Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 12 appraisals
Biomedical physics & engineering express
Stabilizing neuromorphic ECG processors via adaptive fractional fatigue
Spiking neural networks (SNNs) deployed on wearable devices can exhibit runaway firing when processing noisy electrocardiogram (ECG) signals, increasing switching activity and dynamic power and destabilising power regulation. To suppress redundant firing while preserving ECG classification performance, we introduce the adaptive fractional fatigue (AFF) SNN, which equips each hidden neuron with a power-law weighted memory buffer of its past membrane states, thereby forming a fractionally-inspired activity trace that drives an adaptive threshold: as the accumulated trace rises with sustained firing, the effective threshold increases and suppresses further spikes, implementing an intrinsic negative feedback loop. Ten independent seeds were evaluated with a fixed random train/test split of2969/743heartbeat windows (lengthT=180;3712balanced windows total;1856normal,1856arrhythmia) drawn from three publicly available Massachusetts Institute of Technology-Beth Israel Hospital records, with spikes per sample as the primary energy proxy and test accuracy and the area under the receiver operating characteristic curve as secondary endpoints. Spikes/sample decreased from2384.990±537.719(integer-order) to891.481±227.654(AFF), a62.62%reduction (bootstrap 95% confidence interval[54.00%,69.35%]), which was statistically significant (pairedt-testp=0.000015two-sided; Wilcoxon signed-rankp=0.001953two-sided; paired effect sizedz=-2.662). Accuracy was preserved (78.923±1.725%vs79.206±1.541%; pairedt-testp=0.227761), and cross-seed spike variance decreased by a factor of5.58×. AFF suppresses noise-driven hyperactivity and stabilises event traffic, delivering a statistically significant reduction in spikes/sample without accuracy loss and improving predictability for low-power neuromorphic ECG deployment.
30 May 2026
Read appraisal →Progress in biomedical engineering (Bristol, England)
Soft pneumatic actuators for wearable systems: a structural classification and integration-oriented evaluation
Soft pneumatic actuators promise gentle, body-safe assistance, yet many fail at the moment of integration: inflation alters geometry, increases profile, and stresses seams and ports. This topical review reframes actuator selection through a structure-first lens that links how an actuator is built to how it deforms and how it embeds in garments. Actuators are classified by structural architecture, deformation behavior, and fabrication method, and evaluated against four integration criteria central to wearable systems: geometric compatibility, fabrication scalability, system integration readiness, and actuation simplicity. A staged selection pathway is proposed and presented as a literature-informed mapping table that links reported wearable application contexts to dominant integration priorities and a practical structural-class starting point. Planar sheet designs can preserve a thin, predictable pressurized envelope at modest pressures when seam paths, constraint layers, and attachment features are co-designed. Pouch and bladder actuators are thin at rest, simple to fabricate, and readily integrated with textiles, but commonly bulge under load without external constraint; envelope control and port or manifold routing frequently limit garment integration. Fiber-constrained actuators deliver high specific force but often require rigid end terminations and elevated pressures. Segmented elastomers provide rich kinematics through chamber layout while tending toward bulging and routing burden in multi-segment formats. Mechanical metamaterials realize geometry-programmed motion when hinge fidelity and pattern alignment are maintained; durability of compliant joints and consistent crease formation set current limits. The resulting synthesis identifies practical priorities for wearable use: preserve thin profiles under load, embed stitchable or bondable attachment features, document reproducible process windows, minimize dead volume, routing, and valve count with compact pneumatic architectures, and target low-pressure operation compatible with lightweight hardware. Framing integration in structural terms standardizes comparison across actuator classes, clarifies the narrow feasible design space for compact, body-conforming devices, and supports deliberate actuator choice for biomedical wearables.
29 May 2026
Read appraisal →ACS applied materials & interfaces
Boosting Piezoelectricity and Mechanical Properties of Silk Fibroin Films via Polyethylene Glycol Phase Manipulation
Piezoelectric silk fibroin (SF) shows great potential in fabricating sustainable wearable electronics toward health monitoring and human-machine interfacing, yet the processing difficulty and brittleness restrict its practical applications severely. This study proposes a simple strategy to achieve the boosted piezoelectricity and mechanical properties in electrospun regenerated silk fibroin (RSF) nanofiber mats by adding polyethylene glycol (PEG) with different molecular weights to induce the formation of β-sheets via hydrogen bonding and the regulation of PEG phase morphology. Specifically, RSFs consisting of PEG of 2000 and 1000 Da exhibit a significant improvement in the tensile strength (from 6.1 to 9.92 MPa) and elongation at break (from 5.72% to 117.58%), respectively. Meanwhile, RSFs consisting of PEG with a molecular weight of 2000 and 400 Da show a direct piezoelectric force sensitivity of 0.2 mV/N·μm and 0.14 mV/N·μm respectively, superior to that of pure RSF (0.04 mV/N·μm). The piezoelectric force sensors fabricated with RSFs show potential applications in the detection of diverse human motions, including finger tapping for Morse code, grip strength, and knee flexion. Thus, this work unveils a facile strategy to fabricate RSF-based biodegradable piezoelectric force sensors with a trade-off in processability, mechanical ductility, and piezoelectricity.
28 May 2026
Read appraisal →Proceedings of the National Academy of Sciences of the United States of America
Soft, skin-interfaced electronics enable cannula-free wireless monitoring of sleep respiration.
Sleep-related breathing disorders are prevalent yet frequently underdiagnosed, in part due to limitations of conventional respiratory monitoring technologies. Standard nasal cannulas introduce airflow resistance, discomfort, and poor long-term adherence, constraining at-home and longitudinal assessment. Here, we report a soft, skin-interfaced nasal patch that enables cannula-free, wireless monitoring of respiratory activity during sleep. The device is constructed from ultrathin, elastomeric materials that conform to the nasal surface, coupling respiratory-induced tissue deformation to a strain-sensing element. The mechanics of the skin-device interface and the elastomeric response govern the sensitivity and linearity of signal transduction, enabling quantitative capture of breathing dynamics. An integrated wireless platform transmits deformation signals directly to mobile devices, eliminating the need for external tubing or tethered modules. Modular fabrication permits replacement of the strain sensor and skin-contact interface without compromising mechanical performance. Mechanical characterization under physiologically relevant deformation demonstrates high repeatability and low hysteresis, while in vivo studies confirm that the patch accurately reproduces respiratory waveforms and correlates closely with gold-standard nasal cannula measurements. By integrating soft materials mechanics, wearable strain sensing, and wireless electronics, this system provides a minimally obtrusive platform for continuous respiratory monitoring. The class of technologies presented in this work establishes design principles for skin-interfaced devices, in which elastomeric mechanics, strain transduction, and wireless integration combine to enable quantitative, unobtrusive physiological monitoring in clinical and home environments.
22 May 2026
Read appraisal →Science advances
SkinECG: An orthogonal remote powering wearable skin-like sensor
The Internet of Things (IoT) era witnessed a surge in wearable devices for the human body, each requiring a power source that supports long-term operation. However, batteries are depletable and require replacement, while the effectiveness of energy-harvesting techniques is location specific. We developed the SkinECG system, an orthogonal remote powering skin-like electrocardiogram (ECG) sensor. It is powered by body-coupled powering (BCP) using power acquired optimally via suitable energy harvesters at different locations on the human body, solving the location mismatch between the energy-harvesting source and sensor. The remote Orthogonal Energy Harvesting Network (O-EHN) effectively transfers power from multiple energy-harvesting sources without internode interference and cancellation. We demonstrated the 0.71-mm-thin, flexible SkinECG system that conforms to the human chest and detects ECG signals without any cumbersome batteries or directly connected power for long-term health monitoring.
5 May 2026
Read appraisal →Science advances
Augmenting ultrasound for continuous glucose monitoring via a wearable acoustically readable microneedle patch
Continuous glucose monitoring (CGM) represents substantial advancement, yet poses a challenge in wearable health care development. Current enzymatic CGM faces limitations in stability, cost, and durability. We introduce an enzyme-free, wearable acoustically readable microneedle patch (ARMPatch) composed of glucose-responsive hydrogel. Positioned between a standard ultrasound probe and the skin, ARMPatch acts as an acoustic interface enabling CGM using conventional ultrasound. Its hydrogel microneedles minimally penetrate the epidermis, allowing interstitial fluid to trigger variable swelling of the microneedles in response to glucose fluctuations. ARMPatch delivers stable and selective glucose readings for up to 56 days. Glucose variations with millimolar resolution are obtained via ultrasound within a response time of 30 to 60 minutes. In vivo CGM in animal models for 7 days reveals a reversible correlation between microneedle swelling and glucose variations. Acting as "accessory" for standard ultrasound probes, this approach offers a minimally invasive, cost-effective, and long-lasting solution to non-enzymatic CGM, expanding the utility of ultrasound in wearable biosensing.
5 May 2026
Read appraisal →ACS applied materials & interfaces
Fingerprint-Inspired Recyclable Electronic Skin for Non-Contact Urinary Incontinence Monitoring and Sensing
The development of high-performance flexible electronics faces a fundamental challenge: balancing sophisticated multimodal sensing and end-of-life environmental sustainability. Drawing inspiration from the human fingerprint, we present a microelectronic-printing-based arch-shaped sensor that resolves this conflict by integrating dual-mode (contact/non-contact) sensing with inherently recyclable components. The device, fabricated through high-resolution printing of liquid metal circuits (with line widths below 200 μm) on functionally tailored substrates, exhibits a sensitivity of 3.07 kPa-1 and a response time under 60 ms. It operates across a broad pressure range (0-15 kPa) in contact mode and senses proximity up to 5 cm. This robust performance enables an integrated wireless system for encrypted communication, gesture-trajectory tracking, and dynamic gesture recognition with 92.67% classification accuracy. Notably, we demonstrate a closed-loop lifecycle for the key functional materials, achieving 86.2% recovery and direct reuse of the liquid metal conductor. This work provides a versatile design strategy that simultaneously meets the demands for performance, functionality, and sustainability, offering a practical platform for future green and intelligent wearable technologies.
3 May 2026
Read appraisal →Carbohydrate polymers
Multifunctional conductive hydrogel based on carboxymethyl cellulose/oxidized sodium alginate for machine learning-guided sports training
Multifunctional hydrogels have shown great promise in advanced wearable sensing technologies; however, their performance under real-world sweaty and dynamic conditions remains a significant challenge. In this study, a highly conductive and adhesive hydrogel was developed using poly(AM-co-AA), carboxymethyl cellulose (CMC), oxidized sodium alginate (OSA), and polydopamine-modified carbon nanotubes (PDA-CNT). Featuring a dual dynamic cross-linking system based on reversible Schiff base bonds and strong hydrogen bonding, the hydrogel demonstrates high mechanical toughness (2416 kJ/m3), excellent stretchability (1829%), and stable electrical conductivity (1.5 S/m). It exhibits outstanding sweat resistance, maintaining strong adhesion and reliable sensing performance even during intense physical activities, along with high fatigue resistance over 10,000 deformation cycles, enabling long-term reliable monitoring. As a highly sensitive strain sensor, it offers multi-range gauge factors (up to 2.53) and accurately captures human motion and physiological signals without interference from sweat or motion artifacts. When integrated with machine learning algorithms, the sensor achieves a validation accuracy of 98.75%, providing real-time feedback on movement techniques and supporting personalized training optimization. Furthermore, the hydrogel demonstrates significant antibacterial properties and good biocompatibility, making it an ideal candidate for next-generation wearable electronic devices suited for long-term athletic training and high-sweat environments.
17 Apr 2026
Read appraisal →Nanoscale
Bifunctional PVDF/MXene membranes with high piezoelectric sensitivity and near infrared photothermal antibacterial efficacy toward wearable human activity monitoring
In the realm of wearable health monitoring, establishing a reliable interface that ensures both high-fidelity sensing and long-term biological safety remains a critical challenge, particularly due to the risk of bacterial infection caused by sweat accumulation at the device-skin contact. Herein, we address this issue by developing a scenario-driven, bifunctional PVDF/MXene nanofibrous membrane that integrates robust piezoelectric performance with on-demand photothermal antibacterial capability. In this design, MXene nanosheets function simultaneously as nucleating agents to boost the electroactive β-phase content of PVDF from 80.3% to 93.3% and as efficient near-infrared (NIR) photothermal agents. The optimized membrane exhibits a superior piezoelectric sensitivity of 0.502 V/N, enabling the precise detection of diverse human activities ranging from subtle pulse waveforms to vigorous jumping motions, and motion-triggered Morse code communication. Crucially, addressing the hygiene concerns of reusable wearables, the membrane achieves rapid, non-contact sterilization during off-wear intervals. Under safe NIR irradiation (0.3 W cm-2), the surface temperature rises to ∼60 °C within 60 s, achieving an antibacterial efficacy of >99% against S. aureus and E. coli. Combined with excellent in vitro cytocompatibility, this work provides a "one-structure, dual-function" solution for constructing hygienic, high-performance electronic skins.
17 Apr 2026
Read appraisal →Biomacromolecules
A Phase-Separated Cellulose-Ionogel via Sunlight-Initiated Green Fabrication for Self-Powered Wearable Sensors
Ionogels, as soft ionic conductors, face synthesis challenges including toxicity, complexity, and high energy consumption. Herein, we present a green one-pot strategy that effectively dissolves cellulose and undergoes sunlight-induced photopolymerization to form ionogels without the need for cross-linkers or initiators. 1-Butyl-3-methylimidazolium chloride ([BMIM]Cl), as the solvent, enables the disruption of the extensive hydrogen-bond network of cellulose, resulting in rapid and complete dissolution. Subsequent one-step photopolymerization, which proceeds solely under sunlight, simultaneously drives in situ cross-linking and a controlled phase separation process, yielding high-performance ionogels. Importantly, the resulting cellulose ionogel exhibits superior fracture strength (2.75 MPa), high toughness (18.4 MJ m-3), and strong adhesion (6.6 MPa), ameliorating the traditional trade-off between mechanical strength and adhesion capabilities. This work develops an integrated ionogel platform as a soft TENG electrode for human motion monitoring, informing the design of sustainable self-powered electronics.
14 Apr 2026
Read appraisal →ACS applied materials & interfaces
NeuroTex: Functionalized Hybrid Polymer-Metal Textile for Soft, Robust, and Dry Auricular Neural Interfaces
Wearable bioelectronics would benefit from dry, easy-to-apply electrodes for sensing physiological signals. Bioelectronic interfaces must maintain high conductivity, low electrode-skin impedance, and reliable coupling between the electrode and skin under sweat, motion, and prolonged use. Metallic textiles offer good conductivity and stable connections but are hydrophobic, prone to cracking and oxidation, and dependent on conductive gels to achieve the low impedance required for low-amplitude electrophysiological signals. Here, we introduce NeuroTex, a commercially available silver nanowire textile that is PEDOT:PSS-functionalized to improve the electrode-skin-electronics interface. The PEDOT:PSS coating reduced the area-normalized resistance of the textile by almost 50%, suppressed silver oxidation in phosphate-buffered saline, and lowered the contact impedance by more than 85%. Mechanical evaluations under torsion, stretching, bending, and low-force fatigue confirmed the preserved fiber integrity and intact electronic connectivity. Furthermore, the soft and hydrophilic properties of the coating enhanced the conformal skin interfacing. Integrated into an in-ear monitoring platform, NeuroTex enabled multimodal biosignal recordings of in-ear electroencephalography (ieEEG), electro-oculography (ieEOG), electromyography (ieEMG), and electrocardiography (ieECG). Reliable acquisition of the technically demanding ieEEG signal was achieved, demonstrating alpha-modulation responses comparable to those of gel-based electrodes. ieEEG recordings recorded over several hours captured distinct sleep patterns to further confirm stable performance during natural sleep. These results establish NeuroTex as a gel-free, mechanically resilient, and electrochemically stable interface suitable for wearable physiological monitoring.
10 Apr 2026
Read appraisal →Physiological measurement
NeuroSleep: neuromorphic event-driven single-channel EEG sleep staging for edge-efficient sensing
Objective. Reliable, continuous neural sensing on wearable edge platforms is fundamental to long-term health monitoring; however, for electroencephalography (EEG)-based sleep monitoring, dense high-frequency processing is often computationally prohibitive under tight energy budgets.Approach. To address this bottleneck, this paper proposes NeuroSleep, an integrated event-driven sensing and inference system for energy-efficient sleep staging. NeuroSleep first converts raw EEG into complementary multi-scale bipolar event streams using Residual Adaptive Multi-Scale Delta Modulation, enabling an explicit fidelity-sparsity trade-off at the sensing front end. Furthermore, NeuroSleep adopts a hierarchical inference architecture that comprises an Event-based Adaptive Multi-scale Response module for local feature extraction, a Local Temporal-Attention Module for context aggregation, and an epoch-leaky integrate-and-fire module to capture long-term state persistence.Main results. Experimental results using subject-independent 5-fold cross-validation on the sleep-EDF expanded sleep-cassette subset (78 subjects, 153 overnight recordings) with single-channel EEG demonstrate that NeuroSleep achieves a mean accuracy of 74.2% with only 0.932 M parameters while reducing sparsity-adjusted effective operations by approximately 53.6% relative to dense processing. Compared to the representative dense Transformer baseline, NeuroSleep improves accuracy by 7.5% with a 45.8% reduction in computational load.Significance. By coupling neuromorphic event encoding with state-aware context modeling, NeuroSleep offers a deployment-oriented framework for single-channel sleep staging that reduces redundant high-rate processing and improves energy scalability for wearable and edge platforms.
8 Apr 2026
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