United States Army Futures Command

The Holistic Health and Fitness Management System (H2FMS) is a secure, cloud-based platform designed to assess, understand and improve soldier health, fitness and performance across five readiness domains: physical, mental, spiritual, nutritional and sleep. By leveraging automated support actions, domain-specific tools, role-based dashboards and integrated analytics, H2FMS empowers the interdisciplinary Holistic Health and Fitness (H2F) Performance Teams (HPTs) to effectively develop, employ and retain talented soldiers within the US Army.H2FMS unifies data from advanced biometric technologies, performance assessments, self-reported psychometrics and existing systems, ensuring every soldier has on-demand access to HPT support through guided education, interactive coaching, expert-informed training and personalised biofeedback. The platform enhances awareness for individual soldiers, HPT staff and cadre/command teams, driving optimal resource allocation and enabling data-informed interventions that boost performance, reduce injuries, expedite rehabilitation and significantly enhance quality of life and service. H2FMS represents a cost-efficient strategy for scaling HPT access across the Total Army, providing an equitable framework that maximises individual and organisational return on investment.Critically, H2FMS aligns with the Army's modernisation and national defence objectives by supporting multidomain overmatch through superior human performance management. It advances the long-term goal of generating and maintaining a lethal, adaptable and enduring force. This review details the requirements for H2FMS capabilities and illustrates how it can guide optimisation strategies while creating institutional efficiencies essential for modern force management. Ultimately, H2FMS marks a strategic milestone investment in modernising the foundation of the Army's 'human advantage,' ensuring sustained effectiveness and resilience in current and future conflicts.

Respiratory viral infections are a major public health challenge and the most diagnosed medical condition, particularly for individuals living in close proximity, like military personnel. We compared the sensitivity and specificity of the Biomeme FranklinTM and Truelab® RT-PCR thermocyclers to determine which platform is more sensitive and specific at detecting SARS-CoV-2 and influenza A and B viruses. RNA extracted from nasopharyngeal swabs of infected and uninfected individuals was tested on the Biomeme FranklinTM at Lackland and the Truelab® at Wright Patterson Air Force bases. We found an 88% and 71% positivity rate in SARS-CoV-2-infected samples tested on Biomeme and Truelab®, respectively. Likewise, we found a 49% and 80% positivity rate in influenza-positive samples tested on Biomeme and Truelab®, respectively. One hundred percent of uninfected swab samples tested negative for SARS-CoV-2 on both platforms. Conversely, 91% and 100% of uninfected swabs tested negative for flu on Biomeme and Truelab®, respectively. Differences in specificity and sensitivity in detection of SARS-CoV-2 and influenza between Biomeme and Truelab® suggest that Truelab® is a more promising and potentially deployable diagnostic platform for SARS-CoV-2 and influenza viruses' detection in an austere environment.

Abstract Transcranial direct current stimulation (tDCS) has been shown to facilitate surgical training and performance when compared to sham tDCS; however, the potency may be improved by selecting appropriate brain targets based on neuroimaging and mechanistic insights. Published studies have shown the feasibility of portable brain imaging in conjunction with tDCS during Fundamentals of Laparoscopic Surgery (FLS) tasks for concurrently monitoring the cortical activations via functional near-infrared spectroscopy (fNIRS). Then, fNIRS can be combined with electroencephalogram (EEG) where EEG band power changes have been shown to correspond to the changes in oxyhemoglobin (HbO) concentration, found from the fNIRS. In principal accordance with these prior works, our current study aimed to investigate multi-modal imaging of the brain response to cerebellar (CER) and ventrolateral prefrontal cortex (PFC) tDCS that may facilitate the most complex FLS suturing with intracorporal knot tying task. Our healthy human study on twelve novices (age: 22-28 years, 2 males, 1 female with left-hand dominance) from medical/premedical backgrounds aimed for mechanistic insights from neuroimaging brain areas that are related to error-based learning – one of the basic skill acquisition mechanisms. We found that right CER tDCS of the posterior lobe facilitated a statistically significant (q<0.05) brain response at the bilateral prefrontal areas at the start of the FLS task that was higher than sham tDCS. Also, right CER tDCS significantly (p<0.05) improved FLS score when compared to sham tDCS. In contrast, left PFC tDCS failed to facilitate a significant brain response and FLS performance improvement. Moreover, right CER tDCS facilitated activation of the bilateral prefrontal brain areas related to FLS performance improvement provided mechanistic insights into the CER tDCS effects. The mechanistic insights motivated future investigation of CER tDCS effects on the error-related perception action coupling based on directed functional connectivity studies.

Single-task assessments may not identify lingering effects following a concussion that may be detected under dual-task (DT) paradigms. The purpose of this study was to determine the effects of a novel DT paradigm and concussion history on gait and cognitive performance. Hockey and rugby club college athletes (n = 26) completed a box drill and the color and word Stroop test under single task and DT. Distance ambulated around the box, response rate, and accuracy were recorded to calculate dual-task cost. Mean comparisons and linear mixed-effects regression models were performed. Compared to athletes with no concussion history, those with a history had a greater motor than cognitive dual-task cost and were 3.15% less accurate in Stroop responses (p < .01). Athletes walked 0.72-m shorter distance under DT compared to single task (p = .04). A multidirectional, low-tech DT assessment may highlight long-term motor and cognitive deficits among athletes with a concussion history, which will provide valuable information to prepare and track performance within an athletic season.

Error-based learning is one of the basic skill acquisition mechanisms that can be modeled as a perception–action system and investigated based on brain–behavior analysis during skill training. Here, the error-related chain of mental processes is postulated to depend on the skill level leading to a difference in the contextual switching of the brain states on error commission. Therefore, the objective of this paper was to compare error-related brain states, measured with multi-modal portable brain imaging, between experts and novices during the Fundamentals of Laparoscopic Surgery (FLS) “suturing and intracorporeal knot-tying” task (FLS complex task)—the most difficult among the five psychomotor FLS tasks. The multi-modal portable brain imaging combined functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) for brain–behavior analysis in thirteen right-handed novice medical students and nine expert surgeons. The brain state changes were defined by quasi-stable EEG scalp topography (called microstates) changes using 32-channel EEG data acquired at 250 Hz. Six microstate prototypes were identified from the combined EEG data from experts and novices during the FLS complex task that explained 77.14% of the global variance. Analysis of variance (ANOVA) found that the proportion of the total time spent in different microstates during the 10-s error epoch was significantly affected by the skill level (p < 0.01), the microstate type (p < 0.01), and the interaction between the skill level and the microstate type (p < 0.01). Brain activation based on the slower oxyhemoglobin (HbO) changes corresponding to the EEG band power (1–40 Hz) changes were found using the regularized temporally embedded Canonical Correlation Analysis of the simultaneously acquired fNIRS–EEG signals. The HbO signal from the overlying the left inferior frontal gyrus—opercular part, left superior frontal gyrus—medial orbital, left postcentral gyrus, left superior temporal gyrus, right superior frontal gyrus—medial orbital cortical areas showed significant (p < 0.05) difference between experts and novices in the 10-s error epoch. We conclude that the difference in the error-related chain of mental processes was the activation of cognitive top-down attention-related brain areas, including left dorsolateral prefrontal/frontal eye field and left frontopolar brain regions, along with a ‘focusing’ effect of global suppression of hemodynamic activation in the experts, while the novices had a widespread stimulus(error)-driven hemodynamic activation without the ‘focusing’ effect.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40708-022-00179-z.

Virtual reality (VR) simulator has emerged as a laparoscopic surgical skill training tool that needs validation using brain–behavior analysis. Therefore, brain network and skilled behavior relationship were evaluated using functional near-infrared spectroscopy (fNIRS) from seven experienced right-handed surgeons and six right-handed medical students during the performance of Fundamentals of Laparoscopic Surgery (FLS) pattern of cutting tasks in a physical and a VR simulator. Multiple regression and path analysis (MRPA) found that the FLS performance score was statistically significantly related to the interregional directed functional connectivity from the right prefrontal cortex to the supplementary motor area with F (2, 114) = 9, p < 0.001, and R2 = 0.136. Additionally, a two-way multivariate analysis of variance (MANOVA) found a statistically significant effect of the simulator technology on the interregional directed functional connectivity from the right prefrontal cortex to the left primary motor cortex (F (1, 15) = 6.002, p = 0.027; partial η2 = 0.286) that can be related to differential right-lateralized executive control of attention. Then, MRPA found that the coefficient of variation (CoV) of the FLS performance score was statistically significantly associated with the CoV of the interregionally directed functional connectivity from the right primary motor cortex to the left primary motor cortex and the left primary motor cortex to the left prefrontal cortex with F (2, 22) = 3.912, p = 0.035, and R2 = 0.262. This highlighted the importance of the efference copy information from the motor cortices to the prefrontal cortex for postulated left-lateralized perceptual decision-making to reduce behavioral variability.

ADMP-03 (Allied Dependability Management Publications #3) [1] is a recently published (2021) NATO standard that provides guidance for classification and analysis of dependability (or RAM) events. ADMP-03 provides a means to compare the reliability as well as other dependability aspects of NATO defense systems. Some significant contributions of ADMP-03 are:•the structured approach it proposes for classifying RAM events (cause, impact),•definitions and examples of RAM metrics that can be assessed using the classified event data.

Modern day tactical battlefield networks are typically not designed specific to the operational mission they support. These tactical networks are usually large, flat, non-segmented, absent of a robust cybersecurity response process, and overloaded with heterogeneous systems with various bandwidth and Quality of Service (QoS) requirements. These conditions create poor battlefield network performance and introduce significant risk to commanders and their Warfighters. To address these deficiencies we have designed a framework that uses network slicing to address many of the cybersecurity and performance issues unique to modern day tactical battlefield networks. Novel communication technology in 5G networking has the potential to be adapted to work with existing and next-generation tactical radio technologies to create network slices that provide high security, strong segmentation, and guaranteed quality of service performance in both intra and inter-slice communication. Our novel framework contains three components: 1) An intelligent network slice controller that dynamically manages the creation, management, security, and topology of tactical battlefield network slices; 2) a decision making system that continuously analyzes the battlefield network and suggest dynamic reconfiguration based upon network changes, threats, losses, or mission modifications, adjustments, or pivots; and 3) a network slice broker and orchestrator that implements the slice reconfiguration in real-time when it is necessary. In addition to the framework described in this paper, the applicability and contributions to Joint All Domain Command and Control (JADC2) are presented as well as potential challenges in our future work.