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Elgar Fleisch

Publications and source records attributed to Elgar Fleisch.

At least 19 recordsLinked to original sources

TimeRLM: Recursive Language Models Enable Precise Anomaly Localization in Long-Context Time-Series

Precise anomaly localization over long-context time series is a crucial task in monitoring applications across clinical care, industrial operations, financial services, and logistics, where brief evidence may hide inside long spans of high-frequency data. Time-Series Language Models (TSLMs) are able to ingest time series data and verbalize findings on anomalies in natural language; however, recent benchmarks report a decrease in retrieval performance at long contexts, mirroring failure modes in text, vision, and audio. In the text domain, Recursive Language Models (RLMs) can recover much of this lost performance by keeping context external to the large language model (LLM), allowing the model to query it through code. We present TimeRLM, an RLM formulation for time-series that sequentially manipulates the signal using code and vision capabilities. We further introduce AnomalyXL, a synthetic long-context anomaly localization benchmark with programmatically injected anomalies that require precise retrieval. We implement five different task categories and two variants: AnomalyXL-MCQ and AnomalyXL-Localize. TimeRLM outperforms every evaluated TSLM and single-pass baseline on four of the five AnomalyXL-Localize tasks, reaching 0.682 IoU on localization and 0.745 on classify-with-evidence, versus at most 0.329 and 0.072 across all baselines. We post-train TimeRLM using reinforcement learning. The resulting model further improves performance and requires approximately one-third as many agent interaction turns as its untrained base model to produce a final answer. On unseen real-world ECG, sleep and software observability recordings, the post-trained TimeRLM retains or improves performance, surpassing TSLMs despite being trained exclusively on synthetic data. Our findings suggest recursive interaction with time-series is an effective approach for long-horizon retrieval.

cs.LG

Detecting Drunk Driving Using Off-the-Shelf Smartwatches

Alcohol-impaired driving remains a major yet preventable cause of road traffic injury and death, with many drivers underestimating their level of intoxication. Compared to in-vehicle systems, mobile drunk-driving detection using consumer smartwatches offers a scalable way to trigger preventive interventions and increase awareness without additional in-vehicle hardware. We introduce a system that leverages wrist accelerometer data and heart rate variability-derived physiological signals to detect alcohol-related driving impairment. We collected data in a randomized, controlled three-arm test-track study (n=54) and trained both logistic regression models with window-aggregated features and a two-tower 1D convolutional neural network (CNN), to detect alcohol-impaired driving. The CNN achieved a participant-averaged area under the receiver operating characteristic (AUROC) of 0.88 for detecting any alcohol intoxication and 0.86 for detecting driving above the WHO-recommended limit of 0.05 g/dL. To the best of our knowledge, this is the first work to (1) demonstrate drunk-driving detection using consumer smartwatches, (2) develop and evaluate such a system in a real vehicle on a closed test track, and (3) rigorously assess generalization to unseen participants. Together, these findings highlight the potential of wearable-based sensing to support scalable, measurement-driven prevention of alcohol-related traffic harm.

cs.HC

Vocal Prognostic Digital Biomarkers in Monitoring Chronic Heart Failure: A Longitudinal Observational Study

Objective: This study aimed to evaluate which voice features can predict health deterioration in patients with chronic HF. Background: Heart failure (HF) is a chronic condition with progressive deterioration and acute decompensations, often requiring hospitalization and imposing substantial healthcare and economic burdens. Current standard-of-care (SoC) home monitoring, such as weight tracking, lacks predictive accuracy and requires high patient engagement. Voice is a promising non-invasive biomarker, though prior studies have mainly focused on acute HF stages. Methods: In a 2-month longitudinal study, 32 patients with HF collected daily voice recordings and SoC measures of weight and blood pressure at home, with biweekly questionnaires for health status. Acoustic analysis generated detailed vowel and speech features. Time-series features were extracted from aggregated lookback windows (e.g., 7 days) to predict next-day health status. Explainable machine learning with nested cross-validation identified top vocal biomarkers, and a case study illustrated model application. Results: A total of 21,863 recordings were analyzed. Acoustic vowel features showed strong correlations with health status. Time-series voice features within the lookback window outperformed corresponding standard care measures, achieving peak sensitivity and specificity of 0.826 and 0.782 versus 0.783 and 0.567 for SoC metrics. Key prognostic voice features identifying deterioration included delayed energy shift, low energy variability, and higher shimmer variability in vowels, along with reduced speaking and articulation rate, lower phonation ratio, decreased voice quality, and increased formant variability in speech. Conclusion: Voice-based monitoring offers a non-invasive approach to detect early health changes in chronic HF, supporting proactive and personalized care.

cs.SD

Patient-Level Multimodal Question Answering from Multi-Site Auscultation Recordings

Auscultation is a vital diagnostic tool, yet its utility is often limited by subjective interpretation. While general-purpose Audio-Language Models (ALMs) excel in general domains, they struggle with the nuances of physiological signals. We propose a framework that aligns multi-site auscultation recordings directly with a frozen Large Language Model (LLM) embedding space via gated cross-attention. By leveraging the LLM's latent world knowledge, our approach moves beyond isolated classification toward holistic, patient-level assessment. On the CaReSound benchmark, our model achieves a state-of-the-art 0.865 F1-macro and 0.952 BERTScore. We demonstrate that lightweight, domain-specific encoders rival large-scale ALMs and that multi-site aggregation provides spatial redundancy that mitigates temporal truncation. This alignment of medical acoustics with text foundations offers a scalable path for bridging signal processing and clinical assessment.

cs.SD

TS-Haystack: A Multi-Task Retrieval Benchmark for Long-Context Time-Series Reasoning

Time Series Language Models (TSLMs) promise reasoning over real-world temporal data, but their ability to retrieve and reason over long time-series remains largely untested. We introduce TS-Haystack, a multi-domain retrieval benchmark with ten event-grounded question-answering tasks over contexts from 100 seconds to 24 hours, spanning direct retrieval, temporal reasoning, multi-step reasoning, and contextual anomaly detection. Existing TSLMs exhibit severe long-context degradation: accuracy declines with context length, direct-tokenization models run out of memory beyond 100 seconds on high-rate signals, and time-interval-grounded tasks collapse toward near-zero accuracy when increasing the time-series lengths, aligning with existing literature on text and multi-modal long context retrieval. An agentic retrieval framework using specialized time-series classifier tools matches or outperforms SoTA TSLMs on 9 of 10 tasks, highlighting agentic retrieval as a promising approach for long-context TSLMs.

cs.LG

EvoMorph: Counterfactual Explanations for Continuous Time-Series Extrinsic Regression Applied to Photoplethysmography

Wearable devices enable continuous, population-scale monitoring of physiological signals, such as photoplethysmography (PPG), creating new opportunities for data-driven clinical assessment. Time-series extrinsic regression (TSER) models increasingly leverage PPG signals to estimate clinically relevant outcomes, including heart rate, respiratory rate, and oxygen saturation. For clinical reasoning and trust, however, single point estimates alone are insufficient: clinicians must also understand whether predictions are stable under physiologically plausible variations and to what extent realistic, attainable changes in physiological signals would meaningfully alter a model's prediction. Counterfactual explanations (CFE) address these "what-if" questions, yet existing time series CFE generation methods are largely restricted to classification, overlook waveform morphology, and often produce physiologically implausible signals, limiting their applicability to continuous biomedical time series. To address these limitations, we introduce EvoMorph, a multi-objective evolutionary framework for generating physiologically plausible and diverse CFE for TSER applications. EvoMorph optimizes morphology-aware objectives defined on interpretable signal descriptors and applies transformations to preserve the waveform structure. We evaluated EvoMorph on three PPG datasets (heart rate, respiratory rate, and oxygen saturation) against a nearest-unlike-neighbor baseline. In addition, in a case study, we evaluated EvoMorph as a tool for uncertainty quantification by relating counterfactual sensitivity to bootstrap-ensemble uncertainty and data-density measures. Overall, EvoMorph enables the generation of physiologically-aware counterfactuals for continuous biomedical signals and supports uncertainty-aware interpretability, advancing trustworthy model analysis for clinical time-series applications.

cs.LG

OpenTSLM: Time-Series Language Models for Reasoning over Multivariate Medical Text- and Time-Series Data

LLMs have emerged as powerful tools for interpreting multimodal data. In medicine, they hold particular promise for synthesizing large volumes of clinical information into actionable insights and digital health applications. Yet, a major limitation remains their inability to handle time series. To overcome this gap, we present OpenTSLM, a family of Time Series Language Models (TSLMs) created by integrating time series as a native modality to pretrained LLMs, enabling reasoning over multiple time series of any length. We investigate two architectures for OpenTSLM. The first, OpenTSLM-SoftPrompt, models time series implicitly by concatenating learnable time series tokens with text tokens via soft prompting. Although parameter-efficient, we hypothesize that explicit time series modeling scales better and outperforms implicit approaches. We thus introduce OpenTSLM-Flamingo, which integrates time series with text via cross-attention. We benchmark both variants against baselines that treat time series as text tokens or plots, across a suite of text-time-series Chain-of-Thought (CoT) reasoning tasks. We introduce three datasets: HAR-CoT, Sleep-CoT, and ECG-QA-CoT. Across all, OpenTSLM models outperform baselines, reaching 69.9 F1 in sleep staging and 65.4 in HAR, compared to 9.05 and 52.2 for finetuned text-only models. Notably, even 1B-parameter OpenTSLM models surpass GPT-4o (15.47 and 2.95). OpenTSLM-Flamingo matches OpenTSLM-SoftPrompt in performance and outperforms on longer sequences, while maintaining stable memory requirements. By contrast, SoftPrompt grows exponentially in memory with sequence length, requiring around 110 GB compared to 40 GB VRAM when training on ECG-QA with LLaMA-3B. Expert reviews by clinicians find strong reasoning capabilities exhibited by OpenTSLMs on ECG-QA. To facilitate further research, we provide all code, datasets, and models open-source.

cs.LG

CosinorAge: Unified Python and Web Platform for Biological Age Estimation from Wearable- and Smartwatch-Based Activity Rhythms

Every day, millions of people worldwide track their steps, sleep, and activity rhythms with smartwatches and fitness trackers. These continuously collected data streams present a remarkable opportunity to transform routine self-tracking into meaningful health insights that enable individuals to understand -- and potentially influence -- their biological aging. Yet most tools for analyzing wearable data remain fragmented, proprietary, and inaccessible, creating a major barrier between this vast reservoir of personal health information and its translation into actionable insights on aging. CosinorAge is an open-source framework that estimates biological age from wearable-derived circadian, physical activity, and sleep metrics. It addresses the lack of unified, reproducible pipelines for jointly analyzing rest-activity rhythmicity, physical activity, and sleep, and linking them to health outcomes. The Python package provides an end-to-end workflow from raw data ingestion and preprocessing to feature computation and biological age estimation, supporting multiple input sources across wearables and smartwatch. It also makes available trained model parameters (open weights) derived from large-scale population datasets such as UK Biobank, enabling reproducibility, transparency, and generalizability across studies. Its companion web-based CosinorAge Calculator enables non-technical users to access identical analytical capabilities through an intuitive interface. By combining transparent, reproducible analysis with broad accessibility, CosinorAge advances scalable, personalized health monitoring and bridges digital health technologies with biological aging research.

cs.HC

Digital Scale: Open-Source On-Device BMI Estimation from Smartphone Camera Images Trained on a Large-Scale Real-World Dataset

Estimating Body Mass Index (BMI) from camera images with machine learning models enables rapid weight assessment when traditional methods are unavailable or impractical, such as in telehealth or emergency scenarios. Existing computer vision approaches have been limited to datasets of up to 14,500 images. In this study, we present a deep learning-based BMI estimation method trained on our WayBED dataset, a large proprietary collection of 84,963 smartphone images from 25,353 individuals. We introduce an automatic filtering method that uses posture clustering and person detection to curate the dataset by removing low-quality images, such as those with atypical postures or incomplete views. This process retained 71,322 high-quality images suitable for training. We achieve a Mean Absolute Percentage Error (MAPE) of 7.9% on our hold-out test set (WayBED data) using full-body images, the lowest value in the published literature to the best of our knowledge. Further, we achieve a MAPE of 13% on the completely unseen~(during training) VisualBodyToBMI dataset, comparable with state-of-the-art approaches trained on it, demonstrating robust generalization. Lastly, we fine-tune our model on VisualBodyToBMI and achieve a MAPE of 8.56%, the lowest reported value on this dataset so far. We deploy the full pipeline, including image filtering and BMI estimation, on Android devices using the CLAID framework. We release our complete code for model training, filtering, and the CLAID package for mobile deployment as open-source contributions.

cs.CV

GeHirNet: A Gender-Aware Hierarchical Model for Voice Pathology Classification

AI-based voice analysis shows promise for disease diagnostics, but existing classifiers often fail to accurately identify specific pathologies because of gender-related acoustic variations and the scarcity of data for rare diseases. We propose a novel two-stage framework that first identifies gender-specific pathological patterns using ResNet-50 on Mel spectrograms, then performs gender-conditioned disease classification. We address class imbalance through multi-scale resampling and time warping augmentation. Evaluated on a merged dataset from four public repositories, our two-stage architecture with time warping achieves state-of-the-art performance (97.63\% accuracy, 95.25\% MCC), with a 5\% MCC improvement over single-stage baseline. This work advances voice pathology classification while reducing gender bias through hierarchical modeling of vocal characteristics.

cs.SD

HEAPO -- An Open Dataset for Heat Pump Optimization with Smart Electricity Meter Data and On-Site Inspection Protocols

Heat pumps are essential for decarbonizing residential heating but consume substantial electrical energy, impacting operational costs and grid demand. Many systems run inefficiently due to planning flaws, operational faults, or misconfigurations. While optimizing performance requires skilled professionals, labor shortages hinder large-scale interventions. However, digital tools and improved data availability create new service opportunities for energy efficiency, predictive maintenance, and demand-side management. To support research and practical solutions, we present an open-source dataset of electricity consumption from 1,408 households with heat pumps and smart electricity meters in the canton of Zurich, Switzerland, recorded at 15-minute and daily resolutions between 2018-11-03 and 2024-03-21. The dataset includes household metadata, weather data from 8 stations, and ground truth data from 410 field visit protocols collected by energy consultants during system optimizations. Additionally, the dataset includes a Python-based data loader to facilitate seamless data processing and exploration.

cs.CY

Comparative Efficacy of Commercial Wearables for Circadian Rhythm Home Monitoring from Activity, Heart Rate, and Core Body Temperature

Circadian rhythms govern biological patterns that follow a 24-hour cycle. Dysfunctions in circadian rhythms can contribute to various health problems, such as sleep disorders. Current circadian rhythm assessment methods, often invasive or subjective, limit circadian rhythm monitoring to laboratories. Hence, this study aims to investigate scalable consumer-centric wearables for circadian rhythm monitoring outside traditional laboratories. In a two-week longitudinal study conducted in real-world settings, 36 participants wore an Actigraph, a smartwatch, and a core body temperature sensor to collect activity, temperature, and heart rate data. We evaluated circadian rhythms calculated from commercial wearables by comparing them with circadian rhythm reference measures, i.e., Actigraph activities and chronotype questionnaire scores. The circadian rhythm metric acrophases, determined from commercial wearables using activity, heart rate, and temperature data, significantly correlated with the acrophase derived from Actigraph activities (r=0.96, r=0.87, r=0.79; all p<0.001) and chronotype questionnaire (r=-0.66, r=-0.73, r=-0.61; all p<0.001). The acrophases obtained concurrently from consumer sensors significantly predicted the chronotype (R2=0.64; p<0.001). Our study validates commercial sensors for circadian rhythm assessment, highlighting their potential to support maintaining healthy rhythms and provide scalable and timely health monitoring in real-life scenarios.

eess.SP

CLAID: Closing the Loop on AI & Data Collection -- A Cross-Platform Transparent Computing Middleware Framework for Smart Edge-Cloud and Digital Biomarker Applications

The increasing number of edge devices with enhanced sensing capabilities, such as smartphones, wearables, and IoT devices equipped with sensors, holds the potential for innovative smart-edge applications in healthcare. These devices generate vast amounts of multimodal data, enabling the implementation of digital biomarkers which can be leveraged by machine learning solutions to derive insights, predict health risks, and allow personalized interventions. Training these models requires collecting data from edge devices and aggregating it in the cloud. To validate and verify those models, it is essential to utilize them in real-world scenarios and subject them to testing using data from diverse cohorts. Since some models are too computationally expensive to be run on edge devices directly, a collaborative framework between the edge and cloud becomes necessary. In this paper, we present CLAID, an open-source cross-platform middleware framework based on transparent computing compatible with Android, iOS, WearOS, Linux, macOS, and Windows. CLAID enables logical integration of devices running different operating systems into an edge-cloud system, facilitating communication and offloading between them, with bindings available in different programming languages. We provide Modules for data collection from various sensors as well as for the deployment of machine-learning models. Furthermore, we propose a novel methodology, "ML-Model in the Loop" for verifying deployed machine learning models, which helps to analyze problems that may occur during the migration of models from cloud to edge devices. We verify our framework in three different experiments and achieve 100% sampling coverage for data collection across different sensors as well as an equal performance of a cough detection model deployed on both Android and iOS devices. We evaluate the memory and battery consumption of our framework.

cs.DC

Leveraging driver vehicle and environment interaction: Machine learning using driver monitoring cameras to detect drunk driving

Excessive alcohol consumption causes disability and death. Digital interventions are promising means to promote behavioral change and thus prevent alcohol-related harm, especially in critical moments such as driving. This requires real-time information on a person's blood alcohol concentration (BAC). Here, we develop an in-vehicle machine learning system to predict critical BAC levels. Our system leverages driver monitoring cameras mandated in numerous countries worldwide. We evaluate our system with n=30 participants in an interventional simulator study. Our system reliably detects driving under any alcohol influence (area under the receiver operating characteristic curve [AUROC] 0.88) and driving above the WHO recommended limit of 0.05g/dL BAC (AUROC 0.79). Model inspection reveals reliance on pathophysiological effects associated with alcohol consumption. To our knowledge, we are the first to rigorously evaluate the use of driver monitoring cameras for detecting drunk driving. Our results highlight the potential of driver monitoring cameras and enable next-generation drunk driver interaction preventing alcohol-related harm.

cs.HC

"Are you okay, honey?": Recognizing Emotions among Couples Managing Diabetes in Daily Life using Multimodal Real-World Smartwatch Data

Couples generally manage chronic diseases together and the management takes an emotional toll on both patients and their romantic partners. Consequently, recognizing the emotions of each partner in daily life could provide an insight into their emotional well-being in chronic disease management. Currently, the process of assessing each partner's emotions is manual, time-intensive, and costly. Despite the existence of works on emotion recognition among couples, none of these works have used data collected from couples' interactions in daily life. In this work, we collected 85 hours (1,021 5-minute samples) of real-world multimodal smartwatch sensor data (speech, heart rate, accelerometer, and gyroscope) and self-reported emotion data (n=612) from 26 partners (13 couples) managing diabetes mellitus type 2 in daily life. We extracted physiological, movement, acoustic, and linguistic features, and trained machine learning models (support vector machine and random forest) to recognize each partner's self-reported emotions (valence and arousal). Our results from the best models (balanced accuracies of 63.8% and 78.1% for arousal and valence respectively) are better than chance and our prior work that also used data from German-speaking, Swiss-based couples, albeit, in the lab. This work contributes toward building automated emotion recognition systems that would eventually enable partners to monitor their emotions in daily life and enable the delivery of interventions to improve their emotional well-being.

cs.HC

Development, Deployment, and Evaluation of DyMand -- An Open-Source Smartwatch and Smartphone System for Capturing Couples' Dyadic Interactions in Chronic Disease Management in Daily Life

Dyadic interactions of couples are of interest as they provide insight into relationship quality and chronic disease management. Currently, ambulatory assessment of couples' interactions entails collecting data at random or scheduled times which could miss significant couples' interaction/conversation moments. In this work, we developed, deployed and evaluated DyMand, a novel open-source smartwatch and smartphone system for collecting self-report and sensor data from couples based on partners' interaction moments. Our smartwatch-based algorithm uses the Bluetooth signal strength between two smartwatches each worn by one partner, and a voice activity detection machine-learning algorithm to infer that the partners are interacting, and then to trigger data collection. We deployed the DyMand system in a 7-day field study and collected data about social support, emotional well-being, and health behavior from 13 (N=26) Swiss-based heterosexual couples managing diabetes mellitus type 2 of one partner. Our system triggered 99.1% of the expected number of sensor and self-report data when the app was running, and 77.6% of algorithm-triggered recordings contained partners' conversation moments compared to 43.8% for scheduled triggers. The usability evaluation showed that DyMand was easy to use. DyMand can be used by social, clinical, or health psychology researchers to understand the social dynamics of couples in everyday life, and for developing and delivering behavioral interventions for couples who are managing chronic diseases.

cs.HC

Emotion Recognition among Couples: A Survey

Couples' relationships affect the physical health and emotional well-being of partners. Automatically recognizing each partner's emotions could give a better understanding of their individual emotional well-being, enable interventions and provide clinical benefits. In the paper, we summarize and synthesize works that have focused on developing and evaluating systems to automatically recognize the emotions of each partner based on couples' interaction or conversation contexts. We identified 28 articles from IEEE, ACM, Web of Science, and Google Scholar that were published between 2010 and 2021. We detail the datasets, features, algorithms, evaluation, and results of each work as well as present main themes. We also discuss current challenges, research gaps and propose future research directions. In summary, most works have used audio data collected from the lab with annotations done by external experts and used supervised machine learning approaches for binary classification of positive and negative affect. Performance results leave room for improvement with significant research gaps such as no recognition using data from daily life. This survey will enable new researchers to get an overview of this field and eventually enable the development of emotion recognition systems to inform interventions to improve the emotional well-being of couples.

cs.HC

Detecting Receptivity for mHealth Interventions in the Natural Environment

JITAI is an emerging technique with great potential to support health behavior by providing the right type and amount of support at the right time. A crucial aspect of JITAIs is properly timing the delivery of interventions, to ensure that a user is receptive and ready to process and use the support provided. Some prior works have explored the association of context and some user-specific traits on receptivity, and have built post-study machine-learning models to detect receptivity. For effective intervention delivery, however, a JITAI system needs to make in-the-moment decisions about a user's receptivity. To this end, we conducted a study in which we deployed machine-learning models to detect receptivity in the natural environment, i.e., in free-living conditions. We leveraged prior work regarding receptivity to JITAIs and deployed a chatbot-based digital coach~-- Ally~-- that provided physical-activity interventions and motivated participants to achieve their step goals. We extended the original Ally~app to include two types of machine-learning model that used contextual information about a person to predict when a person is receptive: a \textit{static model\/} that was built before the study started and remained constant for all participants and an \textit{adaptive model\/} that continuously learned the receptivity of individual participants and updated itself as the study progressed. For comparison, we included a \textit{control model\/} that sent intervention messages at random times. The app randomly selected a delivery model for each intervention message. We observed that the machine-learning models led up to a 40\% improvement in receptivity as compared to the control model. Further, we evaluated the temporal dynamics of the different models and observed that receptivity to messages from the adaptive model increased over the course of the study.

cs.HC