This work has several direct Earth-based applications. First, the fitness and exercise applications we are developing can be used to assist in the training and evaluation of elite and recreational athletes. Training programs might be prescribed based upon data from this system, and workouts could be monitored in real-time to assure that the correct exercise intensity is being achieved. The device could be used in a similar manner to train astronauts before, during, and after spaceflight as well as in patients participating in physical therapy and reconditioning programs following illness or injury. The sensor, which also is of tremendous interest to the Army, will have application in emergency response vehicles, emergency rooms, and hospitals. Pre-hospital applications include assessing the severity of shock and triaging multiple casualties, as well as providing a sensor for a smart medical system to guide resuscitation from hemorrhage. In the Intensive Care Unit (ICU) we expect that this monitor will find application in helping provide early identification of patients with hemodynamic instability before they go into shock. We are partnering with the Armed Forces Research Institute of Medical Science (AFRIMS) in Bangkok, Thailand to study the application of our sensor for the early identification of shock in children with Dengue hemorrhagic fever. This study is funded by Telemedicine & Advanced Technology Research Center (TATRC). Data collection in the first year of this study was shown to provide an early indication of patients who had significant plasma leakage and were at risk for shock. The company formed to commercialize the sensor, Reflectance Medical, has received substantial funding from the US Army Medical Research and Materiel Command. The company received clearance from the FDA to sell the CareGuide Oximeter 1100, a hospital-based system to noninvasively and continuously determine SmO2. The company has submitted its second 510(k) application for the mobile CareGuide 2100 Oximeter, which is a battery powered SmO2 sensor that displays results on an Android tablet or the Sotera ViSi mobile wrist worn vital sign monitor. The CareGuide 3100 development is complete. The 3100 updates the CareGuide 2100 software to calculate pHm and hematocrit (Hct) from the same spectra. The CareGuide 3100 is targeted for submission to the FDA by the end of 2012.