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The Second Skin: A Wearable Sensor Suite that Enables Real-Time Human Biomechanics Tracking Through Deep Learning

Objective: Real-time determination of human kinematics and kinetics could advance biomechanics research and enable valuable applications of biofeedback and generalizable exoskeleton control. Here, this work aims to investigate a taskindependent, user-independent method for obtaining precise realtime joint state estimation across lower-body joints during a wide variety of tasks. Methods: We developed a generalizable sensing approach using a suit comprised of inertial measurement units (IMUs) and pressure insoles. With the suit, we collected a dataset of 33 tasks commonly performed during construction and hazardous waste cleanup (N = 10). We then trained deep learning user-independent, task-agnostic models to estimate joint lowerbody kinematics and dynamics using only worn sensor data. We likewise computed joint kinematics and dynamics analytically from sensor data to serve as a comparison tool for model results. Results: Our models achieved overall angle estimation root-meansquared-errors (RMSE) of 6.56±.92°, 8.60±1.01°, 7.58±.89°, and 6.00±.73° compared to 13.9±.1.3°, 15.31±1.0°, 10.76±.70°, and 7.56±.48° via analytical methods at the lower back, hip, knee, and ankle, respectively. Likewise, our models achieved overall normalized moment estimation RMSEs of .207±.069 Nm/kg, .242±.044 Nm/kg, .202±.038 Nm/kg, and .193±.034 Nm/kg compared to .306±.036 Nm/kg, .407±.021 Nm/kg, 1.18 ±.022 Nm/kg, and 1.73±.071 Nm/kg via analytical methods at the lower back, hip, knee, and ankle, respectively. Conclusion: These results are comparable to other state-of-the-art wearable sensing systems, establishing deep learning as a viable sensing approach that generalizes to new users and tasks. Significance: This work shows promise for enabling accurate real-world biomechanical data collection and enhancement of biofeedback systems and wearable robot control.

Casey, Ryan T. F. [Georgia Institute of Technology↗

Compliant Intramedullary Stems for Joint Reconstruction

The longevity of current joint replacements is limited by aseptic loosening, which is the primary cause of non-infectious failure for hip, knee, and ankle arthroplasty. Aseptic loosening is typically caused either by osteolysis from particulate wear, or by high shear stresses at the bone-implant interface from over-constraint. Our objective was to demonstrate feasibility of a compliant intramedullary stem that eliminates over-constraint without generating particulate wear. The compliant stem is built around a compliant mechanism that permits rotation about a single axis. We first established several models to understand the relationship between mechanism geometry and implant performance under a given angular displacement and compressive load. We then used a neural network to identify a design space of geometries that would support an expected 100-year fatigue life inside the body. We additively manufactured one representative mechanism for each of three anatomic locations, and evaluated these prototypes on a KR-210 robot. The neural network predicts maximum stress and torsional stiffness with 2.69% and 4.08% error respectively, relative to finite element analysis data. We identified feasible design spaces for all three of the anatomic locations. Simulated peak stresses for the three stem prototypes were below the fatigue limit. Benchtop performance of all three prototypes was within design specifications. Our results demonstrate the feasibility of designing patient- and joint-specific compliant stems that address the root causes of aseptic loosening. Guided by these results, we expect the use of compliant intramedullary stems in joint reconstruction technology to increase implant lifetime.

60 APPLIED LIFE SCIENCES↗

Enhancing segmentation fairness through curriculum learning and progressive loss: a centralized and federated perspective on radiograph analysis

Bias in medical image segmentation can lead to unequal performance across demographic subgroups, raising concerns about fairness and reliability in clinical AI systems. While deep learning models have achieved high segmentation accuracy, ensuring equitable performance across race and gender remains a significant challenge, particularly in privacy-sensitive healthcare environments. This study investigates fairness-aware medical image segmentation for hip and knee radiographs using deep learning models evaluated in both centralized and Federated Learning (FL) settings. We introduce Curriculum Learning (CL) strategies and Progressive Loss (PL) functions to regulate sample difficulty during training. In addition, we propose two novel fairness-oriented federated learning algorithms, Federated Intersection over Union (FedIoU) and Federated Intersection over Union with Outlier Analysis (FedIoUoutlier). Experiments are conducted using multiple segmentation backbones and simulated multi-site data partitions derived from the Osteoarthritis Initiative dataset. Model performance is evaluated using Intersection over Union (IoU), IoU standard deviation, Skewed Error Ratio (SER), and Min-Max Disparity across race and gender subgroups. Statistical significance was verified using paired t-tests to compare per-sample IoU performance against baseline configurations. Across both hip and knee segmentation tasks, curriculum learning and progressive loss strategies consistently improved segmentation accuracy and reduced demographic performance disparities in centralized training. In federated settings, fairness-aware aggregation further enhanced performance. Notably, FedIoUoutlier combined with balanced curriculum learning and tiered progressive loss achieved the highest mean IoU while yielding the lowest SER and Min-Max Disparity, indicating improved fairness without sacrificing accuracy. In several configurations, federated models matched or exceeded the performance of optimized centralized models, with statistically significant improvements in per-sample IoU over baseline configurations. The results demonstrate that structured training strategies and fairness-aware federated aggregation can jointly improve accuracy, stability, and demographic fairness in medical image segmentation. By integrating curriculum learning, progressive loss, and novel FL algorithms, this work provides a practical pathway toward equitable and privacy-preserving AI systems for medical imaging.

97 MATHEMATICS AND COMPUTING↗

Gait Characterization and Analysis of Hereditary Amyloidosis Associated with Transthyretin Patients: A Case Series

Hereditary amyloidosis associated with transthyretin (ATTRv), is a rare autosomal dominant disease characterized by length-dependent symmetric polyneuropathy that has gait impairment as one of its consequences. The gait pattern of V30M ATTRv amyloidosis patients has been described as similar to that of diabetic neuropathy, associated with steppage, but has never been quantitatively characterized. In this study we aim to characterize the gait pattern of patients with V30M ATTRv amyloidosis, thus providing information for a better understanding and potential for supporting diagnosis and disease progression evaluation. We present a case series in which we conducted two gait analyses, 18 months apart, of five V30M ATTRv amyloidosis patients using a 12-camera, marker based, optical system as well as six force platforms. Linear kinematics, ground reaction forces, and angular kinematics results are analyzed for all patients. All patients, except one, showed a delayed toe-off in the second assessment, as well as excessive pelvic rotation, hip extension and external transverse rotation and knee flexion (in stance and swing phases), along with reduced vertical and mediolateral ground reaction forces. The described gait anomalies are not clinically quantified; thus, gait analysis may contribute to the assessment of possible disease progression along with the clinical evaluation.

Vilas-Boas, Maria do Carmo (ORCID:000000025012789X↗