Military medicine
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Tinnitus is prevalent among Service members and Veterans and is often comorbid with mental health disorders. Associations between the severity of individuals' tinnitus and mental health symptoms are not well described. ⋯ Mental health symptoms are strongly associated with Veterans' tinnitus severity. A better understanding of the interplay between these conditions may help improve the provision of interdisciplinary (Audiology and Mental Health) care for Service members and Veterans.
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Early prediction of the acute hypotensive episode (AHE) in critically ill patients has the potential to improve outcomes. In this study, we apply different machine learning algorithms to the MIMIC III Physionet dataset, containing more than 60,000 real-world intensive care unit records, to test commonly used machine learning technologies and compare their performances. ⋯ We were able to predict AHE with precision and recall above 80% 30 minutes in advance with the large real-world dataset. The prediction of regression model can provide a more fine-grained, interpretable signal to practitioners. Model performance is improved by the inclusion of invasive features in predicting AHE, when compared to predicting the AHE based on only the available, restricted set of noninvasive technologies. This demonstrates the importance of exploring more noninvasive technologies for AHE prediction.
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People with partial hand loss represent the largest population of upper limb amputees by a factor of 10. The available prosthetic componentry for people with digit loss provide various methods of control, kinematic designs, and functional abilities. Here, the Point Digit II is empirically tested and a discussion is provided comparing the Point Digit II with the existing commercially available prosthetic fingers. ⋯ The Point Digit II presents novel and exciting features to help those with partial hand amputation return to work and regain ability. The use of additive manufacturing, unique mechanism design, and clinically relevant design features provides both the patient and clinician with a prosthetic digit, which improves upon the existing devices available.
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Operationalizing the Deployment of Low-Titer O-Positive Whole Blood Within a Regional Trauma System.
The implementation of a low-titer O+ whole blood (LTOWB) resuscitation algorithm, particularly in the prehospital environment, has several inherent challenges, including cost, limited and inconsistent supply, and the logistics of cold-chain management. The Southwest Texas Regional Advisory Council has implemented the nation's first multidisciplinary, multi-institutional regional LTOWB program. This research effort was to illustrate the successful deployment of LTOWB within a regional trauma system. ⋯ This work demonstrates a novel model for the development of a trauma system LTOWB program. The program's implementation augments remote damage control resuscitation strategies and requires the integration and collaboration of a multidisciplinary stakeholder team to optimize efficiency, performance, and safety of the program.
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Observational Study
Potential Concussive Event Narratives of Post-9/11 Combat Veterans: Chronic Effects of Neurotrauma Consortium Study.
Deployment-related mild traumatic brain injury (mTBI) affects a significant proportion of those who served in Post-9/11 combat operations. The prevalence of head injuries, including those that lead to mTBI, is often reported quantitatively. However, service member (SM) and Veteran firsthand accounts of their potential concussive events (PCEs) and mTBIs can serve as a rich resource for better understanding the nuances and context of these exposures. ⋯ Prevalence of deployment-related close-range blast exposure, non-blast impact PCEs, and mTBIs among this Post-9/11 combatant sample was substantial, and in many cases potentially preventable. The use of detailed semi-structured interviews may help health care providers and policymakers to better understand the context and circumstances of deployment-related PCEs and mTBIs.