MSMR最新文献 - Book学术

Health outcomes of U.S. active component service members working in high risk occupations for blast overpressure exposure: a retrospective cohort study. 美国现役军人在爆炸超压暴露高风险职业工作的健康结果：一项回顾性队列研究

MSMR Pub Date : 2026-09-20

Jordan E Gildehaus, Carlie N Skellington, Symone M Baker Miller, Chiping Nieh, Shauna L Stahlman

{"title":"Health outcomes of U.S. active component service members working in high risk occupations for blast overpressure exposure: a retrospective cohort study.","authors":"Jordan E Gildehaus, Carlie N Skellington, Symone M Baker Miller, Chiping Nieh, Shauna L Stahlman","doi":"","DOIUrl":"","url":null,"abstract":"Active component military service members are exposed to increased risk of occupational blast overpressure (BOP) exposure during deployment as well as training. This retrospective cohort study examined the incidence of first-time diagnoses of traumatic brain injury (TBI), insomnia, migraine headache, depressive or anxiety disorders, noise-induced hearing injury (NIHI), and essential hypertension among active component service members (ACSMs) in the U.S. Army, Air Force, and Marine Corps. Incidence rates (IRs) were compared between ACSMs who served in occupations at high risk for BOP exposure (n=831,050) and those who never served in such occupations (n=2,229,594). Overall incidence of TBI was 243.8 per 10,000 person-years in the high-risk occupational cohort and 140.9 per 10,000 person-years in the low-risk occupational cohort. Incidence of NIHI was 342.7 and 218.1 per 10,000 person-years in the high- and low-risk cohorts, respectively. After adjusting for demographic and military characteristics, ACSMs in occupations with high risk of BOP experienced higher IRs of TBI (adjusted IR ratio [aIRR] 1.43; 95% CI 1.42, 1.44) and NIHI (aIRR 1.39; 95% CI 1.38, 1.40). Increasing time since entering the cohort was associated with a greater increase in migraine headache incidence among ACSMs in high-risk BOP occupations compared with those in low-risk occupations. Despite these differences, the distribution of disease burden categories from 2024 health care encounters was similar among cohorts. These findings emphasize the importance of mitigating occupational blast hazards and strengthening surveillance efforts to protect the long-term health of ACSMs. Adjusted IRs of TBI and NIHI were higher among service members in occupations at high risk for BOP exposure than among those who had never worked in such occupations. Increasing time in the cohort was associated with a greater increase in migraine headache incidence among service members in high-risk BOP occupations than among those in low-risk occupations.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 9","pages":"3-11"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relevance and comparability of global laboratory molecular detection of influenza by the U.S. Department of War, 2025-2026. 美国陆军部2025-2026年全球流感实验室分子检测的相关性和可比性

MSMR Pub Date : 2026-09-20

Dara A Russell, Marissa K Hetrich, Kathleen E Creppage, M Shayne Gallaway

引用次数: 0

A standardized approach to non-infectious disease cluster investigations in the U.S. Department of the Air Force. 美国空军非传染性疾病聚集性调查的标准化方法。

MSMR Pub Date : 2026-09-20

Amber Britt, Keith Beam, Sarah M Fryman-Wynkoop, Gregory G Wolff

{"title":"A standardized approach to non-infectious disease cluster investigations in the U.S. Department of the Air Force.","authors":"Amber Britt, Keith Beam, Sarah M Fryman-Wynkoop, Gregory G Wolff","doi":"","DOIUrl":"","url":null,"abstract":"The U.S. Air Force School of Aerospace Medicine (USAFSAM) developed a systematic, multi-phased process for receiving, evaluating, and responding to inquiries about potential non-infectious disease clusters, particularly cancer, within the Department of the Air Force. Created in response to a rise in cluster concerns, this process provides a validated, transparent, and objective evaluation framework with 4 distinct phases: 1) establishing lines of communication, 2) feasibility assessment, 3) epidemiological evaluation, and 4) epidemiological investigation. This framework allows a merit-based evaluation for determining if a full epidemiological study is warranted. The framework emphasizes robust risk communication and partnerships to manage expectations and address all concerns with scientific rigor. In 2023 and 2024 this process evinced savings of $6.25 million and 102 months of person-time for the USAFSAM team, ensuring responsible use of public health resources. The process enables a timely, evidence-based response to potential health threats. It ensures public health resources are used responsibly, for scientifically valid investigations, and builds trust within the Air Force community to directly support the health, fitness, and readiness of U.S. Air Force service members.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 9","pages":"12-16"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A new era of research in the U.S. Department of War Serum Repository: a review of published studies, 2013-2024. 美国战争部血清库研究的新时代：2013-2024年发表的研究综述。

MSMR Pub Date : 2026-09-20

Sithembile L Mabila, Scott J Russell, Adewumi Adegboye, Shauna L Stahlman

{"title":"A new era of research in the U.S. Department of War Serum Repository: a review of published studies, 2013-2024.","authors":"Sithembile L Mabila, Scott J Russell, Adewumi Adegboye, Shauna L Stahlman","doi":"","DOIUrl":"","url":null,"abstract":"The Department of War Serum Repository (DOWSR, formerly DODSR1) was established in 1989 after the initiation in 1985 of the U.S. Department of War's universal mandatory human immunodeficiency virus (HIV) screening program. DOWSR, which is currently maintained by the Armed Forces Health Surveillance Division (AFHSD), preserves over 78 million serum specimens. Similar to a study that investigated research conducted from 1985 through 2012 utilizing the serum repository, this study evaluated DOWSR specimen availability, stratified by demographic variables, and conducted an analysis to determine total number and types of research studies performed using the DOWSR from 2013 through 2024. Two methods were employed: a structured PubMed search and an exhaustive online search based on records of requests for serum samples from AFHSD. Results show that the focus of DOWSR's research within the past decade has increased, especially in regulatory molecules, autoimmune indicators, and microRNA expression patterns, with increases in both the number of sponsored studies and variety of analytes investigated. Changes in the types of studies pursued by DOWSR research may reflect changing trends in funded research regarding health concerns for service members and veterans. This review identified 112 published and 21 non-published studies that used DOWSR sera during the study period. Of the published 112 studies, 30 investigated infectious diseases, 25 investigated autoimmune disorders, 13 investigated neoplasms, and 11 investigated chronic metabolic outcomes. More studies using DOWSR specimens were published on environmental exposures and autoimmune disorders compared to prior years.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 9","pages":"17-29"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic insomnia and military separation: a retrospective matched cohort and nested case-control study of U.S. active component service members, 2014-2023. 慢性失眠与军人分离：2014-2023年美国现役军人回顾性匹配队列和巢式病例对照研究

MSMR Pub Date : 2026-08-20

Zachary J Rupert, Shauna L Stahlman, Michael T Fan, Symone M Baker Miller, Nicole M Hsu

{"title":"Chronic insomnia and military separation: a retrospective matched cohort and nested case-control study of U.S. active component service members, 2014-2023.","authors":"Zachary J Rupert, Shauna L Stahlman, Michael T Fan, Symone M Baker Miller, Nicole M Hsu","doi":"","DOIUrl":"","url":null,"abstract":"This study characterized chronic insomnia disorder, utilizing data from the Defense Medical Surveillance System, to identify incident cases among U.S. active component service members from 2014 through 2023. A total of 126,733 service members met the case definition and were matched 1-to-1 with service members without chronic insomnia by sex, age, and time in service. Chronic insomnia was associated with increased probability of early separation from military service and frequently co-occurred with conditions that limit military readiness. Kaplan-Meier analysis showed diverging retention curves approximately 20 months following diagnosis, after which chronic insomnia cases had lower probability of continued active component service. A nested case-control analysis of 55,679 individuals with chronic insomnia found that early separation was associated with service branch, age, sex, race and ethnicity, marital status, rank, occupation, co-occurring diagnoses, and behavioral therapy or pharmacotherapy within 365 days of diagnosis. Behavioral therapy or pharmacotherapy within 365 days of diagnosis was more common among those who separated early. Continued attention to case surveillance, early identification, and timely evidence-based treatment may help mitigate the impacts of insomnia on service outcomes. Service members with chronic insomnia face increased risk of early separation from service in the military. Early separation was more common among service members who had received behavioral therapy or pharmacotherapy within the first year after diagnosis. A high burden of co-occurring conditions was identified, including behavioral health disorders, traumatic brain injury, and chronic pain.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 8","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnoses of mental health disorders among U.S. active component service members, 2021-2025. 美国现役军人精神健康障碍诊断，2021-2025。

MSMR Pub Date : 2026-08-20

{"title":"Diagnoses of mental health disorders among U.S. active component service members, 2021-2025.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"Safeguarding the mental well-being of military service members is a critical strategic imperative for force readiness. This report summarizes the incidence of mental health disorders among U.S. active component service members (ACSMs) from January 1, 2021 through December 31, 2025. During the surveillance period, 582,279 ACSMs received at least 1 mental health diagnosis, and 1,050,231 total incident diagnoses were made. Overall incidence rates peaked in 2023 before declining slightly, through 2025. Adjustment, anxiety, and depressive disorders comprise the clinical burden majority of mental health care, accounting for 66.5% of all incident diagnoses. Diagnostic comorbidity was notably high, with 48.4% of affected ACSMs receiving diagnoses in multiple mental health categories. Female ACSMs generally experienced higher rates for most mental health conditions, while male ACSMs had higher incidence rates for alcohol- and substance-related disorders. Vulnerabilities related to occupation are prominent: Health care personnel evinced highest rates for most disorders, while combat-related functions were most closely associated with substance-related conditions. These findings underscore the ongoing need to prioritize access to mental health services for ACSMs. The high volume of co-occurring diagnoses and distinct occupational risks require robust, multi-disciplinary clinical resources to sustain a resilient and ready joint force. From 2021 through 2025, over 1 million incident mental health diagnoses for U.S. active component service members occurred, with most of that health care burden a result of disorders related to adjustment, anxiety, and depression. Notably, those three disorder categories accounted for approximately two-thirds (66.5%) of all incident mental health diagnoses during the surveillance period.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 8","pages":"3-14"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in postpartum depression and anxiety diagnoses among U.S. active component service women, 2010-2024. 2010-2024年美国现役妇女产后抑郁和焦虑诊断趋势

MSMR Pub Date : 2026-08-20

Bradley S McNeal, Shauna L Stahlman, Saixia Ying, Symone M Baker Miller

{"title":"Trends in postpartum depression and anxiety diagnoses among U.S. active component service women, 2010-2024.","authors":"Bradley S McNeal, Shauna L Stahlman, Saixia Ying, Symone M Baker Miller","doi":"","DOIUrl":"","url":null,"abstract":"This retrospective cohort study evaluated trends in postpartum depression (PPD) and postpartum anxiety (PPA) diagnoses among 138,588 active component service women with live births (2010-2024). Period prevalence of PPD/PPA remained relatively constant from 2010 to 2017 (2.4%) and began increasing in 2018, with a peak in 2022 (13.4%). Multivariable logistic regression (2021-2024) demonstrated a statistically significant decrease in adjusted odds of PPD/PPA diagnosis in 2023-2024 (adjusted odds ratio 0.89), following the pandemic peak. The most significant risk factors for PPD/PPA diagnosis were prior mental health history, service in the Navy, and cesarean delivery. The 15-year increase in diagnostic prevalence may reflect improved administrative documentation and reduced stigma associated with seeking care. Conversely, the post-2022 decline may reflect post-pandemic stabilization and mitigating effects of expanded parental leave. Current PPD/PPA prevalence remains higher than pre-pandemic proportions, however. Prior mental health diagnosis remains the critical predictor, identifying a key population requiring targeted support to enhance military readiness. Period prevalence of PPD/PPA peaked in 2022 before declining in 2023 and 2024, while remaining higher than pre-pandemic levels. Service in the Navy, prior mood disorders, and cesarean delivery correlated with increased diagnostic odds, while Air Force and Space Force service, as well as officer status, were associated with reduced odds compared to Army and enlisted personnel.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 8","pages":"15-22"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mid-season influenza virus genetic characterizations in U.S. Department of War populations, 2025-2026. 2025-2026年美国陆军部人群的季中流感病毒遗传特征

MSMR Pub Date : 2026-08-20

William E Gruner, Deanna Muehleman, Vivian S Hogan, Daniel F Ewing, Appavu K Sundaram, Anthony C Fries

{"title":"Mid-season influenza virus genetic characterizations in U.S. Department of War populations, 2025-2026.","authors":"William E Gruner, Deanna Muehleman, Vivian S Hogan, Daniel F Ewing, Appavu K Sundaram, Anthony C Fries","doi":"","DOIUrl":"","url":null,"abstract":"Continuous monitoring of influenza antigenic drift is vital for vaccine strain selection. This study utilized global Department of War (DOW) surveillance data to evaluate circulating influenza strains and inform the 2026-2027 Northern Hemisphere influenza vaccine recommendations by the World Health Organization. From September 2025 through February 2026, the Department of Defense Global Respiratory Pathogen Surveillance Program collected and analyzed respiratory specimens from over 100 sentinel sites globally. Influenza-positive samples underwent next-generation sequencing, phylogenetic analysis, and antigenic characterization. Analysis of 1,300 sequences revealed A(H3N2) as the predominant (80.1%) subtype, followed by A(H1N1)pdm09 (10.6%) and B/Victoria (9.3%), with variations between combatant commands. Significant antigenic drift led to the dominance of subclades K, D.3.1/D.3.1.1, and C.3.1, respectively. Testing indicated that the 2025-2026 vaccine components offered reduced protection against these emerging strains. Antigenic cartography confirms that the 2026-2027 vaccine strains provide significantly improved protection against circulating viruses. Antiviral resistance markers for neuraminidase inhibitors such as oseltamivir remain rare, with only 2 identified in A(H1N1)pdm09. These data are critical for maintaining force health protection and assessing vaccine performance within highly mobile DOW populations. Analysis of 2025-2026 influenza season data revealed the predominance of subclades A(H1N1)pdm09 D.3.1/D.3.1.1, A(H3N2) K, and B/Victoria C.3.1. Antigenic cartography employing recent candidate vaccine viruses from the U.S. Centers for Disease Control and Prevention confirmed that the World Health Organization's strain recommendations for the 2026-2027 Northern Hemisphere influenza vaccine provide the best protection against these circulating strains.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 8","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Telehealth services among active component members of the U.S. Armed Forces, 2021-2025. 美国武装部队现役成员之间的远程医疗服务，2021-2025。

MSMR Pub Date : 2026-07-31

Adewumi Adegboye, Sithembile L Mabila

引用次数: 0

Malaria among members of the U.S. Armed Forces, 2025. 美国武装部队成员的疟疾，2025年。

MSMR Pub Date : 2026-05-20

{"title":"Malaria among members of the U.S. Armed Forces, 2025.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"Malaria infection remains a potential health threat to U.S. service members located in or near endemic areas due to duty assignments, participation in contingency operations, or personal travel. This report summarizes findings from surveillance of malaria infections among U.S. service members in 2025 and analyzes trends for a 10-year period, from 2016 through 2025. In 2025, 36 cases of malaria were diagnosed among U.S. service members, representing a 12.5% increase from 32 cases reported in 2024. The majority of malaria cases occurred in service members who were male (94.4%), in the active component (80.6%), and serving in the Army (63.9%). Africa was the leading region of acquisition (n=14), primarily for P. falciparum infections. A significant 2025 finding is a shift in the predominant species to P. vivax, which accounted for 41.7% (n=15) of all cases, a notable increase from 10% of all cases in 2024. Most P. vivax cases (80.0%) were acquired in Korea. Seasonality of infection remained consistent, with 72.1% of cases diagnosed May through October. These findings underscore the critical need for continuous surveillance, strict command emphasis on personal protective measures, and region-specific prevention strategies to protect the health of the force and maintain military readiness. The rise of P. vivax from Korea along with persistent P. falciparum infection from Africa not only directly affect force health protection but demonstrate a dynamic, regionally specific threat that requires specialized prevention strategies to maintain military readiness.","PeriodicalId":38856,"journal":{"name":"MSMR","volume":"33 5","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0