Body Systems Research Articles

Inflammatory biomarkers and clinical adverse effects associated with Isotretinoin treatment: A prospective study

Background Isotretinoin is considered now one of the most important drugs in the treatment of different dermatological diseases. However, different body systems can be affected during the treatment due to isotretinoin induced apoptosis. Objectives To evaluate the clinical adverse effects and laboratory changes associated with isotretinoin used in the treatment of different dermatological diseases. Methods 73 patients on isotretinoin treatment fulfilled a questionnaire about side effects associated with isotretinoin. Complete blood count (CBC), fasting lipid profile, liver enzymes, and the inflammatory markers Monocytes/HDL ratio (MHR), Neutrophil/lymphocyte (NLR), and Platelets/lymphocyte ratios (PLR) were assessed before treatment and monthly during the treatment period. Results The commonest adverse effects were related to dryness of skin and mucus membrane. 32.9% complained of myalgia and 12.3% arthralgia. Headache was reported in 13.7%, mood alteration in 11%, and insomnia in 12.3%. 24.5% of studied females reported menstrual irregularities. There were no statistically significant changes in CBC. TG, cholesterol, AST, ALT, and MHR significantly increased while HDL, NLR and PLR ratios significantly decreased after isotretinoin treatment. Conclusion: isotretinoin affects different body systems by side effects that are reversible in most instances; however, some of them are serious and need regular monitoring especially in high- risk patients.

The Role and Mechanism of Vascular Aging in Geriatric Vascular Diseases.

Vascular aging is the pathological basis for the aging of various organ systems in the human body and is a common pathogenesis leading to the development of atherosclerosis, Alzheimer's disease, and other conditions among older adults. Aging is characterized by accelerated pulse wave velocity, thickening of the carotid artery intima-media, and decreased vascular dilation function. Signaling pathways such as mTOR, AMPK, NF-κB, Klotho, SIRT, and other key proteins are likely involved in these processes. The detection of biomarkers related to vascular aging, including senescence-associated β-galactosidase, endothelial progenitor cells, circulating endothelial microparticles, and exosomal miRNAs, aids in assessing vascular status and prognosis. Repairing endothelial injury, reducing oxidative stress-inflammatory responses, and restoring mitochondrial and telomere functions are reliable measures to counter vascular aging. In summary, research on vascular aging is the driving force that will provide rational strategies to intervene in geriatric vascular diseases and achieve the long-term goal of healthy aging.

Titanium (IV) μ-Oxo Complex Supported by Phenoxyimine Ligand: Synthesis, Crystal Structure Characterisation, DFT and Molecular Docking Studies

Background: Most of the transition elements in the 3d series (first row transition metals) have been discovered to be extremely significant and practical in biological systems. Naturally, many of the enzymes that are present in the human body system act as catalysts for biological processes and are made of coordination compounds or complexes. Objective: The complex has been characterised by various spectroscopic and analytic techniques. A suitable crystal analysed by X-ray diffraction establishes the formation of a stable binuclear µ-oxo-complex with a hexacoordinate titanium centre. Methods: A new crystalline complex [Ti{La}] has been synthesised in the reaction of titanium butoxide with a phenoxyimine ligand in a 1:1 stoichiometry in toluene at room temperature under a nitrogen atmosphere. The newly synthesised Ti complex has undergone density functional theory and docking study. Results: The crystal shows a monoclinic system with space group C 1 2/c 1. X-ray crystal structure analysis reveals that this complex has a rhomboidal Ti-O-Ti core and exhibits a C2 symmetric conformation with distorted octahedral geometry. Density Functional Theory (DFT) calculations giving insights into the frontier orbitals and mulliken charge analysis, which showed good correlation with the experimental findings. Additionally, in silico molecular docking of ligand and complex was carried out against the HER2 inhibitor kinase. Conclusion: This complex exhibits a higher binding energy of ΔGb = -19.7 kcal/mol with the active pocket of HER2 (PDB:7JXH) than the ligand ΔGb = -8.5 kcal/mol.

Optimizing care pathways: A study of the urgent dispatch program and its impact on emergency department visits

IntroductionThe use of acute hospital-level care at home (hospital-at-home) for patients who are chronically ill has led to decreased medical costs, amount of sedentary time, and hospital admissions. Our large integrated healthcare system identified the need to develop a mechanism through which to decrease emergency department (ED) visits in this patient population by creating a home acute care program called Urgent Dispatch. The primary objective of this study was to determine the medical condition for referral and seven and 30-day ED visit rates. MethodsThis was a retrospective cohort of all patients referred to the Urgent Dispatch program from April 1, 2021, through February 28, 2022. We assessed encounters for patient demographics, referral source, reason for visit, number of at home visits, total number of days in the program, and determined if the patient had an ED encounter within seven and 30 days of participation in the program. The healthcare system includes 10 hospitals (academic, community and rural), 17 emergency departments (hospital-based and freestanding) and their associated outpatient clinics. ResultsA total of 2218 orders were placed with 1530 (70.8 %) resulting in enrollment in the Urgent Dispatch program. The majority were elderly (75 ± 15.6), white (70 %), female (64.4 %), and had Medicare as their primary insurance (82 %). The average number of visits made by Urgent Dispatch was 1.46 (SD ± 0.95). The average number of days enrolled in the program was 2.4 (SD ± 4.1). The top three referral sources to the program were outpatient primary care (42 %), home care (28 %) and emergency medicine (20 %). The top body systems requiring a visit were cardiovascular (22 %), general (18 %), and respiratory (17.2 %). Of the 1530 urgent dispatch referrals, 19.8 % (n = 303) had an ED visit within seven days, 12 % (n = 183) had an ED visit within eight to 30 days, and 68.2 % (n = 1044) had no ED visit. ConclusionA home-based care model of healthcare delivery for patients with chronic medical conditions can provide effective care, with 80.2 % of patients avoiding an ED visit within seven days and 68.2 % avoiding an ED visit within 30 days.

A pragmatic comprehension of scientific and classical aspects of Rachana Sharir—A systematic review

Ayurveda, a flourishing traditional medical system renowned for its extensive knowledge, includes Rachana Sharir as a fundamental subject. Rachana Sharir Vigyan explores the anatomical aspects (Rachna) of the human body. The immense knowledge of the ancient wisdom of Ayurveda is not comprehensively described yet. The Samhitas and Vedas of Indian literature by different acharyas elaborate on how the human body evolved from a combination of Panchamahabhutas and Atma (Chetana). This review aims to elucidate the classical aspects of Rachana Sharir from Ayurvedic texts and establish correlations with contemporary scientific knowledge. Classical texts such as the Samhitas authored by various acharyas were systematically reviewed to gather insights into the origin, anatomical positions, numerical compositions, and classifications of human body parts, organs, tissues, and systems. The review reveals detailed principles and concepts from Ayurvedic literature, emphasizing contributions from Acharya Sushruta in the Sharir Sthana, particularly his meticulous descriptions of cadaveric studies and preservation techniques. Classical books explained the origins of human bodily parts, their anatomical placements, organs, tissues, systems, and more. These fall under human anatomy (Rachana Sharir), and this article explains its classical aspect with scientific and modern science linkages. In Sharir Sthana, one of Ayurveda’s main principles, cadaveric research and preservation, is beautifully illustrated by Acharya Sushruta. Ayurveda has scientific principles, logic, and subtle knowledge that we must explore to apply its gifts to humanity. This essay shows that Samhitas contains pragmatic and scientific knowledge. Ayurveda combines science and philosophy. Ayurvedic knowledge’s pragmatic and scientific usefulness beyond textual content must be explored and validated to maximize its benefits for humanity.

Cost Of Illness In Diabetic Patients with Hypertension in Inpatients at Sleman Regional Hospital

Abstract In Indonesia in 2017, diabetes was one of 3 diseases that caused high mortality. Uncontrolled diabetes negatively impacts nearly every system of the human body and increases the burden of disease. The risk of developing hypertension is 1.5-2.0 times higher in diabetics compared to non-diabetics, while around a third of hypertensive sufferers have diabetes. This research was conducted to identify and calculate direct costs for diabetes and hypertension patients at Sleman District Hospital. Data collection was carried out for 3 months from medical records purposive nonrandom sampling in diabetic patients with hypertension who routinely use antidiabetic and antihypertensive drugs according to study inclusion. There were 53 patients who met the inclusion criteria consisting of 22 (41.51%) male patients and 31 (58.49%) female patients, dominated by those aged 51-60 years (32.08%) with financing using BPJS (94.34%) in class 3 (56.60%). The presence of other comorbidities during treatment, length of treatment and differences in treatment classes among patients are factors that can influence the overall costs in this study.

The effect of multiple trauma with rhabdomyolysis-induced acute kidney injury on the functional state of main body systems

The effect of multiple trauma with rhabdomyolysis-induced acute kidney injury on the functional state of main body systems

Binding Mechanism of Nitro Musks to Human Lactoferrin: Multispectral Approach, Docking and Molecular Dynamics Simulation.

Nitro musks are highly bioaccumulative and potentially carcinogenic, commonly used as additives in fabric softeners, detergents, and other household products. Furthermore, these substances have been detected in breast milk and human adipose tissue, posing a risk of direct exposure to pregnant women and infants. Human lactoferrin (HLF) is abundant in colostrum, and plays an important role in the non-specific immune system of the human body. In this study, the mechanisms of action of two nitro musk compounds, typical examples of synthetic musks, with HLF were investigated using molecular docking, dynamics simulation and multispectral methods. The fluorescence findings demonstrated that nitro musks quenched the intrinsic fluorescence of human lactoferrin through static quenching. Thermodynamic analysis of the binding parameters suggested that hydrophobic interactions acted synergistically in the formation of the complex. Moreover, analyses utilizing multispectral techniques, such as Fourier transform infrared (FTIR) spectroscopy, validated that the microenvironment and structure of HLF were altered in the presence of nitro musks. Finally, molecular docking and molecular dynamics simulations were employed to explore the specific binding mode of nitro musks with HLF and to assess the stability of the complex. These findings may provide a reference for assessing health risks to pregnant women and infants.

Numerical Simulation Study on Vibration Characteristics and Influencing Factors of Coal Containing Geological Structure

Accurately determining the natural frequency of coal-containing geological structures is crucial for preventing mine dynamic disasters and utilizing vibration waves to break coal and enhance its permeability. Based on the modal theory of rock, vibration models of coal-containing geological structures, including layering and fractures are established. By analysis, the undamped vibration equation and its characteristic equation for both the layered coal system and the fractured coal system are derived. Subsequently, the Lanczos method is employed to solve the system’s vibration modes using ABAQUS. The effects of the layering position, layering thickness, layering physical properties, crack width, and crack length on the natural frequency and vibration response of coal-containing geological structures are investigated. The results indicate that when a single influencing factor is altered, the displacement response distribution of the coal body vibration system with geological structures remains essentially the same, and these single influencing factors have a minimal impact on the vibration displacement of the coal-containing geological structure. The natural frequency of the system decreases exponentially as the distance between the layering and the geometric center of the coal system with geological structures increases. The presence of layering in the coal system with geological structures significantly reduces the system’s natural frequency. The natural frequency of the coal system with geological structures increases in a power function manner as the layering elastic modulus increases. Conversely, the natural frequency decreases with an increase in crack length. When the change ranges of crack width and bedding thickness are the same, the natural frequency of the fractured coal body system exhibits more significant changes. The natural frequency of the coal system with geological structures initially decreases and then increases as bedding thickness and crack width increase. The trend in the natural frequency changes and the position of the extreme point are related to the ratio of the elastic modulus and density of the geological structure.

The Phenotypes and Functions of Neutrophils in Systemic Sclerosis.

Systemic sclerosis (SSc) is a chronic disease of the connective tissue characterized by its multifaceted impact on various bodily systems, yet its precise cause remains elusive. Central to its pathology are abnormal immune activation, vasculopathy, and consequent fibrosis affecting both the skin and internal organs. The intricate interplay between the innate and adaptive immune systems significantly influences the pathogenesis of SSc. Despite substantial research, the role of neutrophils, key players in innate immunity, in the context of SSc has remained enigmatic. Emerging evidence suggests that neutrophils not only contribute to the initiation and perpetuation of SSc but also inflict damage on organs and promote fibrosis-a hallmark of the disease in many patients. This review aims to investigate the nuanced involvement of neutrophils in the development of SSc. By shedding light on the intricate mechanisms through which neutrophils influence the pathogenesis of SSc, we can gain deeper insights into the disease process and potentially identify novel therapeutic targets. Understanding the precise role of neutrophils may pave the way for more targeted and effective interventions to alleviate the burden of SSc on affected individuals.

Analysis of rehabilitation of individuals after cholecystectomy in sanatorium-resort conditions as a prerequisite for the development of the concept of physical therapy

Laparoscopic cholecystectomy (LCС) is the most commonly performed surgical intervention. The presence of diseases of several body systems in individuals may indicate metabolic syndrome. The consequences of cholecystectomy are manifested by various symptoms and are generally called postcholecystectomy syndrome. The purpose of the article is to analyze the methods and means of rehabilitation of patients after LCC at the sanatorium stage on the example of the functioning of the Department "Lavanda Sanatorium" of CJSC "Ukrprofozdorovnytsia" of the sanatorium-resort complex "Morshynkurort". Research methods: analysis and synthesis of scientific and methodological literature, analysis of methods and means of rehabilitation of patients after LCC for one calendar year. A total of 1296 people diagnosed with gallbladder and biliary tract diseases received rehabilitation services, including those after LCC. Patients undergoing rehabilitation in the post-acute and long-term stages after surgical interventions are treated at the Lavanda Sanatorium department. The treatment period is from 18-24 days at the patient's request. The criteria for the quality of rehabilitation services were as follows: improvement of health, disappearance of pain, dyspeptic phenomena, increased appetite, normalization of bowel movements, normalization of instrumental and laboratory blood tests, etc. Patients after LCC have signs of metabolic and postcholecystectomy syndromes. In addition to the dysfunction of the gastrointestinal tract, there are also limitations of other various body systems, their functions, activities and participation. Therefore, it is necessary to use the international assessment tool "International Classification of Functioning and Participation" and, according to the established disorders, to set individual rehabilitation goals for patients. The use of mineral therapeutic water from well No. 3 in the village of Horishne, Stryi district, Lviv region, in a dilution of 3.0-3.4 g/dm3 on the functional state of the liver of patients after LCC in the conditions of the Morshynkurort sanatorium-resort complex leads to an improvement in liver function, which is confirmed by the results of biochemical studies of patients' blood. Conclusions. Preformed physical factors (physical procedures), heat therapy, various baths, mud therapy, reflexology, microclysters, exercise therapy and massage are traditionally the most popular in the prescription department. However, the use of such remedies, in addition to the use of mineral healing water, is a matter of great debate among the professional community and requires more detailed study in terms of evidence-based practice in health care.

Influence of powerlifting on indicators of cardiovascular functional state and the respiratory system of the organization of the collectors

The article discusses the impact of powerlifting classes on indicators of the functional state of the cardiovascular and respiratory systems of the athletes' body. It has been established that powerlifting classes contribute not only to strengthening the health and increasing the level of physical fitness of the participants, but also form a positive motivation in them for systematic physical exercises. The purpose of the article is to study powerlifting classes on the indicators of the functional state of the cardiovascular and respiratory systems of the athletes. Scientific methods were used in the research: analysis of literary sources, pedagogical observation, conversation, assessment of the functional state of the cardiovascular and respiratory systems of the applicants' body. The research concept is based on the theoretical and scientific-methodical levels of the main provisions of pedagogy, theory and methodology of physical education, laws and principles of the educational process in physical culture. The research was conducted at Zhytomyr Ivan Franko State University in 2021–2023, in which students of the second year (34 people) of the physics and mathematics and history faculties took part. During the experiment, the students of the control group studied according to the traditional program of physical education for institutions of higher education, and the students of the experimental group attended powerlifting classes. It has been proven that powerlifting has a positive effect on indicators of the functional state of the cardiovascular and respiratory systems of the athletes.

Structure of the step-by-step sequential program for future officers of military education institutions to engage in the military applied seventh school

High motivation, sufficient level of professional knowledge, excellent physical and functional condition of the main body systems of servicemen are an integral part of the combat readiness and combat capability of the personnel of the units of the Armed Forces of Ukraine. At many stages of the conduct of hostilities during the full-scale invasion of the Russian Federation against Ukraine, the availability of the latest weapons and equipment, as well as the training of personnel to perform assigned tasks, the high level of training of units and units of the Armed Forces of Ukraine, are definitely essential components. The analysis carried out by specialists in physical training and sports (service branches) of the Armed Forces of Ukraine indicates the need for constant improvement and development of military applied (special) physical skills of servicemen. Specialists insist on the need to introduce in the training of military personnel the skills of overcoming obstacles, moving on the battlefield, throwing grenades, firing from small arms from different positions, swimming in uniform and with weapons. The reform of the Armed Forces of Ukraine, the training of future officers in military education institutions today makes it possible to abandon outdated approaches and methods of personnel training, and there are opportunities to introduce more effective methods into the military education system. More effective and innovative methods of training future officers of military educational institutions are organized for servicemen of the Armed Forces of NATO partner countries.

The Role of m6A Methylation in Tumor Immunity and Immune-Associated Disorder.

N6-methyladenosine (m6A) represents the most prevalent and significant internal modification in mRNA, with its critical role in gene expression regulation and cell fate determination increasingly recognized in recent research. The immune system, essential for defense against infections and maintaining internal stability through interactions with other bodily systems, is significantly influenced by m6A modification. This modification acts as a key post-transcriptional regulator of immune responses, though its effects on different immune cells vary across diseases. This review delineates the impact of m6A modification across major system-related cancers-including those of the respiratory, digestive, endocrine, nervous, urinary reproductive, musculoskeletal system malignancies, as well as acute myeloid leukemia and autoimmune diseases. We explore the pathogenic roles of m6A RNA modifications within the tumor immune microenvironment and the broader immune system, highlighting how RNA modification regulators interact with immune pathways during disease progression. Furthermore, we discuss how the expression patterns of these regulators can influence disease susceptibility to immunotherapy, facilitating the development of diagnostic and prognostic models and pioneering new therapeutic approaches. Overall, this review emphasizes the challenges and prospective directions of m6A-related immune regulation in various systemic diseases throughout the body.

USO DE SUBSTÂNCIAS PSICOATIVAS E EFEITOS ADVERSOS: DISTÚRBIOS DECORRENTES DO USO DE ÁLCOOL, CAFEÍNA, CANNABIS, COCAÍNA E NICOTINA.

Introduction: Introduction: The frequent use of psychoactive substances causes harm to the health and quality of life of users, due to the activation of the brain’s reward system by such drugs. Objective: Identify the adverse effects caused by the use of the following substances: alcohol, caffeine, cannabis, crack and nicotine. Methodology: This is an integrative review of the literature, with studies published between 2017 and 2023, in Portuguese and English. Results and Discussion: Thirty articles were selected that addressed the effects resulting from the use of the five substances studied, and several damages to the human body were verified with the continuous consumption of these substances. Several adverse reactions were identified, with recurrence of the effects between the different substances. The presence of disorders was found in seven different body systems, and the most affected systems are the nervous, vascular, cardiac, gastrointestinal and respiratory systems, in addition to skin disorders and gestational disorders. Final Considerations: The study made it possible to expand knowledge on the subject, understand the adverse effects resulting from the use of psychoactive substances and how this understanding is of great help to nursing professionals, since they have close contact with patients and can identify symptoms early.

Desain 3 Dimension Baby Incubator Using SketchUp Application Based On Indonesia National Standars

Premature birth is one of the causes of perinatal death. Premature babies have a higher risk of death because babies find it difficult to adapt to life outside the womb due to immature organ systems of the baby's body. Medical devices used to maintain babies born prematurely are called incubators. In making incubators, usually before being made, you must try making a prototype first. In addition, it must also be simulated so that the results of the incubator are up to standard. Various studies related to simulators have been conducted, such as using matlab. This takes a relatively long time to learn. So the author designed the 3-dimensional design of the incubator is a cutting. Sketchup is easier to learn for beginners, this software is also free. The research method that researchers use is research and development. Researchers carry out several stages, namely literature study, initial design, 3-dimensional design, validation, and discussion. From the results of the design that has been made and given a questionnaire to material experts, a value of 67% or said to be feasible. Validation is also carried out by direct measurement and the results are not much different

Liver Function Markers Response to Different Exercise Intensities in Athletes A Single Bout Perspective

Exercise provides considerable health advantages through promoting proper body system functioning, healthy growth and development, and quality of life. The present study investigated the effect of single bout High- Intensity Exercise (HIE) compared to Low-Intensity Exercise (LIE) on liver function markers in athletes. This cross-sectional study was carried out in the Department of Physical Education, Banaras Hindu University, Varanasi (UP). A total of 20 healthy male athletes with age range from 22 to 26 years were randomly selected and underwent 5 minutes of HIE and LIE separated by one week. Blood samples for selected liver function markers were taken pre-exercise, immediately, 10 and 20 minutes post-HIE and LIE, respectively. A repeated measures ANOVA with greenhouse-geisser correction found a significant difference between high and low intensity exercises for SGOT (F=5.881; p<0.05) and SBT (F=7.154; p<0.05) values, while statistically insignificant in the case of SGPT (F=1.572; p>0.05). In high intensity exercise there was statistically significant difference for SGOT (F=7.564; p<0.05) value between different time points. Post hoc analysis with a bonferroni correction showed that SGOT value was significantly increased immediately after the HIE, reducing 10 minutes after the exercise and closely returned to baseline level after 20 minutes of exercise, whereas LIE showed no significant changes. Exercise intensity is important as it triggers liver pathology by asymptomatic modifying liver function markers. These findings can be used to develop and administer exercise training plans for athletes.

UNDERSTANDING THE MULTI-SYSTEM MANIFESTATIONS OF HYPERMOBILITY IN YOUR PATIENTS

Hypermobility Spectrum Disorder (HSD or hEDS) is attributed to a collagen abnormality associated with excessive joint flexibility. Approximately 90% of females with hip dysplasia have hypermobility. Manifestations of hypermobility in various body systems are unique to every patient, affecting different tissues of the body with varying degrees of severity. Our purposes were to identify the manifestations of hypermobility across multiple body systems and to study the recognition of hypermobility in the medical literature of multiple specialties over multiple decades.A literature search of the major medical disciplines for key words associated with HSD was performed. These specialties included gastroenterology, gynecology, neurology, psychiatry, oral-maxillofacial surgery, cardiology, and orthopaedic surgery. A specialty-specific impact factor (IF) score was calculated as the percentage of research articles that referenced hypermobility as a comorbidity over all articles within that specialty. Statistical differences were identified using single factor ANOVA with significance determined at p<0.05. We reviewed many published, specialty-specific manifestations of hypermobility, and describe them.All six non-orthopaedic specialties demonstrated a continually increasing relative IF ratio throughout the study period with a peak impact average of 0.22 (p<0.05 compared with other time ranges). There was a 93.3% overall increase in IF scores from the 1992–1998 period to the most recent period examined (p<0.05).Hypermobility is increasingly recognized as a significant health issue in multiple disciplines. Since dysplasia is associated with approximately 40% of all primary total hip arthroplasty cases, understanding the multi-system manifestations, and broad impact of hypermobility on patients, is relevant for every hip surgeon. We are expanding our research into other medical disciplines, including urology, ophthalmology, dermatology, clinical psychology, and others.

An Approach to Reduce the Incidence of Submarine Medical Evacuations by Identifying Individual Risk Characteristics: Preliminary Findings.

Military medical evacuations (MEDEVACs) are resource intensive and can disrupt operations and decrease readiness. Medical evacuations are a concern for the submarine force because of the limited medical resources onboard, the impact of manpower loss on smaller crews, and the compromise of operational stealth. Although some medical emergencies cannot be avoided, some MEDEVACs may be preventable. However, there is limited knowledge of the underlying causes and risk factors associated with submarine MEDEVACs. This work describes an approach to identify individual characteristics associated with submarine MEDEVACs by presenting preliminary results and next steps. Identifying those most at risk for a MEDEVAC will foster prevention strategies that lead to fewer MEDEVACs, military operation disruptions, missed work and limited duty days, unplanned losses, early separations, and disability compensation claims among navy submariners. This retrospective study examines MEDEVACs from U.S. Navy submarines from January 1, 2012 to December 31, 2020. Medical evacuation causes were classified by 3 major diagnostic categories: Injury, psychiatric, and medical (i.e., all other non-injury medical events, including dental issues). Diagnostic subcategories were grouped by body region (for injuries) and body system (for non-injuries). Identifiable information from MEDEVAC records were linked to personnel files to capture demographic and occupational variables. Trends across the years were examined, and frequencies and percentages of MEDEVAC cases by both major and sub-diagnostic categories were presented. For cases where both the major diagnostic categories and characteristics were both available, we assessed associations between major diagnostic categories and demographic and occupational characteristics, using Pearson's χ2 test for proportions and Fisher Freeman-Halton exact tests. Pairwise z-tests for proportions were used to determine which proportions differed significantly. A total of 1,283 MEDEVACs were confirmed from 2012 to 2020, with an annual average of 143. Across the years, 24.3% were caused by psychiatric issues (e.g., suicidal ideation), 18.4% were caused by injuries (e.g., blunt trauma), and the remaining 57.3% were caused by other medical emergencies (e.g., gastrointestinal issues). Among the cases linked to personnel files, the major diagnostic category was associated with age, rank, department, and submarine qualification status (group size varied). By age (n = 973), large differences in MEDEVAC causes were seen among submariners 21 to 25 years old who represented 52.4% of psychiatric versus 37.5% of medical MEDEVACs. In contrast, those 35 and older represented 17.0% medical versus 2.7% psychiatric MEDEVACs. Medical, non-injury cases were the most common cause for a MEDEVAC. There were proportionately more psychiatric than medical cases among younger, less experienced submariners. Conversely, there were proportionately more medical than psychiatric cases among older submariners. A centralized approach to collecting MEDEVAC data is needed. This is the most comprehensive study examining risk factors associated with submarine MEDEVACs. Follow-on work will include adding prior medical waiver requests, health indicators, and confirmed diagnoses to the dataset to conduct a risk analysis. Considering submarines have smaller crews than most surface ships, limited medical assets, and often operate in austere environments, examination of submarine MEDEVACs should be distinct from other navy and military MEDEVACs.

Comprehensive Review of Chronic Stress Pathways and the Efficacy of Behavioral Stress Reduction Programs (BSRPs) in Managing Diseases.

The connection between chronic psychological stress and the onset of various diseases, including diabetes, HIV, cancer, and cardiovascular conditions, is well documented. This review synthesizes current research on the neurological, immune, hormonal, and genetic pathways through which stress influences disease progression, affecting multiple body systems: nervous, immune, cardiovascular, respiratory, reproductive, musculoskeletal, and integumentary. Central to this review is an evaluation of 16 Behavioral Stress Reduction Programs (BSRPs) across over 200 studies, assessing their effectiveness in mitigating stress-related health outcomes. While our findings suggest that BSRPs have the potential to enhance the effectiveness of medical therapies and reverse disease progression, the variability in study designs, sample sizes, and methodologies raises questions about the generalizability and robustness of these results. Future research should focus on long-term, large-scale studies with rigorous methodologies to validate the effectiveness of BSRPs.