Military medicine
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Department of Defense policy for Global Health Engagement (GHE) activities prioritizes interoperability and sustainability within security cooperation, yet these elements, along with monitoring and evaluation, are not well reported. ⋯ The year sustainment of the GAF TCCC training program provides hope as a model for future DoD GHEs to attain sustainable development and points to the possibility of long-term programs with meaningful outcomes.
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The 75th Ranger Regiment is an elite U.S. military special operations unit that conducted over 20 years of sustained combat operations. The Regiment has a history of providing novel and cutting-edge prehospital trauma care, advancing and translating medical initiatives, and documenting and reporting casualty care performance improvement efforts. ⋯ Documentation and analysis of casualties and care, mortality and casualty reviews, and other performance improvement efforts can guide combatant commanders, medical directors, and fighting forces to reduce preventable combat deaths and the CFR. Early hemorrhage control, blood product resuscitation, and other lifesaving interventions should be established and maintained as a standard prehospital practice to mitigate fatalities with potentially survivable injuries.
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The effectiveness and durability of vaccination to protect against localized anogenital mpox skin lesions is not well defined. Overestimating vaccine effectiveness against mild infection risks degrading vaccine confidence. Acknowledging and communicating vaccine unknowns and limitations is vital to direct mpox research, maintain vaccine confidence, and optimize uptake.
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Acute kidney injury (AKI) is a common complication in severe burn patients with poor prognosis and high mortality. Reduced kidney perfusion induced by the decreased effective circulating blood volume after severe burn is a common cause of AKI. Routine intravenous resuscitation (IR) is difficult or delayed in extreme conditions such as war and disaster sites. Peritoneal resuscitation (PR) is a simple, rapid resuscitation strategy via a puncture in the abdominal wall. This study investigated whether PR is a validated resuscitation strategy for AKI after severe burns in rats and explored its mechanisms. ⋯ Early PR could protect severe burn injury rats from AKI. It may be an alternative resuscitation strategy in severe burn injury when IR cannot be achieved.
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Randomized Controlled Trial
Diver Underwater Cycling Endurance After Short-Term Warm and Hot Water Acclimation.
It is unclear whether immersion heat acclimation benefits exercise in warm water conditions. This study examined the effects of heat acclimation strategies on heart rate (HR), core temperature, and time to exhaustion (TTE) during cycling exercise in varying warm water conditions. ⋯ Underwater exercise performance did not differ between the two acclimation strategies. This study suggests that passive acclimation to a higher water temperature may improve thermoregulatory and cardiovascular responses to exercise in warm water. Hot water immersion adaptations are dependent on exercise intensity and water temperature.