Search Results (215)

(1) Background: Dioxins and dioxin-like polychlorinated biphenyls (dl-PCBs) are persistent organic pollutants (POPs), characterized by high toxicity and strong lipophilicity, which promote their bioaccumulation in human tissues. Their detection in breast milk raises concerns about early-life exposure during lactation. Although dietary intake is the primary route of maternal exposure, environmental pathways—including inhalation, dermal absorption, and residential proximity to contaminated sites—may also significantly contribute to the maternal body burden. (2) Methods: This narrative review examined peer-reviewed studies investigating maternal and environmental determinants of dioxin and dl-PCB concentrations in human breast milk. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science (2000–2024), identifying a total of 325 records. Following eligibility screening and full-text assessment, 20 studies met the inclusion criteria. (3) Results: The included studies consistently identified key exposure determinants, such as high consumption of animal-based foods (e.g., meat, fish, dairy), living near industrial facilities or waste sites, and maternal characteristics including age, parity, and body mass index (BMI). Substantial geographic variability was observed, with higher concentrations reported in regions affected by industrial activity, military pollution, or inadequate waste management. One longitudinal study from Japan demonstrated a declining trend in dioxin levels in breast milk, suggesting the potential effectiveness of regulatory interventions. (4) Conclusions: These findings highlight that maternal exposure to dioxins is influenced by identifiable environmental and behavioral factors, which can be mitigated through public health policies, targeted dietary guidance, and environmental remediation. Breast milk remains a critical bioindicator of human exposure. Harmonized, long-term research is needed to clarify health implications and minimize contaminant transfer to infants, particularly among vulnerable populations. Full article

Military personnel deployed to Iraq and Afghanistan were exposed to emissions from open-air burn pits, where plastics, metals, and medical waste were incinerated. These exposures have been linked to deployment-related respiratory diseases (DRRD) and may also impact neurological health via the lung–brain axis. To investigate molecular mechanisms, adult male rats were exposed to filtered air, naphthalene (a representative volatile organic compound), or a combination of naphthalene and carbon black (surrogate for particulate matter; CBN) via whole-body inhalation (six hours/day, three consecutive days). Lung, brain, and plasma samples were collected 24 h after the final exposure. Pro-inflammatory biomarkers were assessed using multiplex electrochemiluminescence and western blot. Differentially expressed genes (DEGs) were identified by RNA sequencing, and elastic net modeling was used to define exposure-predictive gene signatures. CBN exposure altered inflammatory biomarkers across tissues, with activation of nuclear factor kappa B (NF-κB) signaling. In the lung, gene set enrichment revealed activated pathways related to proliferation and inflammation, while epithelial–mesenchymal transition (EMT) and oxidative phosphorylation were suppressed. In the brain, EMT, inflammation, and senescence pathways were activated, while ribosomal function and oxidative metabolism were downregulated. Elastic net modeling identified a lung gene signature predictive of CBN exposure, including Kcnq3, Tgfbr1, and Tm4sf19. These findings demonstrate that inhalation of a surrogate burn pit mixture induces inflammatory and metabolic gene expression changes in both lung and brain tissues, supporting the utility of this animal model for understanding systemic effects of airborne military toxicants and for identifying potential biomarkers relevant to DRRD and Veteran health. Full article

Blast-induced polytrauma (BIPT) is a common injury among military personnel exposed to explosive blasts. It is increasingly recognized as a complex, multisystem disorder that extends beyond neurological damage to include systemic metabolic and inflammatory dysfunction. Adipokines, particularly leptin and adiponectin, are hormones secreted by adipose tissue and are emerging as key mediators in the pathophysiology of traumatic brain injuries. Yet, their long-term dynamics following blast exposure remain unclear. This study investigated the temporal profiles of plasma leptin and adiponectin in a longitudinal rat model of BIPT. Adult male Sprague Dawley rats were subjected to either a single (B) or repeated (BB) blast exposure (20 psi) or served as sham controls. Plasma samples were collected at 24 h, 1 month, 6 months, and 12 months post-exposure, and adipokine levels were measured using Enzyme-linked Immunosorbent Assay. Adiponectin levels exhibited a biphasic response: both B and BB groups showed significant early decrease at 24 h and 1 month compared to sham animals, followed by robust elevation at 6 and 12 months, particularly in the repeated blast group. In contrast, leptin levels remained unchanged acutely but rose significantly at 6 and 12 months post-blast, with the BB group again showing the highest levels. These patterns indicate sustained, exposure-dependent dysregulation of adipokine signaling after blast trauma. The study provides the first longitudinal profile of systemic adipokine responses to BIPT, revealing their potential as accessible biomarkers and therapeutic targets. These findings support a model of chronic metabolic and inflammatory imbalance in BIPT and warrant further investigation in human cohorts and mechanistic studies. Full article

Individuals with post-traumatic stress disorder (PTSD) are at increased risk for hazardous drinking, which often complicates treatment and affects trauma-focused psychotherapy outcomes. The present study is an exploratory, secondary analysis investigating differential effects of prolonged exposure (PE) among those with and without hazardous drinking and whether treatment outcomes varied across these groups as a function of PE format. Data used were from a randomized controlled trial that examined two daily, compressed formats of PE treatment for PTSD (massed and intensive outpatient program) in military personnel and veterans (N = 234). Individuals without hazardous drinking had greater PTSD symptom reductions compared to those with hazardous drinking (d = 0.42, p = 0.001). However, the hazardous drinking group also demonstrated significant reductions in PTSD (d = 1.46, p < 0.001) following treatment, as well as in the number of drinks per week (d = 0.63, p = 0.025) at the 6-month follow-up. There was no significant difference in treatment engagement based on drinking classification and outcomes did not vary based on PE format. The findings suggest that PE is an appropriate treatment for individuals with PTSD and hazardous drinking. However, group differences in PTSD symptom reductions indicate concurrent hazardous drinking reduces treatment benefits of PE. Full article

The use of both structural steel and reinforced concrete is common in civil and military infrastructure projects. Anchorage plays a crucial role in these systems, serving as the key element that connects structural components and secures attachments within complex composite structures. This research focuses on evaluating the performance of steel–concrete column connections under the combined effects of lateral loading and fire exposure. Additionally, the study investigates the use of carbon fiber-reinforced polymers (CFRP) for strengthening and repairing these connections. The research methodology combines experimental testing and finite-element modeling to achieve its objectives. First, experimental investigation was carried out to test two groups of steel-reinforced concrete column specimens, each group made of three specimens. The first group specimens were designed based on special moment frame (SMF) detailing, and the other group specimens were designed based on intermediate moment frame (IMF) detailing. These two types of design were selected based on seismic demands, with SMFs offering high ductility and resilience for severe earthquakes and IMFs providing a cost-effective solution for moderate seismic zones, both benefiting from ongoing innovations in connection detailing and design approaches. Then, finite-element analysis was conducted to model the test specimens. High-fidelity finite-element modeling was conducted using ANSYS program, which included three-dimensional coupled thermal-stress analyses for the six tested specimens and incorporated nonlinear temperature-dependent materials characteristics of each component and the interfaces. Both the experimental and numerical results of this study show that fire has a more noticeable effect on displacement compared to the peak capacities of both types of specimens. Fire exposure results in a larger reduction in the initial residual lateral stiffness of the SMF specimens when compared to IMF specimens. While the effect of CFRP wraps on initial residual lateral stiffness was consistent for all specimens, it caused more improvement for the IMF specimen in terms of post-fire ductility when compared to SMF specimens. This exploratory study confirms the need for further research on the effect of fire on the concrete–steel anchorage zones. Full article

Moral injury is increasingly recognized as a significant concern among medical personnel and first responders, particularly in high-stress healthcare and emergency settings. This review aims to synthesize current evidence on the prevalence, risk factors, and outcomes of moral injury among medical personnel and first responders across diverse healthcare and emergency response environments. We included peer-reviewed studies reporting on moral injury among medical personnel or first responders in any healthcare or emergency response setting, excluding studies that did not report original data or focused solely on military populations. We systematically searched PubMed, Google Scholar, and Central, up to April 2025. Risk of bias was assessed directly from the manuscripts. Data were synthesized narratively and, where possible, pooled using random-effects meta-analysis. A total of 41 studies involving 14,500 participants were included. The prevalence of moral injury ranged from 4.1% to 69.44% across settings. Key risk factors identified included exposure to traumatic events, organizational constraints, and lack of support. Meta-analysis indicated a significant association between moral injury and symptoms of PTSD. The evidence is limited by heterogeneity in measurement tools and study designs, as well as a moderate risk of bias in several included studies. In conclusion, moral injury is prevalent among medical personnel and first responders, with important implications for mental health interventions and organizational policy. This review was not funded externally, and is registered in PROSPERO (CRD420251019492). Full article

Objectives: Assessing balance in highly trained individuals, such as military pilots, poses challenges, as deficits may be underestimated when compared to general population norms. To address this, several studies have proposed tailored databases providing reference values for specific populations. This study retrospectively analyzed balance characteristics in active-duty military pilots of the Italian Air Force. Methods: We enrolled 106 subjects split into two groups: 53 military pilots from the Italian Air Force and 53 civilians without flight experience or exposure to specific vestibular stimuli. All participants underwent ENT examinations with audiometric testing to exclude related pathologies, followed by a personal history collection. Subsequently, they completed the EquiTest protocol across six standard conditions. Results: Significant differences were observed between Army Aviators and Non-Aviators. The PREF variable showed the most consistent distinction, with military pilots demonstrating a superior performance (p < 0.01). Additionally, borderline differences were noted in Condition 6 of the equilibrium scores (p = 0.056), and in the Centre of Gravity (COG) analysis along the X-axis for Conditions 1 and 5 (p = 0.090), and for Condition 2 (p = 0.050). These findings suggest enhanced postural control strategies among Army Aviators under conditions of sensory conflict. Conclusions: These findings suggest that normative balance values specific to military pilots should be used when evaluating aviators recovering from balance deficits. Such tailored benchmarks can help determine the need for rehabilitation before returning to duty, ensuring optimal performance under demanding conditions. Further research is necessary to explore the underlying mechanisms responsible for these adaptations and to identify the specific stimuli that contribute to the enhanced balance capabilities observed in this highly trained population. Full article

Background: Limited data exist on the comparative diagnostic value of CT urography (CTU) versus unenhanced CT in evaluating the upper urinary tract in young adults (<50 years) with hematuria in active military service. This population may face an increased risk of urinary tract malignancies due to occupational exposures. Methods: We conducted a retrospective cohort study of 277 consecutive Israel Defense Forces personnel under 50 years old with new-onset hematuria referred for CT evaluation between 2011 and 2020. Two experienced radiologists first interpreted unenhanced CT images, followed by a review of contrast-enhanced phases. Findings were classified based on their detectability on unenhanced CT and whether contrast phases were required. Results: Of the 277 patients, 270 had microscopic hematuria and 7 had macroscopic hematuria. Imaging was normal in 158 cases. Among 119 patients (43%) with positive findings, 46 (16.6%) had clinically significant findings requiring follow-up or treatment. Of these, 42 (91%) were detectable on unenhanced CT alone. Contrast phases were requested in 15 cases (5.4%) and revealed additional benign findings. No urinary tract malignancies were identified. Conclusions: Unenhanced CT may be sufficient for evaluating new-onset hematuria in adults under 50, including active military personnel, minimizing the need for contrast administration. Full article

Exposure to severe combat situations significantly raises the risk of depression and post-traumatic stress disorder (PTSD). Trauma survivors may use dissociation as a defense mechanism, increasing the likelihood of PTSD. This study aims to explore the roles of dissociation and depression in PTSD among soldiers exposed to combat who sought help from the Israel Combat Stress Reaction Unit. Method: This cross-sectional study involved 927 individuals who participated in a particular military operation in 2014 [98.5% male (n = 906); mean age = 27.08 (SD = 5.93)]. Participants completed three questionnaires: the Dissociative Experiences Scale (DES), the Beck Depression Inventory (BDI), and the Post-Traumatic Stress Symptom Checklist (PCL-5) for PTSD. Results: Our results showed that severe PTSD (PCL score ≥ 33) was found in 30.4% of participants, and 76.6% showed dissociative symptoms (DES score ≥ 30). Additionally, 23.5% experienced moderate depression, while 19.1% reported severe depressive symptoms. A Generalized Linear Model revealed that both depression and dissociation significantly contribute to PTSD. Individuals with depression were three times more likely to experience post-traumatic symptoms compared to 1.23 times for those with dissociative symptoms. Conclusions: Life-threatening situations significantly predicted higher PTSD symptoms, serving as a risk factor for depression and dissociation, which play important roles in PTSD, with depression having notably greater impact. Full article

Objectives: To evaluate how a 10-day multi-stressor field-training course—combining high physical and psycho-emotional demands, caloric restriction, and severe sleep deprivation—affects systemic oxidative/antioxidative status and biomarkers of nucleic-acid and skeletal-muscle damage in trained military cadets. Methods: Seventy-five healthy cadets (8 women, 67 men; 22–34 y) completed the course. Standardised operational rations (700–800 kcal day⁻¹) and two 20 min tactical naps per 24 h were enforced. Pre- and post-course venous blood was collected after an overnight fast. Plasma superoxide-dismutase activity (SOD), reduced and oxidised glutathione (GSH, GSSG), malondialdehyde (MDA), and hydrogen peroxide (H₂O₂) were quantified by colourimetric/fluorometric assays; 8-hydroxy-2-deoxyguanosine (8-OHdG) and myoglobin were measured by ELISA. The oxidative-stress index (OSI) was calculated as GSSG·GSH⁻¹. Within-subject differences were assessed with Wilcoxon signed-rank tests; associations between biomarker changes were explored by Spearman correlation. Results: After training, GSH (+175%, p < 0.001) and GSSG (+32%, p < 0.001) rose significantly, whereas SOD (−19%, p = 0.002), H₂O₂ (−20%, p = 0.015), MDA (−50%, p < 0.001), 8-OHdG (−23%, p < 0.001), and OSI (−47%, p < 0.001) declined. Myoglobin remained unchanged (p = 0.603). Reductions in MDA correlated inversely with increases in GSSG (rₛ = −0.25, p = 0.041), while H₂O₂ changes correlated positively with GSSG (rₛ = 0.25, p = 0.046), indicating a glutathione-driven adaptive response. Conclusions: Ten consecutive days of vigorous, calorie- and sleep-restricted field training elicited a favourable redox adaptation characterised by enhanced glutathione-mediated antioxidant capacity and lower circulating oxidant concentrations, without evidence of DNA or skeletal-muscle damage. The data suggest that, in physically prepared individuals, prolonged multi-stressor exposure can strengthen endogenous antioxidant defences rather than precipitate oxidative injury. Full article

Octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) is a globally recognized energetic material that widely used in industrial, mining, and military fields. Like hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) and other nitramine compounds, HMX has also been reported to exhibit neurotoxicity. However, the molecular mechanisms underlying the toxic effects of HMX remain poorly understood. Therefore, this study aims to investigate the neurotoxicity induced by HMX by adopting PC12 cells. The results show that HMX treatment decreased cell viability and upregulated the intracellular free calcium ions (Ca²⁺) in PC12 cells. Furthermore, HMX caused aggravated oxidative stress in PC12 cells, as evidenced by the upregulations of reactive oxygen species (ROS) and malondialdehyde (MDA). Intracellular biochemical assays demonstrated that HMX induced loss of mitochondrial membrane potential in PC12 cells. Notably, altered expression of brain-derived neurotrophic factor (BDNF) and ionotropic glutamate receptors (iGluRs), as well as an abnormal transcription profile, were also observed in PC12 cells treated by HMX. These findings suggest that HMX exerts toxic effects on PC12 cells, involved in oxidative stress, and disturbances in Ca²⁺ and BDNF, accompanied by aberrant iGluRs. Overall, the present study helps us better understand the health hazards associated with HMX and provides valuable insights for developing the health protection standards related to HMX exposure. Full article

The events of 7 October 2023 and the subsequent Iron Swords War have profoundly impacted Israeli society, leaving both Jewish and Arab populations exposed to unprecedented levels of violence and uncertainty. This study examined the roles of trust in state institutions and a sense of coherence (SOC) as coping resources that may mitigate psychological distress following exposure to such events. Four hundred and seventy-one participants (69.9% Jewish, 30.1% Arab) filled out a questionnaire that addressed the demographics, war exposure, trust in institutions, SOC, and mental-health outcomes. The Jewish participants reported greater exposure to war events, a stronger SOC, and less psychological distress than the Arab participants. Levels of trust in different institutions varied significantly between the groups, with Jews expressing greater trust in the military and Arabs reporting higher levels of trust in the parliament, educational system, and media. SOC protected against psychological distress among both groups. Trust in the military was associated with lower levels of distress among Jews, whereas trust in the parliament was linked to higher levels of distress among Arabs. This study highlights the need for tailored interventions that enhance the SOC and address disparities in institutional trust, to foster resilience among different sociocultural groups. Full article

Ammonia is one of the most widely produced inorganic chemicals, with extensive applications in the military, agricultural, and industrial sectors. However, its strong stimulation and corrosive properties pose significant health risks, as long-term exposure to ammonia environments can lead to respiratory tract damage, loss of consciousness, and even cardiopulmonary dysfunction. Over the years, researchers have focused on exploring suitable materials for ammonia adsorption fields such as activated carbon and zeolites. Porous framework materials (PFMs), including metal–organic frameworks, covalent organic frameworks, and hydrogen-bonded organic frameworks, have emerged as possible ammonia adsorption materials due to their high specific surface area, pore size, and structural adjustability. This review focuses on the research and application of materials with excellent adsorption based on PFMs for ammonia adsorption, highlighting their potential applications and providing insights into future developments in this field. Full article

Background: Rescue teams and emergency services face high levels of mental health problems due to their frequent exposure to traumatic situations. Critical incident stress debriefing (CISD) is widely used as a psychological intervention for emergency responders and military personnel exposed to traumatic events. However, its effectiveness remains controversial, with systematic reviews yielding mixed results and some evidence of negative and harmful outcomes. This systematic review, conducted according to PRISMA guidelines, evaluates the evidence on the efficacy of CISD in mitigating psychological distress and preventing post-traumatic stress disorder (PTSD). Methods: A systematic search was conducted in PubMed and PsycINFO from inception to November 2024. Eligibility criteria included randomized controlled trials (RCTs) and cohort studies assessing the impact of CISD on PTSD, anxiety, depression, and psychological distress. Two independent reviewers screened studies, extracted data, and assessed the risk of bias using the PEDro scale. Data narrative synthesis was applicable. Results: A total of 6 out of 371 studies were included, comprising 4751 participants. The PEDro scale showed that one study was of high methodological quality, four were of acceptable quality, and two had deficiencies. The findings revealed mixed outcomes: while some studies reported a reduction in PTSD symptoms, others found no significant effect or even potential harm. Heterogeneity in intervention implementation, population characteristics, and study quality influenced the results. Risk of bias was moderate to high in several studies, with limitations in sample size and follow-up duration. No specific effects have been studied in mountain rescue teams. Conclusions: Current evidence does not unequivocally support the efficacy of CISD in preventing PTSD and psychological distress. Given methodological concerns and potential adverse effects, alternative debriefing methods, such as Battlemind debriefing, warrant further exploration. Future research should focus on well-powered RCTs with standardized intervention protocols to enhance reliability. Full article

Recent U.S. military conflicts have underscored the knowledge gap regarding the neurological changes associated with blast-induced traumatic brain injury (bTBI). In vitro models of TBIs have the advantage of following the neuronal response to biomechanical perturbations in real-time, which can be exceedingly difficult in animal models. Here, we sought to develop an in vitro approach with controlled blast biomechanics to study the direct effects of the primary shock wave at the neuronal level. A blast injury apparatus mimicking the human skull and cerebrospinal fluid was developed. Primary neuronal cells were cultured inside the apparatus and exposed to a 70 kPa peak blast overpressure using helium gas in a blast tube. Neuronal viability was measured 24 h after blast exposure. The transmission of the pressure wave through the skull is believed to be a factor in injury to the cells of the brain. Three thicknesses in the apparatus wall were studied to represent the range of thicknesses in a human skull. To study the transmission of the shock wave to the neurons, the incident pressure at the apparatus location, as well as internal apparatus pressure, were measured. Analysis of the internal pressure wave revealed that wave oscillation frequency, not amplitude, was a significant factor in cell viability after a bTBI. This finding is related to the viscoelastic properties of the brain and suggests that the transmission of the shock wave through the skull is an important variable in blast injury. Full article