Multi-domain Operations Research Articles

Epidemiology, patterns of care and outcomes of traumatic brain injury in deployed military settings: Implications for future military operations.

Traumatic brain injury (TBI) is prevalent and highly morbid among Service Members. A better understanding of TBI epidemiology, outcomes, and care patterns in deployed settings could inform potential approaches to improve TBI diagnosis and management. A retrospective cohort analysis of Service Members who sustained a TBI in deployed settings between 2001 and 2018 was conducted. Among individuals hospitalized with TBI, we compared the demographic characteristics, mechanism of injury, injury type, and severity between combat and noncombat injuries. We compared diagnostic tests and procedures, evacuation patterns, return to duty rates and days in care between individuals with concussion and those with severe TBI. There were 46,309 service members with TBI and 9,412 who were hospitalized; of those hospitalized, 55% (4,343) had isolated concussion and 9% (796) had severe TBI, of whom 17% (132/796) had multiple injuries. Overall mortality was 2% and ranged from 0.1% for isolated concussion to 18% for severe TBI. The vast majority of TBI were evacuated by rotary wing to role 3 or higher, including those with isolated concussion. As compared with severe TBI, individuals with isolated concussion had fewer diagnostic or surgical procedures performed. Only 6% of service members with severe TBI were able to return to duty as compared with 54% of those with isolated concussion. Traumatic brain injury resulted in 123,677 lost duty days; individuals with isolated concussion spent a median of 2 days in care and those with severe TBI spent a median of 17 days in care and a median of 6 days in the intensive care unit. While most TBI in the deployed setting are mild, TBI is frequently associated with hospitalization and multiple injuries. Overtriage of mild TBI is common. Improved TBI capabilities applicable to forward settings will be critical to the success of future multidomain operations with limitations in air superiority. Prognostic and Epidemiologic; Level III.

A Conceptual Framework for Non-Military Investigators to Understand the Joint Roles of Medical Care in the Setting of Future Large Scale Combat Operations

As the wars in Iraq and Afghanistan end, the US military has begun to transition to the multi-domain operations concept with preparation for large scale combat operations against a near-peer adversary. In large scale combat operations, the deployed trauma system will likely see challenges not experienced during the Global War on Terrorism. The development of science and technology will be critical to close existing capability gaps and optimize casualty survival. This review comprises a framework of deployed trauma care to provide nonmilitary investigators a general understanding of our deployed trauma care system. Trauma care begins at the Role 1 which encompasses all care from the point of injury and the battalion aid station, through transport to the Role 2 or forward staged mobile surgical team such as a Forward Resuscitative Surgical Detachment. Role 1 point of injury care approximates the care delivered by Emergency Medical Services (EMS) personnel. The Battalion Aid Station approximates the care available at a freestanding emergency center with significant differences in training level of the providers, number of beds, and diagnostic capabilities. Role 2 medical care is part of an area support medical company with surgical capabilities. The Role 2 represents the first role of care which provides damage control surgery. This capability approximates a small community hospital with the primary difference being limited patient holding capacity and reduced diagnostic equipment. The Role 3 field hospital is the largest military treatment facility in the deployed setting. The Role 3 approximates a civilian level 2 trauma center with smaller holding capabilities and diagnostic abilities limited to that of a computed tomography (CT) scanner and less.

Defeat Mechanisms in Modern Warfare

This article explores the current debate about service and Joint operating concepts, starting with the Army’s multi-domain operations concept. It argues for adaptations to an old operational design technique—defeat mechanisms; updates to Joint and service planning doctrine; and discipline regarding emerging concepts. Rather than debate over attrition versus maneuver, combinations of a suite of defeat mechanisms should be applied to gain victory in the future.

Countering the Multi-Domain Operations of the Adversary

Countering the Multi-Domain Operations of the Adversary

Machine Learning/Artificial Intelligence for Sensor Data Fusion–Opportunities and Challenges

During Fusion 2019 Conference (https://www.fusion2019.org/program.html), leading experts presented ideas on the historical, contemporary, and future coordination of artificial intelligence/machine learning (AI/ML) with sensor data fusion (SDF). While AI/ML and SDF concepts have had a rich history since the early 1900s—emerging from philosophy and psychology—it was not until the dawn of computers that both AI/ML and SDF researchers initiated discussions on how mathematical techniques could be implemented for real-time analysis. ML, and in particular deep learning, has demonstrated tremendous success in computer vision, natural language understanding, and data analytics. As a result, ML has been proposed as the solution to many problems that inherently include multi-modal data. For example, success in autonomous vehicles has validated the promise of ML with SDF, but additional research is needed to explain, understand, and coordinate heterogeneous data analytics for situation awareness. The panel identified opportunities for merging AI/ML and SDF such as computational efficiency, improved decision making, expanding knowledge, and providing security; while highlighting challenges for multi-domain operations, human-machine teaming, and ethical deployment strategies.

Saving the brain after mild-to-moderate traumatic injury: A report on new insights of the physiology underlying adequate maintenance of cerebral perfusion.

Traumatic brain injury (TBI) is associated with increased morbidity and mortality in civilian trauma and battlefield settings. It has been classified across a continuum of dysfunctions, with as much as 80% to 90% of cases diagnosed as mild to moderate in combat casualties. In this report, a framework is presented that focuses on the potential benefits for acute noninvasive treatment of reduced cerebral perfusion associated with mild TBI by harnessing the natural transfer of negative intrathoracic pressure during inspiration. This process is known as intrathoracic pressure regulation (IPR) therapy, which can be applied by having a patient breath against a small inspiratory resistance created by an impedance threshold device. Intrathoracic pressure regulation therapy leverages two fundamental principles for improving blood flow to the brain: (1) greater negative intrathoracic pressure enhances venous return, cardiac output, and arterial blood pressure; and (2) lowering of intracranial pressure provides less resistance to cerebral blood flow. These two effects work together to produce a greater pressure gradient that results in an improvement in cerebral perfusion pressure. In this way, IPR therapy has the potential to counter hypotension and hypoxia, potentially significant contributing factors to secondary brain injury, particularly in conditions of multiple injuries that include severe hemorrhage. By implementing IPR therapy in patients with mild-to-moderate TBI, a potential exists to provide early neuroprotection at the point of injury and a bridge to more definitive care, particularly in settings of prolonged delays in evacuation such as those anticipated in future multidomain operations. Report.

Developing Prediction Based Algorithms for Energy and Exergy Flow

<div class="section abstract"><div class="htmlview paragraph">The future battlefield will include multiple dissimilar manned and unmanned aerial, ground, sea, and space vehicles working in concert with each other to support fires, logistics, maneuvers, communication, and coordination-based missions. Mission effectiveness and efficiency are often at odds, and due to the distributed and dissimilar energy flows inherent in Multi-Domain Operations (MDO) there is a need to understand, identify, and characterize the energy flows. The ability to analyze the energy flows and effectively maintain adequate energy reserves could provide strategic capabilities to the warfighters, permitting energy informed operations to maximize mission effectiveness and efficiency, while mitigating vulnerabilities. This research focuses on developing energy and exergy characterization through development of Artificial Intelligence (AI), Machine Learning (ML), and Artificial Neural Networks (ANNs) for assessing and analyzing performance of a platform. These types of tools were developed for a Mobile Ground Vehicle (MGV) for two primary reasons: (1) reconcile past state information not directly observable from the available sensor measurements, and (2) to characterize the aggregate energy flow behavior, such that Model Predictive Control (MPC) could be applied to customize the performance of the vehicle. Preliminary results indicate that provided a reference drive cycle and an estimation of the tractive force requirements, either a set of ANNs or Long Short-Term Memory (LSTM) recurrent neural networks can be used to reconcile past sensor measurements and extended to estimate energy flow characterizations of the drivetrain and other ancillary components within the vehicular platform that could affect efficiency and mission effectiveness.</div></div>

الجهاد الإلكتروني : دراسة لتنظيم داعش وإستراتيجية الولايات المتحدة لمواجهته

الإرهاب الإلكتروني | الجهاد الإلكتروني | الذئاب المنفردة | الإرهاب الموجه عن بعد | العمليات متعددة المجالات | Cyber Terrorism | Cyber Jihad | Lone Wolves | Remote Directed Terrorism | Multi Domain Operations

الجهاد الإلکترونی: دراسة لتنظیم داعش، واستراتیجیة الولایات المتحدة لمواجهته

تقدم الورقة دراسة عن حالة الصراع علي الفضاء الإلکترونى ما بين الخلافة الإلکترونية لتنظيم داعش، واستراتيجية الدفاع الإلکتروني للولايات المتحدة من خلال تناول الموضوعات التالية: سياسة الجهاد الإلکترونى لتنظيم داعش، وظاهرة الذئاب المنفردة فى إطارها، وأخيرا استراتيجية الولايات المتحدة لمواجهة مثل هذا النمط من الإرهاب. يعکس استخدام تنظيم داعش للفضاء الإلکترونى تميزا واضحا على غيره من الجماعات الإرهابية الأخرى. وإن توظيف داعش للإنترنت يعکس قدرا کبيرا من الاحترافية والتعقيد فى الأداء، کما يبرز فهما عميقا عند قيادات التنظيم للروابط بين عالم الإعلام، وخاصة وسائل التواصل الاجتماعى، وعالم العمليات. لقد تمکن التنظيم الإرهابي من استخدام الإعلام لتعظيم آثار أنشطتهم العملياتية. وهناک أيضا استراتيجية داعش اللامرکزية، وقوامها الإرهاب من خلال الذئاب المنفردة، للإشارة إلى تحريض مجموعة من الأفراد على تنفيذ أعمال إرهابية بصفة منفردة، فى مناطق بعيدة، بعد أن انحسرت انتصاراته فى المناطق المحدودة الخاضعة لسيطرته، عقب إحکام جهود مکافحته وملاحقة قياداته وأتباعه وتقديمهم للمساءلة. ويکون توجيه القيادات إلکترونيا لتصنيع قنابل شديدة الانفجار بأدوات بدائية لتنفيذ الأعمال الإرهابية الخطيرة. ومن ناحية أخرى، تسعى جهود الولايات المتحدة لمکافحة داعش إلى التضييق عليه ومنع فرص انتشاره وتوغله. ولقد سعت وزارة الدفاع الأمريکية إلى دمج الإلکترونية مع قدراتها العسکرية التقليدية والتخطيط الاستراتيجى للعمليات العسکرية، ولديها فرق إلکترونية متکاملة ذات قيادة إقليمية، منتشرة خارج وداخل الولايات المتحدة. لقد ألقت الحرب علي تنظيم داعش الضوء على ضغط البنتاجون من أجل إعداد قواته لما يسمى العمليات متعددة المجالات لدمج الإلکترونية فى کل مراحل التخطيط، فضلا عن زخم غير مسبوق علي مستوى التشريعات الأمريکية لمواجهة الجريمة الإرهابية وما يرتبط بالإرهاب الإلکترونى خاصة. کلمات مفتاحية: الإرهاب الإلکترونى- الجهاد الإلکترونى- الذئاب المنفردة- الإرهاب الموجه عن بعد- متعددة المجالات. Abstract: The paper presents a study on the state of conflict in cyberspace between the cyber terrorism of ISIS and the cyber defense strategy of the United States. ISIS's use of cyberspace reflects a clear distinction from other terrorist groups. ISIS’s employment of the Internet reflects a great deal of professionalism and complexity in performance, as well as a deep understanding among the organization’s leaders of the links between the media world, especially social media, and the world of operations. The terrorist organization has been able to use the media to maximize the effects of their operational activities. There is also ISIS's decentralization strategy, which is based on terrorism through lone wolves, to refer to inciting a group of individuals to carry out terrorist acts alone, in remote areas, after ISIS victories receded in the limited areas under its control, because of tightening efforts to combat it and prosecute its leaders and followers and bring them to justice. On the other hand, the United States' efforts to combat ISIS seek to restrict it and prevent opportunities for its spread and penetration. The US Department of Defense has sought to integrate cyber with its conventional military capabilities and strategic planning for military operations, and has coherent regional-command electronic teams deployed outside and within the United States. The war on ISIS has shed light on the Pentagon's pressure to prepare its forces for so-called multi-domain operations to integrate electronic in all stages of planning, as well as an unprecedented momentum at the level of US legislation to confront terrorist crime and what is related to cyber terrorism in particular.s

THE IMPACT OF MULTI-DOMAIN OPERATION ON THE MILITARY STRATEGY

Currently, there are more and more discussions about multi-domain operation, as an advanced method of approaching military action, superior to the joint operation, and, last but not least, able to revolutionise the way the Armed Forces respond to the specifics of new threats to the security of states and alliances. As a result, in my opinion, it can be said that if the multi-domain operation continues to develop doctrinally and subsequently in practice, at the operational level, it will greatly influence how the strategic military level will be organised. Moreover, the fact that the multi-domain operation can offer new opportunities to address conflicts leads us to the idea that military strategies, national and allied, as programmatic documents, will be largely influenced by it. Given that, in my view, strategic goals can be met to the extent that operational and tactical capabilities allow it, this article will address issues related to how multi-domain operation can transform military strategy.

DeepMDR: A Deep-Learning-Assisted Control Plane System for Scalable, Protocol-Independent, and Multi-Domain Network Automation

This article discusses DeepMDR, which is a deep learning (DL)-assisted control plane (CP) system to realize scalable and protocol-independent path computation in multi-domain packet networks. We develop DeepMDR based on ONOS, make it support protocol-oblivious forwarding (POF) in the data plane, facilitate a hierarchical CP architecture for multi-domain operations, and propose a DL model to achieve fast and high-quality path computation in each domain. Simulation results verify that our DL-assisted routing module achieves better trade-off between path computation time and routing performance than existing approaches. The effectiveness of our proposed DeepMDR is also demonstrated with experiments, which show that it serves inter-domain flow requests quickly with a processing capacity of ~166,000 messages/s or higher.

IMPACTUL OPERAȚIEI MULTI-DOMENIU ASUPRA STRATEGIEI MILITARE

"Currently, there are more and more discussions about multi-domain operation, as an advanced method of approaching military action, superior to the joint operation, and, last but not least, able to revolutionise the way the Armed Forces respond to the specifics of new threats to the security of states and alliances. As a result, in my opinion, it can be said that if the multi-domain operation continues to develop doctrinally and subsequently in practice, at the operational level, it will greatly influence how the strategic military level will be organised. Moreover, the fact that the multi-domain operation can offer new opportunities to address conflicts leads us to the idea that military strategies, national and allied, as programmatic documents, will be largely influenced by it. Given that, in my view, strategic goals can be met to the extent that operational and tactical capabilities allow it, this article will address issues related to how multi-domain operation can transform military strategy."

An Analysis of the Evolution of the Key Terms of the US Army’s “Multi-Domain Operation”

Multi-domain operation; Terminology; Evolution

Command and Control of Multi-domain Operations

The command and control system of NATO's joint operations requires large scale command posts, large numbers of stuff, and spacious, big sized infrastructure that even to operate are cumbersome, but also are an extremely attractive target for the adversary due to its extensive infrastructure and large supporting staff. The Alliance will face unpredictable challenges in the future, extending beyond traditional operational domains such asspace and cyberspace. On top of that, the operations will extent to the full spectrum of operations, that is from low-intensity peacetime military engagement to high-intensity war conflict. These trends will further increase the size of the command posts. This paper presents the requirements for future operational staffs and command posts, while trying to find answers to emerging challenges.

미 국방전략의 변화가 한국에 미치는 영향: 다(多)도메인 작전(MDO)을 중심으로

미 국방전략의 변화가 한국에 미치는 영향: 다(多)도메인 작전(MDO)을 중심으로

Multi-Domain Operations and Lessons from NSC 68 in the Competitive Space

Russia has pursued policies that blur the lines between peace and war. Weapons and enablers used in the five domains (maritime, air, land, space and cyber) have been transformed, leading to improved anti-access and area denial capabilities, as well as faster kinetic and non-kinetic operations. Such changes have occurred before Western democracies have been able to respond. NATO should close this gap by developing a framework for deterrence and containment within this competitive space. The Cold War United States Objectives and Programs for National Security (NSC 68) established goals for policy and promoted guidelines that both limited and authorised necessary acts that shaped an environment advantageous to Western democracies. Tyler Wesley argues that a new framework, inspired by examples drawn from NSC 68, is necessary.◼

Enzymatic Debridement of Porcine Burn Wounds via a Novel Protease, SN514.

Necrotic tissue generated by a thermal injury is typically removed via surgical debridement. However, this procedure is commonly associated with blood loss and the removal of viable healthy tissue. For some patients and contexts such as extended care on the battlefield, it would be preferable to remove devitalized tissue with a nonsurgical debridement agent. In this paper, a proprietary debridement gel (SN514) was evaluated for the ability to debride both deep-partial thickness (DPT) and full-thickness burn wounds using an established porcine thermal injury model. Burn wounds were treated daily for 4 days and visualized with both digital imaging and laser speckle imaging. Strip biopsies were taken at the end of the procedure. Histological analyses confirmed a greater debridement of the porcine burn wounds by SN514 than the vehicle-treated controls. Laser speckle imaging detected significant increases in the perfusion status after 4 days of SN514 treatment on DPT wounds. Importantly, histological analyses and clinical observations suggest that SN514 gel treatment did not damage uninjured tissue as no edema, erythema, or inflammation was observed on intact skin surrounding the treated wounds. A blinded evaluation of the digital images by a burn surgeon indicated that SN514 debrided more necrotic tissue than the control groups after 1, 2, and 3 days of treatment. Additionally, SN514 gel was evaluated using an in vitro burn model that used human discarded skin. Treatment of human burned tissue with SN514 gel resulted in greater than 80% weight reduction compared with untreated samples. Together, these data demonstrate that SN514 gel is capable of debriding necrotic tissue and suggest that SN514 gel could be a useful option for austere conditions, such as military multi-domain operations and prolonged field care scenarios.

Battlespace Next(TM)

Changes in the geopolitical landscape and increasing technological complexity have prompted the U.S. Military to coin the terms Multi-Domain Operations (MDO) and Joint All-Domain Command and Control (JADC2) as over-arching strategy to frame the complexity of warfare across both traditional and emerging warfighting domains. Teaching new concepts associated with these terms requires both innovation as well as distinct education and training tools in order to realize the cultural change advocated by senior military leaders. Battlespace NextTM (BSN) is a serious game designed to teach concepts integral to MDO and initiate discussion on military strategy while conserving time, money, and manpower. BSN, a Collectable Card Game (CCG), is engineered to provide an engaging learning tool that educates on capabilities in a multi-domain conflict. This paper proposes an extensible game framework for modeling and reasoning about MDO concepts and presents our empirical feedback from over 120 military play testers evaluating a moderate to difficult version of the game. Results reveal the game teaches MDO concepts and delivers an engaging, hands-on learning experience. Specifically, we provide evidence it improved military readiness in seven areas of MDO in at least 62% of participants and 76% of respondents reported they enjoyed playing the game.

Não basta vencer em múltiplos domínios: conjecturas sobre a nova doutrina do Exército dos Estados Unidos e os conflitos na zona cinza

O presente artigo oferece uma breve análise dos novos desafios impostos às forças armadas dos EUA, diante de inimigos dotados de poderio bélico equiparado. Uma abordagem ortodoxa da nova doutrina do Exército norte-americano, denominada Operações em Múltiplos Domínios, pode contribuir para o insucesso nos níveis político e estratégico, ainda que lhes assegure a vitória tática no campo de batalha.

119 A Nitric Oxide Releasing Bio-active Wound Dressing for Burn Wound Infection Treatment

Abstract Introduction The future of multi-domain battlefield operation requires wound dressings to prevent infection at the point of injury. Majority of antimicrobial agents only target wound infection while other healing events are left to their natural fates. Nitric oxide (NO) acts against both gram-positive and -negative bacteria and has the potential to positively affect wound healing. In this study we have developed a novel wound dressing integrated with a NO donor - S-nitroso- glutathione (GSNO) in a hybrid formulation of alginate and poly(vinyl alcohol) (PVA) to prevent/treat burn wound infection. Methods The NO releasing wound dressing was fabricated using PVA, alginate, and glycerol, crosslinked with CaCl2 incorporating GSNO. Thereafter, release kinetics were measured up to 4 days. The antibacterial efficacy was determined against both P. aeruginosa and S. aureus. Then the biocompatibility of the NO wound dressing was assessed using in vitro fibroblast proliferation and wound healing assay. Finally, the efficacy of the wound dressing was assessed in vivo using a 3-cm diameter porcine burn wound infection model. Results The Alginate-PVA-GSNO dressing showed a desired physiological level NO flux of 4.42 × 10-10 mol cm-2 min-1 for 72 hours. Alginate−PVA−GSNO dressings showed ~3 log reduction in S. aureus and ~2 log reduction in P. aeruginosa CFU/mg when compared to control. The NO-releasing dressing improved fibroblast proliferation and migration resulting in complete closure of the wound within 48 h in vitro. The safety and efficacy of NO-releasing dressing were successfully established in the both P. aeruginosa and S. aureus infected porcine burn wounds. Histological assessments are carried out to determine the effect of NO-releasing dressing on overall healing process. Conclusions This study shows Alginate−PVA-GSNO wound dressing provides antimicrobial and wound healing properties in vitro. Preliminary in vivo wound healing studies established the safety and efficacy profile of NO-releasing dressing to treat burn wounds. Applicability of Research to Practice An easy to apply, field deployable and effective antimicrobial wound dressing is still a major requisite for combat burn wounds. NO delivering alginate-PVA based wound dressing may be an ideal candidate to inhibit infection as well as promote the wound healing process.