Combat Conditions Research Articles

First experience of endovascular balloon occlusion of the aorta in the wounded with hemorrhagic shock during the war in Ukraine

Background. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used worldwide to stop bleeding in trauma and wounds in patients with hemorrhagic shock. REBOA allows for the hemodynamic stabilization, patient transportation and final bleeding control. The study aims to demonstrate the capabilities of REBOA as a method of bleeding control in the wounded with hemorrhagic shock in the context of war in Ukraine. Materials and methods. Five AFU servicemen who sustained mine-blast wounds in the Eastern Ukraine as a result of shelling by Russian troops were delivered with signs of internal bleeding and hemorrhagic shock to the primary and secondary levels of medical care (Role 1, 2). The REBOA balloon catheter was inserted and inflated by surgeons working in stabilization centers or advanced surgical teams. Upon admission, all patients underwent chest and abdominal ultrasound according to the FAST protocol. We used COBRA-OS 4 Fr and ER-REBOA 7 Fr balloon catheters. The positioning of the balloon in the aorta was performed according to external anatomical landmarks (3 cases) and ultrasound (2 cases). In all clinical cases, the balloon catheter was placed in zone I. In one case, the balloon was moved from zone I to zone III (control of the source of bleeding). The duration of aortic occlusion ranged from 15 to 50 minutes. Immediately after removal of the introducer, manual compression of the puncture site was used (3 cases) or suturing of the arteriotomy (2 cases). Results. The sources of bleeding in our clinical cases were injuries of the iliac vessels (2 cases), the renal artery (1 case), and injuries of the inferior vena cava and liver (2 cases). Four patients were evacuated to a higher level of medical care after the REBOA was installed. In one case, there were complications from vascular access (femoral artery thrombosis). We were unable to save one wounded soldier, most likely due to the delay in evacuation from the previous stage, the severity of injury, and massive blood loss. Conclusions. As our observations have shown, the use of REBOA in combat conditions allows not only to stabilize hemodynamics in the wounded with severe combined trauma and bleeding but also to conduct a successful evacuation to a higher level of medical care to stop bleeding ultimately. REBOA can be successfully used at the prehospital stage. This requires clearly defined indications for the technique’s use, training of medical personnel, and provision of balloon catheters to medical units of the Armed Forces of Ukraine.

Oliguria caused by dehydration in combat trauma (case series)

Background. A combat gunshot wound is significantly different from a civilian trauma. It is characterized by the prevalence of penetrating injuries, which increases the volume of blood loss at the pre-hospital stage, and the destruction of large masses of muscle tissue (rhabdomyolysis), which leads to acute kidney injury. Moreover, combat trauma occurs in conditions of chronic background stress as a result of severe emotional and physical strain, uncomfortable weather conditions, and deprivation of sleep, drinking and food. So, such a phenomenon as voluntary dehydration is common among soldiers in combat conditions. In wounded, oliguria is often considered a result of acute kidney injury, but it can also be a symptom of severe dehydration. The purpose of our work was to analyze three clinical cases of oliguria caused by dehydration in wounded with combat trauma to better understand the severity of the condition of such victims and to improve medical aid for them. Materials and methods. The article describes three cases of men aged 35, 50 and 44 years with combat gunshot wounds to the extremities, who were admitted to the tertiary care hospital on the second day after the injury with oliguria (0.18–0.19 ml/kg/hr) and high creatinine (333 to 457 μmol/L). Results. All three patients were conscious, breathing spontaneously, had stable hemodynamics, and moderate anemia after pre-hospital blood transfusions. Focused ultrasound study revealed hyperdynamic left ventricle and small inferior vena cava with complete inspiratory collapse, which suggested hypovolemia. Upon further investigation of the medical history, patients admitted not drinking any liquid for one to two days prior to injury. Tissue hydrophilicity test was conducted which showed severe dehydration in all three cases. Infusion volume was calculated using P.I. Shelestiuk nomogram (modified by O.V. Kravets et al.) and amounted to 60 ml/kg of balanced crystalloid solutions. Upon starting rehydration, diuresis was restored within two hours and amounted to 0.7–2.1 ml/kg/h in all three patients. Creatinine levels normalized in 2–4 days. Patients were transferred to another hospital in a moderate condition in 4–5 days. Conclusions. Oliguria is a frequent complication of combat gunshot injury. Although it is most often associated with acute kidney injury from rhabdomyolysis, it should also be considered that in a combat environment, soldiers’ access to water may be limited and the injury may be accompanied by dehydration. In the cases presented, the differential diagnosis of the causes of oliguria in the wounded made it possible to detect signs of severe dehydration, abstain from the inappropriate use of saluretics, quickly compensate for the fluid deficit, and to avoid the development of kidney damage and the need for renal replacement therapy.

A Description of the Dental Health and Treatment of Ukraine Military at U.S. Army Clinics in Germany.

Since the start of the Russo-Ukrainian war, most reports have focused on trauma and combat conditions. Trauma care is essential; however, disease and nonbattle injuries (DNBIs) also burden armies and reduce combat effectiveness. Dental emergencies (DEs) account for a substantial portion of DNBI, but there is limited information on Ukrainian military dental readiness. In September 2023, investigators were informed that Ukrainian military personnel were treated for DEs at 2 dental clinics in Germany. The investigators requested deidentified data from the Corporate Dental System (CDS), which is a repository for dental treatment records utilized by the U.S. Army. The data request captured DE treatment performed for Ukrainian military personnel in Germany from January 1, 2023, to September 20, 2023. The CDS report on DE encounters included the following: Gender, age, procedure codes, and provider narratives. This study was approved by the U.S. Army Institute of Surgical Research Institutional Review Board as research not involving human subjects and provided Log Number H-24-030nh. The CDS report captured 408 Ukrainian military DE encounters. A total of 360 Ukrainian military personnel were treated for DE during the 9-month reporting period in 2023. Oral surgery was the most common DE treatment category and accounted for 55.8% (N = 201) of DE procedures. Restorative dentistry procedures accounted for 18.1% of DE procedures. Of the 27 multiple category treatments, 25 had oral surgery procedures as one of the treatments. Restorative dentistry procedures were performed in 19 of the multiple category cases. The DEs in the Ukrainian military cohort suggest that chronic, untreated dental disease has progressed without routine care for years. The assertion that caries has progressed to a nonrestorable condition is supported by the distribution that 63% of all DE visits included oral surgery treatment. Based on the distribution of dental treatment, US dental officers must be proficient in oral surgery and prosthodontic care.

Simulation modeling of artillery operations in computer games: approach based on Markov processes

The object of this research is an approach to simulating the combat operation of artillery in computer games based on Markov processes. In modern computer games, an important role is played by the realism and plausibility of combat simulation. One of the most difficult and at the same time most interesting tasks is the modeling of artillery operations, where it is necessary to take into account numerous factors affecting the effectiveness of combat work. The research was aimed at improving the methods and models of controlling the combat work of artillery under the conditions for the firing position change and the presence of external disturbances. The use of stochastic models allows more accurate modeling of the behavior of artillery units, taking into account the random nature of many parameters, such as projectile speed, reload time, and the probability of detection by enemy forces. The proposed approach includes the development of a simulation model that allows determining optimal strategies to achieve maximum effectiveness of combat work. The model is based on Markov processes, which allows taking into account possible system states and probable transitions between them. This allows not only to simulate combat operations, but also to predict the results depending on different scenarios. The results of the study show that the use of Markov processes in the simulation of combat operations can significantly increase the realism and efficiency of artillery operations in computer games. This opens up new opportunities for game developers to create more immersive and authentic gaming experiences. The proposed model can be used as a basis for further research and improvement of combat simulation methods in computer games. It can also be used in military simulators and simulators where realistic combat conditions must be taken into account.

FORMATION OF COMMAND QUALITIES IN HIGHER EDUCATION STUDENTS OF HIGHER MILITARY EDUCATIONAL INSTITUTIONS: PSYCHOLOGICAL AND PEDAGOGICAL ASPECTS

The article explores the significance of cultivating leadership qualities in cadets of higher military educational institutions in light of contemporary challenges, particularly in the context of the Russian invasion and the anti-terrorist operation in eastern Ukraine. The authors stress that the maintenance of combat readiness in military units is directly linked to the professional training of the command staff, encompassing both theoretical knowledge and practical skills. Key issues that require attention include insufficient training in the organization of combat operations, limited understanding of regulatory and legal frameworks, shortcomings in military and specialized training, and a lack of necessary skills for the effective utilization of modern technologies and decision-making in rapidly evolving situations. Given these challenges, there is a pressing need for the development of new educational programs that align with the current demands placed on military commanders, the establishment of specialized training centers, and the integration of simulation technologies that closely mirror real combat scenarios. Moreover, the authors advocate for enhanced international cooperation to facilitate the exchange of expertise and the adoption of best practices in the training of military leaders. A significant emphasis is placed on the creation of psychological and pedagogical conditions that support the effective development of crucial leadership qualities such as resilience, decisiveness, the ability to make quick decisions, and the capacity to lead. The proposed measures aim not only to elevate the level of command staff training but also to ensure the successful execution of military operations under combat conditions, thereby strengthening the overall security and defense capabilities of the nation.

Physical Fitness in the Armed Forces: A Comprehensive Study of International Assessment Practices

The aim of this study is to thoroughly examine the physical fitness assessment methods used in the armed forces of various countries and to evaluate the physical fitness criteria necessary for military personnel to maintain their operational capabilities and overall health. Within the scope of the research, physical fitness assessment tests used in the armed forces of 17 countries, including the United States, Germany, Australia, Austria, the Czech Republic, China, Finland, France, Georgia, Canada, Ireland, the United Kingdom, Israel, Sweden, Latvia, Russia, and Turkey, were examined. It was observed that the tests aim to determine the soldiers' muscle strength, aerobic capacity, endurance, and overall physical fitness status. Additionally, it was found that while the physical fitness test and evaluation criteria applied by these countries vary, their fundamental purposes in practice are similar. Research has shown that maintaining physical fitness levels results in increased resilience of soldiers against problems and difficulties they may face in combat conditions, contributing to operational success. In this context, it is of great importance for national armies to continue and enhance their physical fitness programs. Moreover, it is essential to systematically review and update physical fitness test evaluations in accordance with scientific advancements, which will contribute to varying operational requirements in the armies. In conclusion, maintaining and improving physical fitness levels is a critical factor for the operational success of soldiers. Therefore, it should be regularly monitored and enhanced. This research aims to emphasize the importance of physical fitness test evaluations applied in national armies and contribute to the development of related studies. By sharing the practices implemented, it aims to take significant steps internationally towards enhancing soldiers' physical capacities.

Some aspects of tactical medicine in service and combat activities of police officers under the conditions of the legal regime of martial state: problem issues in critical situations and combat conditions

The article highlights the problematic issues of tactical training of law enforcement officers in today’s conditions, considers the actual problems and challenges that law enforcement officers may face during the performance of official duties and the provision of first aid in combat conditions and emergency situations. The issue of the interaction of the National Police of Ukraine with other rescue services at the scene for the effective provision of first aid was considered. It is noted that the interaction of the police and other rescue services at the scene of the event in the conditions of martial law requires a special approach and careful planning. It is necessary to ensure a clear coordination of actions, an appropriate level of protection for the personnel of the rescue services, and to take into account the peculiarities of work in the conditions of hostilities. Effective interaction between different services will minimize the consequences of emergency situations and ensure the safety of the population in the conditions of martial law. The article highlights the algorithm of actions for providing assistance to injured persons by police officers under fire, considers the key issues of training law enforcement officers to provide effective first aid in conditions of martial law or extreme situations in general. The authors of the article emphasize the importance of unified training programs for police officers in tactical medicine, which should include both theoretical knowledge and practical skills. Special attention is paid to ensuring a high level of readiness of police officers for quick and effective response to emergency situations and saving lives in the conditions of an aggravated conflict. Service situations in which police officers may find themselves are often accompanied by conflicts and their escalation, up to “fire contact” with the offender. Therefore, for the training of police officers, the section of tactical medicine is the most relevant, which teaches the basic skills of providing self- and mutual aid in combat conditions, which are primarily aimed at eliminating the preventive causes of death, taking into account the threat from combat operations or an active shooter. Unfortunately, there are infamous cases of the death of police officers while performing law enforcement tasks, which indicates the need for mandatory integration of first aid standards into their training and operations in various tactical situations. In addition, it is important to note that training police officers in tactical medicine will not only help them provide effective care to victims, but will also increase their level of safety while performing their duties. Therefore, unified training programs for police officers in tactical medicine should be an integral part of the training of law enforcement officers.

Economic and legal mechanisms of material and technical support of health care institutions

The paper shows that the formation of a network of state and communal health care institutions is a multifactorial process aimed at ensuring high quality, accessibility and efficiency of medical care for all citizens. It is shown that the state plays a key role in the organization of material and technical support of the health care system in order to guarantee the population an appropriate level of medical and rehabilitation assistance. It ensures the availability of the necessary resources to provide the population with a guaranteed level of medical and rehabilitation assistance to individuals and medical institutions, including in the form of equipment, tools, medicines and other necessary materials. The role and imperative of compliance with standards of medical care, clinical protocols, rehabilitation care protocols, as well as material and technical equipment reports in all health care institutions have been defined. It is shown that the record of material and technical equipment plays a key role in ensuring a high level of medical services, optimizing resources and increasing the efficiency of health care institutions and private medical practices. It has been proven that under the conditions of martial law, the role of the Ministry of Defense of Ukraine in the logistical support of health care facilities increases, as it ensures constant monitoring of the effectiveness of approved standards and lists, as well as their regular updating in accordance with new technologies and changes in combat tactics and medical science Medical products and aids must be suitable for use in combat environments, including extreme conditions, mobility and speed of care. The functions of the Ministry of Defense of Ukraine are an important component of ensuring the appropriate level of medical care for servicemen in combat conditions, which contributes to increasing their safety and effectiveness on the battlefield. A comprehensive approach to the logistical support of health care is proposed, which allows to ensure a high level of medical care, support innovations in the medical field, and promote the development of the national medical industry.

Military Situation Awareness: Ukrainian Experience

Situational awareness (SA) has become one of the key concepts in military sector. The Russian-Ukrainian war led to the development of information technology in Ukraine to manage troops and combat situations. The army was supported by numerous volun- teer initiatives involving IT professionals. As a result, Ukrainian army has received modern software solutions based on the principles of SA for use in real combat conditions. The purpose of the study is to analyse the development of military and civilian SA information sys- tems during the war between Russia and Ukraine. In the course of the study, the methods of system analysis of the problem of SA were used. The research classifies information solutions, assesses the dis- tribution of products by different classification sectors, and conducts a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the developed products. Using the example of the most common solutions, the main features of existing software products and the technologies on which they operate were identified. Prospects for the development of solutions, their contribution to military manage- ment, and problematic issues are identified.

THE EXPERIMENTAL COMBAT UNIT COMBAT DETERMINATION WHEN PERFORMING THE MISSION IN THE WEAPONS AND MILITARY EQUIPMENT TESTING AND CERTIFICATION CONTEXT

The article analyses the fact of the first combat robots’ application in a real battle in Iraq. In addition, it was found that modern combat robotic platforms from Ukrainian manufacturers can carry out reconnaissance, surveillance, and target detection missions already today, as well as providing fire support and security of the military on the front lines. It has been studied that deterring aggression and finding ways to confront the enemy was at the head of all transformations. Obviously, it became clear that the use of robotic complexes and systems is properly reflected in the approach of our victory. The need for high-quality training of an experimental combat unit (combat units, groups of scientific and technical support, representatives of manufacturers of robotic complexes (systems)) was substantiated. Such training is carried out both in peacetime and wartime. This is a planned, systematic training of the formation’s personnel, units, and subunits, carried out by commanders, staffs and units of educational work. It provides activities, the most important of which are: tasks and requirements definition; the educational process development; program development; comprehensive provision planning and control methods organization. The composition and duties of the experimental combat unit have been determined. We emphasize the need to create a modular mobile training and testing complex to unify such training. We conducted an analysis of the combat unit training by the sample’s manufacturer according to its own training programs, that are approved by the head of the enterprise and agreed by the military administration body, in whose interests it is planned to supply armament and military equipment. The stages of preparation and the procedure of combat coordination of an experimental combat unit are proposed. It is proposed to carry out the preparation and the tests themselves in 2 stages. The first stage is carried out at the training ground of a designated military unit. The second stage is carried out in combat conditions (in the areas of hostilities). Also, the main key points of each stage are defined. The usefulness of this article’s material lies in the fact that, based on the analysis of the programs and methods of the manufacturers, we make our proposal regarding the order of organization and the procedure of the preparation itself.

SIMULATION MODEL FOR UNMANNED AERIAL COMPLEXES AT LAUNCHING POSITIONS SURVIVABILITY ASSESSEMENT

The relevance of issues related to the justification of the rational approaches to the combat operations planning using unmanned aircraft systems, which are now assigned the main role in attacking the enemy by fire, necessitates the development of methods for evaluating such actions. The issue of increasing the survivability of unmanned aircraft systems under combat conditions is of important applied importance. The subject of the study is the unmanned aircraft systems application under the conditions of enemy action planning process. The article uses operations research methods. The purpose of the work is to develop a simulation model in the form of an algorithm, that allows conducting process research based on quantitative estimates and substantiating decisions aimed at increasing the survivability of unmanned aircraft systems under conditions of enemy action. By varying the parameters of the simulation model, it becomes possible to develop the most rational solutions for the unmanned aircraft systems use, ensuring the maximum level of their survivability under the specific conditions of combat operations. A simulation model is proposed, with the help of which it is possible to quantitatively evaluate decisions regarding the tactics of using UAV and finding ways to increase the level of their survivability under the conditions of enemy fire. During the implementation of the proposed model, statistics of the results of the simulated fire impact are accumulated, that allows to calculate estimates of the probability of UAV, deployed at the launching positions, to get various degrees of damage. By varying the specified parameters, it becomes possible to develop the most rational solutions aimed at increasing the survivability of UAV under the specific conditions of combat activities performing. The proposed simulation model for the survivability of unmanned aircraft systems assessment may be used in the decision support system for the appropriate level commander.

Radar Defense and Active Interception of Kamikaze Drones

The modern combat environment is marked by the active use of kamikaze drones, posing a serious threat to lightly armored vehicles. The development of radar technologies combined with microcontroller-based control systems allows for the effective detection and neutralization of these threats. This paper examines a complex of technical means for detecting and countering kamikaze drones, utilizing radar detection and active interception methods. An analysis of existing solutions in this field is conducted, highlighting their advantages and disadvantages, and technical proposals for constructing a radar control system, guidance unit, and countermeasure device are provided. Special attention is given to the integration of systems to enhance efficiency and automate processes. The presented results confirm the feasibility and effectiveness of the proposed solutions in real combat conditions, as evidenced by their application during Russia's war against Ukraine.

Computer Simulators - Modern Tools For Training Future Officers And Sergets

The purpose of this article was to consider the prerequisites for the emergence, stages and prospects for the development of military computer games in the Republic of Kazakhstan, used in combat training of the armed forces of a number of states, as well as an attempt to conduct a comparative assessment of various military simulators using developed military computer programs. Simulators of military weapons at the present stage play an important role in preparing future reserve officers and sergeants in the Republic of Kazakhstan for real combat operations. They are computer programs or physical devices that help simulate various aspects of military combat activities. One of the main advantages of using computer simulations is the ability to create realistic combat conditions without having to risk lives and resources. Future officers and NCOs can enhance their professional skills through simulations to develop strategic and tactical skills, make real-time decisions and coordinate the actions of their units. In our opinion, the use of military weapons simulators provides an opportunity to gain excellent skills in working with military weapons, reduces training time for beginners, improves reactions and quick decision-making, and of course reduces the risk of injury during training. So, simulators of weapons and military equipment will contribute to the training of future reserve officers and sergeants, helping to develop their skills, leadership qualities and make effective decisions in combat situations. A modern approach effectively complements traditional military training.

Pulmonary Embolism of the Small Branches of the Pulmonary Artery as a Result of Combat Trauma: Review of the Literature and Analysis of a Clinical Case

Pulmonary embolism (PE) is recognized by WHO as one of the most common cardiovascular diseases. Even in peacetime, PE is the third leading cause of sudden death after coronary heart disease and stroke. Today, as a result of the war, there have been significant corrections in the understanding of etiology, pathogenesis, features of the clinical course and treatment of internal pathology in the wounded persons. It was established that an important feature of modern combat activity is a constant increase in the frequency of multiple and combined wounds, while combat injuries of the chest make up to 15% of the structure of sanitary losses, and closed chest injuries under combat conditions can make up to 5%. Diseases of the cardiovascular and respiratory system are observed both early and late after closed chest trauma. The early ones are represented by functional disorders of the blood circulation and breathing system and are the consequences of damage to the chest organs, and the late ones occur in the case of joining a wound infection and are characterized by inflammatory processes in the lungs, pleura, heart and blood vessels, include pneumonia, pleurisy, acute purulent-destructive diseases lungs, thromboembolic complications. The article analyzes the course and possibilities of diagnosis and treatment of PE using the example of a wounded military man. A clinical case is presented which describes the successful diagnosis and treatment of a wounded person with PE of small branches of the pulmonary artery with the development of infarct-pneumonia S8, S9 of the right lung, nosocomial pneumonia in the right lung, which was complicated by the destruction of lung tissue, with the formation of an abscess-hematoma, acute interstitial nephritis, complicated by acute kidney damage of the III degree. This therapeutic pathology arose after a gunshot shrapnel penetrating wound of the chest on the right side with damage to the right subclavian vein, migration and embolization by a metal fragment of the right pulmonary artery, a gunshot shrapnel blind wound of the upper third of the right forearm with a gunshot fracture of the ulna and the presence of a foreign body (debris) in the muscle what tissues of the forearm. During the operation a complication arose in the form of migration of a foreign body from the branches of the right pulmonary artery to the branches of the left pulmonary artery. The result of the patient’s treatment was positive dynamics of the pathological process. The serviceman was discharged from the hospital in satisfactory condition and returned to the Armed Forces of Ukraine after a medical treatment. PE of small branches of the pulmonary artery is a severe complication after gunshot shrapnel injury to the chest organs, which can occur without concomitant deep vein thrombosis of the lower extremities, most likely as a result of the development of shock and the migration of fragments along the branches of the pulmonary artery. Complex treatment with the use of surgical methods and adequate antibacterial therapy is the main method of treatment of chronic destruction of lung tissue with abscessation. Each patient needs a complex of imaging methods for dynamic examination and monitoring of the state of other organs and systems, in particular, kidney function.

Brachial thoracic bullet wound with damage to the left atrium

Bullet wounds to the heart on the battlefield are quite rare. The victims usually die in the near future after being in[1]jured. The injuring agent most often pierces through the heart, thereby causing massive bleeding and cardiac arrest. All rare, unique cases when the wounded remained alive are associated either with the loss of kinetic energy of the injuring agent when the defeat occurs at the limit of flight range, or with a «behind the barrier» defeat when a bullet or fragment initially penetrates the «barrier» (armor, vehicle, ricochet from weapons or other solid objects, etc.). Injuries, when a bullet hits the shoulder, ricochets off the bones of the skeleton or spine and hits the heart, are found in isolated cases.In the presented clinical observation, the combatant was wounded in the left shoulder. At the stages of medical evacuation, a chest injury with heart damage and the presence of a foreign body was revealed. Initially, the wound proceeded without hemodynamic disorders, and only 36 hours after the injury, the first symptoms of a violation of the cardiovascular system appeared. As a matter of urgency, the wounded man was transferred by the intensive care team to a specialized cardiac surgery department, where emergency surgery was performed in conditions of artificial circulation. The postoperative period was smooth. The victim is currently receiving rehabilitation treatment. Heart injuries in combat conditions are highly relevant and are an extremely serious problem of the medical service at all stages of evacuation, diagnosis and treatment. The difficulties in diagnosing heart wounds are associated with the lack of the necessary hardware and diagnostic base near the line of contact and the extremely rapid development of the terminal condition. High mortality rates are due to acute cardiac disorders (cardiac tamponade, damage to the coronary arteries, massive bleeding). Subjective signs of cardiac injuries are often absent due to the admission of such a category of patients in an unconscious state. In this clinical case, timely diagnosis at the stages of medical care and interdisciplinary interaction made it possible to urgently refer a victim with a brachiothoracic bullet wound to the stage of specialized care.

MOBILE ADDITIONAL ARMOR PROTECTION FOR A TRUCK

BACKGROUND: The use of armored vehicles allows, under the threat of constant enemy influence, to protect special vehicles and special equipment from the effects of light and heavy small arms, landmines, hand grenade launchers during marches or special operations. However, at present, the issue of protecting freight transport used for transporting personnel, mortar crews, materiel, etc. is quite acute. The goal of the work is to develop a mobile set of additional armor protection for the body of a truck in order to reduce the likelihood of injury to personnel during their transportation by firearms, cumulative ammunition, fragments of artillery ammunition, as well as military equipment during its transportation. Materials and methods. Determination of parameters for the duration of the penetration process and subsequent behavior of armor protection, obtaining accurate data on the resistance and effectiveness of additional armor, analysis of the stress-strain state was performed in the Ansys program. Data were obtained on the penetration process, transition energy and subsequent behavior of armor protection, which will be used to improve armored structures and structures, as well as to improve the safety of equipment in real combat conditions. Results. The article discusses the problem of armor protection of vehicles. Examples are given of the use of additional armor protection for weapons, military and special equipment, in particular in the context of a special military operation. The study presents a mobile set of additional armor protection for the body of a truck, designed to protect personnel from injury from firearms and fragments from exploding ammunition when transported on trucks. Armor protection is made in the form of hinged armor plates, anti-cumulative grilles, secured on the outside with fastening elements. Installed on the outside of the body, armor screens act as barriers, which significantly increases the protective properties when fired from firearms. The article simulates the proposed protection set and analyzes the stress-strain state. Conclusion. Based on the calculations, the values of the maximum speeds and flight range of the bullet were determined for the strength of the additional set of armor protection.

Analysis of the quality of surgical care for patients with consequences of gunshot combat wounds of the maxillofacial area

One of the most pressing problems of maxillofacial surgery (MFS) is the provision of specialized medical care to the wounded and injured in combat conditions. Even more complex tasks are reconstructive surgical treatment at the stages of evacuation and the most complete rehabilitation of patients with the consequences of combat injuries to the maxillofacial area (MFA). Gunshot combat wounds of the MFA are characterized by severe anatomical and functional disorders, they can manifest themselves as significant defects and severe deformations, which in turn leads to an increase in sanitary losses of army personnel, disability of young and middle (working) age patients, a decrease in the quality of their life, long-term and expensive treatment that requires special knowledge and manual skills from specialists. All this determines not only the medical, but also the socio-economic significance of the topic of this study.Objective. Present an analysis of the quality of surgical care provided to patients with consequences of gunshot combat wounds of the MFA.Methods. The study was carried out by specialists from the State Budgetary Healthcare Institution «Maxillofacial Hospital for War Veterans» of the Moscow Department of Health, under the guidance of the chief, PhD, professor, main specialist in MFS – V.A. Belchenko, for the period from October 2022 to July 2023. Diagnosis, planning and surgical treatment of adult patients with the consequences of gunshot combat wounds of the MFA were carried out at the stages of treatment and evacuation measures. A sample of medical documentation was made, the data obtained was processed by the generally accepted statistical method. The results were analyzed and compared with data from similar studies.Results. The study group included 55 males, aged from 23 to 56 years, the average age of the patients was 36.16±7.79 years. We divided the studied patients into subgroups according to the conditional zones of damage to the MFA: 1st – upper zone of the face (n=3, 5.45%), 2nd – middle zone of the face (n=28; 50.91%), 3rd – lower zone of the face ( n=32; 58.18%). The number of patients with isolated injuries is 18.18% (n=10); with multiple – 81.81% (n=45); with combined – 72.72% (n=40). The article presents the characteristics of patients with the pathology under study, discusses some features of diagnosis and planning, discusses tactics and problems associated with the surgical stage of treatment, as well as further rehabilitation measures.Conclusion. Despite the emergence of new medical equipment, equipment for diagnostics, planning and solving complex problems of surgical intervention, there is a clear need for training specialists, developing and improving the applied medical recommendations, with a clear indication of the method of choosing tactics and methods of surgical treatment. Medical care for adult patients with the consequences of gunshot combat wounds of the MFA must be comprehensive and carried out on the basis of specialized centers, and must include both surgical and orthopedic components, which will minimize the number of errors and complications, increase the effectiveness of treatment and, as a result, make rehabilitation as complete as possible.

Вагітні жінки на фронті та партизанських загонах під час німецько-радянської війни.

The purpose of the research is to investigate the challenges faced by pregnant women in the Red Army and in partisan units during the German-Soviet war to analyze the attitudes of the military command and the Soviet government towards them. The research methodology is based on the principles of historicism, systematicity, and objectivism. The methods used in the work include historical analysis, historical-comparative analysis, deduction, and analysis. The scientific novelty. Based on the available historical material, for the first time in domestic historiography, an attempt was made to study the life of pregnant women in combat conditions comprehensively; the differences in the Red Army and in partisan units were shown, a number of inconveniences they had to face in a militarized society were revealed; Soviet legislation regarding them and probable reasons for pregnancy planning were analyzed. Conclusions. It was found that the life of expectant mothers in the Red Army was different from those in partisan units. While women in the Red Army on the sixth month of pregnancy were on maternity leave at the rear and didn’t give birth or reside at the frontline, female partisans had to give birth and care for children in the forest. The presence of children in paramilitary formations, as evidenced by archival sources and memories of partisans, could cost the lives of both mothers and children. The Soviet leadership drew attention to the problem of pregnant military women at the end of the war and reacted accordingly at the legislative level by regulating the length of stay of pregnant women at the front or on maternity leave and by approving social costs for children after birth. However, the problem of pregnant women in the Soviet army remained unresolved.

Posttraumatic growth and rehabilitative resources of the combatants and demobilized servicemen

The combat experience of military and demobilized persons combines the influence of combat and non-combat stressors with combat conditions and stressors associated with being in the combat zone, which leads to severe personal injury, symptoms of posttraumatic stress disorder and severe stress adaptive capacity. The resource of mastering combat stress is vitality, which is confirmed by the general viable position of the subjects, focused on effective self-development. Combatants show marked signs of maladaptation, but half of them report an increase in the value of life, spiritual growth and a general trend of personal growth, with women significantly exceeding men in terms of increasing personal strength. The aim of the research is to reveal the indicators of posttraumatic growth and personality rehabilitative resources of combatants and demobilized servicemen. Therefore, the posttraumatic growth of combatants goes hand in hand with attempts to adapt to a difficult situation. The main strategies for resisting stress in these conditions are cognition and recourse to physical activity. It is the resource of physical activity that is significantly positively correlated with indicators of posttraumatic personal growth. Personality posttraumatic growth indicators have been substantiated: change in attitude toward others, emergence of new opportunities, increase in strength of personality, spiritual changes, increase in the value of life, and general posttraumatic growth. The resource of rehabilitation potential, which is little used, is the appeal to the sphere of imagination and emotional sphere. The military does not sufficiently use the resources of faith and search for social support, which in crisis conditions are productive strategies. Sustainability is an important component of personal rehabilitation potential, but at this stage of a difficult situation, the personal resources involved are a person’s activity in overcoming difficulties, his/her desire to act and win, the desire not to lose this meaning, to express their personal potential.

Аналіз розвитку основних рухових якостей жінок-військовослужбовців в період правового режиму воєнного стану

The article examines and analyzes the development of basic motor qualities in 30 female military members of the Armed Forces of Ukraine under the conditions of the legal regime of martial law. The average age of the participants was 30.8±2.6 years. The aim of the study was to analyze the development of strength, endurance, and coordination abilities. To achieve the stated goal, the following research methods were used: analysis of scientificmethodical literature, analysis of requirements for the development of basic motor qualities in modern combat conditions, summarizing the advanced experience in the theory and organization of physical training of military personnel, pedagogical testing, application of stabilography method, and methods of mathematical statistics. Results. The analysis of endurance development in female military personnel was conducted based on the performance in a 1 km run. The median time to complete the distance was 5.45 min, indicating a low level, and corresponded to only 58 out of 100 possible points on\ the rating scale. It was found that 23.3 % (n = 7) of the participants completed the distance in 6.35 min to 7.14 min and could score only 38 points or less. The median result in the strength endurance exercise test No. 21 was 78 points. It is important to note that among the study participants, no military servicewomen were found who could score the maximum number of points in the range of 95-100 for the performance of any control exercise. Our results indicate that the physical training program requires correction to improve the level of development of basic motor qualities in this category of military personnel. Analysis of static spatial stability of the body in female military personnel, which involved comparing the results of two tests with open and closed eyes, showed statistically significant changes in the majority of the investigated indicators. The center of pressure (CoP) sway length and CoP mean velocity showed an increase of 401.0 mm (p < 0.001) and an increase from 5.4 mm·s-1 t o 9.1 mm·s-1 respectively (p < 0.001) in the test with closed eyes, indicating the significant influence of the visual analyzer on static stability and the dynamics of the body’s CoP sway. Additionally, the quality of balance function, showed a statistically significant decrease to 72.3 % in the test with closed eyes compared to the result of 90.1 % in the test with open eyes (p < 0.001). The comprehensive study of static spatial stability in female military personnel included the Romberg test, which is a classical method for assessing static balance. It was found that 23.3 % of the participants had above-average results, 40 % were within the norm, and 36.7 % showed below-average results, indicating the need for improvement of methods for training static balance in this category. Conclusion. T he o btained r esults o f t he study of the development of basic motor qualities in female military personnel under the conditions of the legal regime of martial law are an important contribution to the scientific discourse and are relevant for the practical activities of military personnel.