Peter Smielewski

Chenyu Tang, Wentian Yi, Muzi Xu et al.

In wearable smart systems, continuous monitoring and accurate classification of different sleep-related conditions are critical for enhancing sleep quality and preventing sleep-related chronic conditions. However, the requirements for device-skin coupling quality in electrophysiological sleep monitoring systems hinder the comfort and reliability of night wearing. Here, we report a washable, skin-compatible smart garment sleep monitoring system that captures local skin strain signals under weak device-skin coupling conditions without positioning or skin preparation requirements. A printed textile-based strain sensor array responds to strain from 0.1% to 10% with a gauge factor as high as 100 and shows independence to extrinsic motion artefacts via strain-isolating printed pattern design. Through reversible starching treatment, ink penetration depth during direct printing on garments is controlled to achieve batch-to-batch performance variation < 10%. Coupled with deep learning, explainable artificial intelligence (XAI), and transfer learning data processing, the smart garment is capable of classifying six sleep states with an accuracy of 98.6%, maintaining excellent explainability (classification with low bias) and generalization (95% accuracy on new users with few-shot learning less than 15 samples per class) in practical applications, paving the way for next-generation daily sleep healthcare management.

Mengtian Kang, Yansong Hu, Shuo Gao et al.

Childhood myopia constitutes a significant global health concern. It exhibits an escalating prevalence and has the potential to evolve into severe, irreversible conditions that detrimentally impact familial well-being and create substantial economic costs. Contemporary research underscores the importance of precisely predicting myopia progression to enable timely and effective interventions, thereby averting severe visual impairment in children. Such predictions predominantly rely on subjective clinical assessments, which are inherently biased and resource-intensive, thus hindering their widespread application. In this study, we introduce a novel, high-accuracy method for quantitatively predicting the myopic trajectory and myopia risk in children using only fundus images and baseline refraction data. This approach was validated through a six-year longitudinal study of 3,408 children in Henan, utilizing 16,211 fundus images and corresponding refractive data. Our method based on deep learning demonstrated predictive accuracy with an error margin of 0.311D per year and AUC scores of 0.944 and 0.995 for forecasting the risks of developing myopia and high myopia, respectively. These findings confirm the utility of our model in supporting early intervention strategies and in significantly reducing healthcare costs, particularly by obviating the need for additional metadata and repeated consultations. Furthermore, our method was designed to rely only on fundus images and refractive error data, without the need for meta data or multiple inquiries from doctors, strongly reducing the associated medical costs and facilitating large-scale screening. Our model can even provide good predictions based on only a single time measurement. Consequently, the proposed method is an important means to reduce medical inequities caused by economic disparities.

Chenyu Tang, Shuo Gao, Cong Li et al.

Wearable silent speech systems hold significant potential for restoring communication in patients with speech impairments. However, seamless, coherent speech remains elusive, and clinical efficacy is still unproven. Here, we present an AI-driven intelligent throat (IT) system that integrates throat muscle vibrations and carotid pulse signal sensors with large language model (LLM) processing to enable fluent, emotionally expressive communication. The system utilizes ultrasensitive textile strain sensors to capture high-quality signals from the neck area and supports token-level processing for real-time, continuous speech decoding, enabling seamless, delay-free communication. In tests with five stroke patients with dysarthria, IT's LLM agents intelligently corrected token errors and enriched sentence-level emotional and logical coherence, achieving low error rates (4.2% word error rate, 2.9% sentence error rate) and a 55% increase in user satisfaction. This work establishes a portable, intuitive communication platform for patients with dysarthria with the potential to be applied broadly across different neurological conditions and in multi-language support systems.

Yanning Dai, Chenyu Tang, Ruizhi Zhang et al.

Dynamic prediction of locomotor capacity after stroke could enable more individualized rehabilitation, yet current assessments largely provide static impairment scores and do not indicate whether patients can perform specific tasks such as slope walking or stair climbing. Here, we present a wearable-informed data-physics hybrid generative framework that reconstructs a stroke survivor's locomotor control from wearable inertial sensing and predicts task-conditioned post-stroke locomotion in new environments. From a single 20 m level-ground walking trial recorded by five IMUs, the framework personalizes a physics-based digital avatar using a healthy-motion prior and hybrid imitation learning, generating dynamically feasible, patient-specific movements for inclined walking and stair negotiation. Across 11 stroke inpatients, predicted postures reached 82.2% similarity for slopes and 69.9% for stairs, substantially exceeding a physics-only baseline. In a multicentre pilot randomized study (n = 21; 28 days), access to scenario-specific locomotion predictions to support task selection and difficulty titration was associated with larger gains in Fugl-Meyer lower-extremity scores than standard care (mean change 6.0 vs 3.7 points; $p < 0.05$). These results suggest that wearable-informed generative digital avatars may augment individualized gait rehabilitation planning and provide a pathway toward dynamically personalized post-stroke motor recovery strategies.

Yulin Sun, Xiaopeng Si, Runnan He et al.

Timely identification of harmful brain activities via electroencephalography (EEG) is critical for brain disease diagnosis and treatment, which remains limited application due to inter-rater variability, resource constraints, and poor generalizability of existing artificial intelligence (AI) models. In this study, a convolutional neural network model, VIPEEGNet, was developed and validated using EEGs recorded from Massachusetts General Hospital/Harvard Medical School. The VIPEEGNet was developed and validated using two independent datasets, collected between 2006 and 2020. The development cohort included EEG recordings from 1950 patients, with 106,800 EEG segments annotated by at least one experts (ranging from 1 to 28). The online testing cohort consisted of EEG segments from a subset of an additional 1,532 patients, each annotated by at least 10 experts. For the development cohort (n=1950), the VIPEEGNet achieved high accuracy, with an AUROC for binary classification of seizure, LPD, GPD, LRDA, GRDA, and "other" categories at 0.972 (95% CI, 0.957-0.988), 0.962 (95% CI, 0.954-0.970), 0.972 (95% CI, 0.960-0.984), 0.938 (95% CI, 0.917-0.959), 0.949 (95% CI, 0.941-0.957), and 0.930 (95% CI, 0.926-0.935). For multi classification, the sensitivity of VIPEEGNET for the six categories ranges from 36.8% to 88.2% and the precision ranges from 55.6% to 80.4%, and performance similar to human experts. Notably, the external validation showed Kullback-Leibler Divergence (KLD)of 0.223 and 0.273, ranking top 2 among the existing 2,767 competing algorithms, while we only used 2.8% of the parameters of the first-ranked algorithm.

Xuhang Chen, Ihsane Olakorede, Stefan Yu Bögli et al.

Artefacts compromise clinical decision-making in the use of medical time series. Pulsatile waveforms offer probabilities for accurate artefact detection, yet most approaches rely on supervised manners and overlook patient-level distribution shifts. To address these issues, we introduce a generalised label-free framework, GenClean, for real-time artefact cleaning and leverage an in-house dataset of 180,000 ten-second arterial blood pressure (ABP) samples for training. We first investigate patient-level generalisation, demonstrating robust performances under both intra- and inter-patient distribution shifts. We further validate its effectiveness through challenging cross-disease cohort experiments on the MIMIC-III database. Additionally, we extend our method to photoplethysmography (PPG), highlighting its applicability to diverse medical pulsatile signals. Finally, its integration into ICM+, a clinical research monitoring software, confirms the real-time feasibility of our framework, emphasising its practical utility in continuous physiological monitoring. This work provides a foundational step toward precision medicine in improving the reliability of high-resolution medical time series analysis

Chenyu Tang, Ruizhi Zhang, Shuo Gao et al.

At-home rehabilitation for post-stroke patients presents significant challenges, as continuous, personalized care is often limited outside clinical settings. Moreover, the lack of integrated solutions capable of simultaneously monitoring motor recovery and providing intelligent assistance in home environments hampers rehabilitation outcomes. Here, we present a multimodal smart home platform designed for continuous, at-home rehabilitation of post-stroke patients, integrating wearable sensing, ambient monitoring, and adaptive automation. A plantar pressure insole equipped with a machine learning pipeline classifies users into motor recovery stages with up to 94\% accuracy, enabling quantitative tracking of walking patterns during daily activities. An optional head-mounted eye-tracking module, together with ambient sensors such as cameras and microphones, supports seamless hands-free control of household devices with a 100\% success rate and sub-second response time. These data streams are fused locally via a hierarchical Internet of Things (IoT) architecture, ensuring low latency and data privacy. An embedded large language model (LLM) agent, Auto-Care, continuously interprets multimodal data to provide real-time interventions -- issuing personalized reminders, adjusting environmental conditions, and notifying caregivers. Implemented in a post-stroke context, this integrated smart home platform increased mean user satisfaction from 3.9 $\pm$ 0.8 in conventional home environments to 8.4 $\pm$ 0.6 with the full system ($n=20$). Beyond stroke, the system offers a scalable, patient-centered framework with potential for long-term use in broader neurorehabilitation and aging-in-place applications.

Tom Edinburgh, Peter Smielewski, Marek Czosnyka et al.

Waveform physiological data is important in the treatment of critically ill patients in the intensive care unit. Such recordings are susceptible to artefacts, which must be removed before the data can be re-used for alerting or reprocessed for other clinical or research purposes. Accurate removal of artefacts reduces bias and uncertainty in clinical assessment, as well as the false positive rate of intensive care unit alarms, and is therefore a key component in providing optimal clinical care. In this work, we present DeepClean; a prototype self-supervised artefact detection system using a convolutional variational autoencoder deep neural network that avoids costly and painstaking manual annotation, requiring only easily-obtained 'good' data for training. For a test case with invasive arterial blood pressure, we demonstrate that our algorithm can detect the presence of an artefact within a 10-second sample of data with sensitivity and specificity around 90%. Furthermore, DeepClean was able to identify regions of artefact within such samples with high accuracy and we show that it significantly outperforms a baseline principle component analysis approach in both signal reconstruction and artefact detection. DeepClean learns a generative model and therefore may also be used for imputation of missing data.