Comparison of Different Variants of the U.S. Army Occupational Physical Assessment Test

ABSTRACT Introduction The U.S. Army Occupational Physical Assessment Test (OPAT) is a pre-enlistment physical employment screening assessment developed to place recruits and soldiers into Military Occupational Specialties (MOSs) based on their physical capabilities in order to optimize performance and limit injury. The OPAT consists of the seated power throw (SPT), strength deadlift (SDL), standing long jump, and interval aerobic run. During the scientific validation of the OPAT, two variants of the SPT and two variants of the SDL were used. Although the OPAT was validated using both variants for each test, U.S. Army scientists and policymakers have received queries regarding how these variants compare to each other. Therefore, the purpose of this study was to compare different variants of the SPT and SDL. Materials and Methods Thirty-two participants (14 male and 18 female) between the ages of 18 and 42 years visited the laboratory on one occasion and performed two variants of the SPT (seated on the ground [the current OPAT standard] versus seated in a chair with a 35 cm seat height) and two variants of the SDL (using a hex-bar [the current OPAT standard] versus using paired dumbbells). Testing order for the different variants was randomized. The protocol was approved by the U.S. Army Medical Research and Development Command Institutional Review Board. Results Performing the SPT from a chair significantly (P < .05) increased performance when compared to performing the SPT from the ground (5.4 ± 1.3 m versus 5.0 ± 1.4 m, respectively). Values for the two SPT variants were correlated (tau = 0.90). Performing the SDL using the hex-bar significantly increased the maximal weight lifted when compared to performing the SDL using paired dumbbells (86.9 ± 18.4 kg versus 83.1 ± 18.0 kg, respectively). Values for the two SDL variants were correlated (tau = 0.83). Conclusions Performing different variants of the SPT and SDL influenced the resulting score. Although these findings do not alter the administration or scoring of the OPAT, they do provide a valuable reference in the event of future inquiries regarding the development of the OPAT.

Essay Review. The Star Gate Archives

For your consideration, two fragments of Twilit history (as Rod Serling might have put it), a dimension as time-stung as eternity, unnerving as a grating laugh at three in the dark chilly morning. One: In 1946, a would-be suicide named George B. J. Stewart attracted the interest of a beefy, bearded wingless angel named Santa Claus, and discovered how to shift into mirror universes. The post-Second World War US Congress quickly established a research center to contact other angels, especially those with working wings, and subsidized the program until 1974, when President Nixon’s resignation caused funding to dry up. Despite top-secret classification masking the CLARENCE program, Stewart is rumored to be alive and still active at the North Pole at the age of 111. Two: In 1972, three Scientologists and the brother in law of the third best chess grandmaster in history were invited by the US military to launch what would become a $19.933 million program devoted to psychic powers. The initial emphasis was operational, with trained clairvoyants casting their attention into far lands and even the future. Many branches of the intelligence community sought specific double- or triple-blind tasking, alarmed by rumors that the Soviets were making advances in this domain. Despite popular rumors, CIA were not heavily involved; the major funder was DIA (Defense Intelligence Agency). Along with NASA, DARPA, US Army Medical Research and Development Command, Foreign Technology Division and others, DIA repeatedly contracted this espionage methodology. Which, if either, of these ludicrous accounts is true? Well, it turns out that CLARENCE is merely a tall story (one I just concocted). By contrast, military research programs into psychic phenomena became public after long-hidden secret documents surfaced. Most recently, four immense volumes have been published by McFarland—dubbed collectively The Star Gate Archives—providing an opportunity to track government-funded scientific research into psi (purported mental abilities able to reach beyond limits established by canonical sciences). Despite those limits, for two decades the science edge of the program was situated on the West Coast at Stanford Research Institute (SRI) and then Science Applications International Corporation (SAIC). A 2017 summary paper states: “In July 1972, Russell Targ, as principal investigator, submitted a grant application on Research on Techniques to Enhance Extraordinary Human Perception to the Jet Propulsion Laboratory, NASA, with Dr. Harold Puthoff as co-investigator. This started the SRI program in psi research, which eventually closed in 1995 at SAIC.”[1] Its two most effective founding viewers were Ingo Swann and Pat Price, now deceased, both devotees of L. Ron Hubbard’s cult. For internal-security reasons, the success or failure of individual efforts were rarely revealed. But since the psi operatives were sometimes called back for further clandestine tasking, it seems evident that the results were often sufficiently effective and accurate in support of more conventional intelligence activities. There’s ample evidence for this in the various volumes. [1] https://www.academia.edu/38006378/THE_STAR_GATE_ARCHIVES_REPORTS_OF_THE_US_GOVERNMENT_SPONSORED_PSI_PROGRAM_1972-1995._AN_OVERVIEW

0034 When Should You Sleep to Maximize Alertness?

Introduction Working under sleep-restricted conditions may curtail safety and productivity. We could potentially minimize the negative effects of sleep restriction by optimizing the timing of sleep. However, to date, there are no algorithms that can determine the optimal sleep time to maximize alertness when most needed. Methods Our previously validated unified model of performance predicts the recuperative effects of sleep on alertness. Here, we extended this model to predict the likelihood of an individual falling and remaining asleep at any given moment, as a function of recent sleep history and time of day. Then, we combined the model with an optimization algorithm to provide optimal sleep recommendations for a given work/rest schedule. Specifically, using the model to predict the effectiveness of different sleep schedules, the algorithm determines when to sleep and for how long, so as to maximize alertness at desired times. The algorithm takes as inputs the 1) user-provided sleep history, 2) periods when the user has an opportunity to sleep, and 3) desired periods for maximum alertness, and provides as outputs sleep recommendations that are physiologically feasible and optimize alertness for the desired period. We assessed the algorithm by computing and comparing sleep recommendations for five previously published experimental studies of sleep restriction, including diurnal and nocturnal sleep. Results Compared to the original sleep schedules in the studies, our algorithm identified sleep recommendations that increased the predicted alertness by up to 33% and by 18% on average. These results suggest that the algorithm can tailor the timing of sleep to each specific sleep-restriction condition so as to maximize its benefits. Conclusion Our algorithm provides automated, customized guidance to enhance the recuperative benefits of limited sleep opportunities to maximize alertness at the most needed times. As such, it is the first quantitative sleep optimization tool for fatigue-management systems. Support This work was sponsored by the Military Operational Medicine Research Area Directorate of the U.S. Army Medical Research and Development Command, Ft. Detrick, MD.

Improving indicators of tuberculosis program cascades by leveraging HIV program strategies

Background: To improve rates of human immunodeficiency virus (HIV) case detection and treatment, the Nigerian Ministry of Defense Health Implementation Program and the US Army Medical Research Directorate-Africa/Nigeria introduced a HIV standard of care (SOC) package. Given the integration of tuberculosis (TB) and HIV programs and evolving policies, we evaluated the impact of this strategy on TB program indicators.Methods: Routine, de-identified program data from 27 Nigerian military hospitals were analyzed. Using Wilcoxon signed-rank test, bivariate analyses were performed to compare data from 12 months before and after implementation of the SOC package.Results: Our data showed improvements post-implementation as follows: the number of individuals receiving antiretroviral therapy (ART) screened for TB increased from 14 530 to 29 467 (P < 0.001); the number of individuals with presumptive TB identified increased from 803 to 1800 (P < 0.001); the number of ART clients bacteriologically tested for TB increased from 746 to 1717 (P < 0.001); and the number of ART clients treated for TB increased from 152 to 282 (P < 0.001). Newly registered or relapsed TB cases increased from 436 to 906 (P < 0.001), the number of TB cases with known HIV status increased from 437 to 837 (P < 0.001), the number of TB-HIV co-infected cases increased from 182 to 301 (P = 0.006), and the number of TB-HIV co-infected clients who started ART increased from 101 to 176 (P = 0.003).Conclusion: The implementation of the updated HIV SOC package led to the improvement in key TB diagnosis and treatment indicators. When emulated, this could help improve the performance of other TB programs in countries other than Nigeria.

Biomedical Response to Neisseria gonorrhoeae and Other Sexually Transmitted Infections in the US Military

ABSTRACT Introduction Sexually transmitted infections (STIs) continue to plague militaries and defense forces. While the historical recognition of the impact of STIs on operations is evident, contemporary surveillance and research activities are limited. As Neisseria gonorrhoeae and other sexually transmitted pathogens become increasingly resistant to antibiotics, the role of the Department of Defense (DoD) in disease surveillance and clinical research is essential to military Force Health Protection. Methods The Infectious Disease Clinical Research Program (IDCRP) of the Uniformed Services University of the Health Sciences partnered with the DoD Global Emerging Infections Surveillance (GEIS) program to monitor the distribution of gonorrhea antimicrobial resistance (AMR) both domestically and abroad. The DoD gonococcal reference laboratory and repository was established in 2011 as a resource for confirmatory testing and advanced characterization of isolates collected from sites across the continental United States (CONUS) and GEIS-funded sites outside the continental United States (OCONUS). The IDCRP is currently implementing surveillance efforts at CONUS military clinics, including Madigan Army Medical Center, Naval Medical Center Camp Lejeune, Naval Medical Center Portsmouth, Naval Medical Center San Diego, and San Antonio Military Medical Center (efforts were also previously at Womack Army Medical Center). The reference laboratory and repository receives specimens from OCONUS collaborators, including Armed Forces Research Institute of Medical Sciences (AFRIMS; Bangkok, Thailand), Naval Medical Research Unit No. 3 (NAMRU-3), Ghana Detachment (Accra, Ghana), Naval Medical Research Unit No. 6 (NAMRU-6; Lima, Peru), U.S. Army Medical Research Unit – Georgia (USAMRD-G; Tbilisi, Republic of Georgia), and U.S. Army Medical Research Directorate – Kenya (USAMRD-K; Nairobi, Kenya). The gonococcal surveillance program, to include findings, as well as associated clinical research efforts are described. Results Among N. gonorrhoeae isolates tested within the United States, 8% were resistant to tetracycline, 2% were resistant to penicillin, and 30% were resistant to ciprofloxacin. To date, only one of the 61 isolates has demonstrated some resistance (MIC=1 μg/ml) to azithromycin. No resistance to cephalosporins has been detected; however, reduced susceptibility (MIC=0.06–0.125 μg/ml) has been observed in 13% of isolates. Resistance is commonly observed in N. gonorrhoeae isolates submitted from OCONUS clinical sites, particularly with respect to tetracycline, penicillin, and ciprofloxacin. While no azithromycin-resistant isolates have been identified from OCONUS sites, reduced susceptibility (MIC=0.125–0.5 μg/ml) to azithromycin was observed in 23% of isolates. Conclusion Continued monitoring of circulating resistance patterns on a global scale is critical for ensuring appropriate treatments are prescribed for service members that may be infected in the U.S. or while deployed. Domestic surveillance for gonococcal AMR within the Military Health System has indicated that resistance patterns, while variable, are not dramatically different from what is seen in U.S. civilian data. Global patterns of gonococcal AMR have been described through the establishment of a central DoD gonococcal reference laboratory and repository. This repository of global isolates provides a platform for further research and development into biomedical countermeasures against gonococcal infections.

Higher-protein Intakes Are Associated with an Improved Dietary Micronutrient Profile (FS03-06-19)

Objectives The Dietary Guidelines for Americans 2015–2020 indicate that potassium, choline, magnesium, calcium, vitamins A, D, E, and C are underconsumed (i.e., shortfall) micronutrients. Intakes of specific performance-related micronutrients (i.e., calcium, magnesium, folate, choline, iron, zinc, and vitamins A, D, E, B1, B2, B3, and B12), may also be a concern, as suboptimal intakes may limit adaptations to unaccustomed physical training, such as initial military training (IMT). Protein-containing foods are nutrient-dense; therefore, dietary protein intake may alter the amount of shortfall and performance-related micronutrients habitually consumed. This study explored associations between dietary protein (PRO) intake and shortfall or performance-related micronutrient intakes at IMT accession. Methods A 3-month food frequency questionnaire was used to estimate habitual dietary intake in male (n = 276, age: Mean (SD), 21.1 (3.8)) and female (n = 254, age: 21.2 (3.7)) recruits. Multivariate-adjusted MANCOVA and ANCOVA models were used to identify associations between quartiles of PRO intake and shortfall micronutrients or performance-related micronutrients. Models were adjusted for age, sex, ethnicity, race, physical activity, energy density, and total energy intake. Results Mean (SE) energy-adjusted PRO intakes were 29.3 (3.2), 36.0 (1.4), 40.8 (1.3), and 47.7 (3.9) g/1000 kcal for quartiles 1–4, respectively. Composite shortfall micronutrient intake differed (P < 0.001) by PRO quartile, as intake of each micronutrient, except vitamin C, progressively increased (all, P < 0.05) with increasing PRO quartiles. Similarly, composite (P < 0.001), and most individual (all, P < 0.05) performance-related micronutrient intakes, except calcium, were different across PRO quartiles. Calcium intake only differed for PRO quartile 1 and was lower than all other quartiles (P < 0.00). Conclusions These cross-sectional data suggest that habitually consuming more protein is associated with greater intakes of shortfall and performance-related micronutrients in young healthy adults entering the military. Funding Sources Supported by US Army Medical Research and Materiel Command; authors’ views not official US Army or DoD policy.