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Article ; Online: With life there is motion. Activity biomarkers signal important health and performance outcomes.

Friedl, Karl E / Looney, David P

Journal of science and medicine in sport

2023 Volume 26 Suppl 1, Page(s) S3–S8

Abstract: Measures of human motion provide a rich source of health and physiological status information. This paper provides examples of motion-based biomarkers in the form of patterns of movement, quantified physical activity, and characteristic gaits that can ... ...

Abstract	Measures of human motion provide a rich source of health and physiological status information. This paper provides examples of motion-based biomarkers in the form of patterns of movement, quantified physical activity, and characteristic gaits that can now be assessed with practical measurement technologies and rapidly evolving physiological models and algorithms, with research advances fed by the increasing access to motion data and associated contextual information. Quantification of physical activity has progressed from step counts to good estimates of energy expenditure, useful to weight management and to activity-based health outcomes. Activity types and intensity durations are important to health outcomes and can be accurately classified even from carried smart phone data. Specific gaits may predict injury risk, including some re-trainable injurious running or modifiable load carriage gaits. Mood status is reflected in specific types of human movement, with slumped posture and shuffling gait signaling depression. Increased variability in body sway combined with contextual information may signify heat strain, physical fatigue associated with heavy load carriage, or specific neuropsychological conditions. Movement disorders might be identified earlier and chronic diseases such as Parkinson's can be better medically managed with automatically quantified information from wearable systems. Increased path tortuosity suggests head injury and dementia. Rapidly emerging wear-and-forget systems involving global positioning system and inertial navigation, triaxial accelerometry, smart shoes, and functional fiber-based clothing are making it easier to make important health and performance outcome associations, and further refine predictive models and algorithms that will improve quality of life, protect health, and enhance performance.
MeSH term(s)	Humans ; Quality of Life ; Movement ; Exercise ; Posture ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-02-03
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	1437829-2
ISSN	1878-1861 ; 1440-2440
ISSN (online)	1878-1861
ISSN	1440-2440
DOI	10.1016/j.jsams.2023.01.009
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Article ; Online: Human performance and medical treatment during cold weather operations - synthesis of a symposium.

Mekjavic, Igor B / Norheim, Arne Johan / Friedl, Karl E

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2246666

Abstract: In October 2022, the Human Factors and Medicine (HFM) panel of the NATO Science and Technology Organization convened a review of progress in military biomedical research for cold weather operations. This paper represents a summary of the research ... ...

Abstract	In October 2022, the Human Factors and Medicine (HFM) panel of the NATO Science and Technology Organization convened a review of progress in military biomedical research for cold weather operations. This paper represents a summary of the research presentations and future directions. The importance of realistic training was an overarching theme. Many reported studies took advantage of cold weather training exercises to monitor soldiers' health and performance; these are valuable data, using winter exercises as a platform to gain further knowledge regarding human performance in the cold and represent an excellent extension of controlled laboratory studies. Topics also included prevention of Cold Weather Injuries (CWI); effects of cold weather stressors on cognitive function; field treatment of freezing cold injuries (FCI); and new consideration to injury and trauma care in the cold. Future work programmes re-emphasise development of cold weather training and establishment of consensus diagnostic criteria and treatments for FCI and non-FCI. CWI prevention should take advantage of biomathematical models that predict risk of CWI and provide guidance regarding optimal clothing and equipment and move from group averages to personalised predictions. The publication of selected presentations from the symposium in this special issue increases attention to military cold weather research.
MeSH term(s)	Humans ; Cold Temperature ; Weather ; Biomedical Research ; Exercise ; Military Personnel
Language	English
Publishing date	2023-08-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2246666
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Article ; Online: Use case for predictive physiological models: tactical insights about frozen Russian soldiers in Ukraine.

Potter, Adam W / Looney, David P / Friedl, Karl E

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2194504

Abstract: Biomathematical models quantitatively describe human physiological responses to environmental and operational stressors and have been used for planning and real-time prevention of cold injury. These same models can be applied from a military tactical ... ...

Abstract	Biomathematical models quantitatively describe human physiological responses to environmental and operational stressors and have been used for planning and real-time prevention of cold injury. These same models can be applied from a military tactical perspective to gain valuable insights into the health status of opponent soldiers. This paper describes a use case for predicting physiological status of Russian soldiers invading Ukraine using open-source information. In March 2022, media outlets reported Russian soldiers in a stalled convoy invading Ukraine were at serious risk of hypothermia and predicted these soldiers would be "freezing to death" within days because of declining temperatures (down to -20°C). Using existing Army models, clothing data and open-source intelligence, modelling and analyses were conducted within hours to quantitatively assess the conditions and provide science-based predictions. These predictions projected a significant increase in risks of frostbite for exposed skin and toes and feet, with a very low (negligible) risk of hypothermia. Several days later, media outlets confirmed these predictions, reporting a steep rise in evacuations for foot frostbite injuries in these Russian forces. This demonstrated what can be done today with the existing mathematical physiology and how models traditionally focused on health risk can be used for tactical intelligence.
MeSH term(s)	Humans ; Hypothermia ; Cold Temperature ; Military Personnel ; Freezing ; Ukraine ; Frostbite
Language	English
Publishing date	2023-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2194504
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Article ; Online: Military applications of soldier physiological monitoring.

Friedl, Karl E

Journal of science and medicine in sport

2018 Volume 21, Issue 11, Page(s) 1147–1153

Abstract: Wearable physiological status monitoring is part of modern precision medicine that permits predictions about an individual's health and performance from their real-time physiological status (RT-PSM) instead of relying on population-based predictions ... ...

Abstract	Wearable physiological status monitoring is part of modern precision medicine that permits predictions about an individual's health and performance from their real-time physiological status (RT-PSM) instead of relying on population-based predictions informed by estimated human, mission, and environmental/ambient conditions. RT-PSM systems have useful military applications if they are soldier-acceptable and provide important actionable information. Most commercially available systems do not address relevant military needs, typically lack the validated algorithms that make real time computed information useful, and are not open architected to be integrated with the soldier technological ecology. Military RT-PSM development requires committed investments in iterative efforts involving physiologists, biomedical engineers, and the soldier users. Military operational applications include: (1) technological enhancement of performance by providing individual status information to optimize self-regulation, workload distribution, and enhanced team sensing/situational awareness; (2) detection of impending soldier failure from stress load (physical, psychological, and environmental); (3) earliest possible detection of threat agent exposure that includes the "human sensor"; (4) casualty detection, triage, and early clinical management; (5) optimization of individual health and fitness readiness habits; and (6) long term health risk-associated exposure monitoring and dosimetry. This paper is focused on the performance-related applications and considers near term predictions such as thermal-work limits, alertness and fitness for duty status, musculoskeletal fatigue limits, neuropsychological status, and mission-specific physiological status. Each new measurement capability has provided insights into soldier physiology and advances the cycle of invention, lab and field testing, new discovery and redesign.
MeSH term(s)	Attention ; Body Temperature ; Energy Metabolism ; Fatigue ; Humans ; Military Personnel ; Monitoring, Physiologic/methods ; Stress, Physiological ; Stress, Psychological ; Wearable Electronic Devices ; Workload ; Wounds and Injuries/diagnosis
Language	English
Publishing date	2018-06-20
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1437829-2
ISSN	1878-1861 ; 1440-2440
ISSN (online)	1878-1861
ISSN	1440-2440
DOI	10.1016/j.jsams.2018.06.004
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Article ; Online: RE: Does host energy metabolism moderate disease resistance?

Friedl, Karl E

The Journal of infection

2017 Volume 76, Issue 2, Page(s) 211–212

MeSH term(s)	Disease Resistance ; Energy Metabolism ; Humans ; Military Personnel ; Pharynx
Language	English
Publishing date	2017-09-29
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2017.09.017
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Zs.A 1501: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 48: Show issues

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Article ; Online: Integrating women into ground close combat roles: an opportunity to reflect on universal paradigms of arduous training.

Friedl, Karl E / Gifford, Robert M

BMJ military health

2020 Volume 169, Issue 1, Page(s) 1–2

MeSH term(s)	Female ; Humans ; Military Personnel ; Physical Conditioning, Human
Language	English
Publishing date	2020-08-12
Publishing country	England
Document type	Editorial
ZDB-ID	3011686-7
ISSN	2633-3775 ; 2633-3767
ISSN (online)	2633-3775
ISSN	2633-3767
DOI	10.1136/bmjmilitary-2020-001568
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Article ; Online: Human performance and medical treatment during cold weather operations – synthesis of a symposium

Igor B. Mekjavic / Arne Johan Norheim / Karl E. Friedl

International Journal of Circumpolar Health, Vol 82, Iss

2023 Volume 1

Abstract: ABSTRACTIn October 2022, the Human Factors and Medicine (HFM) panel of the NATO Science and Technology Organization convened a review of progress in military biomedical research for cold weather operations. This paper represents a summary of the research ...

Abstract	ABSTRACTIn October 2022, the Human Factors and Medicine (HFM) panel of the NATO Science and Technology Organization convened a review of progress in military biomedical research for cold weather operations. This paper represents a summary of the research presentations and future directions. The importance of realistic training was an overarching theme. Many reported studies took advantage of cold weather training exercises to monitor soldiers’ health and performance; these are valuable data, using winter exercises as a platform to gain further knowledge regarding human performance in the cold and represent an excellent extension of controlled laboratory studies. Topics also included prevention of Cold Weather Injuries (CWI); effects of cold weather stressors on cognitive function; field treatment of freezing cold injuries (FCI); and new consideration to injury and trauma care in the cold. Future work programmes re-emphasise development of cold weather training and establishment of consensus diagnostic criteria and treatments for FCI and non-FCI. CWI prevention should take advantage of biomathematical models that predict risk of CWI and provide guidance regarding optimal clothing and equipment and move from group averages to personalised predictions. The publication of selected presentations from the symposium in this special issue increases attention to military cold weather research.
Keywords	Cold weather injuries ; field medical treatment ; cognitive performance ; protective equipment ; protective clothing ; thermal physiology ; Arctic medicine. Tropical medicine ; RC955-962
Subject code	669
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Use case for predictive physiological models

Adam W. Potter / David P. Looney / Karl E. Friedl

International Journal of Circumpolar Health, Vol 82, Iss

tactical insights about frozen Russian soldiers in Ukraine

2023 Volume 1

Abstract: ABSTRACTBiomathematical models quantitatively describe human physiological responses to environmental and operational stressors and have been used for planning and real-time prevention of cold injury. These same models can be applied from a military ... ...

Abstract	ABSTRACTBiomathematical models quantitatively describe human physiological responses to environmental and operational stressors and have been used for planning and real-time prevention of cold injury. These same models can be applied from a military tactical perspective to gain valuable insights into the health status of opponent soldiers. This paper describes a use case for predicting physiological status of Russian soldiers invading Ukraine using open-source information. In March 2022, media outlets reported Russian soldiers in a stalled convoy invading Ukraine were at serious risk of hypothermia and predicted these soldiers would be “freezing to death” within days because of declining temperatures (down to −20°C). Using existing Army models, clothing data and open-source intelligence, modelling and analyses were conducted within hours to quantitatively assess the conditions and provide science-based predictions. These predictions projected a significant increase in risks of frostbite for exposed skin and toes and feet, with a very low (negligible) risk of hypothermia. Several days later, media outlets confirmed these predictions, reporting a steep rise in evacuations for foot frostbite injuries in these Russian forces. This demonstrated what can be done today with the existing mathematical physiology and how models traditionally focused on health risk can be used for tactical intelligence.
Keywords	biophysics ; modelling ; thermophysiology ; hypothermia ; frostbite ; military operations ; Arctic medicine. Tropical medicine ; RC955-962
Subject code	006
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The classification of freezing cold injuries - a NATO research task group position paper.

Norheim, Arne Johan / Sullivan-Kwantes, Wendy / Steinberg, Tuva / Castellani, John / Friedl, Karl E

International journal of circumpolar health

2023 Volume 82, Issue 1, Page(s) 2203923

Abstract: Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a ... ...

Abstract	Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms. Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes. Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based. Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial.
MeSH term(s)	Humans ; Freezing ; Cold Injury/diagnosis ; Cold Injury/therapy ; Cold Temperature ; Frostbite/diagnosis ; Frostbite/therapy ; Risk Factors
Language	English
Publishing date	2023-04-21
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1386707-6
ISSN	2242-3982 ; 1239-9736
ISSN (online)	2242-3982
ISSN	1239-9736
DOI	10.1080/22423982.2023.2203923
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Article ; Online: New Concerns About Military Recruits with Metabolic Obesity but Normal Weight ("Skinny Fat").

Foulis, Stephen A / Hughes, Julie M / Friedl, Karl E

Obesity (Silver Spring, Md.)

2020 Volume 28, Issue 2, Page(s) 223

Language	English
Publishing date	2020-01-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2230457-5
ISSN	1930-739X ; 1071-7323 ; 1930-7381
ISSN (online)	1930-739X
ISSN	1071-7323 ; 1930-7381
DOI	10.1002/oby.22724
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