Physiological State Monitoring in Advanced Soldiers: Precision Health Strategies for Modern Military Operations

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript provides a multifaceted review of the significance of physiological state monitoring and precision health in modern military operations. The discussion on the integration of technological advances, AI utilization, and ethical considerations is particularly commendable. However, the paper remains largely qualitative, and across most sections, the required technical specifications for military deployment and current limitations of existing technologies remain unclear. Incorporating more quantitative information and discussion would enhance the academic and practical impact of the review. Below are several specific comments.

1. Although this paper aims to present a comprehensive review, the discussion is largely qualitative. For example, what level of accuracy is required for physiological state monitoring in military operations? More generally, throughout the paper, I suggest including quantitative descriptions of the required technical specifications for military applications, as well as the current limitations of available technologies.
2. The paper lacks comparative analysis of existing technologies. It would be helpful to include a comparative table of available sensor and monitoring technologies relevant to military settings.
3. The authors mention that they reviewed literature published between 2010 and 2024; however, the most recent reference cited appears to be from 2022. This raises concern that recent developments may have been overlooked. Additionally, the exclusion criteria mention that studies unrelated to human military populations were omitted, but this decision may warrant reconsideration. Technologies not originally intended for military applications may still hold future potential in such contexts.
4. The title of Section 3 appears to be a typographical error. Should it be "Physiological state monitoring" instead of "Psychological state monitoring"? Please confirm.

Author Response

Dear Reviewer!

Thank you for your time and expertise.

Regarding your comments:

1. Although this paper aims to present a comprehensive review, the discussion is largely qualitative. For example, what level of accuracy is required for physiological state monitoring in military operations? More generally, throughout the paper, I suggest including quantitative descriptions of the required technical specifications for military applications, as well as the current limitations of available technologies. - WE'VE TRIED TO ADD EXTRA INFORMATIONS REGARDING YOUR COMMENTS.
2. The paper lacks comparative analysis of existing technologies. It would be helpful to include a comparative table of available sensor and monitoring technologies relevant to military settings. - WE'VE ADDED TWO MORE TABLES FOR THAT OCCASION.
3. The authors mention that they reviewed literature published between 2010 and 2024; however, the most recent reference cited appears to be from 2022. This raises concern that recent developments may have been overlooked. Additionally, the exclusion criteria mention that studies unrelated to human military populations were omitted, but this decision may warrant reconsideration. Technologies not originally intended for military applications may still hold future potential in such contexts. - I'VE GOT SOME PROBLEMS REGARDING THE CITATIONS, NOW IT IS FIXED, ALSE WE'VE ADDED SOME MORE CITATIONS REGARDING THE NEWEST SMART CLOTHES.
4. The title of Section 3 appears to be a typographical error. Should it be "Physiological state monitoring" instead of "Psychological state monitoring"? Please confirm. - YES, IT IS MY FAULT, THANK YOU

Reviewer 2 Report

Comments and Suggestions for Authors

This article provides an overview of the crucial topic of soldier physiological state monitoring and precision health strategies in modern military operations. Overall, the author has gathered a substantial amount of literature, seamlessly integrating interdisciplinary content from biomedical engineering, military medicine, and precision health management. These contents are of practical significance, showcasing the breadth and comprehensiveness of the review, and can offer valuable references for the fields of military medicine and human factors engineering. However, there are still areas in the following sections that require further improvement:

1. The literature citations are generally abundant, but there is still room for improvement. The author searched for data from 2010 to 2024 and cited many classic studies. However, there are relatively few recent studies in the references after 2022, which may have overlooked the latest developments in this field in recent years. Suggest the author to supplement relevant literature to ensure the forefront and completeness of the review.
2. The correspondence between some statements and citations needs to be verified. For example, the cited references [30] [31] seem to be general research on wearable sensor behavior recognition, rather than directly related to military injury risk prediction. It is recommended that the author ensure that the cited references directly support the statement, or clarify in the wording on which scenarios and metrics these high accuracies are obtained. If the cited literature is not a study in a military context, it may be considered to cite more relevant information or reduce the absolute degree of expression. Besides providing examples, there are other parts that have the same issue. It is recommended that the author revise the wording or add references to support causal relationships. Ensure that each important conclusion in the article is supported by appropriate literature to maintain the rigor of the review. Avoid the problem of excessive inference.
3. The title of Section 3 is "Psychological State Monitoring", but its content actually discusses the continuous monitoring of physiological parameters. This is inconsistent with the theme of the entire text and the subsequent content, and should be a typographical error.
4. The title of the image in the text also contains the aforementioned psychological/physiological vocabulary errors. At the same time, it is recommended that the author cite and mention various figures in appropriate positions in the main text (such as adding a sentence "as shown in Figure 1" when describing the content of the flowchart) to help readers understand the relationship between the figures and the main text.
5. When discussing sensors in Section 5, it is mentioned to monitor parameters such as electrocardiographic (ECG) signals, skin temperature and conductivity, gait dynamics, posture, etc. These contents are very detailed, but it is recommended to ensure that all listed indicators are supported by references or belong to mature technologies. For example, how mature is the monitoring of "gait dynamics" in military wearables, and does it require citation support? If there is no existing literature, the list can be appropriately reduced and the main indicators highlighted to avoid giving readers a feeling of comprehensiveness but lack of depth.
6. The article focuses on emphasizing the positive effects of these technologies, but relatively lacks discussion on their limitations and potential issues. For the sake of rigor and balance, it is suggested that the author supplement the analysis of current technological bottlenecks, such as the accuracy and robustness limitations of wearable sensors in practical environments, the reliability of data analysis, and the practical challenges of implementing these monitoring methods. At present, the author discusses privacy and other challenges in the ethics and security chapters, but from a scientific and practical perspective, it should also be acknowledged that these systems may have shortcomings in practical deployment.
7. At present, the article covers a wide range of content, but mainly focuses on describing the current situation, lacking comparative evaluation and targeted summary of existing work. Suggest adding an explanation of any new perspectives or synthesis in this review.

Author Response

Dear Reviewer!

Thank you for your time and expertise. Regarding your comments:

1. The literature citations are generally abundant, but there is still room for improvement. The author searched for data from 2010 to 2024 and cited many classic studies. However, there are relatively few recent studies in the references after 2022, which may have overlooked the latest developments in this field in recent years. Suggest the author to supplement relevant literature to ensure the forefront and completeness of the review. - I'VE HAD SOME ISSUES WITH THE REFERENCES, NOW IT IS FIXED, THANK YOU.
2. The correspondence between some statements and citations needs to be verified. For example, the cited references [30] [31] seem to be general research on wearable sensor behavior recognition, rather than directly related to military injury risk prediction. It is recommended that the author ensure that the cited references directly support the statement, or clarify in the wording on which scenarios and metrics these high accuracies are obtained. If the cited literature is not a study in a military context, it may be considered to cite more relevant information or reduce the absolute degree of expression. Besides providing examples, there are other parts that have the same issue. It is recommended that the author revise the wording or add references to support causal relationships. Ensure that each important conclusion in the article is supported by appropriate literature to maintain the rigor of the review. Avoid the problem of excessive inference. - WE'VE ADDED SOME MORE CITATIONS IN THE TEXT, WE'VE TRIED TO MAKE MORE CLEAR EVERYTHING
3. The title of Section 3 is "Psychological State Monitoring", but its content actually discusses the continuous monitoring of physiological parameters. This is inconsistent with the theme of the entire text and the subsequent content, and should be a typographical error. - IT IS A TYPO, THANK YOU.
4. The title of the image in the text also contains the aforementioned psychological/physiological vocabulary errors. At the same time, it is recommended that the author cite and mention various figures in appropriate positions in the main text (such as adding a sentence "as shown in Figure 1" when describing the content of the flowchart) to help readers understand the relationship between the figures and the main text. - WE'VE ADDED SOME SENTENCES REGARDING ALL OF THE TABLES, FIGURES
5. When discussing sensors in Section 5, it is mentioned to monitor parameters such as electrocardiographic (ECG) signals, skin temperature and conductivity, gait dynamics, posture, etc. These contents are very detailed, but it is recommended to ensure that all listed indicators are supported by references or belong to mature technologies. For example, how mature is the monitoring of "gait dynamics" in military wearables, and does it require citation support? If there is no existing literature, the list can be appropriately reduced and the main indicators highlighted to avoid giving readers a feeling of comprehensiveness but lack of depth. - WE'VE ADDED SOME MORE DETAILED INFORMATIONS.
6. The article focuses on emphasizing the positive effects of these technologies, but relatively lacks discussion on their limitations and potential issues. For the sake of rigor and balance, it is suggested that the author supplement the analysis of current technological bottlenecks, such as the accuracy and robustness limitations of wearable sensors in practical environments, the reliability of data analysis, and the practical challenges of implementing these monitoring methods. At present, the author discusses privacy and other challenges in the ethics and security chapters, but from a scientific and practical perspective, it should also be acknowledged that these systems may have shortcomings in practical deployment. - THANK YOU FOR YOUR COMMENT. WE'VE TRIED TO MAKE OUR ARTICLE MORE CONCRETE, BUT PLEASE NOTE, THAT THIS IS A NARRATIVE REVIEW. IN OUR FUTURE PROJECTS WE ARE WORKING ON A SYSTEMATIC REVIEW WHICH IS WAY MORE CONCRETE ON OUR SPECIAL ASPECT OF SMART CLOTHING IN MILITARY PURPOSES.
7. At present, the article covers a wide range of content, but mainly focuses on describing the current situation, lacking comparative evaluation and targeted summary of existing work. Suggest adding an explanation of any new perspectives or synthesis in this review. - IT IS ADDED NOW.

Reviewer 3 Report

Comments and Suggestions for Authors

Summary:

This manuscript provides a comprehensive review of real-time monitoring systems for soldiers. It covers both psychological and physiological monitoring and discusses their integration with cutting-edge technologies such as AI and edge computing. The manuscript also addresses ethical issues associated with real-time monitoring. While the paper offers a thorough overview of current physiological monitoring systems, several concerns should be addressed before it can be considered for publication.

Major Comments:

1. Figures and Tables: All figures and tables should be explicitly referenced and discussed in the main text. Without proper mention and explanation, their inclusion is ineffective and may confuse the reader.
2. Distinction from Civilian Systems: Although the paper offers a broad review of health monitoring systems for soldiers, it would significantly benefit from a clearer distinction between systems designed for civilians and those tailored for military personnel. Highlighting the unique requirements or challenges in monitoring soldiers' health could enhance the depth and relevance of the review.
3. Historical Progression: While the manuscript introduces recent technological trends, organizing the advancements in chronological order could help readers better understand the evolution of the field and how current technologies have emerged from earlier approaches.
4. Limitations and Future Directions: The paper touches on potential risks associated with each technique, but it would be more insightful if the authors also discussed the specific drawbacks of each method and proposed potential directions for future research or improvements.

 

Author Response

Dear Reviewer!

Thank you for your time and expertise. Regarding your comments:

1. Figures and Tables: All figures and tables should be explicitly referenced and discussed in the main text. Without proper mention and explanation, their inclusion is ineffective and may confuse the reader. - WE'VE ADDED AND CORRECTED.
2. Distinction from Civilian Systems: Although the paper offers a broad review of health monitoring systems for soldiers, it would significantly benefit from a clearer distinction between systems designed for civilians and those tailored for military personnel. Highlighting the unique requirements or challenges in monitoring soldiers' health could enhance the depth and relevance of the review. - WE'VE ADDED ONE TABLE REGARDING YOUR COMMENT.
3. Historical Progression: While the manuscript introduces recent technological trends, organizing the advancements in chronological order could help readers better understand the evolution of the field and how current technologies have emerged from earlier approaches.- WE'VE CORRECTED IT.
4. Limitations and Future Directions: The paper touches on potential risks associated with each technique, but it would be more insightful if the authors also discussed the specific drawbacks of each method and proposed potential directions for future research or improvements. - WE'VE TRIED TO MAKE IT MORE CLEARLIER FOR THE AUDIENCE.

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The response provided by the authors does not meet the minimum standards expected for a rebuttal letter in the peer review process. As it currently stands, it lacks the structure and content necessary for the reviewer to evaluate whether the concerns raised have been appropriately addressed. Specifically, the authors have not provided point-by-point responses to the individual reviewer comments. Furthermore, they have not indicated where in the revised manuscript the corresponding changes have been made (e.g., specific line numbers, figures, or tables). Without this information, it is not possible to assess the adequacy of the revisions. I strongly recommend that the authors resubmit a properly structured rebuttal letter that includes: A point-by-point response to each reviewer comment. Clear explanations of how each concern was addressed. Precise references to the sections or locations in the manuscript where the changes have been made. Such a structured response is essential to ensure a fair and constructive review process.

Author Response

Dear Reviewer!

Thank you for your time and expertise.

Regarding your comments:

1. Although this paper aims to present a comprehensive review, the discussion is largely qualitative. For example, what level of accuracy is required for physiological state monitoring in military operations? More generally, throughout the paper, I suggest including quantitative descriptions of the required technical specifications for military applications, as well as the current limitations of available technologies. - WE'VE TRIED TO ADD EXTRA INFORMATIONS REGARDING YOUR COMMENTS BETWEEN THE LINES 366-369; ALSO TABLE 2 AND TABLE 3
2. The paper lacks comparative analysis of existing technologies. It would be helpful to include a comparative table of available sensor and monitoring technologies relevant to military settings. - WE'VE ADDED TABLE 2 AND TABLE 3 INTO DISCUSSION PART, LINE 376-389.
3. The authors mention that they reviewed literature published between 2010 and 2024; however, the most recent reference cited appears to be from 2022. This raises concern that recent developments may have been overlooked. Additionally, the exclusion criteria mention that studies unrelated to human military populations were omitted, but this decision may warrant reconsideration. Technologies not originally intended for military applications may still hold future potential in such contexts. -REGARDING TIME FRAME OF THE PUBLICATIONS, NOW IT IS CLEARED AND WE’VE CHANGED IT FOR 2010 AND 2025. REGARDING EXCLUSION CRITERIA, WE’VE ADDED MORE INFORMATION BETWEEN LINE 129-133.
4. The title of Section 3 appears to be a typographical error. Should it be "Physiological state monitoring" instead of "Psychological state monitoring"? Please confirm. - YES, IT IS MY FAULT, THANK YOU - LINE 142.

Reviewer 2 Report

Comments and Suggestions for Authors

The author has successfully completed the editing work. There are no additional suggestions.

Author Response

Dear Reviewer!

Thank you for your time and suggestions.

 

Reviewer 3 Report

Comments and Suggestions for Authors

I believe that all the raised issues have been well addressed and that this revision enhances the quality of the manuscript.

Author Response

Dear Reviewer!

Thank you for your time and previous suggestions.

Round 3

Reviewer 1 Report

Comments and Suggestions for Authors

I don't have any additionnal comments.