BCG-FM: A Foundation Model for Ambient Cardiac Health Sensing

Foundation models for wearable biosignals have matched or exceeded supervised specialists across a range of clinical tasks, yet all rely on modalities that require deliberate user action--wearing a device or visiting a sleep lab. We introduce BCG-FM, the first foundation model for ambient mechanical biosignals. A piezoelectric sensor embedded in the bed surface records ballistocardiography (BCG) each night without user effort; we pretrain BCG-FM with participant-level contrastive learning and using a total of 2.75 million hours of nightly recordings from 145,985 individuals, the largest raw-waveform biosignal pretraining corpus to date. Frozen BCG-FM embeddings achieve 3.26-year MAE on biological-age estimation (the lowest reported for any ambient, contactless modality) and yield clinically relevant discrimination across 15 self-reported health conditions and three independent external cohorts. Pretrained representations from only 500 labeled participants outperform a fully supervised baseline trained on 3,372, and representation quality scales log-linearly with contrastive batch size. These results establish ambient, longitudinal mechanical biosignals as a viable modality for health foundation models.

Think Fast, Talk Smart: Partitioning Deterministic and Neural Computation for Structured Health Text Generation

Large language models (LLMs) are increasingly being used to generate health text from structured records such as wearable time series, biomarkers, vitals, and care-management logs. For recurring health outputs, fluency is not enough: systems must remain faithful to source data, ground explanatory claims in available evidence, follow stated policies, emit machine-readable outputs, and run cheaply enough for repeated use. We ask which responsibilities in structured health generation should be deterministic computation rather than runtime LLM prompting. We introduce Think Fast, Talk Smart, a sleep-health insight pipeline in which deterministic code performs recurring analysis before one bounded LLM writer call. Across 280 user-nights and six models, achieves lower numeric error, lower instruction-compliance error, and lower end-to-end cost than structured zero-shot and few-shot one-call baselines. Layer replacement reveals contract-specific failures: LLM comparison raises numeric error, LLM ranking degrades policy selection, LLM attribution increases unsupported causal language, and an LLM-generated writer interface reintroduces errors even after upstream facts are deterministic. The results support a broader design rule: let code own recurring analysis, and let LLMs express verified facts within bounded interfaces.