Injuries Following Implementation of a Progressive Load Carriage Program in United States Marine Corps Training

PURPOSE: The overall physical demands placed on recruits completing United States Marine Corps (USMC) training is high and comes concomitantly with high rates of injuries. Load carriage with heavy loads is of particular concern. However, load carriage conditioning, if optimised, can reduce injury risk. METHODS: Retrospective injury data of recruits completing training informed this study. Data were drawn from recruits completing an original load carriage (OLC) program (n=2,363) and those completing a modified load carriage (LCMOD) program (n=681). Musculoskeletal injury data were drawn from the USMC San Diego sports medicine injury database. A population estimate of the OLC:LCMOD relative risk ratio (RR) was calculated. RESULTS: The proportion of injuries sustained by the LCMOD cohort (n=268; 39%) was notably lower than that sustained by the OLC cohort (n=1,372; 58%). The reoccurrence rate *f injury for LCMOD soldiers compared to the OLC was 0.68 (95% CI 0.61 to 0.75). The leading nature of injury (i.e., sprains and strains) was consistent between both cohorts (OLC: n=396; 29% vs. LCMOD: n=66; 25%). Inflammation (n=172; 13%) and fractures (n=144; 11%) were next most common for OLC recruits; while pain (n=58; 22%) and medial tibial stress syndrome (n=18; 8%) were next most common for LCMOD recruits. While stress reactions were proportionally higher in LCMOD (n=17; 6%) when compared to OLC (n=4; 0.3%), stress fractures were proportionality lower (LCMOD: n=9; 3% vs. OLC: n=114; 8%). Pre-existing / chronic injuries were higher in LCMOD (+5%) while new overuse injuries were lower (-7%). Totalling 65% (OLC) and 70% (LCMOD) of reported injuries the knee, lower leg, ankle, and foot were the top 4 bodily sites of injuries, although there were variations in the orders of presentations (See Table 1 for top 10 bodily sites). RELEVANCE: Careful periodisation and planning of a load carriage program can reduce injuries without reducing training outcomes

Cardiovascular Demand Differences Between Male and Female US Marine Recruits During Progressive Loaded Hikes

Schram, B, Orr, R, Niederberger, B, Givens, A, Bernards, J, and Kelly, KR. Cardiovascular demand differences between male and female US Marine recruits during progressive loaded hikes. J Strength Cond Res XX(X): 000-000, 2024-Despite having to carry the same occupational load, female soldiers tend to be lighter than male soldiers. The aim of this study was to determine the differences in cardiovascular load between female and male US Marine recruits during progressive load carriage hikes. United States Marine Corps recruits (565 male recruits; 364 female recruits) completed 6 loaded hikes over 6 weeks (1: 10 kg, 30 minutes; 2: 10 kg, 45 minutes; 3: 15 kg, 30 minutes, 4: 15 kg, 45 minutes; 5: 20 kg, 30 minutes; 6: 20 kg, 45 minutes) during which cardiovascular response was measured. Average heart rate (HRavg), HR maximum (HRmax), and pace were measured via a wrist-worn physiological monitor. Independent sample t-tests were conducted to compare between sexes, with significance set at 0.008 after adjusting for multiple comparisons. The average female recruit had significantly lower body mass (BM) compared with the average male recruit (p &lt; 0.001) and thus carried a significantly heavier relative load. (10 kg ∼17%, 15 kg ∼25%, 20 kg ∼33%, p &lt; 0.001). There were no significant differences in pace in any hike, and no significant differences were found in HRavg or HRmax when comparing female and male Marines during Hike 1. For female Marines, HRavg was significantly higher compared with male Marines during Hike 2 (+6.5 b·min-1, p &lt; 0.001) and Hike 3 (+7.4 b·min-1, p &lt; 0.001), and both HRavg and HRmax were significantly higher in Hike 4 (+11.9 b·min-1, +8.4 b·min-1, p &lt; 0.001), Hike 5 (+7.7 b·min-1, +7.9 b·min-1, p &lt; 0.001), and Hike 6 (+6.9 b·min-1, +7.1 b·min-1, p &lt; 0.001), respectively. Female Marines endured greater cardiovascular demand compared with male Marines during load carriage events when carrying loads greater than 15 kg (∼25% BM).</p

Identification of Upper Respiratory Tract Pathogens Using Electrochemical Detection on an Oligonucleotide Microarray

Bacterial and viral upper respiratory infections (URI) produce highly variable clinical symptoms that cannot be used to identify the etiologic agent. Proper treatment, however, depends on correct identification of the pathogen involved as antibiotics provide little or no benefit with viral infections. Here we describe a rapid and sensitive genotyping assay and microarray for URI identification using standard amplification and hybridization techniques, with electrochemical detection (ECD) on a semiconductor-based oligonucleotide microarray. The assay was developed to detect four bacterial pathogens (Bordetella pertussis, Streptococcus pyogenes, Chlamydia pneumoniae and Mycoplasma pneumoniae) and 9 viral pathogens (adenovirus 4, coronavirus OC43, 229E and HK, influenza A and B, parainfluinza types 1, 2, and 3 and respiratory syncytial virus. This new platform forms the basis for a fully automated diagnostics system that is very flexible and can be customized to suit different or additional pathogens. Multiple probes on a flexible platform allow one to test probes empirically and then select highly reactive probes for further iterative evaluation. Because ECD uses an enzymatic reaction to create electrical signals that can be read directly from the array, there is no need for image analysis or for expensive and delicate optical scanning equipment. We show assay sensitivity and specificity that are excellent for a multiplexed format

Recent advances in intraocular sustained-release drug delivery devices.

Topical eye-drop administration and intravitreal injections are the current standard for ocular drug delivery. However, patient adherence to the drug regimen and insufficient administration frequency are well-documented challenges to this field. In this review, we describe recent advances in intraocular implants designed to deliver therapeutics for months to years, to obviate the issues of patient adherence. We highlight recent advances in monolithic ocular implants in the literature, the commercialization pipeline, and approved for the market. We also describe design considerations based on material selection, active pharmaceutical ingredient, and implantation site

Characterization of Female US Marine Recruits: Workload, Caloric Expenditure, Fitness, Injury Rates, and Menstrual Cycle Disruption during Bootcamp

Basic training is centered on developing the physical and tactical skills essential to train a recruit into a Marine. The abrupt increase in activity and energy expenditure in young recruits may contribute to high rates of musculoskeletal injuries, to which females are more susceptible. To date, the total workload of United State Marine Corps (USMC) bootcamp is unknown and should include movement around the military base (e.g., to and from dining facilities, training locations, and classrooms). Thus, the purpose of this effort was to quantify workload and caloric expenditure, as well as qualitatively assess the impact of female reproductive health and injury rates in female recruits. Female recruits (n = 79; age: 19.1 ± 0.2 years, weight: 59.6 ± 0.8 kg, height: 161.6 ± 0.7 cm) wore physiological monitors daily throughout 10 weeks of USMC bootcamp. Physical fitness test scores, physiological metrics from wearables, injury data, and menstrual cycle information were obtained. Female recruits on average expended 3096 ± 9 kcal per day, walked 11.0 ± 0.1 miles per day, and slept 5:43 ± 1:06 h:min per night throughout the 10 weeks of bootcamp. About one-third (35%) of female recruits sustained an injury. In a subset of females that were not taking birth control and had previously been menstruating, 85% experienced cycle dysfunction during boot camp. High levels of physical activity and caloric expenditure, coupled with the stress of a new environment and insufficient sleep, may lead to alterations in female reproductive cycles and musculoskeletal injuries in young USMC recruits

Recent advances in intraocular sustained-release drug delivery devices.

Topical eye-drop administration and intravitreal injections are the current standard for ocular drug delivery. However, patient adherence to the drug regimen and insufficient administration frequency are well-documented challenges to this field. In this review, we describe recent advances in intraocular implants designed to deliver therapeutics for months to years, to obviate the issues of patient adherence. We highlight recent advances in monolithic ocular implants in the literature, the commercialization pipeline, and approved for the market. We also describe design considerations based on material selection, active pharmaceutical ingredient, and implantation site