Gulf War Research Articles

Evaluation of the critical warzone experiences scale among Gulf War I-era veterans: Associations with PTSD symptoms, depressive symptoms, and suicidal thoughts and behaviors

ABSTRACT Prior research has established the psychometric properties of the Critical Warzone Experiences (CWE) scale among post-9/11 Iraq/Afghanistan-era veterans; however, the psychometric properties of the CWE among Gulf War I-era veterans have not yet been established. The first objective of the present study was to examine the psychometric properties of the CWE among Gulf War I-era veterans. The second objective was to test the hypothesis that the CWE would have a significant indirect effect on suicidal thoughts and behaviors via posttraumatic stress disorder (PTSD) and depressive symptoms. To test these hypotheses, a survey packet that included the CWE and measures of PTSD symptoms, depressive symptoms, and suicidal thoughts and behaviors was administered to 1,153 Gulf War I-era veterans. Consistent with prior research in post-9/11 Iraq/Afghanistan-era veterans, the CWE exhibited good internal consistency (α = .85), a unidimensional factor structure (RMSEA = .056, CFI = .959, SRMR = .033; average factor loading = .69), and good concurrent validity with PTSD (r = .47, p < .001) and depressive (r = .31, p < .001) symptoms among Gulf War I-era veterans. Additionally, as hypothesized, a significant indirect effect from the CWE to suicidal thoughts and behaviors via PTSD and depressive symptoms (β = .35, p < .001) was also observed. Taken together, our findings provide strong support for using the CWE with Gulf War I-era veterans.

Arab Gulf States’ naval procurement strategies: A three-level approach

Except Saudi Arabia who obtained ballistic missiles from China in the 80’s during the Iran-Iraq war,11Clayton Thomas, « Arms Sales in the Middle East: Trends and Analytical Perspectives for U.S. Policy », Congressional Research Service, 10/11/17 Arab Gulf States’ weapons procurement strategies seemed not oriented to get the means to guarantee their own security. In fact, despite the fact that these countries spent 24.7 billion dollars buying weapons between 1979 and 1989,22Source: SIPRI Database they were unable to protect themselves against Iraq when the latter launched an invasion of Kuwait in August 1990. After that new Gulf War,33The first Gulf war opposed Iraq to the Islamic Republic of Iran (1980–1988) the main Arab Gulf States pursued their ‘life insurance policy’ by still buying weapons from Western countries, hosting at the same time foreign military bases in their territories44Mainly the US, based in Saudi Arabia, Bahrein, Kuwait and Oman and signing Defense agreements with the greatest powers.However, things began to evolve at the beginning of the 21st century, with a change of strategy by certain Arab Gulf States, notably the United Arab Emirates and Saudi Arabia. These evolutions are largely due to different changes observed in the Gulf region from 2000 on: the Iranian nuclear program and Teheran’s potential hegemony across the Middle East and the waters of the Gulf, the war in Yemen and the operational need for naval capabilities (mainly for the UAE), and the doubts about the American political and military involvement in the Middle East. Moreover, with the aim to reduce their countries’ dependence on oil, many Arab Gulf States have promoted new national strategies to reduce the volume of importations from abroad, including military equipments, along with the targeted goal to promote local production of different products. The aim of this article is to analyze some Arab Gulf States’ naval procurement strategy, according to the political and strategical evolutions that have occurred in the Middle East since the beginning of the 21st century. It will demonstrate that the two main powers of the Arab Gulf, Saudi Arabia and the United Arab Emirates, have developed a three-level procurement strategy in order to get autonomy while increasing operational capabilities and promote national industries. The first level of this strategy consists in pursuing the procurement of naval equipment from Western suppliers. The second level aims to gain skills and experience through transfer of technologies in the context of co-developed military projects. The third one consists to a full how-know production process of middle class vessels. This article will also analyze which challenges the Arab Gulf States are facing in their naval procurement ambitions, and the probability that these challenges could lead them to revise them downwards.

Current Health Status of Gulf War Deployed and Gulf War Era Veterans Who Use Veterans Affairs Health Care.

Background: Although some recent studies have examined the health of female Gulf War (GW) deployed and non-deployed GW era veterans, these all relied on self-report, which can be inaccurate and subject to recall bias. This study investigated the current health of GW deployed and non-deployed GW era female and male veterans using Veterans Health Administration (VHA) electronic health records (EHR). Methods: We performed a cohort study of deployed GW and non-deployed GW era veterans, identified from a list from the Defense Manpower Data Center (DMDC). We used the VA-Frailty Index (VA-FI), calculated with VHA administrative claims and EHR, as a proxy measure of current health. Results: We identified 402,869 veterans (351,496 GW deployed; 51,3373 non-deployed GW era; 38,555 female) in VHA databases. Deployed female veterans had the highest VA-FI (i.e., were frailest) despite being younger than deployed and non-deployed male veterans and non-deployed female veterans. Compared with deployed male veterans, deployed females were more likely to be pre-frail, mildly, and moderately frail. Health differences between deployed and non-deployed female veterans were more prominent among older (60+ years) than younger (<60 years) veterans. Conclusions: Mirroring reports from recent, smaller survey studies of users and non-users of VA health care, findings from this cohort study indicate that deployed female GW veterans who use VA health care are frailer and have more health deficits than non-deployed female GW era and deployed male GW veterans. Because deployed female GW veterans appear to have additional health care needs, this may warrant increased outreach from women's clinics at VA hospitals.

Comprehensive examination of resting state fMRI connectomics yields new insights into brain function deficits in Gulf War illness after accounting for heterogeneity in brain impairment across the ill veteran population

An estimated 200,000 veterans (up to 32% of those deployed) of the 1991 Gulf War (GW) suffer from GW illness (GWI), an incompletely understood chronic medical condition, characterized by multiple symptoms indicative of brain function deficits in various domains. Epidemiologic and animal studies have associated GWI with exposure to neurotoxic chemicals such as nerve agents, organophosphate pesticides and pyridostigmine bromide. One factor that hampers mechanistic investigations into GWI is that there is considerable heterogeneity in brain impairments across the ill GW veteran population. This could reflect the underlying heterogeneity in both exposure to neurotoxic substances, as well as genetic predisposition or resistance to neurotoxicity. Only one of the validated case definitions, the Haley GWI criteria addresses this heterogeneity. It does so by breaking down GWI into three main syndrome variants (GWS1, GWS2, and GWS3) based on factor analysis of symptoms presented by GWI veterans. Resting state fMRI (rsfMRI) is a uniquely useful brain imaging technique in that in a 10-min fMRI scan it can probe numerous brain function domains simultaneously. In this study, we employed a connectomics approach and machine learning on rsfMRI data from a cohort of GW veterans to extract neuroimaging biomarkers specific to each of the three Haley GWI syndromes. Our results revealed a number of new insights into brain function impairment specific to each syndrome group. The findings indicate that these deficits may by and large be driven by brain mechanisms. We also found that pooling the data of all three syndromes in GWI group, as is done by commonly employed case definitions of GWI resulted in failure to detect the fMRI signatures of a lot of these brain impairments.

Anthrax Vaccination, Gulf War Illness, and Human Leukocyte Antigen (HLA).

We report on a highly significant, positive association between anthrax vaccination and occurrence of Gulf War Illness (GWI) in 111 Gulf War veterans (42 with GWI and 69 controls). GWI was diagnosed in 47.1% of vaccinated veterans but only in 17.2% of non-vaccinated veterans (Pearson χ2 = 7.08, p = 0.008; odds ratio = 3.947; relative risk = 2.617), with 1.6x higher GWI symptom severity in vaccinated veterans (p = 0.007, F-test in analysis of covariance). Next, we tested the hypothesis that the susceptibility to GWI following anthrax vaccination could be due to inability to make antibodies against the anthrax protective antigen (PA), the key protein contained in the vaccine. Since the first step in initiating antibody production would be the binding of PA peptide fragments (typically 15-amino acid long [15-mer]) to peptide-binding motifs of human leukocyte antigen (HLA) Class II molecules, we assessed the binding-motif affinities of such HLA specific molecules to all linear 15-mer peptide fragments of the anthrax PA. We identified a total of 58 HLA Class II alleles carried by the veterans in our sample and found that, of those, 18 (31%) were present in the vaccinated group that did not develop GWI but were absent from the vaccinated group who developed GWI. Remarkably, in silico analyses revealed very high binding affinities of peptide-binding motifs of those 18 HLA alleles with fragments of anthrax vaccine PA, leading to the successful production of anti-PA antibodies. Conversely, the absence of these protective HLA alleles points to a reduced ability to develop antibodies against PA, thus resulting in harmful PA persistence and development of GWI.

The Planetary Crisis: Applicability of Negotiorum Gestio

Negotiorum gestio is originally a civil law concept. When an intervenor acts on behalf of, and for the benefit of, the principal without the prior consent of the principal, the intervenor is entitled to reimbursement of expenses. The concept of negotiorum gestio can provide a legal basis for it. Does the concept exist in international law? Although negotiorum gestio is rarely referred to in international law and its legal status is unclear, we can find it in some treaties like salvage conventions as well as some diplomatic practices like the reimbursement of expenses arising from the assistance to abate and prevent environmental damage to the Gulf after the Gulf War in the framework of the United Nations Compensation Commission. Moreover, the application of the concept of negotiorum gestio is indispensable for addressing planetary level crisis such as space debris and planetary defense. Even if international cooperation is difficult due to geopolitical situations, voluntary actions by a State acting in good faith to mitigate the crisis should be promoted. Negotiorum gestio can be the legal basis of such actions.

Preliminary Evidence for the Role of Fungi, Specifically Chaetomium, in Gulf War Illness.

For veterans of the Persian Gulf War (1990-1991), dozens of possible causes for their illness have been proposed. We hypothesize that all may be correct. These may have weakened the immunity of the military personnel to fungal pathogens in the soil. These microbes, in turn, may have afflicted the veterans either directly by infection or indirectly by toxins. In 1990, the military (source confidential) provided the first author with soil samples from the Persian Gulf to determine if there were biothreats present. His team found that per gram of soil, there had few bacteria but many fungi. The National Centre for Human Mycotic Diseases (Edmonton) identified some of these fungi. They sent to the first author reference cultures of 12 pathogenic fungal species isolated from Canadian patients. Supernatant antigens of these fungi were used to assess if control and Gulf War Illness (GWI) patient sera had IgG antibodies against them. Human sera were tested on pathogenic fungal supernatant antigens. Controls had low IgG titers against all 12 fungal sources. Gulf War Illness (GWI) patient sera had low IgG titers against 11 of the 12 fungal antigens. However, 12 of 28 GWI patient sera (43%, P ≤ .0002 compared to controls) had high IgG titers against one fungus, Chaetomium, supernatant antigen. We suggest that the military personnel in the Persian Gulf War (1990-1991) may have had their immunity weakened from a variety of causes. The role of pathogenic fungi and/or their supernatant antigens or toxins as a contributing factor to GWI should be further investigated.

Militarism in medievalism: the Prince of Thieves video game and the Gulf War

ABSTRACT Medievalist video games are often embedded with complex modern militarism. Though the military-industrial-media-entertainment-network is a well-discussed issue in relation to video games, much of this work focuses on first-person shooters and representations of modern military combat. This same militarisation operates through more covert mechanics in medievalist video games – games set deliberately in a distanced, often fantastical, world – but the same logistical, schematic thinking and messaging is still hidden amongst the longbows and castles. This article analyses this phenomena using the 1991 Robin Hood: Prince of Thieves Nintendo video game as a case study text within which two distinct military temporalities operate simultaneously: the 1991 Gulf War and the medieval crusades. It examines the legacies of crusading medievalism but with particular concern for militarism and hypermediacy, exploring the way the American military context of the early 1990s resonates through this game text, particularly through its conceptions of violence and the body of the soldier. The rhetorical power of normalising militarised logistical thinking is significantly increased when it also coalesces with medievalism, and even seemingly simplistic games like Prince of Thieves form a crucial part of the legacy that today manifests in hyper-realistic shooter games that perpetuate racialized violence.

A Double-Humanized Mouse Model for Studying Host Gut Microbiome-Immune Interactions in Gulf War Illness.

Unraveling the multisymptomatic Gulf War Illness (GWI) pathology and finding an effective cure have eluded researchers for decades. The chronic symptom persistence and limitations for studying the etiologies in mouse models that differ significantly from those in humans pose challenges for drug discovery and finding effective therapeutic regimens. The GWI exposome differs significantly in the study cohorts, and the above makes it difficult to recreate a model closely resembling the GWI symptom pathology. We have used a double engraftment strategy for reconstituting a human immune system coupled with human microbiome transfer to create a humanized-mouse model for GWI. Using whole-genome shotgun sequencing and blood immune cytokine enzyme linked immunosorbent assay (ELISA), we show that our double humanized mice treated with Gulf War (GW) chemicals show significantly altered gut microbiomes, similar to those reported in a Veteran cohort of GWI. The results also showed similar cytokine profiles, such as increased levels of IL-1β, IL-6, and TNF R-1, in the double humanized model, as found previously in a human cohort. Further, a novel GWI Veteran fecal microbiota transfer was used to create a second alternative model that closely resembled the microbiome and immune-system-associated pathology of a GWI Veteran. A GWI Veteran microbiota transplant in humanized mice showed a human microbiome reconstitution and a systemic inflammatory pathology, as reflected by increases in interleukins 1β, 6, 8 (IL-1β, IL-6, IL-8), tumor necrosis factor receptor 1 (TNF R-1), and endotoxemia. In conclusion, though preliminary, we report a novel in vivo model with a human microbiome reconstitution and an engrafted human immune phenotype that may help to better understand gut-immune interactions in GWI.

Betting on war? Oil prices, stock returns, and extreme geopolitical events

We show that the ability of oil price changes to predict stock returns is limited to periods of extreme geopolitical unrest. Four events generate most of the predictability: the 1973 Arab-Israel war, the 1986 OPEC collapse, the 1990/91 Persian gulf war, and the 2003 invasion of Iraq. We also find that a market-timing trading strategy based on oil price changes typically generates insignificant abnormal returns, contradicting previously published results. Our findings serve as an example of how a significant predictor in a time series forecasting regression may not be a useful or profitable market-timing signal.

Psychological responses to political hostility: a study on aggression, bullying, and well-being in Qatar

ABSTRACT In 2017, the Gulf crisis led to a blockade that severely restricted Qatar’s air, land, and sea access. This political crisis had far-reaching consequences, particularly affecting cross-national families and children. This qualitative analysis explores the effects of the blockade’s political instability on individuals and families, specifically for Qatari citizens married to non-Qatari spouses and their cross-national children. Applying the General Aggression Model and Social Learning Theory, we interviewed 24 individuals residing in Qatar from nations directly affected by the crisis (Bahrain, Egypt, Saudi Arabia, and the United Arab Emirates). Two main themes emerged: first, the characteristics of aggressive and bullying behaviour, and second, the impacts on the well-being of cross-national families. The results showed that Qatari women and their children suffered disproportionately due to gender-based citizenship rights issues. The impacts on their well-being included heightened anxiety, depression, feelings of danger, uncertainty, and division within individuals, families, and communities. Recommendations include increasing collaborative efforts between governments, educational institutions, and community-based organizations, which are crucial to addressing aggressive and bullying behaviour across all age groups fostering a more harmonious and resilient society.

Irritable Bowel Syndrome in Veterans With Gulf War Illness Evaluated at VA's War-Related Illness and Injury Study Center.

Excess rates of Gulf War illness (GWI) and irritable bowel syndrome (IBS), two chronic multisymptom illnesses, have long been documented among nearly 700,000 veterans who served in the 1990-1991 Persian Gulf War. We sought to report the prevalence, characteristics, and association of GWI and IBS decades after the war in a clinical cohort of deployed Gulf War veterans (GWVs) who were evaluated at the Department of Veterans Affairs' War Related Illness and Injury Study Center (WRIISC) for unexplained chronic symptoms. We analyzed data gathered from clinical intake questionnaires of deployed GWVs who were evaluated at WRIISC clinics between 2008 and 2020. We applied Centers for Disease Control (CDC) criteria to determine the prevalence of severe GWI. IBS was identified using Rome IV diagnostic criteria (current IBS) and veterans' self-reported "history of physician-diagnosed IBS." We examined associations between IBS and GWI using bivariate analyses and multivariable logistic regression. Among the N = 578 GWVs evaluated by the WRIISC, severe GWI (71.8%), history of physician-diagnosed IBS (50.3%) and current IBS (42.2%) were all highly prevalent. Nearly half of GWVs with severe GWI met Rome criteria for IBS (45.8%), and over half reported a history of physician-diagnosed IBS (56.1%). In multivariable models, severe GWI was significantly associated both with current IBS (adjusted odds ratio (aOR): 1.68, 95% CI: 1.11, 2.54) and with veteran-reported history of physician-diagnosed IBS (aOR: 2.15, 95% CI: 1.43, 2.23). IBS with diarrhea (IBS-D) was the most common subtype among GWVs with current IBS (61.1%). However, IBS-mixed affected a significantly greater proportion of veterans with severe GWI, compared to veterans who did not have severe GWI (P = .03). More than 20 years after the Persian Gulf War, our findings indicate a high degree of comorbidity between severe GWI and IBS among deployed GWVs seeking care for unexplained illnesses. Our results suggest GWVs with GWI should be screened for IBS for which evidence-based treatments are available and could potentially reduce symptom burden. Conversely, symptoms of IBS should trigger additional evaluation for non-gastrointestinal symptoms in deployed Gulf War veterans to identify possible GWI and ensure a comprehensive approach to care.

The Development of Video Game Representations of the Middle East

This article critically explores the historical representation of the Middle East in video games until 2002 and following the 9/11 event. Using thematic analysis, we identify four main themes and discuss how this representation shifts with time, offering a brief overview of the broader context. I argue that there is a clear association between political developments and this western representation, for we can clearly observe changes from the romantic, exotic, and orientalist views of the region and Arab and Muslim figure shown within the realms of the Arabian Nights theme to a more militant figure and dangerous place due to featuring armed conflict in the Middle East such as the first Gulf War. Though not included in the discussion, 9/11 introduced a more negative and Islamophobic representation that is associated with Islamist terrorism, and it marks the latest development in these themes.

Exercise does not cause post-exertional malaise in Veterans with Gulf War Illness: A randomized, controlled, dose–response, crossover study

Chronic multisymptom illnesses (CMI) such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Long-COVID, and Gulf War Illness (GWI) are associated with an elevated risk of post-exertional malaise (PEM), an acute exacerbation of symptoms and other related outcomes following exercise. These individuals may benefit from personalized exercise prescriptions which prioritize risk minimization, necessitating a better understanding of dose–response effects of exercise intensity on PEM. MethodsVeterans with GWI (n = 40) completed a randomized controlled crossover experiment comparing 20 min of seated rest to light-, moderate-, and vigorous-intensity cycling conditions over four separate study visits. Symptoms, pain sensitivity, cognitive performance, inflammatory markers (C-reactive protein and plasma cytokines) were measured before and within 1 h after exercise and seated rest. Physical activity behavior was measured ≥ 7 days following each study visit via actigraphy. Linear mixed effects regression models tested the central hypothesis that higher intensity exercise would elicit greater exacerbation of negative outcomes, as indicated by a significant condition-by-time interaction for symptom, pain sensitivity, cognitive performance, and inflammatory marker models and a significant main effect of condition for physical activity models. ResultsSignificant condition-by-time interactions were not observed for primary or secondary measures of symptoms, pain sensitivity, cognitive performance, and a majority of inflammatory markers. Similarly, a significant effect of condition was not observed for primary or secondary measures of physical activity. ConclusionsUndesirable effects such as symptom exacerbation were observed for some participants, but the group-level risk of PEM following light-, moderate-, or vigorous-intensity exercise was no greater than seated rest. These findings challenge several prior views about PEM and lend support to a broader body of literature showing that the benefits of exercise outweigh the risks.

THEORETICAL AND PHILOSOPHICAL APPROACHES TO THE KURDISH SEPARATIST MOVEMENT AFTER 2000

Due to the current economic and international balances in the world, instead of using direct military force against each other, states support illegal organizations within the hostile country and conduct operations on the hostile state through proxy wars. This method, which has been used in every period of history, aims to create civil war within the hostile state. In this context, the "Separatist Kurdish Political Movement", which started in the last century of the Ottoman Empire and has evolved into international terrorism over time, is the most commonly used terror method of imperialist states, although it has manifested itself in different forms. This study examines the change in the theoretical and philosophical approach of the Marxist-Leninist terrorist organization under the name of "Kurdistan Workers' Party" (PKK), which is the last form of the separatist Kurdish movement and was founded in 1978, with the international support it has received since the beginning of the 2000s with the Gulf War. In addition, the study will analyze the separatist Kurdish movement, which gained international support after 2000, increased its goals, and focused on the goal of "Greater Kurdistan" by taking advantage of the chaos in Syria, and will propose original solutions with theoretical and philosophical approaches to political actors and the academic world.

Prolonged Antibiotic Use in Gulf War Chronic Multisymptom Illness Induces Renal Fibrosis-Like Pathology Associated with microRNA-21-Mediated PTEN Inhibition

Gulf War veterans afflicted with chronic multisymptom Illness (GWI) often experience unexplained, debilitating symptoms, including microbiome dysbiosis, gastrointestinal and neuroinflammation. Prolonged antibiotic treatments, especially of fluoroquinolone class are commonly employed in these veterans, raising concerns about their potential side effects. To date, no studies have investigated the effects of Gulf War (GW) chemicals- Pyridostigmine bromide (PB) and insecticide, permethrin exposures on renal dysfunction in the veterans. Therefore, this study aimed to investigate the impact of prolonged antibiotic exposure on renal pathology in GWI and to elucidate the underlying molecular mechanisms leading to renal dysfunction. In this study, we used a persistent Gulf War Illness (GWI) mouse model to study the combined effect of prolonged antibiotic regimen involving Neomycin and Enrofloxacin treatment for 5 months (20 weeks). Our results showed that prolonged antibiotic treatment exacerbated renal inflammation leading to elevated levels of pro- inflammatory cytokines and significant activation of NF-κB signaling over Gulf war chemicals treated (GWI) mice (GWI). Further, we hypothesized the involvement of HMGB1 mediated RAGE activation leading to the inflammatory phenotype in the kidneys of GWI+ AB mice. We observed that prolonged antibiotic exposure in GWI- induced mice led to significant increased HMGB1-mediated RAGE activation compared to GWI mice, which was associated with increased TGF-β production in GWI+ AB mice. Furthermore, miR-21, whose expression is reported to be regulated by TGF-β is widely linked to renal fibrosis, was also significantly upregulated in antibiotic-treated GWI-induced mice. This upregulation was associated with decreased PTEN expression, a direct target of miR-21 in GWI+ AB mice over GWI- mice, resulting in the activation of the AKT signaling pathway and increased extracellular matrix (ECM) deposition in GWI+ AB mice. Furthermore, we examined the involvement of AKT signaling activation in the induction of Epithelial-Mesenchymal Transition (EMT) by assessing the immunoreactivity of α-SMA. The renal tissue of GWI+AB mice exhibited an elevated immunoreactivity of α-SMA, suggesting that the cells were undergoing transition from an epithelial to a mesenchymal state. In contrast, GWI- mice displayed no significant expression of α-SMA or increased fibronectin deposition, indicating that exposure to Gulf War chemicals alone was insuffcient to induce renal fibrosis-like pathology. These findings highlight the complex interplay between GWI, antibiotics, and renal pathology, emphasizing that prolonged antibiotic treatment in Gulf War Chronic Multisymptom Illness leads to renal fibrosis like- pathology by activating TGF- β dependent miR-21/ PTEN/ AKT signaling. This study was supported by VA Merit Award I01CX001923-01 awarded to Dr. Saurabh Chatterjee. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Small Fiber Neuropathy in Veterans With Gulf War Illness.

Gulf War veterans deployed to operations Desert Shield and Desert Storm returned with chronic multisystemic symptoms. This Gulf War Illness (GWI) has defied attempts to identify an underlying etiology. Pain and other symptoms attributable to autonomic nervous system (ANS) dysfunction are common, which may suggest a pathophysiologic underpinning. Small fiber neuropathy (SFN) presents with similar symptoms. Toxic exposures have been implicated in both SFN and GWI. A retrospective chart review of clinical data at the New Jersey War Related Illness and Injury Study Center addressed the following questions: (1) how common was biopsy-confirmed SFN in veterans with GWI; (2) do veterans with GWI and SFN report more symptoms attributable to ANS dysfunction as compared to veterans with GWI and no SFN; and (3) can SFN in veterans with GWI and SFN be explained by conditions commonly associated with SFN? Chart review abstracted GWI status, skin biopsy results, and ANS symptom burden. For veterans with GWI and SFN, additional chart abstraction was explored for commonly reported contributing conditions. From March 1, 2015, to January 31, 2019, 51 Gulf War veterans evaluated at the War Related Illness and Injury Study center had a skin biopsy. Of these, 42 (83%) were diagnosed with GWI and 24 of 42 (57%) also had SFN. No differences were observed in ANS symptoms when compared with veterans with GWI and no SFN. A potential etiology for SFN was identified in 16 of 24 (67%) veterans with GWI and SFN, increasing to 19 (79%) when hyperlipidemia was included. Our analysis did not identify an explanation in 5 of 24 (21%) veterans with GWI and SFN. SFN was common in this clinical sample of veterans diagnosed with GWI. A well-established potential etiology was identified in most cases of SFN. About 20% of veterans with GWI in our clinical sample had idiopathic SFN, and it is plausible that deployment-related exposures could have contributed to this condition. Symptoms of ANS are prevalent in GWI, though SFN cannot solely account for this. Our study does not generally support SFN as etiologic for GWI, though this may still be relevant for some. Additional research is required to explore relationships between Gulf War exposures and SFN.

The Radical Left and the Movement in Australia against the First Gulf War, 1990–91: Anti-Imperialism at the End of the Cold War

The Gulf War in 1990–91 came at the end of the Cold War and at a time when the Left across the globe was reassessing itself as the Soviet Bloc collapsed. In this period of flux, the Australian Radical Left had also experienced a series of debates about its configuration, with several different attempts at unity, as well as reconsiderations about the relationship between the extra-parliamentary Left, the trade unions and the Australian Labor Party. After Saddam Hussein’s Iraq invaded Kuwait in August 1990 and several Western powers, led by the USA and Britain, sought to intervene, Bob Hawke’s Labor government supported the coalition against Iraq. A movement against Western intervention in the Gulf and Australia’s involvement in the coalition was built, including sections of the Labor Left, the trade unions, the peace movement, students and the organisations of the Far Left. Most looked back to the decade-long movement against the Vietnam War for the framework for the anti-war campaign, but the Left, in all its guises, had faded in influence since the 1970s. This article will look at how the movement against the First Gulf War developed between August 1990 and March 1991 and how it reflected a fractured and weakened Left in Australia in the dying days of the Cold War.

Mental Health Scores but not Sleep Quality are Lower in Veterans with Gulf War Illness that have Low Physical Function

PURPOSE: Gulf War Illness (GWI) is a poorly understood illness that impacts about a third of Veterans who were deployed to the Gulf Region during the 1990-1991 Gulf War (GW). GW Veterans have twice the odds of having depression compared to non-deployed Veterans. Depression and sleep quality are associated with impaired physical function, which is notable since physical activity is a modifiable health behavior that can be an effective method to reduce mild to moderate depressive symptoms and improve sleep. We hypothesize that Veterans categorized with GWI and with high physical function scores will have fewer depressive symptoms and better sleep quality compared to those with low physical function. Evaluating the connection between physical and mental health in Veterans with GWI could support behavioral health interventions intended to improve symptom management. Methods: GW Veterans were enrolled in an ongoing VA multi-site remote clinical research study and completed web-based questionnaires: the Modified Kansas questionnaire, short-form 36 (SF-36), Patient Reported Outcomes Measurement Information System (PROMIS)-Emotional Distress Anxiety and Depression, and the Pittsburgh Sleep Quality Index (PSQI). The modified Kansas was used to designate GWI based on 6 self-reported symptom domains. Symptom onset was also required within 5 years of deployment. The SF-36 assessed eight functional domains, including physical functioning measuring mobility disability. GW Ill Veterans were grouped based on the SF-36 physical function score such that those with ≤70 were considered in the poor physical function group (low) and &gt;70 were in the high physical function group (high). The PROMIS Anxiety assessed anxiety and PROMIS Depression assessed negative mood and decreased positive affect. The PSQI global score assessed sleep quality over a one-month period and ranges from 0-21 where a greater score reflects poorer sleep quality. Data were analyzed using student t-tests and linear regressions using Graphpad Prism 9. RESULTS: 63 Veterans (low group: 12 females/35 males, 60±4 years old; high group: 3 females/13 males, 59±5 years old) completed the web-based questionnaires. Anxiety and depression scores were greater in the low vs high group (Anxiety= low: 70.0±29; high: 45.4±14.0, P=0.001; Depression= low: 64.2.0±34.5; high: 41.3±14.7, P=0.01). Sleep quality (low: 12.8±4.0; high: 11.9±4.7, P=0.44) was not different between the groups. Anxiety scores (R2=0.19, P=0.0004) and depression scores (R2=0.11, P=0.007) were related to physical function, thus greater physical function was associated with lower (better) mental health scores. Sleep quality (R2=0.07, P=0.03) was related to physical function, so greater physical function was associated with better sleep quality. CONCLUSIONS: Gulf War Illness is a chronic multi-symptom condition that can be debilitating. Insight about physical function, depression and sleep symptoms could guide therapeutic approaches. The SF-36 is recommended as a core data element in GWI research and as such can provide information on the physical aspects of health. These findings suggest that depression and anxiety differ in those with low versus high physical function and that physical function is related to mental health and sleep quality. Future research should examine how GW Veterans are able to maintain their physical function to improve overall health. VA CSR&amp;D. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Probiotics Mitigate Exercise Fatigue, Memory Deficits, Depression and Neuro/inflammation in a Mouse Model of Gulf War Illness

We have previously found learning/memory, exercise intolerance, metabolic disturbance, gut dysbiosis and deregulation of neuroinflammatory genes, suggesting a possible microbiota-gut-brain interaction in GWI pathology (Kozlova et al., 2022a PMID: 34710444; 2022b PMID: 34801513). Here, we tested the hypothesis that probiotic treatment (P) prevents GWI symptoms. Adult male C57Bl/6N mice were separated into 4 groups (n=16/group): GW receiving pyridostigmine bromide (8.7 mg/kg, PB, po), permethrin (1.3 mg/kg, PER, top), DEET (33%, top); CON/S (vehicle plus stress); CON/S+P and GW+P. Probiotic groups received a gut-protective probiotic (P) cocktail of L. reuteri, L. rhamnosus, L. casei, B. longum (po, 108 CFU/mL, 3 times/wk) for 2 wk prior to and during GW agent treatment and until sacrifice 5 months later. Fecal RT-qPCR showed colonization of all strains except L. rhamnosus after 6-7 doses when compared to saline sham. Colonization after GW agent exposure was strain-specific and varied with time post-exposure. On an exercise endurance (EE) test GW (but not GW+P) mice tired faster relative to CON/S at PT56 (p&lt;0.05) but not at PT150. Repeat testing on the passive avoidance apparatus (15 wk after previous test) showed that GW but not GW+P mice displayed reduced latency to enter aversive chamber on day 1 of acquisition trials, indicating deficient memory (p&lt;0.05). Depressive-like behavior (mean percent time spent mobile) on tail suspension test (TST) showed less time spent mobile for GW (p&lt;0.05) but not GW+P mice than controls at PT50 (but not PT150). Probiotics protected against the GW-induced rise in liver C-reactive protein (CRP) (p&lt;0.05) and brain interleukin-6 (IL-6) (p&lt;0.05). Immunofluorescence probing in the hippocampal CA1 and dentate gyrus showed significantly greater counts of Iba-1 positive cells in GW (but not GW+P) vs CON/S (p&lt;0.05). NeuN immunostaining on the same sections showed abnormal neuronal phenotype indicative of reorganized RNA in GW but not GW+P) vs CON/S (p&lt;0.05). Multi-gene profiling of innate and adaptive immunity genes in brain homogenates (prefrontal cortex, hypothalamus, hippocampus) identified GW agent-induced deregulation (&gt;1.5-fold; p&lt;.05) of pro-inflammatory genes, i.e., upregulation of C5ar1 and Cxcl10 and downregulation of Tlr4; changes prevented by probiotic treatment. In the gut, M1 proinflammatory macrophages appeared to be more abundant in GW (but not GW+P) vs CON/S (p&lt;0.05). We used 16S next generation sequencing to examine probiotic treatment effects on gut microbial communities. In combination, our findings indicate that GW mice can be used to model multi-symptom illness and support previous evidence that the underlying pathophysiology in GWI likely involve systemic, gut and neuroinflammation and bacterial dysbiosis. Importantly, we show for the first time that probiotic treatment protects against some GWI symptom domains. Further study is needed to uncover pathophysiological pathways through which the microbiota-gut-brain axis impacts gut and brain health and toxicant-related pathology. DoD grant GW-180072 to M.C.C. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.