Military Operational Medicine
Abstract
Sustainment of individual performance; mapping and managing deployment and operational stressors; cognitive enhancement; use of dietary and nutritional supplements and military and medical training readiness. FY19 Accomplishments: -- Developed a network within the MHS to systematically, efficiently and effectively manage and triage (from initial medical care to tertiary care) all patients presenting with ERi [i.e. EHi and/or ER] (project 1). The primary focus is on safe return to full duty. We also intend to determine the contribution of intrinsic and extrinsic risk factors associated with ERi, and create a scoring system to triage Service Members to early return to duty or further specialty evaluation for recurrence risk (project 2), and to develop genetic and biologic screening tools for ERi that can be deployed as far forward as possible with the ultimate goal of differentiating those at risk for recurrence and those who can be returned to full duty (project 3). While projects 1 and 2 are moving forward, patients are still referred for clinical workup through the current word of mouth process. Based on case history, some of the patients are offered enrollment in the genetic screening protocol of project 3. This protocol has been ongoing for several years and compares the genome of cases of exertional injuries with the markers of malignant hyperthermia (MH) susceptibility. During the project period, we have enrolled 8 index case individuals in project 3 of the study, and genetic analysis has been started. --Continued development of a self-test kit for rapid diagnosis of hygiene-related urogenital infections. Our comprehensive, MWRUHSQ survey questionnaire is being used to systematically evaluate the impact of varying water and sanitation resources on urogenital health and health behaviors in active duty service women (ADSW), and their views of the female urinary diversion device (FUDD) as a way to mitigate some challenges while in the field for the purpose of enhancing our understanding of ADSW’s gender-specific health needs in austere environments. Preliminarily analyzed data collected from the initial 152 participants and we have submitted a data-based manuscript describing not only our psychometric characterization (to-date), but also our findings. -- Developed predictive models for female Marine officer performance at The Basic School (TBS), including musculoskeletal injury (MSK-I) & graduation outcomes. Enrolled 153 Female & 1217 Males from 7 training Companies (enrolled 80% of eligible Females; exceeded estimate of 120/yr). Completed post-testing on 4 Companies: Female grad rate 89% vs. 98% for Males in our cohort. Data analysis ongoing; injury & graduation outcomes being tracked. Four research abstracts presented at national conferences. -- Made significant progress in elucidating and validating the role of SREBP in mediating the effect of histone deacetylase inhibitors to increase KATP channel subunit expression. We now have convincing data that 1) correlates cellular cholesterol with SUR2 gene expression, 2) demonstrates cleavage and translocation of the SREBP transcription factor, and 3) selective SREPB-dependent activation of the SUR2 promoter. In addition, we have data implicating HDI-dependent decrease in cholesterol uptake pathways (LDL receptor) and marked increase in PCSK9 (an enzyme that promotes degradation of LDL receptor suggesting a mechanism by which histone deacetylase inhibitors cause a decrease in cellular cholesterol). Finally, dominant negative suppression of SREBP function inhibits the action of histone deacetylase inhibitors.
Document Details
- Document Type
- Accomplishment
- Publication Date
- Oct 01, 2021
- Source ID
- 93cf9f6576783b3930d50aafc642be0d