A Blockchain-Enabled Federated Neuro-Symbolic Framework for Secure Wearable Biosensor-Based Health Monitoring.

Wearable biosensors generate continuous physiological data in smart Internet of Disease (IoD) environments. These data can support early disease detection and remote patient monitoring. However, wearable data are often noisy, sensitive, and distributed across different devices. This paper proposes a multimodal neuro-symbolic model to overcome these limitations and incorporates it into a secure Edge-Fog-Cloud framework for anomaly detection in smart healthcare applications. The proposed system integrates the semantic analysis of clinical text using Bio-ClinicalBERT with temporal numerical data using an LSTM-based model, creating a unified neuro-symbolic artificial intelligence (AI) pipeline. Initial data processing is performed at the Edge, whereas inference is carried out at distributed Fog nodes for low-latency anomaly detection. Model training is handled in the Cloud, and privacy-preserving federated learning (FL) is supported through Homomorphic Encryption (HomEnc) to facilitate collaborative model training without sharing raw patient data. A sharded Tangle ledger is also used, with transactions broadcast by the Fog nodes and validated in the Cloud to create tamper-evident transaction logs. Furthermore, Honey Encryption (HoneyEnc) is integrated into the Fog layer to enhance security against brute-force attacks. Experimental results show that the proposed framework achieved 99.22% accuracy and a 99.31% F1-score on the held-out test set, with bootstrap 95% confidence intervals of 98.96-99.47% for accuracy and 99.08-99.53% for the F1-score. It also reduced detection latency from 185 ms in the baseline setting to approximately 50 ms in the Fog-inference setting. The blockchain layer achieved approximately 500 Transactions Per Second (TPS), while higher throughput was observed under increased transaction load and shard parallelism. Because the evaluation is based on synthetic multimodal EHR-like data and controlled simulations, the reported findings should be interpreted as proof-of-concept internal validation rather than evidence of deployment-ready clinical generalizability; external validation using real wearable biosensor data, hospital IoMT streams, or public clinical datasets such as MIMIC-III/MIMIC-IV is required before clinical deployment. These results highlight the potential of the proposed system for secure data processing and trustworthy anomaly detection in smart healthcare environments.