Military medicine
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Bloodstream infections are a significant threat to soldiers wounded in combat and contribute to preventable deaths. Novel and combination therapies that can be delivered on the battlefield or in lower roles of care are urgently needed to address the threat of bloodstream infection among military personnel. In this manuscript, we tested the antibacterial capability of silver ions (Ag+), with long-appreciated antibacterial properties, against ESKAPEE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli) pathogens. ⋯ Our results confirmed that Ag+ has broad-spectrum antibacterial properties. However, the therapeutic value of Ag+ may not extend to the treatment of bloodstream infections because of the inhibition of Ag+ activity in blood and serum.
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Auditory disabilities like tinnitus and hearing loss caused by exposure to blast overpressures are prevalent among military service members and veterans. The high-pressure fluctuations of blast waves induce hearing loss by injuring the tympanic membrane, ossicular chain, or sensory hair cells in the cochlea. The basilar membrane (BM) and organ of Corti (OC) behavior inside the cochlea during blast remain understudied. A computational finite element (FE) model of the full human ear was used by Bradshaw et al. (2023) to predict the motion of middle and inner ear tissues during blast exposure using a 3-chambered cochlea with Reissner's membrane and the BM. The inclusion of the OC in a blast transmission model would improve the model's anatomy and provide valuable insight into the inner ear response to blast exposure. ⋯ This microscale model is the first FE model of the OC to be connected to a macroscale model of the ear, forming a full multiscale ear model, and used to predict the OC's behavior under blast. Future work with this model will incorporate cochlear endolymphatic fluid, increase the number of OHC rows to 19 in total, and use the results of the model to reliably predict the sensorineural hearing loss resulting from blast exposure.
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Addressing hazing within the U.S. Military has become a critical concern to safeguard the well-being of service members; recent attempts to assess hazing prevalence in the military have been unsuccessful due to under representative data. ⋯ Distinct elements of military culture, such as the hierarchical chain of command, loyalty to the brotherhood/sisterhood, and the emphasis on resilience, likely amplify these responses. This study adds to the mounting evidence showcasing gaps in assessing hazing within the U.S. Military. It emphasizes the necessity for a comprehensive hazing prevention program. Presently, prevention relies on mandatory training, often integrated into safety briefings or harassment workshops. However, service members require further assistance in recognizing, rejecting, and reporting instances of hazing despite these trainings.
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Despite the significant need for mechanical ventilation in- and out-of-hospital, mechanical ventilators remain inaccessible in many instances because of cost or size constraints. Mechanical ventilation is especially critical in trauma scenarios, but the impractical size and weight of standard mechanical ventilators restrict first responders from carrying them in medical aid bags, leading to reliance on imprecise manual bag-mask ventilation. This is particularly important in combat-related injury, where airway compromise and respiratory failure are leading causes of preventable death, but medics are left without necessary mechanical ventilation. To address the serious gaps in mechanical ventilation accessibility, we are developing an Autonomous, Modular, and Portable Ventilation platform (AMP-Vent) suitable for austere environments, prolonged critical care, surgical applications, mass casualty incidents, and stockpiling. The core system is remarkably compact, weighing <2.3 kg, and can fit inside a shoebox (23.4 cm × 17.8 cm × 10.7 cm). Notably, this device is 65% lighter than standard transport ventilators and astoundingly 96% lighter than typical intensive care unit ventilators. Beyond its exceptional portability, AMP-Vent can be manufactured at less than one-tenth the cost of conventional ventilators. Despite its reduced size and cost, the system's functionality is uncompromised. The core system is equipped with closed-loop sensors and advanced modes of ventilation (pressure-control, volume-control, and synchronized intermittent mandatory ventilation), enabling quality care in a portable form factor. The current prototype has undergone preliminary preclinical testing and optimization through trials using a breathing simulator (ASL 5000) and in a large animal model (swine). This report aims to introduce a novel ventilation system and substantiate its promising performance through evidence gathered from preclinical studies. ⋯ Preclinical results from this study highlight AMP-Vent's core functionality and consistent performance across varied scenarios. AMP-Vent sets a benchmark for portability with its remarkably compact design, positioning it to revolutionize trauma care in previously inaccessible medical scenarios.
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The ongoing conflict in Ukraine from Russian invasion presents a critical challenge to medical planning in the context of multi-domain battle against a peer adversary deploying conventional weapon systems. The potential escalation of preventable morbidity and mortality, reaching a scale unprecedented since World War II, underscores the paramount importance of effective phases of care from Point of Injury (PoI)/Point of Wounding (PoW) or Point of Exposure (PoE) to Role 1 (R1) and Role 2 (R2) echelons of care.The NATO Vigorous Warrior (VW) Live Exercise (LIVEX) serves as a strategic platform for NATO and its partners, providing an opportunity to challenge operational concepts, experiment, innovate life-saving systems, and foster best practices across the Alliance. ⋯ The VW LIVEX provides a Concept Development and Experimentation platform for SIMEDIS refinement and conclusive insights into medical planning to reduce preventable morbidity and mortality. Recommending further iterations of similar methodologies at other NATO LIVEXs for validation is crucial, as is information sharing across the Alliance and partners to ensure best practice standards are met.