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This article examines the classification and assignment of U.S. Army inductees to military occupational specialty (MOS) 745, rifleman, between 1942 and 1945. Before fall 1944, "high-quality" inductees were primarily sent into the Army Service Forces or Army Air Forces, while "low-quality" men were channeled into the ground combat arms, in particular the infantry. This was a utilitarian error that led to poor combat performance in early deploying divisions and a social inequity that imposed a higher burden of lethal risk on less-privileged men. Only out of dire necessity, late in the war, did high-quality inductees become riflemen in significant numbers. [ABSTRACT FROM AUTHOR]

A metaphor conceptualizes one, typically abstract, experience in terms of another, more concrete, experience with the goal of making it easier to understand. Although combat metaphors have been well described in some health contexts, they have not been well characterized in the setting of critical illness. How do clinicians use combat metaphors when describing critically ill patients and families in the electronic health record? We included notes written about patients aged 18 years or older admitted to ICUs within a large hospital system from 2012 through 2020. We developed a lexicon of combat words and isolated note segments that contained any combat mentions. Combat mentions were defined systematically as a metaphor or not across two coders. Among combat metaphors, we used a grounded theory approach to construct a conceptual framework around their use. Across 6,404 combat-related mentions, 5,970 were defined as metaphors (Cohen κ, 0.84). The most common metaphors were "bout" (26.2% of isolated segments), "combat" (18.5%), "confront" (17.8%), and "struggle" (17.5%). We present a conceptual framework highlighting how combat metaphors can present as identity ("mom is a fighter") and process constructs ("struggling to breathe"). Identity constructs usually were framed around: (1) hope, (2) internal strength, (3) contextualization of current illness based on prior experiences, or (4) a combination thereof. Process constructs were used to describe: (1) "fighting for" (eg, working toward) a goal, (2) "fighting against" an unwanted force, or (3) experiencing internal turmoil. We provide a novel conceptual framework around the use of combat metaphors in the ICU. Further studies are needed to understand intentionality behind their use and how they impact clinician behaviors and patient and caregiver emotional responses. [ABSTRACT FROM AUTHOR]

Posttraumatic growth (PTG) is a possible common reaction to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about correlates of PTG among female combat veterans is sparse. This study examines associations between combat exposure, posttraumatic stress symptoms (PTSS), general self‐efficacy (GSE), and PTG among Israeli female veterans. This is a cross‐sectional studyA volunteer sample of female Israeli combat veterans (n = 616) and non‐combat veterans (n = 484) responded to self‐report questionnaires. Combat veterans reported higher levels of combat exposure, PTSS, GSE, and PTG, as compared to non‐combat veterans. Among combat veterans, combat exposure and GSE were associated with greater PTG. Importantly, PTSS and GSE mediated the link between combat exposure and PTG. The study's findings are among the first to report about possible psychological growth outcomes among Israeli combat veterans. Clinicians treating female veterans coping with combat trauma should be aware of the heterogeneity of reactions to military service challenges and the importance of enhancing veterans' GSE to facilitate PTG. [ABSTRACT FROM AUTHOR]

Trauma-related spinal injuries have been reported as far back as Egyptian times when their severity was recognized but treatment limited and outcomes poor. Advances in the knowledge and management of these injuries have arisen due to increased periods of conflict in the 20th and 21st centuries. With terrorist activity increasing globally, clinicians working in the civilian environment are increasingly being called upon to manage severe, high-energy injuries of the sort usually seen in conflict. This review considers the differences in the mechanism, pattern, and management of spinal trauma in a military combat setting to allow translation to a civilian setting. [ABSTRACT FROM AUTHOR]

In the British Armed Forces, military education is almost exclusively for the officer class. Below the rank of officer, within the 'other ranks', emphasis is typically placed on physical ability. Yet, it is knowledge, acumen and skill that now prove to be the determining factors in combat performance. Conceptual understanding and tactical success are correlated. This underscores the need to fuse the physical component with the conceptual. James White provides an analysis of tactical understanding at the point at which combat takes place–in the sections and platoons responsible for the conduct of fighting–detailing how an academic approach can be used to achieve tactical excellence.◼ [ABSTRACT FROM AUTHOR]

Purpose: Combat deployment increases exposure to potentially traumatic events. Perceived social support (PSS) may promote health and recovery from combat trauma. This systematic review and meta-analysis aimed to synthesize studies investigating the level of PSS and associated factors among (ex-)military personnel who served in the Iraq/Afghanistan conflicts. Methods: Five electronic databases were searched in August 2023 and searches were restricted to the beginning of the Iraq/Afghanistan conflicts in 2001. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A quality assessment was carried out, and a meta-analysis and narrative synthesis were performed. Results: In total, 35 papers consisting of 19,073 participants were included. Of these, 31 studies were conducted in the United States (US) and 23 were cross-sectional. The pooled mean PSS score was 54.40 (95% CI: 51.78 to 57.01). Samples with probable post-traumatic stress disorder had a lower mean PSS score (44.40, 95% CI: 39.10 to 49.70). Approximately half of the included studies (n = 19) investigated mental health in relation to PSS, whilst only four explored physical health. The most frequently reported risk factors for low PSS included post-traumatic stress disorder, depression and anxiety, whilst post-traumatic growth and unit support were protective factors. Conclusion: Higher levels of PSS were generally associated with more positive psychosocial and mental health-related outcomes following deployment. PSS should be targeted in psychosocial interventions and education programmes. Future research should investigate PSS in (ex-)military personnel across other countries and cultures, based on the lack of studies that focused on PSS in countries outside of the US. [ABSTRACT FROM AUTHOR]

In the armies of the late Middle Ages, engineering forces fell into a gray area between combatant and noncombatant. They might fight if necessary, but that was not their primary role, suggesting that late medieval military engineers might best be defined as combat support personnel. A study of contemporary sources supports the argument that engineers in King Edward III of England's expeditionary armies, although proportionately few in comparison to his fighting forces, were key to his strategic successes and that they occupy a pivotal spot in the history of military engineering. [ABSTRACT FROM AUTHOR]

Abstract Background This study investigated whether the Combat compensation method can remove the variability of radiomic features extracted from different scanners, while also examining its impact on the subsequent predictive performance of machine learning models. Materials and methods 135 CT images of Credence Cartridge Radiomic phantoms were collected and screened from three scanners manufactured by Siemens, Philips, and GE. 100 radiomic features were extracted and 20 radiomic features were screened according to the Lasso regression method. The radiomic features extracted from the rubber and resin-filled regions in the cartridges were labeled into different categories for evaluating the performance of the machine learning model. Radiomics features were divided into three groups based on the different scanner manufacturers. The radiomic features were randomly divided into training and test sets with a ratio of 8:2. Five machine learning models (lasso, logistic regression, random forest, support vector machine, neural network) were employed to evaluate the impact of Combat on radiomic features. The variability among radiomic features were assessed using analysis of variance (ANOVA) and principal component analysis (PCA). Accuracy, precision, recall, and area under the receiver curve (AUC) were used as evaluation metrics for model classification. Results The principal component and ANOVA analysis results show that the variability of different scanner manufacturers in radiomic features was removed (P˃0.05). After harmonization with the Combat algorithm, the distributions of radiomic features were aligned in terms of location and scale. The performance of machine learning models for classification improved, with the Random Forest model showing the most significant enhancement. The AUC value increased from 0.88 to 0.92. Conclusions The Combat algorithm has reduced variability in radiomic features from different scanners. In the phantom CT dataset, it appears that the machine learning model’s classification performance may have improved after Combat harmonization. However, further investigation and validation are required to fully comprehend Combat’s impact on radiomic features in medical imaging.

Recent studies investigate grief among soldiers who experienced combat loss, but little research exists on the qualitative lived experience of such an event. In this study, semi-structured interviews were conducted with soldiers (n = 19) who lost a comrade (3–21 years ago) to delve into their bereavement process. The reflexive thematic analysis of soldiers' accounts identified six main themes: (1) an unexpected and shattering experience; (2) emotional dissociation; (3) detachment from the outside world; (4) group formation; (5) accommodating the bereaved family; and (6) life-long impact. These themes were positioned on four distinct circles relating to the self and the surrounding social systems, indicating how soldiers' grief unfolds and remains encapsulated and disenfranchised. The findings emphasize the value of peer support groups that should be facilitated and encouraged by official bodies—even years after—as part of providing social recognition. [ABSTRACT FROM AUTHOR]

In February 2022, the so-called Special Military Operation launched by Vladimir Putin activated the conflict between Russia and Ukraine. This article seeks to answer why the conflict between Russia and Ukraine can be configured as a fifth-generation war. The research found that the confrontation between Russia and Ukraine can be categorized as a fifth-generation war because the fighting is taking place in cities, which are categorized as the military, political and economic centers of gravity. Furthermore, the confrontation, despite taking place on the traditional plane of warfare, has also involved the fifth domain of warfare, cyberspace, and finally, the involvement of private military companies in the conflict was identified. In this respect, the qualitative methodological approach allows us to analyses the characteristics of fifth generation warfare in the light of an international case study. [ABSTRACT FROM AUTHOR]

Introduction: A significant portion of individuals exposed to combat-related trauma will develop posttraumatic stress disorder (PTSD), a severe, debilitating disorder with adverse impacts on both mental and physical functioning. Current treatments are effective for many individuals, however, there is a need for new treatment approaches to improve outcomes in PTSD and address the many existing barriers to seeking or completing treatment. Methods: In this open trial pilot study, we tested a novel, brief, computer-based intervention for PTSD utilizing "affect labeling" that was inspired by recent advances in neuroscience with U.S. veterans. Results: As expected, pre-intervention clinical and fMRI neuroimaging data indicated that U.S. veterans with combat-related PTSD (N = 20) had significantly higher PTSD symptoms, depression symptoms, and amygdala reactivity to trauma cues than trauma-exposed healthy control veterans (N = 20). Veterans with PTSD who completed the affect labeling intervention (N = 13) evidenced reduced PTSD symptoms and these reductions were correlated with reductions in amygdala reactivity. Discussion: Results from this initial proof-of-concept study are intriguing and suggest that affect labeling training offers significant potential as a novel, costeffective, computer-based intervention for PTSD. Implications and next steps for further developing affect labeling interventions for PTSD are discussed. [ABSTRACT FROM AUTHOR]

Combat soldiers are exposed to various potentially traumatic events and face high risk of developing military-related psychopathology, such as depression, posttraumatic stress and grief (PTSS). However, a strong body of research shows that resilience is the default in the aftermath of trauma and indeed, many veterans do not develop high symptomatic levels. To explicate this inconsistency, the current study examined the associations among PTSS, resilience, and patterns of emotional-approach coping. A sample of 595 male combat veterans filled out questionnaires on trauma exposure, PTSS, depressive symptoms, resilience, and emotional-approach coping. Their data were analyzed using structural equation modeling path analysis. Participants reported high exposure to potentially traumatic events during service. Mean scores were high for resilience and relatively low for PTSS and depressive symptoms; 13% had a clinical level of posttraumatic stress disorder. Structural equation modeling revealed that emotional-approach coping strategies mediated the relationship between resilience and PTSS. However, emotional expression was associated with lower PTSS levels, whereas emotional processing was associated with higher PTSS levels. These results suggest that although emotional-approach coping was related to higher resilience, emotional expression (an intrapersonal coping strategy) might have a more positive effect than self-oriented emotional coping strategies. Providing veterans with supportive opportunities and a wider repertoire of emotional coping skills might enhance their well-being, reduce post-service emotional distress while not harming veterans’ resilience levels. [ABSTRACT FROM AUTHOR]

Background: This study investigated whether the Combat compensation method can remove the variability of radiomic features extracted from different scanners, while also examining its impact on the subsequent predictive performance of machine learning models. Materials and methods: 135 CT images of Credence Cartridge Radiomic phantoms were collected and screened from three scanners manufactured by Siemens, Philips, and GE. 100 radiomic features were extracted and 20 radiomic features were screened according to the Lasso regression method. The radiomic features extracted from the rubber and resin-filled regions in the cartridges were labeled into different categories for evaluating the performance of the machine learning model. Radiomics features were divided into three groups based on the different scanner manufacturers. The radiomic features were randomly divided into training and test sets with a ratio of 8:2. Five machine learning models (lasso, logistic regression, random forest, support vector machine, neural network) were employed to evaluate the impact of Combat on radiomic features. The variability among radiomic features were assessed using analysis of variance (ANOVA) and principal component analysis (PCA). Accuracy, precision, recall, and area under the receiver curve (AUC) were used as evaluation metrics for model classification. Results: The principal component and ANOVA analysis results show that the variability of different scanner manufacturers in radiomic features was removed (P˃0.05). After harmonization with the Combat algorithm, the distributions of radiomic features were aligned in terms of location and scale. The performance of machine learning models for classification improved, with the Random Forest model showing the most significant enhancement. The AUC value increased from 0.88 to 0.92. Conclusions: The Combat algorithm has reduced variability in radiomic features from different scanners. In the phantom CT dataset, it appears that the machine learning model's classification performance may have improved after Combat harmonization. However, further investigation and validation are required to fully comprehend Combat's impact on radiomic features in medical imaging. [ABSTRACT FROM AUTHOR]

How does a leader's childhood exposure to war influence their propensity to initiate conflicts? While much research explains leaders' national security policies using their combat and rebel experiences, few scholars have examined the effects of childhood wartime violence. I develop and test two competing arguments about the effects of childhood war trauma on future conflict behavior. One argument expects that leaders exposed to war at a young age will be less likely to initiate conflict because they fear its consequences. An alternative perspective expects that these leaders are more likely to initiate conflict out of anger and a desire for revenge. I test my hypotheses using an original dataset and a research design that reduces inference barriers. Leveraging variations in the level of violence experienced during wartime, I only compare leaders who were exposed to foreign military invasions as children. I find that those who experienced severe war trauma, such as family deaths, injuries, or displacement, are less likely to initiate interstate conflicts than those who did not experience such traumatic events. These effects are substantial, particularly when political constraints are weak. My results suggest that childhood war trauma has a long-term impact on leaders' conservatism about using force. [ABSTRACT FROM AUTHOR]

On February 24, 2022, the armed forces of the Russian Federation invaded Ukraine. After participating in hostilities Ukrainian military personnel accumulated combat stress. Drinking alcohol was one of the ways to overcome them. This study aimed to identify the role of negative emotional reactions and states in increasing the risk of alcohol addiction in Ukrainian military personnel after participation in hostilities. Ukrainian Defense Forces military personnel (N= 405, between 20-60 years of age) participated in this study. To determine the risk of developing alcohol addiction the Alcohol Use Disorders Identification Test was used. To determine the negative emotional experiences the Assessment of Negative Mental Reactions and Conditions in Military Personnel Questionnaire was used. Multiple regression analysis, hierarchical cluster analysis, and exploratory factor analysis were used to determine the relationship between negative emotional experiences and states in military personnel and the risk of alcohol abuse. The results showed that not only the strength of negative affect but also its structure, which determines the ability to regulate emotional experience and behavior, is associated with the risk of alcohol abuse among military personnel after participating in combat operations. As a result, after leaving the combat zone, military personnel with high levels of negative affect abused alcohol to relieve stress artificially. Other servicemen who had a less affective reaction to manifestations of combat stress could timely control the manifestation of negative emotions and were able to predict the negative development of the situation and prepare for it. [ABSTRACT FROM AUTHOR]

Background Among combat injured, invasive fungal infections (IFIs) result in significant morbidity. Cultures and histopathology are the primary diagnostic methods for IFIs, but they have limitations. We previously evaluated a panfungal polymerase chain reaction assay, which was 83% sensitive and 99% specific for angioinvasive IFIs. Here, we evaluated 3 less resource-intensive seminested assays targeting clinically relevant fungi in the order Mucorales and genera Aspergillus and Fusarium. Methods Formalin-fixed paraffin-embedded tissue specimens from a multicenter trauma IFI cohort (2009-2014) were used. Cases were US military personnel injured in Afghanistan with histopathologic IFI evidence. Controls were patients with similar injury patterns and no laboratory IFI evidence (negative culture and histopathology). Seminested assays specific to Mucorales (V4/V5 regions of 18S rDNA), Aspergillus (mitochondrial tRNA), and Fusarium (internal transcribed spacer [ITS]/28A regions of DNA) were compared with a panfungal assay amplifying the internal transcribed spacer 2 region of rDNA and to histopathology. Results Specimens from 92 injury sites (62 subjects) were compared with control specimens from 117 injuries (101 subjects). We observed substantial agreement between the seminested and panfungal assays overall, especially for the order Mucorales. Moderate agreement was observed at the genus level for Aspergillus and Fusarium. When compared with histopathology, sensitivity and specificity of seminested assays were 67.4% and 96.6%, respectively (sensitivity increased to 91.7% when restricted to sites with angioinvasion). Conclusions Prior studies of seminested molecular diagnostics have focused on culture-negative samples from immunocompromised patients. Our findings underscore the utility of the seminested approach in diagnosing soft-tissue IFIs using formalin-fixed paraffin-embedded tissue samples, especially with angioinvasion. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effectiveness of implementing task-specific, post-activation performance enhancement (PAPE) strategies, to acutely improve Army Combat Fitness Test (ACFT) performance. Nineteen ROTC cadets completed two ACFTs, separated by 72 hours. Approximately half (n = 10) completed the traditional “Preparation Drill” as their warm-up prior to the first session and added PAPE warm-up strategies as part of their second session. The other group (n = 9) completed the treatments in the opposite order to facilitate a repeated-measures, crossover design. The participants’ composite ACFT score was used as the primary outcome measure of interest to explore mean difference in a two-way (Time x Treatment), repeated measures ANOVA. There was no interaction [F(1,8) = 0.075, p = 0.79] nor main effect of treatment [F(1,8) = 0.084, p = 0.78]. However, there was a main effect of Time [F(1,8) = 58.87, p < 0.001, d = 0.25] (mean ACFT score ± SD: Session 1 = 527 ± 43, Session 2 = 537 ± 39). The results of this study did not support the use of additional PAPE strategies to improve ACFT performance. However, there was a practice effect when the test was completed twice, separated by 72 hours in those with ACFT experience. The effect of Time was present for ACFT cumulative score, as well as event-level differences in three out of six events. Further research should implement familiarization sessions to minimize a practice effect from influencing results. [ABSTRACT FROM AUTHOR]

This article examines the discursive construction of moral conflict in a military veteran's (post)war story. By closely examining the linguistic details of a single veteran's narrative of war, this article addresses how moral conflict is revealed in shifts among varying modes of morality: from the conventional moral dispositions of the military, in which soldiers are socialized into acting, often violently and without reflection, to conscious ethical reasoning, which soldiers have historically been socialized not to engage in. The analysis of this veteran's narrative, informed by ethnographic research on veterans' experiences of combat and return after deployment, outlines how structural and linguistic components of the narrative engage shifting modes of moral experience. As such, the article provides a critical discussion of moral injury, as well as a potential model for the study of language and morality. [ABSTRACT FROM AUTHOR]

The digital revolution in military affairs has caused repercussions within the military sector and strategic thinking by moving from the traditional concept of Clausewitz, which is based on the rule of combat and confrontation in the physical field, to the concept of Sun Tzu, which focuses on the knowledge base and reducing dependence on the human element and combat in the cyber field. The progress in technological means and information systems has changed the form of confrontation and led to the emergence of new forms of war. The RussianUkrainian war is a clear example of this transformation. The study found that the war has changed not in its nature but in the way it is fought, through Using the contents of the digital revolution in the operational field has enabled Russia to adapt to the situation on the ground. However, it still faces challenges at strategic level of the war. [ABSTRACT FROM AUTHOR]

Abstract Money laundering and financial crimes pose a significant threat to the integrity and stability of South Africa’s financial system. This paper explores the application of artificial intelligence (AI) to detect and prevent money laundering in South African banking institutions. Through the implementation of big data technologies and data processing analytics, AI can enhance the detection and prevention of money laundering activities in South Africa’s banking sector. AI can be harnessed to improve the detection of suspicious activities, enhance accuracy of financial intelligence and adapt to evolving money laundering techniques. The paper also examines the benefits and challenges of implementing AI as an anti-money laundering (AML) measure in the South African banking sector. These include the need for quality data, integration with existing systems, regulatory compliance and ethical considerations. The paper further highlights the potential of AI in transaction monitoring, customer due diligence, outcomes-based risk assessment, and improved detection of suspicious transactions by analysing how AI can enhance the effectiveness and efficiency of AML measures. The importance of coordination between banking institutions, regulatory authorities and law enforcement bodies is also highlighted as an important component of leveraging AI to combat money laundering and related financial crimes in South Africa’s banking sector.

Despite their importance, the role of pikemen in battle and the mechanics of pike combat during the seventeenth century have not received proper attention. Taking English armies of the period as a case study, this article uses contemporary sources and recent research on the warfare of other periods with the goal of redressing this. It examines several seventeenth-century battles involving English armies and concludes that pikemen played a far more critical part than previously assumed. It examines the limitations of previous models used to explain how pikemen actually fought and suggests a new model, based on a close reading of the sources. [ABSTRACT FROM AUTHOR]

Background: Soldiers in combat may experience acute stress reactions (ASRs) in response to trauma. This can disrupt function, increasing both immediate physical danger and the risk for post-trauma mental health sequelae. There are few reported strategies for managing ASRs; however, recent studies suggest a novel peer-based intervention as a promising approach.Objectives: This study assesses the feasibility of ReSTART training, a peer-based course designed to prepare soldiers to manage ASRs. ReSTART builds on programmes established by US and Israeli militaries. The current study evaluates the ReSTART programme in a Norwegian setting, across distinct groups of soldiers, professionals and conscripts.Methods: Participants included professional soldiers deploying to Mali and conscripts with 6 months of service, who completed the ReSTART training course and surveys administered pre- and post-training. These surveys assessed attitudes and programme acceptability. Analyses included 74 soldiers who provided complete survey responses.Results: ReSTART training received high ratings in terms of usefulness, relevance, and importance in managing ASRs. From pre- to post-training, respondents had significant increases in positive attitudes towards ASR management and confidence in handling ASRs personally, and at the unit level; decreases in stigma-related attitudes associated with ASRs; and increased perception of leadership emphasizing ASR management.Conclusions: ReSTART training shows potential as an effective tool when preparing soldiers to manage ASRs in high-risk environments, enhancing military units’ capacity to support each other and effectively respond to stress-induced functional disruptions. This study adds evidence supporting the utility of peer-based ASR management in operational settings and highlights the need for broader implementation and systematic evaluation.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been often used in place of open aortic occlusion for management of hemorrhagic shock in trauma. There is a paucity of data evaluating REBOA usage in military settings. Study Design and Methods: We queried the Department of Defense Trauma Registry (DODTR) for all cases with at least one intervention or assessment available within the first 72 h after injury between 2007 and 2023. We used relevant procedural codes to identify the use of REBOA within the DODTR, and we used descriptive statistics to characterize its use. Results: We identified 17 cases of REBOA placed in combat settings from 2017 to 2019. The majority of these were placed in the operating room (76%) and in civilian patients (70%). A penetrating mechanism caused the injury in 94% of cases with predominantly the abdomen and extremities having serious injuries. All patients subsequently underwent an exploratory laparotomy after REBOA placement, with moderate numbers of patients having spleen, liver, and small bowel injuries. The majority (82%) of included patients survived to hospital discharge. Discussion: We describe 17 cases of REBOA within the DODTR from 2007 to 2023, adding to the limited documentation of patients undergoing REBOA in military settings. We identified patterns of injury in line with previous studies of patients undergoing REBOA in military settings. In this small sample of military casualties, we observed a high survival rate. [ABSTRACT FROM AUTHOR]

Introduction: Video laryngoscope (VL) technology improves first‐pass success. The novel i‐view VL device is inexpensive and disposable. We sought to determine the first‐pass intubation success with the i‐view VL device versus the standard reusable VL systems in routine use at each site. Methods: We performed a prospective, pragmatic study at two major emergency departments (EDs) when VL was used. We rotated i‐view versus reusable VL as the preferred device of the month based on an a priori schedule. An investigator‐initiated interim analysis was performed. Our primary outcome was a first‐pass success with a non‐inferiority margin of 10% based on the per‐protocol analysis. Results: There were 93 intubations using the reusable VL devices and 81 intubations using the i‐view. Our study was stopped early due to futility in reaching our predetermined non‐inferiority margin. Operator and patient characteristics were similar between the two groups. The first‐pass success rate for the i‐view group was 69.1% compared to 84.3% for the reusable VL group. A non‐inferiority analysis indicated that the difference (−15.1%) and corresponding 90% confidence limits (−25.3% to −5.0%) did not fall within the predetermined 10% non‐inferiority margin. Conclusions: The i‐view device failed to meet our predetermined non‐inferiority margin when compared to the reusable VL systems with the study stopping early due to futility. Significant crossover occurred at the discretion of the intubating operator during the i‐view month. [ABSTRACT FROM AUTHOR]

Background: The Role 2 setting represents the most far‐forward military treatment facility with limited surgical and holding capabilities. There are limited data to guide recommendations on blood product utilization at the Role 2. We describe the consumption of blood products in this setting. Study Design and Methods: We analyzed data from 2007 to 2023 from the Department of Defense Trauma Registry (DODTR) that received care at a Role 2. We used descriptive and inferential statistics to characterize the volumes of blood products consumed in this setting. We also performed a secondary analysis of US military, Coalition, and US contractor personnel. Results: Within our initial cohort analysis of 15,581 encounters, 17% (2636) received at least one unit of PRBCs or whole blood, of which 11% received a submassive transfusion, 4% received a massive transfusion, and 1% received a supermassive transfusion. There were 6402 encounters that met inclusion for our secondary analysis. With this group, 5% received a submassive transfusion, 2% received a massive transfusion, and 1% received a supermassive transfusion. Conclusions: We described volumes of blood products consumed at the Role 2 during recent conflicts. The maximum number of units consumed among survivors exceeds currently recommended available blood supply. Our findings suggest that rapid resupply and cold‐stored chain demands may be higher than anticipated in future conflicts. [ABSTRACT FROM AUTHOR]

Airway compromise is the second leading cause of potentially preventable death on the battlefield. Prehospital airway management is often unavoidable in a kinetic combat environment and expected to increase in future wars where timely evacuation will be unreliable and air superiority not guaranteed. We compared characteristics of survivors to non-survivors among combat casualties undergoing prehospital airway intubation. We requested all Department of Defense Trauma Registry (DODTR) encounters during 2007–2023 with documentation of any airway intervention or assessment within the first 72-h after injury. We conducted a retrospective cohort study of all casualties with intubation documented in the prehospital setting. We used descriptive and inferential statistical analysis to compare survivors through 7 days post injury versus non-survivors. We constructed 3 multivariable logistic regression models to test for associations between interventions and 7-day survival after adjusting for injury severity score, mechanism of injury, and receipt of sedatives, paralytics, and blood products. There were 1377 of 48,301 patients with documentation of prehospital intubation in a combat setting. Of these, 1028 (75%) survived through 7 days post injury. Higher proportions of survivors received ketamine, paralytic agents, parenteral opioids, and parenteral benzodiazepines; there was no difference in the proportions of survivors versus non-survivors receiving etomidate. The multivariable models consistently demonstrated positive associations between 7-day survival and receipt of non-depolarizing paralytics and opioid analgesics. We found an association between non-depolarizing paralytic and opioid receipt with 7-day survival among patients undergoing prehospital intubation. The literature would benefit from future multi-center randomized controlled trials to establish optimal pharmacologic strategies for trauma patients undergoing prehospital intubation. [ABSTRACT FROM AUTHOR]

In recent years, the People's Liberation Army Navy (PLAN) has embraced competitive conflict simulation as an approach to train and educate the officer corps for future high-end naval combat. The PLAN regards these wargaming competitions as a useful means to popularise wargaming across the service, thereby allowing more personnel to benefit from conflict simulation. These benefits include increased understanding of the challenges the PLAN would face in a high-end naval conflict and opportunities to hone command leadership skills. Ryan D Martinson argues that although large-scale adoption of wargaming methodologies may achieve some of these anticipated benefits, there are also several likely drawbacks to this approach. ■ [ABSTRACT FROM AUTHOR]

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This study aimed to investigate whether wrestlers of different competitive qualities (i.e., medalists vs. non-medallists) would differ in terms of specific test performance and cardiac and metabolic responses after a demanding testing protocol. The research included 29 wrestlers aged 17.62 ± 1.86 years divided into two performance categories: successful (medallists at the National Championships; n = 13) and less successful (non-medallists; n = 16). The variables included anthropometric indices and specific wrestling fitness test (SWFT) parameters, including the number of throws, heart rate, lactate concentration and calculated cardiac and metabolic indexes. To show differences between quality categories, Student's t-test and receiver operating characteristic curves (ROC) were calculated. Two-way ANOVA for repeated measurements was used to evaluate the differences in performance, cardiac, and metabolic characteristics between the test trials and quality categories. Wrestlers differed in the total number of throws (p < 0.01, AUC = 0.82), cardiac indices (p < 0.03, AUC = 0.73), and metabolic indices (p < 0.04, AUC = 0.75) after the second SWFT trial, with successful wrestlers reaching better results. There were no differences in the first testing trial. The findings of this study indicate that wrestlers exhibit differences in specific performance variables after undergoing an exhaustive testing protocol. Therefore, this study suggests that future research on sport-specific performance in wrestlers should include exhaustive exercise or testing protocols. [ABSTRACT FROM AUTHOR]

Globally, health care providers and facilities are facing growing risks due to political instability, sieges, and warfare. Public health is indisputably at the forefront of saving lives during military operations. In the current climate of global adversity, public health professionals have the responsibility to be prepared at all times and well-informed when responding to medical crises in conflict situations. Complex humanitarian emergencies cause great disruption, disabling, damaging, destroying community well- being. Public health services are evidently at the leading edge of health planning and provision in mass casualty incidents. This editorial letter draws attention to the critical and current subject of health care and medical workers under attack in war zones. Criminal violence is against the law and an action that requires punishment. Lawful conduct that is part of a legally legitimate military operation must comply with the fundamental principles that govern armed conflict. It is important not to confuse the two actions in terms of clarity and purpose. As for the extremely topical and vital issue, this editorial letter calls upon all parties in relevant fields to refresh and update their knowledge of the International Humanitarian Law, the Geneva Conventions and the additional protocols in relation to current crises. Particular emphasis is placed on alerting both national and international audiences at this seminal turning point in history. When health care is faced with war-torn ethical damage, it is incumbent upon every professional to understand the context, to refrain from getting caught up in dilemmas, avoid getting carried away by popular tabloid trends. [ABSTRACT FROM AUTHOR]

Previous research has consistently shown that juvenile violent victimization is associated with an increased risk of future criminal involvement, a phenomenon commonly known as victim-offender overlap. Despite a growing interest in the factors underlying this overlap, potential roles of major life transitions and turning points that may interrupt and reshape the nature of this developmental association have garnered less academic attention. Analyzing nationally representative data from waves I, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 10,205), this study investigates the association between juvenile violent victimization and adult criminal outcomes (i.e., violent offending, non-violent offending, arrest, and incarceration) and whether this association is moderated by military service with and without combat experience in young adulthood. Employing a series of logistic regression analyses and adjusting for a host of covariates, measures of selection, and criminogenic traits, we found that juvenile violent victimization was significantly associated with greater odds of violent offending, arrest, and incarceration in adulthood. Among individuals with violent victimization histories, military service with no combat experience was associated with a 16% decrease in the odds of incarceration in adulthood. Combat experience, however, was associated with over seven times greater odds of violent offending in adulthood for these individuals. These findings have important implications for theory, research, and practice, and highlight the relevance of life transitions and turning points in general, and military service in particular, in mitigating or perpetuating the criminogenic impacts of violent victimization in the life course. [ABSTRACT FROM AUTHOR]

We explore the effects of Clausewitzian fog and friction using a data rate theorem–based model of the phase transition from control to failure for inherently unstable systems that include, but are not limited to, the many possible modalities of organized conflict. Fog-and-friction challenge any and all cognitive structures facing dynamic patterns of threat or opportunity, whether control is manifested through an institution, a machine entity, or some composite. The fundamental nature of challenge appears independent of the degree of sophistication of those institutions, entities, or composites, and of the technical modalities employed. The dialog/Zweikampf of organized conflict is—and will remain—an intimate and most human enterprise. Implications for other existential threats of inherently unstable circumstance, like pandemic disease or climate change, are evident. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the boundary conditions of transformational leadership, follower psychological capital, and their effects on follower mental health outcomes. Specifically, we utilize archival, multi-wave data from a military sample to examine whether the negative relationship between transformational leadership and adverse follower stress outcomes increases as the context shifts from a relatively safe environment to one in which follower lives are at risk. Additionally, psychological capital, a constellation of personal psychological resources, is also assessed to account for individual buffers against extreme stressors. Findings from the current study suggest that the negative relationship between transformational leadership and follower stress increases significantly when the context shifts to a high-risk, mortality-salient environment. [ABSTRACT FROM AUTHOR]

Objects can have rich, complex stories of themselves as items or play a crucial role in telling the tale of another. This article traces the hunting knife from Hunter S. Thompson's Fear and Loathing in Las Vegas as it is contacted by sources of influence and experiences transitions and re-definitions starting with the original tapes recorded by Thompson during the trip, through his original article and book and continuing to include spec scripts, the final movie script and performances on both stage and screen. The hunting knife plays a significant role in certain scenes across all these mediums, one that is a mix of form vs. function and is so complicated that no visual depiction yet has used the actual knife noted in the text because its appearance does not match the emotional dread conjured by the text. This article engages questions of accuracy and narrative truth as it explores the depiction of the weapon and the complicated interface of object identity and adaptation in the material culture of literature and visual performance. [ABSTRACT FROM AUTHOR]

The advanced interest in preventing, investigating and combating corruption crimes is determined by the fact that this phenomenon destroys the principles of good governance, legality and social equity, endangers the rule of law, hinders state and economic development, devalues human rights and endangers morality of the society. Under these conditions, the fight against the phenomenon of corruption occupies the first place in the agenda of many governments and international organizations. Strong calls are being heard in all parts of the world for the proper fight against acts of corruption and the implementation of policies focused on the development of good governance systems to avoid undermining current and potential efforts to prevent and combat corruption. In this article, we carry out an analysis of the circumstances to be established in the process of investigating corruption crimes. We also pay special attention to the problems related to the proof of corruption by the state prosecutor in the process of examining criminal cases regarding acts of corruption in the court of first instance. [ABSTRACT FROM AUTHOR]

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