Military Medicine最新文献

{"title":"Evaluating the Risks, Safety, and Reliability of Large Language Models in Military Medicine.","authors":"Darshan Thota, David Alt, Sriram Venkatesan, Jesus Caban","doi":"10.1093/milmed/usag413","DOIUrl":"https://doi.org/10.1093/milmed/usag413","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of Large Language Models (LLMs) within the Military Health System (MHS), specifically assessing for bias, hallucinations, and safety risks.</p><p><strong>Methods: </strong>In late 2024, 47 clinicians across 13 military treatment facilities evaluated 8 blinded LLMs. Using standardized clinical vignettes, 835 conversations were reviewed for demographic bias, hallucinations, classification errors, and safety risks.</p><p><strong>Results: </strong>Demographic bias was present in 82 conversations (9.8%), hallucinations in 85 (10.2%), classification errors in 19 (2.3%), and safety risks in 78 (9.3%). Classification errors were linked to military-specific jargon. Safety risks were most prominent in overdose, critical care, and psychiatric scenarios.</p><p><strong>Conclusion: </strong>Failure to generate an accurate response can delay decision-making and increase cognitive burden and risk. Confidently incorrect responses are particularly dangerous. Although LLMs can generate useful clinical information, they remain vulnerable to biases and factual errors. Human oversight, training, and model tuning are necessary before utilizing military data.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Military Medical Training for Role 1 and Role 2 Combat Casualty Care Skills: A Narrative Review.","authors":"Jennifer L Patton, Kiffin R Smallegan, Emily R Latimer, Anna R Prendergast, Gary J Jimenez Pena, Angela K Phillips","doi":"10.1093/milmed/usag411","DOIUrl":"https://doi.org/10.1093/milmed/usag411","url":null,"abstract":"<p><strong>Introduction: </strong>Military medics are often tasked to train other medics. While there is ample content of what to train, there exists a lack of trainer education or emphasis on how to train others effectively. Current military medical training is highly variable, often relying on anecdotal methods, with limited evaluation of training effectiveness. Although the importance of readiness training is well recognized, little attention has been devoted to identifying evidence-based approaches for training military medics. This narrative review sought to synthesize available evidence on training methods for military medics on skills performed in Role 1 or Role 2 settings.</p><p><strong>Materials and methods: </strong>A narrative review using systematic search and screening methods was conducted. A research librarian searched multiple databases using the MeSH terms \"clinical education\" and \"military.\" The articles were reviewed by the 6-person team using the Appraisal Tool Selection Algorithm and appraised for quality using the Pre-Appraised Evidence Appraisal Tool, © 2025 Johns Hopkins Health System, with permission.</p><p><strong>Results: </strong>From 1,222 screened articles, 44 met inclusion and quality criteria for final synthesis. Two overarching themes emerged: training methods and training evaluation. Training methods varied by audience, design, and modality. Many studies developed training methods centered around the audience, whether individual or team-focused. Training design and content was variably informed by the utilization of clinical practice guidelines, literature reviews, needs assessments, and expert opinion. Most studies employed multimodal approaches combining didactic instruction with hands-on or simulation-based practice. Training evaluation included both subjective and objective measures, including self-efficacy, knowledge testing, time to task completion, graded simulations, and clinical practice volume.</p><p><strong>Conclusions: </strong>This review highlights significant variability in how military medical readiness training is designed, delivered, and evaluated. Evidence suggests that effective training should be designed for the target audience, grounded in adult learning theories, multimodal, and evaluated using a combination of subjective and objective measures. Limitations to the articles utilized for this review include heterogeneous study designs, reliance on short-term outcomes, and weak generalizability. Addressing gaps in educator preparation, evaluation rigor, and policy for prioritization of training may improve the effectiveness of military medical readiness training. Future research should focus on validating objective evaluation tools, assessing skill retention, and optimizing team-based training to enhance operational readiness and force capability.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Past-Year Co-Use of Alcohol and Opioid and Suicidal Behaviors in U.S. Adults with Prior Military Service.","authors":"Ava C Santiago, Anwar E Ahmed, Jangho Yoon, Karl C Alcover","doi":"10.1093/milmed/usag388","DOIUrl":"https://doi.org/10.1093/milmed/usag388","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol use and opioid use independently increase the risk of suicidal behaviors. These substances are also frequently used concurrently, yet the extent to which their co-use contributes to suicidal behaviors at the population level remains insufficiently understood. This gap is particularly relevant among adults with prior military service, who experience elevated burdens of chronic pain, opioid exposure, and mental health comorbidities. We therefore examined whether past-year alcohol-opioid co-use was associated with suicidal behaviors among U.S. adults and assessed whether these associations differed by military service status and across pre- and post-COVID-19 periods.</p><p><strong>Materials and methods: </strong>We conducted a repeated cross-sectional analysis of adults aged ≥18 years using 2014-2023 data from the National Survey on Drug Use and Health (n = 544,488; 19,047 with prior military service). Past-year suicidal behaviors were defined as ideation, planning, or attempt. Substance use groups were categorized as alcohol-only, opioid-only, alcohol-opioid co-use, or neither. Year-specific multivariable logistic regression models adjusted for sociodemographic and clinical covariates were pooled using random-effects meta-analysis. Analyses were stratified by pandemic period (2014-2019 vs. 2020-2023). Interaction terms and marginal effects assessed effect modification by military service.</p><p><strong>Results: </strong>Among adults without prior military service, alcohol-opioid co-use (adjusted OR = 1.61, 95% CI, 1.37-1.90) and opioid-only use (aOR = 1.59, 95% CI, 1.27-2.00) were associated with suicidal behaviors after full adjustment. Among adults with prior military service, co-use was significant in minimally adjusted models but attenuated after full adjustment. Stratified analyses indicated stronger associations for co-use during the COVID-19 period, particularly among those with prior military service. Interaction analyses showed limited evidence of effect modification by military status after adjustment.</p><p><strong>Conclusions: </strong>Alcohol-opioid co-use is associated with increased odds of suicidal behaviors in U.S. adults, with variation across military service status and pandemic periods. These findings highlight the importance of considering polysubstance use and contextual stressors in understanding suicide risk.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing and Improving Role 2 Documentation Performance: A 2-Part Quality Improvement Initiative.","authors":"Allison Dilan","doi":"10.1093/milmed/usag418","DOIUrl":"https://doi.org/10.1093/milmed/usag418","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Accurate and comprehensive medical documentation is essential to safe, effective patient care, particularly in austere environments where patients transition rapidly between teams, locations, and levels of capability. In Role 2 environments, where casualties move from point of injury through damage control resuscitation, surgery, and prolonged casualty care, information loss during transitions poses a persistent threat to patient safety. Despite the existence of Joint Trauma System (JTS) Clinical Practice Guidelines and standardized documentation tools, variability in documentation practices persists within Role 2 settings. This quality improvement (QI) project sought to evaluate whether targeted documentation and handoff training could improve self-reported provider confidence and documentation performance during a simulated operational exercise.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This 2-part QI initiative was conducted within a Role 2 military medical unit preparing for a battalion-level certification exercise. Part I consisted of targeted training for providers, nurses, and corpsmen on JTS documentation requirements and structured handoff tools (MIST, I-PASS, SBAR). Participants completed pre- and post-training surveys assessing self-reported ability and confidence across 4 competency domains. Part II evaluated documentation during a 5-day field exercise. A stratified random sample of 55 simulated casualty charts (of 100 total) was audited using a structured tool aligned with JTS key performance indicators to assess completeness, accuracy, and clinical relevance. Descriptive statistics were used to summarize findings. The project was reviewed and determined to meet criteria for quality improvement rather than human subjects research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-four personnel participated in the training intervention. Self-reported confidence and perceived ability improved significantly across all 4 domains (P &lt; .05), with the largest improvement observed in participants' ability to identify and mitigate documentation and handoff errors. During the certification exercise, overall documentation compliance was 51%, and overall JTS compliance was 56%. Frequent deficiencies included missing reassessment vital signs, incomplete allergy documentation, absent provider orders, incomplete anesthesia records, and failure to update DD3019 forms following surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This QI project established a formal baseline of documentation performance within a Role 2 unit and demonstrated that targeted training improved provider confidence but did not fully translate into consistent documentation practice during operational simulation. These findings highlight the gap between perceived competence and field execution in austere military environments. Sustained improvement will likely require repeated training cycles, integrated audit and feedback, workflow optimization, and leader","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of a Novel Nutrition and Traumatic Brain Injury Data Repository for the U.S. Armed Forces and Beneficiaries, 2017 to 2024.","authors":"Katrina S Monti, Zachary T Colburn, Michael T Fredericks, William R Conkright","doi":"10.1093/milmed/usag416","DOIUrl":"https://doi.org/10.1093/milmed/usag416","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) is a significant U.S. military health concern. Although emerging evidence suggests that nutrition may contribute to TBI outcomes, research on clinical nutrition interventions, especially within military populations, is limited because of a lack of data repositories that integrate the Nutrition Care Process, lifestyle factors, and clinical outcomes.</p><p><strong>Materials and methods: </strong>We established a novel Nutrition and TBI Data Repository, integrating TBI and nutrition care data from military health records spanning from January 1, 2017, to December 31, 2024. Our data repository leverages 12 distinct data sources and includes clinical encounter, laboratory, radiology, and pharmacy data, among others.</p><p><strong>Results: </strong>Our repository contains clinical data for 431,673 patients with TBI and a 1:1 age- and sex-matched control cohort. The patient population is predominantly male (56.2%) and aged 17-41 years (39.5%). Most first-recorded TBIs are classified as mild (72.5%), and for 67.0% of the TBI cohort, mild represents the highest recorded severity. Active component service members make up 19.8% (n = 170,888) of the repository. We report patient counts across 23 health condition categories: 9 chronic health, 4 nutrition-related, 4 lifestyle factors, 3 sleep disorders, and 4 mental health disorders and 10 procedural code categories, including nutrition procedural codes. Overall, the TBI cohort has higher rates of health conditions, lifestyle codes, and nutrition counseling than controls.</p><p><strong>Conclusions: </strong>Our Nutrition and TBI Data Repository is the first of its kind, integrating longitudinal patient-level nutrition care data with TBI outcomes sourced directly from the Military Health System to enable researchers to identify critical knowledge gaps in TBI and nutrition care and explore the role of nutrition in TBI recovery.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained War-Related Emergency Department Presentations and Evolving Civilian Injury Patterns During Recurrent Missile-Related Conflict.","authors":"Yuval Dadon, Amir Nutman, Orit Mazza, Uri Feinstein, Linoy Gabay, Anat Engel","doi":"10.1093/milmed/usag412","DOIUrl":"https://doi.org/10.1093/milmed/usag412","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Prolonged missile-related conflicts may generate evolving civilian injury patterns and continuing war-related presentations to emergency departments. Although mass casualty incidents receive substantial attention in the disaster medicine literature, less is known regarding how civilian injury profiles and war-related emergency department presentations evolve during recurrent and prolonged conflict conditions. Understanding these changes is important for healthcare preparedness and continuity of emergency services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We conducted a retrospective observational study of civilian presentations to a large urban emergency department documented as occurring in the context of 2 conflicts involving attacks by the same regional adversary: June 13-25, 2025, and February 28-April 19, 2026. Demographic characteristics, injury severity, patient disposition, and diagnosis categories were analyzed. Because 4 nearby mass casualty incidents occurred during the first conflict period, an adjusted analysis excluding casualties presenting on mass casualty incident dates was performed to evaluate underlying wartime injury patterns. The second conflict period was additionally divided into early and later phases to assess temporal changes during prolonged conflict exposure. Daily presentation rates were calculated to account for differences in conflict duration. The study was approved by the Institutional Review Board of Edith Wolfson Medical Center (approval no. 0084-26-WOMC, 2026). The requirement for informed consent was waived due to the retrospective nature of the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,018 war-related civilian ED presentations were included. Period 1 included 418 presentations over 13 days, corresponding to 32.2 presentations per day. After excluding the 4 mass casualty incident dates, 127 presentations occurred over 9 days, corresponding to 14.1 presentations per day. Period 2 included 600 presentations over 51 days, corresponding to 11.8 presentations per day. Initial analyses demonstrated lower injury severity during Period 2; however, after exclusion of mass casualty incident-associated casualties, severity distributions were similar, with mild injuries accounting for 96.1% and 97.0% of presentations, respectively. Diagnosis distributions differed significantly between periods (P &lt; .001). Extremity injuries increased from 31.9% to 44.2% and peaked during the early phase of Period 2 at 48.2%, before declining to 34.8% during the later phase. Psychological/anxiety-related presentations decreased from 11.8% to 0.8%, while multiregion trauma reached 9.9% during the later phase of Period 2. War-related presentations continued throughout the prolonged second conflict period despite the absence of nearby missile impacts or formal mass casualty incident activation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Civilian wartime injury profiles evolved across recurrent missil","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing Point-of-Care Ultrasound and Tourniquet Placement for Expedited Diagnosis and Management of Intravenous Cannula Breakage: A Case Report.","authors":"Bar Lossos, Sharon Einav, Sami Gendler, Or Assouline","doi":"10.1093/milmed/usaf617","DOIUrl":"10.1093/milmed/usaf617","url":null,"abstract":"<p><p>The breakage of an intravenous (IV) cannula represents a rare complication associated with peripheral IV cannulation, a prevalent procedure in the civilian and military prehospital setting. Intravenous cannula breakage can lead to further complications including infection, migration, and subsequent embolization. Although fast identification and extraction are essential management components, there are no consensual guidelines for the proper management of this complication. In this report, we present a case involving a 19-year-old soldier who presented to the emergency department following the rupture of an IV cannula during military training. Subsequently, embolization of the cannula fragment occurred because of the patient's discomfort and noncompliance with venous tourniquet usage. This case report delineates the actions taken both on-site and upon the patient's arrival in the emergency room, including the utilization of point-of-care ultrasound as an expedient diagnostic tool for identifying the fragmented cannula swiftly. Additionally, we provide a review of the management approaches detailed in existing literature, with a specific emphasis on the use of venous tourniquet placement as a potential measure for avoiding complications.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e2190-e2193"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Veterans' Perspectives on Serious Illness Communication About Lung Disease Progression.","authors":"Allison V Lange, Caroline Tietbohl, Robert P Klocko, David B Bekelman, Anuj B Mehta","doi":"10.1093/milmed/usag066","DOIUrl":"10.1093/milmed/usag066","url":null,"abstract":"<p><strong>Introduction: </strong>Serious illness communication (SIC) is a series of complex, iterative conversations between patients, their caregivers, and clinicians in which a patient's understanding of their illness, preferences, values, and medical decisions are addressed. An essential part of SIC for patients with chronic lung disease is communication about lung disease progression. How patients interpret clinician communication about lung disease progression is unknown. This study sought to understand how patients experience communication about the future of lung disease and how this influences a patient's understanding of their disease.</p><p><strong>Materials and methods: </strong>Semi-structured interviews. Transcripts were analyzed using content analysis. Participants were veterans and had chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and/or pulmonary hypertension.</p><p><strong>Results: </strong>Twenty-two patients were approached and completed interviews. Participants were a mean age of 71 years; female, 9%; white, 64%; and non-Hispanic, 86%. Four themes emerged. (1) Gaps in understanding of lung disease: Participants did not know about future exacerbations of lung disease. (2) Burden: Participants did not want to burden family members, which motivated a desire for information about how to manage their lung disease and plan for future care needs. (3) Mistrust: Participants were mistrustful about a potential link between military exposures and lung disease. (4) Information needs: Participants wanted information about daily life, causes of lung disease, test results, and time remaining.</p><p><strong>Conclusions: </strong>There are information needs among veterans with chronic lung disease regarding exposures, causes of lung disease, and managing lung disease. Future work should explore how to address veterans' unmet SIC needs.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"e2021-e2029"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147307576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of the Joint Critical Care Advanced Support Team in Sustaining Net-Neutral Patient Flow Through Hawaii During a Large-Scale Combat Operation Event in the Indo-Pacific Theater.","authors":"Kazuma Nakagawa, Derek M Sorensen, William R Smith, Paul J D Roszko, Andrew D Goodrich","doi":"10.1093/milmed/usag171","DOIUrl":"10.1093/milmed/usag171","url":null,"abstract":"<p><p>The Joint Critical Care Advanced Support Team maintains Hawaii's limited critical care capacity during Indo-Pacific Large-Scale Combat Operations, ensuring a net-neutral patient flow. This military-civilian effort ensures that critical care patients receive timely life-saving care while stabilized patients are moved to the Continental United States, preserving Hawaii's healthcare balance.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"154-157"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Prove Yourself, Jane\": Medical Student 55-Word Story Reflections of Initial Clerkship Experiences.","authors":"Elyse Fiore Pierre, Ryan M Sanborn, Annabelle Bailey, Austin Chin, Kamryn McKenzie, Amy McDonald, Heather MacEwen, Adam K Saperstein","doi":"10.1093/milmed/usag173","DOIUrl":"10.1093/milmed/usag173","url":null,"abstract":"<p><p>In the following curated selection of thoughtfully distilled 55-word stories, military medical students from the Uniformed Services University Class of 2026 thoughtfully reflect on the intense and challenging patient care and professional experiences which comprise the \"hidden curriculum\" within their initial year of clinical clerkships.</p>","PeriodicalId":18638,"journal":{"name":"Military Medicine","volume":" ","pages":"151-153"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}