D. Sten, R. Wareham, K. Loh
S10 Neuro; University of California San Diego,
United States
Keywords: precision diagnostics, cognitive readiness, fatigue detection, human performance, occupational safety
Summary:
Fatigue, thermal stress, and cognitive overload are major contributors to preventable injury, operational error, and reduced decision quality in safety-critical occupations. Most current readiness assessments are binary and retrospective, confirming qualification rather than detecting real-time performance degradation before failure occurs. This work presents CLEAR (Cognitive Load and Early Assessment of Readiness), a precision diagnostics framework for early detection of neuro-cognitive readiness degradation under thermal and operational stress. CLEAR combines multimodal wearable sensing with task-based performance assessments to detect early changes in neuromechanical and cognitive function. Diagnostic indicators include reaction time under cognitive load, postural and movement stability, fine-motor precision, and physiological recovery dynamics. Together, these measures enable objective, task-relevant readiness thresholds that move assessment beyond subjective symptom reporting. Human validation was conducted in both controlled laboratory settings and real-world operational environments, including firefighter live-fire training evolutions and extreme cold exposure protocols. Under high-heat conditions exceeding 1,000°F and during near-freezing cold immersion, participants showed measurable declines in reaction speed, stability, and cognitive task performance. CLEAR consistently identified readiness loss before overt failure or safety events occurred. To validate the functional relevance of detected readiness loss, brief diagnostic-guided recovery and neuro-physical modulation strategies were applied as a downstream response. Compared to non-diagnostic baselines, participants demonstrated meaningful improvements in reaction time, motor stability, and physiological recovery. During heat-stress trials, all participants returned to baseline core body temperature more rapidly, and most showed improved heart-rate recovery. Cold-exposure trials similarly showed improved reaction accuracy and reduced movement instability when response timing was informed by diagnostic thresholds. Unlike fatigue monitoring approaches that rely on workload estimates, self-reporting, or single physiological signals, CLEAR focuses on early diagnostic detection of readiness loss at the neuromechanical and cognitive level. By distinguishing transient compensation from true degradation, CLEAR provides actionable insight in environments where individuals may continue to perform despite elevated injury and error risk. Designed for minimal operational burden, the CLEAR framework uses brief assessment protocols compatible with training, rehabilitation, and operational workflows. Diagnostic outputs are interpretable and actionable, supporting informed decisions about recovery timing, task assignment, and risk exposure. By converting invisible fatigue and cognitive degradation into objective diagnostic signals, CLEAR enables proactive decision support to reduce injury risk and prevent errors before they occur.