Search Results (211)

Wound care in military and combat environments poses distinct challenges that set it apart from conventional medical practice in civilian settings. The nature of injuries sustained on the battlefield—often complex, contaminated, and involving extensive tissue damage—combined with limited access to immediate medical intervention, significantly increases the risk of infection, delayed healing, and adverse outcomes. Traditional wound dressings frequently prove inadequate under such extreme conditions, as they have not been designed to address the specific physiological and logistical constraints present during armed conflicts. This review provides a comprehensive overview of recent progress in the development of advanced wound dressings tailored for use in military scenarios. Special attention has been given to multifunctional dressings that go beyond basic wound coverage by incorporating biologically active macromolecules such as collagen, chitosan, thrombin, alginate, therapeutic peptides, and growth factors. These compounds contribute to properties including moisture balance control, exudate absorption, microbial entrapment, and protection against secondary infection. This review highlights the critical role of advanced wound dressings in improving medical outcomes for injured military personnel. The potential of these technologies to reduce complications, enhance healing rates, and ultimately save lives underscores their growing importance in modern battlefield medicine. Full article

Background/Objectives: This study investigates the therapeutic potential of camel milk-derived extracellular vesicles (CM-EVs) for treating colonic damage caused by high-altitude hypoxia, supporting the WHO’s “Food as Medicine” initiative. Methods: Using a 5500 m mouse model, researchers induced colonic injury and treated it with oral CM-EVs for 15 days, comparing results to whole camel milk. Results: CM-EVs outperformed whole milk, significantly improving colon health by restoring barrier integrity and reducing disease activity index (DAI) (p < 0.01). They boosted beneficial bacteria like Lactobacillus and Bifidobacterium and decreased Enterobacteriaceae (p < 0.01). Metabolic analysis showed restored bile acid balance and amino acid modulation via the FXR/NF-κB pathway, reducing TLR4/MyD88-mediated inflammation and oxidative stress (p < 0.01). Fecal microbiota transplantation in the CM-EVs group notably decreased DAI and increased colon length (p < 0.05). Conclusions: CM-EVs repair mucosal damage, balance microbiota, and regulate metabolism to combat hypoxia-induced colonic damage, suggesting their potential as nutraceuticals and altitude-adaptive foods. This showcases nanotechnology’s role in enhancing traditional dietary benefits via precision nutrition. Full article

Background: Brazilian Jiu-Jitsu (BJJ) is a physically demanding sport associated with a notable risk of musculoskeletal injuries. Understanding injury patterns, rehabilitation approaches, and psychological readiness to return to sport (RTS) is essential for prevention and management strategies. This study aimed to investigate injury characteristics among Italian BJJ athletes, assess their rehabilitation processes and psychological recovery, and identify key risk factors such as belt level, body mass index (BMI), and training load. Methods: A cross-sectional survey was conducted among members of the Italian BJJ community, including amateur and competitive athletes. A total of 360 participants completed a 36-item online questionnaire. Data collected included injury history, rehabilitation strategies, RTS timelines, and responses to the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale. A Random Forest machine learning algorithm was used to identify and rank potential injury risk factors. Results: Of the 360 respondents, 331 (92%) reported at least one injury, predominantly occurring during training sessions. The knee was the most frequently injured joint, and the action “attempting to pass guard” was the most reported mechanism. Most athletes (65%) returned to training within one month. BMI and age emerged as the most significant predictors of injury risk. Psychological readiness scores indicated moderate confidence, with the lowest levels associated with playing without pain. Conclusions: Injuries in BJJ are common, particularly affecting the knee. Psychological readiness, especially confidence in training without pain, plays a critical role in RTS outcomes. Machine learning models may aid in identifying individual risk factors and guiding injury prevention strategies. Full article

Traumatic brain injury (TBI) leads to severe neurological dysfunction, disability, and even death. Surgical intervention and neurorehabilitation represent the current clinical management methods, yet there remains no effective treatment for recovery after TBI. Post-traumatic hyperinflammation and vascular injury are the key therapeutic challenges. Therefore, a novel-designed multifunctional HT/SAA/HSYA hydrogel based on hyaluronic acid (HA) co-loaded with salvianolic acid A (SAA) and hydroxysafflor yellow A (HSYA) was developed in order to simultaneously target inflammation and vascular injury, addressing key pathological processes in TBI. The HT hydrogel was formed through covalent cross-linking of tyramine-modified HA catalyzed by horseradish peroxidase (HRP). Results demonstrated that the HT hydrogel possesses a porous structure, sustained release capabilities of loaded drugs, suitable biodegradability, and excellent biocompatibility both in vitro and in vivo. WB, immunofluorescence staining, and PCR results revealed that SAA and HSYA significantly reduced the expression level of pro-inflammatory cytokines (IL-1β and TNF-α) and inhibited M1 macrophage polarization through the suppression of the TLR4/NF-κB inflammatory pathway. In vivo experiments confirmed that the HT/SAA/HSYA hydrogel exhibited remarkable pro-angiogenic effects, as evidenced by increased expression of CD31 and α-SMA. Finally, H&E staining showed that the HT/SAA/HSYA hydrogel effectively reduced the lesion volume in a mouse TBI model, and demonstrated more pronounced effects in promoting brain repair at the injury site, compared to the control and single-drug-loaded hydrogel groups. In conclusion, the HT hydrogel co-loaded with SAA and HSYA demonstrates excellent anti-inflammatory and pro-angiogenic effects, offering a promising therapeutic approach for brain repair following TBI. Full article

Acute lung injury is a severe disease with a high mortality rate, which can result in increased oxidative stress and further mitochondrial damage and cell apoptosis. L-Clausenamide is an amide from the fruit wampee. This study combined network pharmacology, molecular docking, and in vitro study to elucidate the effect of combating acute lung injury and the underlying mechanism of L-Clausenamide. Network pharmacology indicated that the 152 targets can treat acute lung injury through regulating oxidative stress. Based on PPI analysis and screening of the central target, AKT1 is the key target of the underlying mechanism. KEGG and GO enrichment analysis demonstrated that apoptosis is an important pathway for this curing effect. In the in vitro study, treatment with L-Clausenamide alleviates intracellular ROS accumulation, mitochondrial membrane potential loss, mitochondrial morphological distortion, ATP decrease, and the CASP3 activity. The SPR analysis was performed to validate the binding between AKT1 and L-Clausenamide. The Western blot result showed that L-Clausenamide increases the phosphorylation of Akt and decreases cleavage of CASP3. L-Clausenamide can alleviate lipopolysaccharide (LPS)-induced acute lung injury through targeting AKT1 and show an improvement in mitochondrial abnormality and inhibition against ROS-activated caspase-3-dependent apoptosis activation. Full article

Thoracic injuries account for a high percentage of combat casualty mortalities, with 80% of preventable deaths resulting from abdominal or thoracic hemorrhage. An effective method for detecting and triaging thoracic injuries is point-of-care ultrasound (POCUS), as it is a cheap and portable noninvasive imaging method. POCUS image interpretation of pneumothorax (PTX) or hemothorax (HTX) injuries requires a skilled radiologist, which will likely not be available in austere situations where injury detection and triage are most critical. With the recent growth in artificial intelligence (AI) for healthcare, the hypothesis for this study is that deep learning (DL) models for classifying images as showing HTX or PTX injury, or being negative for injury can be developed for lowering the skill threshold for POCUS diagnostics on the future battlefield. Three-class deep learning classification AI models were developed using a motion-mode ultrasound dataset captured in animal study experiments from more than 25 swine subjects. Cluster analysis was used to define the “population” based on brightness, contrast, and kurtosis properties. A MobileNetV3 DL model architecture was tuned across a variety of hyperparameters, with the results ultimately being evaluated using images captured in real-time. Different hyperparameter configurations were blind-tested, resulting in models trained on filtered data having a real-time accuracy from 89 to 96%, as opposed to 78–95% when trained without filtering and optimization. The best model achieved a blind accuracy of 85% when inferencing on data collected in real-time, surpassing previous YOLOv8 models by 17%. AI models can be developed that are suitable for high performance in real-time for thoracic injury determination and are suitable for potentially addressing challenges with responding to emergency casualty situations and reducing the skill threshold for using and interpreting POCUS. Full article

As one of the medicinal and edible resources, Gastrodia elata (GE) is considered to hold potential in alleviating alcoholic liver injury, yet its mechanism needs further elucidation. To explore the molecular mechanisms of GE against alcoholic liver injury, network pharmacology, molecular docking, molecular dynamics simulations, and cell experiments were employed. Thirty-two active components of GE may exert efficacy against alcohol-induced liver injury via regulating 207 targets. Among them, the main functional components might be 4-hydroxybenzyl methyl ether, 4-ethoxytolyl-4′-hydroxybenzyl ether, pseudolaric acid B, palmitic acid, and myricetin. Analyses of Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment showed that a total of 322 GO items and 154 KEGG pathways are related to the effects of GE against alcoholic liver injury. The results of molecular docking show that the main active components of GE might interact with the key target proteins of GAPDH, PPARG, EGFR, STAT3, and AKT1. Molecular dynamics simulation further determined that pseudolaric acid B, as the core component, stably binds to these key target proteins. Cell experiments demonstrate that pseudolaric acid B exhibits a protective effect on ethanol-induced HepG2 cell injury by down-regulating the protein expression levels of GAPDH, STAT3, PPARG, and EGFR. Furthermore, the agent also suppresses IL-6 and inhibits the abnormal absorption of total cholesterol in HepG2 cells. Our findings suggest the efficacy and mechanism of GE in combating alcoholic liver injury and lay the groundwork for the precise development and utilization of GE. Full article

The management of penetrating rectal trauma has evolved from a historic 4-D algorithm (Divert, Drain, Direct repair, and Distal washout) to a more selective approach. This case report describes a patient with multiple wounds, including a high-grade extraperitoneal rectal injury resulting from a pelvic explosive injury. The patient was successfully treated with intraluminal vacuum therapy (ILVT). This case highlights ILVT as a novel method for managing complicated blast-related rectal injuries. While there are limited publications on combat-related penetrating rectal injuries that provide evidence-based guidelines, we suggest an aggressive surgical approach combined with negative pressure wound therapy for optimal patient outcomes. Full article

Background: This study examined the incidence of acute complications within the first year following combat-related lower extremity injuries in United States (U.S.) Service members (SMs). The research compared outcomes between primary amputation (PA), limb salvage (LS), and non-threatening limb trauma (NTLT) groups, and conducted a subgroup analysis within the LS group, differentiating between SM who underwent a secondary amputation (LS-SA) and those who did not (LS-NA). Methods: A retrospective analysis of combat-related lower extremity injuries sustained between January 2001 and October 2015 was performed using data from the Military Health System Medical Data Repository. Chi-square tests and adjusted logistic regression analysis were used to compare complication frequencies by injury severity. Results: The analysis of the 4275 SM revealed that 21% had undergone PA, 47% LS (with 13% experiencing LS-SA and 87% LS-NA), and NTLT was observed in 32% of cases. The PA group exhibited higher rates of most acute complications compared to other groups, with three exceptions—i.e., non-union fractures, compartment syndrome, and orthopedic device complications were more prevalent in the LS group than the PA group. The LS-SA group had higher complication rates than the LS-NA group for most complications. Notably, the PA group was associated with the highest rates of post-hemorrhagic anemia and heterotopic ossification, while the LS-SA group exhibited the highest rates of osteomyelitis, non-union fractures, non-healing wounds, and compartment syndrome. Conclusions: Individuals with amputation (PA or LS-SA) were more likely to experience acute complications compared to their counterparts (PA vs. LS and NTLT; LS-SA vs. LS-NA), with the exception of non-union fractures, which were more frequent in the LS group than the PA group. These findings highlight the need for close monitoring and targeted interventions to address post-surgical complications in Service members with limb salvage. Full article

Firework-related injuries remain a serious public health issue in Germany, especially during New Year’s Eve. While many injuries are minor, the misuse of illegal or homemade fireworks can cause severe trauma resembling military combat injuries and can heavily burden emergency services. Notably, injury rates declined during the COVID-19 firework bans, underscoring the impact of preventive measures. We report two cases of young males with severe injuries from illicit fireworks. The first is a case of a 16-year-old that detonated an illegal Polish firework ball bomb, sustaining 9% total body surface area (TBSA) burns (second- to third-degree), hand fractures, compartment syndrome of the hand, and soft-tissue trauma. He underwent multiple surgeries, including fasciotomy, osteosynthesis, and skin grafting. The other case presented is a 19-year-old man who was injured by a homemade device made of bundled firecrackers, suffering deep facial and bilateral hand burns. He required prolonged ventilation, surgical debridement, and treatment with Kerecis^® fish skin and Epicite^® dressings. Both required intensive ICU care, interdisciplinary management, and lengthy rehabilitation. Total hospital costs amounted to €58,459.52 and €94,230.23, respectively, as calculated according to the standardized German DRG. These cases illustrate the devastating impact of illegal fireworks. The devastating consequences of explosive trauma are often difficult to treat and may lead to long-term functional and psychological impairments. Prevention through public education, stricter regulations, and preparedness is essential. Pandemic-era injury reductions support sustained policy efforts. Full article

Background/Objectives: Mixed martial arts (MMA) is a combat sport which heavily involves upper limb strength, mobility, and stability. Shoulder injuries, given their impact on striking and grappling, may significantly hinder performance and career longevity. However, their specific effects on competitive outcomes remain poorly defined. This study evaluates return-to-sport rates, fight performance, and long-term success in professional MMA athletes following shoulder injuries. Methods: A retrospective cohort study was conducted using publicly available databases to identify professional MMA fighters from the UFC, Bellator, and Strikeforce who sustained shoulder injuries requiring withdrawal from scheduled bouts. Fighter demographics, injury characteristics, and treatment approaches were recorded. Performance metrics—including winning percentage, takedown (TD), knockdown (KD), and significant strike (SS) rates—were compared before and after injury. Independent t-tests were used, and significance was set at p < 0.05. Results: A total of 27 fighters with 34 documented shoulder injuries were included. The most common injury was a torn labrum (41.2%), with 76.5% requiring surgical intervention. Aggregate winning rates significantly declined from 81.96% pre-injury to 54.7% post-injury (p < 0.001). Aggregate KD rates also dropped significantly (p < 0.001), while TD rates trended downward without reaching statistical significance. SS rates remained stable, suggesting potential compensatory mechanisms. Injury recurrence was observed in 22.2% of cases. Conclusions: Shoulder injuries in MMA are associated with a substantial decline in competitive success, particularly in knockout capability, emphasizing the critical role of shoulder integrity in fight performance. The high recurrence rate suggests the need for optimized rehabilitation protocols and stricter return-to-sport guidelines to enhance fighter longevity. Full article

Brain ischemia-reperfusion (IR) injury is a critical pathological process that leads to extensive neuronal death, with hippocampal pyramidal cells, particularly those in the cornu Ammonis 1 (CA1) subfield, being highly vulnerable. Until now, human olfactory mitral cell resistance to IR injury has not been directly studied, but olfactory dysfunction in humans is frequently reported in systemic vascular conditions such as ischemic heart failure and may serve as an early clinical marker of neurological or cardiovascular disease. Mitral cells, the principal neurons of the olfactory bulb (OB), exhibit remarkable resistance to IR injury, suggesting the presence of unique molecular adaptations that support their survival under ischemic stress. Several factors may contribute to the resilience of mitral cells. They have a lower susceptibility to excitotoxicity, mitigating the harmful effects of excessive glutamate signaling. Additionally, they maintain efficient calcium homeostasis, preventing calcium overload—a major trigger for cell death in vulnerable neurons. Mitral cells may also express high baseline levels of antioxidant enzymes and their activities, counteracting oxidative stress. Their robust mitochondrial function enhances energy production and reduces susceptibility to metabolic failure. Furthermore, neuroprotective signaling pathways, including phosphatidylinositol-3-kinase (PI3K)/Akt, mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK), and nuclear factor erythroid-2-related factor 2 (Nrf2)-mediated antioxidative responses, further bolster their resistance. In addition to these intrinsic mechanisms, the unique microvascular architecture and metabolic support within the olfactory bulb provide an extra layer of protection. By comparing mitral cells to ischemia-sensitive neurons, key vulnerabilities—such as oxidative stress, excitotoxicity, calcium dysregulation, and mitochondrial dysfunction—can be identified and potentially mitigated in other brain regions. Understanding these molecular determinants of neuronal survival may offer valuable insights for developing novel neuroprotective strategies to combat IR injury in highly vulnerable areas, such as the hippocampus and cortex. Full article

Mixed Martial Arts (MMA) is a highly dynamic combat sport that requires precise motor coordination and technical execution. Video-based motion analysis, including two-dimensional (2D) and three-dimensional (3D) motion capture systems, plays a critical role in optimizing movement patterns, enhancing training efficiency, and reducing injury risk. However, the comparative validity of 2D and 3D systems for evaluating punching mechanics under external stressors remains unclear. This study aimed to first validate the measurement agreement between 2D and 3D motion analyses during sagittal-plane punches, and second, to examine the impact of fatigue and balance disruption on arm kinematics and punch dynamics in elite MMA athletes. Twenty-one male MMA fighters (mean age: 24.85 ± 7.24 years) performed standardized straight right punches (SRPs) and swing punches (SPs) under three experimental conditions: normal, balance-disrupted, and fatigued. Participants were instructed to deliver maximal-effort punches targeting a designated striking pad placed at a consistent height and distance. Each punch type was executed three times per condition. Kinematic data were collected using the my Dartfish Express(version 7.2.0) app (2D system) and MaxPRO infrared motion capture system (3D system). Statistical analyses included Pearson’s correlation coefficients, one-way analysis of variance (ANOVA), and linear mixed models (LMMs). Strong correlations (r = 0.964–0.999) and high intraclass correlation coefficient (ICC) values (0.81–0.99) confirmed the high reliability of 2D analysis for sagittal-plane techniques. Fatigue significantly decreased punch velocity and impact force (p < 0.01), while increasing joint angle variability (p < 0.01). These findings highlight the complementary use of 2D and 3D motion capture methods, supporting individualized monitoring, adaptive technique evaluation, and performance optimization in combat sports. Full article

Background and Objectives: PTSD and traumatic brain injury (TBI) frequently co-occur in survivors of combat exposure, blasts, assaults, or motor vehicle accidents (MVAs), yet the impact of TBI on the psychotherapy outcomes for PTSD, especially in civilians, remains underexplored and frequently underestimated. Methods: This study focused on analysis of the effectiveness of psychotherapies (trauma-focused: prolonged exposure (PE); non-trauma-focused: self-efficacy-focused cognitive therapy (SEF-CT)) in individuals with PTSD, comparing those with and without TBIs. The data of 45 PTSD patients with TBIs were drawn from a clinical trial cohort, with a total of 134 completing treatment. PTSD symptoms were assessed pre- and post-treatment using CAPS-5 and PDS-5. Cognitive functioning was measured via tests of fluid and crystallized intelligence. ANCOVA models examined the level of post-treatment PTSD symptoms with the control of pretreatment symptoms and the effects of TBI, treatment type, gender, age, education, time since the MVA, and level of cognitive functioning. Results: Both psychotherapies were equally effective in reducing PTSD symptoms, regardless of TBI status. The early initiation of treatment predicted better outcomes in non-TBI patients but not in those with TBIs. The TBI participants who began treatment earlier exhibited lower fluid intelligence scores, suggesting mild cognitive impairments that may have moderated the therapy benefits. Conclusions: Patients with PTSD and TBIs can benefit from both trauma-focused and non-trauma-focused CBT. While earlier intervention is beneficial for patients with PTSD alone, cognitive impairments may reduce this advantage in those with TBIs. Full article

Background: Recreational participation in Mixed Martial Arts (MMA) has rapidly increased. Despite consistent evidence of a high injury prevalence in MMA athletes, the neuromuscular implications of regular MMA training remain underexplored. The cervical spine is particularly vulnerable to trauma due to repetitive impacts and high mechanical demands in combat sports. Methods: This case-control study compared cervical spine function and self-reported symptoms between 25 recreational MMA athletes and 25 matched individuals who engaged in general fitness training. Outcome measures included Neck Disability Index (NDI), Post-Concussion Symptom Scale (PCSS), pain and headache reports, cervical range of motion (ROM), proprioception, isometric strength, and endurance. Multivariate logistic regression analysis was used to identify the predictors of group classification. Results: The MMA group exhibited significantly higher values for post-concussion symptoms (p = 0.012), cervical flexor endurance (p = 0.031), and the number of concussions (p = 0.001) but lower flexion ROM (p = 0.031). No significant differences were observed in strength, proprioception, or NDI scores. Logistic regression identified the number of concussions, age, total cervical ROM, and average rotation strength as significant predictors of group membership (model AUC = 0.96; Nagelkerke R² = 0.797). Conclusions: Recreational MMA athletes demonstrated higher rates of concussion-related symptoms and reduced cervical flexion ROM than noncontact exercisers despite no statistically significant differences in strength and proprioception. These findings suggest that cumulative exposure to amateur MMA is associated with alterations in cervical neuromuscular characteristics. These results support the implementation of targeted mobility, endurance, and injury prevention programs in recreational MMA training. Full article