Objective: Controlling the spread of the COVID-19 pandemic largely depends on scaling up the testing infrastructure for identifying infected individuals. Consumer-grade wearables may present a solution to detect the presence of infections in the population, but the current paradigm requires collecting physiological data continuously and for long periods of time on each individual, which poses limitations in the context of rapid screening. Technology: Here, we propose a novel paradigm based on recording the physiological responses elicited by a short (~2 minutes) sequence of activities (i.e. “snapshot”), to detect symptoms associated with COVID-19. We employed a novel body-conforming soft wearable sensor placed on the suprasternal notch to capture data on physical activity, cardio-respiratory function, and cough sounds. Results: We performed a pilot study in a cohort of individuals (n=14) who tested positive for COVID-19 and detected altered heart rate, respiration rate and heart rate variability, relative to a group of healthy individuals (n=14) with no known exposure. Logistic regression classifiers were trained on individual and combined sets of physiological features (heartbeat and respiration dynamics, walking cadence, and cough frequency spectrum) at discriminating COVID-positive participants from the healthy group. Combining features yielded an AUC of 0.94 (95% CI=[0.92, 0.96]) using a leave-one-subject-out cross validation scheme. Conclusions and Clinical Impact: These results, although preliminary, suggest that a sensor-based snapshot paradigm may be a promising approach for non-invasive and repeatable testing to alert individuals that need further screening.

Traumatic brain injury (TBI) is a complex injury that is hard to predict and diagnose, with many studies focused on associating head kinematics to brain injury risk. Recently, there has been a push towards using computationally expensive finite element (FE) models of the brain to create tissue deformation metrics of brain injury. Here, we develop a new brain injury metric, the Brain Angle Metric (BAM), based on the dynamics of a 3 degree-of-freedom lumped parameter brain model. The brain model is built based on the measured natural frequencies of a FE brain model simulated with live human impact data. We show it can be used to rapidly estimate peak brain strains experienced during head rotational accelerations. On our dataset, the simplified model highly correlates with peak principal FE strain (R 2 =0.80). Further, coronal and axial model displacement correlated with fiber-oriented peak strain in the corpus callosum (R 2 =0.77). Our proposed injury metric BAM uses the maximum angle predicted by our brain model, and is compared against a number of existing rotational and translational kinematic injury metrics on a dataset of head kinematics from 27 clinically diagnosed injuries and 887 non-injuries. We found that BAM performed comparably to peak angular acceleration, linear acceleration, and angular velocity in classifying injury and non-injury events. Metrics which separated time traces into their directional components had improved model deviance to those which combined components into a single time trace magnitude. Our brain model can be used in future work both as a computationally efficient alternative to FE models and for classifying injuries over a wide range of loading conditions. Key words:Brain injury, injury criterion, injury prediction, concussion 159.32, 131.53, and 132.02 respectively. Further, metrics such as HIC and SI which analyze acceleration magnitudes performed with lower sensitivity to those which treated each direction separately. Similarly, the VTCP, which takes into account peak linear and angular acceleration magnitude, had lower model deviance and higher AUCPR and AUCROC than metrics which treated each anatomical direction separately. Peak linear acceleration ( ⃗) had lower deviance, AUCPR, and AUCROC to peak angular kinematics and BAM but still outperformed many other metrics. While many previous studies suggest rotation is a primary cause of brain injury 16,17,56 , the results shown here indicate that linear acceleration still has predictive value in classifying brain injuries. This could be because in our dataset, with the majority of injuries taken from laboratory reconstruction data, the linear and angular acceleration values may be coupled more so than in-vivo data.However, single variate injury criteria, based on linear acceleration, had extremely low sensitivity in our dataset. We see that both HIC15 and SI predict only a single event with >50% risk of injury on our dataset due to a few non-injury events with high HIC15 and SI values. Surprisingly, many existing metrics had hig...

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Real-time quantification of head impacts using wearable sensors is an appealing approach to assess concussion risk. Traditionally, sensors were evaluated for accurately measuring peak resultant skull accelerations and velocities. With growing interest in utilizing model-estimated tissue responses for injury prediction, it is important to evaluate sensor accuracy in estimating tissue response as well. Here, we quantify how sensor kinematic measurement errors can propagate into tissue response errors. Using previous instrumented mouthguard validation datasets, we found that skull kinematic measurement errors in both magnitude and direction lead to errors in tissue response magnitude and distribution. For molar design instrumented mouthguards susceptible to mandible disturbances, 150-400% error in skull kinematic measurements resulted in 100% error in regional peak tissue response. With an improved incisor design mitigating mandible disturbances, errors in skull kinematics were reduced to <50%, and several tissue response errors were reduced to <10%. Applying 30[Formula: see text] rotations to reference kinematic signals to emulate sensor transformation errors yielded below 10% error in regional peak tissue response; however, up to 20% error was observed in peak tissue response for individual finite elements. These findings demonstrate that kinematic resultant errors result in regional peak tissue response errors, while kinematic directionality errors result in tissue response distribution errors. This highlights the need to account for both kinematic magnitude and direction errors and accurately determine transformations between sensors and the skull.

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Despite numerous research efforts, the precise mechanisms of concussion have yet to be fully uncovered. Clinical studies on high-risk populations, such as contact sports athletes, have become more common and give insight on the link between impact severity and brain injury risk through the use of wearable sensors and neurological testing. However, as the number of institutions operating these studies grows, there is a growing need for a platform to share these data to facilitate our understanding of concussion mechanisms and aid in the development of suitable diagnostic tools. To that end, this paper puts forth two contributions: (1) a centralized, open-access platform for storing and sharing head impact data, in collaboration with the Federal Interagency Traumatic Brain Injury Research informatics system (FITBIR), and (2) a deep learning impact detection algorithm (MiGNet) to differentiate between true head impacts and false positives for the previously biomechanically validated instrumented mouthguard sensor (MiG2.0), all of which easily interfaces with FITBIR. We report 96% accuracy using MiGNet, based on a neural network model, improving on previous work based on Support Vector Machines achieving 91% accuracy, on an out of sample dataset of high school and collegiate football head impacts. The integrated MiG2.0 and FITBIR system serve as a collaborative research tool to be disseminated across multiple institutions towards creating a standardized dataset for furthering the knowledge of concussion biomechanics.

This analysis quantifies the importance of head positioning prior to impact, and may help to explain why other species are naturally more resilient to head impacts than humans.

Mild traumatic brain injury (mTBI), more colloquially known as concussion, is common in contact sports such as American football, leading to increased scrutiny of head protective gear. Standardized laboratory impact testing, such as the yearly NFL helmet test, is used to rank the protective performance of football helmets, motivating new technologies to improve the safety of helmets relative to existing equipment. In this work, we hypothesized that a helmet which transmits a nearly constant minimum force will result in a reduced risk of mTBI. To evaluate the plausibility of this hypothesis, we first show that the optimal force transmitted to the head, in a reduced order model of the brain, is in fact a constant force profile. To simulate the effects of a constant force within a helmet, we conceptualize a fluid-based shock absorber system for use within a football helmet. We integrate this system within a computational helmet model and simulate its performance on the standard NFL helmet test impact conditions. The simulated helmet is compared with other helmet designs with different technologies. Computer simulations of head impacts with liquid shock absorption predict that, at the highest impact speed (9.3 m/s), the average brain tissue strain is reduced by 27.6% ± 9.3 compared to existing helmet padding when tested on the NFL helmet protocol. This simulation-based study puts forth a target benchmark for the future design of physical manifestations of this technology.