Monitoring Metabolic Status Predicting Decrements in Physiological and Cognitive Performance (2004) / Chapter Skim
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1 Rationale for Military Interest and Current Capabilities in Monitoring Metabolism
1 Rationale for Military Interest and Current Capabilities in Monitoring Metabolism
Pages 15-36
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From page 15... ...
Monitoring metabolic processes is needed to predict the readiness status of individuals in training and operational settings where human performance is important. NEED FOR PHYSIOLOGICAL MONITORING Monitoring combat service member status has become increasingly important as a result of new complex and lethal technologies that require high levels of cognitive readiness, such as computerized weapon systems; complicated communications and targeting devices; high-performance aircraft, tanks, and maritime vessels; and even the technologically advanced diagnostic systems used in the maintenance of military equipment.
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From page 16... ...
Helicopter pilots must remain cognitively alert at all times if they are to successfully pilot their aircraft at speeds of 50 to 100 mph while maintaining altitudes of only 50 ft above terrain obstacles. Flying close combat support means that helicopter pilots are operating under conditions that are quite similar to those faced by combat military personnel on the ground: they are close to enemy threats, they are often hot or cold due to the lack of air conditioning, and they are required to live in the most austere and uncomfortable environments for days, weeks, or months at a time.
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In addition, today's high-performance aircraft can easily exceed the limits of human physiological tolerances. One concept for physiological monitoring includes monitoring a pilot's approaching loss of consciousness in order to trigger an automatic take over of the plane's controls (Forster et al., 19944.
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RECENT EVOLUTION OF MONITORING RESEARCH Physiological monitoring concepts are not new. Fifty years ago, the Office of Naval Research and the Army Surgeon General cooperatively studied infantrymen in combat to identify metabolic predictors of mental status (Davis et al., 19524.
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, 2003~. The goal of the Warfighter Physiological Status Monitoring (WPSM)
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may predict a potential problem before unambiguous changes in core body temperature can be detected. Bone and muscle turnover studies are important to the military to solve the near-term problem of high rates of injury during physical training most impor
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Far-future technologies are concepts that might be achievable but have not been seriously explored and remain "marks on the wall." Mitochondrial redox state in specific brain tissues has been suggested as the key marker of brain function status based on the importance of neural cell bioenergetics. Intracerebral monitoring of energy-related metabolites is currently being conducted with neurosurgical patients to follow acute conditions involving hypoxia and ischemia.
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From page 22... ...
Heart rate variability a EEG = electroencephalogram, CPK = creatine phosphokinase, IGF-1 = insulin-like growth factor-1, IL = interleukin, NK = natural killer, IG = immunoglobulin, ACTH = adrenocorticotropic hormone. identified biomarkers.
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The Technologies for Metabolic Monitoring research program (supported by the Juvenile Diabetes Research Foundation) is testing novel approaches to measure functional outcomes related to biochemical status and energy metabolism, notably glucose regulation, but including the development of lactate sensors and the exploration of other physiological indicators of metabolic status.
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Sensor hardware is important in ambulatory metabolic and physiological monitoring. However, sensor development is only one of a series of steps needed to reliably generate a useful flow of health status information in a harsh and highly constrained wearable environment.
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Relevant combat service member characteristics include job type (military occupational specialty) , gender, ethnicity, age, height, body weight, percent body fat, thermal and altitude acclimation history, and aerobic fitness.
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This and other surrogate measures of core temperature may be appropriate when risk of hype- or hyperthermia is moderate and more precise core temperature measurements, such as those provided by the ingested radio telemetry pill, are not needed. The core temperature requirement is likely to be replaced by improvements in heat flux modeling from measures of cutaneous responses and temperatures.
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.,^ it ~1 J 1 2:00:00 Time of Day (Local) 13:00:00 14:00:00 FIGURE 1-2 Heart rate, core temperature, and physiological strain index in two combat service members engaged in similar training activities during a hot-weather field exercise at the Joint Readiness Training Center, Ft.
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From page 29... ...
Negative energy balance, commonly associated with undereating in the field, can usually be managed with little consequence by drawing on substantial body fat reserves. Body energy reserves can be calculated from percent body fat (estimated from waist circumference J less the 5 percent absolute minimum body fat levels attainable in underfed, healthy male combat service members (Friedl et al., 1994~.
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From page 30... ...
An ability to monitor and model acclimatization status will make it easier to plan high-altitude missions and minimize altitude illnesses. EXAMPLE APPLICATION: CHARACTERISTICS OF A HEAT CASUALTY Heat strain provides a demonstration of nascent capabilities for physiological monitoring.
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The heat casualty had a higher percent body fat, carried a heavier load, was less physically fit, and was not heat acclimated (by interview) as compared with his unaffected cohort.
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It's All Wet Stuff Anyway, Isn 't It? Presented at the Institute of Medicine, Committee on Metabolic Monitoring Technologies for Military Field Applications Workshop on Metabolic Monitoring Technologies for Military Field Applications, San Antonio, Texas, January 8-9.
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2001. Warf ghter Physiological Status Monitoring (WPSMJ: Energy Balance and Thermal Status during a 10-day Cold Weather U.S.
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1998. A physiological strain index to evaluate heat stress.
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1974. Estimation of relative body fat and lean body weight in a United States Marine Corps population.
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