Teaching of Medical Ethics Regarding Military, Genetic, Reproductive, Student Ethics, and the Holocaust at the Uniformed Services University of the Health Sciences (USUHS) During Its First Fifty Years.

Introduction: The first class at USUHS took its initial course in medical ethics in 1977. I directed this course until recently when COVID first emerged. In this piece, I review what these students were taught during the last 5 of 8 class sessions involving the military, genetic, reproduction, student ethics, and the Holocaust.

Impact of SARS-CoV-2 Infection on Physical Fitness in Air Force Basic Trainees.

Introduction: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on physical fitness in previously healthy adults is not well understood. In this study, we assess the impact of SARS-CoV-2 infection on the physical fitness test (PT) scores of Air Force basic trainees.

Materials And Methods: SARS-CoV-2 testing data and trainee fitness test scores for the calendar year 2021 were obtained from U.

Self-Directed Skills Laboratories Increase Emergency Medicine Physician Confidence in High-Acuity, Low-Opportunity Procedures.

Introduction: The critical role of emergency physicians in military settings underscores the necessity for a broad and proficient skill set, especially in life-saving procedures such as thoracostomies, endotracheal intubations, and cricothyrotomies, to maintain combat readiness. The current peacetime phase, however, presents challenges in maintaining these skills because of decreased exposure to high-acuity medical scenarios. This decrease in exposure jeopardizes skills retention among military emergency medicine physicians, highlighted by studies showing a significant decline in performance over time because of reduced practice.

Pathways From Socioeconomic Factors to Major Cardiovascular Events Among Postmenopausal Veteran and Nonveteran Women: Findings From the Women's Health Initiative.

Background: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

Methods And Results: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which 16 108 major CVD events were documented.

IL-1ra and CCL5, but not IL-10, are promising targets for treating SMA astrocyte-driven pathology.

Spinal muscular atrophy (SMA) is a pediatric genetic disorder characterized by the loss of spinal cord motor neurons (MNs). Although the mechanisms underlying MN loss are not clear, current data suggest that glial cells contribute to disease pathology. We have previously found that SMA astrocytes drive microglial activation and MN loss potentially through the upregulation of NF-κB-mediated pro-inflammatory cytokines.

Redefining faculty workload metrics: A data-driven approach.

Background: Benchmarking faculty workload is key for equity, but a standard model like the Carnegie Unit, originally designed for student workload, does not fit all scenarios.

Methods: A novel Faculty Effort Data Collection Tool assessed whether the Carnegie Unit accurately reflected faculty effort in a graduate nursing program. Workload was evaluated course-by-course based on faculty self-reported hours.

Normative Ranges for Oculomotor and Reaction Time Tests in U.S. Military Service Members and Veterans.

Background:  Oculomotor and reaction time tests are frequently used assessments of vestibular symptoms, traumatic brain injury (TBI), or other neurological disorders in both clinical and research contexts. When interpreting these tests it is important to have a reference interval (RI) as a comparison for what constitutes a typical/expected response; however, the current body of research has only limited information regarding normative ranges calculated according to established standards or for a military-specific sample.

Purpose:  The purpose of the present study was to describe RIs for oculomotor and reaction time tests in a cohort of service members and veterans (SMVs) for use as comparators by clinicians and scientists.

The ternary complex of Mn, synthetic decapeptide DP1 (DEHGTAVMLK), and orthophosphate is a superb antioxidant.

Mn coordinated by orthophosphate (Pi), metabolites, or peptides acts as a superoxide dismutase (SOD), and these Mn antioxidant complexes are universally accumulated in extremely radiation-resistant cell types across the tree of life. This behavior prompted design of decapeptide DP1 (DEHGTAVMLK) as a Mn ligand, and development of a highly potent Mn-antioxidant (MDP) containing [Pi] = 25 mM, and [DP1] = 3 mM, the ratio found in the radioresistant bacterium , with [Mn] = 1 mM. MDP is an exceptional antioxidant, both in vitro and in vivo, and has reinvigorated the development of radiation-inactivated whole-cell vaccines.

Predicting blood loss volume in a canine model of hemorrhagic shock using arterial waveform machine learning analysis.

Objective: To determine if the compensatory reserve algorithm validated in humans can be applied to canines. Our secondary objective was to determine if a simpler waveform analysis could predict the percentage of blood loss volume.

Methods: 6 purpose-bred, anesthetized dogs underwent 5 rounds of controlled hemorrhage and resuscitation while continuously recording invasive arterial blood pressure waveforms in this prospective, experimental study.

Death of the P Value? Bayesian Statistics for Orthopaedic Surgeons.

Statistical interpretation is foundational to evidence-based medicine. Frequentist (P value testing) and Bayesian statistics are two major approaches for hypothesis testing. Studies analyzed with Bayesian methods are increasingly common with a 4-fold increase in the past 10 years.

Synergistic label-free fluorescence imaging and miRNA studies reveal dynamic human neuron-glial metabolic interactions following injury.

Neuron-glial cell interactions following traumatic brain injury (TBI) determine the propagation of damage and long-term neurodegeneration. Spatiotemporally heterogeneous cytosolic and mitochondrial metabolic pathways are involved, leading to challenges in developing effective diagnostics and treatments. An engineered three-dimensional brain tissue model comprising human neurons, astrocytes, and microglia is used in combination with label-free, two-photon imaging and microRNA studies to characterize metabolic interactions between glial and neuronal cells over 72 hours following impact injury.

Home Use Therapies for Pain, Disability, and Quality of Life in Military Service Members with a Musculoskeletal Injury: An Updated Systematic Review Meta-Analysis.

Introduction: Musculoskeletal (MSK) injury can negatively affect service members by compromising job performance and readiness. These injuries can impact the service member's physical health, functional abilities, and quality of life (QoL). Rehabilitation therapies for MSK injuries can reduce these impacts.

Simulation-based education's impact on medical students' tolerance of uncertainty: A grounded theory study.

The purpose of this grounded study was to explore how medical students encountered and managed uncertainty during a high-fidelity simulation. We interviewed 15 fourth year medical students as they progressed through the scenario and used constant comparative analysis to analyze our interview data. Three themes emerged from our data, which informed our theoretical framework: 1) Uncontrollable circumstances were the root of uncertainty; 2) uncertainty drove unhelpful responses evident in self and team; and 3) enhanced tolerance of uncertainty developed through cognitive restructuring and collaboration.

Associations of plasma extracellular microRNAs with new-onset breast cancer in the Framingham heart study.

Breast cancer is the second leading cause of cancer deaths among women. Multiple microRNAs (miRNAs) have been reported to be associated with breast cancer progression or metastasis. The purpose of the current study was to identify plasma extracellular miRNAs associated with incident breast cancer.

Factors Associated With Return to Activity After Concussion Among Female Service Academy Members: Findings From the NCAA-DoD CARE Consortium.

Introduction: Service academy members are at high risk for concussions as a result of participation in both sports and military-specific training activities. Approximately 17% of active duty service members are female, and they face unique challenges in achieving timely recovery from concussions. Understanding the unique characteristics affecting return to unrestricted activity (RTA) among female service academy members is imperative for the ever-growing proportion of females across the U.

Cholangiocarcinoma (CCA) mortality in Vietnam war era veterans.

Background: There is concern about the risk of cholangiocarcinoma mortality (CCA) among U.S. veterans who deployed to the Vietnam War theater.

Methodology used to develop the minimum common data elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement.

Background: The objective was to summarize the methodology used to reach consensus for recommended minimum data elements that should be collected and reported when conducting injury surveillance research in military settings. This paper summarizes the methodology used to develop the international Minimum Data Elements for surveillance and Reporting of Musculoskeletal Injuries in the MILitary (ROMMIL) statement.

Methods: A Delphi methodology was employed to reach consensus for minimum reporting elements.

The first use of "lupus" as a disease.

Objectives: Describe the history of the use of the term "lupus" as a disease and to point out the inaccuracies of previous lupus historical articles and correct the historical record.

Methods: An exhaustive review of Medieval and later texts regarding the use of the term "lupus" as it was used for the name of a disease as well as personal communications with Medieval experts who have studied this topic.

Results: There are three possible first uses of "lupus" as a disease: an affidavit written in 963 AD by Eraclius (Bishop of Liège, Belgium), in a 12th century historical account of the Bishop of Liège, falsely ascribed to the 9th century Bishop Herbernus, or in an 1170 AD letter written by Pierre de Blois about the death of archbishop Stephan du Perche.

The Turkish Earthquake: Adapting a Relevant Medical Relief Response Mode.

On February 6, 2023, a Mw 7.8 earthquake struck southern and central Turkey and northern and western Syria. Over 50 000 people were confirmed dead, and nearly 130 000 were injured.

Incidence rates of soft tissue sarcoma among U.S. military servicemen: Comparison with the rates in the general U.S. population.

Background: Soft tissue sarcoma (STS) is one of the most frequently diagnosed cancers among men younger than age 30 years and a leading cause of cancer death in men younger than age 40 years. The military may be more exposed to STS risk factors and have generally better health and health care access than the general population, which may relate to lower cancer risk and/or early detection. This study compared STS incidence between servicemen and men in the general U.