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The military gear microbiome: risk factors surrounding the warfighter
ABSTRACT Combat extremity wounds are highly susceptible to contamination from surrounding environmental material. This bioburden could be partially transferred from materials in immediate proximity to the wound, including fragments of the uniform and gear. However, the assessment of the microbial bioburden present on military gear during operational conditions of deployment or training is relatively unexplored. Opportunistic pathogens that can survive on gear represent risk factors for infection following injury, especially following combat blasts, where fibers and other materials are embedded in wounded tissue. We utilized 16S rRNA sequencing to assess the microbiome composition of different military gear types (boot, trouser, coat, and canteen) from two operational environments (training in Hawai’i and deployed in Indonesia) across time (days 0 and 14). We found that microbiome diversity, stability, and composition were dependent on gear type, training location, and sampling timepoint. At day 14, species diversity was significantly higher in Hawai’i samples compared to Indonesia samples for boot, coat, and trouser swabs. In addition, we observed the presence of potential microbial risk factors, as opportunistic pathogenic species, such as Acinetobacter , Pseudomonas, and Staphylococcus , were found to be present in all sample types and in both study sites. These study outcomes will be used to guide the design of antimicrobial materials and uniforms and for infection control efforts following combat blasts and other injuries, thereby improving treatment guidance during military training and deployment. IMPORTANCE Combat extremity wounds are vulnerable to contamination from environments of proximity to the warfighter, leading to potential detrimental outcomes such as infection and delayed wound healing. Therefore, microbial surveillance of such environments is necessary to aid the advancement of military safety and preparedness through clinical diagnostics, treatment protocols, and uniform material design.
Predicting Postoperative Injury and Military Discharge Status After Knee Surgery in the US Army
Background: Researchers have assessed postoperative injury or disability predictors in the military setting but typically focused on 1 type of surgical procedure at a time, used relatively small sample sizes, or investigated mixed cohorts with civilian populations. Purpose: To identify the relationship between baseline variables and injury incidence or military discharge status in US Army soldiers after knee surgery. Study Design: Case-control study; Level of evidence, 3. Methods: Data were obtained from a repository containing personnel, performance, and medical records for all active-duty US Army soldiers. Multivariate logistic regressions were used to estimate the effects of numerous variables on postoperative injury or on medical discharge. Variable selection and model validation were conducted using the k-fold method. Results: A total of 7567 soldiers underwent knee surgery between 2017 and 2019. Meniscal procedures were the most common type of surgery (39%), and approximately 71% of the cohort had a postoperative injury. Significant predictors for sustaining a postoperative injury included having a previous nonknee injury (odds ratio [OR], 1.5), female sex (OR, 1.3), and Black race (OR, 1.2). Within 4 years after surgery, 17% of soldiers were discharged from the military because of knee-related disability. Significant predictors for discharge from duty included enlisted rank (OR, 2.3), recent fitness test failure (OR, 1.9), number of previous knee surgeries (OR, 1.7), and having a previous nonknee injury (OR, 1.6). Conclusion: After knee surgery, nearly three-fourths of the soldiers in this cohort sustained a postoperative injury and almost one-fifth of soldiers were medically discharged from the military within 4 years. This study identified variables that indicate statistically increased risk for these postoperative outcomes and highlighted potentially modifiable factors.
Waste management strategies for military-generated waste in the United States
Sustainable and energy efficient municipal solid waste (MSW) management is vital for the health and performance of deployed soldiers, as they play an important role in the safety and dignity of a country. As the United States targets net-zero carbon-free emission goals, research and development are essential to surpassing current practices for management of MSW at military installations, both at home and abroad. To achieve this, it is important to act upon and implement the policies and instructions set by government agencies such as the Environmental Protection Agency (EPA), the Department of Energy (DOE), and the Department of Defense (DoD). Understanding the composition of waste and disposal methods that are in use at military installations is a crucial step to success. Here, the authors show this through analyzed data from trusted sources, such as government agencies, reports, magazines, journals, and other publications on MSW management techniques. By defining these challenges, possible solutions can be better understood for improved management of MSW at military installations in the United States. Finally, an integrated approach with deployable units capable of waste-to-energy technology using waste reduction, diversion, and recycling strategies shows to be an effective pathway for MSW conversion into energy and other useful products.
Prevalence of Self-Reported Voice Concerns and Associated Risk Markers in a Nonclinical Sample of Military Service Members
Introduction: Difficult communication environments are common in military settings, and effective voice use can be critical to mission success. This study aimed to estimate the prevalence of self-reported voice disorders among U.S. military service members and to identify factors that contribute to their voice concerns. Method: A nonclinical sample of 4,123 active-duty service members was recruited across Department of Defense hearing conservation clinics. During their required annual hearing evaluation, volunteers provided responses to voice-related questions including a slightly adapted version of the Voice Handicap Index-10 (VHI-10) as part of a larger survey about communication issues. Changepoint detection was applied to age and years of service to explore cohort effects in the reporting of voice concerns. Logistic regression analyses examined multiple available factors related to communication to identify factors associated with abnormal results on the VHI-10. Results: Among the respondents, 41% reported experiencing vocal hoarseness or fatigue at least several times per year, and 8.2% ( n = 336) scored above the recommended abnormal cut-point value of 11 on the VHI-10. Factors independently associated with the greatest risk for self-reported voice concerns were sex (female), cadmium exposure, vocal demands (the need for a strong, clear voice), and auditory health measures (frequency of experiencing temporary threshold shifts; self-reported hearing difficulties). Conclusions: Based on self-reported voice concerns and false negative rates reported in the literature, the prevalence of dysphonia in a large sample of active-duty service members is estimated to be 11.7%, which is higher than that in the general population. Certain predictors for voice concerns were expected based on previous literature, like female sex and voice use, but frequency of temporary threshold shifts and exposure to cadmium were surprising. The strong link between voice and auditory problems has particular implications regarding the need for effective communication in high-noise military and other occupational environments.
Field expedient stool collection methods for gut microbiome analysis in deployed military environments
ABSTRACT Field expedient devices and protocols for the collection, storage, and shipment of stool samples in deployed settings are needed for the advancement of microbiome research in military health. Relevant assessments include the evaluation of microbiome signatures associated with susceptibility to travelers’ diarrhea and recovery of gut function following infection. However, inherent biases in microbial measurements due to preservatives and sampling methods are unclear and should be assessed for an accurate evaluation of the microbiome. We performed shotgun metagenomic sequencing and compared the microbiome composition in paired fecal samples collected using Flinters Technology Associates (FTA) cards and OMNIgene (OG) Gut tubes, prior to and during international travel, from 49 adult participants, 39 of whom remained asymptomatic and 10 experienced travelers’ diarrhea. Higher concentrations of nucleic acid and sequencing libraries were observed in OG samples. A majority of genera (82.9%) were detected with both methods, and detections of genera limited to one collection method were not highly prevalent across samples and were present in extremely low relative abundances (<0.01%). Differences in beta diversity were largely explained by inter-individuality of microbiome composition, followed by the effect of collection method and timepoint-disease states. Differential abundance analysis indicated that Corynebacterium and Blautia were consistently higher in abundance across all groups with FTA and OG collection, respectively. The observed differences in microbiome composition between methods suggest the need for consistent and standardized protocols within a study. Overall, the data presented here could help guide the future design of fecal microbiome study protocols in field and military deployment settings. IMPORTANCE The assessment of field-deployable methods for fecal sample collection and storage is required to reliably capture samples collected in remote and austere locations. This study describes a comparative metagenomics analysis between samples collected by two different commercially available methods in a military-deployed setting. The results presented here are foundational for the future design of fecal microbiome study protocols in an operational context.
From War to Work: Risks, Challenges, and Evidence-Based Strategies Across the Military Deployment Cycle
This report examines what happens when military service members return from deployment and reenter family life and civilian work. Reintegration is an evolving process shaped by an individual’s military experience and potential combat trauma, family dynamics, and workplace conditions, and it occurs within a broader social context. Reintegration varies widely depending on deployment experiences, the preparedness of families, the stability of home and work environments, and whether a person served on active duty or in the reserves. What emerges consistently across U.S., Israeli, and allied nation studies is the same core insight: Reintegration is deeply individual, often nonlinear, and profoundly influenced by the systems surrounding the returning veteran.
Deep learning models for interpretation of point of care ultrasound in military working dogs
Introduction: Military working dogs (MWDs) are essential for military operations in a wide range of missions. With this pivotal role, MWDs can become casualties requiring specialized veterinary care that may not always be available far forward on the battlefield. Some injuries such as pneumothorax, hemothorax, or abdominal hemorrhage can be diagnosed using point of care ultrasound (POCUS) such as the Global FAST® exam. This presents a unique opportunity for artificial intelligence (AI) to aid in the interpretation of ultrasound images. In this article, deep learning classification neural networks were developed for POCUS assessment in MWDs. Methods: Images were collected in five MWDs under general anesthesia or deep sedation for all scan points in the Global FAST® exam. For representative injuries, a cadaver model was used from which positive and negative injury images were captured. A total of 327 ultrasound clips were captured and split across scan points for training three different AI network architectures: MobileNetV2, DarkNet-19, and ShrapML. Gradient class activation mapping (GradCAM) overlays were generated for representative images to better explain AI predictions. Results: Performance of AI models reached over 82% accuracy for all scan points. The model with the highest performance was trained with the MobileNetV2 network for the cystocolic scan point achieving 99.8% accuracy. Across all trained networks the diaphragmatic hepatorenal scan point had the best overall performance. However, GradCAM overlays showed that the models with highest accuracy, like MobileNetV2, were not always identifying relevant features. Conversely, the GradCAM heatmaps for ShrapML show general agreement with regions most indicative of fluid accumulation. Discussion: Overall, the AI models developed can automate POCUS predictions in MWDs. Preliminarily, ShrapML had the strongest performance and prediction rate paired with accurately tracking fluid accumulation sites, making it the most suitable option for eventual real-time deployment with ultrasound systems. Further integration of this technology with imaging technologies will expand use of POCUS-based triage of MWDs.
Webinar: Strategies for Recruiting, Hiring and Retaining Military Talent: A Toolkit for Solar Industry Employers
SEIA and IREC’s recently published toolkit is intended to support solar employers with resources, strategies, and best practices to recruit, hire, and retain military connected talent across all levels and sectors of the solar workforce. This free webinar focuses on the key strategies – beginning with the business case for companies to invest in military connected talent through successful onboarding and retention.
Normative Ranges for Oculomotor and Reaction Time Tests in U.S. Military Service Members and Veterans
AbstractBackground Oculomotor and reaction time tests are frequently used assessments of vestibular symptoms, traumatic brain injury (TBI), or other neurological disorders in both clinical and research contexts. When interpreting these tests it is important to have a reference interval (RI) as a comparison for what constitutes a typical/expected response; however, the current body of research has only limited information regarding normative ranges calculated according to established standards or for a military-specific sample.Purpose The purpose of the present study was to describe RIs for oculomotor and reaction time tests in a cohort of service members and veterans (SMVs) for use as comparators by clinicians and scientists.Research Design Descriptive.Study Sample Participants were prospectively enrolled in the Defense and Veterans Brain Injury Center-Traumatic Brain Injury Center of Excellence 15-year Longitudinal Traumatic Brain Injury Study. Only SMVs without a history of TBI or blast exposure were included in the RI calculations.Data Collection and Analysis The test paradigms included in this analysis were: smooth pursuit, prosaccades, antisaccades, saccades and reaction time, predictive saccades, optokinetic nystagmus, auditory reaction time, and visual reaction time. Nonparametric methods, based on the U.S. Food and Drug Administration's recognized consensus standards, were used to calculate 95% RIs. A comparison between the calculated RIs and those available from previously published research is provided.Results Summary statistics and RIs were calculated for 47 outcome parameters from 13 oculomotor and reaction time tests. Sample sizes and age ranges varied across outcome parameters depending on the availability of reference values for RI calculations. The sample sizes used to calculate RIs ranged from 51 to 69. The age of SMVs included in each RI ranged from 19 to 61 years with mean ages ranging from 37 to 39 years. Similarities/differences between the RIs in the present study and those in previously published research are highly dependent on the outcome parameter; however, in general, the RIs in the present study tended to be somewhat wider.Conclusion The RIs provided in this paper can serve as comparisons for clinicians and scientists who are utilizing these oculomotor and reaction time testing paradigms in similar cohorts of patients or research participants.
Flood Estimation under Snowmelt and Rain-on-Snow Processes in Alaska: A Military Installation Perspective
Accurate flood estimation in snow-dominated and high-latitude regions remains challenging due to complex interactions among rainfall, snowmelt, and rain-on-snow (ROS) processes, which are not captured in conventional precipitation-based intensity-duration-frequency (PREC-IDF) curves. This study evaluates the Next-Generation IDF (NG-IDF) framework, an extension of PREC-IDF that incorporates total water available for runoff (precipitation minus changes in snow water equivalent), in two contrasting Alaskan watersheds of Department of Defense (DoD) significance: the Little Chena River Basin (LCRB) in interior Alaska, a tributary of the Chena River that flows through Fort Wainwright and near Eielson Air Force Base, and the Upper Ship Creek Basin (USCB), which drains Joint Base Elmendorf-Richardson near Anchorage. Using long-term SNOTEL observations and event-based rainfall-runoff modeling, NG-IDF and PREC-IDF flood estimates were compared against observation-based flood frequency analyses. Results show that NG-IDF consistently reduces flood-estimation bias by 15–20% relative to PREC-IDF, particularly for snowmelt- and ROS-dominated events. In the interior LCRB, permafrost conditions can substantially amplify flood responses during snowmelt events, an effect not explicitly represented in standard design tools. These findings demonstrate that NG-IDF provides a more physically consistent and transferable framework for flood estimation in cold regions, with potential relevance to mission-critical DoD installation resilience. Projected increases in ROS frequency and permafrost degradation across Alaska further emphasize the need to integrate physics-based hydrologic models that explicitly represent snow and permafrost processes to enhance design resilience and operational readiness for military and other critical infrastructure.
Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study
Background: The effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk. Methods: This study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined. Results: There was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 1.61, 95% CI, 1.09, 2.38; p for trend = 0.05) and significantly decreased risk of follicular variant PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 0.38, 95% CI, 0.16, 0.91; p for trend = 0.04). Further stratified by sex, risk of classical PTC was higher for females (third tertile above LOD vs. <LOD, OR = 2.23, 95% CI: 1.23, 4.06; p-trend = 0.02) than for males (OR = 1.22, 95%CI: 0.72–2.08; p-trend = 0.56), though the test for interaction by sex was not statistically significant (p-interaction = 0.30). Similarly, β-hexachlorocyclohexane (β-HCCH) was associated with a higher risk for classical PTC for women with concentrations ≥LOD versus <LOD (OR = 1.76, 95% CI: 1.07, 2.89), while the effects were null for men. There were no consistent trends when stratified by race or birth year. Conclusions: The U.S. Environmental Protection Agency has classified HCB and other OCPs we studied here as probable human carcinogens. Our findings of increased risks for classical PTC associated with increased concentrations of HCB and β-HCCH, which were stronger among females, should be replicated in future studies of other populations.
Demonstration of a Novel Technology to Manage Electricity Demand in Grid-Independent Military Microgrids
This research was conducted by the National Renewable Energy Laboratory (NREL) in collaboration with the S&C Electric Inc. through funding provided by the ESTCP. The project demonstrates use of cybersecure Automated Demand Response (ADR) technology to effectively manage microgrid loads during grid-independent, also known as "islanded," operation. When military microgrids become isolated from the main electrical grid, they are required to balance electricity supply and demand locally. Given that local generation may be constrained, the prevailing strategy involves shedding all but the most critical loads by tripping smart circuit breakers, which then necessitate manual resetting. This approach is generally implemented at the building level, which means that the buildings with mission-critical activities are exempt from load management and remain fully powered, whereas those deemed non-critical can experience a complete loss of service. In this research we developed a method that allows building automation systems to selectively control their assets in response to load shedding request from a microgrid controller, avoiding total loss of service in contrast to the conventional control approach. A commercial OpenADR client server by GridFabric is used for communication between the microgrid controller and the building management system (BMS). The microgrid controller monitors both generation capacity and various assets within the microgrid and issues a demand reduction request when necessary. This request is communicated to the OpenADR server via Modbus. Upon receiving the request, the OpenADR server forwards it to the BMS utilizing the OpenADR protocol. The BMS is pre-configured with various levels of load reduction strategies based on the controllable assets available, allowing for a nuanced approach to demand reduction. Both lab and field tests were performed that considered load shedding needed to achieve closed transition into island mode and to accommodate changing loads and power source availability while islanded. A commercial microgrid controller was used for these tests with normal programming within the expected constraints of the system capabilities. That is, the solution did not require any specialized modification to the code base of the controller. Given the latency of the round-trip communication path between the microgrid controller and the various devices involved with the load shed processes, there are certain scenarios for which the demonstrated solution are appropriate and some which are not. The methods described in this report can be used for load shedding/restoration during transitions between islanded and grid-tied modes of operation, as well as accommodating normal variations in load and the need to remove a power source from operation for maintenance. These methods should not be used for scenarios that require load shedding within a second or two such as sudden and unanticipated significant load increases or loss of power sources through equipment faults.
Strategies for Recruiting, Hiring, and Retaining Military Talent: A Guide for Solar Industry Employers
IREC and the Solar Energies Industries Association (SEIA) have created a new toolkit for employers that explores best practices, strategies, and additional resources for recruiting, hiring, and retaining military connected talent.
Leveraging Military Veteran Talent Through SkillBridge Training: Recommendations for the Solar Industry
Solar Energy International (SEI), in partnership with IREC, has published a white paper, Leveraging Military Veteran Talent Through SkillBridge Training: Recommendations for the Solar Industry. This resource presents SkillBridge as a key strategy for solar employers to attract, develop, and retain qualified veteran talent, and provides model training frameworks aligned with four key occupations, including solar installation, operations and maintenance, technical sales, and solar design.
Long-Duration Energy Storage: Resiliency for Military Installations
This report provides a quantitative techno-economic analysis of a long-duration energy storage (LDES) technology, when coupled to on-base solar photovoltaics (PV), to meet the U.S. Department of Defense's (DoD's) 14-day requirement to sustain critical electric loads during a power outage and significantly reduce an installation's carbon footprint. The LDES modeled is Antora Energy's battery energy storage system (BESS). It is currently at a technology readiness level (TRL) of 7 and not ready for full-scale deployment. To support decisions on the value of near-term demonstrations, this analysis looked at the potential value of Antora Energy's BESS if deployed in the future.
Improved Diet Quality in Elite and Entry-Level Military Women Compared With Civilian-Matched Counterparts
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Serum concentrations of persistent endocrine-disrupting chemicals in U.S. military personnel: A comparison by race/ethnicity and sex
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