We introduce a novel multimodal dataset and benchmark results for continuous PPG recordings during outdoor activities from 16 participants over 13.5 hours,

Biosignals can be viewed as mixtures measuring particular physiological events, and blind source separation (BSS) aims to extract underlying source signals from mixtures. This paper proposes a self-supervised multi-encoder autoencoder (MEAE) to separate heartbeat-related source signals from photoplethysmogram (PPG), enhancing heart rate (HR) detection in noisy PPG data. The MEAE is trained on PPG signals from a large open polysomnography database without any pre-processing or data selection. The trained network is then applied to a noisy PPG dataset collected during the daily activities of nine subjects. The extracted heartbeat-related source signal significantly improves HR detection as compared to the original PPG. The absence of pre-processing and the self-supervised nature of the proposed method, combined with its strong performance, highlight the potential of MEAE for BSS in biosignal analysis.

Continuous cardiovascular monitoring can play a key role in precision health. However, some fundamental cardiac biomarkers of interest, including stroke volume and cardiac output, require invasive measurements, e.g., arterial pressure waveforms (APW). As a non-invasive alternative, photoplethysmography (PPG) measurements are routinely collected in hospital settings. Unfortunately, the prediction of key cardiac biomarkers from PPG instead of APW remains an open challenge, further complicated by the scarcity of annotated PPG measurements. As a solution, we propose a hybrid approach that uses hemodynamic simulations and unlabeled clinical data to estimate cardiovascular biomarkers directly from PPG signals. Our hybrid model combines a conditional variational autoencoder trained on paired PPG-APW data with a conditional density estimator of cardiac biomarkers trained on labeled simulated APW segments. As a key result, our experiments demonstrate that the proposed approach can detect fluctuations of cardiac output and stroke volume and outperform a supervised baseline in monitoring temporal changes in these biomarkers.

Photoplethysmography (PPG) is widely used in wearable health monitoring, yet large PPG foundation models remain difficult to deploy on resource-limited devices. We present PPG-Distill, a knowledge distillation framework that transfers both global and local knowledge through prediction-, feature-, and patch-level distillation. PPG-Distill incorporates morphology distillation to preserve local waveform patterns and rhythm distillation to capture inter-patch temporal structures. On heart rate estimation and atrial fibrillation detection, PPG-Distill improves student performance by up to 21.8% while achieving 7X faster inference and reducing memory usage by 19X, enabling efficient PPG analysis on wearables.

Foundation models are large-scale machine learning models that are pre-trained on massive amounts of data and can be adapted for various downstream tasks. They have been extensively applied to tasks in Natural Language Processing and Computer Vision with models such as GPT, BERT, and CLIP. They are now also increasingly gaining attention in time-series analysis, particularly for physiological sensing. However, most time series foundation models are specialist models - with data in pre-training and testing of the same type, such as Electrocardiogram, Electroencephalogram, and Photoplethysmogram (PPG). Recent works, such as MOMENT, train a generalist time series foundation model with data from multiple domains, such as weather, traffic, and electricity. This paper aims to conduct a comprehensive benchmarking study to compare the performance of generalist and specialist models, with a focus on PPG signals. Through an extensive suite of total 51 tasks covering cardiac state assessment, laboratory value estimation, and cross-modal inference, we comprehensively evaluate both models across seven dimensions, including win score, average performance, feature quality, tuning gain, performance variance, transferability, and scalability. These metrics jointly capture not only the models' capability but also their adaptability, robustness, and efficiency under different fine-tuning strategies, providing a holistic understanding of their strengths and limitations for diverse downstream scenarios. In a full-tuning scenario, we demonstrate that the specialist model achieves a 27% higher win score. Finally, we provide further analysis on generalization, fairness, attention visualizations, and the importance of training data choice.

Photoplethysmography (PPG) is widely used in wearable health monitoring, but its reliability is often degraded by noise and motion artifacts, limiting downstream applications such as heart rate (HR) estimation. This paper presents a deep learning framework for PPG denoising with an emphasis on preserving physiological information. In this framework, we propose DPNet, a Mamba-based denoising backbone designed for effective temporal modeling. To further enhance denoising performance, the framework also incorporates a scale-invariant signal-to-distortion ratio (SI-SDR) loss to promote waveform fidelity and an auxiliary HR predictor (HRP) that provides physiological consistency through HR-based supervision. Experiments on the BIDMC dataset show that our method achieves strong robustness against both synthetic noise and real-world motion artifacts, outperforming conventional filtering and existing neural models. Our method can effectively restore PPG signals while maintaining HR accuracy, highlighting the complementary roles of SI-SDR loss and HR-guided supervision. These results demonstrate the potential of our approach for practical deployment in wearable healthcare systems.

We introduce a novel multimodal dataset and benchmark results for continuous PPG recordings during outdoor activities from 16 participants over 13.5 hours,

Smart wearables enable continuous tracking of established biomarkers such as heart rate, heart rate variability, and blood oxygen saturation via photoplethysmography (PPG). Beyond these metrics, PPG waveforms contain richer physiological information, as recent deep learning (DL) studies demonstrate. However, DL models often rely on features with unclear physiological meaning, creating a tension between predictive power, clinical interpretability, and sensor design. We address this gap by introducing PPGen, a biophysical model that relates PPG signals to interpretable physiological and optical parameters. Building on PPGen, we propose hybrid amortized inference (HAI), enabling fast, robust, and scalable estimation of relevant physiological parameters from PPG signals while correcting for model misspecification. In extensive in-silico experiments, we show that HAI can accurately infer physiological parameters under diverse noise and sensor conditions. Our results illustrate a path toward PPG models that retain the fidelity needed for DL-based features while supporting clinical interpretation and informed hardware design.

The 12-lead electrocardiogram (ECG) is the gold standard for cardiovascular monitoring, offering superior diagnostic granularity and specificity compared to photoplethysmography (PPG). However, existing 12-lead ECG systems rely on cumbersome multi-electrode setups, limiting sustained monitoring in ambulatory settings, while current PPG-based methods fail to reconstruct multi-lead ECG due to the absence of inter-lead constraints and insufficient modeling of spatial-temporal dependencies across leads. To bridge this gap, we introduce P2Es, an innovative demographic-aware diffusion framework designed to generate clinically valid 12-lead ECG from PPG signals via three key innovations. Specifically, in the forward process, we introduce frequency-domain blurring followed by temporal noise interference to simulate real-world signal distortions. In the reverse process, we design a temporal multi-scale generation module followed by frequency deblurring. In particular, we leverage KNN-based clustering combined with contrastive learning to assign affinity matrices for the reverse process, enabling demographic-specific ECG translation. Extensive experimental results show that P2Es outperforms baseline models in 12-lead ECG reconstruction.

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.