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Military looks to biosensors to reduce training deaths, build mightier

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Michael Giannattasio was 22 when he collapsed and died at Camp Pendleton on an elite Marine reconnaissance course consisting of desert, brush, mountains and ocean. His death in August, recalled Col. Jeffrey Holt, Giannattasio's commander at School of Infantry West, “was very difficult to explain to his mother” – reported POLITICO.

Only one in four Marines who enter the school graduates the arduous course, pulling off lengthy swims and lugging 100-pound packs on 12-mile hikes. But Giannattasio seemed like the perfect candidate. A cross-country and rugby standout from Michigan with an IQ of 140, he had graduated at the top of his boot camp class, with perfect fitness scores.

The Marines haven’t given the exact cause of Giannattasio’s death. But like the other branches of the U.S. military, they are spending hundreds of millions of dollars to develop information technology that might help protect trainees and active-duty troops by providing detailed real-time information on their health.

"Could we have used sensors and data gathering to increase our awareness as he approached the black zone?” Holt asked at a health conference shortly after Giannattasio’s death. “We had no idea he was in distress. Can a wearable technology make the difference? Maybe data could have told us something was wrong.”

Giannattassio is one of more than 1,400 Marines who have died in training since 2001, compared to around 1,250 Marine combat deaths over that time. The training casualties are a source of anguish and frustration to the U.S. military. So are the tens of thousands of recruits who fail out of training despite their desire to be Marines and, in many case, strengths that would make them good fighters. Such issues are particularly pressing when military units are struggling to meet force-building goals.

One answer may lie in using data, apps and biosensors to create “precision training,” in the words of Col. Dennis McGurk, director of the Medical Research and Materiel Command's Military Operational Medicine Research Program at Fort Detrick, Md. The idea is to monitor recruits — and, eventually, regular troops — to protect the vulnerable and enable the healthy to go as far as possible.

“Our service members will push themselves because they don’t want to quit. They don’t want to fail or leave their buddies behind,” said McGurk. “But you had data that say, ‘McGurk, you’ve been working in the humidity and your core temp is elevated, give that mortar base plate to McKnight,’ they’ll accept it.”

McKnight — Lt. Col. James McKnight — is the environmental science officer under McGurk at Fort Detrick. Training tailored to individual needs and capacities, said McKnight, “is going to require a huge cultural shift with tactics, techniques and procedures. But it’s going to be a useful tool to monitor for readiness and for us to be deployable.”

All four branches of the services are experimenting with the use of biosensors to measure things like heartbeat, blood pressure, sleep and cognition. The Defense Advanced Research Projects Agency, DARPA, is funding lots of related research. Special Forces units are already using sensors in the field, though whatever results they’re getting aren’t widely publicized, unsurprisingly.

Meanwhile, Holt and other officers at Camp Pendleton are working with the University of Southern California’s Center for Body Computing, which has also employed biosensors to measure the limits of endurance in elite athletes.

“We’re going to see what we can learn in extremis or over time to build a more resilient Marine,” Holt said. “The pain of that loss is no less. But having the right information at the right time can the reduce risk of it happening.”

In addition to cases like Giannattasio, Marine commanders at Pendleton are “tortured by 10 to 15 percent of the trainees who don’t make it,” says Leslie Saxon, director of the body computing center. “There are 50 percent who just don’t have what it takes, but there are others who flunk out that they want to keep. So they said to us,
‘Help us not flunk those guys out. And let’s have nobody die in training.’”

Heat injuries are a major focus at Pendleton and throughout the military, which for the past 16 years has been training young men and women to carry heavy loads into pitched battles in deserts on the other side of the globe.

Work at Fort Detrick and elsewhere now enables scientists to calculate core body temperature from heart rate and skin temperature. Such measurements already are used by National Guard response teams that wear tent-like protective clothing while investigating biological or chemical warfare agents.

“A lot of our metabolic energy production goes to heat,” explains Reed Hoyt, chief of biophysics and biomedical modeling division at the U.S. Army Research Institute of Environmental Medicine in Natick, Mass. “It keeps us in a high-performance state, but when you’re zipped up in protective ensembles or even semi-encapsulated in combat gear, you store too much of it.”

Another military goal is to predict the future readiness of troops in the field. DARPA is funding research by a company called Profusa that uses a seed-sized tissue implant to measure things like oxygen and lactate acid, values that can reveal if someone is getting sick before they feel any symptoms. Technology like this would be useful to track soldiers in tropical areas threatened by diseases like Ebola or malaria, said Col. Matthew Hepburn, program manager for several DARPA projects.

“My dream is to have them implanted in service members everywhere,” he said.

DARPA scientist Angelos Keromytis is working on design of a system employing smartphones to monitor troop well-being. Data from the phone’s camera, microphone, touch sensor, accelerator and gyroscope could show gait, balance and language; in combination with measures like heartbeat it might — if perfectible — detect everything from depression to flu to post-traumatic stress disorder.

At the Walter Reed Army Institute of Research outside Washington, D.C., researchers are using data derived from years of lab-based sleep studies to link sleep deprivation with cognitive performance. Sleep data could give officers “a quick snapshot of their soldiers’ readiness,” said Col. Jeffrey Thomas, director of the Center for Military Psychiatry and Neuroscience at Walter Reed.

Other technology might go in a pilot’s helmet to assure that his or her maneuvers aren’t affecting consciousness. “We want to know, ‘Is this person awake and able to perform, or are they degraded in a way where we need the machine to take over more of their responsibilities?’” said James Christensen, a portfolio manager at the Air Force Research Lab’s 711th Human Performance Wing at Wright-Patterson Air Force Base.

Though the immediate target of biosensor use is to protect troops in training, some dream of using them to create more deadly and invincible warriors — to “increase the lethality of our Marines,” said battle commander Col. Warren Cook.

At a conference organized by Saxon at USC this fall, Pendleton officers riffed on a future in which data could predict which Marines would remain stable after seeing horrible battlefield injuries — one where wearables did more than simply track a state of being.

“How can we characterize the brain activity to control the responses most important in battle: fear, flight, fight? Can that be manipulated?” asked Holt. “Can you imagine an array that turns fear or flight into fight? That’s what we need. That’s where I hope this goes in the future. Not just passive, but active.”

For now, however, the military is just as uncertain as the rest of society about the meaning of the data it gathers, says Saxon. “They are struggling with the same issues as us," she says. “There’s no manual for how to make this stuff work yet.”

There’s also some ambiguity about where the data goes. Cook said Marine officers view the data as something to be used by officers, rather than troops, who already have too many other things to worry about. This raises serious matters of privacy and control.

Such debates are already playing out in the world of sports, where data collection is widespread, and administrators and player organizations have battled for control of it. NBA players last January negotiated an agreement forbidding owners from tracking a player’s data without his consent. In the NFL, meanwhile, the players association has demanded a stake in any deals that teams make with wearable companies that collect their data.

But in sports, as in the military and everywhere else, hopes for leveraging the data currently outstrip our understanding of their meaning.

“You can get things like blood oxygen, skin temperature, blood pressure, heart rate," said Michael Bergeron, director of the National Youth Sports Health and Safety Institute. "Is it accurate? Who knows. What can you do with it? Who knows.”

When Saxon’s team put sensors on NFL players, they discovered that some of them were doing a whole game’s worth of exercise before they played. In theory, this kind of tracking would enable coaches to keep an eye on their players and get them to act sensibly by, say, not wearing themselves out before a game.

But “you have to be very humble in how you look at the data,” Saxon said. “Do you tell a six-time Pro Bowler they shouldn’t be doing that?”

Unclear data poses particularly worrisome dilemmas both for athletes and warriors. It may be useful to enhance performance or protect health. But if it’s used predictively, to push people off of starting rosters or exclude them from combat units, those whose data are being collected may be resentful or resistant.

When Saxon works with the Marines at Pendleton, she gets consent from each Marine without their commanding officer being present, to make sure there is no coercion, she said. She wants to provide the military with de-identified information that will help commanders understand their units.

Read more at politico.com

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