Changes in Post-traumatic Stress Disorder Service Connection Among Veterans Under Age 55: An 18-Year Ecological Cohort Study.
CONCLUSIONS: Particularly for men, discontinuing or reducing PTSD service connection in this cohort was rare and often reversed. Regardless of gender, most Veterans with discontinued PTSD service connection did not experience reductions in their overall, total disability rating. Cost-benefit analyses could help determine if mandated, age-based re-evaluations of PTSD service connection are cost-effective. PMID: 30938816 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Simulated Casualty Evacuation Performance Is Augmented by Deadlift Peak Force.
Authors: Poser WM, Trautman KA, Dicks ND, Christensen BK, Lyman KJ, Hackney KJ Abstract INTRODUCTION: The purpose of the current study was to examine if isometric peak force and rate of force development (RFD) were related to the ability to successfully perform a simulated casualty evacuation task in both unweighted and weighted conditions. METHODS: Eighteen male participants from Army Reserve Officers' Training Corps (ROTC) completed a maximum isometric deadlift on a force plate (IRB#HE16227). Isometric peak force and RFD were calculated from ground reaction force. Two simulated casualty evacuation performance...
Source: Military Medicine - April 4, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Improvements in Gulf War Illness Symptoms After Near-Infrared Transcranial and Intranasal Photobiomodulation: Two Case Reports.
This report describes the first documentation of improved GWI symptoms in two GW veterans following 12 weeks of PBM treatments. PMID: 30916762 [PubMed - as supplied by publisher] (Source: Military Medicine)
Source: Military Medicine - March 29, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development and Implementation of U.S. Army Guidelines for Managing Soldiers at Risk of Suicide.
CONCLUSIONS: Combined efforts in crafting policy for risk identification and communication resulted in a policy that was acceptable and feasible from the perspective of commanders and clinicians. Synchronization efforts between commanders, clinicians, and support services are crucial to ensure effective intervention to prevent suicide behavior. PMID: 30901390 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prehospital Interventions Performed in Afghanistan Between November 2009 and March 2014.
CONCLUSIONS: In our study, the most commonly performed prehospital LSI in a combat setting were for vascular access and hemorrhage control. The most common incorrectly performed and missed interventions were airway interventions and chest procedures respectively. PMID: 30901391 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

IV DripAssist: An Innovative Way to Monitor Intravenous Infusions Away From an Outlet?
Authors: Couperus K, Kmiecik K, Kang C Abstract Intravenous (IV) administration of fluids and medications are a significant part of patient treatment. In austere environments, typical methods of counting drops from gravity drips or infusion pumps both have limitations such as accuracy, weight, and need for power. The DripAssist device calculates drip rates by counting drops in IV tubing drip chambers and may provide a useful patient safety monitor adjunct. The protocol was IRB approved, prospective, and designed as a pilot study involving 28 Madigan Army Medical Center Emergency Department personnel. After a brief ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

An Association Between Herpes Zoster Vaccination and Stroke Reduction Among Elderly Individuals.
Authors: Klaric JS, Beltran TA, McClenathan BM Abstract Herpes zoster (HZ, shingles) affects individuals (60+ years) by reactivation of varicella virus from primary infection. Approximately one-third of the general population will develop HZ and are at increased risk of stroke. Our objective was describing possible associations between self-reported HZ vaccination and stroke with the Centers for Disease Control and Prevention's Behavioral Risk Factors Surveillance System, a cross-sectional nationwide telephone survey. Non-institutionalized U.S. adults answered items concerning health risk behaviors. 2014 survey dat...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Augmented Reality as a Medium for Improved Telementoring.
Authors: Rojas-Muñoz E, Andersen D, Cabrera ME, Popescu V, Marley S, Zarzaur B, Mullis B, Wachs JP Abstract Combat trauma injuries require urgent and specialized care. When patient evacuation is infeasible, critical life-saving care must be given at the point of injury in real-time and under austere conditions associated to forward operating bases. Surgical telementoring allows local generalists to receive remote instruction from specialists thousands of miles away. However, current telementoring systems have limited annotation capabilities and lack of direct visualization of the future result of the surgica...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Percutaneous Peripheral Nerve Stimulation to Control Postoperative Pain, Decrease Opioid Use, and Accelerate Functional Recovery Following Orthopedic Trauma.
The objective of this report is to summarize the findings of case series of a non-opioid therapy-percutaneous peripheral nerve stimulation (PNS) - and describe its potential for postoperative analgesia, early opioid cessation, and improved function following orthopedic trauma. Percutaneous PNS has been evaluated for the treatment of multiple types of pain, including two case series on postoperative pain following total knee replacement (n = 10 and 8, respectively) and a case series on postamputation pain (n = 9). The orthopedic trauma induced during TKR is highly representative of multiple types of orthopedic trauma sustai...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Preliminary Investigation of Civilian Clinician Perspectives & Just-in-Time Guidance for Tourniquet Use to "Stop the Bleed".
This study aimed to determine surgical trainee knowledge and attitudes regarding tourniquet application and compare the effectiveness of instructions. METHODS: Thirty surgical trainees performed a tourniquet application simulation using a Combat Application Tourniquet and one of the three instructions sets developed by ACS, Department of Homeland Security, and the tourniquet manufacturer. Participants reported tourniquet knowledge, attitudes, and confidence and discussed the instructions. One instruction set was updated and compared to the original set with 20 new trainees. RESULTS: Participants with ACS instructio...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prevalence of Musculoskeletal Injuries Sustained During Marine Corps Recruit Training.
Authors: Jensen AE, Laird M, Jameson JT, Kelly KR Abstract Musculoskeletal injuries cost the U.S. Marine Corps approximately $111 million and 356,000 lost duty days annually. Information identifying the most common types of injuries and events leading to their cause would help target mitigation efforts. The purpose of this effort was to conduct an archival data review of injuries and events leading to injury during recruit training. An archival dataset of Marine recruits from 2011 to 2016 was reviewed and included 43,004 observations from 28,829 unique individuals. Injuries were classified as mild, moderate, and se...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Assessing the Burden of Chlamydia and Gonorrhea for Deployed and Active Duty Personnel Assigned Outside the USA.
This study assessed chlamydia and gonorrhea rates by unit of country assignment and evaluated the demographic profile of affected personnel during deployment. Chlamydia and gonorrhea cases among active duty personnel were identified from laboratory results and ambulatory encounter records in the Military Health System from fiscal years October 2006 through September 2015; these were linked to personnel and deployment records to ascertain demographic characteristics, unit of country assignment, and if the case was captured during a period of deployment. Case rates were higher for chlamydia (1,321.7 per 100,000) than gonorrh...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Using Simulation to Address a Training Gap in Battlefield Ocular Trauma: A Lateral Canthotomy and Cantholysis (LCC) Prototype Training System.
Authors: Sotomayor TM, Bailey MP, Dorton SL Abstract Over the past 15 years of conflict, eye injuries have ocurred at a steady rate of 5-10% of combat casualties, attributed to the enemy's use of improvised explosive devices. Many of these injuries result in a compartment syndrome of the orbit, easily decompressed through the use of a simple procedure called a Lateral Canthotomy and Cantholysis (LCC). Current training curricula at the U.S. Army Center for Pre-Hospital Medicine at Fort Sam Houston, Texas incorporates LCC training presented in lectures and taught using cadavers and goats (resources permitting), but l...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Development of a Mobile Motion Capture (MO2CA) System for Future Military Application.
Authors: Parks M, Chien JH, Siu KC Abstract State-of-the-art three-dimensional motion analysis systems, which are utilized to predict, diagnose, and treat many musculoskeletal and neurological disorders, are expensive and space consuming. These systems have only been widely used in large research facilities because of their lack of this transportability. Since device portability is a critically important in the military, most small military hospitals are therefore deprived of these systems. The purpose of this study was to develop a mobile motion capture system, MO2CA, to automatically detect the movement of the hu...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Army Body Composition Program Study Results Concerning: Enrollees Are More Over Fat Than Expected.
CONCLUSION: Soldiers in this study had higher body fat percentages than expected with a majority of Soldiers classified as obese. Achieving and maintaining ABCP standards may be more challenging for obese Soldiers. To maintain Soldier readiness, commanders should consider intervening earlier when signs of weight gain are observed. PMID: 30901401 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Effect of Sodium Lauryl Sulfate (SLS) on Primary Human Gingival Fibroblasts in an In Vitro Wound Healing Model.
CONCLUSION: Our results showed a dose- and time-dependent inhibition on HGFs wound fill by SLS; however, future in vivo studies are needed to validate if our in vitro findings using SLS-free dentifrices to avoid the potential delay of wound healing. PMID: 30901402 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Formative Assessment of Performance in Diagnostic Ultrasound Using Simulation and Quantitative and Objective Metrics.
Authors: Sheehan FH, McConnaughey S, Freeman R, Zierler RE Abstract BACKGROUND: We developed simulator-based tools for assessing provider competence in transthoracic echocardiography (TTE) and vascular duplex scanning. METHODS: Psychomotor (technical) skill in TTE image acquisition was calculated from the deviation angle of an acquired image from the anatomically correct view. We applied this metric for formative assessment to give feedback to learners and evaluate curricula.Psychomotor skill in vascular ultrasound was measured in terms of dexterity and image plane location; cognitive skill was assessed from me...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Correlates of Depression in U.S. Military Service Members With a History of Mild Traumatic Brain Injury.
CONCLUSIONS: Results confirm chronically elevated the rates of depressive disorders and PTSD comorbidity among service members with a history of mTBI. Depression screening and treatment within the Military Health System should remain a priority for service members reporting a remote history of mTBI. Individuals with chronic PTSD, women, service members undergoing MEB and those who served in greater than three combat deployments are at particular risk. PMID: 30901404 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

3D Tibia Reconstruction Using 2D Computed Tomography Images.
CONCLUSIONS: Subject-specific tibia models can provide even great insights into the mechanisms of stress fracture injury, which are common in military and athletic settings. Rapid development of 3D tibia models allows for the future work of determining peak stress-related injury correlates to stress fracture outcomes. PMID: 30901405 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Biomechanics of Blast TBI With Time-Resolved Consecutive Primary, Secondary, and Tertiary Loads.
Authors: Przekwas A, Garimella HT, Tan XG, Chen ZJ, Miao Y, Harrand V, Kraft RH, Gupta RK Abstract Blast-induced traumatic brain injury (bTBI) has become a signature casualty of recent military operations. In spite of significant clinical and preclinical TBI research, current understanding of injury mechanisms and short- and long-term outcomes is limited. Mathematical models of bTBI biomechanics may help in better understanding of injury mechanisms and in the development of improved neuroprotective strategies. Until present, bTBI has been analyzed as a single event of a blast pressure wave propagating through the b...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Fast Fourier Transformation of Peripheral Venous Pressure Changes More Than Vital Signs with Hemorrhage.
Authors: Bonasso PC, Dassinger MS, McLaughlin B, Burford JM, Sexton KW Abstract Vital signs are included in the determination of shock secondary to hemorrhage; however, more granular predictors are needed. We hypothesized that fast Fourier transformation (FFT) would have a greater percent change after hemorrhage than heart rate (HR) or systolic blood pressure (SBP). Using a porcine model, nine 17 kg pigs were hemorrhaged 10% of their calculated blood volume. Peripheral venous pressure waveforms, HR and SBP were collected at baseline and after 10% blood loss. FFT was performed on the peripheral venous pressure wavef...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Differential Effects of Caffeine on Motor and Cognitive Outcomes of Penetrating Ballistic-Like Brain Injury.
This study assessed the effect of caffeine on neurobehavioral recovery in the WRAIR penetrating ballistic-like brain injury (PBBI) model. Unilateral frontal PBBI was produced in the right hemisphere of anesthetized rats at moderate (7%-PBBI) or severe (10%-PBBI) injury levels. Animals were randomly assigned to pretreatment groups: acute caffeine (25 mg/kg CAF gavage, 1 h prior to PBBI), or chronic caffeine (0.25 g/L CAF drinking water, 30 days prior to PBBI). Motor function was evaluated on the rotarod at fixed-speed increments of 10, 15, and 20 RPM. Cognitive performance was evaluated on the Morris water maze. Acute caffe...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Novel Arterial Line Simulation Model.
We describe, to our knowledge, the first arterial line insertion and transducing model utilizing only items found in the deployed environment. This model can be easily made and utilized to train medical personnel of all skill levels to augment the capabilities of medical units in areas where mass casualty events are likely. PMID: 30901409 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Utilizing Plasma Composition Data to Help Determine Procoagulant Dynamics in Patients with Thermal Injury: A Computational Assessment.
In this study, we use a computational model to study the FXa dynamics underlying tissue factor-initiated thrombin generation in a small cohort of burn patients. MATERIALS AND METHODS: Plasma samples were collected upon admission (Hour 0) from nine subjects (five non-survivors) with major burn injuries and then at 48 hours. Coagulation factor concentrations (II, V, VII, VIII, IX, X, TFPI, antithrombin (AT), protein C (PC)) were measured and used in a computational model to generate time course profiles for thrombin (IIa), FXa, extrinsic tenase, intrinsic tenase and prothrombinase complexes upon a 5 pM tissue factor stim...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The Impact of Affective States on Postconcussive Symptoms in a TBI Population.
Authors: Garcia K, Moore B, Kim G, Dsurney J, Chan L Abstract The occurrence of persistent postconcussive symptoms (PCS) associated with traumatic brain injury (TBI) is an increasing cause of disability and lost productivity. The reasons for these persistent symptoms in a percentage of even mild TBI are poorly understood. The existence of comorbid conditions such as post-traumatic stress disorder or other traumatic injuries may be factors that impact the presence of PCS. We expect that greater levels of affective symptoms will be associated with increases in PCS assessed on the Neurobehavioral Symptom Inventory (NS...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Prominent Injury Types in Vehicle Underbody Blast.
CONCLUSION: Skeletal fractures are the most frequent AIS 2+ injury resulting from UBB events. Visceral torso injuries are infrequent in individuals that survive and they generally occur in conjunction with skeletal injuries. PMID: 30901412 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparison of a Novel Trainer to a Traditional Swine Model for Training Providers in Lateral Canthotomy and Cantholysis.
Authors: Herder PAP, Lu MM, LaPorta AJ, Ross DW, Calvano CJ, Enzenauer RW Abstract RESEARCH OBJECTIVE: Military personnel are at greater risks of head and facial traumas and permanent blindness from orbital compartment syndrome in modern warfare. Rapid treatment must be implemented with a low-risk surgical remedy: lateral canthotomy and cantholysis (LCC). Traditional training of LCC is primarily performed using an animal tissue trainer (ATT); however, limitations to these types of trainers exist. Therefore, our research objectives were focused on highlighting the effectiveness, benefits, and vision-saving potential...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Portable System for Neuro-Optical Diagnostics Using Virtual Reality Display.
Authors: Versek C, Rissmiller A, Tran A, Taya M, Chowdhury K, Bex P, Sridhar S Abstract A new product prototype system for diagnosing vision and neurological disorders, called NeuroDotVR, is described herein: this system utilizes a novel wireless NeuroDot brain sensor [Versek C et al. J Neural Eng. 2018 Aug; 15(4):046027] that quantitatively measures visual evoked potentials and fields resulting from custom visual stimuli displayed on a smartphone housed in a virtual reality headset. The NeuroDot brain sensor is unique in that it can be operated both in regular electroencephalography mode, as well as a new electric...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Perceptions and Response to Conservative Treatment of Low Back Pain in Soldiers During Initial Entry Training: A Convergence Mixed Methods Study.
This study's purpose was to (1) describe clinical changes in psychosocial factors of LBP following a self-management intervention and (2) explore the LBP experience of military trainees. Ten participants in Initial Entry Training (IET) were included in this mixed methods study. A self-management intervention of exercises and psychosocial education was provided. Quantitative instruments assessing psychosocial factors were delivered at baseline and 6 weeks. Qualitative data were gathered after treatment and analyzed using a phenomenological approach. Low levels of psychosocial risk factors were reported. Patient satisfaction...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of the Commercial, Off-the-Shelf (COTS) King-Devick Eye Tracking System.
Authors: Onge PS, Temme LA, McAtee A, O'Brien KJ, Byrd BK Abstract Concussion biomarkers are important guides for diagnosis and return-to-duty decisions. Recent literature describes the King-Devick (KD) test as a sensitive sports-related concussion screener. This test involves timing an individual reading aloud 120 digits printed on three test cards. The test is commonly considered to evaluate the effects of concussion and other factors on reading-related eye movements (EMs). However, the extent to which the KD test reflects EMs remains a matter of conjecture since the test reports only reading speed and number of ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Sources of Stress and Psychological Health Outcomes Among U.S. Air Force Total Force Distributed Common Ground System Operators.
This study re-examines the most frequently reported occupational stressors, as well as the prevalence of occupational burnout (i.e., high-emotional exhaustion and cynicism, and low professional efficacy), and psychological distress within this population. Active duty (n = 1717), ANG (n = 139), and Reserve (n = 173) Intel operators participated in a comprehensive, online, occupational health assessment. Results reveal that occupational stressors contributing to elevated rates of distress, regardless of TF status (i.e., low manning, long work hours, excessive workload, and organizational communication concerns) are consisten...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

A Mobile Device Dual-Task Paradigm for the Assessment of mTBI.
CONCLUSION: The optimal dual-task paradigm to evaluate cognitive-motor performance with minimal floor and ceiling effects consists of tandem stance with eyes closed while stimuli are presented at a rate of one per second. PMID: 30901418 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Improving Relative Bioavailability of Oral Imidazolidinedione by Reducing Particle Size Using Homogenization and Ultra-Sonication.
Authors: Zeng Q, Xie L, Zhang J, Vuong C, Potter B, Aylor S, Sousa J, Black C, Li Q Abstract Particle size is an important determinant of gastrointestinal absorption of compounds administrated orally. The present study evaluates the effect of a reduction in particle size assessed by homogenization, sonication, and homogenization plus sonication on the bioavailability of imidazolidinedione (IZ), an antimalarial compound with known causal prophylactic activity and radical cure of relapsing malaria. Formulations were administrated intragastrically to mice, and blood samples were collected for LC-MS/MS analysis. The ho...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Crossover Assessment of Intraoral and Cuffed Ventilation by Emergency Responders.
Authors: McCrory B, Lowndes BR, Thompson DL, Wadman MC, Sztajnkrycer MD, Walker R, Lomneth CS, Hallbeck MS Abstract OBJECTIVES: A cuffed bag valve mask (BVM) is the most common device used by emergency medical responders to ventilate patients. The BVM can be difficult for users to seal around the patient's mouth and nose. An intraoral mask (IOM) with snorkel-like design may facilitate quicker and better ventilation particularly under austere conditions. METHODS: Both a BVM and IOM were utilized by 27 trained emergency medical technicians and paramedics to ventilate a lightly embalmed cadaver. Ventilation effica...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Self-Reported Sleep, Anxiety, and Cognitive Performance in a Sample of U.S. Military Active Duty and Veterans.
This study examined the relationship between U.S. active duty and veterans' (n = 233) self-reported sleep (Pittsburgh Sleep Quality Index), anxiety (Zung Self-Rating Anxiety Scale), and cognitive performance (Automated Neuropsychological Assessment Metric). Statistical analyses included Pearson product moment correlations and multivariate analysis of variance, with Tukey-b post-hoc tests, with a p
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Naval Health Research Center Surveillance for Meningococcal Disease.
Authors: Broderick M, Myers C Abstract Historically, meningococcal disease has had a devastating impact on U.S. military personnel, but since the introduction of a vaccine in the 1970s, rates have dropped over 90%.1 Department of Defense instructions mandate a meningococcal vaccine for all service personnel. In the last 5 years, rates of meningococcal disease in the military are similar to the U.S. general population. The active duty incidence was 0.21 cases per 100,000 person-years from 2013-2017. Six cases occurred in the 6 months between September 2016 and February 2017; of these, only one was determined to be a...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

The 2017 Military Health System Research Symposium Awards.
Authors: Reilly PA PMID: 30901423 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

4-Aminopyridine as a Single Agent Diagnostic and Treatment for Severe Nerve Crush Injury.
CONCLUSION: 4-AP singularly provides both a new potential therapy to promote durable recovery and remyelination in acute peripheral nerve injury and a means of identifying lesions in which this therapy would be most likely to be of value. The ability to distinguish injuries that may respond to extended therapy without intervention can offer benefit to wounded soldiers. PMID: 30901424 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Modeling Framework Used to Analyze and Describe Junctional Tourniquet Skills.
Authors: Bauchwitz BR, Curley T, Kwan C, Niehaus JM, Pugh CM, Weyhrauch PW Abstract Medical educators have acknowledged the importance of simulation training in developing procedural skills. While simulation training in other disciplines has benefitted from evaluations of users' skill acquisition, the majority of medical training simulators continue to be developed from overly simplified descriptions of procedures, such as techniques prescribed by existing instructional material. Our objective was to use a modeling framework to characterize the skill of various users in applying junctional tourniquets in order to d...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Mental Health Care for Service Members and Their Families Across the Globe.
Authors: McGraw K, Adler J, Andersen SB, Bailey S, Bennett C, Blasko K, Blatt AD, Greenberg N, Hodson S, Pittman D, Ruscio AC, Stoltenberg CDG, Tate KE, Kuruganti K Abstract The U.S. Defense Department partnered with the International Initiative for Mental Health Leadership on effective leadership and operational practices for delivery of mental health (MH) as well as addiction services throughout the world for Service Members (SM) and beneficiaries. A Military Issues Work Group (MIWG) was established in 2011 to focus on challenges experienced by military SM and beneficiaries among countries. The MIWG found common ...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Reduced Complications of Supraclavicular Approach in Simulated Central Venous Access: Applicability to Military Medicine.
Authors: Sappenfield J, Grek S, Cooper LA, Lizdas DE, Lampotang S Abstract In a study with 76 anesthesia providers on a mixed reality simulator, central venous access via the supraclavicular approach to the subclavian vein, without ultrasonography required less attempts compared to the infraclavicular approach. Participants had shorter times to venous access and larger improvements in confidence. Results from this simulation-based study indicate that the supraclavicular approach may deserve consideration as an alternative approach for central venous access in deployed military environments. The use of ultrasonograp...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Comparison of AR, ITS, CBT, and Didactic Training and Evaluation of Retinopathy-Based Diagnosis.
CONCLUSION: Periodic simulator intervention could result in significant knowledge retention over extended periods of time. PMID: 30901428 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Acellular Fish Skin Grafts for Management of Split Thickness Donor Sites and Partial Thickness Burns: A Case Series.
Authors: Alam K, Jeffery SLA Abstract METHODS: Ten patients having split-thickness skin grafting for burn injury were treated with the fish skin xenografts. RESULTS: There were no adverse reactions noted on the use of the fish skin grafts. No patient had any reaction to the fish skin and there was a zero incidence of infection. The handling of the fish skin was excellent, a robust and pliable xenograft that was easy to apply.The quality of donor site healing was judged to be good in all cases. Both the analgesic effect noted and the relatively short average times until 100% re-epithelialization are promising. W...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Females Engaged in Elite Training Previously Only Open to Males: Exploring the Variables of Successful Outcomes.
Authors: Givens ML, Eklund K Abstract To date, there has been no analysis of the skills or attributes predicting success in female trainees who undergo traditionally male elite military training. This retrospective case control study characterized variables specific to females in the Special Operations Combat Medic course. 20/39 males and 15/38 females successfully completed the course. Several objective variables of interest including height and body weight, marital status, dependents, and physical fitness scores revealed trends but marital status and dependents were the only variables that achieved statistical si...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of Aircrew Low-Intensity Threat Laser Eye Protection.
Authors: Reddix MD, Funke ME, Kinney MJ, Bradley JL, Irvin G, Rea EJ, Kunkle CK, McCann MB, Gomez J Abstract Prototype low-intensity threat laser eye protection (LIT-LEP) spectacles were evaluated for US Coast Guard (USCG) cockpits and night vision goggle compatibility. The impetus for interest in aviation LIT-LEP is driven in part by the fact that easily accessible 0.5-2.0 W high-power laser pointers exceed safety standards for direct on-axis viewing. A repeated-measures experimental design was used to assess LIT-LEP performance relative to a no-LEP control for the following tasks: Near- and far contrast acuity, n...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Characteristics of Iraqi Patients Treated During Operation Inherent Resolve by a Forward Surgical Team.
CONCLUSIONS: Given the Role 2 configuration, these results demonstrate FSTs must be capable of managing critically ill patients with markedly limited resources. This management will include general operations in both adult and pediatric patients, resuscitation with a limited blood supply, and patient assessment with minimal to no diagnostic tools. This analysis can inform resident training, pre-deployment training, as well as sustainment training for surgeons after residency. PMID: 30901432 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Computational Modeling of Primary Blast Lung Injury: Implications for Ventilator Management.
In this study, we developed a computational lung model with mechanical properties consistent with healthy and PBLI conditions. PBLI conditions were simulated with bilateral derecruitment and increased perihilar tissue stiffness. As a result of these tissue abnormalities, airway flow was heterogeneously distributed in the model under PBLI conditions, during both conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation. PBLI conditions resulted in over three-fold higher parenchymal strains compared to the healthy condition during CMV, with flow distributed according to regional tissue stiffness. D...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Impact of Tinnitus on Military Service Members.
CONCLUSIONS: This study has revealed that, for these samples of study participants, tinnitus has an impact on military Service members that is comparable to how it affects Veterans who have completed their military service within the previous 2.5 years. PMID: 30901434 [PubMed - in process] (Source: Military Medicine)
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Maximizing the Resilience of Healthcare Workers in Multi-hazard Events: Lessons from the 2014-2015 Ebola Response in Africa.
Authors: Schreiber M, Cates DS, Formanski S, King M Abstract There is increasing knowledge that health care workers (HCWs) can experience a variety of emotional impacts when responding to disasters and terrorism events. The Anticipate, Plan and Deter (APD) Responder Risk and Resilience Model was developed to provide a new, evidence-informed method for understanding and managing psychological impacts among HCWs. APD includes pre-deployment development of an individualized resilience plan and an in-theater, real-time self-triage system, which together allow HCWs to assess and manage the full range of psychological ri...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research

Evaluation of the Military Functional Assessment Program for Return-to-Duty Decision Making: A Longitudinal Study.
Authors: Kelley AM, Showers M Abstract Following concussion, return-to-duty decisions are made by medical providers and leaders using informal assessment, review of symptom resolution, and clinical assessments. In an effort to provide military-specific tasks for use in the decision making regarding return-to-duty, a battery developed from the set of basic soldier skills, the Military Functional Assessment Program (MFAP), was evaluated for construct validity using clinical assessment outcomes as well as the relationships between MFAP performance and indicators of long-term performance and satisfaction. A total of 48...
Source: Military Medicine - March 23, 2019 Category: International Medicine & Public Health Tags: Mil Med Source Type: research