Wilderness & Environmental Medicine最新文献

{"title":"Trail Running Safety: A Review of Serious Adverse Events Reported in Online News Articles.","authors":"Carel Viljoen, Monique da Cruz, Kgame Matlala, Megan Groves, Kaylin du Toit, Loria Fourie, Bruno Silva, Volker Scheer, Candice MacMillan, Dina C Janse van Rensburg","doi":"10.1177/10806032251338703","DOIUrl":"10.1177/10806032251338703","url":null,"abstract":"<p><p>Trail running is an endurance sport that entails running outdoors on natural terrain. Scientific literature provides minimal information on serious adverse events that occur during trail running. The objectives of this review were to identify and summarize the available information published in online worldwide news articles and to categorize the results in fatal, missing, and catastrophic events in trail running. Over a 14-wk period, online news articles were searched using Google Advanced Search and DuckDuckGo for reports on serious adverse events during trail running. Data were extracted and summarized from online news articles that met the inclusion criteria. Ninety-four online news articles reported on 127 runners involved in serious adverse events during trail running. Among the serious adverse events reported in this review, 82% (n = 104) were fatal trail running events; 29% (n = 37) were related to missing events, of which 54% (n = 20) of the missing events resulted in death; and 6% (n = 6) were catastrophic injuries. Most runners were males (73%) aged 16 to 75 y (41.5 ± 12.6 y). The most common intrinsic causes of death were cardiac arrest (58%) and collapse (38%), whereas the most common extrinsic causes of death were cold weather resulting in potential hypothermia (40%) and blunt trauma following falling/slipping (25%). Almost half the runners who went missing (41%) were found. The 6 runners involved in catastrophic events (6%) suffered severe burn wounds, brain damage, and frostbite. Serious adverse events in trail running seem to be rare. This review reports multiple serious adverse events during trail running. Although these events are rare, they highlight the need for further research and improved reporting. These findings can assist in developing future prevention strategies for trail running events and guide medical staff during race-day medical planning.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"416-433"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081545","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":"Extensor Mechanism Disruption with Multiligamentous Knee Injury from Bouldering.","authors":"Vivek M Abraham, Grant Cochran, Charles J Osier","doi":"10.1177/10806032251325571","DOIUrl":"10.1177/10806032251325571","url":null,"abstract":"<p><p>Extensor mechanism injuries and multiligamentous knee injuries are rare and typically are caused by high-energy injury mechanisms. We present a case of an active-duty military service member who sustained a patellar tendon rupture with concomitant multiligamentous knee injury due to a fall while bouldering. This case report is the first to highlight this significant injury due to bouldering, in addition to the surgical steps taken to get the patient fit for full military duty. These injuries often go undiagnosed and are incredibly important to recognize given the importance of prompt evaluation and ultimate surgical care in these scenarios.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"368-372"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674792","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 Radiology: Emerging Nonsonographic Medical Imaging Techniques and the Potential Applications for Human Spaceflight.","authors":"Michael Pohlen","doi":"10.1177/10806032241283380","DOIUrl":"10.1177/10806032241283380","url":null,"abstract":"<p><p>Space medicine is a multidisciplinary field that requires the integration of medical imaging techniques and expertise in diagnosing and treating a wide range of acute and chronic conditions to maintain astronaut health. Medical imaging within this domain has been viewed historically through the lens of inflight point-of-care ultrasound and predominantly research uses of cross-sectional imaging before and after flight. However, space radiology, a subfield defined here as the applications of imaging before, during, and after spaceflight, will grow to necessitate the involvement of more advanced imaging techniques and subspecialist expertise as missions increase in length and complexity. While the performance of imaging in spaceflight is limited by equipment mass and volume, power supply, radiation exposure, communication delays, and personnel training, recent developments in nonsonographic modalities have opened the door to their potential for in-mission use. Additionally, improved exam protocols and scanner technology in combination with artificial intelligence algorithms have greatly advanced the utility of possible pre- and postflight studies. This article reviews the past and present of space radiology and discusses possible use cases, knowledge gaps, and future research directions for radiography, fluoroscopy, computed tomography, and magnetic resonance imaging within space medicine, including both the performance of new exam types for new indications and the increased extraction of information from exams already routinely obtained. Through thoughtfully augmenting the use of these tools, medical mission risk may be reduced substantially through preflight screening, inflight diagnosis and management, and inflight and postflight surveillance.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"113S-122S"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367182","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":"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":"61S-76S"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","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":"Edward F. Adolph, PhD: A Preeminent Physiologist Who Studied Human Exposure to Desert Heat.","authors":"Brad L Bennett, Tony Islas","doi":"10.1177/10806032251337474","DOIUrl":"10.1177/10806032251337474","url":null,"abstract":"<p><p>During combat with German Nazis in the deserts of North Africa, it became imperative for the United States Army to research to ascertain the physiological limits of military ground troops subjected to extreme desert heat exposure. In the 1940s, Edward F. Adolph, PhD, from the University of Rochester School of Medicine & Dentistry (URSMD), was funded through a contract with the government to initiate research on human tolerance to the extremes of desert heat. Consequently, Adolph and his associates established the university's Desert Research Unit in the California desert. In the 1930s, a team from Harvard University's Fatigue Laboratory established the \"Harvard Desert Expedition\" for field research in the Nevada desert. Notably, both Harvard and Rochester research teams investigated human metabolic responses in desert heat, with Dr Adolph participating in both desert locations. These field studies were conducted during Adolph's time as a faculty member in the Department of Physiology at the URSMD, which spanned over 62 years. Adolph's research interests encompassed investigations into the physiological responses of humans in desert environments, including regulation of water and heat metabolism, sweat formation, dehydration, thirst, physiological adaptations to extreme heat, and survival without water. Adolph authored or co-authored a substantial body of work, including 155 articles and 4 books, culminating in the seminal text <i>Physiology of Man in the Desert</i> (1947). We aim to provide some pertinent lessons learned and practical applications derived from the research conducted by Adolph and his associates in the desert.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"434-444"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062938","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":"Predicting Exploration Crew Medical Officer Training Needs: Applying Evidence-Based Predictive Analytics to Space Medicine Training.","authors":"Dana R Levin, Lauren McIntyre, Jon G Steller, Ariana Nelson, Chris Zahner, Arian Anderson, Prashant Parmar, David C Hilmers","doi":"10.1177/10806032241292535","DOIUrl":"10.1177/10806032241292535","url":null,"abstract":"<p><p>IntroductionPredictive analytics may be a useful adjunct to identify training needs for exploration class medical officers onboard deep space vehicles.MethodsThis study used a preliminary version of NASA's newest medical predictive analytics tool, the Medical Extensible Database Probabilistic Risk Assessment Tool (MEDPRAT), to test the application of predictive analytics to exploration crew medical officer curriculum design for 5 distinct design reference mission (DRM) profiles. Partial and fully treated paradigms were explored. Curriculum elements were identified using a leave-one-out analysis and a threshold of 5% risk increase over the fully treated baseline.ResultsFor the partial treatment scenario, among the 5 DRM profiles 4-32 curriculum elements met the 5% RRI increase. For the absolute treatment scenario, among the 5 DRM profiles, 13-126 curriculum elements met the 5% RRI increase. For the partial treatment paradigm, 13 capabilities are present in at least 3 of the 5 DRM profiles, and these elements may constitute a common baseline curriculum. This covers 41% of the skillsets needed for an ISS-like profile, 100% of a late Artemis-like profile, 41% of a Mars mission-like profile, 100% of a Starship orbital-like profile, and 68% of a Starship lunar flyby-like profile.ConclusionsThis proof-of-concept study demonstrated that predictive analytics can rapidly generate generic and mission profile-specific exploration CMO curricula using an evidence-based process driven by optimizing mission risk reduction. This technique may serve as part of a human-machine team approach to medical curriculum planning for future space missions. It has significant potential to improve astronaut health and save time and effort for planners, trainers, and trainees.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"7S-23S"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802719","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":"Acceptance of Risk and Confidence Assessing Avalanche Terrain and Conditions: A Large Cross-Sectional Study.","authors":"Cameron C Shonnard, Rondo J Bauer, Lingchen Wang, David C Fiore","doi":"10.1177/10806032251368754","DOIUrl":"https://doi.org/10.1177/10806032251368754","url":null,"abstract":"<p><p>IntroductionThe COVID-19 pandemic affected the ski industry globally, including limiting access to ski resorts and prompting more skiers and snowboarders to explore the backcountry. In this study, we quantified the willingness to take risks (risk propensity) and self-perceived ability to assess hazards in the backcountry and to explore correlations between these factors.MethodsWe based our study on a previously reported data set gathered under the supervision of our senior author, who collected anonymous responses to a 29-question online survey completed by 4792 self-identified backcountry skiers and snowboarders (aged ≥18 yr) in the United States and Canada. The survey was distributed primarily through regional avalanche centers, education providers, and skiing organizations. Pearson correlation coefficients and multivariable linear regression models were used to analyze associations among variables. More specifically, we examined the relationships among confidence in assessing avalanche terrain and willingness to take risks, level of avalanche training, years of experience, and days per season of backcountry skiing.ResultsWe identified a positive correlation between confidence in assessing avalanche terrain and willingness to take risks, level of avalanche training, years of experience, and days per season of backcountry skiing. Female respondents demonstrated lower risk willingness and self-reported ability to assess avalanche risk compared to males. Over 30% of individuals lacking level 1 avalanche training expressed confidence in appraising complex terrain. Our findings demonstrated a positive correlation between greater risk propensity, formal avalanche education, and increasing confidence in assessing avalanche terrain. However, we also observed concerningly high confidence levels among skiers with minimal or no training.ConclusionsAvalanche education should focus on aligning skiers' confidence with their actual abilities to reduce overconfidence and enhance safety. We recommend that future research aim to include a more diverse sample, especially those less engaged in formal avalanche education.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"10806032251368754"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976366","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":"Evaluating Risk for Astronaut Involvement in In-Space Manufacturing: Analog Field Testing and Future Planetary Surface Procedures.","authors":"Madelyn MacRobbie, Palak B Patel","doi":"10.1177/10806032251322091","DOIUrl":"10.1177/10806032251322091","url":null,"abstract":"<p><p>IntroductionA key objective of the NASA Artemis program is to establish a sustained human presence on the Moon, along with its international and commercial partners. NASA aims to establish a lunar economy, increasing the need for infrastructure to support human habitation and facilitate growth. In-space manufacturing (ISM) coupled with in situ resource utilization (ISRU) can reduce launch mass and reduce the dependency on Earth resupply for long-term habitation, enabling rapid expansion. However, the space environment introduces unique challenges compared to Earth, such as the absence of an atmosphere, reduced gravity levels, and high consequences of human-machine interactions given the barrier to evacuating an astronaut injured in a manufacturing accident on the Moon, necessitating new safety standards for ISM processes.MethodsThis study proposes the application of a modified analytical hierarchy process (AHP) to identify high-risk aspects of crew procedures in molten regolith electrolysis (MRE) for both Earth-based analog testing and lunar production.ResultsThe modified AHP assists in pinpointing areas needing hazard mitigation to protect crew members, enabling the improvement of safety standards for MRE in both environments.ConclusionFindings will inform the development of robust safety protocols for ISM, crucial for the success of NASA's Artemis missions and the broader goal of sustained human presence on the Moon and Mars.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"34S-43S"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744181","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":"<i>Thevetia peruviana</i> or Yellow Oleander (Apocynaceae) Poisoning with Myocardial Bridging: An Autopsy-Based Case Report.","authors":"Arushi Verma, Vikas Vaibhav, Raviprakash Meshram, Ashish Bhute, Dilip Vaishnav, Ravi H Phulware","doi":"10.1177/10806032251320372","DOIUrl":"10.1177/10806032251320372","url":null,"abstract":"<p><p>Autopsy surgeons routinely encounter cases involving alleged use of poison. Many of these cases are due to poisonous plant species that grow wildly in different regions of the world and are readily accessible to the general population. <i>Thevetia peruviana</i> (syn. <i>Cascabela thevetia</i>) is a cardiotoxic evergreen shrub that is native to Latin America and has been introduced horticulturally to other global tropical and subtropical regions with subsequent establishment among the native flora. The cardiac glycosides found in the plant have digoxin-like effects. A 50-y-old male with an alleged history of accidental ingestion of <i>T peruviana</i> was brought for autopsy to the mortuary at the Department of Forensic Medicine and Toxicology. This case report highlights the postmortem findings in a case of <i>T peruviana</i> poisoning. It provides valuable insights for autopsy surgeons, ensuring their preparedness when confronted with similar cases.</p>","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"378-383"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626605","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":"Robert B Schoene, William D Binder","doi":"10.1177/10806032251349090","DOIUrl":"10.1177/10806032251349090","url":null,"abstract":"","PeriodicalId":49360,"journal":{"name":"Wilderness & Environmental Medicine","volume":" ","pages":"299-300"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","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}