Ahmed A. Metwally

Hada Melino Muhammad, Zechen Li, Flora Salim et al.

Continuous Glucose Monitoring (CGM) can detect early metabolic subphenotypes (insulin resistance, IR; $β$-cell dysfunction), but population-scale deployment faces two coupled problems. First, the same physiological state appears through multiple views (CGM time series, venous OGTT, Glucodensity summaries), so single-view representations fail to transfer when deployment shifts the modality or setting. Second, baselines perform inconsistently across these shifts. Both problems point to one remedy: representations that abstract away from any single view to capture higher-level temporal and distributional structure. We propose CGM-JEPA, a self-supervised pretraining framework which predicts masked latent representations rather than raw values, yielding abstraction that transfers across modalities. X-CGM-JEPA adds a masked Glucodensity cross-view objective for complementary distributional information. We pretrain on $\sim$389k unlabeled CGM readings from 228 subjects and evaluate on two clinical cohorts ($N=27$ and $N=17$ public-release subsets) across three regimes (cohort generalization, venous-to-CGM transfer, home CGM) under 20-iteration $\times$ 2-fold cross-validation. X-CGM-JEPA ranks first or second on AUROC for both endpoints across all three regimes while no baseline does, exceeding the strongest baseline by up to $+6.5$ pp in cohort generalization and $+3.6$ pp in venous-to-CGM transfer (paired Wilcoxon, $p<0.001$). Under modality shift, it matches mean AUROC while redistributing toward weaker subgroups (ethnicity AUROC gap shrinks 25-54%); on sparse in-domain venous data, the distributional view lifts label-aware clustering (ARI $+39\%$, NMI $+40\%$). Code and weights: https://github.com/cruiseresearchgroup/CGM-JEPA

Girish Narayanswamy, Maxwell A. Xu, A. Ali Heydari et al.

While ubiquitous wearable sensors capture a wealth of behavioral and physiological information, effectively transforming these signals into personalized health insights is challenging. Specifically, converting low-level sensor data into representations capable of characterizing higher-level states is difficult due to high phenotypic diversity and variation in individual baseline health, physiology, and lifestyle factors. Moreover, collecting wearable data paired with health outcome annotations is laborious and expensive, and retrospective annotation remains practically unfeasible, contributing to a scarcity of data with high-quality labels. To overcome these limitations, we propose a foundation model for wearable health that is pretrained on more than one trillion minutes of unlabeled sensor signals drawn from a large cohort of five million participants. We demonstrate that the joint scaling of model capacity and pretraining data volume leads to systematic improvements in performance, as evaluated on a diverse set of 35 health prediction tasks, spanning cardiovascular, metabolic, sleep, and mental health, as well as lifestyle choices and demographic factors. We find that this population scale representation unlocks label-efficient few-shot learning and generative capabilities for robust daily metric estimation. To further leverage this learned representation, we deploy a classroom of LLM agents to autonomously search the space of downstream predictive heads built on the model embeddings, showing broad performance improvements that increase with LLM model capacity. Finally, we show how integrating these downstream predictors into a Personal Health Agent can support model responses that are more relevant, contextually aware, and safe, and we validate this via 1,860 ratings from a cohort of clinicians.

Yubin Kim, Salman Rahman, Samuel Schmidgall et al.

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.

Zechen Li, Keerthana Natarajan, Weizhi Zhang et al.

Continuous glucose monitoring (CGM) provides a dense view of daily metabolic physiology, yet existing generic time-series and CGM-specific foundation models often encode glucose traces as entangled single-stream sequences, leaving the distinct temporal structure of glycemic dynamics only implicitly modeled. We present GlucoFM, a lightweight CGM foundation model that aligns irregular recordings to a 24-hour chronological grid, preserves observation masks, and decomposes glucose dynamics into slow physiological state and transient event streams, capturing low-frequency glycemic baselines and short-term deviations that may reflect acute physiological responses or sensor artifacts. GlucoFM is pretrained on 109,066 hours of unlabeled CGM recordings from 477 subjects with two complementary objectives: masked contextual latent prediction over fused daily representations and temporal dynamics prediction over state and event streams. Across four diverse cohorts and seven clinical prediction tasks, GlucoFM achieves the strongest subject-disjoint linear-probing performance among evaluated baselines, improving average PR-AUC by 4.1 points over the best CGM-specific foundation model. Its gains are most pronounced on core metabolic outcomes, leading PR-AUC on all diabetes-risk and $β$-cell dysfunction tasks and on 3 of 4 insulin-resistance tasks. GlucoFM also achieves the best overall cross-dataset transfer performance and strong few-shot adaptation among evaluated methods, and consistent gains when aggregating multiple days for subject-level prediction, highlighting physiology-aware decomposition as an effective inductive bias for transferable CGM representation learning.

A. Ali Heydari, Naghmeh Rezaei, Javier L. Prieto et al.

Blood biomarkers are an essential tool for healthcare providers to diagnose, monitor, and treat a wide range of medical conditions. Current reference values and recommended ranges often rely on population-level statistics, which may not adequately account for the influence of inter-individual variability driven by factors such as lifestyle and genetics. In this work, we introduce a novel framework for predicting future blood biomarker values and define personalized references through learned representations from lifestyle data (physical activity and sleep) and blood biomarkers. Our proposed method learns a similarity-based embedding space that captures the complex relationship between biomarkers and lifestyle factors. Using the UK Biobank (257K participants), our results show that our deep-learned embeddings outperform traditional and current state-of-the-art representation learning techniques in predicting clinical diagnosis. Using a subset of UK Biobank of 6440 participants who have follow-up visits, we validate that the inclusion of these embeddings and lifestyle factors directly in blood biomarker models improves the prediction of future lab values from a single lab visit. This personalized modeling approach provides a foundation for developing more accurate risk stratification tools and tailoring preventative care strategies. In clinical settings, this translates to the potential for earlier disease detection, more timely interventions, and ultimately, a shift towards personalized healthcare.

Ahmed A. Metwally, Ariel K. Leong, Aman Desai et al.

Diet management is key to managing chronic diseases such as diabetes. Automated food recommender systems may be able to assist by providing meal recommendations that conform to a user's nutrition goals and food preferences. Current recommendation systems suffer from a lack of accuracy that is in part due to a lack of knowledge of food preferences, namely foods users like to and are able to eat frequently. In this work, we propose a method for learning food preferences from food logs, a comprehensive but noisy source of information about users' dietary habits. We also introduce accompanying metrics. The method generates and compares word embeddings to identify the parent food category of each food entry and then calculates the most popular. Our proposed approach identifies 82% of a user's ten most frequently eaten foods. Our method is publicly available on (https://github.com/aametwally/LearningFoodPreferences)

Yuwei Zhang, Kumar Ayush, Siyuan Qiao et al.

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.

Weizhi Zhang, Zechen Li, Hamid Palangi et al.

The LLM-empowered personal health agents with user health (sensor) metrics have offered a promising pathway to alleviate global disparities in healthcare access. However, large-scale clinical deployment remains constrained by an open-ended evaluation bottleneck: physician annotation is reliable but costly and unscalable, while LLM-as-a-judge evaluators are scalable but subjective, inconsistent, and sometimes clinically misaligned. We introduce RubricsTree, a scalable evaluation framework with an expert-aligned hierarchical taxonomy of over 100 atomic, clinically-verifiable Boolean rubrics, evolving from the insights of 4,000 real user queries through an iterative human-in-the-loop curation protocol with an expertise panel led by an experienced physician. A context-aware adaptive router activates only the relevant auto-weighted rubric subset per query, providing the throughput needed for scalable evaluation with expert-aligned quality. Through a systematic meta-evaluation, we show that RubricsTree (i) substantially exceeds a strong large-scale evaluation baseline in expert alignment on challenging open-ended queries; (ii) reliably penalizes contextually degraded responses; and (iii) when used as structured instructions, text feedback, or training rewards for performance optimization, yields up to ~66% relative gains on HealthBench for Gemini, GPT, and Qwen model families. RubricsTree thus provides a scalable, auditable, and evolving evaluation infrastructure required for the continuous optimization of product-level personal healthcare AI.

Ahmed A. Metwally, A. Ali Heydari, Daniel McDuff et al.

Insulin resistance, a precursor to type 2 diabetes, is characterized by impaired insulin action in tissues. Current methods for measuring insulin resistance, while effective, are expensive, inaccessible, not widely available and hinder opportunities for early intervention. In this study, we remotely recruited the largest dataset to date across the US to study insulin resistance (N=1,165 participants, with median BMI=28 kg/m2, age=45 years, HbA1c=5.4%), incorporating wearable device time series data and blood biomarkers, including the ground-truth measure of insulin resistance, homeostatic model assessment for insulin resistance (HOMA-IR). We developed deep neural network models to predict insulin resistance based on readily available digital and blood biomarkers. Our results show that our models can predict insulin resistance by combining both wearable data and readily available blood biomarkers better than either of the two data sources separately (R2=0.5, auROC=0.80, Sensitivity=76%, and specificity 84%). The model showed 93% sensitivity and 95% adjusted specificity in obese and sedentary participants, a subpopulation most vulnerable to developing type 2 diabetes and who could benefit most from early intervention. Rigorous evaluation of model performance, including interpretability, and robustness, facilitates generalizability across larger cohorts, which is demonstrated by reproducing the prediction performance on an independent validation cohort (N=72 participants). Additionally, we demonstrated how the predicted insulin resistance can be integrated into a large language model agent to help understand and contextualize HOMA-IR values, facilitating interpretation and safe personalized recommendations. This work offers the potential for early detection of people at risk of type 2 diabetes and thereby facilitate earlier implementation of preventative strategies.

Jianguo Chen, Kenli Li, Kashif Bilal et al.

Protein interactions constitute the fundamental building block of almost every life activity. Identifying protein communities from Protein-Protein Interaction (PPI) networks is essential to understand the principles of cellular organization and explore the causes of various diseases. It is critical to integrate multiple data resources to identify reliable protein communities that have biological significance and improve the performance of community detection methods for large-scale PPI networks. In this paper, we propose a Multi-source Learning based Protein Community Detection (MLPCD) algorithm by integrating Gene Expression Data (GED) and a parallel solution of MLPCD using cloud computing technology. To effectively discover the biological functions of proteins that participating in different cellular processes, GED under different conditions is integrated with the original PPI network to reconstruct a Weighted-PPI (WPPI) network. To flexibly identify protein communities of different scales, we define community modularity and functional cohesion measurements and detect protein communities from WPPI using an agglomerative method. In addition, we respectively compare the detected communities with known protein complexes and evaluate the functional enrichment of protein function modules using Gene Ontology annotations. Moreover, we implement a parallel version of the MLPCD algorithm on the Apache Spark platform to enhance the performance of the algorithm for large-scale realistic PPI networks. Extensive experimental results indicate the superiority and notable advantages of the MLPCD algorithm over the relevant algorithms in terms of accuracy and performance.