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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