WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveforms

Wearable sensors enable the continuous acquisition of high-resolution physiological waveforms, such as photoplethysmography and accelerometry, under free-living conditions. However, inferring health-related phenotypes from these signals presents significant challenges due to high sampling frequencies, multimodal dependencies, and extreme sequence lengths (e.g., weeks of recordings), compounded by a scarcity of ground-truth labels. To address these challenges, existing self-supervised learning (SSL) methodologies typically follow two paradigms: (1) learning rich morphological representations from short waveform segments while collapsing longitudinal dynamics through simple aggregation, or (2) modeling behavioral patterns from coarse, hand-crafted features (e.g. heart rate, step counts) spanning longer horizons but foregoing subtle, predictive signatures in raw waveforms. To bridge this gap, we propose WavesFM, a foundation model utilizing a two-stage SSL framework for longitudinal physiological data. Specifically, we decompose the learning problem into two stages: first, a segment-level encoder is pretrained to extract local embeddings from short waveforms; subsequently, a temporal encoder is trained to model the sequence of these embeddings across a multi-day horizon. This hierarchical approach overcomes the computational complexity of high-resolution, long-sequence data, allowing the overall model to capture both local signal semantics and the complex circadian and inter-day variations governing physiological dynamics. Pretrained on over 6.8M hours (N=324k individuals) of recordings for the first stage and 5.3M hours (N=10k) for the second stage, WavesFM demonstrates superior performance across 58 diverse tasks spanning demographics, lifestyle, health conditions, and medications.

SymptomAI: Towards a Conversational AI Agent for Everyday Symptom Assessment

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.

CoDaS: AI Co-Data-Scientist for Biomarker Discovery via Wearable Sensors

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.

How Well Do Multimodal Models Reason on ECG Signals?

While multimodal large language models offer a promising solution to the "black box" nature of health AI by generating interpretable reasoning traces, verifying the validity of these traces remains a critical challenge. Existing evaluation methods are either unscalable, relying on manual clinician review, or superficial, utilizing proxy metrics (e.g. QA) that fail to capture the semantic correctness of clinical logic. In this work, we introduce a reproducible framework for evaluating reasoning in ECG signals. We propose decomposing reasoning into two distinct, components: (i) Perception, the accurate identification of patterns within the raw signal, and (ii) Deduction, the logical application of domain knowledge to those patterns. To evaluate Perception, we employ an agentic framework that generates code to empirically verify the temporal structures described in the reasoning trace. To evaluate Deduction, we measure the alignment of the model's logic against a structured database of established clinical criteria in a retrieval-based approach. This dual-verification method enables the scalable assessment of "true" reasoning capabilities.

Towards a Science of Scaling Agent Systems

Agents, language model-based systems that are capable of reasoning, planning, and acting are becoming the dominant paradigm for real-world AI applications. Despite this widespread adoption, the principles that determine their performance remain underexplored. We address this by deriving quantitative scaling principles for agent systems. We first formalize a definition for agentic evaluation and characterize scaling laws as the interplay between agent quantity, coordination structure, model capability, and task properties. We evaluate this across four benchmarks: Finance-Agent, BrowseComp-Plus, PlanCraft, and Workbench. With five canonical agent architectures (Single-Agent and four Multi-Agent Systems: Independent, Centralized, Decentralized, Hybrid), instantiated across three LLM families, we perform a controlled evaluation spanning 180 configurations. We derive a predictive model using coordination metrics, that achieves cross-validated R^2=0.524, enabling prediction on unseen task domains. We identify three effects: (1) a tool-coordination trade-off: under fixed computational budgets, tool-heavy tasks suffer disproportionately from multi-agent overhead. (2) a capability saturation: coordination yields diminishing or negative returns once single-agent baselines exceed ~45%. (3) topology-dependent error amplification: independent agents amplify errors 17.2x, while centralized coordination contains this to 4.4x. Centralized coordination improves performance by 80.8% on parallelizable tasks, while decentralized coordination excels on web navigation (+9.2% vs. +0.2%). Yet for sequential reasoning tasks, every multi-agent variants degraded performance by 39-70%. The framework predicts the optimal coordination strategy for 87% of held-out configurations. Out-of-sample validation on GPT-5.2, achieves MAE=0.071 and confirms four of five scaling principles generalize to unseen frontier models.

Smartphone monitoring of smiling as a behavioral proxy of well-being in everyday life

Subjective well-being is a cornerstone of individual and societal health, yet its scientific measurement has traditionally relied on self-report methods prone to recall bias and high participant burden. This has left a gap in our understanding of well-being as it is expressed in everyday life. We hypothesized that candid smiles captured during natural smartphone interactions could serve as a scalable, objective behavioral correlate of positive affect. To test this, we analyzed 405,448 video clips passively recorded from 233 consented participants over one week. Using a deep learning model to quantify smile intensity, we identified distinct diurnal and daily patterns. Daily patterns of smile intensity across the week showed strong correlation with national survey data on happiness (r=0.92), and diurnal rhythms documented close correspondence with established results from the day reconstruction method (r=0.80). Higher daily mean smile intensity was significantly associated with more physical activity (Beta coefficient = 0.043, 95% CI [0.001, 0.085]) and greater light exposure (Beta coefficient = 0.038, [0.013, 0.063]), whereas no significant effects were found for smartphone use. These findings suggest that passive smartphone sensing could serve as a powerful, ecologically valid methodology for studying the dynamics of affective behavior and open the door to understanding this behavior at a population scale.

InvThink: Towards AI Safety via Inverse Reasoning

We present InvThink, a simple yet powerful approach that gives large language models (LLMs) the capability of inverse thinking: reasoning through failure modes before generating responses. Unlike existing safety alignment methods that optimize directly for safe response, InvThink instructs models to 1) enumerate potential harms, 2) analyze their consequences, and 3) generate safe outputs that proactively avoid these risks. Our method reveals three key findings: (i) safety improvements show stronger scaling with model size compared to existing safety methods. (ii) InvThink mitigates safety tax; by training models to systematically consider failure modes, it preserves general reasoning capabilities on standard benchmarks. (iii) beyond general safety tasks, InvThink excels in high-stakes domains including external-facing (medicine, finance, law) and agentic (blackmail, murder) risk scenarios, achieving up to 15.7% reduction in harmful responses compared to baseline methods like SafetyPrompt. We further implement InvThink via supervised fine-tuning, and reinforcement learning across three LLM families. These results suggest that inverse reasoning provides a scalable and generalizable path toward safer, more capable language models.

Tiered Agentic Oversight: A Hierarchical Multi-Agent System for AI Safety in Healthcare

Current large language models (LLMs), despite their power, can introduce safety risks in clinical settings due to limitations such as poor error detection and single point of failure. To address this, we propose Tiered Agentic Oversight (TAO), a hierarchical multi-agent framework that enhances AI safety through layered, automated supervision. Inspired by clinical hierarchies (e.g., nurse, physician, specialist), TAO conducts agent routing based on task complexity and agent roles. Leveraging automated inter- and intra-tier collaboration and role-playing, TAO creates a robust safety framework. Ablation studies reveal that TAO's superior performance is driven by its adaptive tiered architecture, which improves safety by over 3.2% compared to static single-tier configurations; the critical role of its lower tiers, particularly tier 1, whose removal most significantly impacts safety; and the strategic assignment of more advanced LLM to these initial tiers, which boosts performance by over 2% compared to less optimal allocations while achieving near-peak safety efficiently. These mechanisms enable TAO to outperform single-agent and multi-agent frameworks in 4 out of 5 healthcare safety benchmarks, showing up to an 8.2% improvement over the next-best methods in these evaluations. Finally, we validate TAO via an auxiliary clinician-in-the-loop study where integrating expert feedback improved TAO's accuracy in medical triage from 40% to 60%.

Non-Contact Health Monitoring During Daily Personal Care Routines

Remote photoplethysmography (rPPG) enables non-contact, continuous monitoring of physiological signals and offers a practical alternative to traditional health sensing methods. Although rPPG is promising for daily health monitoring, its application in long-term personal care scenarios, such as mirror-facing routines in high-altitude environments, remains challenging due to ambient lighting variations, frequent occlusions from hand movements, and dynamic facial postures. To address these challenges, we present LADH (Long-term Altitude Daily Health), the first long-term rPPG dataset containing 240 synchronized RGB and infrared (IR) facial videos from 21 participants across five common personal care scenarios, along with ground-truth PPG, respiration, and blood oxygen signals. Our experiments demonstrate that combining RGB and IR video inputs improves the accuracy and robustness of non-contact physiological monitoring, achieving a mean absolute error (MAE) of 4.99 BPM in heart rate estimation. Furthermore, we find that multi-task learning enhances performance across multiple physiological indicators simultaneously. Dataset and code are open at https://github.com/McJackTang/FusionVitals.

SensorLM: Learning the Language of Wearable Sensors

We present SensorLM, a family of sensor-language foundation models that enable wearable sensor data understanding with natural language. Despite its pervasive nature, aligning and interpreting sensor data with language remains challenging due to the lack of paired, richly annotated sensor-text descriptions in uncurated, real-world wearable data. We introduce a hierarchical caption generation pipeline designed to capture statistical, structural, and semantic information from sensor data. This approach enabled the curation of the largest sensor-language dataset to date, comprising over 59.7 million hours of data from more than 103,000 people. Furthermore, SensorLM extends prominent multimodal pretraining architectures (e.g., CLIP, CoCa) and recovers them as specific variants within a generic architecture. Extensive experiments on real-world tasks in human activity analysis and healthcare verify the superior performance of SensorLM over state-of-the-art in zero-shot recognition, few-shot learning, and cross-modal retrieval. SensorLM also demonstrates intriguing capabilities including scaling behaviors, label efficiency, sensor captioning, and zero-shot generalization to unseen tasks.