Theater Of Operations Research Articles

Aspects of Outlining a Post-Modern Management Necessary for the Physical Training of Military Students

In a postmodern world which is extremely dynamic and anchored in a communication that requires online accesses in almost all fields, the training and preparation of young generations is required to be carried out in such a way that the acquisition of practical skills should be reflected in their future activities. Along with the other forms of training, physical training is a defining part of those who are part of the military environment. There are various aspects when, in the lives of the military, physical training can influence the course of their military career. Moreover, the motivations of behavioral changes, either inner or external, can cause increased attention to this type of training. Military physical training is a stand-alone activity in the military environment, a basic component of military training programs. We will also highlight physical training through its importance in the context of preparing the military for participation in theatres of operations, facilitating the understanding of its role in modern conflicts and the support it can offer in achieving military tasks and objectives. Moreover, an advanced level of physical training will lead to the maximization of the psycho-moral and physical components of the combative capacities, will support the improvement and maintenance of general physical and mental health and will help to develop the capacity for resistance to stress conditions such as fatigue, fear, panic, hunger etc.

Imaginaries of omniscience: Automating intelligence in the US Department of Defense.

The current reanimation of artificial intelligence includes a resurgence of investment in automating military intelligence on the part of the US Department of Defense. A series of programs set forth a technopolitical imaginary of fully integrated, comprehensive and real-time 'situational awareness' across US theaters of operation. Locating this imaginary within the history of 'closed world' discourse, I offer a critical reading of dominant scholarship within military circles that sets out the military's cybernetic model of situational awareness in the form of the widely referenced Observe, Orient, Decide, Act or OODA Loop. I argue that the loop's promise of dynamic homeostasis is held in place by the enduring premise of objectivist knowledge, enabled through a war apparatus that treats the contingencies and ambiguities of relations on the ground as noise from which a stable and unambiguous signal can be extracted. In contrast, recent challenges to the closed-world imaginary, based on critical scholarship and investigative journalism, suggest that the aspiration to closure is an engine for the continued destructiveness of US interventions and the associated regeneration of enmity. To challenge these technopolitics of violence we need a radically different kind of situational awareness, one that recognizes the place of ignorance in perpetuating the project of militarism. Only that kind of awareness can inform the public debate required to re-envision a future place for the US in the world, founded in alternative investments in demilitarization and commitments to our collective security.

Advantages of Language Proficiency in the Military Environment

Abstract Multilingualism describes the fact of using several living languages, understanding them, and mastering their nuances. Languages apprenticeship is long, tedious, but rewarding. Worldwide, 60-75% of the population speaks at least two languages. To be monolingual is to be part of a minority. For the new generations of military leaders, speaking several languages is a huge advantage, socially, professionally and neurologically. After briefly reviewing some scientific data on the advantages of the bilingual brain, the paper discusses how bilingualism positively affects their cognitive development as future Army leaders. Indeed, the obligation to juggle between two languages, the mother tongue and the language learned, offers bilingual people better control of the executive functions of their brain. In other words, the faculties of attention, memory, reasoning developed by learning the language are reinforced. This is an advantage for the military leader, who can thus process each piece of information more quickly and adapt more effectively to the evolution of a situation in a theatre of operations, for example. Cognitive control skills, mental flexibility, the ability to perform tasks requiring change, monitoring and conflict control are thus easier for a bilingual army officer.

Useful Approaches in Training and Developing the Professional Conduct of Land Forces Tactical Operational Leaders

Abstract The professional development of military leaders in accordance with the requirements of global and regional military challenges calls for their continuous education and training that harness the intellectual and practical tools necessary for the success of military action in times of peace, crisis or possible armed conflict, determined over time by the conditions of an unpredictable and unstable world. Regardless of the challenges faced today by NATO and by the military, it is obvious that the leaders of tactical structures must acquire moral and ethical qualities necessary for the leadership of operational military organizations in theatres (areas) of operations characterized by uncertainty and increased risk. This objective of this article is to highlight some aspects related to the tactical military leader’s attributes and competences that typify their professional conduct, which allow them to master the art of effective and successful operational leadership in the context of tactical combat structures These abilities are acquired progressively, during training and throughout military university studies as well as afterwards. Given the technological evolution of tactical combat potential and the need to ensure operational resilience through proactive and anticipatory risk management actions, we can argue that the leadership process characterizing this commander is quite different from the one of the past. Our approach is based on connections with some concepts that are considered familiar, due to the fact that, in the future, the leadership performed by the leader of a tactical operational structure will be increasingly complex and, consequently, will require ongoing learning and training.

Lessons Learned from the Modern Armed Forces Strategic Deployment in Operations

Abstract The purpose of this paper is to analyze the deployment of forces in expeditionary operations, in relation to the operations performed in the past by the modern armed forces. Thus, the intention is to approach the deployment of forces by identifying the most important actions, practical and decisional landmarks, which have decisively influenced the strategic maneuver, reception, staging and onward movement processes, in order to integrate forces in the contemporary theaters of operations. Going straight for the stated objectives, I conducted a multiple-case study, based on reviewing the relevant available literature, in order to efficiently access all the elements in the concerned field of interest.

Evaluation of robotic-assisted mitral surgery in a contemporary experience.

To evaluate the safety/effectiveness of a recently established robotic-assisted mitral surgery program. Cohort study with prospective collection of clinical data of 59 consecutive recipients (May 2019-August 2021) of robotic-assisted (fourth-generation platform, DaVinci X) mitral valve repair for degenerative disease, using a totally endoscopic technique. Patients' selection was based on defined anatomical and clinical criteria. We established a dedicated multidisciplinary protocol to facilitate postoperative fast-tracking, and a systematic in-house clinical and echocardiographic follow-up at 3, 6, and 12 postoperative months. All patients (89.8% men, average age 58 ± 12 years) received mitral valve repair; there was no operative mortality, one conversion to sternotomy (1.7%) and one stroke (1.7%). Extubation within the operative theater occurred in 28.8%; average mechanical ventilation time and ICU stay was 2.8 ± 4.1 and 32.5 ± 15.8 h (after exclusion of one outlier, learning-curve period, suffering from perioperative stroke); average postoperative hospital stay was 6.8 ± 3.4 days and 96.6% of patients were discharged home. One patient was transfused (1.7%); there were no other complications. Follow-up revealed stability of the results of mitral repair, with one (1.7%) persistent (>2+/4+) mitral regurgitation, and stability of coaptation height over time. We observed optimal functional results (class I was 98% at 3 months and 96% at 12 months). Quarterly case load consistently increased during the experience. This initial experience suggests the reliability and clinical safety of a recently established local robotic-assisted mitral surgery. This strategy can facilitate faster postoperative recovery, and its positioning in the therapeutic armamentarium needs to be defined.

Update on How to Improve the Outcome of Radical Cystectomy: A Systematic Review

Context Radical cystectomy (RCX) is the most difficult urologic procedure. It is usually performed in patients with morbidities and associated with a high rate of complications. So, every effort must be done to improve the outcome of this surgery. Objective This systematic review tries to put an up to date analysis of the literature on how to improve the outcome of RCX. Evidence acquisition A systematic literature search in the PubMed and Cochrane databases was performed from 1990 to July 2022 in English language using the keywords ‘‘radical cystectomy’, ‘Enhanced recovery’ and ‘Improved outcome’. Prospective studies were preferred; however, retrospective studies were used when no prospective studies were available. Evidence synthesis In all, 237 relevant articles were identified and 46 articles were included in this systematic review. RCX may be associated by complications that may reach 70%. Preoperative patient preparation, optimization and counseling are critical. Enhanced recovery after surgery protocols should be adopted. The radicality of surgery is affected by the use of neo-adjuvant and/or adjuvant therapy, timing of surgery, the presence of a well-organized team and the surgeon experience. Ureteral dissection, urethral stump preparation and nerve sparing are three important steps during RCX greatly affecting the function of the following reconstructive step. Close follow up after RCX especially in the first two years is critical. Conclusions Multiple factors should be followed to achieve good RCX. Regular skilled operative team, high volume surgeon, well equipped operative theater, excellent postoperative care are keys of success.

Update on How to Improve the Outcome of Radical Cystectomy: A Systematic Review

Context Radical cystectomy (RCX) is the most difficult urologic procedure. It is usually performed in patients with morbidities and associated with a high rate of complications. So, every effort must be done to improve the outcome of this surgery. Objective This systematic review tries to put an up to date analysis of the literature on how to improve the outcome of RCX. Evidence acquisition A systematic literature search in the PubMed and Cochrane databases was performed from 1990 to July 2022 in English language using the keywords ‘‘radical cystectomy’, ‘Enhanced recovery’ and ‘Improved outcome’. Prospective studies were preferred; however, retrospective studies were used when no prospective studies were available. Evidence synthesis In all, 237 relevant articles were identified and 46 articles were included in this systematic review. RCX may be associated by complications that may reach 70%. Preoperative patient preparation, optimization and counseling are critical. Enhanced recovery after surgery protocols should be adopted. The radicality of surgery is affected by the use of neo-adjuvant and/or adjuvant therapy, timing of surgery, the presence of a well-organized team and the surgeon experience. Ureteral dissection, urethral stump preparation and nerve sparing are three important steps during RCX greatly affecting the function of the following reconstructive step. Close follow up after RCX especially in the first two years is critical. Conclusions Multiple factors should be followed to achieve good RCX. Regular skilled operative team, high volume surgeon, well equipped operative theater, excellent postoperative care are keys of success.

Patient-tailored algorithm for laparoscopic cruroplasty standardization: comparison with hiatal surface area and medium-term outcomes.

Different methods have been described for laparoscopic hiatoplasty and hiatus hernia (HH) repair. All techniques are not standardized and the choice to reinforce or not the hiatus with a mesh is left to the operating surgeon's preference. Hiatal surface area (HSA) has been described as an attempt at standardization; in case the area is > 4 cm2, a mesh is used to reinforce the repair. The aim of this study was to describe a new patient-tailored algorithm (PTA), compare its performance in predicting crura mesh buttressing to HSA, and analyze outcomes. Retrospective, single-center, descriptive study (September 2018-September 2021). Adult patients (≥ 18 years old) who underwent laparoscopic HH repair. Outcomes and quality of life measured with the disease-specific gastroesophageal reflux disease health-related quality of life (GERD-HRQL) and reflux symptom index (RSI) were analyzed. Fifty patients that underwent laparoscopic hiatoplasty and Toupet fundoplication were included. The median age was 61 years (range 32-83) and the median BMI was 26.7 (range 17-36). According to the PTA, 27 patients (54%) underwent simple suture repair while crural mesh buttressing with Phasix-ST® was used in 23 (46%). According to the HSA, the median hiatus area was 4.7 cm2 while 26 patients had an HSA greater than 4 cm2. The overall concordance rate between PTA and HSA was 94% (47/50). The median hospital stay was 1.9 days (range 1-8) and the 90-day complication rate was 4%. The median follow-up was 18.6 months (range 1-35). Hernia recurrence was diagnosed in 6%. Postoperative dysphagia occurred in one patient (2%). The GERD-HRQL (p < 0.001) and RSI (p = 0.001) were significantly improved. The application of PTA for cruroplasty standardization in the setting of HH repair seems effective. While concordance with HSA is high, the PTA seems easier and promptly available in the operative theater with a potential increase in procedure standardization, reproducibility, and teaching.

THE SECURITY IMPACT OF THE MILITARIZATION OF OUTER SPACE

The competition for the military conquest of outer space dominated the public agenda during the Cold War. It was the spatial side of the geopolitical competition between the capitalist West and the communist East. It started with the researches for the development of strategic armaments and it ended with the military space programs launched by the great powers of the post-war era, which transformed the outer space into a real theater of operations. Theater currently relieved, by the Cosmic Space Treaty, of weapons of mass destruction. However, the unregulated military action in outer space, and especially the problems of defining the boundary between outer space and atmospheric space, can become explosive at any time. This article aims to present the main space powers, the space military programs they run and the potential security impact of the militarization of outer space.&#x0D;

Building a sustainable Mil-Civ partnership to ensure a ready medical force: A single partnership site's experience.

One of the challenges in military medicine is ensuring that the medical force deployed to the theater of combat operations is prepared to perform life, limb, and eyesight saving care at a level of care comparable to our top civilian Level I trauma centers. There is increasingly more evidence demonstrating that the majority of military physicians are not exposed to trauma or combat casualty care-relevant surgical cases on a consistent basis in their daily practice at their garrison military treatment facility (MTF). To prevent this widening skills and experience gap from become more of a reality, the 2017 National Defense Authorization Act called for the expansion of military and civilian (Mil-Civ) medical partnerships, working toward embedding military medical providers and surgical teams in busy civilian trauma centers. Vanderbilt University Medical Center is one of the busiest trauma centers in the country and being in close proximity to the local MTF at Fort Campbell, KY, it is primed to become one of the premier Mil-Civ partnerships. Creating a strategy that builds the partnership in a calculated and stepwise fashion through multiple avenues with centralized leadership has resulted in the early success of the program. However, Vanderbilt University Medical Center is not immune to challenges similar to those at other Mil-Civ partnerships, but only by sharing best practices can we continue to make progress.

Project Eagle: Polscy wywiadowcy w raportach i dokumentach wojennych amerykańskiego Biura Służb Strategicznych [Project Eagle: Polish Agents in the Reports and Wartime Documents of the American Office of Strategic Services

<i>Project Eagle: Polscy wywiadowcy w raportach i dokumentach wojennych amerykańskiego Biura Służb Strategicznych</i> [Project Eagle: Polish Agents in the Reports and Wartime Documents of the American Office of Strategic Services

Incidence of Viral Hepatitis in Military Personnel Performing External Missions

Soldiers on missions are at risk of contracting major infectious diseases. Some of the most common food or water-borne diseases include diarrhea (bacterial and protozoan), hepatitis A, and typhoid fever, all of which pose serious threats to communities. The studied group consists of 102 people who performed missions in the theater of operations in Mali between December 2020 and September 2021. The tests were performed in the medical analysis laboratory of the Military Emergency Hospital. The group consists of male with an average age of 35-45 years. Analyzes were performed in the fields of microbiology, virology and biochemistry. negative on departure and return only one person was positive, Ac anti HCV remained the same (97 negative people and 5 positive), Ac anti HAV were present in all military personnel returned from the mission, only one soldier returned with Ag Hbe positive (those in which Ag Bhs was also positive), Ac anti Hbs positive in all military. Following the analyzes performed, we came to the conclusion that the protection measures taken in the theaters of operations are effective, as there is no contamination on the studied group with endemic germs of the area.

Environmentally Friendly Operative Room (Green Operative Theater) Initiative

Environmentally Friendly Operative Room (Green Operative Theater) Initiative

Border policing at sea: Tactics, routines, and the law in a Frontex patrol boat

AbstractThis article explores how Frontex border policing is organized and performed at the level of the everyday. Based on ethnographic research in the Aegean Sea and interviews with Frontex and Hellenic Coast Guard officers, it details the mundane workings of ‘early detection’—a bordering practice that is systematically performed at EUrope’s frontier. By analysing the tactical labour and interactions with the host authority, the article documents a transformation in Frontex officers’ understandings of their role from humanitarian rescue towards deterrence. A focus on the day-to-day practices of Frontex officers and their limited conception of human rights reveals the ways unlawful bordering tactics become routinized within the Frontex operational theatre.

Legal Considerations Regarding the Interdiction of Using Children as Spies, Guides or Couriers During Armed Conflicts

Abstract This study performs a detailed examination of the provisions of Article 81 of Law no. 272/2004 for protection and promotion of childrenʼs rights, text of law according to which “No child shall be used a spy, guide or courier during armed conflicts”. Derived from the three fundamental human rights – the right of life, the right to physical integrity and the right to mental integrity, the legal interdiction of using children during armed conflicts as spies, guides or couriers, appears as a real instrument for protection and guarantee of minorsʼ rights, in correlation with their sheltering against the hostilities generated in conflict environments, by avoiding their use as human pawns in the theatres of operations. The lot of substantial information of the study has the vocation to transmit a firm message – to protect the children in case of war and to respect the standards of conduct in armed conflicts.

Long term mortality and morbidity of Italian soldiers after deployment in Iraq as related to biomarkers assessment: Results of the SIGNUM study

IntroductionThe health profile of military veterans deployed in foreign operative theatres was assessed by several international studies because of potential exposure to depleted uranium and other pollutants. Here we reported results of 15-year epidemiological surveillance assessing long-term health effects in a cohort of Italian soldiers deployed in Iraq in 2004–2005 and participating in a biomonitoring campaign to identify potential genotoxic exposure to environmental xenobiotics before and after deployment (n = 981, SIGNUM cohort). MethodsWe evaluated mortality and hospitalization risks of the SIGNUM cohort retrospectively until 2016 and 2018 respectively. A wide cohort of military personnel never deployed abroad (n = 114,260) and the general Italian population were used as control populations in risk assessment. Causes of death and diagnoses of hospitalization were derived through deterministic record linkage with official national databases of mortality and hospital discharge. Standardized Mortality Ratio (SMR) and Standardized Hospitalization Ratio (SHR) were computed adjusting according to sex, age, area of birth, and calendar year. Differential pre-post deployment in xenobiotics concentrations and early effect biomarkers (oxidative DNA alterations and micronuclei) measured in blood serum were analysed in relation to cancer hospitalization. ResultsMortality risk due to pathologies was more than halved compared to the general population (SMR = 0.41, 95% CI 0.11–1.05) and not significantly different compared to soldiers never deployed abroad (SMR = 0.69, 95% CI 0.19–1.68).Similarly overall hospitalization risk due to pathologies was decreased with respect to the general population (SHR = 0.86, 95% CI 0.80–0.92) and comparable to the control military group (SHR = 0.99, 95% CI: 0.93–1.06). For haematological cancers a decreased hospitalization risk compared to the Italian general population was observed (SHR = 0.38, 95% CI 0–0.92). No statistically significant differences emerged in the patterns of biomarkers in association with cancer hospitalization. ConclusionThe study confirms the so called ‘healthy warrior’ effect for the SIGNUM veterans and showed no correlation between cancer occurrence and biomonitoring markers measured on field.

“In the Character of their Material, Animate and Inanimate, the Troops of the United States Excelled”

Abstract This article considers logistics and supply in the China Relief Expedition. In the China campaign, as in all armed conflicts, the availability of matériel and subsistence determined what military options were available to commanders. In 1900, because of a strong industrial base and a burgeoning logistical network, the US Army, Marine Corps, and Navy demonstrated an increased capacity and capability to project power on hemispheric scales. Throughout the entirety of their intervention in China, Americans moved animals, artillery, medical supplies, men, ordnance, and subsistence across great distances – over sea and land, to and within the theatre of operations – with remarkable efficiency under difficult conditions. Thus, the China Relief Expedition was instructive for the US profession of arms, and pointed to a future in which large-scale combat operations on land and at sea would require careful integration and more extensive logistical support than military operations of nineteenth-century conflicts.

New Training Program for the New Requirements of Combat of Tactical Athletes

Actual theaters of operations are complex contexts where soldiers must face different situations, such as symmetrical, asymmetrical, or close quarter combat. The requirements of the actual battlefield are different to the traditional conditioning military training. This new changing scenario produces an activation of the innate fight or flight defense mechanisms with large activations of the anaerobic metabolic pathways and the sympathetic autonomic nervous system. In these scenarios, the anaerobic, aerobic, and strength demands are so specific and the time to improve all training demands in the units is limited. We propose a new training periodization for the military population based on the latest research into the psychophysiological response of soldiers in actual theaters of operations (actual military missions) and actual civilian models of training and periodization to develop a specific, easy, and reliable periodization model for actual tactical athletes. This training intervention was developed in order to improve operational training according to the demands of actual theaters of operations, based on recent research in military and civilian populations. We tried to conduct a proposal that is easy to apply, with minimal use of material different to what could be found in a military base and that could be implemented in a short period of time.

Spectrum of paediatric surgical cases and their outcome in a tertiary care hospital

Introduction: Paediatric surgical cases has been operated by general surgeon due to lack of paediatric surgeons. Complex cases in neonates and infants is being referred to other centres with paediatric surgical services. This study aims to compare the spectrum of paediatric surgical cases and their outcome before and after availability of paediatric surgeon.&#x0D; Method: This is the Retrospective study conducted at Patan Academy of Health Sciences over a period of 4 years. Group 1 included surgeries during 1st 2 y before and Group 2 during 2nd 2 y period after the availability of paediatric surgeon. Ethical approval was obtained. Patient age, sex, diagnosis, operative procedure, type of surgery and outcome data were collected from operative theater register and patients file from medical record section. Data analysis was done using SPSS 16.&#x0D; Result: Among 1157 cases, 369 cases were in group 1 and 788 in group 2. Male to female ratio was 2.8:1. Laparotomy 270(23.2%) was the most performed inpatient surgery and hernitomy 221(19.1%) in day care. There was total 52(4.5%) neonates, 2(4%) in group 1 and 50(96%) neonates in group 2. Among total cases mortality rate was 8(0.7%) in group 2, due to preterm birth, delayed presentation and septicemia.&#x0D; Conclusion: Lower GI tract and skin and soft tissue were most common system involved. Laparotomy and incision and drainage were most performed surgery before and after availability of paediatric surgeon. There was 96% increment in neonatal cases (50 v/s 2) after availability of paediatric surgeon. Mortality was 8(0.7%) in group-2 due to delayed presentation and septicemia.