The impact of a 20-h rotating watch schedule on cognitive and mood states in submarine operations.

This is the first study to provide valuable insights into the effects of the Israeli Navy's 20-h rotating watch schedule on submariners' alertness, mood states, risk-taking behaviours, and sleep. Specifically, we assessed the impact of the non-circadian-aligned schedule on cognitive performance, mood, and behavioural outcomes in a highly controlled submarine environment. A total of 20 male submariners participated in an at-sea mission, where their cognitive performance, mood states, risk-taking propensity, and caffeine consumption were measured.

The Significance of Body Surface Area to Mass Ratio for Thermal Responses to a Standardized Exercise-Heat Stress Test.

Purpose: To evaluate the significance of body surface area-to-mass ratio (BSA/mass) on the heat-tolerance test (HTT) results. We hypothesized that individuals defined as heat tolerant (HT) would have on average higher BSA/mass compared with heat intolerant (HI) individuals.

Methods: A retrospective reanalysis of the HTT results of 517 soldiers (age, 18-38 yr; M/F, 96%:4%), who were tested by the Israel Defense Forces HTT protocol.

caffeine consumption, cognitive performance, and sleep in special forces soldiers during a 96-h combat exercise.

Introduction: This observational study investigated the effects of sleep deprivation and ad libitum caffeine consumption on cognitive performance, risk behavior, and mood among 28 Israeli Special Forces (SF) soldiers (mean age: 20.57 ± 0.92 years) during a 96-hour combat exercise.

Facial electromyography during exercise using soft electrode array: A feasibility study.

The use of wearable sensors for real-time monitoring of exercise-related measures has been extensively studied in recent years (e.g., performance enhancement, optimizing athlete's training, and preventing injuries).

Practicing Emergency Medicine in the Metaverse: A Novel Mixed Reality Casualty Care Training Platform.

Background: Current casualty care training modalities present several challenges, including limited simulation facilities, instructor dependence, lack of standardization, documentation of trainees' performance and training personalization. The study presents the design, development and preliminary evaluation of a novel hybrid training platform to address these challenges.

Methods: A mixed reality platform was chosen and developed to address field operators' requirements.

Heat Intolerance, Body Size, and Return to Duty.

Exertional heatstroke affects athletes and soldiers and can lead to temporary heat intolerance. The heat tolerance test (HTT) was developed to assist in the return-to-duty decisions of military personnel. Although there are several possible causes for heat intolerance, a soldier who fails the test is prevented from returning to serve in a front-line combat unit, regardless of the underlying reason.

Lessons from outbreaks of COVID-19 at Israeli military bases.

Background: To mitigate the spread of coronavirus disease 2019 (COVID-19), national guidelines, in accordance with international health authorities, mandated 14 days of quarantine for every close contact of a confirmed COVID-19 patient. Although health benefits are obvious, consequences are profound, especially for organizations required to maintain operational preparedness.

Objectives: To present the Israel Defense Force (IDF) experience with outbreaks regarding quarantined individuals.

Data Empowerment of Decision-Makers in an Era of a Pandemic: Intersection of "Classic" and Artificial Intelligence in the Service of Medicine.

Background: The COVID-19 outbreak required prompt action by health authorities around the world in response to a novel threat. With enormous amounts of information originating in sources with uncertain degree of validation and accuracy, it is essential to provide executive-level decision-makers with the most actionable, pertinent, and updated data analysis to enable them to adapt their strategy swiftly and competently.

Objective: We report here the origination of a COVID-19 dedicated response in the Israel Defense Forces with the assembly of an operational Data Center for the Campaign against Coronavirus.

Short Communication: Combining Ethics With Efficiency-Israel Defense Forces' Experience in Clinical Trials During the Coronavirus Disease 2019 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic, first reported in China, soon spread worldwide, has evolved into one of the most complex global public health crises the world has encountered in the last several decades. Conducting military medical research is vital to study the unique influences of military service conditions on soldiers' health and to improve the medical response in various emergency periods. The Israel Defense Forces (IDF) Medical Corps maintains an Institutional Review Board (IRB) which reviews clinical studies conducted within the IDF.

Assessing rectal temperature with a novel non-invasive sensor.

Athletes, soldiers, and workers who perform intense physical activities under extreme hot conditions might encounter increased physiological thermal strain. Consequently, the increase in body core temperature (T) might result in heat exhaustion and heatstroke. Thus, continuously following changes in T is of utmost importance.

Self-reported symptoms in healthy young adults to predict potential coronavirus disease 2019.

Objective: To assess the utility of self-reported symptoms in identifying positive coronavirus disease 2019 (COVID-19) cases among predominantly healthy young adults in a military setting.

Methods: A questionnaire regarding COVID-19 symptoms and exposure history was administered to all individuals contacting the Israeli Defence Forces Corona call-centre, before PCR testing. Surveyed symptoms included cough, fever, sore throat, rhinorrhoea, loss of taste or smell, chest pain and gastrointestinal symptoms.

Mild Physical Activity Does Not Improve Spatial Learning in a Virtual Environment.

It is well-established that physical exercise in humans improves cognitive functions, such as executive functions, pattern separation, and working memory. It is yet unknown, however, whether spatial learning, long known to be affected by exercise in rodents, is also affected in humans. In order to address this question, we recruited 20 healthy young male adults (18-30 years old) divided into exercise and control groups ( = 10 in each group).

[PHYSIOLOGICAL GENDER DIFFERENCES AND THEIR EFFECT ON COVID-19 CAUSED MORBIDITY].

The coronavirus disease 2019 (COVID-19) outbreak has resulted in considerable morbidity and mortality, and caused comprehensive social and financial damages. Anatomical, physiological and occupational differences observed between men and women might influence the reaction to treatment and medications. This article reviews sex differences and their potential effect on COVID-19 infection, pathogenesis and prognosis in women compared to men.

Sex Differences in Human Thermoregulation: Relevance for 2020 and Beyond.

The participation of women in physically strenuous athletic and occupational tasks has increased substantially in the past decade. Female sex steroids have influences on thermoregulatory processes that could impact physical performance in the heat. Here, we summarize and evaluate the current literature regarding sex differences in thermoregulation and provide recommendations for heat-illness risk-mitigation strategies.

Physiological Differences Between Heat Tolerant and Heat Intolerant Young Healthy Women.

 Heat intolerance (HI) is determined in the Israel Defense Force according to a heat tolerance test (HTT) before returning to duty after an exertional heat stroke (EHS) event. Recently, increased numbers of female combatants resulted in an increased number of EHS cases among women and a higher percentage of heat intolerance (HI) individuals. We aimed to evaluate the differences between tolerance to heat among women performing an HTT in relation to their menstrual cycle phase.

The relation between central variables, electromyography signals and peripheral microcirculation during intensive treadmill exercise.

Background: Aerobic exercise under muscle fatigue can lead to muscular damage and injuries. Finding the correlations between central and peripheral microcirculation variables, as well as with electromyography signals of leg muscles during aerobic exercise, may contribute to early muscle fatigue identification. The goal of this study was to characterize the peripheral compensation following intensive exercise for assessment of muscle performance based on non-invasive techniques.

Probability of Heat Intolerance: Standardized Interpretation of Heat-Tolerance Testing Results Versus Specialist Judgment.

Context:   The heat-tolerance test (HTT) is a screening tool for secondary prevention of exertional heat illness by the Israel Defense Forces. To discern participant tolerance, recruits are exposed to intermediate environmental and exercise stresses, and their physiological responses, core temperature, and heart rate are monitored. When their physiological measures rise at a higher rate or exceed the upper levels of absolute values compared with other participants, heat intolerance (HI) is diagnosed.

Individualized estimation of human core body temperature using noninvasive measurements.

A rising core body temperature (T) during strenuous physical activity is a leading indicator of heat-injury risk. Hence, a system that can estimate T in real time and provide early warning of an impending temperature rise may enable proactive interventions to reduce the risk of heat injuries. However, real-time field assessment of T requires impractical invasive technologies.

The validity of the heat tolerance test in prediction of recurrent exertional heat illness events.

Objectives: Heat-tolerance-testing (HTT) protocol is used as a screening test for secondary prevention of exertional heat illness (EHI) in the military. Subjects whose test results are positive (heat-intolerant, HI) are presumed to be at higher risk of repeated EHI events than heat-tolerant subjects (HT) and are therefore prevented from return to combat duty, but may return to unsupervised recreational activity. Our aim was to determine, whether HTT results predict the risk of repeated episodes of exertional heat illness (EHI).

Measuring core body temperature with a non-invasive sensor.

In various occupations, workers may be exposed to extreme environmental conditions and physical activities. Under these conditions the ability to follow the workers' body temperature may protect them from overheating that may lead to heat related injuries. The "Dräger" Double Sensor (DS) is a novel device for assessing body-core temperature (T).

Wheeled assistive device for load carriage - the effects on human gait and biomechanics.

Soldiers are often required to carry loads which impose biomechanical strain on the human body. This can adversely affect physical performances. Recently, wheel-based devices (WBD) were designed to reduce the load on the soldier.

Return to duty/play after exertional heat injury: do we have all the answers? A lesson from two case studies.

Background: The common practice in the Israel defense Forces is that exertional heat related injury patients undergo a heat tolerance test 6-8 weeks post event as part of the "return to duty" process. In the case of a positive heat tolerance test the individual is classified as heat intolerant, in some cases however, the thermoregulatory recovery may be longer (several months), and therefore a second heat tolerance test is scheduled 6-8 weeks later. The presented case reports emphasize the possibility of different recovery periods of the thermoregulatory center and the distinction between congenital and acquired physiological heat intolerance.

Physiological Evaluation of a Wheeled Assistive Device for Load Carriage.

Carrying heavy weight imposes high physiological strain on the human body, which can adversely affect physical performance. This is especially important for soldiers whose physical performance level may influence mission completion and survival. Recently, wheel-based devices (WBDs), designed to reduce the load on the soldier, have been suggested as a possible solution.