Enhancing Construction Worker Safety in Extreme Heat: A Machine Learning Approach Utilizing Wearable Technology for Predictive Health Analytics

Construction workers are highly vulnerable to heat stress, yet tools that translate real-time physiological data into actionable safety intelligence remain scarce. This study addresses this gap by developing and evaluating deep learning models, specifically a baseline Long Short-Term Memory (LSTM) network and an attention-based LSTM, to predict heat stress among 19 workers in Saudi Arabia. Using Garmin Vivosmart 5 smartwatches to monitor metrics such as heart rate, HRV, and oxygen saturation, the attention-based model outperformed the baseline, achieving 95.40% testing accuracy and significantly reducing false positives and negatives. With precision, recall, and F1 scores of 0.982, this approach not only improves predictive performance but also offers interpretable results suitable for integration into IoT-enabled safety systems and BIM dashboards, advancing proactive, informatics-driven safety management in the construction industry.

Personalized and Context-Aware Transformer Models for Predicting Post-Intervention Physiological Responses from Wearable Sensor Data

Consumer wearables enable continuous measurement of physiological data related to stress and recovery, but turning these streams into actionable, personalized stress-management recommendations remains a challenge. In practice, users often do not know how a given intervention, defined as an activity intended to reduce stress, will affect heart rate (HR), heart rate variability (HRV), or inter-beat intervals (BBI) over the next 15 to 120 minutes. We present a framework that predicts post-intervention trajectories and the direction of change for these physiological indicators across time windows. Our methodology combines a Transformer model for multi-horizon trajectories of percent change relative to a pre-intervention baseline, direction-of-change calls (positive, negative, or neutral) at each horizon, and an empirical study using wearable sensor data overlaid with user-tagged events and interventions. This proof of concept shows that personalized post-intervention prediction is feasible. We encourage future integration into stress-management tools for personalized intervention recommendations tailored to each person's day following further validation in larger studies and, where applicable, appropriate regulatory review.

Dynamic Heartbeat Modeling with Recurrent Neural Networks and Inverse Gaussian Point Process Modeling

Heart rate variability (HRV) analysis is important for the assessment of autonomic cardiovascular regulation. The inverse Gaussian process (IGP) has been widely used for beat-to-beat HRV modeling, as it gives a physiological relevant interpretation of heart depolarization process. A key challenge in IGP-based heartbeat modeling is the accurate estimation of time-varying parameters. In this study, we investigated whether recurrent neural networks (RNNs) can be used for IGP parameter identification and thereby enhance probabilistic modeling of R-R dynamics. Specifically, four representative RNN architectures, namely, GRU, LSTM, Structured State Space sequence model (S4), and Mamba, were evaluated using the Kolmogorov-Smirnov statistics. The results demonstrate the possibility of combining neural sequence models with the IGP framework for beat-wise R-R series modeling. This approach provides a flexible basis for probabilistic HRV modeling and for future incorporation of more complex physiological mechanisms and dynamic conditions.

Frontier-Eng: Benchmarking Self-Evolving Agents on Real-World Engineering Tasks with Generative Optimization

Current LLM agent benchmarks, which predominantly focus on binary pass/fail tasks such as code generation or search-based question answering, often neglect the value of real-world engineering that is often captured through the iterative optimization of feasible designs. To this end, we introduce Frontier-Eng, a human-verified benchmark for generative optimization -- an iterative propose-execute-evaluate loop in which an agent generates candidate artifacts, receives executable verifier feedback, and revises them under a fixed interaction budget -- spanning $47$ tasks across five broad engineering categories. Unlike previous suites, Frontier-Eng tasks are grounded in industrial-grade simulators and verifiers that provide continuous reward signals and enforce hard feasibility constraints under constrained budgets. We evaluate eight frontier language models using representative search frameworks, finding that while Claude 4.6 Opus achieves the most robust performance, the benchmark remains challenging for all models. Our analysis suggests a dual power-law decay in improvement frequency ($\sim$ 1/iteration) and magnitude ($\sim$ 1/improvement count). We further show that although width improves parallelism and diversity, depth remains crucial for hard-won improvements under a fixed budget. Frontier-Eng establishes a new standard for assessing the capacity of AI agents to integrate domain knowledge with executable feedback to solve complex, open-ended engineering problems.

MCAnalysis: An Open-Source Package for Preprocessing, Modelling, and Visualisation of Menstrual Cycle Effects in Digital Health Data

The menstrual cycle influences numerous physiological and psychological outcomes, yet standardised, open-source statistical methods for quantifying these cyclic effects remain lacking. We developed mcanalysis, an open-source package in R and Python implementing a Fourier-basis generalised additive model (GAM) for menstrual cycle research. The package provides a complete pipeline: processing period dates, labelling cycle days relative to menstruation onset, filtering physiologically plausible cycles, normalising outcomes to individual means, fitting cyclic GAMs with bootstrap confidence intervals, and identifying turning points to generate phase-specific linear trend estimates. We demonstrate the package on 15 wearable and self-reported outcomes using data from the Juli chronic health management application (N = 2,816 users). Nine of 15 outcomes showed evidence of association with the menstrual cycle (p < 0.05), spanning physiological (HRV p < 0.001, oxygen saturation p = 0.002), sleep (p = 0.003), symptom (migraine p < 0.001, headache p = 0.005), mood (EMA mood p = 0.024, PHQ-8 lack of energy p = 0.008, mania p = 0.041), and activity (hours outside p = 0.019) domains. No tested confounders were significantly associated with cycle-normalised outcomes. mcanalysis provides a standardised, reproducible approach to menstrual cycle analysis for users at all levels of statistical expertise. The package is freely available at https://github.com/kyradelray/mcanalysis, with a no-code web interface at https://kyradelray.shinyapps.io/mcanalysis/.

Frailty Estimation in Elderly Oncology Patients Using Multimodal Wearable Data and Multi-Instance Learning

Frailty and functional decline strongly influence treatment tolerance and outcomes in older patients with cancer, yet assessment is typically limited to infrequent clinic visits. We propose a multimodal wearable framework to estimate frailty-related functional change between visits in elderly breast cancer patients enrolled in the multicenter CARDIOCARE study. Free-living smartwatch physical activity and sleep features are combined with ECG-derived heart rate variability (HRV) features from a chest strap and organized into patient-horizon bags aligned to month 3 (M3) and month 6 (M6) follow-ups. Our innovation is an attention-based multiple instance learning (MIL) formulation that fuses irregular, multimodal wearable instances under real-world missingness and weak supervision. An attention-based MIL model with modality-specific multilayer perceptron (MLP) encoders with embedding dimension 128 aggregates variable-length and partially missing longitudinal instances to predict discretized change-from-baseline classes (worsened, stable, improved) for FACIT-F and handgrip strength. Under subject-independent leave-one-subject-out (LOSO) evaluation, the full multimodal model achieved balanced accuracy/F1 of 0.68 +/- 0.08/0.67 +/- 0.09 at M3 and 0.70 +/- 0.10/0.69 +/- 0.08 at M6 for handgrip, and 0.59 +/- 0.04/0.58 +/- 0.06 at M3 and 0.64 +/- 0.05/0.63 +/- 0.07 at M6 for FACIT-F. Ablation results indicated that smartwatch activity and sleep provide the strongest predictive information for frailty-related functional changes, while HRV contributes complementary information when fused with smartwatch streams.

Detecting Neurovascular Instability from Multimodal Physiological Signals Using Wearable-Compatible Edge AI: A Responsible Computational Framework

We propose Melaguard, a multimodal ML framework (Transformer-lite, 1.2M parameters, 4-head self-attention) for detecting neurovascular instability (NVI) from wearable-compatible physiological signals prior to structural stroke pathology. The model fuses heart rate variability (HRV), peripheral perfusion index, SpO2, and bilateral phase coherence into a composite NVI Score, designed for edge inference (WCET <=4 ms on Cortex-M4). NVI - the pre-structural dysregulation of cerebrovascular autoregulation preceding overt stroke - remains undetectable by existing single-modality wearables. With 12.2 million incident strokes annually, continuous multimodal physiological monitoring offers a practical path to community-scale screening. Three-stage independent validation: (1) synthetic benchmark (n=10,000), AUC=0.88 [0.83-0.92]; (2) clinical cohort PhysioNet CVES (n=172; 84 stroke, 88 control) - Transformer-lite achieves AUC=0.755 [0.630-0.778], outperforming LSTM (0.643), Random Forest (0.665), SVM (0.472); HRV-SDNN discriminates stroke (p=0.011); (3) PPG pipeline PhysioNet BIDMC (n=53) -- pulse rate r=0.748 and HRV surrogate r=0.690 vs. ECG ground truth. Cross-modality validation on PPG-BP (n=219) confirms PPG morphology classifies cerebrovascular disease at AUC=0.923 [0.869-0.968]. Multimodal fusion consistently outperforms single-modality baselines. Code: https://github.com/ClevixLab/Melaguard

From Pen Strokes to Sleep States: Detecting Low-Recovery Days Using Sigma-Lognormal Handwriting Features

While handwriting has traditionally been studied for character recognition and disease classification, its potential to reflect day-to-day physiological fluctuations in healthy individuals remains unexplored. This study examines whether daily variations in sleep-related recovery states can be inferred from online handwriting dynamics. % We propose a personalized binary classification framework that detects low-recovery days using features derived from the Sigma-Lognormal model, which captures the neuromotor generation process of pen strokes. In a 28-day in-the-wild study involving 13 university students, handwriting was recorded three times daily, and nocturnal cardiac indicators were measured using a wearable ring. For each participant, the lowest (or highest) quartile of four sleep-related metrics -- HRV, lowest heart rate, average heart rate, and total sleep duration -- defined the positive class. Leave-One-Day-Out cross-validation showed that PR-AUC significantly exceeded the baseline (0.25) for all four variables after FDR correction, with the strongest performance observed for cardiac-related variables. Importantly, classification performance did not differ significantly across task types or recording timings, indicating that recovery-related signals are embedded in general movement dynamics. These results demonstrate that subtle within-person autonomic recovery fluctuations can be detected from everyday handwriting, opening a new direction for non-invasive, device-independent health monitoring.

C-GRASP: Clinically-Grounded Reasoning for Affective Signal Processing

Heart rate variability (HRV) is a pivotal noninvasive marker for autonomic monitoring; however, applying Large Language Models (LLMs) to HRV interpretation is hindered by physiological hallucinations. These include respiratory sinus arrhythmia (RSA) contamination, short-data instability in nonlinear metrics, and the neglect of individualized baselines in favor of population norms. We propose C-GRASP (Clinically-Grounded Reasoning for Affective Signal Processing), a guardrailed RAG-enhanced pipeline that decomposes HRV interpretation into eight traceable reasoning steps. Central to C-GRASP is a Z-score Priority Hierarchy that enforces the weighting of individualized baseline shifts over normative statistics. The system effectively mitigates spectral hallucinations through automated RSA-aware guardrails, preventing contamination of frequency-domain indices. Evaluated on 414 trials from the DREAMER dataset, C-GRASP integrated with high-scale reasoning models (e.g., MedGemma3-thinking) achieved superior performance in 4-class emotion classification (37.3% accuracy) and a Clinical Reasoning Consistency (CRC) score of 69.6%. Ablation studies confirm that the individualized Delta Z-score module serves as the critical logical anchor, preventing the "population bias" common in native LLMs. Ultimately, C-GRASP transitions affective computing from black-box classification to transparent, evidence-based clinical decision support, paving the way for safer AI integration in biomedical engineering.

Cross-Modal Computational Model of Brain-Heart Interactions via HRV and EEG Feature

The electroencephalogram (EEG) has been the gold standard for quantifying mental workload; however, due to its complexity and non-portability, it can be constraining. ECG signals, which are feasible on wearable equipment pieces such as headbands, present a promising method for cognitive state monitoring. This research explores whether electrocardiogram (ECG) signals are able to indicate mental workload consistently and act as surrogates for EEG-based cognitive indicators. This study investigates whether ECG-derived features can serve as surrogate indicators of cognitive load, a concept traditionally quantified using EEG. Using a publicly available multimodal dataset (OpenNeuro) of EEG and ECG recorded during working-memory and listening tasks, features of HRV and Catch22 descriptors are extracted from ECG, and spectral band-power with Catch22 features from EEG. A cross-modal regression framework based on XGBoost was trained to map ECG-derived HRV representations to EEG-derived cognitive features. In order to address data sparsity and model brain-heart interactions, we integrated the PSV-SDG to produce EEG-conditioned synthetic HRV time series.This addresses the challenge of inferring cognitive load solely from ECG-derived features using a combination of multimodal learning, signal processing, and synthetic data generation. These outcomes form a basis for light, interpretable machine learning models that are implemented through wearable biosensors in non-lab environments. Synthetic HRV inclusion enhances robustness, particularly in sparse data situations. Overall, this work is an initiation for building low-cost, explainable, and real-time cognitive monitoring systems for mental health, education, and human-computer interaction, with a focus on ageing and clinical populations.