LSM-2: Learning from Incomplete Wearable Sensor Data

Foundation models, a cornerstone of recent advancements in machine learning, have predominantly thrived on complete and well-structured data. Wearable sensor data frequently suffers from significant missingness, posing a substantial challenge for self-supervised learning (SSL) models that typically assume complete data inputs. This paper introduces the second generation of Large Sensor Model (LSM-2) with Adaptive and Inherited Masking (AIM), a novel SSL approach that learns robust representations directly from incomplete data without requiring explicit imputation. AIM's core novelty lies in its use of learnable mask tokens to model both existing ("inherited") and artificially introduced missingness, enabling it to robustly handle fragmented real-world data during inference. Pre-trained on an extensive dataset of 40M hours of day-long multimodal sensor data, our LSM-2 with AIM achieves the best performance across a diverse range of tasks, including classification, regression and generative modeling. Furthermore, LSM-2 with AIM exhibits superior scaling performance, and critically, maintains high performance even under targeted missingness scenarios, reflecting clinically coherent patterns, such as the diagnostic value of nighttime biosignals for hypertension prediction. This makes AIM a more reliable choice for real-world wearable data applications.

Advancing Conversational Diagnostic AI with Multimodal Reasoning

Large Language Models (LLMs) have demonstrated great potential for conducting diagnostic conversations but evaluation has been largely limited to language-only interactions, deviating from the real-world requirements of remote care delivery. Instant messaging platforms permit clinicians and patients to upload and discuss multimodal medical artifacts seamlessly in medical consultation, but the ability of LLMs to reason over such data while preserving other attributes of competent diagnostic conversation remains unknown. Here we advance the conversational diagnosis and management performance of the Articulate Medical Intelligence Explorer (AMIE) through a new capability to gather and interpret multimodal data, and reason about this precisely during consultations. Leveraging Gemini 2.0 Flash, our system implements a state-aware dialogue framework, where conversation flow is dynamically controlled by intermediate model outputs reflecting patient states and evolving diagnoses. Follow-up questions are strategically directed by uncertainty in such patient states, leading to a more structured multimodal history-taking process that emulates experienced clinicians. We compared AMIE to primary care physicians (PCPs) in a randomized, blinded, OSCE-style study of chat-based consultations with patient actors. We constructed 105 evaluation scenarios using artifacts like smartphone skin photos, ECGs, and PDFs of clinical documents across diverse conditions and demographics. Our rubric assessed multimodal capabilities and other clinically meaningful axes like history-taking, diagnostic accuracy, management reasoning, communication, and empathy. Specialist evaluation showed AMIE to be superior to PCPs on 7/9 multimodal and 29/32 non-multimodal axes (including diagnostic accuracy). The results show clear progress in multimodal conversational diagnostic AI, but real-world translation needs further research.

Towards an AI co-scientist

Scientific discovery relies on scientists generating novel hypotheses that undergo rigorous experimental validation. To augment this process, we introduce an AI co-scientist, a multi-agent system built on Gemini 2.0. The AI co-scientist is intended to help uncover new, original knowledge and to formulate demonstrably novel research hypotheses and proposals, building upon prior evidence and aligned to scientist-provided research objectives and guidance. The system's design incorporates a generate, debate, and evolve approach to hypothesis generation, inspired by the scientific method and accelerated by scaling test-time compute. Key contributions include: (1) a multi-agent architecture with an asynchronous task execution framework for flexible compute scaling; (2) a tournament evolution process for self-improving hypotheses generation. Automated evaluations show continued benefits of test-time compute, improving hypothesis quality. While general purpose, we focus development and validation in three biomedical areas: drug repurposing, novel target discovery, and explaining mechanisms of bacterial evolution and anti-microbial resistance. For drug repurposing, the system proposes candidates with promising validation findings, including candidates for acute myeloid leukemia that show tumor inhibition in vitro at clinically applicable concentrations. For novel target discovery, the AI co-scientist proposed new epigenetic targets for liver fibrosis, validated by anti-fibrotic activity and liver cell regeneration in human hepatic organoids. Finally, the AI co-scientist recapitulated unpublished experimental results via a parallel in silico discovery of a novel gene transfer mechanism in bacterial evolution. These results, detailed in separate, co-timed reports, demonstrate the potential to augment biomedical and scientific discovery and usher an era of AI empowered scientists.

Scaling Wearable Foundation Models

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.

Operationalizing Contextual Integrity in Privacy-Conscious Assistants

Advanced AI assistants combine frontier LLMs and tool access to autonomously perform complex tasks on behalf of users. While the helpfulness of such assistants can increase dramatically with access to user information including emails and documents, this raises privacy concerns about assistants sharing inappropriate information with third parties without user supervision. To steer information-sharing assistants to behave in accordance with privacy expectations, we propose to operationalize $\textit{contextual integrity}$ (CI), a framework that equates privacy with the appropriate flow of information in a given context. In particular, we design and evaluate a number of strategies to steer assistants' information-sharing actions to be CI compliant. Our evaluation is based on a novel form filling benchmark composed of synthetic data and human annotations, and it reveals that prompting frontier LLMs to perform CI-based reasoning yields strong results.

Quantum Circuit Optimization with AlphaTensor

A key challenge in realizing fault-tolerant quantum computers is circuit optimization. Focusing on the most expensive gates in fault-tolerant quantum computation (namely, the T gates), we address the problem of T-count optimization, i.e., minimizing the number of T gates that are needed to implement a given circuit. To achieve this, we develop AlphaTensor-Quantum, a method based on deep reinforcement learning that exploits the relationship between optimizing T-count and tensor decomposition. Unlike existing methods for T-count optimization, AlphaTensor-Quantum can incorporate domain-specific knowledge about quantum computation and leverage gadgets, which significantly reduces the T-count of the optimized circuits. AlphaTensor-Quantum outperforms the existing methods for T-count optimization on a set of arithmetic benchmarks (even when compared without making use of gadgets). Remarkably, it discovers an efficient algorithm akin to Karatsuba's method for multiplication in finite fields. AlphaTensor-Quantum also finds the best human-designed solutions for relevant arithmetic computations used in Shor's algorithm and for quantum chemistry simulation, thus demonstrating it can save hundreds of hours of research by optimizing relevant quantum circuits in a fully automated way.

Consensus, dissensus and synergy between clinicians and specialist foundation models in radiology report generation

Radiology reports are an instrumental part of modern medicine, informing key clinical decisions such as diagnosis and treatment. The worldwide shortage of radiologists, however, restricts access to expert care and imposes heavy workloads, contributing to avoidable errors and delays in report delivery. While recent progress in automated report generation with vision-language models offer clear potential in ameliorating the situation, the path to real-world adoption has been stymied by the challenge of evaluating the clinical quality of AI-generated reports. In this study, we build a state-of-the-art report generation system for chest radiographs, \textit{Flamingo-CXR}, by fine-tuning a well-known vision-language foundation model on radiology data. To evaluate the quality of the AI-generated reports, a group of 16 certified radiologists provide detailed evaluations of AI-generated and human written reports for chest X-rays from an intensive care setting in the United States and an inpatient setting in India. At least one radiologist (out of two per case) preferred the AI report to the ground truth report in over 60$\%$ of cases for both datasets. Amongst the subset of AI-generated reports that contain errors, the most frequently cited reasons were related to the location and finding, whereas for human written reports, most mistakes were related to severity and finding. This disparity suggested potential complementarity between our AI system and human experts, prompting us to develop an assistive scenario in which \textit{Flamingo-CXR} generates a first-draft report, which is subsequently revised by a clinician. This is the first demonstration of clinician-AI collaboration for report writing, and the resultant reports are assessed to be equivalent or preferred by at least one radiologist to reports written by experts alone in 80$\%$ of in-patient cases and 60$\%$ of intensive care cases.

Learning to Decode the Surface Code with a Recurrent, Transformer-Based Neural Network

Quantum error-correction is a prerequisite for reliable quantum computation. Towards this goal, we present a recurrent, transformer-based neural network which learns to decode the surface code, the leading quantum error-correction code. Our decoder outperforms state-of-the-art algorithmic decoders on real-world data from Google's Sycamore quantum processor for distance 3 and 5 surface codes. On distances up to 11, the decoder maintains its advantage on simulated data with realistic noise including cross-talk, leakage, and analog readout signals, and sustains its accuracy far beyond the 25 cycles it was trained on. Our work illustrates the ability of machine learning to go beyond human-designed algorithms by learning from data directly, highlighting machine learning as a strong contender for decoding in quantum computers.

Unlocking Accuracy and Fairness in Differentially Private Image Classification

Privacy-preserving machine learning aims to train models on private data without leaking sensitive information. Differential privacy (DP) is considered the gold standard framework for privacy-preserving training, as it provides formal privacy guarantees. However, compared to their non-private counterparts, models trained with DP often have significantly reduced accuracy. Private classifiers are also believed to exhibit larger performance disparities across subpopulations, raising fairness concerns. The poor performance of classifiers trained with DP has prevented the widespread adoption of privacy preserving machine learning in industry. Here we show that pre-trained foundation models fine-tuned with DP can achieve similar accuracy to non-private classifiers, even in the presence of significant distribution shifts between pre-training data and downstream tasks. We achieve private accuracies within a few percent of the non-private state of the art across four datasets, including two medical imaging benchmarks. Furthermore, our private medical classifiers do not exhibit larger performance disparities across demographic groups than non-private models. This milestone to make DP training a practical and reliable technology has the potential to widely enable machine learning practitioners to train safely on sensitive datasets while protecting individuals' privacy.

Evaluating AI systems under uncertain ground truth: a case study in dermatology

For safety, AI systems in health undergo thorough evaluations before deployment, validating their predictions against a ground truth that is assumed certain. However, this is actually not the case and the ground truth may be uncertain. Unfortunately, this is largely ignored in standard evaluation of AI models but can have severe consequences such as overestimating the future performance. To avoid this, we measure the effects of ground truth uncertainty, which we assume decomposes into two main components: annotation uncertainty which stems from the lack of reliable annotations, and inherent uncertainty due to limited observational information. This ground truth uncertainty is ignored when estimating the ground truth by deterministically aggregating annotations, e.g., by majority voting or averaging. In contrast, we propose a framework where aggregation is done using a statistical model. Specifically, we frame aggregation of annotations as posterior inference of so-called plausibilities, representing distributions over classes in a classification setting, subject to a hyper-parameter encoding annotator reliability. Based on this model, we propose a metric for measuring annotation uncertainty and provide uncertainty-adjusted metrics for performance evaluation. We present a case study applying our framework to skin condition classification from images where annotations are provided in the form of differential diagnoses. The deterministic adjudication process called inverse rank normalization (IRN) from previous work ignores ground truth uncertainty in evaluation. Instead, we present two alternative statistical models: a probabilistic version of IRN and a Plackett-Luce-based model. We find that a large portion of the dataset exhibits significant ground truth uncertainty and standard IRN-based evaluation severely over-estimates performance without providing uncertainty estimates.