5,923 research outputs found
Reference values and clinical predictors of bone strength for HR-pQCT-based distal radius and tibia strength assessments in women and men.
Reference values for radius and tibia strength using multiple-stack high-resolution peripheral quantitative computed tomography (HR-pQCT) with homogenized finite element analysis are presented in order to derive critical values improving risk prediction models of osteoporosis. Gender and femoral neck areal bone mineral density (aBMD) were independent predictors of bone strength.
INTRODUCTION
The purpose was to obtain reference values for radius and tibia bone strength computed by using the homogenized finite element analysis (hFE) using multiple stacks with a HR-pQCT.
METHODS
Male and female healthy participants aged 20-39Â years were recruited at the University Hospital of Bern. They underwent interview and clinical examination including hand grip, gait speed and DXA of the hip. The nondominant forearm and tibia were scanned with a double and a triple-stack protocol, respectively, using HR-pQCT (XCT II, SCANCO Medical AG). Bone strength was estimated by using the hFE analysis, and reference values were calculated using quantile regression. Multivariable analyses were performed to identify clinical predictors of bone strength.
RESULTS
Overall, 46 women and 41 men were recruited with mean ages of 25.1 (sd 5.0) and 26.2 (sd 5.2) years. Sex-specific reference values for bone strength were established. Men had significantly higher strength for radius (mean (sd) 6640 (1800) N vs. 4110 (1200) N; p < 0.001) and tibia (18,200 (4220) N vs. 11,970 (3150) N; p < 0.001) than women. In the two multivariable regression models with and without total hip aBMD, the addition of neck hip aBMD significantly improved the model (p < 0.001). No clinical predictors of bone strength other than gender and aBMD were identified.
CONCLUSION
Reference values for radius and tibia strength using multiple HR-pQCT stacks with hFE analysis are presented and provide the basis to help refining accurate risk prediction models. Femoral neck aBMD and gender were significant predictors of bone strength
The physiological and morphological benefits of shadowboxing
Is shadowboxing an effective form of functional exercise? What physiological and morphological changes result from an exercise program based exclusively on shadowboxing for 3 weeks? To date, no empirical research has focused specifically on addressing these questions. Since mixed martial arts (MMA) is the fastest growing sport in the world, and since boxing and kickboxing fitness classes are among the most popular in gyms and fitness clubs worldwide, the lack of research on shadowboxing and martial arts-based fitness programs in the extant literature is a shortcoming that the present article aims to address. This case study involved a previously sedentary individual engaging in an exercise program based exclusively on shadowboxing for 3 weeks. Body composition and heart rate data were collected before, throughout, and upon completion of the 3-week exercise program to determine the effectiveness of shadowboxing for functional fitness purposes. An original shadowboxing program prepared by an Everlast Master Instructor and NASM Certified Personal Trainer (NASM-CPT) and Performance Enhancement Specialist (NASM-PES) was used for this 3-week period. The original shadowboxing program with goals, techniques, and combinations to work on throughout the 3-week program is included in this article. This case study demonstrates that a 3-week exercise program based exclusively on shadowboxing can increase aerobic capacity, muscle mass, bone mass, basal metabolic rate, and daily calorie intake, and decrease resting heart rate, fat mass, body fat percentage, and visceral fat rating in a previously sedentary individual. The results of this research demonstrate that shadowboxing can be a safe and effective form of exercise leading to morphological and physiological improvements including fat loss and increased aerobic capacity. The results of this research also demonstrate that the Tanita BC-1500 is a reliable tool for individuals to evaluate their own fitness progress over time
Beam scanning by liquid-crystal biasing in a modified SIW structure
A fixed-frequency beam-scanning 1D antenna based on Liquid Crystals (LCs) is designed for application in 2D scanning with lateral alignment. The 2D array environment imposes full decoupling of adjacent 1D antennas, which often conflicts with the LC requirement of DC biasing: the proposed design accommodates both. The LC medium is placed inside a Substrate Integrated Waveguide (SIW) modified to work as a Groove Gap Waveguide, with radiating slots etched on the upper broad wall, that radiates as a Leaky-Wave Antenna (LWA). This allows effective application of the DC bias voltage needed for tuning the LCs. At the same time, the RF field remains laterally confined, enabling the possibility to lay several antennas in parallel and achieve 2D beam scanning. The design is validated by simulation employing the actual properties of a commercial LC medium
Virtual Stiffness: A Novel Biomechanical Approach to Estimate Limb Stiffness of a Multi-Muscle and Multi-Joint System
In recent years, different groups have developed algorithms to control the stiffness of a robotic device through the electromyographic activity collected from a human operator. However, the approaches proposed so far require an initial calibration, have a complex subject-specific muscle model, or consider the activity of only a few pairs of antagonist muscles. This study described and tested an approach based on a biomechanical model to estimate the limb stiffness of a multi-joint, multi-muscle system from muscle activations. The “virtual stiffness” method approximates the generated stiffness as the stiffness due to the component of the muscle-activation vector that does not generate any endpoint force. Such a component is calculated by projecting the vector of muscle activations, estimated from the electromyographic signals, onto the null space of the linear mapping of muscle activations onto the endpoint force. The proposed method was tested by using an upper-limb model made of two joints and six Hill-type muscles and data collected during an isometric force-generation task performed with the upper limb. The null-space projection of the muscle-activation vector approximated the major axis of the stiffness ellipse or ellipsoid. The model provides a good approximation of the voluntary stiffening performed by participants that could be directly implemented in wearable myoelectric controlled devices that estimate, in real-time, the endpoint forces, or endpoint movement, from the mapping between muscle activation and force, without any additional calibrations
Rational development of stabilized cyclic disulfide redox probes and bioreductive prodrugs to target dithiol oxidoreductases
Countless biological processes allow cells to develop, survive, and proliferate. Among these, tightly balanced regulatory enzymatic pathways that can respond rapidly to external impacts maintain dynamic physiological homeostasis. More specifically, redox homeostasis broadly affects cellular metabolism and proliferation, with major contributions by thiol/disulfide oxidoreductase systems, in particular, the Thioredoxin Reductase Thioredoxin (TrxR/Trx) and the Glutathione Reductase-Glutathione-Glutaredoxin (GR/GSH/Grx) systems.
These cascades drive vital cellular functions in many ways through signaling, regulating other proteins' activity by redox switches, and by stoichiometric reductant transfers in metabolism and antioxidant systems. Increasing evidence argues that there is a persistent alteration of the redox environment in certain pathological states, such as cancer, that heavily involve the Trx system: upregulation and/or overactivity of the Trx system may support or drive cancer progression, making both TrxR and Trx promising targets for anti-cancer drug development.
Understanding the biochemical mechanisms and connections between certain redox cascades requires research tools that interact with them. The state-of-the-art genetic tools are mostly ratiometric reporters that measure reduced:oxidized ratios of selected redox pairs or the general thiol pool. However, the precise cellular roles of the central oxidoreductase systems, including TrxR and Trx, remain inaccessible due to the lack of probes to selectively measure turnover by either of these proteins. However, such probes would allow measuring their effective reductive activity apart from expression levels in native systems, including in cells, animals, or patient samples. They are also of high interest to identify chemical inhibitors for TrxR/Trx in cells and to validate their potential use as anti-cancer agents (to date, there is no selective cellular Trx inhibitor, and most known TrxR inhibitors were not comprehensively evaluated considering selectivity and potential off-targets). However, small molecule redox imaging tools are underdeveloped: their protein specificity, spectral properties, and applicability remain poorly precedented.
This work aimed to address this opportunity gap and develop novel, small molecule diagnostic and therapeutic tools to selectively target the Trx system based on a modular trigger cargo design: artificial cyclic disulfide substrates (trigger) for oxidoreductases are tethered to molecular agents (cargo) such that the cargo’s activity is masked and is re-established only through reduction by a target protein.
The rational design of these novel reduction sensors to target the cell's strongest disulfide-reducing enzymes was driven by the following principles: (i) cyclic disulfide triggers with stabilized ring systems were used to gain low reduction potentials that should resist reduction except by the strongest cellular reductases, such as Trx; and (ii) the cyclic topology also offers the potential for kinetic reversibility that should select for dithiol-type redox proteins over the cellular monothiol background. Creating imaging agents based on such two-component designs to selectively measure redox protein activity in native cells required to combine the correct trigger reducibility, probe activation kinetics, and imaging modalities and to consider the overall molecular architecture.
The major prior art in this field has applied cyclic 5-membered disulfides (1,2 dithiolanes) as substrates for TrxR in a similar way to create such tools. However, this motif was described elsewhere as thermodynamically instable and was due to widely used for dynamic covalent cascade reactions. By comparing a novel 1,2 dithiolane-based probe to the state-of-the-art probes, including commercial TrxR sensors, by screening a conclusive assay panel of cellular TrxR modulations, I clarified that 1,2 dithiolanes are not selective substrates for TrxR in biological settings (Nat Commun 2022).
Instead, aiming for more stable ring systems and thus more robust redox probes, during this work, I developed bicyclic 6 membered disulfides (piperidine fused 1,2 dithianes) with remarkably low reduction potentials. I showed that molecular probes using them as reduction sensors can be mostly processed by thioredoxins while being stable against reduction by GSH. The thermodynamically stabilized decalin like topology of the cis-annelated 1,2 dithianes requires particularly strong reductants to be cleaved. They also select for dithiol type redox proteins, like Trx, based on kinetic reversibility and offer fast cyclization due to the preorganization by annelation (JACS 2021).
This work further expanded the system’s modularity with structural cores based on piperazine-fused 1,2 dithianes with the two amines allowing independent derivatization. Diagnostic tools using them as reduction sensors proved equally robust but with highly improved activation kinetics and were thus cellularly activated. Cellular studies evolved that they are substrates for both Trxs and their protein cousins Grxs, so measuring the cellular dithiol protein pool rather than solely Trx activity (preprint 2023).
Finally, a trigger based on a slightly adapted reduction sensor, a desymmetrized 1,2 thiaselenane, was designed for selective reduction by TrxR’s selenol/thiol active site, then combined with a precipitating large Stokes’ shift fluorophore and a solubilizing group, to evolve the first selective probe RX1 to measure cellular TrxR activity, which even allowed high throughput inhibitor screening (Chem 2022).
The central principle of this work was further advanced to therapeutic prodrugs based on the duocarmycin cargo (CBI) with tunable potency (JACS Au 2022) that can be used to create off-to-on therapeutic prodrugs. Such CBI prodrugs employing stabilized 1,2 dichalcogenide triggers proved to be cytotoxins that depend on Trx system activity in cells. They could further be exploited for cell-line dependent reductase activity profiling by screening their redox activation indices, the reduction-dependent part of total prodrug activation, in 177 cell lines. Beyond that, these prodrugs were well-tolerated in animals and showed anti-cancer efficacy in vivo in two distinct mouse tumor models (preprint 2022).
Taken together, I introduced unique monothiol-resistant reducible motifs to target the cellular Trx system with chemocompatible units for each for TrxR and Trx/Grx, where the cyclic nature of the dichalcogenides avoids activation by GSH. By using them with distinct molecular cargos, I developed novel selective fluorescent reporter probes; and introduced a new class of bioreductive therapeutic constructs based on a common modular design. These were either applied to selectively measure cellular reductase activity or to deliver cytotoxic anti cancer agents in vivo. Ongoing work aims to differentiate between the two major redox effector proteins Trx and Grx, requiring additional layers of selectivity that may be addressed by tuned molecular recognition. The flexible use of various molecular cargos allows harnessing the same cellular redox machinery by either probes or prodrugs. This allows predictive conclusions from diagnostics to be directly translated into therapy and offers great potential for future adaptation to other enzyme classes and therapeutic venues.Die zelluläre Redox-Homöostase hängt von Thiol/Disulfid-Oxidoreduktasen ab, die den Stoffwechsel, die Proliferation und die antioxidative Antwort von Zellen beeinflussen. Die wichtigsten Netzwerke sind die Thioredoxin Reduktase-Thioredoxin (TrxR/Trx) und Glutathion Reduktase-Glutathion-Glutaredoxin (GR/GSH/Grx) Systeme, die über Redox-Schalter in Substratproteinen lebenswichtige zelluläre Funktionen steuern und so an der Redox-Regulation und -Signalübertragung beteiligt sind. Persistente Veränderungen des Redoxmilieus in pathologischen Zuständen, wie z. B. bei Krebs, sind in hohem Maße mit dem Trx-System verbunden. Eine Hochregulierung und/oder Überaktivität des Trx-Systems, die bei vielen Krebsarten auftreten, unterstützt zudem das Fortschreiten des Krebswachstums, was TrxR/Trx zu vielversprechenden Zielproteinen für die Entwicklung neuer Krebsmedikamente macht.
Um die biochemischen Prozesse dahinter zu erforschen, sind spezielle Techniken zur Visualisierung und Messung enzymatischer Aktivität nötig. Die hierzu geeigneten, meist genetischen Sensoren messen ratiometrisch das Verhältnis reduzierter/oxidierter Spezies in zellulärem Umfeld oder spezifisch ausgewählte Redoxpaare. Die weitere Erforschung der exakten Funktion von TrxR/Trx und deren Substrate ist jedoch durch mangelnde Nachweismethoden limitiert. Diese sind außerdem zur Validierung chemischer Hemmstoffe für TrxR/Trx in Zellen und deren potenziellen Verwendung als Krebsmittel von großem Interesse. Bislang gibt es keinen selektiven zellulären Trx-Inhibitor und potenzielle Off-Target-Effekte der bekannten TrxR-Inhibitoren wurden nicht abschließend bewertet.
Ziel dieser Arbeit ist die Entwicklung niedermolekularer, diagnostischer und therapeutischer Werkzeuge, die selektiv auf das Trx-System abzielen und auf einem modularen Trigger-Cargo Design basieren. Hierzu werden zyklische Disulfid-Substrate (Trigger) für Oxidoreduktasen so mit molekularen Wirkstoffen (Cargo) verknüpft, dass dabei die Wirkstoffaktivität maskiert, und erst nach Reduktion durch ein Zielprotein wiederhergestellt wird. Diese neuartigen, synthetischen Reduktionssensoren basieren auf den folgenden Grundprinzipien: (i) Zyklische Disulfide sind thermodynamisch stabilisiert und können nur durch die stärksten Reduktasen gespalten werden; und (ii) die zyklische Topologie ermöglicht die kinetische Reversibilität der zwei Thiol-Disulfid-Austauschreaktionen, die eine erste Reaktion mit Monothiolen, wie z. B. GSH, sofort umkehrt und so eine vollständige Reduktion verhindert.
Die meisten früheren Arbeiten auf diesem Gebiet verwendeten ein zyklisches, fünfgliedriges Disulfid (1,2 Dithiolan) als Substrat für TrxR. Das gleiche Strukturmotiv wurde jedoch an anderer Stelle als thermodynamisch instabil beschrieben und aufgrund dieser Eigenschaft explizit für dynamische Kaskadenreaktionen verwendet. Deshalb vergleicht diese Arbeit zu Beginn einen neuen 1,2 Dithiolan basierten fluorogenen Indikator mit bestehenden, z. T. kommerziellen, Redox Sonden für TrxR in einer Reihe von Zellkultur-Experimenten unter Modulation der zellulären TrxR Aktivität und stellt so einen Widerspruch in der Literatur klar: 1,2 Dithiolane eignen sich nicht als selektive Substrate für TrxR, da sie labil sowohl gegen die Reduktion durch andere Redoxproteine, als auch gegen den Monothiol Hintergrund in Zellen sind (Nat. Commun. 2022).
Als alternatives Strukturmotiv wird in dieser Arbeit ein bizyklisches sechsgliedriges Disulfid (anneliertes 1,2 Dithian) etabliert. Durch sein niedriges Reduktionspotenzial, also seine hohe Resistenz gegen Reduktion, werden molekulare Sonden basierend auf diesem 1,2 Dithian als Reduktionssensor fast ausschließlich von Trx aktiviert, nicht aber von TrxR oder GSH (JACS 2021). Dieses Kernmotiv bestimmt dabei die Reduzierbarkeit, und damit die Enzymspezifität, durch seine zyklische Natur und die Annelierung, auch unter Verwendung unterschiedlicher Farb-/Wirkstoffe. Auf dieser Grundlage konnte die molekulare Struktur durch einen weiteren Modifikationspunkt für die flexible Verwendung weiterer funktioneller Einheiten ergänzt werden. Obwohl zelluläre Studien ergaben, dass diese neuartigen 1,2 Dithian Einheiten in Zellen sowohl Trx als auch das strukturell verwandte Grx adressieren, sind die daraus resultierenden diagnostischen Moleküle wertvoll, um den katalytischen Umsatz zellulärer Dithiol-Reduktasen, der sogenannten Trx Superfamilie, selektiv anzuzeigen (Preprint 2023).
Begünstigt durch das modulare Moleküldesign stellt diese Arbeit zudem das erste Reportersystem RX1 zum selektiven Nachweis der TrxR-Aktivität in Zellen vor. Es basiert auf der Verwendung eines zyklischen, unsymmetrischen Selenenylsulfid-Sensors (1,2 Thiaselenan), der selektiv von dem einzigartigen Selenolat der TrxR angegriffen wird, und dadurch letztlich nur von TrxR reduziert werden kann. RX1 eignete sich zudem für eine Hochdurchsatz-Validierung bestehender TrxR Inhibitoren und unterstreicht dadurch den kommerziellen Nutzen derartiger Diagnostika (Chem 2022).
Das zentrale Trigger-Cargo Konzept dieser Arbeit wurde für therapeutische Zwecke weiterentwickelt und nutzt dabei den einzigartigen Wirkmechanismus der Duocarmycin-Naturstoffklasse (CBI) (JACS Au 2022) zur Entwicklung reduktiv aktivierbarer Therapeutika. CBI Prodrugs basierend auf stabilisierten Redox-Schaltern (1,2 Dithiane für Trx; 1,2 Thiaselenan für TrxR) reagierten signifikant auf TrxR-Modulation in Zellen. Sie wurden darüber hinaus durch das Referenzieren ihrer Aktivität gegenüber nicht-reduzierbaren Kontrollmoleküle für die Erstellung zelllinienabhängiger Profile der Reduktaseaktivität in 177 Zelllinien genutzt. Schließlich waren diese neuen Krebsmittel im Tiermodell gut verträglich und zeigten in zwei verschiedenen Mausmodellen eine krebshemmende Wirkung (Preprint 2022b).
Zusammenfassend präsentiert diese Dissertation monothiol-resistente reduzierbare Trigger-Einheiten für das zelluläre Trx-System zur Entwicklung neuartiger, selektiver Reporter-Sonden, sowie eine neue Klasse reduktiv aktivierbarer Krebsmittel auf Basis eines adaptierbaren Trigger-Cargo Designs. Diese fanden entweder zur selektiven Messung zellulärer Proteinaktivität oder zum Einsatz als Antikrebsmittel Verwendung. Es wurden chemokompatible Motive sowohl für TrxR als auch für Trx/Grx identifiziert, wobei deren zyklische Natur eine Aktivierung durch GSH verhindert. Eine weitere Differenzierung zwischen den beiden Redox-Proteinen Trx und Grx und anderen Proteinen der Trx-Superfamilie erfordert eine zusätzliche Ebene der Selektierung, z. B. durch molekulare Erkennung, und ist Gegenstand laufender Arbeiten.
Die flexible Verwendung verschiedener molekularer Wirkstoffe ermöglicht dabei die „Pipeline-Entwicklung“ von Diagnostika und Therapeutika, die von der zellulären Redox-Maschinerie analog umgesetzt werden, und dadurch Schlussfolgerungen aus der Diagnostik direkt auf eine Therapie übertragbar machen. Dies birgt großes Potenzial für künftige Entwicklungen bei einer potenziellen Übertragung des modularen Konzepts auf andere Enzymklassen und therapeutische Einsatzgebiete
An exploratory study evaluating the effectiveness of a data driven approach to identifying coordinative features that are associated with sprint velocity
Sprint performance is multifactorial in nature and is dependent on a variety of coordination and motor control features. During the sequential phases of a sprint, the athlete completes a series of spatiotemporal coordination strategies to achieve the fastest possible velocity. The overall aim of the study was to leverage wearable sensor technology and data- driven tools to objectively assess the kinematic and neuromuscular determinants of optimal sprint velocity from a large dataset of university-aged sprinters. To achieve this, we recruited participants to run three 60 m sprints as fast as possible, while being outfitted with wireless electromyography (EMG) and a full-body inertial measurement unit (IMU) suit to obtain full- body 3D kinematics. Five strides about peak sprint velocity were selected and used for inputs into a principal components analysis (PCA). Significant stepwise multivariable regression models were generated for both kinematic and EMG features identified using PCA, with the kinematic model outperforming the EMG model as the kinematic model displayed a higher R2 value. This suggests that the kinematic dataset used in this study is a better predictor of sprint performance when compared to the EMG dataset, and that both may be viable options in the development of data-driven objective sprint coaching tools
Autonomous Radar-based Gait Monitoring System
Features related to gait are fundamental metrics of human motion [1]. Human gait has been shown to be a valuable and feasible clinical marker to determine the risk of physical and mental functional decline [2], [3]. Technologies that detect changes in people’s gait patterns, especially older adults, could support the detection, evaluation, and monitoring of parameters related to changes in mobility, cognition, and frailty. Gait assessment has the potential to be leveraged as a clinical measurement as it is not limited to a specific health care discipline and is a consistent and sensitive test [4].
A wireless technology that uses electromagnetic waves (i.e., radar) to continually measure gait parameters at home or in a hospital without a clinician’s participation has been proposed as a suitable solution [3], [5]. This approach is based on the interaction between electromagnetic waves with humans and how their bodies impact the surrounding and scattered wireless signals. Since this approach uses wireless waves, people do not need to wear or carry a device on their bodies. Additionally, an electromagnetic wave wireless sensor has no privacy issues because there is no video-based camera.
This thesis presents the design and testing of a radar-based contactless system that can monitor people’s gait patterns and recognize their activities in a range of indoor environments frequently and accurately. In this thesis, the use of commercially available radars for gait monitoring is investigated, which offers opportunities to implement unobtrusive and contactless gait monitoring and activity recognition. A novel fast and easy-to-implement gait extraction algorithm that enables an individual’s spatiotemporal gait parameter extraction at each gait cycle using a single FMCW (Frequency Modulated Continuous Wave) radar is proposed. The proposed system detects changes in gait that may be the signs of changes in mobility, cognition, and frailty, particularly for older adults in individual’s homes, retirement homes and long-term care facilities retirement homes. One of the straightforward applications for gait monitoring using radars is in corridors and hallways, which are commonly available in most residential homes, retirement, and long-term care homes. However, walls in the hallway have a strong “clutter” impact, creating multipath due to the wide beam of commercially available radar antennas. The multipath reflections could result in an inaccurate gait measurement because gait extraction algorithms employ the assumption that the maximum reflected signals come from the torso of the walking person (rather than indirect reflections or multipath) [6].
To address the challenges of hallway gait monitoring, two approaches were used: (1) a novel signal processing method and (2) modifying the radar antenna using a hyperbolic lens. For the first approach, a novel algorithm based on radar signal processing, unsupervised learning, and a subject detection, association and tracking method is proposed. This proposed algorithm could be paired with any type of multiple-input multiple-output (MIMO) or single-input multiple-output (SIMO) FMCW radar to capture human gait in a highly cluttered environment without needing radar antenna alteration. The algorithm functionality was validated by capturing spatiotemporal gait values (e.g., speed, step points, step time, step length, and step count) of people walking in a hallway. The preliminary results demonstrate the promising potential of the algorithm to accurately monitor gait in hallways, which increases opportunities for its applications in institutional and home environments. For the second approach, an in-package hyperbola-based lens antenna was designed that can be integrated with a radar module package empowered by the fast and easy-to-implement gait extraction method. The system functionality was successfully validated by capturing the spatiotemporal gait values of people walking in a hallway filled with metallic cabinets. The results achieved in this work pave the way to explore the use of stand-alone radar-based sensors in long hallways for day-to-day long-term monitoring of gait parameters of older adults or other populations.
The possibility of the coexistence of multiple walking subjects is high, especially in long-term care facilities where other people, including older adults, might need assistance during walking. GaitRite and wearables are not able to assess multiple people’s gait at the same time using only one device [7], [8]. In this thesis, a novel radar-based algorithm is proposed that is capable of tracking multiple people or extracting walking speed of a participant with the coexistence of other people. To address the problem of tracking and monitoring multiple walking people in a cluttered environment, a novel iterative framework based on unsupervised learning and advanced signal processing was developed and tested to analyze the reflected radio signals and extract walking movements and trajectories in a hallway environment. Advanced algorithms were developed to remove multipath effects or ghosts created due to the interaction between walking subjects and stationary objects, to identify and separate reflected signals of two participants walking at a close distance, and to track multiple subjects over time. This method allows the extraction of walking speed in multiple closely-spaced subjects simultaneously, which is distinct from previous approaches where the speed of only one subject was obtained. The proposed multiple-people gait monitoring was assessed with 22 participants who participated in a bedrest (BR) study conducted at McGill University Health Centre (MUHC).
The system functionality also was assessed for in-home applications. In this regard, a cloud-based system is proposed for non-contact, real-time recognition and monitoring of physical activities and walking periods within a domestic environment. The proposed system employs standalone Internet of Things (IoT)-based millimeter wave radar devices and deep learning models to enable autonomous, free-living activity recognition and gait analysis. Range-Doppler maps generated from a dataset of real-life in-home activities are used to train deep learning models. The performance of several deep learning models was evaluated based on accuracy and prediction time, with the gated recurrent network (GRU) model selected for real-time deployment due to its balance of speed and accuracy compared to 2D Convolutional Neural Network Long Short-Term Memory (2D-CNNLSTM) and Long Short-Term Memory (LSTM) models. In addition to recognizing and differentiating various activities and walking periods, the system also records the subject’s activity level over time, washroom use frequency, sleep/sedentary/active/out-of-home durations, current state, and gait parameters. Importantly, the system maintains privacy by not requiring the subject to wear or carry any additional devices
Anwendungen maschinellen Lernens für datengetriebene Prävention auf Populationsebene
Healthcare costs are systematically rising, and current therapy-focused healthcare systems are not sustainable in the long run. While disease prevention is a viable instrument for reducing costs and suffering, it requires risk modeling to stratify populations, identify high- risk individuals and enable personalized interventions. In current clinical practice, however, systematic risk stratification is limited: on the one hand, for the vast majority of endpoints, no risk models exist. On the other hand, available models focus on predicting a single disease at a time, rendering predictor collection burdensome. At the same time, the den- sity of individual patient data is constantly increasing. Especially complex data modalities, such as -omics measurements or images, may contain systemic information on future health trajectories relevant for multiple endpoints simultaneously. However, to date, this data is inaccessible for risk modeling as no dedicated methods exist to extract clinically relevant information. This study built on recent advances in machine learning to investigate the ap- plicability of four distinct data modalities not yet leveraged for risk modeling in primary prevention. For each data modality, a neural network-based survival model was developed to extract predictive information, scrutinize performance gains over commonly collected covariates, and pinpoint potential clinical utility. Notably, the developed methodology was able to integrate polygenic risk scores for cardiovascular prevention, outperforming existing approaches and identifying benefiting subpopulations. Investigating NMR metabolomics, the developed methodology allowed the prediction of future disease onset for many common diseases at once, indicating potential applicability as a drop-in replacement for commonly collected covariates. Extending the methodology to phenome-wide risk modeling, elec- tronic health records were found to be a general source of predictive information with high systemic relevance for thousands of endpoints. Assessing retinal fundus photographs, the developed methodology identified diseases where retinal information most impacted health trajectories. In summary, the results demonstrate the capability of neural survival models to integrate complex data modalities for multi-disease risk modeling in primary prevention and illustrate the tremendous potential of machine learning models to disrupt medical practice toward data-driven prevention at population scale.Die Kosten im Gesundheitswesen steigen systematisch und derzeitige therapieorientierte Gesundheitssysteme sind nicht nachhaltig. Angesichts vieler verhinderbarer Krankheiten stellt die Prävention ein veritables Instrument zur Verringerung von Kosten und Leiden dar. Risikostratifizierung ist die grundlegende Voraussetzung für ein präventionszentri- ertes Gesundheitswesen um Personen mit hohem Risiko zu identifizieren und Maßnah- men einzuleiten. Heute ist eine systematische Risikostratifizierung jedoch nur begrenzt möglich, da für die meisten Krankheiten keine Risikomodelle existieren und sich verfüg- bare Modelle auf einzelne Krankheiten beschränken. Weil für deren Berechnung jeweils spezielle Sets an Prädiktoren zu erheben sind werden in Praxis oft nur wenige Modelle angewandt. Gleichzeitig versprechen komplexe Datenmodalitäten, wie Bilder oder -omics- Messungen, systemische Informationen über zukünftige Gesundheitsverläufe, mit poten- tieller Relevanz für viele Endpunkte gleichzeitig. Da es an dedizierten Methoden zur Ex- traktion klinisch relevanter Informationen fehlt, sind diese Daten jedoch für die Risikomod- ellierung unzugänglich, und ihr Potenzial blieb bislang unbewertet. Diese Studie nutzt ma- chinelles Lernen, um die Anwendbarkeit von vier Datenmodalitäten in der Primärpräven- tion zu untersuchen: polygene Risikoscores für die kardiovaskuläre Prävention, NMR Meta- bolomicsdaten, elektronische Gesundheitsakten und Netzhautfundusfotos. Pro Datenmodal- ität wurde ein neuronales Risikomodell entwickelt, um relevante Informationen zu extra- hieren, additive Information gegenüber üblicherweise erfassten Kovariaten zu quantifizieren und den potenziellen klinischen Nutzen der Datenmodalität zu ermitteln. Die entwickelte Me-thodik konnte polygene Risikoscores für die kardiovaskuläre Prävention integrieren. Im Falle der NMR-Metabolomik erschloss die entwickelte Methodik wertvolle Informa- tionen über den zukünftigen Ausbruch von Krankheiten. Unter Einsatz einer phänomen- weiten Risikomodellierung erwiesen sich elektronische Gesundheitsakten als Quelle prädik- tiver Information mit hoher systemischer Relevanz. Bei der Analyse von Fundusfotografien der Netzhaut wurden Krankheiten identifiziert für deren Vorhersage Netzhautinformationen genutzt werden könnten. Zusammengefasst zeigten die Ergebnisse das Potential neuronaler Risikomodelle die medizinische Praxis in Richtung einer datengesteuerten, präventionsori- entierten Medizin zu verändern
Co-simulation of human digital twins and wearable inertial sensors to analyse gait event estimation
We propose a co-simulation framework comprising biomechanical human body models and wearable inertial sensor models to analyse gait events dynamically, depending on inertial sensor type, sensor positioning, and processing algorithms. A total of 960 inertial sensors were virtually attached to the lower extremities of a validated biomechanical model and shoe model. Walking of hemiparetic patients was simulated using motion capture data (kinematic simulation). Accelerations and angular velocities were synthesised according to the inertial sensor models. A comprehensive error analysis of detected gait events versus reference gait events of each simulated sensor position across all segments was performed. For gait event detection, we considered 1-, 2-, and 4-phase gait models. Results of hemiparetic patients showed superior gait event estimation performance for a sensor fusion of angular velocity and acceleration data with lower nMAEs (9%) across all sensor positions compared to error estimation with acceleration data only. Depending on algorithm choice and parameterisation, gait event detection performance increased up to 65%. Our results suggest that user personalisation of IMU placement should be pursued as a first priority for gait phase detection, while sensor position variation may be a secondary adaptation target. When comparing rotatory and translatory error components per body segment, larger interquartile ranges of rotatory errors were observed for all phase models i.e., repositioning the sensor around the body segment axis was more harmful than along the limb axis for gait phase detection. The proposed co-simulation framework is suitable for evaluating different sensor modalities, as well as gait event detection algorithms for different gait phase models. The results of our analysis open a new path for utilising biomechanical human digital twins in wearable system design and performance estimation before physical device prototypes are deployed
- …