Military medicine
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Evaluation of chronic respiratory symptoms in deployed military personnel has been conducted at Brooke Army Medical Center as part of the Study of Active Duty Military for Pulmonary Disease Related to Environmental Deployment Exposures III study. Although asthma and airway hyperreactivity have been the most common diagnoses, the clinical findings in these patients may be multifactorial. This study aims to evaluate the utility of impulse oscillometry (IOS) in diagnosing airway obstruction in patients undergoing multiple pulmonary function testing (PFT) studies. ⋯ Impulse oscillometry may serve as an adjunct to diagnosis but likely cannot replace a standard spirometric evaluation. Our study highlights the future utility for diagnosing early obstructive disease in the symptomatic individual.
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Apps that support telemedicine on the battlefield typically run on classified devices and transmit information over classified networks, whereas the medical data the apps create and transmit are unclassified. Current systems treat these data as classified, so a cross-domain solution is required to transfer the data back to an unclassified domain, which adds delays and costs to the process of transmitting critical data needed to treat injured warfighters. To address this gap, ATC-NY developed DroidChamber, which is a software-based Android system that enables multilevel security and which runs on smartphones and tablets. DroidChamber enables warfighters to execute apps in multiple security domains without risking information leakage. ⋯ DroidChamber improves telemedicine applications by enabling the warfighter to share information without requiring a cross-domain guard that may erroneously block some data. Using DroidChamber, a warfighter can use a single mobile device to manage/transmit data at different security levels, thereby reducing the cost and complexity of a mission.
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Between 5% and 20% of all combat-related casualties are attributed to burn wounds. A decrease in the mortality rate of burns by about 36% can be achieved with early treatment, but this is contingent upon accurate characterization of the burn. Precise burn injury classification is recognized as a crucial aspect of the medical artificial intelligence (AI) field. An autonomous AI system designed to analyze multiple characteristics of burns using modalities including ultrasound and RGB images is described. ⋯ This work demonstrates the feasibility of accurate and automated burn characterization for AI and indicates that these systems can be improved with additional features when a human expert is combined with explainable AI. This is demonstrated on real data (human for segmentation and porcine for depth classification) and establishes the groundwork for further deep-learning thrusts in the area of burn analysis.
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Prevention and treatment of traumatic brain injuries is critical to preserving soldier brain health. Laboratory studies are commonly used to reproduce injuries, understand injury mechanisms, and develop tolerance limits; however, this approach has limitations for studying brain injury, which requires a physiological response. The nonhuman primate (NHP) has been used as an effective model for investigating brain injury for many years. Prior research using the NHP provides a valuable resource to leverage using modern analysis and modeling techniques to improve our understanding of brain injury. The objectives of the present study are to develop an anatomically accurate finite element model of the NHP and determine regional brain responses using previously collected NHP data. ⋯ Recognizing that NHPs are the closest surrogate to humans combined with the limitations of conducting brain injury research in the laboratory, a detailed anatomically accurate finite element model of an NHP was developed and exercised using previously collected data from the Naval Biodynamics Laboratory. The presently developed model can be used to conduct additional analyses to act as pilot data for the design of newer experiments with statistical power because of the sensitivity and resources needed to conduct experiments with NHPs.
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The CDC updated their guidelines in 2021 to recommend all doctors speak about pre-exposure prophylaxis (PrEP) against human immunodeficiency virus infection with all sexually active patients. In addition, there is a demonstrated need for physicians to counsel patients on PrEP to achieve military readiness. Results from the 2018 Health Related Behaviors Survey indicate 21.8% of U.S. service members were at high risk for human immunodeficiency virus. This improvement project aimed to assess deficiencies in providers' knowledge before and after an educational intervention and describe policies clinics can adopt to adhere to CDC recommendations. ⋯ This improvement project increased provider knowledge and comfort with PrEP, but only marginally affected behavior changes among providers. This failure may be related to the specific clinic in which the study was implemented. Further research is needed to facilitate routine counseling of PrEP among military women's health care providers.