Wilderness & Environmental Medicine最新文献

{"title":"Mosquito-Borne Infections in International Travelers.","authors":"Robert J Rolfe, Sofia Zavala, Elizabeth R Blackwood, Regina C LaRocque, Edward T Ryan","doi":"10.1177/10806032251356485","DOIUrl":"https://doi.org/10.1177/10806032251356485","url":null,"abstract":"<p><p>Mosquito-borne infections are a common cause of illness among returning travelers. Frontline healthcare providers should maintain a high degree of suspicion for these infections when evaluating ill returning travelers. This narrative review provides an overview of the most common mosquito-borne infections in travelers. We conducted a search of the medical literature for updates in the past 5 y. We reviewed resources of the US Centers for Disease Control (Yellow Book, Advisory Committee on Immunization Practices), and US Food and Drug Administration. Arboviral infections and malaria are the most frequently diagnosed mosquito-borne infections in returning travelers. Among the mosquito-borne arboviral infections, chikungunya, yellow fever, and Japanese encephalitis are all vaccine preventable. Dengue fever, although the most common arboviral infection worldwide, does not yet have a vaccine approved for use in US travelers. The incidence of Zika virus infection has decreased substantially in recent years, including a reduced frequency of infections reported in travelers. The risk of mosquito-borne illnesses can be reduced by behavioral changes and use of insect repellent, screens, netting, and insecticide-impregnated clothing. Malaria can be further prevented through the appropriate use of chemoprophylaxis.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251356485"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676332","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":"A Case of Limb Swelling and Gum Bleeding from Rural Nepal.","authors":"Arbin Dev Sapkota, Bibhuti Kc, Samata Nepal, Lokaratna Gyawali, Alok Atreya","doi":"10.1177/10806032251356486","DOIUrl":"https://doi.org/10.1177/10806032251356486","url":null,"abstract":"","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251356486"},"PeriodicalIF":1.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676331","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":"Restructuring Riley's Historic 3-Compartment Lung Model for Evaluation of Pulmonary Gas Exchange.","authors":"Jack A Loeppky, Marcos F Vidal Melo","doi":"10.1177/10806032251350582","DOIUrl":"https://doi.org/10.1177/10806032251350582","url":null,"abstract":"<p><p>In 1951, Riley's classic 3-compartment model of gas exchange estimated pulmonary shunt, alveolar dead space, and an effective compartment representing the functioning lung. But trial-and-error steps and conversion charts made its application impractical. We implemented estimates of alveolar and effective PCO₂ to simplify computations, making it useful when more advanced technologies are unavailable. Using stepwise computations, we studied 10 healthy individuals and 43 outpatients with mild to severe chronic obstructive pulmonary disease and, in another study, 32 healthy subjects during 12 h of hypobaric hypoxia at 426 mm Hg (ALT). The \"effective\" PaCO₂ due to pulmonary shunt and Haldane effect when breathing increased O₂ was calculated via the CO₂ dissociation curve. The model was applied while breathing air and 25% O₂ to simulate sea level in outpatients at 1620 m. Pulmonary shunt rose significantly with increasing hypoxemia (<i>P</i><0.001), whereas alveolar dead space remained high. Breathing 25% O₂ reduced the shunt (<i>P</i><0.001) by elevating systemic PO₂. The effective compartment in healthy subjects was 0.87, but only 0.41 in patients with severe hypoxemia, increasing to 0.45 on 25% O₂ (<i>P</i>=0.031). In ALT, a scoring system demonstrated that 16 subjects experienced acute mountain sickness (AMS) after 1 h with a significant increase in pulmonary shunt compared with 16 subjects without AMS. The model shows that hypoxemia in patients is associated with perfusion redistribution from high to low V/Q regions, consistent with reports using more sophisticated techniques. Subjects susceptible to AMS also increased shunt, suggesting autonomic instability.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251350582"},"PeriodicalIF":1.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660825","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":"Space Oncology: A Comprehensive Scoping Review.","authors":"Nafise Niknam, Hossein Akbarialiabad, Mohsen Farjoud Kouhanjani, Lydia Johnson Kolaparambil Varghese, Amy Berrington de González, Matthew Mark Melin, Mohammad Shafie'ei, Seyedeh Maryam Mousavi, Seyed Ali Hosseini, Seyed Reza Taha, Thais Russomano, Dedee F Murrell, Ayman Grada, Sancy A Leachman, Zahra Akbari, Armita Jokar Derisi, Marta Jurga, Ajay Kumar, Saswati Das, Jessica D'Urbano, Gabriella Hakim, Najmeh Sadeghian, Shahram Paydar, Michelle Tarbox, Cameron West, Seyyed Mojtaba Ghorashi, Seyed Hossein Hosseini, Timothy Squire, Christopher G Bunick, Rowena Christiansen","doi":"10.1177/10806032251349442","DOIUrl":"https://doi.org/10.1177/10806032251349442","url":null,"abstract":"<p><p>Space exploration exposes astronauts to unique conditions such as microgravity and space radiation, potentially influencing gene expression and triggering carcinogenesis. Paradoxically, these extreme environments could uncover other pro-treatment aspects of cancer biology. Despite numerous reviews addressing these aspects in isolation, a comprehensive synthesis of the effects of space stressors on cancer development is incomplete. This scoping review aims to provide a holistic perspective on the influence of spaceflight and associated stressors-including gravitation (hyper- and microgravity), radiation, and vibration-on the potential for cancer development and altered cellular mechanisms. We adhered to the PRISMA-ScR checklist for our review. A multitiered search strategy was employed in English, starting with a preliminary keyword identification in Google Scholar and PubMed. Subsequently, the main search was conducted across five databases-Cochrane, Embase, PubMed, Scopus, and Web of Science-until 22 February 2024. All included studies were thoroughly assessed by two independent reviewers. Of the 15,553 identified articles, 158 were deemed eligible. The majority (92%) were experimental studies, predominantly cell-based (74.17%). Breast (15.19%), thyroid (13.92%), and hematopoietic (11.40%) cancers were the most frequently examined. Spaceflight stressors could affect different biological systems variably, with microgravity impacting spatial growth and metastasis, and cosmic radiation exerting both tumor-suppressive and mutagenic effects. Our findings highlight the need for large-scale, prolonged analog studies mimicking space conditions to enhance mission safety and shed light on the nuanced effects of space stressors on cancer. Additionally, further extensive studies need to be performed in the true weightlessness of spaceflight, both animal-based and on human tissue (cell cultures and potentially whole perfusion organ models), in addition to crew pre/intra/post-flight long-duration evaluations. Furthermore, this unique research avenue may reveal cancer cell sensitivities to these stressors, opening new pathways for innovative therapeutic strategies in cancer treatment.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251349442"},"PeriodicalIF":1.4,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627544","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":"Qualitative Assessment of Terrestrial Care Settings to Inform Self-sufficient Spaceflight Medical Care.","authors":"Allison Porter, Katya Arquilla, Aleksandra Stankovic","doi":"10.1177/10806032251351589","DOIUrl":"https://doi.org/10.1177/10806032251351589","url":null,"abstract":"<p><p>IntroductionLong communication latencies in exploration spaceflight will necessitate in situ resolution to medical problems. Integrating automation into the care paradigm can address challenges posed by resource gaps inherent to spaceflight operations. However, it is not clear what aspects of exploration care are most well suited for automation integration.MethodsTo probe the potential role of automation in spaceflight medicine, we began by decomposing the human-automation system to first characterize the work domain(s) of the human tasks. Using the lens of point-of-care ultrasound, we leveraged existing analogous Earth medical domains to conduct in situ observations in a hospital emergency department to understand how clinicians process contextual information to provide urgent care using ultrasound and semistructured interviews with specialists to identify key procedural information components for automation.ResultsThis investigation allowed us to characterize the dynamic system surrounding a task that does not exist in its intended-currently inaccessible-use case (ie, point-of-care ultrasound on Mars) to guide future human-automation systems development.ConclusionWe conclude that specific aspects of the care environment that influence the result of a task or process (\"mediating factors\") from candidate work domains call for distinct, targeted guidance for automation support and are valuable in providing system developers with tunable automation level and implementation guidelines within and/or between those work domains. Such evidence-based design practice is directly translatable to automation assistance for medical providers in resource-limited environments as well as to any situation where a person's sensory processing, perception, decision making, or response selection could be aided by automation to accomplish a task.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251351589"},"PeriodicalIF":1.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610160","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":"Epidemiology of Electronic Mountain Biking Injuries: An Unexplored Emerging Extreme Sport.","authors":"Gemma Ruddick, Larissa Trease, Sue Pearson","doi":"10.1177/10806032251356489","DOIUrl":"https://doi.org/10.1177/10806032251356489","url":null,"abstract":"<p><p>IntroductionMountain biking is a fast-growing recreational activity. Electronic mountain bikes (EMTBs) are becoming more common and can attract a different demographic to traditional mountain bikes. The difference in bike design could lead to a differing injury profile. This study examined acute EMTB injuries, an unstudied area.MethodsA voluntary online survey collected data on EMTB injuries sustained by riders in the Australian Capital Territory and New South Wales. Descriptive statistics were used to analyze injury events.ResultsOver the study period (November 2022-June 2023) 67 injuries were recorded across 46 injury events. The median age of participants was 49 y (range, 20-67 y), and respondents were predominantly male (males 63%, females 35%, other 2%). Common injuries were superficial skin injuries (42%), mainly to the limbs. The study recorded 7 fractures to the limbs and 7 to the head and trunk. Most injuries were sustained from collisions or obstacles (49%). Most occurred traveling downhill (63%) on blue graded single tracks (65%), and 22% injuries occurred whilst traveling uphill. Injury management were spread across self-managed (44%), Emergency Department care (31%) and other health providers (26%). In the 7-d period following the injury 59% of riders experienced moderate to severe pain, and 50% were unable to participate in MTB riding.ConclusionElectronic mountain biking participants have a similar injury profile to traditional mountain bikers, but their demographics may differ. More research is needed to determine whether there is increased representation of female and older riders in electronic mountain biking.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251356489"},"PeriodicalIF":1.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585408","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":"Methodologic Opportunities for Space Health Research: Integrating Biological Anthropology Methods in Human Research for Precision Space Health and Medical Data.","authors":"M S Sarma, A M Niclou, K J Hurd","doi":"10.1177/10806032251349436","DOIUrl":"https://doi.org/10.1177/10806032251349436","url":null,"abstract":"<p><p>As the field of health and medicine in space develops alongside the spaceflight research paradigm, there are methodologic opportunities to integrate data collection for research with providing precision and personalized healthcare. Specifically, existing field methods in biological anthropology developed and practiced in austere settings can be translated to spaceflight research and the development of healthcare infrastructure with implications for space medical practice. In our era of expanding spaceflight, data-collection methodologies should be flexible, agile, and accessible, paralleling innovative strategies by biological anthropology field researchers assessing human health, behavior, and well-being in austere terrestrial settings. Here we offer an introduction to the methodologic approaches and theoretical frameworks from biological anthropology, including operational insights from investigators working in the field, highlighting flexible mixed methods, low-tech solutions, dialectic engagement with participants, and iterative research protocols. These tools, when performed together with standardized approaches, can be beneficial and augment the advancement of spaceflight health and medicine.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251349436"},"PeriodicalIF":1.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576745","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":"West Ridge Forerunner: Thomas F. Hornbein and the Development of the Maytag Oxygen Mask for the 1963 American Mount Everest Expedition.","authors":"George W Rodway, Robert B Schoene","doi":"10.1177/10806032251351587","DOIUrl":"https://doi.org/10.1177/10806032251351587","url":null,"abstract":"<p><p>Those with an interest in the history of mountaineering are aware of the visionary achievement of the first ascent of the West Ridge of Everest-and first traverse of the mountain-by Tom Hornbein and Willi Unsoeld during the 1963 American Mount Everest expedition led by Norman Dyrunfurth. In many respects, this climb defined Hornbein (1930-2023) in the eyes of the international mountaineering community. One aspect of his career in high altitude mountaineering that also reflected his professional interests has received scant attention. This largely overlooked contribution was that of the design and development, in the years and months leading up to the American expedition to Everest, of a more capable and comfortable mask for use with an open-circuit supplemental oxygen system. The primary intent of this paper was to relate the story of what came to be known as the Maytag mask, but the authors also provide a brief backdrop to Hornbein's life and times to give perspective to his endeavors in the valleys as well as on the peaks.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251351587"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530688","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":"Embarking in the Backcountry: Traumatic Injuries Sustained in the Boundary Waters Canoe Area.","authors":"Anna Marie Rauzi, Melissa Harry, Kristin Colling","doi":"10.1177/10806032251351842","DOIUrl":"https://doi.org/10.1177/10806032251351842","url":null,"abstract":"<p><p>IntroductionThe Boundary Waters Canoe Area (BWCA) is a backcountry recreation area. This study aimed to characterize injuries sustained in the BWCA.MethodsA single reviewer completed a retrospective chart review of trauma admissions to Essentia Health from January 1, 2014 to February 25, 2023. Patients were included if their injury was documented to have occurred in the BWCA and they had not opted out of research.ResultsEighteen patients were found to have sustained injury in the BWCA. Most were adult males (78%), White (89%), and nonsmokers (94%). Most patients had no alcohol (83.3%) or drug (94.4%) use related to the injury. Seven patients self-extricated out to the BWCA, 6 were transported by ground Emergency Medical Services, and 5 required flight extrication. Median time from notification of injury to Emergency Medical Services arrival was 64 min. Time from notification of injury to hospital arrival was a median of 131 min. Falls were the main mechanism of injury (61%), followed by strike injury (22%) and water injury (17%). A few patients required lifesaving interventions (eg, prehospital intubations, needle thoracostomy, and blood transfusion). Twelve patients required a procedure (eg, <5 chest tubes and 10 surgeries). All 18 patients were alive at discharge.ConclusionThe most common injuries sustained in the BWCA were from falls, strikes, and water injuries. In collaboration with forest ranger stations, we plan to provide this information to backpackers to assist in their preparation for backcountry emergencies.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251351842"},"PeriodicalIF":1.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530687","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":"Wilderness.","authors":"","doi":"10.1177/10806032251349090","DOIUrl":"https://doi.org/10.1177/10806032251349090","url":null,"abstract":"","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251349090"},"PeriodicalIF":1.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509137","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}