Military medicine
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Recent advancements in virtual environment (VE) technology and the increasing use of VEs for treatment are opening up possibilities for rehearsal in safe and rich environments. Research has shown that VEs can be used to treat individuals with posttraumatic stress disorder (PTSD), but little research has been done to suggest guidelines for creating an effective environment. The aim of this study was to determine the design of systems that would allow military veterans to rehearse potentially stressful events in a VE before having to step into the actual environment. This research evaluated the responses to six stimuli: startle sound, direct eye contact, horizontal movement across the visual field, social conflict, an abandoned item, and a crowded auditorium. Measures used included change in heart rate (ΔHR), change in subjective unit of discomfort scores, and participant behavior. ⋯ Findings imply that VEs other than virtual combat zones can elicit behavioral, emotional, and physiological responses in individuals with PTSD, and these types of environments should be further studied for use with veterans suffering from PTSD. In future studies, systems should include initial stimuli that can be configured to allow focus on specific past traumatic experiences. Stimuli should also include both a crowded room and a startle noise scenario.
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Osseointegrated implants for direct skeletal attachment of transtibial prosthesis carry risks that are yet to be fully resolved, such as early loosening, mechanical failure of percutaneous and medullar parts of implant, periprosthetic issues, and infections. Underloading could lead to early loosening and infection. Overloading might compromise the bone-implant interface. Therefore, Goldilocks loading regimen applied by transtibial bone-anchored prostheses is critical for safe and efficient development of osseointegration around the implant during rehabilitation and beyond. We hypothesized that Goldilocks loading could be achieved when ambulating with a so-called anthropomorphic prosthetic ankle showing moment-angle relationship similar to a sound ankle. ⋯ Indexes of anthropomorphicity, while of different magnitude, were positive in control able-bodied group and in the amputee group wearing Free-Flow Foot, which was qualitatively associated with concave shape of their moment-angle curves. The 3 usual feet worn by the participants were classified as nonanthropomorphic as their individual moment-angle curves were convex and the corresponding IAs were negative. Furthermore, this study showed that a foot with anthropomorphic characteristics tends to decrease maximal loads at the bone-implant interface as compared to the nonanthropomorphic feet and possibly may minimize the risks to compromise the integrity of this interface.
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This effort, motivated and guided by prior simulated injury results of the unprotected head, is to assess and compare helmet pad configurations on the head for the effective mitigation of blast pressure transmission in the brain in multiple blast exposure environments. ⋯ Optimizing helmet pad size and/or placement could provide an improved protection by minimizing the side blast orientation effects and mitigating high-pressure fields in the brain from repeated blast exposures.
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Injury mechanics of blunt impact projectiles differ from those experienced in whole body motor vehicle collisions because the effects are localized around the point of impact, and thus, injury thresholds based upon gross chest kinematics (e.g., force, velocity) may not be applicable across impact types. Therefore, knowledge of biomechanically based tissue injury correlates for blunt impact projectiles are needed to better guide design and development of protective systems as well as assess injury risks from blunt impact projectile weapons. ⋯ Normalized strain-energy density was found to be the best correlate for prediction of lung tissue damage and correlate well to extent of contused lung volume.
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The CogScreen-Aeromedical Edition (CogScreen-AE) is a computerized neurocognitive assessment screening tool developed for the Federal Aviation Administration as a rapid, reliable means of measuring neurocognitive deficiency in civilian airline pilots. This has potential use and assessment of military aviators flying high performance aircraft under extreme conditions; however, no data exist on how the dynamic flight environment affects CogScreen-AE scores. The objectives of this study were to determine what changes in performance on CogScreen-AE scores are seen post-flight in Naval Aviators flying high performance aircraft and to determine the potential for use of CogScreen-AE as a screening tool to evaluate degree of impairment, recovery from neurological illness, and return to duty status of a military aviator. ⋯ The CogScreen-AE performance is shown to be consistent preflight to post-flight. These data show that CogScreen-AE may be a reliable clinical instrument for assessing aviators' cognitive function with regard to return to flight duty decision-making. We anticipate future work in determining how CogScreen-AE can be utilized in the operational environment and documenting recovery from neurologic illness.