Embedded Sensing Group ESG Institute of Computer Science in V orarlberg ICV, University of St. Gallen HSG, Switzerland E-mail: leonardo.rossi@student.unisg.ch, Abstract--Triathlon training, which involves high-volume swimming, cycling, and running, places athletes at substantial risk for overuse injuries due to repetitive physiological stress. Current injury prediction approaches primarily rely on training load metrics, often neglecting critical factors such as sleep quality, stress, and individual lifestyle patterns that significantly influence recovery and injury susceptibility. We introduce a novel synthetic data generation framework tailored explicitly for triathlon. This framework generates physiologically plausible athlete profiles, simulates individualized training programs that incorporate periodization and load-management principles, and integrates daily-life factors such as sleep quality, stress levels, and recovery states. We evaluated machine learning models (LASSO, Random Forest, and XGBoost) showing high predictive performance (AUC up to 0.86), identifying sleep disturbances, heart rate variability, and stress as critical early indicators of injury risk. This wearable-driven approach not only enhances injury prediction accuracy but also provides a practical solution to overcoming real-world data limitations, offering a pathway toward a holistic, context-aware athlete monitoring. Triathlon is a demanding multi-sport discipline that combines swimming, cycling, and running.

In precision sports such as archery, athletes' performance depends on both biomechanical stability and psychological resilience. Traditional motion analysis systems are often expensive and intrusive, limiting their use in natural training environments. To address this limitation, we propose a machine learning-based multimodal framework that integrates wearable sensor data for simultaneous action recognition and stress estimation. Using a self-developed wrist-worn device equipped with an accelerometer and photoplethysmography (PPG) sensor, we collected synchronized motion and physiological data during real archery sessions. For motion recognition, we introduce a novel feature--Smoothed Differential Acceleration (SmoothDiff)--and employ a Long Short-Term Memory (LSTM) model to identify motion phases, achieving 96.8% accuracy and 95.9% F1-score. For stress estimation, we extract heart rate variability (HRV) features from PPG signals and apply a Multi-Layer Perceptron (MLP) classifier, achieving 80% accuracy in distinguishing high- and low-stress levels. The proposed framework demonstrates that integrating motion and physiological sensing can provide meaningful insights into athletes' technical and mental states. This approach offers a foundation for developing intelligent, real-time feedback systems for training optimization in archery and other precision sports.

Human emotions fundamentally shape decision-making, social interactions, and cognitive processes. Modern human-computer interaction (HCI) systems, however, remain largely oblivious to users' affective states, relying exclusively on explicit inputs such as touch, speech, or gaze. The proliferation of consumer wearables such as smartwatches, fitness trackers, and health monitors has democratized access to continuous physiological data, creating unprecedented opportunities for emotionally intelligent computing [1, 2]. Physiological signals offer several advantages over traditional modalities (facial expressions, voice) for emotion recognition: they are continuous, difficult to consciously manipulate, and unaffected by environmental factors such as lighting or occlusion [3]. Among these signals, heart rate variability (HR V), the temporal variation between consecutive heartbeats, has emerged as a robust biomarker of autonomic nervous system activity and emotional states [4, 5]. Despite significant research advances in affective computing, most emotion recognition systems exhibit two critical limitations: 1. Privacy vulnerabilities: Cloud-based inference requires transmitting sensitive bio-metric data to external servers, exposing users to data breaches, surveillance, and loss of autonomy [6].

Chagas disease affects nearly 6 million people worldwide, with Chagas cardiomyopathy representing its most severe complication. In regions where serological testing capacity is limited, AI-enhanced electrocardiogram (ECG) screening provides a critical diagnostic alternative. However, existing machine learning approaches face challenges such as limited accuracy, reliance on large labeled datasets, and more importantly, weak integration with evidence-based clinical diagnostic indicators. W e propose a retrieval-augmented generation framework, CardioRAG, integrating large language models with interpretable ECG-based clinical features, including right bundle branch block, left anterior fascicular block, and heart rate variability metrics. The framework uses vari-ational autoencoder-learned representations for semantic case retrieval, providing contextual cases to guide clinical reasoning. Evaluation demonstrated high recall performance of 89.80%, with a maximum F1 score of 0.68 for effective identification of positive cases requiring prioritized serological testing. CardioRAG provides an interpretable, clinical evidence-based approach particularly valuable for resource-limited settings, demonstrating a pathway for embedding clinical indicators into trustworthy medical AI systems.

Due to the complex and resource-intensive nature of diagnosing Autism Spectrum Condition (ASC), several computer-aided diagnostic support methods have been proposed to detect autism by analyzing behavioral cues in patient video data. While these models show promising results on some datasets, they struggle with poor gaze feature performance and lack of real-world generalizability. To tackle these challenges, we analyze a standardized video dataset comprising 168 participants with ASC (46% female) and 157 non-autistic participants (46% female), making it, to our knowledge, the largest and most balanced dataset available. We conduct a multimodal analysis of facial expressions, voice prosody, head motion, heart rate variability (HRV), and gaze behavior. To address the limitations of prior gaze models, we introduce novel statistical descriptors that quantify variability in eye gaze angles, improving gaze-based classification accuracy from 64% to 69% and aligning computational findings with clinical research on gaze aversion in ASC. Using late fusion, we achieve a classification accuracy of 74%, demonstrating the effectiveness of integrating behavioral markers across multiple modalities. Our findings highlight the potential for scalable, video-based screening tools to support autism assessment.

Non-invasive glucose monitoring remains a critical challenge in the management of diabetes. HRV during sleep shows promise for glucose prediction however, age-related autonomic changes significantly confound traditional HRV analyses. We analyzed 43 subjects with multi-modal data including sleep-stage specific ECG, HRV features, and clinical measurements. A novel age-normalization technique was applied to the HRV features by, dividing the raw values by age-scaled factors. BayesianRidge regression with 5-fold cross-validation was employed for log-glucose prediction. Age-normalized HRV features achieved R2 = 0.161 (MAE = 0.182) for log-glucose prediction, representing a 25.6% improvement over non-normalized features (R2 = 0.132). The top predictive features were hrv rem mean rr age normalized (r = 0.443, p = 0.004), hrv ds mean rr age normalized (r = 0.438, p = 0.005), and diastolic blood pressure (r = 0.437, p = 0.005). Systematic ablation studies confirmed age-normalization as the critical component, with sleep-stage specific features providing additional predictive value. Age-normalized HRV features significantly enhance glucose prediction accuracy compared with traditional approaches. This sleep-aware methodology addresses fundamental limitations in autonomic function assessment and suggests a preliminary feasibility for non-invasive glucose monitoring applications. However, these results require validation in larger cohorts before clinical consideration.

Monitoring and analyzing electrocardiogram (ECG) signals, even under varying physiological conditions, including those influenced by physical activity, drugs and stress, is crucial to accurately assess cardiac health. However, current AI-based methods often fail to account for how these factors interact and alter ECG patterns, ultimately limiting their applicability in real-world settings. This study introduces IKrNet, a novel neural network model, which identifies drug-specific patterns in ECGs amidst certain physiological conditions. IKrNet's architecture incorporates spatial and temporal dynamics by using a convolutional backbone with varying receptive field size to capture spatial features. A bi-directional Long Short-Term Memory module is also employed to model temporal dependencies. By treating heart rate variability as a surrogate for physiological fluctuations, we evaluated IKrNet's performance across diverse scenarios, including conditions with physical stress, drug intake alone, and a baseline without drug presence. Our assessment follows a clinical protocol in which 990 healthy volunteers were administered 80mg of Sotalol, a drug which is known to be a precursor to Torsades-de-Pointes, a life-threatening arrhythmia. We show that IKrNet outperforms state-of-the-art models' accuracy and stability in varying physiological conditions, underscoring its clinical viability.

The dead-in-bed syndrome describes the sudden and unexplained death of young individuals with Type 1 Diabetes (T1D) without prior long-term complications. One leading hypothesis attributes this phenomenon to nocturnal hypoglycemia (NH), a dangerous drop in blood glucose during sleep. This study aims to improve NH prediction in children with T1D by leveraging physiological data and machine learning (ML) techniques. We analyze an in-house dataset collected from 16 children with T1D, integrating physiological metrics from wearable sensors. We explore predictive performance through feature engineering, model selection, architectures, and oversampling. To address data limitations, we apply transfer learning from a publicly available adult dataset. Our results achieve an AUROC of 0.75 +- 0.21 on the in-house dataset, further improving to 0.78 +- 0.05 with transfer learning. This research moves beyond glucose-only predictions by incorporating physiological parameters, showcasing the potential of ML to enhance NH detection and improve clinical decision-making for pediatric diabetes management.

Personalized virtual reality exposure therapy is a therapeutic practice that can adapt to an individual patient, leading to better health outcomes. Measuring a patient's mental state to adjust the therapy is a critical but difficult task. Most published studies use subjective methods to estimate a patient's mental state, which can be inaccurate. This article proposes a virtual reality exposure therapy (VRET) platform capable of assessing a patient's mental state using non-intrusive and widely available physiological signals such as photoplethysmography (PPG). In a case study, we evaluate how PPG signals can be used to detect two binary classifications: peaceful and stressful states. Sixteen healthy subjects were exposed to the two VR environments (relaxed and stressful). Using LOSO cross-validation, our best classification model could predict the two states with a 70.6% accuracy which outperforms many more complex approaches.

Alterations in Heart Rate (HR) and Heart Rate Variability (HRV) can reflect autonomic dysfunction associated with neurodegeneration. We investigate the influence of Mild Cognitive Impairment (MCI) on HR and its variability measures in the Indian population by designing a complete signal processing pipeline to detect the R-wave peaks and compute HR and HRV features from ECG recordings of 10 seconds, for point-of-care applications. The study cohort involves 297 urban participants, among which 48.48% are male and 51.51% are female. From the Addenbrooke's Cognitive Examination-III (ACE-III), MCI is detected in 19.19% of participants and the rest, 80.8% of them are cognitively healthy. Statistical features like central tendency (mean and root mean square (RMS) of the Normal-to-Normal (NN) intervals) and dispersion (standard deviation (SD) of all NN intervals (SDNN) and root mean square of successive differences of NN intervals (RMSSD)) of beat-to-beat intervals are computed. The Wilcoxon rank sum test reveals that mean of NN intervals (p = 0.0021), the RMS of NN intervals (p = 0.0014), the SDNN (p = 0.0192) and the RMSSD (p = 0.0206) values differ significantly between MCI and non-MCI classes, for a level of significance, 0.05. Machine learning classifiers like, Support Vector Machine (SVM), Discriminant Analysis (DA) and Naive Bayes (NB) driven by mean NN intervals, RMS, SDNN and RMSSD, show a high accuracy of 80.80% on each individual feature input. Individuals with MCI are observed to have comparatively higher HR than healthy subjects. HR and its variability can be considered as potential biomarkers for detecting MCI.