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Running poses a high risk of developing running-related injuries (RRIs). The majority of RRIs are the result of an imbalance between cumulative musculoskeletal load and load capacity. A general estimate of whole-body biomechanical load can be inferred from ground reaction forces (GRFs). Unfortunately, GRFs typically can only be measured in a controlled environment, which hinders its wider applicability. The advent of portable sensors has enabled training machine-learned models that are able to monitor GRF characteristics associated with RRIs in a broader range of contexts. Our study presents and evaluates a machine-learning method to predict the contact time, active peak, impact peak, and impulse of the vertical GRF during running from three-dimensional sacral acceleration. The developed models for predicting active peak, impact peak, impulse, and contact time demonstrated a root-mean-squared error of 0.080 body weight (BW), 0.198 BW, 0.0073 BW ⋅ seconds, and 0.0101 seconds, respectively. Our proposed method outperformed a mean-prediction baseline and two established methods from the literature. The results indicate the potential utility of this approach as a valuable tool for monitoring selected factors related to running-related injuries.

In this study, we show how both machine learning and alternative data can be successfully leveraged to improve and develop trading strategies. Starting from a trading strategy that harvests the EUR/USD volatility risk premium by selling one-week straddles every weekday, we present a machine learning approach to more skillfully time new trades and thus prevent unfavorable ones. To this end, we build probability-calibrated Random Forests on various predictors, extracted from both traditional market data and financial news, to predict the closing Sharpe ratio of short one-week delta-hedged straddles. We then demonstrate how the output of these calibrated machine learning models can be used to engineer intuitive new trading strategies. Ultimately, we show that our proposed strategies outperform the original strategy on risk-based performance measures. Moreover, the features that we derived from financial news articles significantly improve the performance of the approach.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) plays an important role in the most severe trauma and medical patients with cardiac arrest. Its use in pre-hospital emergency medicine in Germany does not yet regularly occur, and the vast majority of rapid response vehicles are not equipped with REBOA devices. In this article we will describe the introduction of REBOA for bleeding patients, as well as an adjunct for refractory out-of-hospital cardiac arrest (OHCA), in a German helicopter emergency medical service (HEMS). Methods: The DRF-Luftrettung HEMS base in Halle (Saale) Germany has incorporated REBOA in pre-hospital emergency medicine and will accompany this introduction with a feasibility study. We will describe the implementation of REBOA and the results of the training course. The training consists of theoretical and practical issues within different case scenarios. This was carried out before introducing REBOA into pre-hospital emergency medicine. Using a pre- and post-course exam and a self-assessment questionnaire the theoretical and practical knowledge and the performance of the critical care teams were determined. Results: The results of the pre-course exam in comparison with the post-course exam improved from 82% to 96%. Based on the self-assessment questionnaires, all participants felt a relevant improvement of their theoretical and practical knowledge. All physicians successfully performed REBOA under ongoing cardiopulmonary resuscitation in manikin simulators. Conclusions: The results from the training course indicate that there was a significant improvement of the theoretical and practical knowledge, as well as the performance of REBOA. The on-going feasibility study will show if it is worth introducing REBOA in a civilian HEMS for the patients in extremis.

Although running has many benefits for both the physical and mental health, it also involves the risk of injuries which results in negative physical, psychological and economical consequences. Those injuries are often linked to specific running biomechanical parameters such as the pressure pattern of the foot while running, and they could potentially be indicative for future injuries. Previous studies focus solely on some specific type of running injury and are often only applicable to a gender or running-experience specific population. The purpose of this study is, for both male and female, first-year students, (i) to predict the development of a lower extremity overuse injury in the next 6 months based on foot pressure measurements from a pressure plate and (ii) to identify the predictive loading features. For the first objective, we developed a machine learning pipeline that analyzes foot pressure measurements and predicts whether a lower extremity overuse injury is likely to occur with an AUC of 0.639 and a Brier score of 0.201. For the second objective, we found that the higher pressures exerted on the forefoot are the most predictive for lower extremity overuse injuries and that foot areas from both the lateral and the medial side are needed. Furthermore, there are two kinds of predictive features: the angle of the FFT coefficients and the coefficients of the autoregressive AR process. However, these features are not interpretable in terms of the running biomechanics, limiting its practical use for injury prevention.

A new method for automated sleep stage scoring of polysomnographies is proposed that uses a random forest approach to model feature interactions and temporal effects. The model mostly relies on features based on the rules from the American Academy of Sleep Medicine, which allows medical experts to gain insights into the model. A common way to evaluate automated approaches to constructing hypnograms is to compare the one produced by the algorithm to an expert's hypnogram. However, given the same data, two expert annotators will construct (slightly) different hypnograms due to differing interpretations of the data or individual mistakes. A thorough evaluation of our method is performed on a multi-labeled dataset in which both the inter-rater variability as well as the prediction uncertainties are taken into account, leading to a new standard for the evaluation of automated sleep stage scoring algorithms. On all epochs, our model achieves an accuracy of 82.7%, which is only slightly lower than the inter-rater disagreement. When only considering the 63.3% of the epochs where both the experts and algorithm are certain, the model achieves an accuracy of 97.8%. Transition periods between sleep stages are identified and studied for the first time. Scoring guidelines for medical experts are provided to complement the certain predictions by scoring only a few epochs manually. This makes the proposed method highly time-efficient while guaranteeing a highly accurate final hypnogram.

Osteoarthritis is a common musculoskeletal disorder. Classification models can discriminate an osteoarthritic gait pattern from that of control subjects. However, whether the output of learned models (probability of belonging to a class) is usable for monitoring a person’s functional recovery status post-total knee arthroplasty (TKA) is largely unexplored. The research question is two-fold: (I) Can a learned classification model’s output be used to monitor a person’s recovery status post-TKA? (II) Is the output related to patient-reported functioning? We constructed a logistic regression model based on (1) pre-operative IMU-data of level walking, ascending, and descending stairs and (2) 6-week post-operative data of walking, ascending-, and descending stairs. Trained models were deployed on subjects at three, six, and 12 months post-TKA. Patient-reported functioning was assessed by the KOOS-ADL section. We found that the model trained on 6-weeks post-TKA walking data showed a decrease in the probability of belonging to the TKA class over time, with moderate to strong correlations between the model’s output and patient-reported functioning. Thus, the LR-model’s output can be used as a screening tool to follow-up a person’s recovery status post-TKA. Person-specific relationships between the probabilities and patient-reported functioning show that the recovery process varies, favouring individual approaches in rehabilitation.

Even though practicing sports has great health benefits, it also entails a risk of developing overuse injuries, which can elicit a negative impact on physical, mental, and financial health. Being able to predict the risk of an overuse injury arising is of widespread interest because this may play a vital role in preventing its occurrence. In this paper, we present a machine learning model trained to predict the occurrence of a lower-limb overuse injury (LLOI). This model was trained and evaluated using data from a three-dimensional accelerometer on the lower back, collected during a Cooper test performed by 161 first-year undergraduate students of a movement science program. In this study, gender-specific models performed better than mixed-gender models. The estimated area under the receiving operating characteristic curve of the best-performing male- and female-specific models, trained according to the presented approach, was, respectively, 0.615 and 0.645. In addition, the best-performing models were achieved by combining statistical and sports-specific features. Overall, the results demonstrated that a machine learning injury prediction model is a promising, yet challenging approach.

Running is a popular way to become or stay physically active and to maintain and improve one's musculoskeletal load tolerance. Despite the health benefits, running-related injuries affect millions of people every year and have become a substantial public health issue owing to the popularity of running. Running-related injuries occur when the musculoskeletal load exceeds the load tolerance of the human body. Therefore, it is crucial to provide runners with a good estimate of the cumulative loading during their habitual training sessions. In this study, we validated a wearable system to provide an estimate of the external load on the body during running and investigated how much of the cumulative load during a habitual training session is explained by GPS-based spatiotemporal parameters. Ground reaction forces (GRF) as well as 3D accelerations were registered in nine habitual runners while running on an instrumented treadmill at three different speeds (2.22, 3.33, and 4.44 m/s). Linear regression analysis demonstrated that peak vertical acceleration during running explained 80% of the peak vertical GRF. In addition, accelerometer-based as well as GPS-based parameters were registered during 498 habitual running session of 96 runners. Linear regression analysis showed that only 70% of the cumulative load (sum of peak vertical accelerations) was explained by duration, distance, speed, and the number of steps. Using a wearable device offers the ability to provide better estimates of cumulative load during a running program and could potentially serve as a better guide to progress safely through the program.

Hip osteoarthritis patients exhibit changes in kinematics and kinetics that affect joint loading. Monitoring this load can provide valuable information to clinicians. For example, a patient's joint loading measured across different activities can be used to determine the amount of exercise that the patient needs to complete each day. Unfortunately, current methods for measuring joint loading require a lab environment which most clinicians do not have access to. This study explores employing machine learning to construct a model that can estimate joint loading based on sensor data obtained solely from a mobile phone. In order to learn such a model, we collected a dataset from 10 patients with hip osteoarthritis who performed multiple repetitions of nine different exercises. During each repetition, we simultaneously recorded 3D motion capture data, ground reaction force data, and the inertial measurement unit data from a mobile phone attached to the patient's hip. The 3D motion and ground reaction force data were used to compute the ground truth joint loading using musculoskeletal modeling. Our goal is to estimate the ground truth loading value using only the data captured by the sensors of the mobile phone. We propose a machine learning pipeline for learning such a model based on the recordings of a phone's accelerometer and gyroscope. When evaluated for an unseen patient, the proposed pipeline achieves a mean absolute error of 29% for the left hip and 36% for the right hip. While our approach is a step in the direction of using a minimal number of sensors to estimate joint loading outside the lab, developing a tool that is accurate enough to be applicable in a clinical context still remains an open challenge. It may be necessary to use sensors at more than one location in order to obtain better estimates.

Ground reaction forces are often used by sport scientists and clinicians to analyze the mechanical risk-factors of running related injuries or athletic performance during a running analysis. An interesting ground reaction force-derived variable to track is the maximal vertical instantaneous loading rate (VILR). This impact characteristic is traditionally derived from a fixed force platform, but wearable inertial sensors nowadays might approximate its magnitude while running outside the lab. The time-discrete axial peak tibial acceleration (APTA) has been proposed as a good surrogate that can be measured using wearable accelerometers in the field. This paper explores the hypothesis that applying machine learning to time continuous data (generated from bilateral tri-axial shin mounted accelerometers) would result in a more accurate estimation of the VILR. Therefore, the purpose of this study was to evaluate the performance of accelerometer-based predictions of the VILR with various machine learning models trained on data of 93 rearfoot runners. A subject-dependent gradient boosted regression trees (XGB) model provided the most accurate estimates (mean absolute error: 5.39 ± 2.04 BW⋅s–1, mean absolute percentage error: 6.08%). A similar subject-independent model had a mean absolute error of 12.41 ± 7.90 BW⋅s–1 (mean absolute percentage error: 11.09%). All of our models had a stronger correlation with the VILR than the APTA (p < 0.01), indicating that multiple 3D acceleration features in a learning setting showed the highest accuracy in predicting the lab-based impact loading compared to APTA.

The aging population has resulted in interest in remote monitoring of elderly individuals’ health and well being. This paper describes a simple unsupervised monitoring system that can automatically detect if an elderly individual’s pattern of presence deviates substantially from the recent past. The proposed system uses a small set of low-cost motion sensors and analyzes the produced data to establish an individual’s typical presence pattern. Then, the algorithm uses a distance function to determine whether the individual’s observed presence for each day significantly deviates from their typical pattern. Empirically, the algorithm is validated on both synthetic data and data collected by installing our system in the residences of three older individuals. In the real-world setting, the system detected, respectively, five, four, and one deviating days in the three locations. The deviating days detected by the system could result from a health issue that requires attention. The information from the system can aid caregivers in assessing the subject’s health status and allows for a targeted intervention. Although the system can be refined, we show that otherwise hidden but relevant events (e.g., fall incident and irregular sleep patterns) are detected and reported to the caregiver.

(1) Background: Joint loading is an important parameter in patients with osteoarthritis (OA). However, calculating joint loading relies on the performance of an extensive biomechanical analysis, which is not possible to do in a free-living situation. We propose the concept and design of a novel blended-care app called JOLO (Joint Load) that combines free-living information on activity with lab-based measures of joint loading in order to estimate a subject’s functional status. (2) Method: We used an iterative design process to evaluate the usability of the JOLO app through questionnaires. The user interfaces that resulted from the iterations are described and provide a concept for feedback on functional status. (3) Results: In total, 44 people (20 people with OA and 24 health-care providers) participated in the testing of the JOLO app. OA patients rated the latest version of the JOLO app as moderately useful. Therapists were predominantly positive; however, their intention to use JOLO was low due to technological issues. (4) Conclusion: We can conclude that JOLO is promising, but further technological improvements concerning activity recognition, the development of personalized joint loading predictions and a more comfortable means to carry the device are needed to facilitate its integration as a blended-care program.

Maximal oxygen uptake (VO2max) is often used to assess an individual's cardiorespiratory fitness. However, measuring this variable requires an athlete to perform a maximal exercise test which may be impractical, since this test requires trained staff and specialized equipment, and may be hard to incorporate regularly into training programs. The aim of this study is to develop a new model for predicting VO2max by exploiting its relationship to heart rate and accelerometer features extracted during submaximal running. To do so, we analyzed data collected from 31 recreational runners (15 men and 16 women) aged 19-26 years who performed a maximal incremental test on a treadmill. During this test, the subjects' heart rate and acceleration at three locations (the upper back, the lower back and the tibia) were continuously measured. We extracted a wide variety of features from the measurements of the warm-up and the first three stages of the test and employed a data-driven approach to select the most relevant ones. Furthermore, we evaluated the utility of combining different types of features. Empirically, we found that combining heart rate and accelerometer features resulted in the best model with a mean absolute error of 2.33 ml ⋅ kg-1 ⋅ min-1 and a mean absolute percentage error of 4.92%. The model includes four features: gender, body mass, the inverse of the average heart rate and the inverse of the variance of the total tibia acceleration during the warm-up stage of the treadmill test. Our model provides a practical tool for recreational runners in the same age range to estimate their VO2max from submaximal running on a treadmill. It requires two body-worn sensors: a heart rate monitor and an accelerometer positioned on the tibia.