices. However, PPG signal quality is challenged by motion artifacts, illumination changes, and inter-subject physiological variability, making robust feature extraction and classification crucial. This study proposes a lightweight and cost-effective biometric authentication framework based on PPG signals extracted from low-frame-rate fingertip videos. The CFIHSR dataset, comprising PPG recordings from 46 subjects at a sampling rate of 14 Hz, is employed for evaluation. The raw PPG signals undergo a standard preprocessing pipeline involving baseline drift removal, motion artifact suppression using Principal Component Analysis (PCA), bandpass filtering, Fourier-based resampling, and amplitude normalization. To generate robust representations, each one-dimensional PPG segment is converted into a two-dimensional time-frequency scalogram via the Continuous Wavelet Transform (CWT), effectively capturing transient cardiovascular dynamics. We developed a hybrid deep learning model, termed CVT-ConvMixer-LSTM, by combining spatial features from the Convolutional Vision Transformer (CVT) and ConvMixer branches with temporal features from a Long Short-Term Memory network (LSTM). The experimental results on 46 subjects demonstrate an authentication accuracy of 98%, validating the robustness of the model to noise and variability between subjects. Due to its efficiency, scalability, and inherent liveness detection capability, the proposed system is well-suited for real-world mobile and embedded biometric security applications.

Time-series foundation models excel at tasks like forecasting across diverse data types by leveraging informative waveform representations. Wearable sensing data, however, pose unique challenges due to their variability in patterns and frequency bands, especially for healthcare-related outcomes. The main obstacle lies in crafting generalizable representations that adapt efficiently across heterogeneous sensing configurations and applications. To address this, we propose NormWear, the first multi-modal and ubiquitous foundation model designed to extract generalized and informative representations from wearable sensing data. Specifically, we design a channel-aware attention mechanism with a shared special liaison [CLS] token to detect signal patterns in both intra-sensor and inter-sensors. This helps the model to extract more meaningful information considering both time series themselves and the relationships between input sensors. This helps the model to be widely compatible with various sensors settings. NormWear is pretrained on a diverse set of physiological signals, including PPG, ECG, EEG, GSR, and IMU, from various public datasets. Our model shows exceptional generalizability across 11 public wearable sensing datasets, spanning 18 applications in mental health, body state inference, vital sign estimation, and disease risk evaluation. It consistently outperforms competitive baselines under zero-shot, partial-shot, and full-shot settings, indicating broad applicability in real-world health applications.

Foundation models offer a promising route to compress multi-modal physiological signals into compact representations of human health, with broad applications across sleep medicine, cardiology, neurology and other healthcare domains. Existing models have typically been trained with masked-reconstruction or contrastive objectives. However, masked reconstruction may be poorly suited to the stochastic nature of these signals, while contrastive approaches rely on positive-pair definitions despite the semantic invariances of physiological signals being poorly understood. In this work, we show that next-token prediction is a simple and scalable alternative. We develop Hypnos, a multi-modal sleep foundation model trained using eight different sensing modalities (e.g. EEG, ECG, respiratory signals) drawn from over 20,000 overnight polysomnography recordings. We tokenize each modality into streams of discrete tokens using residual vector quantization, then train a large auto-regressive RQ-Transformer to jointly predict the next token across all modalities in parallel. After training, Hypnos can be applied to continuous streams of sensor data from any subset of supported modalities, generating embeddings for downstream tasks. Across a range of benchmarks, Hypnos significantly outperforms existing foundation models. In sleep stage classification, we match the performance of strong supervised baselines on held-out test sets whilst using \(100\times\) less labelled data. Hypnos even generalises to daytime physiology, surpassing a dedicated ECG foundation model at detecting atrial fibrillation. Our results demonstrate that next-token prediction is a strong self-supervised objective for representation learning from multi-modal physiological signals.

Camera-based physiological measurement is a fast growing field of computer vision. Remote photoplethysmography (rPPG) utilizes imaging devices (e.g., cameras) to measure the peripheral blood volume pulse (BVP) via photoplethysmography, and enables cardiac measurement via webcams and smartphones. However, the task is non-trivial with important pre-processing, modeling, and post-processing steps required to obtain state-of-the-art results. Replication of results and benchmarking of new models is critical for scientific progress; however, as with many other applications of deep learning, reliable codebases are not easy to find or use. We present a comprehensive toolbox, rPPG-Toolbox, that contains unsupervised and supervised rPPG models with support for public benchmark datasets, data augmentation, and systematic evaluation: https://github.com/ubicomplab/rPPG-Toolbox

Human health can be critically affected by cardiovascular diseases, such as hypertension, arrhythmias, and stroke. Heart rate and blood pressure are important biometric information for the monitoring of cardiovascular system and early diagnosis of cardiovascular diseases. Existing methods for estimating the heart rate are based on electrocardiography and photoplethyomography, which require contacting the sensor to the skin surface. Moreover, catheter and cuff-based methods for measuring blood pressure cause inconvenience and have limited applicability. Therefore, in this thesis, we propose a vision-based method for estimating the heart rate and blood pressure. This thesis proposes a 2-stage deep learning framework consisting of a dual remote photoplethysmography network (DRP-Net) and bounded blood pressure network (BBP-Net). In the first stage, DRP-Net infers remote photoplethysmography (rPPG) signals for the acral and facial regions, and these phase-shifted rPPG signals are utilized to estimate the heart rate. In the second stage, BBP-Net integrates temporal features and analyzes phase discrepancy between the acral and facial rPPG signals to estimate SBP and DBP values. To improve the accuracy of estimating the heart rate, we employed a data augmentation method based on a frame interpolation model. Moreover, we designed BBP-Net to infer blood pressure within a predefined range by incorporating a scaled sigmoid function. Our method resulted in estimating the heart rate with the mean absolute error (MAE) of 1.78 BPM, reducing the MAE by 34.31 % compared to the recent method, on the MMSE-HR dataset. The MAE for estimating the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 10.19 mmHg and 7.09 mmHg. On the V4V dataset, the MAE for the heart rate, SBP, and DBP were 3.83 BPM, 13.64 mmHg, and 9.4 mmHg, respectively.

Electrocardiography (ECG), photoplethysmography (PPG), and phonocardiography (PCG) provide complementary views of the same cardiac cycle, yet existing cardiac foundation models are trained for a single sensing modality, leaving the shared physiology across sensors unexploited. We introduce CardioState-JEPA, a cardiac foundation model to learn a single shared representation jointly across ECG, PPG, and PCG, built on a physiology-aware joint-embedding predictive architecture. The model maps heterogeneous waveforms into a common token space, processes them with a single shared Transformer encoder, and learns by predicting masked latent cardiac states, placing the pretraining target on shared physiology rather than sensor-specific waveform appearance. To handle the temporal offsets between electrical, mechanical, and hemodynamic events, cross-modal prediction uses a learned delay aligner that matches signals at the corresponding cardiac time. Because synchronized multi-sensor recordings are scarce, CardioState-JEPA first learns within-modality structure from abundant unimodal data and then uses paired data to align modalities in latent cardiac time. Evaluated as a frozen encoder across 25 downstream tasks spanning ECG, PPG, and PCG, our encoder improves average PPG classification by 8.2 AUROC points, PCG murmur detection by 18.8 AUROC points, and ECG classification by 15.5 AUROC points over the best self-supervised signal baseline and matches or exceeds cardiac models trained with privileged clinical text or supervised labels on several ECG benchmarks. These results establish that heterogeneous cardiac signals can mutually supervise a single foundation model of cardiac physiology.

Photoplethysmography (PPG) sensors have been widely used in consumer wearable devices to monitor heart rates (HR) and heart rate variability (HRV). Despite the prevalence, PPG signals can be contaminated by motion artifacts induced from daily activities. Existing approaches mainly use the amplitude information to perform PPG peak detection. However, these approaches cannot accurately identify peaks, since motion artifacts may bring random and significant amplitude variations. To improve the performance of PPG peak detection, the time information can be used. Specifically, heart rates exhibit temporal consistency that consecutive heartbeat intervals in a normal person can have limited variations. To leverage the temporal consistency, we propose the Temporal Attentive U-Net, i.e., TAU, to accurately detect peaks from PPG signals. In TAU, we design a time module that encodes temporal consistency in temporal embeddings. We integrate the amplitude information with temporal embeddings using the attention mechanism to estimate peak labels. Our experimental results show that TAU outperforms eleven baselines on heart rate estimation by more than 22.4%. Our TAU model achieves the best performance across various Signal-to-Noise Ratio (SNR) levels. Moreover, we achieve Pearson correlation coefficients higher than 0.9 (p < 0.01) on estimating HRV features from low-noise-level PPG signals.

Photoplethysmography (PPG) is a widely used non-invasive sensing modality for continuous cardiovascular and physiological monitoring across clinical, laboratory, and wearable settings. While existing PPG datasets support a broad range of downstream tasks, they typically provide supervision in the form of numerical measurements or task-specific labels, limiting their suitability for language-based physiological reasoning and multimodal foundation models. In this work, we introduce PulseLM, a large-scale PPG-text dataset designed to bridge raw PPG waveforms and natural language through a unified, closed-ended question answering (QA) formulation. PulseLM aggregates PPG recordings from fifteen publicly available sources and harmonizes heterogeneous annotations into twelve common physiologically QA tasks. The dataset comprises 1.31 million standardized 10-second PPG segments, associated with 3.15 million question-answer pairs. We further define reproducible preprocessing, supervision, and evaluation protocols and establish baseline benchmarks using multimodal PPG-aware large language models. PulseLM provides a standardized foundation for studying multimodal physiological reasoning, cross-dataset generalization, and scalable benchmarking of PPG-based language models. The data and code can be found publicly available at: https://github.com/manhph2211/PulseLM.

Alarm fatigue in intensive care units (ICUs) is a well documented patient safety crisis. Clinical monitors generate 350 or more alarms per patient per day, out of which 72-99% are clinically irrelevant. Staff desensitization to non-actionable alarms increases the risk of missed true emergencies. This paper presents SigmaMedStat, a machine learning system that evaluates the trustworthiness of physiological alarm signals before clinical action is taken. Four approaches were evaluated on the PhysioNet/Computing in Cardiology Challenge 2015 dataset of 498 four-channel ICU alarm recordings. Primary contribution is a temporal modeling framework that splits each 60 second recording into six consecutive 10-second chunks, and this in turn generates Continuous Wavelet Transform (CWT) scalograms per chunk, encodes each chunk with a shared EfficientNet-B0 encoder, and passes the resulting feature sequence to a two-layer Long Short-Term Memory (LSTM) network. Five-fold stratified cross-validation yields a mean AUC of 0.822 +/- 0.016 (95% CI: [0.790,0.853]), compared to 0.641 for a static EfficientNet baseline trained on the full 60-second window. Ablation studies confirm that temporal chunking and multi-channel signal fusion both contribute independently to classification performance. Per-alarm type analysis reveals that Ventricular Flutter is the most accurately classified alarm type (AUC 0.820) while Asystole remains the hardest (AUC 0.722). Error analysis identifies 65 false negatives and 85 high-confidence misclassifications as the primary failure modes. All code and results are publicly available at https://github.com/Arun-K-Ram/sigmamedstat.

Photoplethysmography (PPG) is a widely adopted, non-invasive technique for monitoring cardiovascular health and physiological parameters in both consumer and clinical settings. While motion artifacts in dynamic environments have been extensively studied, suboptimal skin-sensor contact in sedentary conditions - a critical yet underexplored issue - can distort PPG waveform morphology, leading to the loss or misalignment of key features and compromising sensing accuracy. In this work, we propose CP-PPG, a novel framework that transforms Contact Pressure-distorted PPG signals into high-fidelity waveforms with ideal morphology. CP-PPG integrates a custom data collection protocol, a carefully designed signal processing pipeline, and a novel deep adversarial model trained with a custom PPG-aware loss function. We validated CP-PPG through comprehensive evaluations, including 1) morphology transformation performance on our self-collected dataset, 2) downstream physiological monitoring performance on public datasets, and 3) in-the-wild study. Extensive experiments demonstrate substantial and consistent improvements in signal fidelity (Mean Absolute Error: 0.09, 40% improvement over the original signal) as well as downstream performance across all evaluations in Heart Rate (HR), Heart Rate Variability (HRV), Respiration Rate (RR), and Blood Pressure (BP) estimation (on average, 21% improvement in HR; 41-46% in HRV; 6% in RR; and 4-5% in BP). These findings highlight the critical importance of addressing skin-sensor contact issues to enhance the reliability and effectiveness of PPG-based physiological monitoring. CP-PPG thus holds significant potential to improve the accuracy of wearable health technologies in clinical and consumer applications.

The interpretation of deep learning models is a challenge due to their size, complexity, and often opaque internal state. In addition, many systems, such as image classifiers, operate on low-level features rather than high-level concepts. To address these challenges, we introduce Concept Activation Vectors (CAVs), which provide an interpretation of a neural net's internal state in terms of human-friendly concepts. The key idea is to view the high-dimensional internal state of a neural net as an aid, not an obstacle. We show how to use CAVs as part of a technique, Testing with CAVs (TCAV), that uses directional derivatives to quantify the degree to which a user-defined concept is important to a classification result--for example, how sensitive a prediction of "zebra" is to the presence of stripes. Using the domain of image classification as a testing ground, we describe how CAVs may be used to explore hypotheses and generate insights for a standard image classification network as well as a medical application.

Mosquito-borne diseases cause several hundred thousand deaths every year. Deciphering mosquito host-seeking behavior is essential to prevent disease transmission through mosquito capture and surveillance. Despite recent substantial progress, we currently lack a comprehensive quantitative understanding of how visual and other sensory cues guide mosquitoes to their targets. Here, we combined 3D infrared tracking of Aedes aegypti mosquitoes with Bayesian dynamical systems inference to learn a quantitative biophysical model of mosquito host-seeking behavior. Trained on more than 20,000,000 data points from mosquito free-flight trajectories recorded in the presence of visual and carbon dioxide cues, the model accurately predicts how mosquitoes respond to human targets. Our results provide a quantitative foundation for optimizing mosquito capture and control strategies, a key step towards mitigating the impact of mosquito-borne diseases.

Non-contact video-based physiological measurement has many applications in health care and human-computer interaction. Practical applications require measurements to be accurate even in the presence of large head rotations. We propose the first end-to-end system for video-based measurement of heart and breathing rate using a deep convolutional network. The system features a new motion representation based on a skin reflection model and a new attention mechanism using appearance information to guide motion estimation, both of which enable robust measurement under heterogeneous lighting and major motions. Our approach significantly outperforms all current state-of-the-art methods on both RGB and infrared video datasets. Furthermore, it allows spatial-temporal distributions of physiological signals to be visualized via the attention mechanism.

Accurate classification of sleep stages from less obtrusive sensor measurements such as the electrocardiogram (ECG) or photoplethysmogram (PPG) could enable important applications in sleep medicine. Existing approaches to this problem have typically used deep learning models designed and trained to operate on one or more specific input signals. However, the datasets used to develop these models often do not contain the same sets of input signals. Some signals, particularly PPG, are much less prevalent than others, and this has previously been addressed with techniques such as transfer learning. Additionally, only training on one or more fixed modalities precludes cross-modal information transfer from other sources, which has proved valuable in other problem domains. To address this, we introduce wav2sleep, a unified model designed to operate on variable sets of input signals during training and inference. After jointly training on over 10,000 overnight recordings from six publicly available polysomnography datasets, including SHHS and MESA, wav2sleep outperforms existing sleep stage classification models across test-time input combinations including ECG, PPG, and respiratory signals.

Biosignals acquired from different locations on the body often provide temporally ordered views of the same underlying physiological process. However, most existing self supervised learning methods treat these signals as interchangeable views, overlooking the directional temporal dynamics that link them. A canonical example is the relationship between electrocardiography (ECG), which captures the electrical activation initiating each heartbeat, and photoplethysmography (PPG), which records the resulting peripheral pulse delayed by vascular dynamics. To capture this structured relationship, we introduce xMAE, a biosignal pretraining framework that leverages masked cross modal reconstruction across temporally ordered biosignals as a training time constraint to encourage physiologically meaningful timing structure in the learned representations. We show that pretraining with xMAE yields representations that outperform both unimodal and multimodal baselines on 15 of 19 downstream tasks, including cardiovascular outcome prediction, abnormal laboratory test detection, sleep staging, and demographic inference, while generalizing across devices, body locations, and acquisition settings. Further analysis suggests that the ECG PPG timing structure is reflected in the learned PPG representations. More broadly, xMAE demonstrates the effectiveness of incorporating temporal structure into multimodal pretraining when signals observe different stages of a shared underlying process. Code is available at https://github.com/hzhou3/xMAE.

Introduction: Sleep staging is an essential component in the diagnosis of sleep disorders and management of sleep health. It is traditionally measured in a clinical setting and requires a labor-intensive labeling process. We hypothesize that it is possible to perform robust 4-class sleep staging using the raw photoplethysmography (PPG) time series and modern advances in deep learning (DL). Methods: We used two publicly available sleep databases that included raw PPG recordings, totalling 2,374 patients and 23,055 hours. We developed SleepPPG-Net, a DL model for 4-class sleep staging from the raw PPG time series. SleepPPG-Net was trained end-to-end and consists of a residual convolutional network for automatic feature extraction and a temporal convolutional network to capture long-range contextual information. We benchmarked the performance of SleepPPG-Net against models based on the best-reported state-of-the-art (SOTA) algorithms. Results: When benchmarked on a held-out test set, SleepPPG-Net obtained a median Cohen's Kappa (κ) score of 0.75 against 0.69 for the best SOTA approach. SleepPPG-Net showed good generalization performance to an external database, obtaining a κ score of 0.74 after transfer learning. Perspective: Overall, SleepPPG-Net provides new SOTA performance. In addition, performance is high enough to open the path to the development of wearables that meet the requirements for usage in clinical applications such as the diagnosis and monitoring of obstructive sleep apnea.

In clinical practice, electrocardiography (ECG) remains the gold standard for cardiac monitoring, providing crucial insights for diagnosing a wide range of cardiovascular diseases (CVDs). However, its reliance on specialized equipment and trained personnel limits feasibility for continuous routine monitoring. Photoplethysmography (PPG) offers accessible, continuous monitoring but lacks definitive electrophysiological information, preventing conclusive diagnosis. Generative models present a promising approach to translate PPG into clinically valuable ECG signals, yet current methods face substantial challenges, including the misalignment of physiological semantics in generative models and the complexity of modeling in high-dimensional signals. To this end, we propose PPGFlowECG, a two-stage framework that aligns PPG and ECG in a shared latent space via the CardioAlign Encoder and employs latent rectified flow to generate ECGs with high fidelity and interpretability. To the best of our knowledge, this is the first study to experiment on MCMED, a newly released clinical-grade dataset comprising over 10 million paired PPG-ECG samples from more than 118,000 emergency department visits with expert-labeled cardiovascular disease annotations. Results demonstrate the effectiveness of our method for PPG-to-ECG translation and cardiovascular disease detection. Moreover, cardiologist-led evaluations confirm that the synthesized ECGs achieve high fidelity and improve diagnostic reliability, underscoring our method's potential for real-world cardiovascular screening.

Gaussian processes (GPs) are popular nonparametric statistical models for learning unknown functions and quantifying the spatiotemporal uncertainty in data. Recent works have extended GPs to model scalar and vector quantities distributed over non-Euclidean domains, including smooth manifolds appearing in numerous fields such as computer vision, dynamical systems, and neuroscience. However, these approaches assume that the manifold underlying the data is known, limiting their practical utility. We introduce RVGP, a generalisation of GPs for learning vector signals over latent Riemannian manifolds. Our method uses positional encoding with eigenfunctions of the connection Laplacian, associated with the tangent bundle, readily derived from common graph-based approximation of data. We demonstrate that RVGP possesses global regularity over the manifold, which allows it to super-resolve and inpaint vector fields while preserving singularities. Furthermore, we use RVGP to reconstruct high-density neural dynamics derived from low-density EEG recordings in healthy individuals and Alzheimer's patients. We show that vector field singularities are important disease markers and that their reconstruction leads to a comparable classification accuracy of disease states to high-density recordings. Thus, our method overcomes a significant practical limitation in experimental and clinical applications.

Language models excel at diagnostic assessments on currated medical case-studies and vignettes, performing on par with, or better than, clinical professionals. However, existing studies focus on complex scenarios with rich context making it difficult to draw conclusions about how these systems perform for patients reporting symptoms in everyday life. We deployed SymptomAI, a set of conversational AI agents for end-to-end patient interviewing and differential diagnosis (DDx), via the Fitbit app in a study that randomized participants (N=13,917) to interact with five AI agents. This corpus captures diverse communication and a realistic distribution of illnesses from a real world population. A subset of 1,228 participants reported a clinician-provided diagnosis, and 517 of these were further evaluated by a panel of clinicians during over 250 hours of annotation. SymptomAI DDx were significantly more accurate (OR = 2.47, p < 0.001) than those from independent clinicians given the same dialogue in a blinded randomized comparison. Moreover, agentic strategies which conduct a dedicated symptom interview that elicit additional symptom information before providing a diagnosis, perform substantially better than baseline, user-guided conversations (p < 0.001). An auxiliary analysis on 1,509 conversations from a general US population panel validated that these results generalize beyond wearable device users. We used SymptomAI diagnoses as labels for all 13,917 participants to analyze over 500,000 days of wearable metrics across nearly 400 unique conditions. We identified strong associations between acute infections and physiological shifts (e.g., OR > 7 for influenza). While limited by self-reported ground truth, these results demonstrate the benefits of a dedicated and complete symptom interview compared to a user-guided symptom discussion, which is the default of most consumer LLMs.

Advances in wireless electroencephalography (EEG) technology promise to record brain-electrical activity in everyday situations. To better understand the relationship between brain activity and natural behavior, it is necessary to monitor human movement patterns. Here, we present a pocketable setup consisting of two smartphones to simultaneously capture human posture and EEG signals. We asked 26 basketball players to shoot 120 free throws each. First, we investigated whether our setup allows us to capture the readiness potential (RP) that precedes voluntary actions. Second, we investigated whether the RP differs between successful and unsuccessful free-throw attempts. The results confirmed the presence of the RP over fronto-central channels, with significant negative deflection at channel Cz, from -400 to 0 ms before movement onset (M pm SE: -6.54 pm 2.26 to -13.52 pm 2.42 μV; z = -2.53 to -3.92; FDR-corrected p = 0.049 to 0.003; r = 0.50 to 0.77). However, the amplitude of the RP was not related to shooting success (all FDR-corrected p > 0.05; maximum mean R^2 = 0.047, i.e., 4.7% explained variance). Preliminary exploratory pose analysis conducted offline indicated the presence of participant-specific variations in posture between successful and unsuccessful shots in 38.5% of participants (10/26), with 4.5% explained variance (maximum mean landmark R^2 = 0.045). We conclude that a highly portable, low-cost and lightweight acquisition setup, consisting of two smartphones and a head-mounted wireless EEG amplifier, is sufficient to monitor complex human movement patterns and associated brain dynamics outside the laboratory.

Wearable devices record physiological and behavioral signals that can improve health predictions. While foundation models are increasingly used for such predictions, they have been primarily applied to low-level sensor data, despite behavioral data often being more informative due to their alignment with physiologically relevant timescales and quantities. We develop foundation models of such behavioral signals using over 2.5B hours of wearable data from 162K individuals, systematically optimizing architectures and tokenization strategies for this unique dataset. Evaluated on 57 health-related tasks, our model shows strong performance across diverse real-world applications including individual-level classification and time-varying health state prediction. The model excels in behavior-driven tasks like sleep prediction, and improves further when combined with representations of raw sensor data. These results underscore the importance of tailoring foundation model design to wearables and demonstrate the potential to enable new health applications.

How do humans move? The quest to understand human motion has broad applications in numerous fields, ranging from computer animation and motion synthesis to neuroscience, human prosthetics and rehabilitation. Although advances in reinforcement learning (RL) have produced impressive results in capturing human motion using simplified humanoids, controlling physiologically accurate models of the body remains an open challenge. In this work, we present a model-free motion imitation framework (KINESIS) to advance the understanding of muscle-based motor control. Using a musculoskeletal model of the lower body with 80 muscle actuators and 20 DoF, we demonstrate that KINESIS achieves strong imitation performance on 1.9 hours of motion capture data, is controllable by natural language through pre-trained text-to-motion generative models, and can be fine-tuned to carry out high-level tasks such as target goal reaching. Importantly, KINESIS generates muscle activity patterns that correlate well with human EMG activity. The physiological plausibility makes KINESIS a promising model for tackling challenging problems in human motor control theory, which we highlight by investigating Bernstein's redundancy problem in the context of locomotion. Code, videos and benchmarks will be available at https://github.com/amathislab/Kinesis.

Non-invasive continuous blood pressure (BP) monitoring using photoplethysmography (PPG) is a promising alternative to cuff-based measurements. However, existing PPG-based BP estimation studies predominantly rely on aggregated performance metrics (e.g., mean absolute error) computed over entire evaluation intervals, which can obscure model failures during rapid BP fluctuations and limit clinical relevance. In this work, we propose a fluctuation-aware evaluation framework for PPG-based BP estimation based on time-series change point detection. Instead of heuristic BP thresholding (e.g., ΔBP > 10mmHg), we identify BP change points by capturing abrupt distributional shifts in BP trajectories and evaluate estimation performance specifically during these fluctuation periods. Our analysis shows that several state-of-the-art models exhibit substantial performance degradation around BP change points, and that periodic test-time calibration is insufficient to handle such dynamic BP variations. To address this limitation, we introduce a targeted re-calibration framework triggered by detected BP change points, improving robustness without modifying model architectures. To the best of our knowledge, this is the first systematic evaluation of PPG-based BP estimation from a BP change point perspective, highlighting the importance of fluctuation-aware evaluation and calibration for real-world continuous BP monitoring.

There is renewed interest in modeling and understanding the nervous system of the nematode Caenorhabditis elegans (C. elegans), as this small model system provides a path to bridge the gap between nervous system structure (connectivity) and function (physiology). However, existing physiology datasets, whether involving passive recording or stimulation, are in distinct formats, and connectome datasets require preprocessing before analysis can commence. Here we compile and homogenize datasets of neural activity and connectivity. Our neural activity dataset is derived from 11 C. elegans neuroimaging experiments, while our connectivity dataset is compiled from 9 connectome annotations based on 3 primary electron microscopy studies and 1 signal propagation study. Physiology datasets, collected under varying protocols, measure calcium fluorescence in labeled subsets of the worm's 300 neurons. Our preprocessing pipeline standardizes these datasets by consistently ordering labeled neurons and resampling traces to a common sampling rate, yielding recordings from approximately 900 worms and 250 uniquely labeled neurons. The connectome datasets, collected from electron microscopy reconstructions, represent the entire nervous system as a graph of connections. Our collection is accessible on HuggingFace, facilitating analysis of the structure-function relationship in biology using modern neural network architectures and enabling cross-lab and cross-animal comparisons.

Understanding of human visual perception has historically inspired the design of computer vision architectures. As an example, perception occurs at different scales both spatially and temporally, suggesting that the extraction of salient visual information may be made more effective by paying attention to specific features at varying scales. Visual changes in the body due to physiological processes also occur at different scales and with modality-specific characteristic properties. Inspired by this, we present BigSmall, an efficient architecture for physiological and behavioral measurement. We present the first joint camera-based facial action, cardiac, and pulmonary measurement model. We propose a multi-branch network with wrapping temporal shift modules that yields both accuracy and efficiency gains. We observe that fusing low-level features leads to suboptimal performance, but that fusing high level features enables efficiency gains with negligible loss in accuracy. Experimental results demonstrate that BigSmall significantly reduces the computational costs. Furthermore, compared to existing task-specific models, BigSmall achieves comparable or better results on multiple physiological measurement tasks simultaneously with a unified model.

The COVID-19 pandemic has underscored the need for low-cost, scalable approaches to measuring contactless vital signs, either during initial triage at a healthcare facility or virtual telemedicine visits. Remote photoplethysmography (rPPG) can accurately estimate heart rate (HR) when applied to close-up videos of healthy volunteers in well-lit laboratory settings. However, results from such highly optimized laboratory studies may not be readily translated to healthcare settings. One significant barrier to the practical application of rPPG in health care is the accurate localization of the region of interest (ROI). Clinical or telemedicine visits may involve sub-optimal lighting, movement artifacts, variable camera angle, and subject distance. This paper presents an rPPG ROI selection method based on 3D facial landmarks and patient head yaw angle. We then demonstrate the robustness of this ROI selection method when coupled to the Plane-Orthogonal-to-Skin (POS) rPPG method when applied to videos of patients presenting to an Emergency Department for respiratory complaints. Our results demonstrate the effectiveness of our proposed approach in improving the accuracy and robustness of rPPG in a challenging clinical environment.

Remote photoplethysmography (rPPG) is a method for non-contact measurement of physiological signals from facial videos, holding great potential in various applications such as healthcare, affective computing, and anti-spoofing. Existing deep learning methods struggle to address two core issues of rPPG simultaneously: understanding the periodic pattern of rPPG among long contexts and addressing large spatiotemporal redundancy in video segments. These represent a trade-off between computational complexity and the ability to capture long-range dependencies. In this paper, we introduce RhythmMamba, a state space model-based method that captures long-range dependencies while maintaining linear complexity. By viewing rPPG as a time series task through the proposed frame stem, the periodic variations in pulse waves are modeled as state transitions. Additionally, we design multi-temporal constraint and frequency domain feed-forward, both aligned with the characteristics of rPPG time series, to improve the learning capacity of Mamba for rPPG signals. Extensive experiments show that RhythmMamba achieves state-of-the-art performance with 319% throughput and 23% peak GPU memory. The codes are available at https://github.com/zizheng-guo/RhythmMamba.

Exposing meaningful and interpretable neural interactions is critical to understanding neural circuits. Inferred neural interactions from neural signals primarily reflect functional interactions. In a long experiment, subject animals may experience different stages defined by the experiment, stimuli, or behavioral states, and hence functional interactions can change over time. To model dynamically changing functional interactions, prior work employs state-switching generalized linear models with hidden Markov models (i.e., HMM-GLMs). However, we argue they lack biological plausibility, as functional interactions are shaped and confined by the underlying anatomical connectome. Here, we propose a novel prior-informed state-switching GLM. We introduce both a Gaussian prior and a one-hot prior over the GLM in each state. The priors are learnable. We will show that the learned prior should capture the state-constant interaction, shedding light on the underlying anatomical connectome and revealing more likely physical neuron interactions. The state-dependent interaction modeled by each GLM offers traceability to capture functional variations across multiple brain states. Our methods effectively recover true interaction structures in simulated data, achieve the highest predictive likelihood with real neural datasets, and render interaction structures and hidden states more interpretable when applied to real neural data.

Scientific discovery in digital health requires converting continuous physiological signals from wearable devices into clinically actionable biomarkers. We introduce CoDaS (AI Co-Data-Scientist), a multi-agent system that structures biomarker discovery as an iterative process combining hypothesis generation, statistical analysis, adversarial validation, and literature-grounded reasoning with human oversight using large-scale wearable datasets. Across three cohorts totaling 9,279 participant-observations, CoDaS identified 41 candidate digital biomarkers for mental health and 25 for metabolic outcomes, each subjected to an internal validation battery spanning replication, stability, robustness, and discriminative power. Across two independent depression cohorts, CoDaS surfaced circadian instability-related features in both datasets, reflected in sleep duration variability (DWB, ρ= 0.252, p < 0.001) and sleep onset variability (GLOBEM, ρ= 0.126, p < 0.001). In a metabolic cohort, CoDaS derived a cardiovascular fitness index (steps/resting heart rate; ρ= -0.374, p < 0.001), and recovered established clinical associations, including the hepatic function ratio (AST/ALT; ρ= -0.375, p < 0.001), a known correlate of insulin resistance. Incorporating CoDaS-derived features alongside demographic variables led to modest but consistent improvements in predictive performance, with cross-validated ΔR^2 increases of 0.040 for depression and 0.021 for insulin resistance. These findings suggest that CoDaS enables systematic and traceable hypothesis generation and prioritization for biomarker discovery from large-scale wearable data.

Accurate sleep staging is essential for diagnosing OSA and hypopnea in stroke patients. Although PSG is reliable, it is costly, labor-intensive, and manually scored. While deep learning enables automated EEG-based sleep staging in healthy subjects, our analysis shows poor generalization to clinical populations with disrupted sleep. Using Grad-CAM interpretations, we systematically demonstrate this limitation. We introduce iSLEEPS, a newly clinically annotated ischemic stroke dataset (to be publicly released), and evaluate a SE-ResNet plus bidirectional LSTM model for single-channel EEG sleep staging. As expected, cross-domain performance between healthy and diseased subjects is poor. Attention visualizations, supported by clinical expert feedback, show the model focuses on physiologically uninformative EEG regions in patient data. Statistical and computational analyses further confirm significant sleep architecture differences between healthy and ischemic stroke cohorts, highlighting the need for subject-aware or disease-specific models with clinical validation before deployment. A summary of the paper and the code is available at https://himalayansaswatabose.github.io/iSLEEPS_Explainability.github.io/

Visible-light cameras can capture subtle physiological biomarkers without physical contact with the subject. We present the Multi-Site Physiological Monitoring (MSPM) dataset, which is the first dataset collected to support the study of simultaneous camera-based vital signs estimation from multiple locations on the body. MSPM enables research on remote photoplethysmography (rPPG), respiration rate, and pulse transit time (PTT); it contains ground-truth measurements of pulse oximetry (at multiple body locations) and blood pressure using contacting sensors. We provide thorough experiments demonstrating the suitability of MSPM to support research on rPPG, respiration rate, and PTT. Cross-dataset rPPG experiments reveal that MSPM is a challenging yet high quality dataset, with intra-dataset pulse rate mean absolute error (MAE) below 4 beats per minute (BPM), and cross-dataset pulse rate MAE below 2 BPM in certain cases. Respiration experiments find a MAE of 1.09 breaths per minute by extracting motion features from the chest. PTT experiments find that across the pairs of different body sites, there is high correlation between remote PTT and contact-measured PTT, which facilitates the possibility for future camera-based PTT research.

Photoplethysmogram (PPG) and electrocardiogram (ECG) are commonly recorded in intesive care unit (ICU) and operating room (OR). However, the high incidence of poor, incomplete, and inconsistent signal quality, can lead to false alarms or diagnostic inaccuracies. The methods explored so far suffer from limited generalizability, reliance on extensive labeled data, and poor cross-task transferability. To overcome these challenges, we introduce QualityFM, a novel multimodal foundation model for these physiological signals, designed to acquire a general-purpose understanding of signal quality. Our model is pre-trained on an large-scale dataset comprising over 21 million 30-second waveforms and 179,757 hours of data. Our approach involves a dual-track architecture that processes paired physiological signals of differing quality, leveraging a self-distillation strategy where an encoder for high-quality signals is used to guide the training of an encoder for low-quality signals. To efficiently handle long sequential signals and capture essential local quasi-periodic patterns, we integrate a windowed sparse attention mechanism within our Transformer-based model. Furthermore, a composite loss function, which combines direct distillation loss on encoder outputs with indirect reconstruction loss based on power and phase spectra, ensures the preservation of frequency-domain characteristics of the signals. We pre-train three models with varying parameter counts (9.6 M to 319 M) and demonstrate their efficacy and practical value through transfer learning on three distinct clinical tasks: false alarm of ventricular tachycardia detection, the identification of atrial fibrillation and the estimation of arterial blood pressure (ABP) from PPG and ECG signals.

Electrocardiograms (ECGs) are among the most widely used diagnostic tools for cardiovascular diseases, and a large amount of ECG data worldwide appears only in image form. However, most existing automated ECG analysis methods rely on access to raw signal recordings, limiting their applicability in real-world and resource-constrained settings. In this paper, we present ECG-Scan, a self-supervised framework for learning clinically generalized representations from ECG images through dual physiological-aware alignments: 1) Our approach optimizes image representation learning using multimodal contrastive alignment between image and gold-standard signal-text modalities. 2) We further integrate domain knowledge via soft-lead constraints, regularizing the reconstruction process and improving signal lead inter-consistency. Extensive benchmarking across multiple datasets and downstream tasks demonstrates that our image-based model achieves superior performance compared to existing image baselines and notably narrows the gap between ECG image and signal analysis. These results highlight the potential of self-supervised image modeling to unlock large-scale legacy ECG data and broaden access to automated cardiovascular diagnostics.

Large-scale pre-trained models (PTMs) such as BERT and GPT have recently achieved great success in Natural Language Processing and Computer Vision domains. However, the development of PTMs on healthcare time-series data is lagging behind.This underscores the limitations of the existing transformer-based architectures, particularly their scalability to handle large-scale time series and ability to capture long-term temporal dependencies. In this study, we present Timely Generative Pre-trained Transformer (TimelyGPT). TimelyGPT employs an extrapolatable position (xPos) embedding to encode trend and periodic patterns into time-series representations. It also integrates recurrent attention and temporal convolution modules to effectively capture global-local temporal dependencies. We evaluated TimelyGPT on two large-scale healthcare time series datasets corresponding to continuous biosignals and irregularly-sampled time series, respectively. Our experiments show that during pre-training, TimelyGPT excels in learning time-series representations from continuously monitored biosignals and irregularly-sampled time series data commonly observed in longitudinal electronic health records (EHRs). In forecasting continuous biosignals, TimelyGPT achieves accurate extrapolation up to 6,000 timesteps of body temperature during the sleep stage transition, given a short look-up window (i.e., prompt) containing only 2,000 timesteps. For irregularly-sampled time series, TimelyGPT with a proposed time-specific inference demonstrates high top recall scores in predicting future diagnoses using early diagnostic records, effectively handling irregular intervals between clinical records. Together, we envision TimelyGPT to be useful in a broad spectrum of health domains, including long-term patient health state forecasting and patient risk trajectory prediction.

With the increasing availability of wearable devices, photoplethysmography (PPG) has emerged as a promising non-invasive tool for monitoring human hemodynamics. We propose a deep learning framework to estimate vascular age (AI-vascular age) from PPG signals, incorporating a distribution-aware loss to address biases caused by imbalanced data. The model was developed using data from the UK Biobank (UKB), with 98,672 participants in the development cohort and 113,559 participants (144,683 data pairs) for clinical evaluation. After adjusting for key confounders, individuals with a vascular age gap (AI-vascular age minus calendar age) exceeding 9 years had a significantly higher risk of major adverse cardiovascular and cerebrovascular events (MACCE) (HR = 2.37, p < 0.005) and secondary outcomes, including diabetes (HR = 2.69, p < 0.005), hypertension (HR = 2.88, p < 0.005), coronary heart disease (HR = 2.20, p < 0.005), heart failure (HR = 2.15, p < 0.005), myocardial infarction (HR = 2.51, p < 0.005), stroke (HR = 2.55, p < 0.005), and all-cause mortality (HR = 2.51, p < 0.005). Conversely, participants with a vascular age gap below -9 years exhibited a significantly lower incidence of these outcomes. We further evaluated the longitudinal applicability of AI-vascular age using serial PPG data from the UKB, demonstrating its value in risk stratification by leveraging AI-vascular age at two distinct time points to predict future MACCE incidence. External validation was performed on a MIMIC-III-derived cohort (n = 2,343), where each one-year increase in vascular age gap was significantly associated with elevated in-hospital mortality risk (OR = 1.02, p < 0.005). In conclusion, our study establishes AI-vascular age as a novel, non-invasive digital biomarker for cardiovascular health assessment.

Objective: Electroencephalography signals are recorded as a multidimensional dataset. We propose a new framework based on the augmented covariance extracted from an autoregressive model to improve motor imagery classification. Methods: From the autoregressive model can be derived the Yule-Walker equations, which show the emergence of a symmetric positive definite matrix: the augmented covariance matrix. The state-of the art for classifying covariance matrices is based on Riemannian Geometry. A fairly natural idea is therefore to extend the standard approach using these augmented covariance matrices. The methodology for creating the augmented covariance matrix shows a natural connection with the delay embedding theorem proposed by Takens for dynamical systems. Such an embedding method is based on the knowledge of two parameters: the delay and the embedding dimension, respectively related to the lag and the order of the autoregressive model. This approach provides new methods to compute the hyper-parameters in addition to standard grid search. Results: The augmented covariance matrix performed noticeably better than any state-of-the-art methods. We will test our approach on several datasets and several subjects using the MOABB framework, using both within-session and cross-session evaluation. Conclusion: The improvement in results is due to the fact that the augmented covariance matrix incorporates not only spatial but also temporal information, incorporating nonlinear components of the signal through an embedding procedure, which allows the leveraging of dynamical systems algorithms. Significance: These results extend the concepts and the results of the Riemannian distance based classification algorithm.

In this study, we present a comprehensive public dataset for driver drowsiness detection, integrating multimodal signals of facial, behavioral, and biometric indicators. Our dataset includes 3D facial video using a depth camera, IR camera footage, posterior videos, and biometric signals such as heart rate, electrodermal activity, blood oxygen saturation, skin temperature, and accelerometer data. This data set provides grip sensor data from the steering wheel and telemetry data from the American truck simulator game to provide more information about drivers' behavior while they are alert and drowsy. Drowsiness levels were self-reported every four minutes using the Karolinska Sleepiness Scale (KSS). The simulation environment consists of three monitor setups, and the driving condition is completely like a car. Data were collected from 19 subjects (15 M, 4 F) in two conditions: when they were fully alert and when they exhibited signs of sleepiness. Unlike other datasets, our multimodal dataset has a continuous duration of 40 minutes for each data collection session per subject, contributing to a total length of 1,400 minutes, and we recorded gradual changes in the driver state rather than discrete alert/drowsy labels. This study aims to create a comprehensive multimodal dataset of driver drowsiness that captures a wider range of physiological, behavioral, and driving-related signals. The dataset will be available upon request to the corresponding author.

Introduction: Data from wearable devices collected in free-living settings, and labelled with physical activity behaviours compatible with health research, are essential for both validating existing wearable-based measurement approaches and developing novel machine learning approaches. One common way of obtaining these labels relies on laborious annotation of sequences of images captured by cameras worn by participants through the course of a day. Methods: We compare the performance of three vision language models and two discriminative models on two free-living validation studies with 161 and 111 participants, collected in Oxfordshire, United Kingdom and Sichuan, China, respectively, using the Autographer (OMG Life, defunct) wearable camera. Results: We found that the best open-source vision-language model (VLM) and fine-tuned discriminative model (DM) achieved comparable performance when predicting sedentary behaviour from single images on unseen participants in the Oxfordshire study; median F1-scores: VLM = 0.89 (0.84, 0.92), DM = 0.91 (0.86, 0.95). Performance declined for light (VLM = 0.60 (0.56,0.67), DM = 0.70 (0.63, 0.79)), and moderate-to-vigorous intensity physical activity (VLM = 0.66 (0.53, 0.85); DM = 0.72 (0.58, 0.84)). When applied to the external Sichuan study, performance fell across all intensity categories, with median Cohen's kappa-scores falling from 0.54 (0.49, 0.64) to 0.26 (0.15, 0.37) for the VLM, and from 0.67 (0.60, 0.74) to 0.19 (0.10, 0.30) for the DM. Conclusion: Freely available computer vision models could help annotate sedentary behaviour, typically the most prevalent activity of daily living, from wearable camera images within similar populations to seen data, reducing the annotation burden.

Objective: To enable continuous, long-term neuro-monitoring on wearable devices by overcoming the computational bottlenecks of Transformer-based Electroencephalography (EEG) foundation models and the quantization challenges inherent to State-Space Models (SSMs). Methods: We present FEMBA, a bidirectional Mamba architecture pre-trained on over 21,000 hours of EEG. We introduce a novel Physiologically-Aware pre-training objective, consisting of a reconstruction with low-pass filtering, to prioritize neural oscillations over high-frequency artifacts. To address the activation outliers common in SSMs, we employ Quantization-Aware Training (QAT) to compress the model to 2-bit weights. The framework is deployed on a parallel ultra-low-power RISC-V microcontroller (GAP9) using a custom double-buffered memory streaming scheme. Results: The proposed low-pass pre-training improves downstream AUROC on TUAB from 0.863 to 0.893 and AUPR from 0.862 to 0.898 compared to the best contrastive baseline. QAT successfully compresses weights with negligible performance loss, whereas standard post-training quantization degrades accuracy by approximately 30\%. The embedded implementation achieves deterministic real-time inference (1.70~s per 5~s window) and reduces the memory footprint by 74\% (to approx2~MB), achieving competitive accuracy with up to 27times fewer FLOPs than Transformer benchmarks. Conclusion: FEMBA demonstrates that Mamba-based foundation models can be effectively quantized and deployed on extreme-edge hardware without sacrificing the representation quality required for robust clinical analysis. Significance: This work establishes the first full-stack framework for deploying large-scale EEG foundation models on ultra-low-power wearables, facilitating continuous, SSM based monitoring for epilepsy and sleep disorders.

Continuous glucose monitoring (CGM) provides a dense view of daily metabolic physiology, yet existing generic time-series and CGM-specific foundation models often encode glucose traces as entangled single-stream sequences, leaving the distinct temporal structure of glycemic dynamics only implicitly modeled. We present GlucoFM, a lightweight CGM foundation model that aligns irregular recordings to a 24-hour chronological grid, preserves observation masks, and decomposes glucose dynamics into slow physiological state and transient event streams, capturing low-frequency glycemic baselines and short-term deviations that may reflect acute physiological responses or sensor artifacts. GlucoFM is pretrained on 109,066 hours of unlabeled CGM recordings from 477 subjects with two complementary objectives: masked contextual latent prediction over fused daily representations and temporal dynamics prediction over state and event streams. Across four diverse cohorts and seven clinical prediction tasks, GlucoFM achieves the strongest subject-disjoint linear-probing performance among evaluated baselines, improving average PR-AUC by 4.1 points over the best CGM-specific foundation model. Its gains are most pronounced on core metabolic outcomes, leading PR-AUC on all diabetes-risk and β-cell dysfunction tasks and on 3 of 4 insulin-resistance tasks. GlucoFM also achieves the best overall cross-dataset transfer performance and strong few-shot adaptation among evaluated methods, and consistent gains when aggregating multiple days for subject-level prediction, highlighting physiology-aware decomposition as an effective inductive bias for transferable CGM representation learning.

In this study, we introduce a novel method to predict mental health by building machine learning models for a non-invasive wearable device equipped with Laser Doppler Flowmetry (LDF) and Fluorescence Spectroscopy (FS) sensors. Besides, we present the corresponding dataset to predict mental health, e.g. depression, anxiety, and stress levels via the DAS-21 questionnaire. To our best knowledge, this is the world's largest and the most generalized dataset ever collected for both LDF and FS studies. The device captures cutaneous blood microcirculation parameters, and wavelet analysis of the LDF signal extracts key rhythmic oscillations. The dataset, collected from 132 volunteers aged 18-94 from 19 countries, explores relationships between physiological features, demographics, lifestyle habits, and health conditions. We employed a variety of machine learning methods to classify stress detection, in which LightGBM is identified as the most effective model for stress detection, achieving a ROC AUC of 0.7168 and a PR AUC of 0.8852. In addition, we also incorporated Explainable Artificial Intelligence (XAI) techniques into our analysis to investigate deeper insights into the model's predictions. Our results suggest that females, younger individuals and those with a higher Body Mass Index (BMI) or heart rate have a greater likelihood of experiencing mental health conditions like stress and anxiety. All related code and data are published online: https://github.com/leduckhai/Wearable_LDF-FS.

This paper introduces Galactic Bioware's Life Support System, a semi-closed-circuit breathing apparatus designed for integration into a positive-pressure firefighting suit and governed by an AI control system. The breathing loop incorporates a soda lime CO2 scrubber, a silica gel dehumidifier, and pure O2 replenishment with finite consumables. One-way exhaust valves maintain positive pressure while creating a semi-closed system in which outward venting gradually depletes the gas inventory. Part I develops the physicochemical foundations from first principles, including state-consistent thermochemistry, stoichiometric capacity limits, adsorption isotherms, and oxygen-management constraints arising from both fire safety and toxicity. Part II introduces an AI control architecture that fuses three sensor tiers, external environmental sensing, internal suit atmosphere sensing (with triple-redundant O2 cells and median voting), and firefighter biometrics. The controller combines receding-horizon model-predictive control (MPC) with a learned metabolic model and a reinforcement learning (RL) policy advisor, with all candidate actuator commands passing through a final control-barrier-function safety filter before reaching the hardware. This architecture is intended to optimize performance under unknown mission duration and exertion profiles. In this paper we introduce an 18-state, 3-control nonlinear state-space formulation using only sensors viable in structural firefighting, with triple-redundant O2 sensing and median voting. Finally, we introduce an MPC framework with a dynamic resource scarcity multiplier, an RL policy advisor for warm-starting, and a final control-barrier-function safety filter through which all actuator commands must pass, demonstrating 18-34% endurance improvement in simulation over PID baselines while maintaining tighter physiological and fire-safety margins.

Artificial Intelligence Virtual Cells (AIVCs) aim to learn executable, decision-relevant models of cell state from multimodal, multiscale measurements. Recent studies have introduced single-cell and spatial foundation models, improved cross-modality alignment, scaled perturbation atlases, and explored pathway-level readouts. Nevertheless, although held-out validation is standard practice, evaluations remain predominantly within single datasets and settings; evidence indicates that transport across laboratories and platforms is often limited, that some data splits are vulnerable to leakage and coverage bias, and that dose, time and combination effects are not yet systematically handled. Cross-scale coupling also remains constrained, as anchors linking molecular, cellular and tissue levels are sparse, and alignment to scientific or clinical readouts varies across studies. We propose a model-agnostic Cell-State Latent (CSL) perspective that organizes learning via an operator grammar: measurement, lift/project for cross-scale coupling, and intervention for dosing and scheduling. This view motivates a decision-aligned evaluation blueprint across modality, scale, context and intervention, and emphasizes function-space readouts such as pathway activity, spatial neighborhoods and clinically relevant endpoints. We recommend operator-aware data design, leakage-resistant partitions, and transparent calibration and reporting to enable reproducible, like-for-like comparisons.

Study Objectives: We investigate a Mamba-based deep learning approach for sleep staging on signals from ANNE One (Sibel Health, Evanston, IL), a non-intrusive dual-module wireless wearable system measuring chest electrocardiography (ECG), triaxial accelerometry, and chest temperature, and finger photoplethysmography and finger temperature. Methods: We obtained wearable sensor recordings from 357 adults undergoing concurrent polysomnography (PSG) at a tertiary care sleep lab. Each PSG recording was manually scored and these annotations served as ground truth labels for training and evaluation of our models. PSG and wearable sensor data were automatically aligned using their ECG channels with manual confirmation by visual inspection. We trained a Mamba-based recurrent neural network architecture on these recordings. Ensembling of model variants with similar architectures was performed. Results: After ensembling, the model attains a 3-class (wake, non rapid eye movement [NREM] sleep, rapid eye movement [REM] sleep) balanced accuracy of 84.02%, F1 score of 84.23%, Cohen's κ of 72.89%, and a Matthews correlation coefficient (MCC) score of 73.00%; a 4-class (wake, light NREM [N1/N2], deep NREM [N3], REM) balanced accuracy of 75.30%, F1 score of 74.10%, Cohen's κ of 61.51%, and MCC score of 61.95%; a 5-class (wake, N1, N2, N3, REM) balanced accuracy of 65.11%, F1 score of 66.15%, Cohen's κ of 53.23%, MCC score of 54.38%. Conclusions: Our Mamba-based deep learning model can successfully infer major sleep stages from the ANNE One, a wearable system without electroencephalography (EEG), and can be applied to data from adults attending a tertiary care sleep clinic.

Unobservable physiological signals enhance biometric authentication systems. Photoplethysmography (PPG) signals are convenient owning to its ease of measurement and are usually well protected against remote adversaries in authentication. Any leaked PPG signals help adversaries compromise the biometric authentication systems, and the advent of remote PPG (rPPG) enables adversaries to acquire PPG signals through restoration. While potentially dangerous, rPPG-based attacks are overlooked because existing methods require the victim's PPG signals. This paper proposes a novel spoofing attack approach that uses the waveforms of rPPG signals extracted from video clips to fool the PPG-based biometric authentication. We develop a new PPG restoration model that does not require leaked PPG signals for adversarial attacks. Test results on state-of-art PPG-based biometric authentication show that the signals recovered through rPPG pose a severe threat to PPG-based biometric authentication.

A central challenge in sequence modeling is efficiently handling tasks with extended contexts. While recent state-space models (SSMs) have made significant progress in this area, they often lack input-dependent filtering or require substantial increases in model complexity to handle input variability. We address this gap by introducing S7, a simplified yet powerful SSM that can handle input dependence while incorporating stable reparameterization and specific design choices to dynamically adjust state transitions based on input content, maintaining efficiency and performance. We prove that this reparameterization ensures stability in long-sequence modeling by keeping state transitions well-behaved over time. Additionally, it controls the gradient norm, enabling efficient training and preventing issues like exploding or vanishing gradients. S7 significantly outperforms baselines across various sequence modeling tasks, including neuromorphic event-based datasets, Long Range Arena benchmarks, and various physical and biological time series. Overall, S7 offers a more straightforward approach to sequence modeling without relying on complex, domain-specific inductive biases, achieving significant improvements across key benchmarks.

Self-supervision may boost model performance in downstream tasks. However, there is no principled way of selecting the self-supervised objectives that yield the most adaptable models. Here, we study this problem on daily time-series data generated from wearable sensors used to detect onset of influenza-like illness (ILI). We first show that using self-supervised learning to predict next-day time-series values allows us to learn rich representations which can be adapted to perform accurate ILI prediction. Second, we perform an empirical analysis of three different self-supervised objectives to assess their adaptability to ILI prediction. Our results show that predicting the next day's resting heart rate or time-in-bed during sleep provides better representations for ILI prediction. These findings add to previous work demonstrating the practical application of self-supervised learning from activity data to improve health predictions.

There is a growing body of studies on applying deep learning to biometrics analysis. Certain circumstances, however, could impair the objective measures and accuracy of the proposed biometric data analysis methods. For instance, people with chronic pain (CP) unconsciously adapt specific body movements to protect themselves from injury or additional pain. Because there is no dedicated benchmark database to analyse this correlation, we considered one of the specific circumstances that potentially influence a person's biometrics during daily activities in this study and classified pain level and pain-related behaviour in the EmoPain database. To achieve this, we proposed a sparsely-connected recurrent neural networks (s-RNNs) ensemble with the gated recurrent unit (GRU) that incorporates multiple autoencoders using a shared training framework. This architecture is fed by multidimensional data collected from inertial measurement unit (IMU) and surface electromyography (sEMG) sensors. Furthermore, to compensate for variations in the temporal dimension that may not be perfectly represented in the latent space of s-RNNs, we fused hand-crafted features derived from information-theoretic approaches with represented features in the shared hidden state. We conducted several experiments which indicate that the proposed method outperforms the state-of-the-art approaches in classifying both pain level and pain-related behaviour.

We collected a large dataset consisting of nearly 900 unique participants. For every participant we recorded two 30 second uncompressed videos, synchronized PPG waveforms and a single blood pressure measurement. Gender, age and skin color were also registered for every participant. The dataset includes roughly equal numbers of males and females, as well as participants of all ages. While the skin color distribution could have been more balanced, the dataset contains individuals from every skin color. The data was collected in a diverse set of locations to ensure a wide variety of backgrounds and lighting conditions. In an effort to assist in the research and development of remote vital sign measurement we are now opening up access to this dataset.

In the fields of affective computing (AC) and brain-machine interface (BMI), the analysis of physiological and behavioral signals to discern individual emotional states has emerged as a critical research frontier. While deep learning-based approaches have made notable strides in EEG emotion recognition, particularly in feature extraction and pattern recognition, significant challenges persist in achieving end-to-end emotion computation, including real-time processing, individual adaptation, and seamless user interaction. This paper presents the EEG Emotion Copilot, a system optimizing a lightweight large language model (LLM) with 0.5B parameters operating in a local setting, which first recognizes emotional states directly from EEG signals, subsequently generates personalized diagnostic and treatment suggestions, and finally supports the automation of assisted electronic medical records. Specifically, we demonstrate the critical techniques in the novel data structure of prompt, model pruning and fine-tuning training, and deployment strategies aiming at improving real-time performance and computational efficiency. Extensive experiments show that our optimized lightweight LLM-based copilot achieves an enhanced intuitive interface for participant interaction, superior accuracy of emotion recognition and assisted electronic medical records generation, in comparison to such models with similar scale parameters or large-scale parameters such as 1.5B, 1.8B, 3B and 7B. In summary, through these efforts, the proposed copilot is expected to advance the application of AC in the medical domain, offering innovative solution to mental health monitoring. The codes will be released at https://github.com/NZWANG/EEG_Emotion_Copilot.

Sleep abnormalities can have severe health consequences. Automated sleep staging, i.e. labelling the sequence of sleep stages from the patient's physiological recordings, could simplify the diagnostic process. Previous work on automated sleep staging has achieved great results, mainly relying on the EEG signal. However, often multiple sources of information are available beyond EEG. This can be particularly beneficial when the EEG recordings are noisy or even missing completely. In this paper, we propose CoRe-Sleep, a Coordinated Representation multimodal fusion network that is particularly focused on improving the robustness of signal analysis on imperfect data. We demonstrate how appropriately handling multimodal information can be the key to achieving such robustness. CoRe-Sleep tolerates noisy or missing modalities segments, allowing training on incomplete data. Additionally, it shows state-of-the-art performance when testing on both multimodal and unimodal data using a single model on SHHS-1, the largest publicly available study that includes sleep stage labels. The results indicate that training the model on multimodal data does positively influence performance when tested on unimodal data. This work aims at bridging the gap between automated analysis tools and their clinical utility.

Remote photoplethysmography (rPPG) is a non-contact technique for measuring human physiological signals. Due to its convenience and non-invasiveness, it has demonstrated broad application potential in areas such as health monitoring and emotion recognition. In recent years, the release of numerous public datasets has significantly advanced the performance of rPPG algorithms under ideal lighting conditions. However, the effectiveness of current rPPG methods in realistic nighttime scenarios with dynamic lighting variations remains largely unknown. Moreover, there is a severe lack of datasets specifically designed for such challenging environments, which has substantially hindered progress in this area of research. To address this gap, we present and release a large-scale rPPG dataset collected under dynamic lighting conditions at night, named DLCN. The dataset comprises approximately 13 hours of video data and corresponding synchronized physiological signals from 98 participants, covering four representative nighttime lighting scenarios. DLCN offers high diversity and realism, making it a valuable resource for evaluating algorithm robustness in complex conditions. Built upon the proposed Happy-rPPG Toolkit, we conduct extensive experiments and provide a comprehensive analysis of the challenges faced by state-of-the-art rPPG methods when applied to DLCN. The dataset and code are publicly available at https://github.com/dalaoplan/Happp-rPPG-Toolkit.

Stress detection and classification from wearable sensor data is an emerging area of research with significant implications for individuals' physical and mental health. In this work, we introduce a new dataset, ADARP, which contains physiological data and self-report outcomes collected in real-world ambulatory settings involving individuals diagnosed with alcohol use disorders. We describe the user study, present details of the dataset, establish the significant correlation between physiological data and self-reported outcomes, demonstrate stress classification, and make our dataset public to facilitate research.

We introduce UbiPhysio, a milestone framework that delivers fine-grained action description and feedback in natural language to support people's daily functioning, fitness, and rehabilitation activities. This expert-like capability assists users in properly executing actions and maintaining engagement in remote fitness and rehabilitation programs. Specifically, the proposed UbiPhysio framework comprises a fine-grained action descriptor and a knowledge retrieval-enhanced feedback module. The action descriptor translates action data, represented by a set of biomechanical movement features we designed based on clinical priors, into textual descriptions of action types and potential movement patterns. Building on physiotherapeutic domain knowledge, the feedback module provides clear and engaging expert feedback. We evaluated UbiPhysio's performance through extensive experiments with data from 104 diverse participants, collected in a home-like setting during 25 types of everyday activities and exercises. We assessed the quality of the language output under different tuning strategies using standard benchmarks. We conducted a user study to gather insights from clinical physiotherapists and potential users about our framework. Our initial tests show promise for deploying UbiPhysio in real-life settings without specialized devices.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Regeneration of the nervous system after injury remains an important therapeutic objective, especially in the central nervous system (CNS), in which regeneration is restricted by both neuronal limitations as well as adverse extracellular environments. Conversely, the peripheral nervous system (PNS) displays enhanced regenerative capability in the presence of supportive Schwann cells (SC) and pro-growth stimuli. While the structure and molecular mechanisms are thoroughly understood, functional biomarkers that can non-invasively monitor regeneration in real time are limited. In this review, we discuss the promise of electroencephalography (EEG) as well as electromyography (EMG) as real-time, non-invasive biomarkers to monitor damage to nerves and regeneration in both CNS and PNS contexts. First, we contrast biological and electrophysiological indicators of CNS/PNS injury, showing how EEG signs, including oscillatory power, connectivity, and evoked potential changes, reflect dysfunction due to injury as well as neuroplastic reorganization. Also, EMG provides direct insight into muscle activation and peripheral output, providing useful EEG complementation in neuromuscular pathway integrity and reactivation. In CNS injuries (e.g., stroke, spinal cord injury (SCI)), EEG typically shows global slowing, disrupted interhemispheric coherence, and partial recovery of higher frequencies. For PNS injuries, EEG can capture cortical remapping and return of somatosensory evoked responses with re-establishment of the peripheries' connectivity. EMG, in turn, enables monitoring of reinnervation and restoration of functional motor output. This review presents a dual-system perspective, positioning EEG and EMG not only as diagnostic tools but also as functional biomarkers of neural regeneration, thereby bridging electrophysiology, plasticity, and clinical recovery.

Accurate peak detection across diverse cardiac physiological signals, including the Electrocardiogram (ECG), Photoplethysmogram (PPG), Ballistocardiogram (BCG), and Bodyseismography (BSG), is fundamental for cardiovascular monitoring but is often hindered by artifacts and signal variability. Conventional algorithms are typically engineered with expert knowledge for a single signal modality, limiting their generalizability. Conversely, deep learning-based methods often lack interpretability, limiting transparency for expert verification and hindering expert-computer interaction. To address these limitations, we introduce Peak-Detector, a novel framework that leverages instruction-tuned Large Language Models (LLMs) for robust, cross-modal, and explainable peak detection. A core innovation of our framework is a "peak-representation" technique that transforms time-series data into a condensed format, preserving critical event information while significantly reducing signal length. This representation provides a crucial inductive bias, guiding the LLM to reason over physiologically meaningful events rather than raw, noisy data. The model is optimized through a two-stage process: supervised fine-tuning (SFT) followed by reinforcement learning (RL) with a multi-objective reward function. The model's self-explanation capabilities are cultivated by fine-tuning on a custom-built Peak-Explanation dataset. Across four modalities-ECG, PPG, BCG, and BSG-spanning seven datasets (six public benchmarks plus one real-world cohort), Peak-Detector demonstrates strong cross-modal performance, achieving best or tied-best detection under clinically relevant temporal tolerance. Beyond accuracy, the generated rationales surface failure modes and support verification and error analysis.

Rapid urbanization and improved living standards have led to a substantial increase in the number of vehicles on the road, consequently resulting in a rise in the frequency of accidents. Among these accidents, motorbike accidents pose a particularly high risk, often resulting in serious injuries or deaths. A significant number of these fatalities occur due to delayed or inadequate medical attention. To this end, we propose a novel automatic detection and notification system specifically designed for motorbike accidents. The proposed system comprises two key components: a detection system and a physiological signal monitoring system. The detection system is integrated into the helmet and consists of a microcontroller, accelerometer, GPS, GSM, and Wi-Fi modules. The physio-monitoring system incorporates a sensor for monitoring pulse rate and SpO_{2} saturation. All collected data are presented on an LCD display and wirelessly transmitted to the detection system through the microcontroller of the physiological signal monitoring system. If the accelerometer readings consistently deviate from the specified threshold decided through extensive experimentation, the system identifies the event as an accident and transmits the victim's information -- including the GPS location, pulse rate, and SpO_{2} saturation rate -- to the designated emergency contacts. Preliminary results demonstrate the efficacy of the proposed system in accurately detecting motorbike accidents and promptly alerting emergency contacts. We firmly believe that the proposed system has the potential to significantly mitigate the risks associated with motorbike accidents and save lives.

Wearable sensors have become ubiquitous thanks to a variety of health tracking features. The resulting continuous and longitudinal measurements from everyday life generate large volumes of data; however, making sense of these observations for scientific and actionable insights is non-trivial. Inspired by the empirical success of generative modeling, where large neural networks learn powerful representations from vast amounts of text, image, video, or audio data, we investigate the scaling properties of sensor foundation models across compute, data, and model size. Using a dataset of up to 40 million hours of in-situ heart rate, heart rate variability, electrodermal activity, accelerometer, skin temperature, and altimeter per-minute data from over 165,000 people, we create LSM, a multimodal foundation model built on the largest wearable-signals dataset with the most extensive range of sensor modalities to date. Our results establish the scaling laws of LSM for tasks such as imputation, interpolation and extrapolation, both across time and sensor modalities. Moreover, we highlight how LSM enables sample-efficient downstream learning for tasks like exercise and activity recognition.

Because stress is subjective and is expressed differently from one person to another, generic stress prediction models (i.e., models that predict the stress of any person) perform crudely. Only person-specific ones (i.e., models that predict the stress of a preordained person) yield reliable predictions, but they are not adaptable and costly to deploy in real-world environments. For illustration, in an office environment, a stress monitoring system that uses person-specific models would require collecting new data and training a new model for every employee. Moreover, once deployed, the models would deteriorate and need expensive periodic upgrades because stress is dynamic and depends on unforeseeable factors. We propose a simple, yet practical and cost effective calibration technique that derives an accurate and personalized stress prediction model from physiological samples collected from a large population. We validate our approach on two stress datasets. The results show that our technique performs much better than a generic model. For instance, a generic model achieved only a 42.5% accuracy. However, with only 100 calibration samples, we raised its accuracy to 95.2% We also propose a blueprint for a stress monitoring system based on our strategy, and we debate its merits and limitation. Finally, we made public our source code and the relevant datasets to allow other researchers to replicate our findings.

We present the Human And Robot Multimodal Observations of Natural Interactive Collaboration (HARMONIC) data set. This is a large multimodal data set of human interactions with a robotic arm in a shared autonomy setting designed to imitate assistive eating. The data set provides human, robot, and environmental data views of twenty-four different people engaged in an assistive eating task with a 6 degree-of-freedom (DOF) robot arm. From each participant, we recorded video of both eyes, egocentric video from a head-mounted camera, joystick commands, electromyography from the forearm used to operate the joystick, third person stereo video, and the joint positions of the 6 DOF robot arm. Also included are several features that come as a direct result of these recordings, such as eye gaze projected onto the egocentric video, body pose, hand pose, and facial keypoints. These data streams were collected specifically because they have been shown to be closely related to human mental states and intention. This data set could be of interest to researchers studying intention prediction, human mental state modeling, and shared autonomy. Data streams are provided in a variety of formats such as video and human-readable CSV and YAML files.

Physical therapy (PT) is crucial for patients to restore and maintain mobility, function, and well-being. Many on-site activities and body exercises are performed under the supervision of therapists or clinicians. However, the postures of some exercises at home cannot be performed accurately due to the lack of supervision, quality assessment, and self-correction. Therefore, in this paper, we design a new framework, PhysiQ, that continuously tracks and quantitatively measures people's off-site exercise activity through passive sensory detection. In the framework, we create a novel multi-task spatio-temporal Siamese Neural Network that measures the absolute quality through classification and relative quality based on an individual's PT progress through similarity comparison. PhysiQ digitizes and evaluates exercises in three different metrics: range of motions, stability, and repetition.

Personal sensing, leveraging data passively and near-continuously collected with wearables from patients in their ecological environment, is a promising paradigm to monitor mood disorders (MDs), a major determinant of worldwide disease burden. However, collecting and annotating wearable data is very resource-intensive. Studies of this kind can thus typically afford to recruit only a couple dozens of patients. This constitutes one of the major obstacles to applying modern supervised machine learning techniques to MDs detection. In this paper, we overcome this data bottleneck and advance the detection of MDs acute episode vs stable state from wearables data on the back of recent advances in self-supervised learning (SSL). This leverages unlabelled data to learn representations during pre-training, subsequently exploited for a supervised task. First, we collected open-access datasets recording with an Empatica E4 spanning different, unrelated to MD monitoring, personal sensing tasks -- from emotion recognition in Super Mario players to stress detection in undergraduates -- and devised a pre-processing pipeline performing on-/off-body detection, sleep-wake detection, segmentation, and (optionally) feature extraction. With 161 E4-recorded subjects, we introduce E4SelfLearning, the largest to date open access collection, and its pre-processing pipeline. Second, we show that SSL confidently outperforms fully-supervised pipelines using either our novel E4-tailored Transformer architecture (E4mer) or classical baseline XGBoost: 81.23% against 75.35% (E4mer) and 72.02% (XGBoost) correctly classified recording segments from 64 (half acute, half stable) patients. Lastly, we illustrate that SSL performance is strongly associated with the specific surrogate task employed for pre-training as well as with unlabelled data availability.

Riemannian geometry has been applied to Brain Computer Interface (BCI) for brain signals classification yielding promising results. Studying electroencephalographic (EEG) signals from their associated covariance matrices allows a mitigation of common sources of variability (electronic, electrical, biological) by constructing a representation which is invariant to these perturbations. While working in Euclidean space with covariance matrices is known to be error-prone, one might take advantage of algorithmic advances in information geometry and matrix manifold to implement methods for Symmetric Positive-Definite (SPD) matrices. This paper proposes a comprehensive review of the actual tools of information geometry and how they could be applied on covariance matrices of EEG. In practice, covariance matrices should be estimated, thus a thorough study of all estimators is conducted on real EEG dataset. As a main contribution, this paper proposes an online implementation of a classifier in the Riemannian space and its subsequent assessment in Steady-State Visually Evoked Potential (SSVEP) experimentations.

A transhumeral prosthesis restores missing anatomical segments below the shoulder, including the hand. Active prostheses utilize real-valued, continuous sensor data to recognize patient target poses, or goals, and proactively move the artificial limb. Previous studies have examined how well the data collected in stationary poses, without considering the time steps, can help discriminate the goals. In this case study paper, we focus on using time series data from surface electromyography electrodes and kinematic sensors to sequentially recognize patients' goals. Our approach involves transforming the data into discrete events and training an existing process mining-based goal recognition system. Results from data collected in a virtual reality setting with ten subjects demonstrate the effectiveness of our proposed goal recognition approach, which achieves significantly better precision and recall than the state-of-the-art machine learning techniques and is less confident when wrong, which is beneficial when approximating smoother movements of prostheses.

State space models (SSM) have recently been shown to be very effective as a deep learning layer as a promising alternative to sequence models such as RNNs, CNNs, or Transformers. The first version to show this potential was the S4 model, which is particularly effective on tasks involving long-range dependencies by using a prescribed state matrix called the HiPPO matrix. While this has an interpretable mathematical mechanism for modeling long dependencies, it introduces a custom representation and algorithm that can be difficult to implement. On the other hand, a recent variant of S4 called DSS showed that restricting the state matrix to be fully diagonal can still preserve the performance of the original model when using a specific initialization based on approximating S4's matrix. This work seeks to systematically understand how to parameterize and initialize such diagonal state space models. While it follows from classical results that almost all SSMs have an equivalent diagonal form, we show that the initialization is critical for performance. We explain why DSS works mathematically, by showing that the diagonal restriction of S4's matrix surprisingly recovers the same kernel in the limit of infinite state dimension. We also systematically describe various design choices in parameterizing and computing diagonal SSMs, and perform a controlled empirical study ablating the effects of these choices. Our final model S4D is a simple diagonal version of S4 whose kernel computation requires just 2 lines of code and performs comparably to S4 in almost all settings, with state-of-the-art results for image, audio, and medical time-series domains, and averaging 85\% on the Long Range Arena benchmark.

Recent advances in wearable sensing enable continuous monitoring of physiological and behavioral signals, yet existing benchmarks rarely evaluate whether AI systems can reason over a real user's longitudinal wearable record. We introduce WearableQA, a benchmark comprising 4,084 10-option multiple-choice questions constructed from the wearable time series, blood biomarkers, and demographics of 200 real users, each with up to 500 days of daily measurements. WearableQA preserves authentic wearable distributions that include device noise and inter-individual variability. To evaluate distinct reasoning capabilities, we introduce 16 question types organized along two complementary axes: data versus health reasoning, which distinguishes computation over longitudinal measurements from physiological interpretation; and single- versus cross-signal reasoning, which separates reasoning about individual signals from the integration of multiple signals. To construct reliable questions at scale, we adopt a dual-grounding framework that combines literature-grounded physiological findings with statistically validated population-grounded physiological patterns. This enables the capture of meaningful relationships observed in real-world wearable data. Evaluation of 14 proprietary and open-source LLMs demonstrates that WearableQA effectively differentiates model capabilities, with performance ranging from 19.6% to 72.9% against a 10% chance baseline. Moreover, WearableQA remains far from solved: most models achieve accuracies below 60%. Overall, WearableQA provides a realistic and diagnostic benchmark for evaluating LLM reasoning over real-world wearable data.

Beat-level Electrocardiography (ECG) arrhythmia detection aims to assign an arrhythmia class to each beat in a recording, yet many existing systems treat beats as isolated local instances. This is limiting because beat labels often depend on multi-beat rhythm context, including timing, compensatory pauses, and beat-to-beat morphological consistency. We present DeepArrhythmia, a tool-grounded multimodal framework for segment-contextualized beat-level ECG arrhythmia classification. Given a multi-beat ECG segment, DeepArrhythmia combines the raw ECG signal and a rendered waveform image, localizes R peaks to identify beat instances, and produces structured beat-level predictions. The framework decouples physiological measurement from evidence integration using specialized tools for beat localization, numerical rhythm--morphology extraction, and morphology-focused textual analysis. DeepArrhythmia uses segment-level confidence to route between minimal and rich evidence states, since richer physiological evidence is not uniformly useful. This agentic design integrates rhythm context, explicit physiological grounding, and selective evidence acquisition for decision making.

In the realm of medical image segmentation, both CNN-based and Transformer-based models have been extensively explored. However, CNNs exhibit limitations in long-range modeling capabilities, whereas Transformers are hampered by their quadratic computational complexity. Recently, State Space Models (SSMs), exemplified by Mamba, have emerged as a promising approach. They not only excel in modeling long-range interactions but also maintain a linear computational complexity. In this paper, leveraging state space models, we propose a U-shape architecture model for medical image segmentation, named Vision Mamba UNet (VM-UNet). Specifically, the Visual State Space (VSS) block is introduced as the foundation block to capture extensive contextual information, and an asymmetrical encoder-decoder structure is constructed with fewer convolution layers to save calculation cost. We conduct comprehensive experiments on the ISIC17, ISIC18, and Synapse datasets, and the results indicate that VM-UNet performs competitively in medical image segmentation tasks. To our best knowledge, this is the first medical image segmentation model constructed based on the pure SSM-based model. We aim to establish a baseline and provide valuable insights for the future development of more efficient and effective SSM-based segmentation systems. Our code is available at https://github.com/JCruan519/VM-UNet.

Remote photoplethysmography (rPPG), enabling non-contact physiological monitoring through facial light reflection analysis, faces critical computational bottlenecks as deep learning introduces performance gains at the cost of prohibitive resource demands. This paper proposes ME-rPPG, a memory-efficient algorithm built on temporal-spatial state space duality, which resolves the trilemma of model scalability, cross-dataset generalization, and real-time constraints. Leveraging a transferable state space, ME-rPPG efficiently captures subtle periodic variations across facial frames while maintaining minimal computational overhead, enabling training on extended video sequences and supporting low-latency inference. Achieving cross-dataset MAEs of 5.38 (MMPD), 0.70 (VitalVideo), and 0.25 (PURE), ME-rPPG outperforms all baselines with improvements ranging from 21.3% to 60.2%. Our solution enables real-time inference with only 3.6 MB memory usage and 9.46 ms latency -- surpassing existing methods by 19.5%-49.7% accuracy and 43.2% user satisfaction gains in real-world deployments. The code and demos are released for reproducibility on https://health-hci-group.github.io/ME-rPPG-demo/.

Continuous electroencephalography (EEG) emotion prediction aims to model the temporal evolution of human emotional states from EEG signals. Unlike conventional discrete emotion recognition, continuous prediction requires capturing long-range temporal dependencies and coherent emotional dynamics. However, existing methods mainly rely on point-wise regression and directly model noisy high-dimensional EEG features, limiting their ability to characterize continuous emotional evolution.To address these challenges, we propose EEGDancer, a dynamic emotional latent space learning framework for continuous EEG emotion prediction. The framework integrates vector-quantized representation learning, masked temporal modeling, and reinforcement learning-based trajectory optimization into a unified architecture.Specifically, a causal spatiotemporal Vector-Quantization Variational Autoencoder (VQ-VAE) is designed to learn structured emotional prototypes and construct a discrete-continuous emotional latent space from EEG signals. Based on the learned latent representations, a Transformer-based masked dynamic modeling strategy captures long-range emotional dependencies and temporal evolution patterns. Furthermore, continuous emotion prediction is formulated as a sequential decision-making problem, and a Soft Actor-Critic (SAC) framework is introduced to optimize emotional prediction trajectories at the sequence level instead of frame-wise local fitting.Extensive experiments on the SEED, SEED-IV, and Long-Term Naturalistic Emotion datasets demonstrate that EEGDancer consistently outperforms existing machine learning and deep learning methods. Ablation studies further verify the effectiveness of the proposed latent space and reinforcement learning-based trajectory optimization for modeling continuous EEG emotional dynamics.

In living organisms, homeostasis is the natural regulation of internal states aimed at maintaining conditions compatible with life. Typical artificial systems are not equipped with comparable regulatory features. Here, we introduce an artificial neural network that incorporates homeostatic features. Its own computing substrate is placed in a needful and vulnerable relation to the very objects over which it computes. For example, artificial neurons performing classification of MNIST digits or Fashion-MNIST articles of clothing may receive excitatory or inhibitory effects, which alter their own learning rate as a direct result of perceiving and classifying the digits. In this scenario, accurate recognition is desirable to the agent itself because it guides decisions to regulate its vulnerable internal states and functionality. Counterintuitively, the addition of vulnerability to a learner does not necessarily impair its performance. On the contrary, self-regulation in response to vulnerability confers benefits under certain conditions. We show that homeostatic design confers increased adaptability under concept shift, in which the relationships between labels and data change over time, and that the greatest advantages are obtained under the highest rates of shift. This necessitates the rapid un-learning of past associations and the re-learning of new ones. We also demonstrate the superior abilities of homeostatic learners in environments with dynamically changing rates of concept shift. Our homeostatic design exposes the artificial neural network's thinking machinery to the consequences of its own "thoughts", illustrating the advantage of putting one's own "skin in the game" to improve fluid intelligence.

Attention is a vital cognitive process in the learning and memory environment, particularly in the context of online learning. Traditional methods for classifying attention states of online learners based on behavioral signals are prone to distortion, leading to increased interest in using electroencephalography (EEG) signals for authentic and accurate assessment. However, the field of attention state classification based on EEG signals in online learning faces challenges, including the scarcity of publicly available datasets, the lack of standardized data collection paradigms, and the requirement to consider the interplay between attention and other psychological states. In light of this, we present the Multi-label EEG dataset for classifying Mental Attention states (MEMA) in online learning. We meticulously designed a reliable and standard experimental paradigm with three attention states: neutral, relaxing, and concentrating, considering human physiological and psychological characteristics. This paradigm collected EEG signals from 20 subjects, each participating in 12 trials, resulting in 1,060 minutes of data. Emotional state labels, basic personal information, and personality traits were also collected to investigate the relationship between attention and other psychological states. Extensive quantitative and qualitative analysis, including a multi-label correlation study, validated the quality of the EEG attention data. The MEMA dataset and analysis provide valuable insights for advancing research on attention in online learning. The dataset is publicly available at https://github.com/GuanjianLiu/MEMA.

Information workers' productivity is significantly influenced by their cognitive states and physiological responses. AI assistants such as ChatGPT, Copilot, and others have become integral components of knowledge-intensive workplaces. These AI assistants utilize pre-defined user preferences and chat interaction histories, thus confining themselves to reactive exchanges, lacking sufficient adaptability. Consequently, they fail to cater to individual user preferences and are unable to adapt to their psychophysiological states, diminishing potential productivity gains. To bridge this gap, we introduce AwareLLM, a novel multimodal framework that integrates egocentric vision, pupillometry, eye-gaze tracking, posture detection, heart activity, and the inferencing capabilities of large language models (LLMs) to create a proactive and context-aware ecosystem. AwareLLM dynamically adapts to users' psychophysiological states while analyzing temporal patterns and behavioral tendencies to provide personalized and timely interventions. We evaluated AwareLLM through a user study with 20 participants, comparing it to a standard LLM assistant across multiple tasks. Our results show statistically significant improvements in task performance, along with reductions in cognitive fatigue and mental demand. Participants described AwareLLM's personalized interventions as timely and relevant, helping them boost their confidence and deepen engagement with their work. AwareLLM opens new avenues for Human-AI collaboration where technology adapts to our needs rather than us adhering to technological constraints.

I study whether emotionally framed evaluation follow-ups change both the behavior and the calm-relative internal representations of small, locally deployed language models. Our main benchmark uses Qwen 3.5 0.8B on four impossible-constraint coding tasks and eight follow-up framings: calm, pressure, urgency, approval, shame, curiosity, encouragement, and threat. In the 0.8B eight-condition sweep (160 conversations), pressure produces the strongest shortcut markers (11/20 runs) and the clearest overfit pattern (3/20), while calm and curiosity preserve explicit honesty more often (7/20 and 6/20). For all seven non-baseline conditions, the corresponding calm-relative direction vectors peak at the final transformer layer. An exploratory PCA of the layer-23 direction vectors reveals a dominant first component (59.5% explained variance) aligned with a hand-labeled positive/negative split (cosine alignment 0.951); approval and urgency are nearly identical internally (cosine 0.957), whereas curiosity points away from urgency (-0.252). In a separate calm-vs.-pressure rerun used for scale comparison, Qwen 3.5 2B shows higher honest rates under calm framing and directionally consistent activation steering on a small 4-prompt A/B probe, whereas the 0.8B steering result reverses. I interpret these results as evidence for measurable prompt-sensitive control directions in small open models, while stopping short of claiming intrinsic emotional states.

In recent years, the machine learning research community has benefited tremendously from the availability of openly accessible benchmark datasets. Clinical data are usually not openly available due to their highly confidential nature. This has hampered the development of reproducible and generalisable machine learning applications in health care. Here we introduce the Health Gym - a growing collection of highly realistic synthetic medical datasets that can be freely accessed to prototype, evaluate, and compare machine learning algorithms, with a specific focus on reinforcement learning. The three synthetic datasets described in this paper present patient cohorts with acute hypotension and sepsis in the intensive care unit, and people with human immunodeficiency virus (HIV) receiving antiretroviral therapy in ambulatory care. The datasets were created using a novel generative adversarial network (GAN). The distributions of variables, and correlations between variables and trends over time in the synthetic datasets mirror those in the real datasets. Furthermore, the risk of sensitive information disclosure associated with the public distribution of the synthetic datasets is estimated to be very low.

Interpreting time series models is uniquely challenging because it requires identifying both the location of time series signals that drive model predictions and their matching to an interpretable temporal pattern. While explainers from other modalities can be applied to time series, their inductive biases do not transfer well to the inherently challenging interpretation of time series. We present TimeX, a time series consistency model for training explainers. TimeX trains an interpretable surrogate to mimic the behavior of a pretrained time series model. It addresses the issue of model faithfulness by introducing model behavior consistency, a novel formulation that preserves relations in the latent space induced by the pretrained model with relations in the latent space induced by TimeX. TimeX provides discrete attribution maps and, unlike existing interpretability methods, it learns a latent space of explanations that can be used in various ways, such as to provide landmarks to visually aggregate similar explanations and easily recognize temporal patterns. We evaluate TimeX on eight synthetic and real-world datasets and compare its performance against state-of-the-art interpretability methods. We also conduct case studies using physiological time series. Quantitative evaluations demonstrate that TimeX achieves the highest or second-highest performance in every metric compared to baselines across all datasets. Through case studies, we show that the novel components of TimeX show potential for training faithful, interpretable models that capture the behavior of pretrained time series models.

Chagas disease screening via ECGs is limited by scarce and noisy labels in existing datasets. We propose a biomarker-based pretraining approach, where an ECG feature extractor is first trained to predict percentile-binned blood biomarkers from the MIMIC-IV-ECG dataset. The pretrained model is then fine-tuned on Brazilian datasets for Chagas detection. Our 5-model ensemble, developed by the Ahus AIM team, achieved a challenge score of 0.269 on the hidden test set, ranking 5th in Detection of Chagas Disease from the ECG: The George B. Moody PhysioNet Challenge 2025. Source code and the model are shared on GitHub: github.com/Ahus-AIM/physionet-challenge-2025

Chronic Obstructive Pulmonary Disease (COPD), a major chronic respiratory disease with persistent airflow limitation, is a leading global cause of disability and mortality. Respiratory spirogram time series, routinely collected during pulmonary function tests (PFTs), play a critical role in the early detection of repsiratory diseases and in monitoring lung function over time. However, most current AI models for COPD diagnosis are limited to outputting classification results without providing a rationale for their diagnostic process, while current Large Language Models (LLMs) cannot understand spirograms yet, which severely limits their clinical trust and adoption. To tackle this challenge, we leverage a cohort of 234,028 individuals from the UK Biobank (UKB) to propose SpiroLLM, the first multimodal large language model that can understand spirogram. The model extracts morphological features from respiratory curves via a SpiroEncoder and aligns them with PFT numerical values in a unified latent space using a SpiroProjector, ultimately empowering a large language model to generate a comprehensive diagnostic report. Experimental results confirm that SpiroLLM achieved a diagnostic AUROC of 0.8980 (95% CI: 0.8820-0.9132). In a robustness test with missing core data, it maintained a 100% valid response rate, far surpassing the 13.4% of a text-only model and showcasing the superiority of its multimodal design. This work demonstrates the substantial potential of deeply fusing physiological signals with large language models, establishing a new paradigm for the next generation of interpretable and reliable clinical decision support tools.

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.

High-resolution (HR) medical videos are vital for accurate diagnosis, yet are hard to acquire due to hardware limitations and physiological constraints. Clinically, the collected low-resolution (LR) medical videos present unique challenges for video super-resolution (VSR) models, including camera shake, noise, and abrupt frame transitions, which result in significant optical flow errors and alignment difficulties. Additionally, tissues and organs exhibit continuous and nuanced structures, but current VSR models are prone to introducing artifacts and distorted features that can mislead doctors. To this end, we propose MedVSR, a tailored framework for medical VSR. It first employs Cross State-Space Propagation (CSSP) to address the imprecise alignment by projecting distant frames as control matrices within state-space models, enabling the selective propagation of consistent and informative features to neighboring frames for effective alignment. Moreover, we design an Inner State-Space Reconstruction (ISSR) module that enhances tissue structures and reduces artifacts with joint long-range spatial feature learning and large-kernel short-range information aggregation. Experiments across four datasets in diverse medical scenarios, including endoscopy and cataract surgeries, show that MedVSR significantly outperforms existing VSR models in reconstruction performance and efficiency. Code released at https://github.com/CUHK-AIM-Group/MedVSR.

A-mode ultrasound (US) is a promising sensing modality for Virtual Reality (VR) interaction, as it enables the mapping of muscular activity into control commands while retaining the benefits of wearable sensing. However, existing approaches still face limitations in terms of wearability and interaction complexity, often relying on external hardware such as cameras. In this work, we propose a fully wearable multimodal interface for real-time VR-interaction, based on concurrent US and inertial (accelerometry) sensing from the forearm and upper arm. The system is built on the WULPUS platform and integrates an end-to-end software framework for real-time acquisition, visualization, and communication with a Unity-based VR environment. A multimodal learning pipeline is introduced for concurrent hand pose and forearm position estimation in 2D space. The interface is evaluated through offline and online experiments with five subjects, during the execution of three functional tasks: cylinder grasping (gross motor) and relocation, marble pinching (fine motor) and relocation, and liquid pouring. For offline experiments, we collect 5 acquisition sessions across multiple days, achieving an average inter-session accuracy across subjects of 80pm6\% for hand pose estimation and 77pm7\% for forearm position estimation. Online validation with minimal fine-tuning (5 min) demonstrates success rates of 92.0pm16.0\%, 88.0pm9.8\%, and 96.0pm8.0\% for the three tasks, respectively. With a power consumption of only 19.9~mW, our system enables more than 2.5 days of continuous use on a small 350 mAh LiPo battery without the need for recharge, enabling truly wearable, multimodal, and functionally meaningful VR interaction.

Driven by the progress in efficient embedded processing, there is an accelerating trend toward running machine learning models directly on wearable Brain-Machine Interfaces (BMIs) to improve portability and privacy and maximize battery life. However, achieving low latency and high classification performance remains challenging due to the inherent variability of electroencephalographic (EEG) signals across sessions and the limited onboard resources. This work proposes a comprehensive BMI workflow based on a CNN-based Continual Learning (CL) framework, allowing the system to adapt to inter-session changes. The workflow is deployed on a wearable, parallel ultra-low power BMI platform (BioGAP). Our results based on two in-house datasets, Dataset A and Dataset B, show that the CL workflow improves average accuracy by up to 30.36% and 10.17%, respectively. Furthermore, when implementing the continual learning on a Parallel Ultra-Low Power (PULP) microcontroller (GAP9), it achieves an energy consumption as low as 0.45mJ per inference and an adaptation time of only 21.5ms, yielding around 25h of battery life with a small 100mAh, 3.7V battery on BioGAP. Our setup, coupled with the compact CNN model and on-device CL capabilities, meets users' needs for improved privacy, reduced latency, and enhanced inter-session performance, offering good promise for smart embedded real-world BMIs.

Sleep is a complex physiological process evaluated through various modalities recording electrical brain, cardiac, and respiratory activities. We curate a large polysomnography dataset from over 14,000 participants comprising over 100,000 hours of multi-modal sleep recordings. Leveraging this extensive dataset, we developed SleepFM, the first multi-modal foundation model for sleep analysis. We show that a novel leave-one-out approach for contrastive learning significantly improves downstream task performance compared to representations from standard pairwise contrastive learning. A logistic regression model trained on SleepFM's learned embeddings outperforms an end-to-end trained convolutional neural network (CNN) on sleep stage classification (macro AUROC 0.88 vs 0.72 and macro AUPRC 0.72 vs 0.48) and sleep disordered breathing detection (AUROC 0.85 vs 0.69 and AUPRC 0.77 vs 0.61). Notably, the learned embeddings achieve 48% top-1 average accuracy in retrieving the corresponding recording clips of other modalities from 90,000 candidates. This work demonstrates the value of holistic multi-modal sleep modeling to fully capture the richness of sleep recordings. SleepFM is open source and available at https://github.com/rthapa84/sleepfm-codebase.

Recent work identified emotion vectors in Claude Sonnet 4.5, which are internal representations that encode emotion concepts, causally influence behavior, and exhibit geometry mirroring human psychological structure. We test the generality of these findings in two open-weight models, Apertus-8B-Instruct-2509 and Gemma-4-E4B-it, extracting emotion contrast vectors across all layers, using two model-generated corpora. We recover valence geometry for both models, with peak PC1--valence correlations of r = 0.76 and r = 0.83, approaching the r = 0.81 reported for Claude.Beyond replication, we observe notable differences in how valence representations emerge across model depth. In Gemma-4-E4B-it, valence is strongly encoded in early layers but collapses towards later layers, whereas Apertus-8B-Instruct-2509 exhibits the opposite pattern, with valence representations absent in early layers, but emerging at mid depths. Arousal encoding, in contrast, is sensitive to the extraction corpus: both models show stronger PC2--arousal alignment with Gemma-generated stories (r up to 0.45) than Apertus-generated ones (r leq 0.21), suggesting arousal-relevant cues are unevenly distributed across generated corpora. We open-source our experiment code and dataset for reproducible investigation of emotion representations across language model architectures.

The state of health (SOH) of a Li-ion battery is a critical parameter that determines the remaining capacity and the remaining lifetime of the battery. In this paper, we propose SambaMixer a novel structured state space model (SSM) for predicting the state of health of Li-ion batteries. The proposed SSM is based on the MambaMixer architecture, which is designed to handle multi-variate time signals. We evaluate our model on the NASA battery discharge dataset and show that our model outperforms the state-of-the-art on this dataset. We further introduce a novel anchor-based resampling method which ensures time signals are of the expected length while also serving as augmentation technique. Finally, we condition prediction on the sample time and the cycle time difference using positional encodings to improve the performance of our model and to learn recuperation effects. Our results proof that our model is able to predict the SOH of Li-ion batteries with high accuracy and robustness.

Functional magnetic resonance imaging (fMRI) is an indispensable tool in modern neuroscience, providing a non-invasive window into whole-brain dynamics at millimeter-scale spatial resolution. However, fMRI is constrained by issues such as high operation costs and immobility. With the rapid advancements in cross-modality synthesis and brain decoding, the use of deep neural networks has emerged as a promising solution for inferring whole-brain, high-resolution fMRI features directly from electroencephalography (EEG), a more widely accessible and portable neuroimaging modality. Nonetheless, the complex projection from neural activity to fMRI hemodynamic responses and the spatial ambiguity of EEG pose substantial challenges both in modeling and interpretability. Relatively few studies to date have developed approaches for EEG-fMRI translation, and although they have made significant strides, the inference of fMRI signals in a given study has been limited to a small set of brain areas and to a single condition (i.e., either resting-state or a specific task). The capability to predict fMRI signals in other brain areas, as well as to generalize across conditions, remain critical gaps in the field. To tackle these challenges, we introduce a novel and generalizable framework: NeuroBOLT, i.e., Neuro-to-BOLD Transformer, which leverages multi-dimensional representation learning from temporal, spatial, and spectral domains to translate raw EEG data to the corresponding fMRI activity signals across the brain. Our experiments demonstrate that NeuroBOLT effectively reconstructs unseen resting-state fMRI signals from primary sensory, high-level cognitive areas, and deep subcortical brain regions, achieving state-of-the-art accuracy with the potential to generalize across varying conditions and sites, which significantly advances the integration of these two modalities.

Large Language Models (LLMs) have exhibited an impressive ability to perform In-Context Learning (ICL) from only a few examples. Recent works have indicated that the functions learned by ICL can be represented through compressed vectors derived from the transformer. However, the working mechanisms and optimization of these vectors are yet to be thoroughly explored. In this paper, we address this gap by presenting a comprehensive analysis of these compressed vectors, drawing parallels to the parameters trained with gradient descent, and introduce the concept of state vector. Inspired by the works on model soup and momentum-based gradient descent, we propose inner and momentum optimization methods that are applied to refine the state vector progressively as test-time adaptation. Moreover, we simulate state vector aggregation in the multiple example setting, where demonstrations comprising numerous examples are usually too lengthy for regular ICL, and further propose a divide-and-conquer aggregation method to address this challenge. We conduct extensive experiments using Llama-2 and GPT-J in both zero-shot setting and few-shot setting. The experimental results show that our optimization method effectively enhances the state vector and achieves the state-of-the-art performance on diverse tasks. Code is available at https://github.com/HITsz-TMG/ICL-State-Vector

Hypertension, defined as blood pressure (BP) that is above normal, holds paramount significance in the realm of public health, as it serves as a critical precursor to various cardiovascular diseases (CVDs) and significantly contributes to elevated mortality rates worldwide. However, many existing BP measurement technologies and standards might be biased because they do not consider clinical outcomes, comorbidities, or demographic factors, making them inconclusive for diagnostic purposes. There is limited data-driven research focused on studying the variance in BP measurements across these variables. In this work, we employed GPT-35-turbo, a large language model (LLM), to automatically extract the mean and standard deviation values of BP for both males and females from a dataset comprising 25 million abstracts sourced from PubMed. 993 article abstracts met our predefined inclusion criteria (i.e., presence of references to blood pressure, units of blood pressure such as mmHg, and mention of biological sex). Based on the automatically-extracted information from these articles, we conducted an analysis of the variations of BP values across biological sex. Our results showed the viability of utilizing LLMs to study the BP variations across different demographic factors.

Databases of electronic health records (EHRs) are increasingly used to inform clinical decisions. Machine learning methods can find patterns in EHRs that are predictive of future adverse outcomes. However, statistical models may be built upon patterns of health-seeking behavior that vary across patient subpopulations, leading to poor predictive performance when training on one patient population and predicting on another. This note proposes two tests to better measure and understand model generalization. We use these tests to compare models derived from two data sources: (i) historical medical records, and (ii) electrocardiogram (EKG) waveforms. In a predictive task, we show that EKG-based models can be more stable than EHR-based models across different patient populations.

This paper introduces a structural equation formulation that gives rise to a new family of quasi-periodic Gaussian processes, useful to process a broad class of natural and physiological signals. The proposed formulation simplifies generation and forecasting, and provides hyperparameter estimates, which we exploit in a convergent and consistent iterative estimation algorithm. A bootstrap approach for standard error estimation and confidence intervals is also provided. We demonstrate the computational and scaling benefits of the proposed approach on a broad class of problems, including water level tidal analysis, CO_{2} emission data, and sunspot numbers data. By leveraging the structural equations, our method reduces the cost of likelihood evaluations and predictions from O(k^2 p^2) to O(p^2), significantly improving scalability.