Wearable Devices and Digital Biomarkers for Optimizing Training Tolerances and Athlete Performance: A Case Study of a National Collegiate Athletic Association Division III Soccer Team over a One-Year Period

Wearable devices in sports have been used at the professional and higher collegiate levels, but not much research has been conducted at lower collegiate division levels. The objective of this retrospective study was to gather big data using the Catapult wearable technology, develop an algorithm for musculoskeletal modeling, and longitudinally determine the workloads of male college soccer (football) athletes at the Division III (DIII) level over the course of a 12-week season. The results showed that over the course of a season, (1) the average match workload (432 ± 47.7) was 1.5× greater than the average training workload (252.9 ± 23.3) for all positions, (2) the forward position showed the lowest workloads throughout the season, and (3) the highest mean workload was in week 8 (370.1 ± 177.2), while the lowest was in week 4 (219.1 ± 26.4). These results provide the impetus to enable the interoperability of data gathered from wearable devices into data management systems for optimizing performance and health.

Unveiling Bias: Examining the Influence of Positive Results on Ergogenic Aids in Published Sports Science Studies

We investigated the potential for publication bias in the field of sports science regarding studies on ergogenic aids and their effects on exercise performance. We found evidence to suggest that journals tend to prioritize studies with positive results (76%) while neglecting those with negative outcomes (2.7%). Worryingly, this could lead to a discrepancy between reported conclusions and actual study outcomes. We also identified inconsistencies between reported outcomes and actual performance variable outcomes. Taken together, these data highlight the need for future research to reduce bias and encourage the publication of studies with both positive and negative results to improve the reliability of scientific evidence in this field.

Evaluation of the Effectiveness of ROTC Army Cadet Exercise Training for the Army Combat Fitness Test

The Army Combat Fitness Test (ACFT) is used to evaluate the fitness level of potential Cadets for military readiness. The purpose of this study was to evaluate the effectiveness of the exercise training program implemented by an Army Reserve Officers' Training Corps (ROTC) program to gauge the performance metrics of the ACFT.

METHODS

Twenty-six student Cadets of the ROTC at the University of Alabama at Birmingham (UAB) program participated in the study. Over an 8-month period, the ROTC Cadets trained on campus three days per week. Training was performed in a circuit training format and each participant cycled through each of the four training stations (Strength, Conditioning, Core, and Endurance) for 15 minutes each session (for a total training time of 60 minutes). Each Cadet had body mass and body composition assessed as well as each component of the ACFT [maximum dead lift (MDL), standing power throw (SPT), hand release push-up (HRP), sprint-drag-carry (SDC), leg tuck/plank (LTK/PLK), and 2-mile run (2MR)]. Each variable was evaluated at three time points (pre-, mid-, and post-training program).

RESULTS

There was a significant difference in the 2MR score between time points [F(2,50) = 4.530, p = .016, η2 = 0.153] with a significant difference between time point at pre- and post-training (p = .02). No other variables displayed a significant change: body mass (p = .741), body fat percentage (p = .238), MDL (p = .061), SPT (p = .308), HRP (p = .126), SDC (p = 0.132), LTK/PLK (p = 0.583).

CONCLUSION

The results of this study suggest that the short-term training program used improves 2MR, but not other components of the ACFT over the course of an academic year.

Global practitioner assessment and management of mental fatigue and mental recovery in high-performance sport: A need for evidence-based best-practice guidelines

BACKGROUND

Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high-performance sport are necessary.

OBJECTIVE

To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high-performance sport.

METHODS

A mixed-methods survey approach obtained information from 156 multi-disciplinary high-performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon-signed rank analysis. Thematic analysis interpreted open-text responses.

RESULTS

Only 11.5% and 5.1% of respondents indicated they were "very" knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete-buy in, time-availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi-disciplinary in nature.

CONCLUSION

Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence-based assessment and management practices in high-performance sport.

Upper and Lower Limbs Acute Fatigue Did Not Mitigate Male Trained Air Force Soldiers' Marksmanship

In this study, we aimed to investigate the impact of acute fatigue on pistol shooting performance among Air Force marksmen. We compared the accuracy, precision, speed-accuracy trade-off, shooting cycle time, and hits on a silhouette target among 12 Brazilian Air Force servicemen (M age = 21.5, SD - 1.6 years) under both fatigue and non-fatigue conditions in a crossover design. In the fatigued condition, the participants performed a fatigue protocol composed of side runs, vertical jumps, push-ups, running, and burpees exercises before shooting. Participants performed the countermovement jump and the plyometric push-ups tests on a contact mat before and immediately after the fatigue protocol to compare the heights achieved pre- and post-fatigue. Paired t-tests showed a significant performance reduction of 34.36% and 40.02% for the countermovement jump and plyometric push-ups, respectively, indicating that participants were fatigued in their lower and upper limbs. In the non-fatigued condition, no exercise was performed before shooting. Results indicated no significant differences between conditions on shooting precision (p = .125; ES: .54), speed-accuracy trade-off (p = .261; ES = .33), hits within the silhouette (p = .167; ES = .41), or shooting cycle times (p = .868; ES = .05); but accuracy was greater (p = .025; ES: .54) when fatigued. We concluded that overall shooting performance was not impaired by physical fatigue, and shooting accuracy appeared to be improved. Perhaps physical fatigue was not enough to impair shooting accuracy in this young adult group, as accuracy decline is expected instead when shooters are in an exhausted state. Further research is needed to confirm these findings and test this presumption.

Physiological and physical performance changes during a 20-day winter military training course and its subsequent 10-day recovery period

The present study investigated physiological, mental and physical performance changes during a 20-day winter military training course and the following 10-day recovery period. Fifty-eight (age 19 ± 1 years, height 182 ± 6 cm, body mass 78.5 ± 7.2 kg) male soldiers volunteered. Body composition, serum biomarker levels and performance tests were measured four times during the study. In addition, questionnaires were collected daily for subjective stress and rate of perceived exertion. The course induced significant declines in body (-3.9%, p < 0.05) and fat mass (-31.6%, p < 0.05) as well as in all assessed physical performance variables (-9.2 - -20.2%, p < 0.05), testosterone (-73.7%, p < 0.001) and IGF-1 concentrations (-43.6%, p < 0.001). At the same time, the sex hormone-binding globulin, creatine kinase, and C-reactive protein values increased significantly (46.3-1952.7%, p < 0.05). After the 10-day recovery period, the body composition and hormonal values returned to the baseline (p < 0.05), as did some physical performance variables, such as 2 min sit-ups and the evacuation test (p < 0.05). However, explosive force production in the upper and lower bodies remained unrecovered. The 20-day winter military training caused significant physiological and mental stress, as well as a drastic decline in physical performance even for highly physically fit soldiers, and the 10-day recovery period did not establish full recovery.

Do robots outperform humans in human-centered domains?

The incessant progress of robotic technology and rationalization of human manpower induces high expectations in society, but also resentment and even fear. In this paper, we present a quantitative normalized comparison of performance, to shine a light onto the pressing question, "How close is the current state of humanoid robotics to outperforming humans in their typical functions (e.g., locomotion, manipulation), and their underlying structures (e.g., actuators/muscles) in human-centered domains?" This is the most comprehensive comparison of the literature so far. Most state-of-the-art robotic structures required for visual, tactile, or vestibular perception outperform human structures at the cost of slightly higher mass and volume. Electromagnetic and fluidic actuation outperform human muscles w.r.t. speed, endurance, force density, and power density, excluding components for energy storage and conversion. Artificial joints and links can compete with the human skeleton. In contrast, the comparison of locomotion functions shows that robots are trailing behind in energy efficiency, operational time, and transportation costs. Robots are capable of obstacle negotiation, object manipulation, swimming, playing soccer, or vehicle operation. Despite the impressive advances of humanoid robots in the last two decades, current robots are not yet reaching the dexterity and versatility to cope with more complex manipulation and locomotion tasks (e.g., in confined spaces). We conclude that state-of-the-art humanoid robotics is far from matching the dexterity and versatility of human beings. Despite the outperforming technical structures, robot functions are inferior to human ones, even with tethered robots that could place heavy auxiliary components off-board. The persistent advances in robotics let us anticipate the diminishing of the gap.

To automate or not to automate: advocating the 'cliff-edge' principle

We reflect briefly on the last forty years or so of ergonomics and human factors research in automation, observing that many of the issues being discussed today are the same as all those decades ago. In this paper, we explicate one of the key arguments regarding the application of automation in complex safety-critical domains, which proposes restraining the capabilities of automation technology until it is able to fully and completely take over the task at hand. We call this the 'cliff-edge' principle of automation design. Instead, we espouse a use for the technology in a more problem-driven, human-centred way. These are not entirely new ideas and such a philosophy is already gaining traction in ergonomics and human factors. The point is that in a given system, tasks should be controlled either by human or by automation; anything in between only causes problems for system performance.

Is Running Power a Useful Metric? Quantifying Training Intensity and Aerobic Fitness Using Stryd Running Power Near the Maximal Lactate Steady State

We sought to determine the utility of Stryd, a commercially available inertial measurement unit, to quantify running intensity and aerobic fitness. Fifteen (eight male, seven female) runners (age = 30.2 [4.3] years; V·O2max = 54.5 [6.5] ml·kg-1·min-1) performed moderate- and heavy-intensity step transitions, an incremental exercise test, and constant-speed running trials to establish the maximal lactate steady state (MLSS). Stryd running power stability, sensitivity, and reliability were evaluated near the MLSS. Stryd running power was also compared to running speed, V·O2, and metabolic power measures to estimate running mechanical efficiency (EFF) and to determine the efficacy of using Stryd to delineate exercise intensities, quantify aerobic fitness, and estimate running economy (RE). Stryd running power was strongly associated with V·O2 (R2 = 0.84; p < 0.001) and running speed at the MLSS (R2 = 0.91; p < 0.001). Stryd running power measures were strongly correlated with RE at the MLSS when combined with metabolic data (R2 = 0.79; p < 0.001) but not in isolation from the metabolic data (R2 = 0.08; p = 0.313). Measures of running EFF near the MLSS were not different across intensities (~21%; p > 0.05). In conclusion, although Stryd could not quantify RE in isolation, it provided a stable, sensitive, and reliable metric that can estimate aerobic fitness, delineate exercise intensities, and approximate the metabolic requirements of running near the MLSS.

A Neurophysiological Evaluation of Cognitive Load during Augmented Reality Interactions in Various Industrial Maintenance and Assembly Tasks

Augmented reality (AR) has been shown to improve productivity in industry, but its adverse effects (e.g., headaches, eye strain, nausea, and mental workload) on users warrant further investigation. The objective of this study is to investigate the effects of different instruction methods (i.e., HoloLens AR-based and paper-based instructions) and task complexity (low and high-demanding tasks) on cognitive workloads and performance. Twenty-eight healthy males with a mean age of 32.12 (SD 2.45) years were recruited in this study and were randomly divided into two groups. The first group performed the experiment using AR-based instruction, and the second group used paper-based instruction. Performance was measured using total task time (TTT). The cognitive workload was measured using the power of electroencephalograph (EEG) features and the NASA task load index (NASA TLX). The results showed that using AR instructions resulted in a reduction in maintenance times and an increase in mental workload compared to paper instructions, particularly for the more demanding tasks. With AR instruction, 0.45% and 14.94% less time was spent on low- and high-demand tasks, respectively, as compared to paper instructions. According to the EEG features, employing AR to guide employees during highly demanding maintenance tasks increased information processing, which could be linked with an increased germane cognitive load. Increased germane cognitive load means participants can better facilitate long-term knowledge and skill acquisition. These results suggested that AR is superior and recommended for highly demanding maintenance tasks since it speeds up maintenance times and increases the possibility that information is stored in long-term memory and encrypted for recalls.

Longitudinal Impacts of Simulated Long-Duration Spaceflight Missions on Operationally Relevant Measures of Human Performance Using a Portable Simulation Platform

OBJECTIVE

This project quantifies operationally relevant measures of flight performance and workload in a high-fidelity long-duration spaceflight analog, longitudinally across mission duration, using a portable simulation platform.

BACKGROUND

Real-time performance measures allow for the objective assessment of task performance and the timely identification of performance degradations.

METHODS

Measures of flight performance on a piloted lunar lander task were collected on 32 total crewmembers across 8 simulated space missions of 45 days each (623 total sessions).

RESULTS

Mission duration demonstrated a significant effect on measures of flight performance across all campaigns. Flight measures showed a general pattern of peaking in accuracy during the middle-late quartiles of overall mission time, then degrading again towards baseline. On the workload measure, however, a general linear decrease in workload consistent with progressive task learning was observed in both campaigns.

CONCLUSION

This investigation demonstrated the disruptive effect of time in mission on some, but not all, aspects of task performance. While mission interval differentially impacted measures of flight accuracy, workload, by contrast, seemed to steadily decrease with in-mission time.

APPLICATION

While more work is needed, the observed discrepancy between progression of flight performance and workload assessment highlights the importance of sensitive and specific measurement tools for the tracking of distinct performance metrics.

Oxidative Stress Response Kinetics after 60 Minutes at Different (1.4 ATA and 2.5 ATA) Hyperbaric Hyperoxia Exposures

Hyperbaric oxygen therapy (HBOT) is a therapeutical approach based on exposure to pure oxygen in an augmented atmospheric pressure. Although it has been used for years, the exact kinetics of the reactive oxygen species (ROS) between different pressures of hyperbaric oxygen exposure are still not clearly evidenced. In this study, the metabolic responses of hyperbaric hyperoxia exposures for 1 h at 1.4 and 2.5 ATA were investigated. Fourteen healthy non-smoking subjects (2 females and 12 males, age: 37.3 ± 12.7 years old (mean ± SD), height: 176.3 ± 9.9 cm, and weight: 75.8 ± 17.7 kg) volunteered for this study. Blood samples were taken before and at 30 min, 2 h, 24 h, and 48 h after a 1 h hyperbaric hyperoxic exposure. The level of oxidation was evaluated by the rate of ROS production, nitric oxide metabolites (NOx), and the levels of isoprostane. Antioxidant reactions were assessed through measuring superoxide dismutase (SOD), catalase (CAT), cysteinylglycine, and glutathione (GSH). The inflammatory response was measured using interleukine-6, neopterin, and creatinine. A short (60 min) period of mild (1.4 ATA) and high (2.5 ATA) hyperbaric hyperoxia leads to a similar significant increase in the production of ROS and antioxidant reactions. Immunomodulation and inflammatory responses, on the contrary, respond proportionally to the hyperbaric oxygen dose. Further research is warranted on the dose and the inter-dose recovery time to optimize the potential therapeutic benefits of this promising intervention.

Shaping Human Movement via Bimanually-Dependent Haptic Force Feedback

Haptic feedback can enhance training and performance of human operators; however, the design of haptic feedback for bimanual coordination in robot-assisted tasks (e.g., control of surgical robots) remains an open problem. In this study, we present four bimanually-dependent haptic force feedback conditions aimed at shaping bimanual movement according to geometric characteristics: the number of targets, direction, and symmetry. Haptic conditions include a virtual spring, damper, combination spring-damper, and dual springs placed between the hands. We evaluate the effects of these haptic conditions on trajectory shape, smoothness, and speed. We hypothesized that for subjects who perform worse with no haptic feedback (1) a spring will improve the shape of parallel trajectories, (2) a damper will improve the shape of point symmetric trajectories, (3) dual springs will improve the shape of trajectories with one target, and (4) a damper will improve smoothness for all trajectories. Hypotheses (1) and (2) were statistically supported at the p < 0.001 level, but hypotheses (3) and (4) were not supported. Moreover, bimanually-dependent haptic feedback tended to improve shape accuracy for movements that subjects performed worse on under no haptic condition. Thus, bimanual haptic feedback based on geometric trajectory characteristics shows promise to improve performance in robot-assisted motor tasks.

Neurocognitive assessment in microgravity: review of tools and benefits of increasing their clinical validity for long duration missions

INTRODUCTION

Clinical complications are not expected in current space missions; however, for future long-duration missions to the Moon and Mars, a new perspective may be needed - a more clinical approach. Different risks, both environmental, such as radiation, accidents, and biopsychological, including neurological problems, represent potential sources of subsequent neurocognitive deficits.

AIMS

This study aims to review research studies published to this date in microgravity conditions using existing spaceflight neurocognitive assessment batteries. This study also discusses the different risks of neuropsychological impairment in spaceflight and the potential benefits of increasing the clinical validity of these tools with neurological clinical samples on Earth for future long-duration missions.

METHOD

A PRISMA guidelines-based review of specialized literature on neurocognitive assessment batteries and human spaceflight was performed. Different factors including type of tool or battery used, sample size, mission duration, etc. were included in this review. After the scrutiny of 192 articles, a total of 27 studies were detailed in the review outcome.

RESULTS

Results showed that neuropsychological function research target has changed over the years, with working memory and perception studies being predominant in the 80s and 90s while reaction time being more frequent in recent research. We also found a lack of language-related research in microgravity and the predominance of two neurocognitive assessment batteries in microgravity research.

CONCLUSIONS

With this study, we want to emphasize the importance of increasing the clinical validity of neurocognitive or neuropsychological assessment tools to be used in space, especially in long-duration missions because in this type of mission the risk of suffering a brain injury or neurological condition increases due to multiple factors. Testing these tools with neurological clinical samples and using machine learning, predictive systems may help crews in early detection of potential clinical, neurological, or neurocognitive problems during these long-duration missions to Mars and beyond.

Oxidative Stress Response Kinetics after 60 Minutes at Different Levels (10% or 15%) of Normobaric Hypoxia Exposure

In this study, the metabolic responses of hypoxic breathing for 1 h to inspired fractions of 10% and 15% oxygen were investigated. To this end, 14 healthy nonsmoking subjects (6 females and 8 males, age: 32.2 ± 13.3 years old (mean ± SD), height: 169.1 ± 9.9 cm, and weight: 61.6 ± 16.2 kg) volunteered for the study. Blood samples were taken before, and at 30 min, 2 h, 8 h, 24 h, and 48 h after a 1 h hypoxic exposure. The level of oxidative stress was evaluated by considering reactive oxygen species (ROS), nitric oxide metabolites (NOx), lipid peroxidation, and immune-inflammation by interleukin-6 (IL-6) and neopterin, while antioxidant systems were observed in terms of the total antioxidant capacity (TAC) and urates. Hypoxia abruptly and rapidly increased ROS, while TAC showed a U-shape pattern, with a nadir between 30 min and 2 h. The regulation of ROS and NOx could be explained by the antioxidant action of uric acid and creatinine. The kinetics of ROS allowed for the stimulation of the immune system translated by an increase in neopterin, IL-6, and NOx. This study provides insights into the mechanisms through which acute hypoxia affects various bodily functions and how the body sets up the protective mechanisms to maintain redox homeostasis in response to oxidative stress.

Examination of acetone findings in suspected drug-facilitated sexual assaults: A case series

Acetone presence in human biological specimens can result from exogenous administration or endogenous production, resulting from diabetes, dietary composition, alcoholism, and stress response. Victims of drug-facilitated sexual assaults (DFSA) are understood to experience enhanced stress. At the Harris County Institute of Forensic Sciences (HCIFS), DFSA drug testing includes analysis of volatile compounds, ethanol, methanol, isopropanol, and acetone, by headspace gas chromatography/flame ionization detection. The prevalence of acetone-positive specimens in DFSA casework has been observed to exceed that of other human performance case types. In this report, DFSA cases received between 2019 and 2021 (n = 393) were reviewed and 41 acetone-positive cases were detailed. Overall, nearly 11% of the DFSA cases had acetone-positive blood or urine specimens, where 3% identified acetone only, 6% identified acetone and other drug(s), and 2% identified acetone, ethanol, and other drug(s). Acetone concentrations ranged from 0.010 to 0.147 g/100 mL in urine. Other drugs such as nor-carboxy-Δ⁹ -tetrahydrocannabinol, amphetamine, methamphetamine, ethanol, and benzoylecgonine were commonly detected. Elevated stress response encountered during DFSAs may facilitate the mechanism behind enhanced acetone production leading to increased identification. Limited availability of victim medical history precludes understanding the contribution of other disease states or physiological conditions. Nonetheless, the identification of acetone in DFSA specimens supports its potential as a biomarker of trauma in forensic toxicology casework and warrants future research within the community.

Neuropsychological considerations for long-duration deep spaceflight

The deep space environment far beyond low-Earth orbit (LEO) introduces multiple and simultaneous risks for the functioning and health of the central nervous system (CNS), which may impair astronauts' performance and wellbeing. As future deep space missions to Mars, moons, or asteroids will also exceed current LEO stay durations and are estimated to require up to 3 years, we review recent evidence with contemporary and historic spaceflight case studies addressing implications for long-duration missions. To highlight the need for specific further investigations, we provide neuropsychological considerations integrating cognitive and motor functions, neuroimaging, neurological biomarkers, behavior changes, and mood and affect to construct a multifactorial profile to explain performance variability, subjective experience, and potential risks. We discuss the importance of adopting a neuropsychological approach to long-duration deep spaceflight (LDDS) missions and draw specific recommendations for future research in space neuropsychology.

Implementing human factors in anaesthesia: guidance for clinicians, departments and hospitals: Guidelines from the Difficult Airway Society and the Association of Anaesthetists: Guidelines from the Difficult Airway Society and the Association of Anaesthetists

Human factors is an evidence-based scientific discipline used in safety critical industries to improve safety and worker well-being. The implementation of human factors strategies in anaesthesia has the potential to reduce the reliance on exceptional personal and team performance to provide safe and high-quality patient care. To encourage the adoption of human factors science in anaesthesia, the Difficult Airway Society and the Association of Anaesthetists established a Working Party, including anaesthetists and operating theatre team members with human factors expertise and/or interest, plus a human factors scientist, an industrial psychologist and an experimental psychologist/implementation scientist. A three-stage Delphi process was used to formulate a set of 12 recommendations: these are described using a 'hierarchy of controls' model and classified into design, barriers, mitigations and education and training strategies. Although most anaesthetic knowledge of human factors concerns non-technical skills, such as teamwork and communication, human factors is a broad-based scientific discipline with many other additional aspects that are just as important. Indeed, the human factors strategies most likely to have the greatest impact are those related to the design of safe working environments, equipment and systems. While our recommendations are primarily provided for anaesthetists and the teams they work with, there are likely to be lessons for others working in healthcare beyond the speciality of anaesthesia.

The neurophysiology of intraoperative error: An EEG study of trainee surgeons during robotic-assisted surgery simulations

Surgeons operate in mentally and physically demanding workspaces where the impact of error is highly consequential. Accurately characterizing the neurophysiology of surgeons during intraoperative error will help guide more accurate performance assessment and precision training for surgeons and other teleoperators. To better understand the neurophysiology of intraoperative error, we build and deploy a system for intraoperative error detection and electroencephalography (EEG) signal synchronization during robot-assisted surgery (RAS). We then examine the association between EEG data and detected errors. Our results suggest that there are significant EEG changes during intraoperative error that are detectable irrespective of surgical experience level.

Oxidative Stress Response's Kinetics after 60 Minutes at Different (30% or 100%) Normobaric Hyperoxia Exposures

Oxygen is a powerful trigger for cellular reactions and is used in many pathologies, including oxidative stress. However, the effects of oxygen over time and at different partial pressures remain poorly understood. In this study, the metabolic responses of normobaric oxygen intake for 1 h to mild (30%) and high (100%) inspired fractions were investigated. Fourteen healthy non-smoking subjects (7 males and 7 females; age: 29.9 ± 11.1 years, height: 168.2 ± 9.37 cm; weight: 64.4 ± 12.3 kg; BMI: 22.7 ± 4.1) were randomly assigned in the two groups. Blood samples were taken before the intake at 30 min, 2 h, 8 h, 24 h, and 48 h after the single oxygen exposure. The level of oxidation was evaluated by the rate of reactive oxygen species (ROS) and the levels of isoprostane. Antioxidant reactions were observed by total antioxidant capacity (TAC), superoxide dismutase (SOD), and catalase (CAT). The inflammatory response was measured using interleukin-6 (IL-6), neopterin, creatinine, and urates. Oxidation markers increased from 30 min on to reach a peak at 8 h. From 8 h post intake, the markers of inflammation took over, and more significantly with 100% than with 30%. This study suggests a biphasic response over time characterized by an initial "permissive oxidation" followed by increased inflammation. The antioxidant protection system seems not to be the leading actor in the first place. The kinetics of enzymatic reactions need to be better studied to establish therapeutic, training, or rehabilitation protocols aiming at a more targeted use of oxygen.

No Influence of Mechatronic Poles on the Movement Pattern of Professional Nordic Walkers

This study compared selected temporal and kinematic parameters of normal gait and Nordic Walking (NW) performed with classic and mechatronic poles (classic poles equipped with sensors). It was assumed that equipping NW poles with sensors for biomechanical gait analysis would not impair the NW walking technique. Six professional NW instructors and athletes, including three women, participated in the study. The MyoMotion MR3 motion analysis system was used to collect gait kinematic variables. The subject's task was to cover a 100-m distance with three types of gait: a gait without poles, a gait with classic NW poles, and a gait with mechatronic poles at the preferred speed. Parameters were measured both on the right and left sides of the body. No significant differences were found between gait types for three temporal parameters: step cadence, step, and stride time. For the other variables, all the differences identified were between free-walking and walking with poles, with no differences between standard and mechatronic poles. For nine kinematic parameters, differences between free-walking and walking with poles for both the left and right sides were found, while no differences were due to the pole type. All temporal parameters were characterized by symmetry, while among kinematic parameters, only two were asymmetrical (shoulder abduction-adduction in walking with regular poles and elbow flexion-extension in walking without poles). Equipping classic NW poles with additional signaling and measuring devices (mechatronic poles) does not impair the NW technique, making it possible to use them in further studies of gait biomechanics.

The Normobaric Oxygen Paradox-Hyperoxic Hypoxic Paradox: A Novel Expedient Strategy in Hematopoiesis Clinical Issues

Hypoxia, even at non-lethal levels, is one of the most stressful events for all aerobic organisms as it significantly affects a wide spectrum of physiological functions and energy production. Aerobic organisms activate countless molecular responses directed to respond at cellular, tissue, organ, and whole-body levels to cope with oxygen shortage allowing survival, including enhanced neo-angiogenesis and systemic oxygen delivery. The benefits of hypoxia may be evoked without its detrimental consequences by exploiting the so-called normobaric oxygen paradox. The intermittent shift between hyperoxic-normoxic exposure, in addition to being safe and feasible, has been shown to enhance erythropoietin production and raise hemoglobin levels with numerous different potential applications in many fields of therapy as a new strategy for surgical preconditioning aimed at frail patients and prevention of postoperative anemia. This narrative review summarizes the physiological processes behind the proposed normobaric oxygen paradox, focusing on the latest scientific evidence and the potential applications for this strategy. Future possibilities for hyperoxic-normoxic exposure therapy include implementation as a synergistic strategy to improve a patient's pre-surgical condition, a stimulating treatment in critically ill patients, preconditioning of athletes during physical preparation, and, in combination with surgery and conventional chemotherapy, to improve patients' outcomes and quality of life.

Sex comparisons in physiological and cognitive performance during hypoxic challenge

Within the tactical aviation community, human performance research lags in considering potential psychophysiological differences between male and female aviators due to little inclusion of females during the design and development of aircraft systems. A poor understanding of how male and female aviators differ with respect to human performance results in unknown potential sex differences on aeromedically relevant environmental stressors, perchance leading to suboptimal performance, safety, and health guidelines. For example, previous hypoxia studies have excluded female participants or lacked a sizeable sample to examine sex comparisons. As such, progress toward sensor development and improving hypoxia familiarization training are stunted due to limited knowledge of how individual differences, including sex, may or may not underlie hypoxia symptoms and performance impairment. Investigating sex differences bridges the gap between aerospace medicine and operational health, and addressing hypoxia is one of many facets yet to be studied. In the current study, we retrospectively examined N = 6 hypoxia studies with male-female participant samples (total, N = 189; male, n = 118; female, n = 71). We explored sex as a predictor of physiological response, sensory deficits, the severity of cognitive performance declines, and symptom manifestation via linear and binary logistic regression models. We found that the female sex predicted lower peripheral oxygen saturation and the likelihood of headache reporting in response to hypoxic challenge, yet explained little variance when combined with age and body mass index. The sensory and cognitive performance models did not converge, suggesting high intra-individual variability. Together, sex, age, and body mass index were not the most robust predictors in responses to hypoxic challenge; we cannot infer this for sensory deficits and cognitive performance within an experimentally induced hypoxic environment. The findings have implications for improving hypoxia familiarization training, monitoring sensor development, and emergency response and recovery protocols in case of a hypoxia occurrence suitable for all aircrew. We recommend continuing to elucidate the impact of sex and intrapersonal differences in hypoxia and other aeromedically relevant stressors in tactical aviation.

Neuromuscular Fatigue and Metabolic Stress during the 15 Minutes of Rest after Carrying Out a Bench Press Exercise Protocol

Background: Velocity loss (VL) at 1 m·s−1 can help to determine neuromuscular fatigue after performing an exercise protocol. The aim of this study was to analyse muscle fatigue and metabolic stress during the 15 min that follow the execution of a bench press (BP) exercise protocol. Methods: Forty-four healthy male students of sports science performed two exercise sessions separated by one week of rest. In the first week, the participants carried out a test with progressive loads in the (BP) exercise until reaching the one-repetition maximum (1RM) in order to obtain the load−velocity relationship of each participant. In the second week, each participant conducted three BP exercise sets at an intensity of 70% of 1RM, determining this load through the mean propulsive velocity (MPV) obtained from the individual load−velocity relationship, with the participants performing the maximum number of repetitions (MNR) to muscle failure. Two minutes of rest were allocated between sets. MPV at 1 m·s−1 and blood lactate concentrations were recorded before executing the exercise and at minute 0, 5, 10 and 15 after performing the exercise protocol. Results: A two-factor repeated measures ANOVA was performed. MPV at 1 m·s−1 in minute 0 post-exercise was −33.3% (p < 0.05), whereas in minute 10 and 15 post-exercise, it was ≈−9% (p > 0.05). Regarding the blood lactate levels, significant differences were observed in all measurements before and after the exercise protocol (p < 0.001), obtaining ≈7 mmol·L−1 at minute 10 post-exercise and 4.3 mmol·L−1 after 15 min of recovery. Conclusions: MPV with medium or moderate loads shows a certain recovery from minute 10 of rest. However, the blood lactate levels are still high (>5 mmol·L−1). Therefore, although there seem to be certain conditions to reach a similar maximum MPV peak, the residual fatigue at the neuromuscular level and the non-recovery of metabolic homeostasis would hinder the reproduction of these protocols, both at the level of applied stimulus and from a methodological perspective, since a long recovery time would be required between sets and exercises.

Artificially long legs directly enhance long sprint running performance

This comment addresses the incomplete presentation and incorrect conclusion offered in the recent manuscript of Beck et al. (R. Soc. Open Sci. 9, 211799 (doi:10.1098/rsos.211799)). The manuscript introduces biomechanical and performance data on the fastest-ever, bilateral amputee 400 m runner. Using an advantage standard of not faster than the fastest non-amputee runner ever (i.e. performance superior to that of the intact-limb world record-holder), the Beck et al. manuscript concludes that sprint running performance on bilateral, lower-limb prostheses is not unequivocally advantageous compared to the biological limb condition. The manuscript acknowledges the long-standing support of the authors for the numerous eligibility applications of the bilateral-amputee athlete. However, it does not acknowledge that the athlete's anatomically disproportionate prosthetic limb lengths (+15 cm versus the World Para Athletics maximum) are ineligible in both Olympic and Paralympic track competition due to their performance-enhancing properties. Also not acknowledged are the slower sprint performances of the bilateral-amputee athlete on limbs of shorter length that directly refute their manuscript's primary conclusion. Our contribution here provides essential background information and data not included in the Beck et al. manuscript that make the correct empirical conclusion clear: artificially long legs artificially enhance long sprint running performance.

Do People Work Hard to Maintain Social Distance?

How far away from each other people sit or stand reveals much about their social proximity, but merely sitting or standing may not test the limits of social boundaries as much as collaborating on tasks requiring physical coordination. In this study, we asked university students to walk two abreast while carrying a long pipe from one end of a workspace to another. Hurdles in the workspace forced the dyads to decide whether to walk close together without stepping over the hurdles or walk farther apart, stepping over the hurdles. The subjects often chose the latter option, stepping over 18-inch high hurdles rather than walking on level ground.

Engineering a Synthetic Dopamine-Responsive Riboswitch for In Vitro Biosensing

The detection of chemicals using natural allosteric transcription factors is a powerful strategy for point-of-use molecular sensing, particularly using fieldable cell-free gene expression (CFE) systems. However, the reliance of detection schemes on characterized protein-based sensors limits the number of measurable analytes. One alternative solution to this issue is to develop new sensors by generating RNA aptamers against the target analyte and then incorporating them directly into a riboswitch scaffold for ligand-inducible genetic control of a reporter protein. However, this strategy has not generated more than a handful of successful portable cell-free molecular sensors. To address this gap, here we convert dopamine-binding aptamers into functional dopamine-sensing riboswitches that regulate gene expression in a freeze-dried CFE reaction. We then develop an assay for direct detection and semi-quantification of dopamine in human urine. We anticipate that this work will be broadly applicable for converting many in vitro-generated RNA aptamers into fieldable molecular diagnostics.

3D Visual Tracking to Quantify Physical Contact Interactions in Human-to-Human Touch

Across a plethora of social situations, we touch others in natural and intuitive ways to share thoughts and emotions, such as tapping to get one’s attention or caressing to soothe one’s anxiety. A deeper understanding of these human-to-human interactions will require, in part, the precise measurement of skin-to-skin physical contact. Among prior efforts, each measurement approach exhibits certain constraints, e.g., motion trackers do not capture the precise shape of skin surfaces, while pressure sensors impede skin-to-skin contact. In contrast, this work develops an interference-free 3D visual tracking system using a depth camera to measure the contact attributes between the bare hand of a toucher and the forearm of a receiver. The toucher’s hand is tracked as a posed and positioned mesh by fitting a hand model to detected 3D hand joints, whereas a receiver’s forearm is extracted as a 3D surface updated upon repeated skin contact. Based on a contact model involving point clouds, the spatiotemporal changes of hand-to-forearm contact are decomposed as six, high-resolution, time-series contact attributes, i.e., contact area, indentation depth, absolute velocity, and three orthogonal velocity components, together with contact duration. To examine the system’s capabilities and limitations, two types of experiments were performed. First, to evaluate its ability to discern human touches, one person delivered cued social messages, e.g., happiness, anger, sympathy, to another person using their preferred gestures. The results indicated that messages and gestures, as well as the identities of the touchers, were readily discerned from their contact attributes. Second, the system’s spatiotemporal accuracy was validated against measurements from independent devices, including an electromagnetic motion tracker, sensorized pressure mat, and laser displacement sensor. While validated here in the context of social communication, this system is extendable to human touch interactions such as maternal care of infants and massage therapy.

Reproducibility and Applicability of Traditional Strength Training Prescription Recommendations

Background: The aim of this study was to verify the reproducibility of a resistance training protocol in the bench press (BP) exercise, based on traditional recommendations, analysing the effect of the muscle fatigue of each set and of the whole exercise protocol. Methods: In this cross-sectional study, thirty male physical education students were divided into three groups according to their relative strength ratio (RSR), and they performed a 1RM BP test (T1). In the second session (T2), which was one week after T1, the participants performed a BP exercise protocol of three sets with the maximum number of repetitions (MNR) possible to muscle failure, using a relative load corresponding to 70% 1RM determined through the mean propulsive velocity (MPV) obtained from the individual load−velocity relationship, with 2 min rests between sets. Two weeks later, a third session (T3) identical to the second session (T2) was performed. The MPV of each repetition of each set and the blood lactate level after each set were calculated, and mechanical fatigue was quantified through the velocity loss percentage of the set (% loss MPV) and in a pre-post exercise test with an individual load that could be lifted at ~1 m·s−1 of MPV. Results: The number of repetitions performed in each set was significantly different (MNR for the total group of participants: set 1 = 12.50 ± 2.19 repetitions, set 2 = 6.06 ± 1.98 repetitions and set 3 = 4.20 ± 1.99 repetitions), showing high variation coefficients in each of the sets and between groups according to RSR. There were significant differences also in MPVrep Best (set 1 = 0.62 ± 0.10 m·s−1, set 2 = 0.42 ± 0.07 m·s−1, set 3 = 0.36 ± 0.10 m·s−1), which significantly reduced the % loss MPV of all sets (set 1 = 77.4%, set 2 = 64%, set 3 = 54.2%). The lactate levels increased significantly (p < 0.05) (set 1 = 4.9 mmo·L−1, set 2 = 6 mmo·L−1, set 3 = 6.5 mmo·L−1), and MPV loss at 1 m·s−1 after performing the three sets was 36% in T2 and 34% in T3, with acceptable intrasubject variability (MPV at 1 m·s−1 pre-exercise: SEM ≤ 0.09 m·s−1, CV = 9.8%; MPV at 1 m·s−1 post-exercise: SEM ≤ 0.07 m·s−1, CV = 11.7%). Conclusions: These exercise propositions are difficult to reproduce and apply. Moreover, the number of repetitions performed in each set was significantly different, which makes it difficult to define and control the intensity of the exercise. Lastly, the fatigue generated in each set could have an individual response depending on the capacity of each subject to recover from the preceding maximum effort.

Effects of Acute Hypoxia on Early Visual and Auditory Evoked Potentials

Reduced levels of environmental oxygen lead to hypoxic hypoxia and are a primary threat in tactical aviation. The visual system is particularly vulnerable to hypoxia, and its impairment can severely impact performance. The auditory system is relatively spared by hypoxia, although which stages of auditory processing are most impacted by hypoxia remains unclear. Previous work has used electroencephalography (EEG) to assess neural markers of cognitive processing for visual and auditory stimuli and found that these markers were sensitive to a normobaric hypoxic exposure. In the current study, we assessed whether early sensory evoked potentials, that precede cognitive activity, are also impaired by normobaric hypoxia. In a within-subjects design, we compared visual (P100) and auditory evoked potentials (sensory gating for the P50, N100, and P200) in 34 healthy adults during normoxic (21% O2) and two separate hypoxic (9.7% O₂) exposures. Self-reported symptoms of hypoxia were also assessed using the Hypoxia Symptom Questionnaire (HSQ). We found that P100 mean amplitude was not reduced under hypoxic compared to normoxic conditions, suggesting no statistically significant impairment of early visual processing. The sensory gating ratio for auditory stimuli was intact for paired responses of the P50 and N100. However, the P200 sensory gating ratio was attenuated under hypoxic compared to normoxic conditions, suggesting disruption of the auditory system specific to the level of allocating attention that follows basic auditory processing. Exploratory analyses of HSQ scores identified a robust effect of hypoxia. However, consistency of symptoms reported between the two hypoxia exposures exhibited high intra-individual variability, which may have implications for the theory that individuals have a consistent hypoxia signature or reliable constellation of responses to hypoxia. These findings suggest that early sensory processing is not impaired during hypoxia, but for the auditory system there is impairment at the level of attentional processing. Given the previous findings of impaired visual performance under hypoxia, these results suggest that this impairment does not stem from early visual processing deficits in visual cortex. Together these findings help focus the search on when and where hypoxia-induced deficits occur and may guide the development of countermeasures for hypoxia in tactical aviation.

The Prevalence of Dietary Supplement Usage in Military Aviators

Background: The prevalence of dietary supplement (DS) and energy drink (ED) usage in military personnel differs from branch to branch and is between 55% and 76% (higher values in special operations forces). Aviators with highly demanding tasks might be especially interested in using dietary supplements. To date, there are only limited data available for this special profession inside the military. Methods: An internet-based survey was conducted on the prevalence of DS and ED usage, the reasons for their usage and the place of purchase for all wings of the German Armed Forces. Results: Of the 181 pilots who participated in the survey, 34% used DSs and 16% EDs. Usage was linked to sports activities but not to the type of aircraft. DSs were purchased on the internet by 50% of the respondents; mostly protein supplements, magnesium and omega-3fatty acids. Only 42% said they would feel an effect from taking DSs. Conclusions: Although the present study showed that the prevalence of usage was comparable to that of the civilian population, the sources of supply and the range of the substances taken give cause for concern. This calls for education and information campaigns to make the pilots aware of the possible risks to their health.

Aerobic Dance on an Air Dissipation Platform Improves Cardiorespiratory, Muscular and Cellular Fitness in the Overweight and Obese Elderly

Background: Obesity is a global health problem associated with a high number of comorbidities that decrease functional capacity, especially in elderly people. Aerobic dance is considered a viable strategy to prevent the effects of aging, mainly in obese and overweight elderly people. This study aimed to evaluate the effects of aerobic dance on an air dissipation platform (ADP) on body composition, oxidative stress and muscular and cardiorespiratory fitness in elderly people. Methods: In total, 32 elderly adults (67.1 ± 3.6) were divided into 3 groups based on body mass index: healthy (HG), overweight (OWG) and obese (OG). Training program of aerobic dance on an ADP was carried out twice a week for 12 weeks. Results: OWG (p = 0.016) and OG decreased their weight (p < 0.001). There was a significant decrease in malondialdehyde concentrations in all experimental groups (p < 0.05). OWG and OG significantly improved their peak oxygen uptake (p < 0.01). HG increased the vertical jump height (p < 0.05), and HG and OG improved the power output of the lower extremities (p < 0.05). Conclusions: The aerobic dance on an ADP may be an effective alternative to lose weight, prevent oxidative stress and improve cardiorespiratory fitness in obese and overweight elderly people.

Assessment of Physiological Responses During Field Science Task Performance: Feasibility and Future Needs

Objective

By understanding the physiological demands of different types of tasks that will be performed during extravehicular activity (EVA) on Mars, human performance safety risks can be mitigated. In addition, such understanding can assist in planning EVAs with an appropriate balance of human health and safety with scientific mission return.

Background

This paper describes the results of a study of technical feasibility performed within a Mars human research analog, with participants conducting scientifically relevant planetary science sample analysis and return tasks in two distinct field locations.

Methods

The authors collected heart rate, respiration rate, and heart rate variability (HRV) data, using commercial off-the-shelf hardware and software from study participants as they performed field science tasks within a concept of operations for a Mars science return human expedition mission. These data were remotely monitored, shared in real time, and later analyzed to identify different responses to different tasks in order to determine if there were any predictable or consistent patterns among participants.

Results

It was ultimately determined that, while differences exist between responses to tasks, they are highly subject to multiple sources of individual variability, dynamics of evolving field science tasks, and demands of a demanding physical environment. Further, distributional analyses of participants do not support parametric statistical analysis techniques.

Conclusion

The authors conclude that the physiology of individual astronauts should be extensively studied and modeled to support individualized automated monitoring tools for each crew member that is sent to Mars. Application: Physiological monitoring for specialized populations will require significant individual-level analysis, baselining, and bootstrap statistical methods to enable appropriate human performance determinations.

Improved Endurance Running Performance Following Haskap Berry (Lonicera caerulea L.) Ingestion

BACKGROUND

Food high in (poly)phenolic compounds, such as anthocyanins, have the potential to improve exercise recovery and exercise performance. Haskap berries are rich in anthocyanins, but no research has examined the potential to improve human performance. The aim of this study was to determine the influence of Haskap berry on parameters of endurance running performance.

METHODS

Using a double-blind, placebo controlled, independent groups design, 30 male recreational runners (mean ± SD age, 33 ± 7 years; stature, 178.2 ± 7.2 cm; mass, 77.7 ± 10.6 kg; V˙O2peak, 52.2 ± 6.6 mL/kg/min) volunteered to participate. Following familiarisation, volunteers visited the laboratory twice (separated by seven days) to assess submaximal, maximal and 5 km time trial running performance. After the first visit, volunteers were randomly assigned to consume either the Haskap berry intervention or an isocaloric placebo control.

RESULTS

There were modest changes in heart rate and V˙O2 at submaximal intensities (p < 0.05). Time to exhaustion during the V˙O2peak test was longer in the Haskap group by 20 s (p = 0.031). Additionally, 5 km time trial performance was improved in the Haskap group by ~21 s (p = 0.016), which equated to a 0.25 km/h increase in mean running speed compared to the placebo control; this represented a >2% improvement in running performance.

CONCLUSIONS

The application of this newly identified functional food to athletes has the capacity to improve endurance running performance.

Effects of short sprint interval training on aerobic and anaerobic indices: A systematic review and meta-analysis

The effects of short sprint interval training (sSIT) with efforts of ≤10 seconds on maximal oxygen consumption (V̇O₂ max), aerobic and anaerobic performances remain unknown. To verify the effectiveness of sSIT in physically active adults and athletes, a systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases PubMed/MEDLINE, ISI Web of Science, SPORTDiscus were systematically searched on the 9^th of May 2020 and updated on the 14^th of September 2021. Inclusion criteria were based on PICO and included healthy athletes and active adults of any sex (≤40 years), performing supervised sSIT (≤10 s of "all out" and non "all out" efforts) of at least 2 weeks, with a minimum of 6 sessions. As a comparator, a non-sSIT control group, another high-intensity interval training (HIIT) group, or a continuous training (CT) group were required. A total of 18 studies was deemed eligible. The estimated SMDs based on the random-effects model were -0.56 (95% CI: -0.79, -0.33, p < 0.001) for V̇O₂ max, -0.43 (95% CI: -0.67, -0.20, p < 0.001) for aerobic performance, and -0.44 (95% CI: -0.70, -0.18, p < 0.001) for anaerobic performance after sSIT vs. no exercise/usual training. However, there were no significant differences (p > 0.05) for all outcomes when comparing sSIT vs. HIIT/CT. Our findings indicate a very high effectiveness of sSIT protocols in different exercise modes (e.g. cycling, running, paddling, punching) to improve V̇O₂ max, aerobic and anaerobic performances in physically active young healthy adults and athletes.

Fusion Models for Generalized Classification of Multi-Axial Human Movement: Validation in Sport Performance

We introduce a set of input models for fusing information from ensembles of wearable sensors supporting human performance and telemedicine. Veracity is demonstrated in action classification related to sport, specifically strikes in boxing and taekwondo. Four input models, formulated to be compatible with a broad range of classifiers, are introduced and two diverse classifiers, dynamic time warping (DTW) and convolutional neural networks (CNNs) are implemented in conjunction with the input models. Seven classification models fusing information at the input-level, output-level, and a combination of both are formulated. Action classification for 18 boxing punches and 24 taekwondo kicks demonstrate our fusion classifiers outperform the best DTW and CNN uni-axial classifiers. Furthermore, although DTW is ostensibly an ideal choice for human movements experiencing non-linear variations, our results demonstrate deep learning fusion classifiers outperform DTW. This is a novel finding given that CNNs are normally designed for multi-dimensional data and do not specifically compensate for non-linear variations within signal classes. The generalized formulation enables subject-specific movement classification in a feature-blind fashion with trivial computational expense for trained CNNs. A commercial boxing system, 'Corner', has been produced for real-world mass-market use based on this investigation providing a basis for future telemedicine translation.

Human performance research for military operations in extreme cold environments

OBJECTIVES

Soldier performance in the Arctic depends on planning and training, protective equipment, and human physiological limits. The purpose of this review was to highlight the span of current research on enhancing soldier effectiveness in extreme cold and austere environments.

METHODS

The practices of seasoned soldiers who train in the Arctic and cold-dwelling natives inform performance strategies. We provide examples of research and technology that build on these concepts.

RESULTS

Examples of current performance research include evaluation of equipment and tactics such as the bioenergetics of load carriage over snow in Norwegian exercises; Canadian field monitoring of hand temperatures and freezing cold injuries for better protection of manual dexterity; and Dutch predictive modeling of cold-wet work tolerances. Healthy young men can respond to cold with a substantial thermogenic response based on US and Canadian studies on brown adipose tissue and other mechanisms of non-shivering thermogenesis; the potential advantage of greater fat insulation is offset in obese unfit subjects by a smaller thermogenic response. Current physiological studies are addressing previously unanswered problems of cold acclimation procedures, thermogenic enhancement and regulation, and modulation of sympathetic activation, all of which may further enhance cold survival and expand the performance envelope.

CONCLUSION

There is an inseparable behavioral component to soldier performance in the Arctic, and even the best equipment does not benefit soldiers who have not trained in the actual environment. Training inexperienced soldiers to performance limits may be helped with personal monitoring technologies and predictive models.

Toward Predicting Human Performance Outcomes From Wearable Technologies: A Computational Modeling Approach

Wearable technologies for measuring digital and chemical physiology are pervading the consumer market and hold potential to reliably classify states of relevance to human performance including stress, sleep deprivation, and physical exertion. The ability to efficiently and accurately classify physiological states based on wearable devices is improving. However, the inherent variability of human behavior within and across individuals makes it challenging to predict how identified states influence human performance outcomes of relevance to military operations and other high-stakes domains. We describe a computational modeling approach to address this challenge, seeking to translate user states obtained from a variety of sources including wearable devices into relevant and actionable insights across the cognitive and physical domains. Three status predictors were considered: stress level, sleep status, and extent of physical exertion; these independent variables were used to predict three human performance outcomes: reaction time, executive function, and perceptuo-motor control. The approach provides a complete, conditional probabilistic model of the performance variables given the status predictors. Construction of the model leverages diverse raw data sources to estimate marginal probability density functions for each of six independent and dependent variables of interest using parametric modeling and maximum likelihood estimation. The joint distributions among variables were optimized using an adaptive LASSO approach based on the strength and directionality of conditional relationships (effect sizes) derived from meta-analyses of extant research. The model optimization process converged on solutions that maintain the integrity of the original marginal distributions and the directionality and robustness of conditional relationships. The modeling framework described provides a flexible and extensible solution for human performance prediction, affording efficient expansion with additional independent and dependent variables of interest, ingestion of new raw data, and extension to two- and three-way interactions among independent variables. Continuing work includes model expansion to multiple independent and dependent variables, real-time model stimulation by wearable devices, individualized and small-group prediction, and laboratory and field validation.

Applying Heart Rate Variability to Monitor Health and Performance in Tactical Personnel: A Narrative Review

Human performance optimization of tactical personnel requires accurate, meticulous, and effective monitoring of biological adaptations and systemic recovery. Due to an increased understanding of its importance and the commercial availability of assessment tools, the use of heart rate variability (HRV) to address this need is becoming more common in the tactical community. Measuring HRV is a non-invasive, practical method for objectively assessing a performer's readiness, workload, and recovery status; when combined with additional data sources and practitioner input, it provides an affordable and scalable solution for gaining actionable information to support the facilitation and maintenance of operational performance. This narrative review discusses the non-clinical use of HRV for assessing, monitoring, and interpreting autonomic nervous system resource availability, modulation, effectiveness, and efficiency in tactical populations. Broadly, HRV metrics represent a complex series of interactions resulting from internal and external stimuli; therefore, a general overview of HRV applications in tactical personnel is discussed, including the influence of occupational specific demands, interactions between cognitive and physical domains, and recommendations on implementing HRV for training and recovery insights into critical health and performance outcomes.

Menthol Mouth Rinsing Is More Than Just a Mouth Wash-Swilling of Menthol to Improve Physiological Performance

Interventions that solely act on the central nervous system (CNS) are gaining considerable interest, particularly products consumed through the oral cavity. The oropharyngeal cavity contains a wide array of receptors that respond to sweet, bitter, and cold tastants, all of which have been shown to improve physiological performance. Of late, the ergogenic benefits of carbohydrate (CHO) and caffeine (CAF) mouth rinsings (MRs) have been widely studied; however, less is known about menthol (MEN). That the physiological state and environmental conditions impact the response each product has is increasingly recognized. While the effects of CHO and CAF MRs have been thoroughly studied in both hot and thermoneutral conditions, less is known about MEN as it has only been studied in hot environments. As such, this review summarizes the current knowledge regarding the MEN MR and exercise modality, frequency of the mouth rinse, and mouth rinse duration and compares two different types of study designs: time trials vs. time to exhaustion (TTE).

The Analysis of Occurrences Associated with Air Traffic Volume and Air Traffic Controllers' Alertness for Fatigue Risk Management

Fatigue is an inevitable hazard in the provision of air traffic services and it has the potential to degrade human performance leading to occurrences. The International Civil Aviation Organization (ICAO) requires air navigation services which providers establish fatigue risk management systems (FRMS) based on scientific principles for the purpose of managing fatigue. To develop effective FRMSs, it is important to investigate the relationship between traffic volume, air traffic management occurrences, and fatigue. Fifty-seven qualified ATCOs from a European Air Navigation Services provider participated in this research by providing data indicating their alertness levels over the course of a 24-hour period. ATCOs' fatigue data were compared against the total of 153 occurrences and 962,328 air traffic volumes from the Eurocontrol TOKAI incident database in 2019. The result demonstrated that ATCO fatigue levels are not the main contributory factor associated with air traffic management occurrences, although fatigue did impact ATCOs' performance. High traffic volume increases ATCO cognitive task load that can surpass available attention resources leading to occurrences. Furthermore, human resilience drives ATCOs to maintain operational safety though they suffer from circadian fatigue. Consequently, FRMS appropriately implemented can be used to mitigate the effects of fatigue. First-line countermeasure strategies should focus on enough rest breaks and roster schedule optimization; secondary strategies should focus on monitoring ATCOs' task loads that may induce fatigue. It is vital to consider traffic volume and ATCOs' alertness levels when implementing effective fatigue risk management protocols.

The Effects of Biofeedback on Performance and Technique of the Boxing Jab

A growing body of research has addressed the application of movement-based biofeedback techniques for improving sports performers’ gross motor skills. Unlike in previous research, we aimed in this study to quantify the effects of this “external” biofeedback on selected performance and technique variables for the boxing jab among both novices and experts. The technical setup included two inertial measurement units linked wirelessly to a video game system with audio output. The units were configured to provide auditory external biofeedback, based on the peak acceleration of the bag (i.e., biofeedback with an external attentional focus). Sixteen participants (8 novices and 8 experts) performed boxing jabs against the bag in blocked phases of biofeedback. When compared to baseline, the acute effects of externally focused biofeedback on peak bag acceleration were possibly positive in both retention phases for novices (d = 0.29; d = 0.41) and likely positive for experts (d = 0.41; d = 0.30), respectively. The experts’ performance improvements were accompanied by substantive increases in trunk rotation, though this was not true for the novices. Thus, technique improvements can be promoted indirectly via externally focused biofeedback, but only when these actions are within the performers’ motor repertoire. Overall, biofeedback via inertial sensors appears to be a potent technique for modifying human movement patterns in both experts and novices. This low-cost technology could be used to support training across sports, rehabilitation and human-computer interactions.

The Neuroscience of the Flow State: Involvement of the Locus Coeruleus Norepinephrine System

Flow is a state of full task engagement that is accompanied with low-levels of self-referential thinking. Flow is considered highly relevant for human performance and well-being and has, therefore, been studied extensively. Yet, the neurocognitive processes of flow remain largely unclear. In the present mini-review we focus on how the brain's locus coeruleus-norepinephrine (LC-NE) system may be involved in a range of behavioral and subjective manifestations of flow. The LC-NE system regulates decisions regarding task engagement vs. disengagement. This is done via different modes of baseline and stimulus-evoked norepinephrine release. We emphasize the theoretical and empirical overlap between the LC-NE system and flow. For both, a match between a person's skill and task challenge is important in order to induce high levels task-related attention. Moreover, psychophysiological indicators of LC-NE system activity, such as eye pupil diameter and arousal are also sensitive to flow states. Flow is related to arousal in an inverted U-shape. Similarly, in theories on the LC-NE system, task engagement is highest with intermediate levels of arousal. We argue that knowledge about the role of the LC-NE system in establishing the flow experience may help to gain fundamental knowledge of flow and can contribute to unifying various empirical findings on this topic.

Brain Activation Imaging in Emotional Decision Making and Mental Health: A Review-Part 2

In this report, we integrate the principles described in part 1 and describe an operational model for emotional decision making that incorporates brain activation data along with subjective experience correlates. This model takes the form of a state machine that carries out transitions between a finite set of 16 possible states of emotional and decision-making response. By considering a 4 × 4 grid of possible states based on left and right activation, in primary (sensation) and secondary (perception/comprehension) response, the range of responses is completely specified. The transition probabilities within this repertoire of possible response states can be used to characterize an individual (or any system) in terms of its likelihood to respond in a particular fashion. The possible value of this model in psychiatry, psychology, and counseling is introduced and discussed.

Brain Activation Imaging in Emotional Decision Making and Mental Health: A Review-Part 1

In part 1 of this article, we describe an approach and methodology that bridges 2 worlds: the internal, subjective experience of emotions and thoughts, and the external world of brain electrical activity. Using a novel event-related brain activation imaging method, we demonstrate that within single trials, short-term mental processes, on the order of 100 ms, can be clearly related to observed brain activation in controlled experiments. We use an ipsative assessment validation process that combines self-report with real-time EEG recordings to provide a combined picture of both the mental and the brain activity, during short-term reactions, emotions, and decisions regarding controlled information. Part 2 provides a detailed description of the emerging emotional decision-making model.

Supporting Holistic Wellbeing for Performing Artists During the COVID-19 Pandemic and Recovery: Study Protocol

The COVID-19 pandemic resulted in the abrupt closure of circus schools, venues, and companies, introducing a myriad of novel stressors. Performers and students must now attempt to maintain their technical, physical, artistic, creative, and cognitive abilities without in-person support from their coaches and must manage the isolation from their training and performing spaces. For circus artists, the transposition of the work space to a home environment is not possible, which creates novel stressors that could lead to the exacerbation and escalation of mental health issues. The purpose of this study is to develop, implement and evaluate a holistic interventional program based on the socio-ecological model of resilience and operationalized through physical literacy. This will be a prospective longitudinal study with a retrospective comparison to data from a similar student cohort pre-pandemic. Interventions were designed using a population-specific, participant-based developmental model within a knowledge translation framework. The interventional program includes group webinars, small group information sessions, and one-on-one Zoom meetings, in addition to the distribution of electronic educational materials. The interventions will holistically provide psychological, physical, social, technical, artistic, and creative supports. Resources will be deployed throughout the closure period and through recovery, as transitions to return to training after prolonged hiatus will magnify known psychological and physical difficulties. Repeated, longitudinal assessment of students will be utilized to track changes over time at key transitions in the pandemic and school year and will be compared to a pre-pandemic school year. The framework for this program will be translatable to other performing arts and high-performance contexts. The program has implications for the mental health and overall wellbeing of artists and for cultural and economic recovery of the industry.

A Critical Review of Cranial Electrotherapy Stimulation for Neuromodulation in Clinical and Non-clinical Samples

Cranial electrotherapy stimulation (CES) is a neuromodulation tool used for treating several clinical disorders, including insomnia, anxiety, and depression. More recently, a limited number of studies have examined CES for altering affect, physiology, and behavior in healthy, non-clinical samples. The physiological, neurochemical, and metabolic mechanisms underlying CES effects are currently unknown. Computational modeling suggests that electrical current administered with CES at the earlobes can reach cortical and subcortical regions at very low intensities associated with subthreshold neuromodulatory effects, and studies using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) show some effects on alpha band EEG activity, and modulation of the default mode network during CES administration. One theory suggests that CES modulates brain stem (e.g., medulla), limbic (e.g., thalamus, amygdala), and cortical (e.g., prefrontal cortex) regions and increases relative parasympathetic to sympathetic drive in the autonomic nervous system. There is no direct evidence supporting this theory, but one of its assumptions is that CES may induce its effects by stimulating afferent projections of the vagus nerve, which provides parasympathetic signals to the cardiorespiratory and digestive systems. In our critical review of studies using CES in clinical and non-clinical populations, we found severe methodological concerns, including potential conflicts of interest, risk of methodological and analytic biases, issues with sham credibility, lack of blinding, and a severe heterogeneity of CES parameters selected and employed across scientists, laboratories, institutions, and studies. These limitations make it difficult to derive consistent or compelling insights from the extant literature, tempering enthusiasm for CES and its potential to alter nervous system activity or behavior in meaningful or reliable ways. The lack of compelling evidence also motivates well-designed and relatively high-powered experiments to assess how CES might modulate the physiological, affective, and cognitive responses to stress. Establishing reliable empirical links between CES administration and human performance is critical for supporting its prospective use during occupational training, operations, or recovery, ensuring reliability and robustness of effects, characterizing if, when, and in whom such effects might arise, and ensuring that any benefits of CES outweigh the risks of adverse events.

Human factors: the pharmaceutical supply chain as a complex sociotechnical system

Background

The Covid 19 pandemic has exacerbated pre-existing weaknesses in the global supply chain. Regional assessments by the Food and Drug Administration (FDA), European Medicine Agency (EMA), and independent consultants, have demonstrated various contributory causal factors requiring changes in policy, relationships, and incentives within the dynamic and developing networks. Human Factors/Ergonomics (HFE) is an approach that encourages sociotechnical systems thinking to optimise the performance of systems that involve human activity. The global supply chain can be considered such a system. However, it has neither been systematically examined from this perspective.

Methods

In 2015, the UK Chartered Institute of Ergonomics and Human Factors established the Pharmaceutical Sector Group. This unique group is open to all who work in the pharmaceutical sector at any level and in any discipline who share the vision of a pharmaceutical system that places an understanding of HFE at the heart of improving the use of healthcare products throughout their life cycles including their supply chains.

Results

For this complex system to work efficiently it is paramount that we have effective coordination and integration between the different elements in the supply chain. HFE can give valuable insights and solutions for developing these complex social-technical systems effectively.

Conclusion

By partnering with international groups such as Biophorum and Bio Supply Chain Management Alliance, the wish stimulate discussion about how sociotechnical thinking about HFE may help develop better monitoring and investigative techniques to strengthen global supply chains.