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Clothing and Equipment Fit Among Male and Female Canadian Armed Forces Members. 加拿大武装部队男女成员的服装和装备适合度。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae179
Kristina M Gruevski, Adrienne Sy, Linda Bossi, Emma Moon, Junhan Bae, Allan Keefe

Introduction: The fit of military clothing and equipment is essential for the health and safety of military operators. Given the aim of increasing the proportion of women and the known biological and morphological differences between male and female soldiers, an understanding of fit across different items of kit is needed. The aim of this study was to quantify subjective fit ratings of 8 items of military clothing and equipment, including combat shirt, combat pants, rucksack, small pack, tactical vest, fragmentation vest, helmet, and ballistic eyewear as a function of relative stature and occupational group among male and female Canadian Armed Forces members.

Materials and methods: An online survey was distributed to male and female Canadian Armed Forces members, where fit was reported by participants according to a 7-point Likert acceptability scale. Participants were binned into 1 of 6 (3 males, 3 females) standing stature categories based on percentiles in a male and female distribution that included (1) under 35th percentile stature, (2) 35th to 80th percentile stature, and (3) over 80th percentile stature. Additionally, participants were separated according to occupational group: Group A: Infantry, Combat Engineer, Artillery, Armored; group B: Signals, Medical Technician, Intelligence, Signals Intelligence/Cyber Ops; group C: Supply Technician, Weapons Technician, Vehicle Technician, Electronic-Optronic Technician, Ammunition Technician; other: Not in other groups, examples include: Financial Services Administrator, Cook. This study was approved by the Defence Research and Development Canada Human Research Ethics Committee under protocol 2019-048, Amendment 2.

Results: There were significant effects attributable to stature category and occupational group on the fit of equipment. Specifically, fit acceptability of the rucksack helmet, small pack, and tactical vest was significantly affected by occupational group. Differences between stature categories were detected in all items with the exception of the small pack.

Conclusions: Military equipment fit has previously been shown to have implications for protection, performance, and mobility. The results of the investigation demonstrate different patterns of fit acceptability in male and female soldiers across items of clothing and equipment and may require different solutions.

简介:军用服装和装备的合身性对军事人员的健康和安全至关重要。鉴于增加女兵比例的目标,以及男女士兵之间已知的生理和形态差异,需要了解不同装备的合身性。本研究的目的是量化加拿大武装部队男性和女性成员对 8 种军用服装和装备(包括作战衬衫、作战裤子、背包、小背包、战术背心、防弹背心、头盔和防弹眼镜)的主观合身性评分,并将其与相对身材和职业类别挂钩:我们向加拿大武装部队的男女成员发放了一份在线调查问卷,参与者根据 7 点李克特可接受性量表来报告是否适合自己。根据男性和女性分布中的百分位数,将参与者分为 6 个站立身材类别(3 男 3 女)中的 1 个,这些类别包括:(1)低于第 35 百分位数的身材;(2)第 35 至 80 百分位数的身材;以及(3)超过第 80 百分位数的身材。此外,还根据职业组别对参与者进行了分类:A 组:步兵、战斗工兵、炮兵、装甲兵;B 组:信号兵、医疗技术员、情报员、信号情报员/网络行动员;C 组:供应技术员、武器技术员:供应技术员、武器技术员、车辆技术员、电子-光电技术员、弹药技术员;其他:不属于其他组别,例如财务管理员、厨师。本研究获得了加拿大国防研究与发展部人类研究伦理委员会(Defence Research and Development Canada Human Research Ethics Committee)2019-048号协议第2修正案的批准:结果:身材类别和职业组别对装备的合身性有明显影响。具体来说,职业类别对背包头盔、小背包和战术背心的合身性有显著影响。除小背包外,所有装备在身材类别上都存在差异:军事装备的适配性先前已被证明对防护、性能和机动性有影响。调查结果表明,男性和女性士兵对不同服装和装备的合身性有不同的接受模式,可能需要不同的解决方案。
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引用次数: 0
Evaluation of a Military Global Health Engagement Mission for Critical Wartime Surgical Specialty Readiness. 对战时关键外科专科准备工作的全球军事卫生参与任务进行评估。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae242
Joseph Aryankalayil, Margaret Shields, Michael Baird, Rathnayaka M K D Gunasingha, W Michael Pullen, Mark Johnson, Jamie Fitch, Ian Uber, Tamara Worlton

Introduction: Surgical volume at Military Treatment Facilities (MTFs) has been gradually decreasing for roughly the past 2 decades. The Knowledge, Skills, and Abilities (KSA) Clinical Readiness Program linked surgical volume and readiness using a tool known as the KSA metric. However, the extent to which military medical missions contribute to the readiness of critical wartime specialties has not been evaluated using this metric.

Methods: In this study, a retrospective analysis was conducted using the surgical case logs from the US Naval Ship (USNS) Comfort missions in 2018 and 2019. The comprehensive case log data were categorized by year, surgeon, procedure, and location. The analysis focused on providing detailed descriptive statistics, including percentages pertaining to the types of procedures performed during these missions. The 2018 mission was 11 weeks in duration, and supported activities in Ecuador, Peru, Colombia, and Honduras. The USNS Comfort mission in 2019 lasted 6 months (June-November 2019), and visited 12 countries in Central America, South America, and the Caribbean.

Results: The 2019 mission case log, spanning 6 months, was evaluated using the KSA score in order to assess readiness and compare against 6 months of MTF KSA values within the same calendar year. In 2019, the orthopedic surgeon aboard the USNS Comfort had a total KSA score of 44,006, but the 6-month USNS Comfort mission only contributed 5,364 points (12% of the annual score). The general surgery practice aboard the USNS Comfort produced lower KSA scores compared to each surgeon's respective MTF practice (Table III). Analyzing the cases logged by general surgeons also highlights minimal surgical diversity during these missions, with more than 90% of cases being hernia repairs or laparoscopic cholecystectomies (Table I). In addition, 35% of total procedures performed in 2018 and 2019 were performed laparoscopically.

Conclusions: The analysis of operative data from the 2019 USNS Comfort mission, in comparison with the surgeons' work at their respective MTFs, reveals limited benefit in the ability of hospital-ship missions to bolster surgical readiness as measured by the KSA score. However, this is not a reflection on the value of Global Health Engagement (GHE) itself but a review of the way in which it is leveraged to support surgical readiness. Military surgeons participate in GHE as part of a larger strategy to strengthen relationships with partner nations, improve military medical force interoperability, and bolster partner nation medical capacity and capabilities. The KSA score offers an excellent tool to compare readiness metrics across significantly different GHE missions, and facilitates the opportunity for future prospective studies to improve case volume, diversity, and ultimately readiness.

导言:大约在过去 20 年中,军事治疗设施(MTF)的手术量一直在逐渐减少。知识、技能和能力(KSA)临床准备计划使用一种称为 KSA 指标的工具将手术量和准备状态联系起来。然而,军事医疗任务在多大程度上促进了关键战时专科的战备状态还没有使用该指标进行过评估:在本研究中,我们使用 2018 年和 2019 年美国海军舰艇(USNS)"舒适 "号任务的手术病例日志进行了回顾性分析。综合病例日志数据按年份、外科医生、手术和地点进行了分类。分析的重点是提供详细的描述性统计数字,包括与这些任务期间实施的手术类型有关的百分比。2018 年的任务为期 11 周,支持在厄瓜多尔、秘鲁、哥伦比亚和洪都拉斯开展的活动。美国海军 "舒适 "号2019年的任务为期6个月(2019年6月至11月),访问了中美洲、南美洲和加勒比海地区的12个国家:使用 KSA 分数对跨度为 6 个月的 2019 年任务病例日志进行了评估,以评估准备情况,并与同一日历年内 6 个月的 MTF KSA 值进行比较。2019 年,美国海军 "舒适 "号上的骨科医生的 KSA 总分为 44006 分,但美国海军 "舒适 "号 6 个月的任务只贡献了 5364 分(占年度总分的 12%)。与每位外科医生各自的 MTF 实践相比,"舒适 "号上的普通外科实践产生的 KSA 分数较低(表 III)。对普外科医生记录的病例进行分析后还发现,在这些任务中,外科手术的多样性极少,90% 以上的病例都是疝修补术或腹腔镜胆囊切除术(表 I)。此外,2018 年和 2019 年进行的手术总数中有 35% 是通过腹腔镜进行的:通过对 2019 年美国海军 "舒适 "号任务的手术数据进行分析,并与外科医生在各自 MTF 的工作情况进行比较,发现医院船任务在加强手术准备能力(以 KSA 分数衡量)方面的益处有限。然而,这并不是对全球卫生参与(GHE)本身价值的反思,而是对利用全球卫生参与支持外科手术准备的方式的回顾。军事外科医生参与全球卫生参与是加强与伙伴国关系、提高军事医疗部队互操作性、增强伙伴国医疗能力的更大战略的一部分。KSA 评分提供了一个很好的工具,可用于比较明显不同的 GHE 任务的准备度量,并为未来的前瞻性研究提供机会,以提高病例量、多样性并最终改善准备度。
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引用次数: 0
Obesity and Overweight: First Comprehensive Overview in the French Armed Forces. 肥胖与超重:法国武装部队首次全面概述。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae217
Livia Mannaioni, Thierry Jay, Yvain Goudard, Olivier Aoun, Ghislain Pauleau, Anne Montois, Bruno de La Villéon

Introduction: The global rise in obesity is well-established, with significant health implications. This study aims to comprehensively assess overweight and obesity prevalence within the French Armed Forces.

Materials and methods: Using data from the Unique Medical-Military Software (UMMS) in 2018, a cross-sectional study was conducted on active French Military personnel aged 18 and above, who underwent periodic medical examinations (PME) in 2017. Body Mass Index (BMI) served as the main criterion for overweight and obesity classification. A representative sample was obtained through random sampling.

Results: The sample included 17,082 individuals, revealing an average age of 33.5 years, with 36.1% classified as overweight and 9.6% as obese. The mean BMI of women was significantly lower than that of men (23.9 vs 25.3 kg/m2-P < .001). Results indicated that 22.4% of women vs 38.5% of men were overweight (P < .001). For obesity, the difference was not significant (8.8% of women vs 9.8% of men-P = .138). BMI increased with age, and non-commissioned officers (NCOs) showed the highest prevalence of obesity. Gendarmes exhibited the highest BMI and overweight rates (50.1%) among military branches.

Conclusion: While obesity is less prevalent in the French Armed Forces compared to the general population, the study emphasizes the equivalent prevalence of overweight. We confirm here that the global epidemic of obesity and overweight affects all armed forces. France seems less affected than other Western armies. Targeting specific groups, such as NCOs and the national gendarmerie, is crucial for prevention.

引言肥胖症在全球呈上升趋势,对健康产生了重大影响。本研究旨在全面评估法国武装部队中超重和肥胖的发生率:利用2018年唯一医疗军事软件(UMMS)的数据,对2017年接受定期体检(PME)的18岁及以上法国现役军人进行了横断面研究。体重指数(BMI)作为超重和肥胖分类的主要标准。通过随机抽样获得了具有代表性的样本:样本包括 17 082 人,平均年龄为 33.5 岁,36.1% 的人被归类为超重,9.6% 的人被归类为肥胖。女性的平均体重指数明显低于男性(23.9 vs 25.3 kg/m2-P 结论:虽然与普通人群相比,法国武装部队中肥胖症的发病率较低,但这项研究强调了超重的流行程度相当。我们在此证实,肥胖和超重在全球的流行影响着所有武装部队。与其他西方国家的军队相比,法国受到的影响似乎较小。针对军士和国家宪兵等特定群体进行预防至关重要。
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引用次数: 0
Differences in Perceived Stress During the COVID-19 Pandemic Among Military Dental Postgraduate Residents. 军队口腔医学研究生在 COVID-19 大流行期间感知到的压力差异。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae270
James M Ross, Nora L Watson, Nicholas J Hamlin, John E Schmidt

Introduction: In military training settings, stress can improve focus and motivation fostering effective learning. However, high perceived stress can be debilitating resulting in poor learning and clinical errors. Multiple studies have focused on medical residency stress; but there has been minimal focus on dental residents and even less on the impact of the unique stressors from the COVID-19 pandemic. The objectives of this study were to determine the impact of the COVID-19 pandemic on perceived stress of residents in a military dental residency training program and explore the association among perceived stress and anxiety, depression, sleep quality, and social support.

Materials and methods: Dental residents (N = 20) at the Naval Postgraduate Dental School participated in this study. Residents were assessed via self-report measures quarterly from March 2020 through June 2021. The assessment included measures of anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS), fatigue (FSI), and social support (DUKE-SSQ).

Results: Before the pandemic shutdown, 60% of participants reported high perceived stress. These residents reported an initial decrease in symptoms of anxiety, depression, and fatigue compared to residents reporting low pre-pandemic perceived stress but returned to baseline levels post-shutdown. Additionally, the high stress participants reported lower social support.

Conclusions: Based on pre-pandemic perceived stress, participants responded differently to the impact of the pandemic shutdown. The low baseline stress participants may have a more robust sense of grit and resilience. These findings suggest that postgraduate dental training programs should integrate coping skills training opportunities, especially for residents reporting high perceived stress before residency.

介绍:在军事训练环境中,压力可以提高注意力和动力,促进有效学习。然而,高感知压力可能会导致学习效果不佳和临床错误。已有多项研究关注了医学住院医师的压力,但对牙科住院医师的关注却很少,而对 COVID-19 大流行病所带来的独特压力的影响的关注就更少了。本研究的目的是确定 COVID-19 大流行对军事牙科住院医师培训项目中住院医师感知压力的影响,并探讨感知压力与焦虑、抑郁、睡眠质量和社会支持之间的关联:海军牙科研究生院的牙科住院医师(N = 20)参与了这项研究。从 2020 年 3 月到 2021 年 6 月,住院医师每季度接受一次自我报告评估。评估内容包括焦虑(GAD-7)、抑郁(PHQ-9)、感知压力(PSS)、疲劳(FSI)和社会支持(DUKE-SSQ):在大流行关闭之前,60% 的参与者表示感受到了很大的压力。与大流行前感知压力较低的居民相比,这些居民最初的焦虑、抑郁和疲劳症状有所减轻,但在关机后又恢复到基线水平。此外,高压力参与者的社会支持也较低:结论:根据大流行前的压力感知,参与者对大流行关闭的影响做出了不同的反应。基线压力低的学员可能具有更强的勇气和适应力。这些研究结果表明,口腔医学研究生培训项目应整合应对技能培训机会,尤其是针对住院医师在实习前感知压力较大的情况。
{"title":"Differences in Perceived Stress During the COVID-19 Pandemic Among Military Dental Postgraduate Residents.","authors":"James M Ross, Nora L Watson, Nicholas J Hamlin, John E Schmidt","doi":"10.1093/milmed/usae270","DOIUrl":"10.1093/milmed/usae270","url":null,"abstract":"<p><strong>Introduction: </strong>In military training settings, stress can improve focus and motivation fostering effective learning. However, high perceived stress can be debilitating resulting in poor learning and clinical errors. Multiple studies have focused on medical residency stress; but there has been minimal focus on dental residents and even less on the impact of the unique stressors from the COVID-19 pandemic. The objectives of this study were to determine the impact of the COVID-19 pandemic on perceived stress of residents in a military dental residency training program and explore the association among perceived stress and anxiety, depression, sleep quality, and social support.</p><p><strong>Materials and methods: </strong>Dental residents (N = 20) at the Naval Postgraduate Dental School participated in this study. Residents were assessed via self-report measures quarterly from March 2020 through June 2021. The assessment included measures of anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS), fatigue (FSI), and social support (DUKE-SSQ).</p><p><strong>Results: </strong>Before the pandemic shutdown, 60% of participants reported high perceived stress. These residents reported an initial decrease in symptoms of anxiety, depression, and fatigue compared to residents reporting low pre-pandemic perceived stress but returned to baseline levels post-shutdown. Additionally, the high stress participants reported lower social support.</p><p><strong>Conclusions: </strong>Based on pre-pandemic perceived stress, participants responded differently to the impact of the pandemic shutdown. The low baseline stress participants may have a more robust sense of grit and resilience. These findings suggest that postgraduate dental training programs should integrate coping skills training opportunities, especially for residents reporting high perceived stress before residency.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e2700-e2709"},"PeriodicalIF":1.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emerging Trends in the Prevalence of Military Medicine Interest Groups and Specialty Tracks at U.S. Medical Schools. 美国医学院军事医学兴趣小组和专业方向的流行趋势。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae250
Donald P Keating Iii, Megan A Unrath, Rachel M Steffes, Timothy M Guenther, Bryan G Beutel

Introduction: A challenge confronting health care is the national physician shortage, notably impacting the DoD's recruitment of military physicians. To address this, the Health Professions Scholarship Program is annually awarded to medical students to facilitate their transition into the U.S. Armed Forces. There is a glaring absence of military medical education in civilian schools to accommodate the unique interests of these students. While medical schools have adapted with interest groups and specialty tracks, the current presence of military medicine interest groups (MMIGs) and military medicine specialty tracks (MMSTs) remains under-explored. This study aimed to (1) update the prevalence of MMIGs in U.S. medical institutions, (2) identify the presence of MMSTs, and (3) compare military medicine involvement between allopathic and osteopathic programs.

Methods: The study was approved for exempt status from the Kansas City University Institutional Review Board (study number 20,211,568-1). In a cross-sectional analysis, surveys were sent to 208 U.S. medical schools, with responses from student services or available public data from 200 institutions included in the final analysis. A secondary survey was sent to respondents who provided MMIG or MMST contacts.

Results: Results indicated that 62% (n = 124/200) of schools currently have an established MMIG, a modest growth from 56% (n = 70/125) in 2015 (p = .14). MMST prevalence, however, is minimal at 2.5% (5/200). Osteopathic institutions demonstrated a significantly greater engagement in military medicine education (88.7%) compared to allopathic schools (52.4%) (p < .001).

Conclusion: This research underscores the need for comprehensive military medical training in medical schools to meet the interests and career aspirations of their students. Future studies should also evaluate the efficacy of MMIGs and MMSTs in preparing students for military medical roles.

导言:医疗保健面临的一项挑战是全国性的医生短缺问题,这尤其影响了国防部招募军医的工作。为解决这一问题,美国每年都会向医科学生颁发 "卫生职业奖学金计划",以帮助他们向美国武装部队过渡。平民学校明显缺乏军事医学教育,无法满足这些学生的独特兴趣。虽然医学院已经通过兴趣小组和专业方向进行了调整,但目前军事医学兴趣小组(MMIGs)和军事医学专业方向(MMSTs)的存在仍未得到充分探索。本研究旨在:(1) 更新军事医学兴趣小组在美国医疗机构中的普遍程度;(2) 确定军事医学专业方向(MMST)的存在情况;(3) 比较全科医学和骨科医学项目在军事医学方面的参与情况:该研究获得了堪萨斯城大学机构审查委员会的豁免批准(研究编号 20,211,568-1)。在横断面分析中,我们向 208 所美国医学院校发送了调查问卷,最终分析包括了 200 所院校学生服务部门的回复或可获得的公共数据。对提供 MMIG 或 MMST 联系方式的受访者进行了二次调查:结果显示,62%(n = 124/200)的学校目前已建立了MMIG,与2015年的56%(n = 70/125)相比略有增长(p = .14)。然而,MMST 的流行率极低,仅为 2.5%(5/200)。与对抗疗法学校(52.4%)相比,整骨疗法机构在军事医学教育中的参与度明显更高(88.7%)(p 结论:这项研究强调,医学院需要开展全面的军事医学培训,以满足学生的兴趣和职业抱负。未来的研究还应评估 MMIGs 和 MMSTs 在培养学生适应军事医学角色方面的功效。
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引用次数: 0
Correction To: Ebola Virus Disease Outbreaks: Lessons Learned From Past and Facing Future Challenges. 更正为埃博拉病毒疾病爆发:从过去汲取的教训和面对未来的挑战。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae328
{"title":"Correction To: Ebola Virus Disease Outbreaks: Lessons Learned From Past and Facing Future Challenges.","authors":"","doi":"10.1093/milmed/usae328","DOIUrl":"10.1093/milmed/usae328","url":null,"abstract":"","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e2740"},"PeriodicalIF":1.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comment on "Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection". 对 "新确诊感染艾滋病毒的现役空军成员对艾滋病毒感染风险的自我感知和艾滋病毒感染风险的计算 "的评论。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae255
Hinpetch Daungsupawong, Viroj Wiwanitkit
{"title":"Comment on \"Self-Perception of Risk for HIV Acquisition and Calculated Risk for HIV Acquisition Among Active Duty Air Force Members With Newly Diagnosed HIV Infection\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/milmed/usae255","DOIUrl":"10.1093/milmed/usae255","url":null,"abstract":"","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"318-319"},"PeriodicalIF":1.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Hidden Enemy: Mal de Débarquement Syndrome and Its Impact on Military Operations. 隐藏的敌人:人格障碍综合症及其对军事行动的影响。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usad449
Charlotte K Hughes, Michael J Eliason, Akihiro J Matsuoka

Mal de Débarquement Syndrome (MdDS) is a poorly understood vestibular disorder that frequently affects military personnel exposed to motion during transportation and deployment. It is characterized by a persistent sensation of motion often experienced after disembarking from a ship or other mode of transportation. It can significantly affect a service member's balance, coordination, attention, and focus, which can then substantially impact their quality of life, ability to perform their military duties, and overall mission readiness. Despite its potential impact, comprehensive studies on MdDS are scarce, especially within the military. The unique conditions of military service, including frequent travel, long flights, maritime deployments, and high-stress environments, make the military well suited to study MdDS. Increased awareness and understanding of MdDS is crucial for everyone in the military-from medical personnel responsible for the diagnosis and treatment of MdDS to commanders who must consider the operational impact of impaired personnel.

伤残伤残综合症(MdDS)是一种鲜为人知的前庭障碍,经常影响在运输和部署过程中暴露于运动的军事人员。它的特点是经常在从船上或其他交通工具下船后出现持续的运动感。它会严重影响军人的平衡、协调、注意力和专注力,从而严重影响他们的生活质量、履行军事职责的能力和整体任务准备程度。尽管有潜在的影响,但对MdDS的全面研究很少,特别是在军队中。军事服务的独特条件,包括频繁的旅行、长途飞行、海上部署和高压力环境,使军队非常适合研究MdDS。提高对伤残人员的认识和了解对军队中的每一个人都至关重要,从负责诊断和治疗伤残人员的医务人员到必须考虑伤残人员的行动影响的指挥官。
{"title":"The Hidden Enemy: Mal de Débarquement Syndrome and Its Impact on Military Operations.","authors":"Charlotte K Hughes, Michael J Eliason, Akihiro J Matsuoka","doi":"10.1093/milmed/usad449","DOIUrl":"10.1093/milmed/usad449","url":null,"abstract":"<p><p>Mal de Débarquement Syndrome (MdDS) is a poorly understood vestibular disorder that frequently affects military personnel exposed to motion during transportation and deployment. It is characterized by a persistent sensation of motion often experienced after disembarking from a ship or other mode of transportation. It can significantly affect a service member's balance, coordination, attention, and focus, which can then substantially impact their quality of life, ability to perform their military duties, and overall mission readiness. Despite its potential impact, comprehensive studies on MdDS are scarce, especially within the military. The unique conditions of military service, including frequent travel, long flights, maritime deployments, and high-stress environments, make the military well suited to study MdDS. Increased awareness and understanding of MdDS is crucial for everyone in the military-from medical personnel responsible for the diagnosis and treatment of MdDS to commanders who must consider the operational impact of impaired personnel.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"299-303"},"PeriodicalIF":1.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138176736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Optimization and Validation of an FTIR-based, All-in-one System for Viable MDR Bacteria Detection in Combat-related Wound Infection. 优化和验证基于傅立叶变换红外技术的一体化系统,用于检测与战斗有关的伤口感染中可存活的 MDR 细菌。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae068
Ying Chen, Andrew Leung, Yulia Wang, Nathan K Archer
<p><strong>Introduction: </strong>The U.S. Military members experiencing combat-related injuries have a higher chance of developing infections by multidrug-resistant (MDR) bacteria at admission to military hospitals. MDR wound infections result in higher amputation rates and greater risks for subsequent or chronic infections that require readmission or extended stay in the hospital. Currently, there is no FDA-clear, deployable early diagnostic system for suitable field use.We are reporting our efforts to improve a previously developed Rapid Label-free Pathogen Identification (RAPID) system to detect viable MDR bacteria in wound infections and perform antibiotic susceptibility testing (AST). Specifically, we added multiplex and automation capability and significantly simplified the sample preparation process. A functional prototype of the improved system was built, and its performance was validated using a variety of lab-prepared spiked samples and real-world samples.</p><p><strong>Materials and methods: </strong>To access the baseline performance of the improved RAPID system in detecting bacteria presence, we selected 17 isolates, most of them from blood or wound infections, and prepared mono-strain spiked samples at 104 to 106 cfu/mL concentration. These samples were processed and analyzed by the RAPID system. To demonstrate the AST capability of the system, we selected 6 strains against 6 different antibiotics and compared the results from the system with the ones from the gold standard method.To validate the system's performance with real-world samples, we first investigated its performance on 3 swab samples from epicutaneous methicillin-resistant Staphylococcus aureus-exposed mouse model. The AST results from our system were compared with the ones from the gold standard method. All animal experiments were approved by the Johns Hopkins University Animal Care and Use Committee (Protocol No. MO21M378). Then, we obtained swab samples from 7 atopic dermatitis (AD) patients and compared our AST results with the ones from the gold standard method. The human subject protocol was approved by the Johns Hopkins Medicines Institutional Review Boards (Study No. CR00043438/IRB00307926) and by USAMRDC (Proposal Log Number/Study Number 20000251).</p><p><strong>Results: </strong>High-quality data were obtained from the spiked samples of all 17 strains. A quantitative analysis model built using these data achieved 94% accuracy in predicting the species ID in 8 unknown samples. The AST results on the spiked samples had shown 100% matching with the gold standard method. Our system successfully detects the presence/absence of viable bacteria in all 3 mouse and 7 AD patient swab samples. Our system shows 100% and 85.7% (6 out of 7) accuracy when compared to the oxacillin susceptibility testing results for the mouse and the AD patient swabs, respectively.</p><p><strong>Conclusions: </strong>Our system has achieved excellent performance in detecting viable bacteria
导言:经历过与战斗有关的伤害的美国军人在进入军队医院时,有更高的机会受到耐多药(MDR)细菌的感染。MDR 伤口感染会导致更高的截肢率和更大的后续或慢性感染风险,从而需要再次入院或延长住院时间。目前,还没有适合野外使用的、经 FDA 批准的、可部署的早期诊断系统。我们报告了我们为改进先前开发的快速无标签病原体识别 (RAPID) 系统所做的努力,该系统可检测伤口感染中存活的 MDR 细菌,并执行抗生素药敏试验 (AST)。具体来说,我们增加了多重和自动化功能,并大大简化了样品制备过程。我们建立了改进系统的功能原型,并使用各种实验室制备的加标样本和实际样本验证了其性能:为了了解改进型 RAPID 系统在检测细菌存在方面的基准性能,我们选择了 17 种分离菌株(其中大部分来自血液或伤口感染),并制备了 104 至 106 cfu/mL 浓度的单菌株加标样本。RAPID 系统对这些样本进行了处理和分析。为了证明该系统的 AST 能力,我们选择了 6 种菌株针对 6 种不同的抗生素,并将该系统得出的结果与金标准方法得出的结果进行了比较。我们将系统得出的 AST 结果与金标准方法得出的结果进行了比较。所有动物实验均获得了约翰霍普金斯大学动物护理和使用委员会(Protocol No.MO21M378)的批准。然后,我们采集了 7 名特应性皮炎(AD)患者的拭子样本,并将我们的 AST 结果与金标准方法的结果进行了比较。该人体试验方案获得了约翰霍普金斯大学医学机构审查委员会(研究编号:CR00043438/IRB00307926)和美国医学研究与发展中心(提案编号/研究编号:20000251)的批准:结果:从所有 17 个菌株的加标样品中获得了高质量的数据。利用这些数据建立的定量分析模型在预测 8 个未知样本的物种 ID 方面达到了 94% 的准确率。加标样品的 AST 结果显示与金标准方法的匹配率为 100%。我们的系统能成功检测出所有 3 个小鼠样本和 7 个 AD 患者拭子样本中是否存在存活细菌。与小鼠和 AD 患者拭子中的奥沙西林药敏试验结果相比,我们的系统分别显示出 100% 和 85.7% 的准确率(7 个样本中的 6 个):我们的系统在检测存活细菌的存在以及以多重、自动和易于操作的方式对实验室制备的样本和真实样本进行 AST 检测方面表现出色。我们的研究结果为开发一种快速(从样本到答案的时间不超过 3 小时)、准确、灵敏、物种特异性强的便携式系统指明了道路,该系统可用于检测野外环境中是否存在 MDR 战斗相关伤口感染。我们未来的工作包括加固 RAPID 系统并评估其在相关环境条件下的性能。
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引用次数: 0
Comparison of Vestibular/Ocular Motor Screening (VOMS) and Computerized Eye-tracking to Identify Exposure to Repetitive Head Impacts. 比较前庭/眼球运动筛查 (VOMS) 和计算机化眼球跟踪技术,以确定头部是否受到重复性撞击。
IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-05 DOI: 10.1093/milmed/usae065
Anthony P Kontos, Aaron J Zynda, Amir Minerbi
<p><strong>Introduction: </strong>Military service members (SMs) are exposed to repetitive head impacts (RHIs) in combat and training that are purported to adversely affect brain health, including cognition, behavior, and function. Researchers have reported that RHI from blast-related exposure may affect both vestibular and ocular function, which in turn may be related to symptomology. As such, an examination of the effects of RHI on exposed military SMs should incorporate these domains. To date, researchers have not compared groups of exposed special operations forces (SOF) operators on combined clinical vestibular/ocular and eye-tracker-based outcomes. Therefore, the primary purpose of this study was to compare participant-reported symptoms and performance on the Vestibular/Ocular Motor Screening (VOMS) tool with performance on the computerized RightEye tracking system between SOF operators exposed to blast-related RHI and healthy controls without blast-related exposure. In addition, the study aimed to compare subgroups of snipers and breachers exposed to RHI to controls on the preceding metrics, as well as identify a subset of individual (demographic) factors, participant-reported symptoms, and performance metrics on VOMS and RightEye that best identify SOF operators exposed to RHI from unexposed controls.</p><p><strong>Materials and methods: </strong>The study involved a cross-sectional design including 25 Canadian SOF SMs comprised of breachers (n = 9), snipers (n = 9), and healthy, unexposed controls (n = 7). The former 2 groups were combined into an RHI group (n = 18) and compared to controls (n = 7). Participants provided demographics and completed a self-reported concussion-related symptom report via the Military Acute Concussion Evaluation 2, the VOMS, and RightEye computerized eye-tracking assessments. Independent samples t-tests and ANOVAs were used to compare the groups on the outcomes, with receiver operating characteristic curve and area under the curve (AUC) analyses to identify predictors of blast exposure. This study was approved by the Defence Research Development Canada Human Research Ethics Committee and the Canadian Forces Surgeon General/Special Forces Command.</p><p><strong>Results: </strong>The results from t-tests supported group differences for age (P = .012), participant-reported symptoms (P = .006), and all VOMS items (P range = <.001-.02), with the RHI group being higher than healthy controls on all variables. ANOVA results supported group differences among snipers, breachers, and controls for age (P = .01), RightEye saccades (P = .04), participant-reported total symptom severity (P = .03), and VOMS total scores (P = .003). The results of the receiver operating characteristic curve analyses supported age (AUC = 0.81), Military Acute Concussion Evaluation 2 participant-reported total symptom severity (AUC = 0.87), and VOMS total scores (AUC = 0.92) as significant predictors of prior blast exposure.</p><p><strong>Concl
导言:军人(SMs)在作战和训练中会受到重复性头部撞击(RHIs),据称会对大脑健康(包括认知、行为和功能)产生不利影响。研究人员报告称,与爆炸相关的 RHI 可能会影响前庭和眼部功能,进而可能与症状有关。因此,研究 RHI 对暴露在爆炸环境中的军方工作人员的影响应包括这些方面。迄今为止,研究人员还没有比较过暴露于环境中的特种作战部队(SOF)操作人员组别在临床前庭/眼部和眼动追踪器基础上的综合结果。因此,本研究的主要目的是比较暴露于爆炸相关 RHI 的特种作战部队操作人员与未暴露于爆炸相关风险的健康对照组之间的参与者报告症状、前庭/眼球运动筛查 (VOMS) 工具的表现以及计算机化 RightEye 跟踪系统的表现。此外,该研究还旨在比较暴露于 RHI 的狙击手和突破者亚组与对照组在前述指标上的表现,并确定个人(人口统计学)因素、参与者报告的症状以及 VOMS 和 RightEye 性能指标的子集,这些子集最能将暴露于 RHI 的 SOF 操作员与未暴露于 RHI 的对照组区分开来:研究采用横断面设计,包括 25 名加拿大特种作战部队 SM,其中包括突破者(9 人)、狙击手(9 人)和健康的未暴露对照组(7 人)。前两组被合并为 RHI 组(n = 18),并与对照组(n = 7)进行比较。参与者提供人口统计数据,并通过军事急性脑震荡评估 2(Military Acute Concussion Evaluation 2)、VOMS 和 RightEye 计算机化眼动追踪评估完成脑震荡相关症状的自我报告。独立样本 t 检验和方差分析用于比较各组的结果,接收者工作特征曲线和曲线下面积 (AUC) 分析用于确定爆炸暴露的预测因素。这项研究获得了加拿大国防研究发展部人类研究伦理委员会和加拿大军队外科医生/特种部队司令部的批准:t检验结果支持年龄(P = .012)、参与者报告的症状(P = .006)和所有VOMS项目(P范围 = 结论)的组间差异:参与者报告的脑震荡症状、VOMS 分数和年龄有助于从对照组中识别暴露于 RHI 的 SOF 操作员。RightEye 指标在区分 RHI 组别与对照组方面没有作用。狙击手和突破者之间的差异值得进一步研究。总之,研究结果表明,VOMS 可能是筛查暴露于 RHI 对 SOF 操作员影响的有用工具。未来的调查应在更大的军事特战队员样本中进行,考虑更多因素(如 RHI 暴露水平、病史和性别),并包括更多的评估领域(如平衡、认知和心理)。
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Military Medicine
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