Military medicine
-
Pilots of high-performance F15 and F16 jets must undergo periodic assessment of +8.5 Gz tolerance in a centrifuge, which is classified as a high-intensity exercise. Prior research has indicated that exercise performance may be correlated with alpha-actinin3 (ACTN3) and angiotensin-converting enzyme (ACE) genes, frequently termed the sports genes. This study aimed to investigate how ACTN3 and ACE genotypes correlate with high-g tolerance of Korean F15 and F16 pilots. ⋯ In a preliminary study, the RR ACTN3 genotype showed a significant correlation with +8.5 Gz tolerance. Pilots with the DI genotype showed the highest high-g tolerance in this test; however, the test pass rate was higher in pilots with the DD genotype in the preliminary study. This result shows the possibility of test passing and tolerance superiority consisting of two different factors in the relationship between high-g tolerance and ACE genotype. This study showed that pilots with the RR + DI genotype had the highest high-g tolerance, which correlated with the presence of the R and D alleles of the ACTN3 and ACE genes, respectively. However, body composition parameters were not significantly correlated with genotype. These results could suggest a plural gene effect on high-g tolerance; further follow-up is required to determine the practical usage and applications of these results.
-
During exercises or operations, there may be times when U.S. medical capabilities are not available and the next best or only option may be to use partner nation (PN) or host nation capabilities. Joint Publication 4-02 Joint Health Services states that "medical planners should always consider the quality, suitability, and availability of multinational and host-nation support." It is normal practice for medical planners to survey PN medical capabilities as part of the pre-deployment planning process. Currently, medical capability surveys are not conducted in a consistent and systematic manner across the DoD global health engagement enterprise. The lack of a systematic approach undermines medical operations planners' ability to conduct efficient and adequate pre-deployment surveys. ⋯ There are significant inconsistencies in the types of capabilities and services documented and how the quality of the capabilities and services is characterized. These inconsistencies can be attributed, in part, to the absence of information that explicitly confirmed whether or not the facility had a capability. Such variation results in obscured or incomplete depictions of facility capabilities, thereby undermining the ability of medical planners to coordinate effective medical readiness for engagements, exercises, or real-life operations. Guidance and survey templates could support better-informed decision-making by including information about survey methods and documenting the lack of confirmatory information. The DoD enterprise should consider how guidance and a standard survey template could improve the relevance, accuracy, and efficiency of data collection and reporting.
-
Obstructive sleep apnea (OSA) is a chronic condition that could lead to debilitating and sometimes life-threatening consequences. Oral appliance therapy (OAT) is effective in providing a conservative, nonsurgical treatment option for patients diagnosed with mild-to-moderate OSA. The primary goal of this study is to describe a symptom-based titration protocol and determine if the patients can be effectively managed with oral appliances (OAs). ⋯ Oral appliance therapy (OAT) can be a reliable treatment modality to treat OSA, and performing a separate overnight posttreatment titration study further ensures its effectiveness. Furthermore, OAT can be an effective treatment modality even for moderate-to-severe OSA with posttreatment titration.
-
The ability of military clinicians to conduct military medical research is often limited because of competing priorities and a lack of research mentorship. The Clinician-Scientist Investigator Opportunity Network (CSION) was developed with the intent of training clinicians how to engage in requirements-driven research within the DoD. ⋯ The CSION research education program is a 2-year additional duty research fellowship producing clinician-scientists conducting military-relevant medical research and publications and may be considered a low-cost/highly efficient alternative to achieve the reported benefits of the MD-PhD tract. The expansion of the CSION program may improve the quality of military medical research and health care.
-
In response to the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act being signed into law, several research groups in Colorado organized the First Annual PACT Act Research Symposium for Veteran Health. The 2-day symposium was interested in research relevant to military exposures with a primary focus on respiratory and mental health. Information on the PACT Act, data sources in the Department of Veteran Affairs and DOD, and research opportunities at the Veteran Affairs were presented. ⋯ On the second day of meetings, a smaller group of participants discussed next steps in military exposure research, as well as priorities for future research. Per the latter, recommendations for future research were made regarding the need for more precise exposure characterization, longitudinal data collection, and efforts to increase understanding regarding disease pathogenesis, as well as the impact of exposures across multiple organs. Such efforts will require interdisciplinary collaboration.