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Lawrence Cai

Publications and source records attributed to Lawrence Cai.

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WavesFM: Hierarchical Representation Learning for Longitudinal Wearable Sensor Waveforms

Wearable sensors enable the continuous acquisition of high-resolution physiological waveforms, such as photoplethysmography and accelerometry, under free-living conditions. However, inferring health-related phenotypes from these signals presents significant challenges due to high sampling frequencies, multimodal dependencies, and extreme sequence lengths (e.g., weeks of recordings), compounded by a scarcity of ground-truth labels. To address these challenges, existing self-supervised learning (SSL) methodologies typically follow two paradigms: (1) learning rich morphological representations from short waveform segments while collapsing longitudinal dynamics through simple aggregation, or (2) modeling behavioral patterns from coarse, hand-crafted features (e.g. heart rate, step counts) spanning longer horizons but foregoing subtle, predictive signatures in raw waveforms. To bridge this gap, we propose WavesFM, a foundation model utilizing a two-stage SSL framework for longitudinal physiological data. Specifically, we decompose the learning problem into two stages: first, a segment-level encoder is pretrained to extract local embeddings from short waveforms; subsequently, a temporal encoder is trained to model the sequence of these embeddings across a multi-day horizon. This hierarchical approach overcomes the computational complexity of high-resolution, long-sequence data, allowing the overall model to capture both local signal semantics and the complex circadian and inter-day variations governing physiological dynamics. Pretrained on over 6.8M hours (N=324k individuals) of recordings for the first stage and 5.3M hours (N=10k) for the second stage, WavesFM demonstrates superior performance across 58 diverse tasks spanning demographics, lifestyle, health conditions, and medications.

cs.LG

Beyond BMI: Smartphone Body Composition Phenotyping for Cardiometabolic Risk Assessment

Body Mass Index (BMI) is a widely accessible but imprecise proxy of cardiometabolic health. While assessing true body composition is superior, gold-standard methods like Dual-Energy X-ray Absorptiometry (DXA) are not scalable. We address this gap by developing and validating "PhotoScan," a method to estimate body composition from smartphone imagery. We pretrained a deep learning model on UK Biobank participants (N=35,323) and fine-tuned on a newly recruited clinical cohort (PhotoBIA cohort, N=677) with diverse ethnicity, age, and body fat distribution, achieving high accuracy against DXA for total body fat percentage (BF%, MAE = 2.15%), Android-to-Gynoid fat ratio (A/G, MAE = 0.11), and visceral-to-subcutaneous fat area ratio (V/S, MAE = 0.09). Generalizability of the model was demonstrated on an independent metabolic health study cohort (MetabolicMosaic cohort, N=132 participants), achieving MAEs of 2.13% for BF%, 0.09 for A/G, and 0.09 for V/S. We then evaluated the clinical utility of these metrics in the MetabolicMosaic cohort by predicting insulin resistance (IR). Adding PhotoScan-derived body composition metrics to baseline demographics model (Age, Sex, BMI) significantly improved insulin resistance classification (Area Under the Receiver Operating Characteristic Curve "AUROC" 76.0% vs 69.2%, DeLong test p=0.002, Net Reclassification Index "NRI" 0.593). Crucially, this accessible smartphone method achieved performance nearly equivalent to adding clinical-grade DXA data to baseline demographics model (AUROC 77.3% vs 69.2%, DeLong test p=0.004, NRI 0.748). These findings demonstrate that smartphone-based phenotyping captures clinically meaningful risk signals missed by BMI and anthropometrics, offering a scalable alternative to DXA for cardiometabolic risk stratification.

q-bio.QM

Smartphone monitoring of smiling as a behavioral proxy of well-being in everyday life

Subjective well-being is a cornerstone of individual and societal health, yet its scientific measurement has traditionally relied on self-report methods prone to recall bias and high participant burden. This has left a gap in our understanding of well-being as it is expressed in everyday life. We hypothesized that candid smiles captured during natural smartphone interactions could serve as a scalable, objective behavioral correlate of positive affect. To test this, we analyzed 405,448 video clips passively recorded from 233 consented participants over one week. Using a deep learning model to quantify smile intensity, we identified distinct diurnal and daily patterns. Daily patterns of smile intensity across the week showed strong correlation with national survey data on happiness (r=0.92), and diurnal rhythms documented close correspondence with established results from the day reconstruction method (r=0.80). Higher daily mean smile intensity was significantly associated with more physical activity (Beta coefficient = 0.043, 95% CI [0.001, 0.085]) and greater light exposure (Beta coefficient = 0.038, [0.013, 0.063]), whereas no significant effects were found for smartphone use. These findings suggest that passive smartphone sensing could serve as a powerful, ecologically valid methodology for studying the dynamics of affective behavior and open the door to understanding this behavior at a population scale.

cs.CV

A High-Throughput Platform to Bench Test Smartphone-Based Heart Rate Measurements Derived From Video

Smartphone-based heart rate (HR) monitoring apps using finger-over-camera photoplethysmography (PPG) face significant challenges in performance evaluation and device compatibility due to device variability and fragmentation. Manual testing is impractical, and standardized methods are lacking. This paper presents a novel, high-throughput bench-testing platform to address this critical need. We designed a system comprising a test rig capable of holding 12 smartphones for parallel testing, a method for generating synthetic PPG test videos with controllable HR and signal quality, and a host machine for coordinating video playback and data logging. The system achieved a mean absolute percentage error (MAPE) of 0.11% +/- 0.001% between input and measured HR, and a correlation coefficient of 0.92 +/- 0.008 between input and measured PPG signals using a clinically-validated smartphone-based HR app. Bench-testing results of 20 different smartphone models correctly classified all the devices as meeting the ANSI/CTA accuracy standards for HR monitors (MAPE <10%) when compared to a prospective clinical study with 80 participants, demonstrating high positive predictive value. This platform offers a scalable solution for pre-deployment testing of smartphone HR apps to improve app performance, ensure device compatibility, and advance the field of mobile health.

cs.CV

Passive Heart Rate Monitoring During Smartphone Use in Everyday Life

Resting heart rate (RHR) is an important biomarker of cardiovascular health and mortality, but tracking it longitudinally generally requires a wearable device, limiting its availability. We present PHRM, a deep learning system for passive heart rate (HR) and RHR measurements during everyday smartphone use, using facial video-based photoplethysmography. Our system was developed using 225,773 videos from 495 participants and validated on 185,970 videos from 205 participants in laboratory and free-living conditions, representing the largest validation study of its kind. Compared to reference electrocardiogram, PHRM achieved a mean absolute percentage error (MAPE) < 10% for HR measurements across three skin tone groups of light, medium and dark pigmentation; MAPE for each skin tone group was non-inferior versus the others. Daily RHR measured by PHRM had a mean absolute error < 5 bpm compared to a wearable HR tracker, and was associated with known risk factors. These results highlight the potential of smartphones to enable passive and equitable heart health monitoring.

q-bio.TO