Longitudinal cardio-respiratory fitness prediction through wearables in free-living environments

Machine Learning-Based VO2 Estimation Using a Wearable Multiwavelength Photoplethysmography Device

The rate of oxygen consumption, which is measured as the volume of oxygen consumed per mass per minute (VO2) mL/kg/min, is a critical metric for evaluating cardiovascular health, metabolic status, and respiratory function. Specifically, VO2 is a powerful prognostic predictor of survival in patients with heart failure (HF) because it provides an indirect assessment of a patient's ability to increase cardiac output (CO). In addition, VO2 measurements, particularly VO2 max, are significant because they provide a reliable indicator of your cardiovascular fitness and aerobic endurance. However, traditional VO2 assessment requires bulky, breath-by-breath gas analysis systems, limiting frequent and continuous monitoring to specialized settings. This study presents a novel wrist-worn multiwavelength photoplethysmography (PPG) device and machine learning algorithm designed to estimate VO2 continuously. Unlike conventional wearables that rely on static formulas for VO2 max estimation, our algorithm leverages the data from the PPG wearable and uses the Beer-Lambert Law with inputs from five wavelengths (670 nm, 770 nm, 810 nm, 850 nm, and 950 nm), incorporating the isosbestic point at 810 nm to differentiate oxy- and deoxy-hemoglobin. A validation study was conducted with eight subjects using a modified Bruce protocol, comparing the PPG-based estimates to the gold-standard Parvo Medics gas analysis system. The results demonstrated a mean absolute error of 1.66 mL/kg/min and an R2 of 0.94. By providing precise, individualized VO2 estimates using direct tissue oxygenation data, this wearable solution offers significant clinical and practical advantages over traditional methods, making continuous and accurate cardiovascular assessment readily available beyond clinical environments.

Machine learning prediction of pulmonary oxygen uptake from muscle oxygen in cycling

The purpose of this study was to test whether a machine learning model can accurately predict VO2 across different exercise intensities by combining muscle oxygen (MO2) with heart rate (HR). Twenty young highly trained athletes performed the following tests: a ramp incremental exercise, three submaximal constant intensity exercises, and three severe intensity exhaustive exercises. A Machine Learning model was trained to predict VO2, with model inputs including heart rate, MO2 in the left (LM) and right legs (RM). All models demonstrated equivalent results, with the accuracy of predicting VO2 at different exercise intensities varying among different models. The LM+RM+HR model performed the best across all intensities, with low bias in predicted VO2 for all intensity exercises (0.08 ml/kg/min, 95% limits of agreement: -5.64 to 5.81), and a very strong correlation (r = 0.94, p < 0.001) with measured VO2. Furthermore, the accuracy of predicting VO2 using LM+HR or RM+HR was higher than using LM+RM, and higher than the accuracy of predicting VO2 using LM, RM, or HR alone. This study demonstrates the potential of a machine learning model combining MO2 and HR to predict VO2 with minimal bias, achieving accurate predictions of VO2 for different intensity levels of exercise.

Highly Sensitive Biomimetic Crack Pressure Sensor with Selective Frequency Response

High-sensitivity sensors in practical applications face the issue of environmental noise interference, requiring additional noise reduction circuits or filtering algorithms to improve the signal-to-noise ratio (SNR). To address this issue, this study proposes a biomimetic crack pressure sensor with selective frequency response based on hydrogel dampers. The core of this research is to construct a biomimetic crack pressure sensor with selective frequency response using the high-pass filtering characteristics of gelatin-chitosan hydrogels. This design, inspired by the slit sensilla and stratum corneum structure of spider legs, delves into the material properties and principles of hydrogel dampers, exploring their application in biomimetic crack pressure sensors, including parameter selection, structural design, and performance optimization. By delving into the nuanced characteristics and working principles of hydrogel dampers, their integration in biomimetic crack pressure sensors is examined, focusing on aspects like parameter selection, structural engineering, and performance enhancement to selectively sieve out low-frequency noise and transmit target vibrational signals. Experimental results demonstrate that this innovative sensor, while suppressing low-frequency vibration signals, can selectively detect high-frequency signals with high sensitivity. At different vibration frequencies, the relative change in resistance exceeds 200%, and the sensor sensitivity is 7 × 104 kPa-1. Furthermore, this sensor was applied to human voice detection, and the corresponding results verified its frequency-selective performance evidently. This study not only proposes a new design for pressure sensors but also offers fresh insights into the application of biomimetic crack pressure sensors in intricate environments.

Proteomic analysis of cardiorespiratory fitness for prediction of mortality and multisystem disease risks

Despite the wide effects of cardiorespiratory fitness (CRF) on metabolic, cardiovascular, pulmonary and neurological health, challenges in the feasibility and reproducibility of CRF measurements have impeded its use for clinical decision-making. Here we link proteomic profiles to CRF in 14,145 individuals across four international cohorts with diverse CRF ascertainment methods to establish, validate and characterize a proteomic CRF score. In a cohort of around 22,000 individuals in the UK Biobank, a proteomic CRF score was associated with a reduced risk of all-cause mortality (unadjusted hazard ratio 0.50 (95% confidence interval 0.48-0.52) per 1 s.d. increase). The proteomic CRF score was also associated with multisystem disease risk and provided risk reclassification and discrimination beyond clinical risk factors, as well as modulating high polygenic risk of certain diseases. Finally, we observed dynamicity of the proteomic CRF score in individuals who undertook a 20-week exercise training program and an association of the score with the degree of the effect of training on CRF, suggesting potential use of the score for personalization of exercise recommendations. These results indicate that population-based proteomics provides biologically relevant molecular readouts of CRF that are additive to genetic risk, potentially modifiable and clinically translatable.

Wearable Sensors as a Preoperative Assessment Tool: A Review

Surgery is a common first-line treatment for many types of disease, including cancer. Mortality rates after general elective surgery have seen significant decreases whilst postoperative complications remain a frequent occurrence. Preoperative assessment tools are used to support patient risk stratification but do not always provide a precise and accessible assessment. Wearable sensors (WS) provide an accessible alternative that offers continuous monitoring in a non-clinical setting. They have shown consistent uptake across the perioperative period but there has been no review of WS as a preoperative assessment tool. This paper reviews the developments in WS research that have application to the preoperative period. Accelerometers were consistently employed as sensors in research and were frequently combined with photoplethysmography or electrocardiography sensors. Pre-processing methods were discussed and missing data was a common theme; this was dealt with in several ways, commonly by employing an extraction threshold or using imputation techniques. Research rarely processed raw data; commercial devices that employ internal proprietary algorithms with pre-calculated heart rate and step count were most commonly employed limiting further feature extraction. A range of machine learning models were used to predict outcomes including support vector machines, random forests and regression models. No individual model clearly outperformed others. Deep learning proved successful for predicting exercise testing outcomes but only within large sample-size studies. This review outlines the challenges of WS and provides recommendations for future research to develop WS as a viable preoperative assessment tool.

Considerations on How to Prevent Parkinson's Disease Through Exercise

The increasing prevalence of people with Parkinson's disease (PD) necessitates a high priority for finding interventions to delay or even prevent the onset of PD. There is converging evidence that exercise may exert disease-modifying effects in people with clinically manifest PD, but whether exercise also has a preventive effect or is able to modify the progression of the pathology in the prodromal phase of PD is unclear. Here we provide some considerations on the design of trials that aim to prevent PD through exercise. First, we discuss the who could benefit from exercise, and potential exercise-related risks. Second, we discuss what specific components of exercise mediate the putative disease-modifying effects. Third, we address how methodological challenges such as blinding, adherence and remote monitoring could be handled and how we can measure the efficacy of exercise as modifier of the course of prodromal PD. We hope that these considerations help in designing exercise prevention trials for persons at risk of developing PD.

Human-centred artificial intelligence for mobile health sensing: challenges and opportunities

Advances in wearable sensing and mobile computing have enabled the collection of health and well-being data outside of traditional laboratory and hospital settings, paving the way for a new era of mobile health. Meanwhile, artificial intelligence (AI) has made significant strides in various domains, demonstrating its potential to revolutionize healthcare. Devices can now diagnose diseases, predict heart irregularities and unlock the full potential of human cognition. However, the application of machine learning (ML) to mobile health sensing poses unique challenges due to noisy sensor measurements, high-dimensional data, sparse and irregular time series, heterogeneity in data, privacy concerns and resource constraints. Despite the recognition of the value of mobile sensing, leveraging these datasets has lagged behind other areas of ML. Furthermore, obtaining quality annotations and ground truth for such data is often expensive or impractical. While recent large-scale longitudinal studies have shown promise in leveraging wearable sensor data for health monitoring and prediction, they also introduce new challenges for data modelling. This paper explores the challenges and opportunities of human-centred AI for mobile health, focusing on key sensing modalities such as audio, location and activity tracking. We discuss the limitations of current approaches and propose potential solutions.