Take it Personally: The Limits of General SSL Representations for Real-Life PPG Emotion Detection

While Self-Supervised Learning (SSL) effectively extracts general representations from noisy, unconstrained physiological signals such as photoplethysmography (PPG), its suitability for highly subjective tasks remains unproven. In this work, we evaluate the efficacy of PPG-based SSL for real-life intense emotion detection. First, we pretrain a Real-Life PPG encoder (RL-PPG) on unconstrained, real-life data. As a rigorous sanity check, we demonstrate that these representations transfer exceptionally well to an objective physical activity recognition task, yielding almost 5-fold increase in performance over baselines in a leave-one-subject-out evaluation (LOSO). However, when applied to a~subjective real-life emotion detection task, these same general representations fail to surpass naive baselines under the LOSO protocol. Using an Across-Time validation strategy, we establish that incorporating an individual's personal data during fine-tuning is the main driver of predictive performance, outweighing the benefits of population-level pretraining. Ultimately, our findings indicate that in the evaluated scenario, general SSL representations may be insufficient for subjective affective inference, suggesting that personalization is likely a key component for real-world emotion recognition. To support future research, we share the code and pretrained RL-PPG~encoder~weights.

DMT: Demographic Conditioning, Morphology-Enhanced Transformer for Cuffless Blood Pressure Estimation from PPG Signals

Blood pressure (BP) is a key marker for cardiovascular risk assessment and therapeutic decision-making, and Photoplethysmography (PPG) enables low-cost, wearable-friendly cuffless BP estimation. However, even with recent progress, many PPG-based models are trained with BP regression alone and may rely on amplitude-dominated shortcuts. In addition, demographic covariates that systematically modulate vascular compliance are often incorporated only via late fusion, limiting subject-specific representation learning. We propose a Transformer-based network for cuffless BP estimation from PPG signal, leveraging self-attention to capture long-range dependencies across multiple cardiac cycles. To account for subject-specific vascular differences, the model is conditioned on demographics via FiLM-style feature modulation applied through the attention and feed-forward sublayers of Transformer blocks. In addition, we add an auxiliary morphology head to guide the model to attend to BP-relevant waveform morphology associated with arterial stiffness and wave reflection. Under calibration-based evaluation protocols on the large-scale PulseDB dataset, the proposed method achieves MAE of 4.56 mmHg for systolic BP and 2.62 mmHg for diastolic BP, reducing errors by 47% and 50% compared with prior demographic-enhanced PPG baselines. The resulting lightweight, single-sensor model supports scalable and clinically grounded cuffless BP estimation in calibration-enabled deployment settings.

A Comprehensive Inference-Time Augmentation Framework in Physiological Signals: Application to PPG-Based AF Detection

Objective: Accurate classification of physiological signals in real-world deployments is challenged by sensor noise, motion artifacts, and distribution shifts between training and deployment data. Inference-time augmentation (ITA), which applies augmentations during inference rather than retraining, offers a simple, model-agnostic mechanism to improve robustness. However, ITA application to physiological signals has remained narrow in scope, relying on limited augmentation methods with fixed, unoptimized parameters. This work proposes a unified ITA framework to address that gap. Approach: The framework incorporates 13 augmentation methods spanning time-domain, amplitude-domain, frequency-domain, and artifact-injection transformations, with hyperparameters optimized via Bayesian optimization. We evaluate on atrial fibrillation (AF) detection from 30-second PPG signals using GPT-PPG and ResNet across five datasets comprising more than 400 patients and ${\sim}$9,800 hours of recording. Main results: Standard ITA consistently improved AUROC (up to 8.5% for GPT-PPG and 0.7% for ResNet) and AUPRC (up to 10.6% for GPT-PPG and 0.8% for ResNet). Selective ITA further reduced average FPR by up to 4.4% (GPT-PPG) and 1.3% (ResNet) on non-AF datasets. Significance: These findings establish ITA as a practical, model-agnostic approach for improving PPG-based AF classification reliability in deployment settings where retraining is not feasible, with broader applicability to physiological signal analysis.