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Article
| Open AccessA noninvasive model for chronic kidney disease screening and common pathological type identification from retinal images
The diagnosis and prognosis of chronic kidney disease (CKD) relies on invasive renal biopsies, which can be clinically constrained. Here, the authors develop a non-invasive model using retinal images that can be used to screen for CKD and identify five common pathological types of CKD.
- Qianni Wu
- , Jianbo Li
- & Haotian Lin
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Article
| Open AccessSARS-CoV-2 rebound and post-acute mortality and hospitalization among patients admitted with COVID-19: cohort study
SARS-CoV-2 rebound is a recurrence of symptoms or return to test positivity after initial recovery. Here, the authors demonstrate an association between SARS-CoV-2 rebound and post-acute COVID conditions using data from Hong Kong.
- Ka Chun Chong
- , Yuchen Wei
- & Zihao Guo
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Article
| Open AccessImpact of the COVID-19 pandemic on incident diagnoses in German refugee centres 2018 to 2023
Refugee populations have been at high risk of COVID-19 but the impacts of the pandemic on healthcare-seeking and diagnosis of other conditions are not well described. Here, the authors use data from a network of refugee centres in Germany to explore impacts of the COVID-19 pandemic on incident diagnosis patterns.
- Kayvan Bozorgmehr
- , Stella Erdmann
- & Rosa Jahn
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Article
| Open AccessLarge-vocabulary forensic pathological analyses via prototypical cross-modal contrastive learning
To overcome various challenges in forensic pathology, the authors present SongCi, a visual-language AI trained on multi-modal autopsy cases of various cohorts. SongCi detects diverse post-mortem diseases and injuries and gives clear image-text explanations for forensic analysis, rivaling senior pathologists.
- Chen Shen
- , Chunfeng Lian
- & Zhenyuan Wang
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Article
| Open AccessOpen-source computational pipeline flags instances of acute respiratory distress syndrome in mechanically ventilated adult patients
Acute respiratory distress syndrome (ARDS) in intensive care unit patients is an often underdiagnosed but life-threatening condition. Here, the authors develop an open-source tool that uses machine learning to automatically detect ARDS.
- Félix L. Morales
- , Feihong Xu
- & Luís A. Nunes Amaral
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Article
| Open AccessAccelerated brain ageing during the COVID-19 pandemic
This study shows that the COVID-19 pandemic accelerated brain ageing in UK adults, even without infection. The effect was stronger in older individuals, in men, and those from deprived backgrounds. Cognitive decline was seen only in those infected.
- Ali-Reza Mohammadi-Nejad
- , Martin Craig
- & Dorothee P. Auer
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Article
| Open AccessSilicon nanocolumn-based disposable and flexible ultrasound patches
A lead-free, flexible, and disposable ultrasound patch using silicon nanocolumns enables vascular imaging and real-time blood pressure monitoring, offering a low-cost and eco-friendly solution for wearable medical diagnostics.
- Dong-Hyun Kang
- , Seonghun Cho
- & Byung Chul Lee
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Article
| Open AccessEvolving infectious disease dynamics shape school-based intervention effectiveness
School-based non-pharmaceutical interventions were widely used for COVID-19 control. Here, the authors use simulations to investigate how the potential effectiveness of these interventions can vary depending on the relative contribution of community and school-based transmission.
- Javier Perez-Saez
- , Mathilde Bellon
- & Elsa Lorthe
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Article
| Open AccessEvaluating the safety of XBB.1.5-containing COVID-19 mRNA vaccines using a self-controlled case series study
SARS-CoV-2 vaccines containing Omicron subvariant XBB 1.5 were introduced in the United States in 2023. Here, the authors assess the safety of these vaccines by analysing the occurrence of 15 adverse events of special interest following vaccine receipt using electronic health record data.
- Yuanyi Pan
- , Yun Han
- & Christopher G. Chute
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Article
| Open AccessThe Helicobacter pylori AI-clinician harnesses artificial intelligence to personalise H. pylori treatment recommendations
Higgins et al. present an AI tool that uses patient data to personalise treatment for Helicobacter pylori, the leading agent of gastric cancer, demonstrating improved eradication rates over prescribed therapies in retrospective clinical analysis.
- Kyle Higgins
- , Olga P. Nyssen
- & Kirill Veselkov
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Article
| Open AccessGenerative AI enables medical image segmentation in ultra low-data regimes
The use of deep learning in medical image segmentation is limited by the low availability of annotated images. Here, the authors develop GenSeg, a generative deep learning framework that can generate high-quality paired segmentation masks and medical images that can improve the performance of segmentation models under ultra low-data regimes across multiple scenarios.
- Li Zhang
- , Basu Jindal
- & Pengtao Xie
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Article
| Open AccessAchieving Quality and Effectiveness in Dementia Using Crisis Teams (AQUEDUCT): a randomised controlled trial evaluating the impact of a best practice Resource Kit used by teams managing crisis in dementia
This study found no significant impact of the AQUEDUCT Best Practice Resource Kit on psychiatric hospital admissions for people with dementia, highlighting implementation challenges and the need for further evaluation.
- M. Orrell
- , L. O’Raw
- & D. Challis
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Article
| Open AccessRisk assessment and perspectives of local transmission of chikungunya and dengue in Italy, a European forerunner
Dengue and chikungunya are an increasing public health concern in Europe, and Italy is particularly affected. Here, the authors analyse travel-related cases and outbreaks in Italy from 2006 to 2023 and assess current transmission risks.
- Francesco Menegale
- , Mattia Manica
- & Flavia Riccardo
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Article
| Open AccessConnective tissue disorder and high risk pregnancy: a case series with personalised external aortic root support (PEARS)
Aortopathy poses a high risk of aortic dissection, particularly during pregnancy and the postpartum period. Here the authors report a retrospective case series of seven women with aortopathy who underwent PEARS, a surgical strategy to prevent aortic root dilatation, and a subsequent pregnancy.
- Claudia Montanaro
- , Polona Kacar
- & Michael A. Gatzoulis
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Article
| Open AccessThe impact of elective surgical hubs on elective surgery in acute hospital trusts in England
Elective surgical hubs in England aim to improve efficiency, reduce cancellations, and enhance patient and staff experiences by focusing on High-Volume, Low Complexity (HVLC) surgeries. Here, the authors show that new hubs significantly increased HVLC surgery rates and established hubs demonstrated resilience during the Covid-19 pandemic.
- Melissa Co
- , Tatjana Marks
- & Geraldine M. Clarke
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Article
| Open AccessRespiratory syncytial virus hospitalisation by chronological month of age and by birth month in infants
Passive immunisation for respiratory syncytial virus for infants is recommended by the World Health Organization but products currently available have limited duration of protection. Here, the authors investigate the age distribution of infant hospitalisation for respiratory syncytial virus to inform optimal timing of immunisation.
- Ling Guo
- , Sebastien Kenmoe
- & Eva Molero
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Article
| Open AccessEthnic disparities in COVID-19 mortality and cardiovascular disease in England and Wales between 2020-2022
Ethnic disparities in severe outcomes of COVID-19 were observed from early in the pandemic. Here, the authors investigate whether differences in mortality and cardiovascular disease outcomes persisted until 2.5 years after the start of the pandemic using electronic health record data from England and Wales.
- Marta Pineda-Moncusí
- , Freya Allery
- & Sara Khalid
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Article
| Open AccessIntraoperative nerve-specific fluorescence visualization in head and neck surgery: a Phase 1 trial
Surgical nerve injuries can cause significant morbidity, yet no approved fluorescent agents exist for visualization. Here, the authors show in a Phase I multi-site trial that bevonescein was safe, established optimal dosing and timing, and provided a fluorescence signal for intraoperative nerve identification.
- Yu-Jin Lee
- , Ryan K. Orosco
- & Eben L. Rosenthal
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Comment
| Open AccessHealth data issues in Africa: time for digitization, standardization and harmonization
This commentary discusses health data challenges in Africa, focusing on digitization, standardization, and harmonization as key solutions. It highlights how addressing these foundational issues can enable AI and data science to transform healthcare systems across the continent.
- Abdoelnaser Degoot
- , Ismaël Koné
- & Bubacarr Bah
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Article
| Open AccessCost-effectiveness of the ReDIRECT/counterweight-plus weight management programme to alleviate symptoms of long COVID
A recent randomised controlled trial demonstrated effectiveness of a remote diet intervention to reduce long covid symptoms in people living with overweight/obesity in the UK. Here, the authors assess the cost-effectiveness of this intervention from the health system and societal perspectives.
- Heather L. Fraser
- , Laura Haag
- & Emma McIntosh
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Article
| Open AccessSystematic review of post-COVID condition in Nordic population-based registry studies
Nordic countries maintain population-based registries that have been used to quantify long-term impacts of COVID-19. Here, the authors conduct a systematic review including studies from Sweden, Denmark and Norway on incidence of post-COVID condition, associated healthcare use, sick leave, and new onset diseases.
- Jan Peter William Himmels
- , Karin Magnusson
- & Kjetil Gundro Brurberg
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Article
| Open AccessPotential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa
Long-acting injectable drugs for viral suppression of HIV are not yet available in African settings. Here, the authors present a mathematical modelling and cost effectiveness study of a long-acting drug combination in adults living with HIV in East, Central, Southern and West Africa.
- Andrew Phillips
- , Jennifer Smith
- & Paul Revill
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Article
| Open AccessAir pollution-induced proteomic alterations increase the risk of child respiratory infections
Ambient air pollution exposure in early childhood has been linked to infection risk but the mechanism is unclear. Here, the authors investigate the association between air pollution-linked proteomic profiles in pregnancy and infection in early childhood using data from Denmark and Sweden.
- Nicklas Brustad
- , Tingting Wang
- & Bo Chawes
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Article
| Open AccessPersonalized azithromycin treatment rules for children with watery diarrhea using machine learning
Pathogen diagnostics are strong determinants of azithromycin effects on diarrhea duration, but host factors may better predict benefits for severe outcomes. In this work, authors utilise a machine learning-based approach to evaluate personalized rules for the decision to treat watery diarrhea with azithromycin.
- Sara S. Kim
- , Allison Codi
- & Elizabeth T. Rogawski McQuade
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Article
| Open AccessCharacterizing trachoma elimination using serology
The study advances the use of serological surveys to guide trachoma elimination program decisions and provides a way to set thresholds for whether or not to continue an intervention program.
- Everlyn Kamau
- , Pearl Anne Ante-Testard
- & Benjamin F. Arnold
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Article
| Open AccessFrailty and depressive symptoms in relation to cardiovascular disease risk in middle-aged and older adults
Global aging emphasizes the exploration of frailty and depression in relation to incident CVD in middle-aged and older adults. Here, the authors show that frailty is associated with increased CVD risk, partially through depression, with the association influenced by frailty transitions and stronger in males, the elderly, and those with unhealthy lifestyles.
- Zheng Zhang
- , Huijie Xu
- & Yuanyuan Wang
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Article
| Open AccessInvestigating setting-specific superspreading potential and generation intervals of COVID-19 in Hong Kong
Super spreading events are considered important contributors to the spread of COVID−19, but the extent to which superspreading varies by transmission setting is unclear. Here, the authors demonstrate heterogeneity in superspreading and the generation interval between COVID−19 cases in different settings using data from Hong Kong.
- Dongxuan Chen
- , Dillon C. Adam
- & Sheikh Taslim Ali
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Article
| Open AccessA machine learning model using clinical notes to identify physician fatigue
Physician fatigue can impact patient care. Here, the authors develop a machine learning model to identify physician fatigue using written clinical notes.
- Chao-Chun Hsu
- , Ziad Obermeyer
- & Chenhao Tan
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Article
| Open AccessA skin-interfaced three-dimensional closed-loop sensing and therapeutic electronic wound bandage
Electronic wound bandages have to balance conformability and wound healing properties. Here, the authors develop a smart patch (iSAFE) using biomaterials with bioelectronics to facilitate permeability with waterproofing. This achieves intelligent wound management with real-time wound monitoring and active therapy.
- Xingcan Huang
- , Qiang Zhang
- & Xinge Yu
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Article
| Open AccessDeep learning quantifies pathologists’ visual patterns for whole slide image diagnosis
This study uses deep learning and gaze-tracking to track pathologists' work and learn how they review tissue images. This “learned expertise” was applied to guide artificial intelligence models, such as weakly supervised learning and reinforcement learning, to achieve accurate diagnosis of Whole Slide Images.
- Tianhang Nan
- , Song Zheng
- & Xiaoyu Cui
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Article
| Open AccessLevosimendan for postoperative subclinical heart failure after noncardiac surgery: a randomized, double-blinded, phase III trial
Here, the authors investigate the effect of perioperative levosimendan on postoperative subclinical heart failure, evaluated via NT-proBNP measurements in cardiac risk patients undergoing noncardiac surgery, and show no significant difference between levosimendan and placebo on the postoperative maximum NT-proBNP release.
- Christian Reiterer
- , Barbara Kabon
- & Edith Fleischmann
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Article
| Open AccessEngineering STING Nanoadjuvants for spatiotemporally-tailored innate immunity stimulation and cancer vaccination therapy
Spatiotemporally activating DC cells in lymph nodes (LN) for cancer vaccine therapy remains a challenge. Here the authors combine antigen loaded STING nanoadjuvants with LN-confined laser or ultrasound stimulation to activate DC cells, sequentially enhances antigen-specific CD8+ T cell response and reduces tumor size.
- Fangmin Chen
- , Huijuan Zhang
- & Haijun Yu
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Article
| Open AccessExtracting circumstances of Covid-19 transmission from free text with large language models
Open-ended survey questions may provide useful detail on possible venues of transmission of infectious diseases, but data are difficult to analyse at scale. Here, the authors use large language models to extract potential transmission venues in ~80,000 responses to an open-ended COVID-19 survey question in France.
- Gaston Bizel-Bizellot
- , Simon Galmiche
- & Christophe Zimmer
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Article
| Open AccessMultiplexed self-adaptable Janus hydrogels rescue epithelial malfunction to promote complete trachea repair
Epithelial malfunction is an unmet critical challenge in trachea repair. Here, Chen et al. developed a multiplexed hydrogel to promote tracheal repair with native-like epithelium in pre-clinical models, exhibiting clinical translation potential.
- Yi Chen
- , Hai Tang
- & Chang Chen
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Article
| Open AccessAI-Based screening for thoracic aortic aneurysms in routine breast MRI
Routine breast MRI scans provide an opportunity to screen for thoracic aortic aneurysms, which are more fatal in women. Here, the authors show that a fully automated AI tool can screen for these aneurysms using routine breast MRI scans.
- Dimitrios Bounias
- , Tobit Führes
- & Sebastian Bickelhaupt
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Article
| Open AccessEfficacy of clindamycin and LACTIN-V for in vitro fertilization patients with vaginal dysbiosis: a randomised double-blind, placebo-controlled multicentre trial
Here, the authors present the results of a randomised, double-blind, placebo-controlled trial testing whether clindamycin and live Lactobacillus crispatus CTV-05 (LACTIN-V) improve clinical pregnancy rates in IVF patients with abnormal vaginal microbiota, showing that successful treatment of vaginal dysbiosis was independent and not related to the reproductive success.
- Thor Haahr
- , Nina la Cour Freiesleben
- & Peter Humaidan
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Perspective
| Open AccessFrom precision interventions to precision health
We consider the shift from broad, population-level medicine to ultra-precise, individualized medicine using emerging therapeutic constructs, AI, deep phenotyping, and individual-centered trials to optimize health across diverse individual genetic and physiological profiles.
- Nicholas J. Schork
- & Laura H. Goetz
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Article
| Open AccessTracing the spatial origins and spread of SARS-CoV-2 Omicron lineages in South Africa
Genomic epidemiology studies have indicated southern Africa as likely sources of emergence of six Omicron lineages since November 2021. Here, the authors trace the geographic origins and dispersion patterns of these six lineages and highlight Gauteng province in South Africa as likely to have played a key role.
- Graeme Dor
- , Eduan Wilkinson
- & Tulio de Oliveira
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Article
| Open AccessBlood-triggered self-sealing and tissue adhesive hemostatic nanofabric
Seepage can be an issue in haemostatic dressings. Here, the authors combine anionic and cationic nanofibers, which can absorb surface blood and form a seal, encapsulating blood components and forming a rapid thrombus while remaining biocompatibility and biodegradation properties.
- Yan Fang
- , Linyu Wang
- & Haiqing Liu
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Article
| Open AccessSurveillance of avian influenza through bird guano in remote regions of the global south to uncover transmission dynamics
Highly pathogenic avian influenza is an increasing global concern but its distribution in remote regions is not known. Here, the authors conduct an environmental influenza surveillance study in remote, uninhabited regions of the Global South by sampling fresh bird guano.
- Dhammika Leshan Wannigama
- , Mohan Amarasiri
- & Shuichi Abe
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Article
| Open AccessMulti-organ metabolome biological age implicates cardiometabolic conditions and mortality risk
Aging affects multiple organs and tracking these changes could improve our understanding of disease risk. Here, the authors show that metabolomics-based organ-specific aging clocks can predict future risk of cardiometabolic disease and mortality.
- Andrew Zalesky
- , Ye Ella Tian
- & Junhao Wen
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Article
| Open AccessHSK21542 in patients with postoperative pain: two phase 3, multicentre, double-blind, randomized, controlled trials
Commonly used opioids for pain management primarily target the mu opioid receptor. However, mu opioid receptor agonists often come with harmful side effects. Here, the authors report the results of two phase 3 trials of HSK21542 (anrikefon), a highly selective activator of peripheral kappa opioid receptor agonists, for postoperative pain treatment following abdominal surgery.
- Yinbo Zhong
- , Younian Xu
- & Min Yan
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Article
| Open AccessImpact of unequal testing on vaccine effectiveness estimates across two study designs: a simulation study
Estimates of effectiveness of SARS-CoV-2 vaccines against symptomatic infection from observational studies may be biased if testing rates differ according to vaccination status. Here, the authors use simulations to quantify the impact of this testing bias in retrospective cohort and test-negative study designs.
- Korryn Bodner
- , Linwei Wang
- & Sharmistha Mishra
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Article
| Open AccessEpidemic-induced local awareness behavior inferred from surveys and genetic sequence data
Local and adaptive preventive behaviour influenced the spread of the COVID-19 pandemic. Here, the authors investigate whether genomic data can reveal this behavioural impact on epidemic dynamics.
- Gergely Ódor
- & Márton Karsai
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Article
| Open AccessBioresorbable, wireless dual stimulator for peripheral nerve regeneration
Wireless bioresorbable stimulators are promising therapeutic implants that naturally dissolve after use. Here, the authors developed a device that operates for months and enables simultaneous multi-site stimulation, preventing early muscle atrophy and accelerating reinnervation in nerve injury models.
- Hak-Young Ahn
- , Jordan B. Walters
- & John A. Rogers
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Article
| Open AccessDermatologist-like explainable AI enhances melanoma diagnosis accuracy: eye-tracking study
Artificial intelligence (AI) system is known to improve dermatologists’ diagnostic accuracy for melanoma. This group applies the eye-tracking technology on dermatologists when diagnosing dermoscopic images of melanomas and reports improved balanced diagnostic accuracy when using an X(explainable) AI system comparing to the standard one.
- Tirtha Chanda
- , Sarah Haggenmueller
- & Titus J. Brinker
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Article
| Open AccessMultidrug-resistant Shigella flexneri outbreak affecting humans and non-human primates in New Mexico, USA
A large outbreak of shigellosis occurred in Albuquerque, New Mexico in 2021–2023 and affected non-human primates at a local zoo as well as humans. Here, the authors describe the outbreak investigation and demonstrate that cases in non-human primates were caused by the same strain of Shigella flexneri as those causing human cases.
- Sarah Shrum Davis
- , Paris Salazar-Hamm
- & Daryl Domman
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Article
| Open AccessGenetic surveillance of Plasmodium falciparum populations following treatment policy revisions in the Greater Mekong Subregion
Genetic surveillance of Plasmodium falciparum has been ongoing in the Greater Mekong Subregion since 2017. Here, the authors report data until 2022, and demonstrate changes in drug resistance profiles of circulating strains coinciding with changes in frontline therapy policies.
- Varanya Wasakul
- , Tess D. Verschuuren
- & Olivo Miotto
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Article
| Open AccessAtrial fibrillation detection via contactless radio monitoring and knowledge transfer
Atrial fibrillation is a prevalent and serious arrhythmia associated with increased morbidity and mortality worldwide. Here the authors show a contactless, operation-free, and device-free AF detection framework utilizing artificial intelligence-powered radio technology, achieving performance comparable to conventional ECG-based methods.
- Yuqin Yuan
- , Jinbo Chen
- & Yan Chen