Daily Papers

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

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.

Video photoplethysmography (vPPG) is an emerging method for non-invasive and convenient measurement of physiological signals, utilizing two primary approaches: remote video PPG (rPPG) and contact video PPG (cPPG). Monitoring vitals in high-altitude environments, where heart rates tend to increase and blood oxygen levels often decrease, presents significant challenges. To address these issues, we introduce the SUMS dataset comprising 80 synchronized non-contact facial and contact finger videos from 10 subjects during exercise and oxygen recovery scenarios, capturing PPG, respiration rate (RR), and SpO2. This dataset is designed to validate video vitals estimation algorithms and compare facial rPPG with finger cPPG. Additionally, fusing videos from different positions (i.e., face and finger) reduces the mean absolute error (MAE) of SpO2 predictions by 7.6\% and 10.6\% compared to only face and only finger, respectively. In cross-subject evaluation, we achieve an MAE of less than 0.5 BPM for HR estimation and 2.5\% for SpO2 estimation, demonstrating the precision of our multi-camera fusion techniques. Our findings suggest that simultaneous training on multiple indicators, such as PPG and blood oxygen, can reduce MAE in SpO2 estimation by 17.8\%.

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.

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

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.

Remote photoplethysmography (rPPG) can remotely extract physiological signals from RGB video, which has many advantages in detecting heart rate, such as low cost and no invasion to patients. The existing rPPG model is usually based on the transformer module, which has low computation efficiency. Recently, the Mamba model has garnered increasing attention due to its efficient performance in natural language processing tasks, demonstrating potential as a substitute for transformer-based algorithms. However, the Mambaout model and its variants prove that the SSM module, which is the core component of the Mamba model, is unnecessary for the vision task. Therefore, we hope to prove the feasibility of using the Mambaout-based module to remotely learn the heart rate. Specifically, we propose a novel rPPG algorithm called uncomplicated and enhanced learning capability rPPG (TYrPPG). This paper introduces an innovative gated video understanding block (GVB) designed for efficient analysis of RGB videos. Based on the Mambaout structure, this block integrates 2D-CNN and 3D-CNN to enhance video understanding for analysis. In addition, we propose a comprehensive supervised loss function (CSL) to improve the model's learning capability, along with its weakly supervised variants. The experiments show that our TYrPPG can achieve state-of-the-art performance in commonly used datasets, indicating its prospects and superiority in remote heart rate estimation. The source code is available at https://github.com/Taixi-CHEN/TYrPPG.

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.

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.

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/.

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.

Non-contact remote photoplethysmography (rPPG) technology enables heart rate measurement from facial videos. However, existing network models still face challenges in accu racy, robustness, and generalization capability under complex scenarios. This paper proposes an end-to-end rPPG extraction network that employs 3D convolutional neural networks to reconstruct accurate rPPG signals from raw facial videos. We introduce a differential frame fusion module that integrates differential frames with original frames, enabling frame-level representations to capture blood volume pulse (BVP) variations. Additionally, we incorporate Temporal Shift Module (TSM) with self-attention mechanisms, which effectively enhance rPPG features with minimal computational overhead. Furthermore, we propose a novel dynamic hybrid loss function that provides stronger supervision for the network, effectively mitigating over fitting. Comprehensive experiments were conducted on not only the PURE and UBFC-rPPG datasets but also the challenging MMPD dataset under complex scenarios, involving both intra dataset and cross-dataset evaluations, which demonstrate the superior robustness and generalization capability of our network. Specifically, after training on PURE, our model achieved a mean absolute error (MAE) of 7.58 on the MMPD test set, outperforming the state-of-the-art models.

Deep remote photoplethysmography (rPPG) attains sub-bpm heart-rate error on frontal, stationary faces yet degrades sharply under head pose: on MMPD, the state-of-the-art FactorizePhys backbone's MAE grows 1.60times from frontal (|yaw|{<}15^circ) to large-yaw (|yaw|{geq}45^circ) frames. We argue that pose is a coordinate-structural nuisance rather than a data-augmentation problem: in image coordinates the same pixel maps to different anatomy at different poses, blocking three priors otherwise natural for rPPG, namely the dichromatic reflection model, pulse-phase invariance across skin regions, and the POS/CHROM chromaticity projection, each of which presumes a stable anatomy-to-pixel mapping. We introduce CanonicalPhys, which prepends a differentiable four-point homography that fixes four facial anchors at canonical positions; in this canonical frame the three priors become expressible as a per-pixel Lambertian weight, a cross-ROI temporal consistency loss, and knowledge distillation from windowed POS, none of which adds trainable parameters over the backbone. At an identical parameter count, CanonicalPhys reduces MMPD's frontal-to-large-yaw MAE degradation from 1.60times to 1.33times and flattens the mild-yaw bin from 1.32times to 1.07times (across CanonicalPhys variants), with matched cross-dataset MAE reductions of up to 32% on pose-rich targets. Code: https://github.com/infraface/CanonicalPhys

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.

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.

With the improvement of sensor technology and significant algorithmic advances, the accuracy of remote heart rate monitoring technology has been significantly improved. Despite of the significant algorithmic advances, the performance of rPPG algorithm can degrade in the long-term, high-intensity continuous work occurred in evenings or insufficient light environments. One of the main challenges is that the lost facial details and low contrast cause the failure of detection and tracking. Also, insufficient lighting in video capturing hurts the quality of physiological signal. In this paper, we collect a large-scale dataset that was designed for remote heart rate estimation recorded with various illumination variations to evaluate the performance of the rPPG algorithm (Green, ICA, and POS). We also propose a low-light enhancement solution (technical solution) for remote heart rate estimation under the low-light condition. Using collected dataset, we found 1) face detection algorithm cannot detect faces in video captured in low light conditions; 2) A decrease in the amplitude of the pulsatile signal will lead to the noise signal to be in the dominant position; and 3) the chrominance-based method suffers from the limitation in the assumption about skin-tone will not hold, and Green and ICA method receive less influence than POS in dark illuminance environment. The proposed solution for rPPG process is effective to detect and improve the signal-to-noise ratio and precision of the pulsatile signal.

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.

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.

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.

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.

Recent studies demonstrated that the average heart rate (HR) can be measured from facial videos based on non-contact remote photoplethysmography (rPPG). However for many medical applications (e.g., atrial fibrillation (AF) detection) knowing only the average HR is not sufficient, and measuring precise rPPG signals from face for heart rate variability (HRV) analysis is needed. Here we propose an rPPG measurement method, which is the first work to use deep spatio-temporal networks for reconstructing precise rPPG signals from raw facial videos. With the constraint of trend-consistency with ground truth pulse curves, our method is able to recover rPPG signals with accurate pulse peaks. Comprehensive experiments are conducted on two benchmark datasets, and results demonstrate that our method can achieve superior performance on both HR and HRV levels comparing to the state-of-the-art methods. We also achieve promising results of using reconstructed rPPG signals for AF detection and emotion recognition.

This study introduces a novel application of a Generative Pre-trained Transformer (GPT) model tailored for photoplethysmography (PPG) signals, serving as a foundation model for various downstream tasks. Adapting the standard GPT architecture to suit the continuous characteristics of PPG signals, our approach demonstrates promising results. Our models are pre-trained on our extensive dataset that contains more than 200 million 30s PPG samples. We explored different supervised fine-tuning techniques to adapt our model to downstream tasks, resulting in performance comparable to or surpassing current state-of-the-art (SOTA) methods in tasks like atrial fibrillation detection. A standout feature of our GPT model is its inherent capability to perform generative tasks such as signal denoising effectively, without the need for further fine-tuning. This success is attributed to the generative nature of the GPT framework.

Traditional diagnosis of aortic valve disease relies on echocardiography, but its cost and required expertise limit its use in large-scale early screening. Photoplethysmography (PPG) has emerged as a promising screening modality due to its widespread availability in wearable devices and its ability to reflect underlying hemodynamic dynamics. However, the extreme scarcity of gold-standard labeled PPG data severely constrains the effectiveness of data-driven approaches. To address this challenge, we propose and validate a new paradigm, Physiology-Guided Self-Supervised Learning (PG-SSL), aimed at unlocking the value of large-scale unlabeled PPG data for efficient screening of Aortic Stenosis (AS) and Aortic Regurgitation (AR). Using over 170,000 unlabeled PPG samples from the UK Biobank, we formalize clinical knowledge into a set of PPG morphological phenotypes and construct a pulse pattern recognition proxy task for self-supervised pre-training. A dual-branch, gated-fusion architecture is then employed for efficient fine-tuning on a small labeled subset. The proposed PG-SSL framework achieves AUCs of 0.765 and 0.776 for AS and AR screening, respectively, significantly outperforming supervised baselines trained on limited labeled data. Multivariable analysis further validates the model output as an independent digital biomarker with sustained prognostic value after adjustment for standard clinical risk factors. This study demonstrates that PG-SSL provides an effective, domain knowledge-driven solution to label scarcity in medical artificial intelligence and shows strong potential for enabling low-cost, large-scale early screening of aortic valve disease.

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.

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.

Camera-based vital signs monitoring in recent years has attracted more and more researchers and the results are promising. However, a few research works focus on heart rate extraction under extremely low illumination environments. In this paper, we propose a novel framework for remote heart rate estimation under low-light conditions. This method uses singular spectrum analysis (SSA) to decompose the filtered signal into several reconstructed components. A spectral masking algorithm is utilized to refine the preliminary candidate components on the basis of a reference heart rate. The contributive components are fused into the final pulse signal. To evaluate the performance of our framework in low-light conditions, the proposed approach is tested on a large-scale multi-illumination HR dataset (named MIHR). The test results verify that the proposed method has stronger robustness to low illumination than state-of-the-art methods, effectively improving the signal-to-noise ratio and heart rate estimation precision. We further perform experiments on the PUlse RatE detection (PURE) dataset which is recorded under normal light conditions to demonstrate the generalization of our method. The experiment results show that our method can stably detect pulse rate and achieve comparative results. The proposed method pioneers a new solution to the remote heart rate estimation in low-light conditions.

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.

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.

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.

Accurate extraction of heart rate from photoplethysmography (PPG) signals remains challenging due to motion artifacts and signal degradation. Although deep learning methods trained as a data-driven inference problem offer promising solutions, they often underutilize existing knowledge from the medical and signal processing community. In this paper, we address three shortcomings of deep learning models: motion artifact removal, degradation assessment, and physiologically plausible analysis of the PPG signal. We propose KID-PPG, a knowledge-informed deep learning model that integrates expert knowledge through adaptive linear filtering, deep probabilistic inference, and data augmentation. We evaluate KID-PPG on the PPGDalia dataset, achieving an average mean absolute error of 2.85 beats per minute, surpassing existing reproducible methods. Our results demonstrate a significant performance improvement in heart rate tracking through the incorporation of prior knowledge into deep learning models. This approach shows promise in enhancing various biomedical applications by incorporating existing expert knowledge in deep learning models.

Nowadays, Hearth Rate (HR) monitoring is a key feature of almost all wrist-worn devices exploiting photoplethysmography (PPG) sensors. However, arm movements affect the performance of PPG-based HR tracking. This issue is usually addressed by fusing the PPG signal with data produced by inertial measurement units. Thus, deep learning algorithms have been proposed, but they are considered too complex to deploy on wearable devices and lack the explainability of results. In this work, we present a new deep learning model, PULSE, which exploits temporal convolutions and multi-head cross-attention to improve sensor fusion's effectiveness and achieve a step towards explainability. We evaluate the performance of PULSE on three publicly available datasets, reducing the mean absolute error by 7.56% on the most extensive available dataset, PPG-DaLiA. Finally, we demonstrate the explainability of PULSE and the benefits of applying attention modules to PPG and motion data.

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.

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.