Ninety percent of the blinded sample described the treatment intervention as a partial or complete success. CONCLUSION ST is no better than sham treatment in decreasing pain. Yet, patient perceptions of treatment effectiveness are equally important in chronic pain treatment. selleckchem © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail [email protected] Maintaining readiness among Army surgeons is increasingly challenging because of declining operative experience during certain deployments. Novel solutions should be considered. MATERIALS AND METHODS A pilot program was conducted to rotate surgical teams from a military treatment facility with a low volume of combat casualty care to one with a higher volume. Pre- and postrotation surveys were conducted to measure relative operative experience, trauma experience, and perceived readiness among rotators. RESULTS Operative volumes and trauma volumes were increased and that perceived readiness among rotators, especially those with the fewest previous deployments, was improved. CONCLUSIONS Maintaining readiness among Army surgeons is a difficult task, but a combination of increased trauma care while in garrison, as well as increased humanitarian care during deployments, may be helpful. Additionally, rotating providers from facilities caring for few combat casualties to facilities caring for more combat casualties may also be feasible, safe, and helpful. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail [email protected] Posttraumatic stress disorder (PTSD) can develop during the aftermath of traumatic events. Although many are impacted by several stressors, nearly 3.6% suffer from PTSD in the United States with higher incidence reported in military service personnel. Any injury to the blood-brain barrier can ignite an array of biological signaling molecules in the immune-privileged brain parenchyma, which can disrupt the synaptic neural network, resulting in altered behavior. MATERIALS AND METHODS In this preliminary study, we compared 20 PTSD veterans with age-matched healthy veterans to identify plasma levels of brain-specific protein markers using enzyme-linked immunosorbent assay/immunofluorometric sandwich assay for neurotrophic factors and neuropoietic cytokines, and catalytic activity of matrix metalloproteinase (MMP) by zymography. RESULTS We observed an increased level of glial fibrillary acidic protein, tumor necrosis factor-alpha, interleukin 6, and MMP2 and MMP9 but decreased level of brain-derived neurotrophic factor, nerve growth factor-beta, and negligible difference in astroglial marker S100 calcium-binding protein B compared to controls. CONCLUSION Identification of neural biomarkers is essential to understand the subclinical symptoms for the diagnosis PTSD, which may not be visible by magnetic resonance imaging (MRI/fMRI) and may take years to clinically manifest. © The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States. All rights reserved. For permissions, please e-mail [email protected] This study examined the effects of simulated and actual vessel motion at high seas on task load and surgical performance. METHODS This project was performed in phases. Phase I was a feasibility study. Phase II utilized a motion base simulator to replicate vessel motion. Phase III was conducted aboard the U.S. Naval Ship Brunswick. After performing surgical tasks on a surgical simulation mannequin, participants completed the Surgical Task Load Index (TLX) designed to collect workload data. Simulated surgeries were evaluated by subject matter experts. RESULTS TLX scores were higher in Phase III than Phase II, particularly at higher sea states. Surgical performance was not significantly different between Phase II (84%) and Phase III (89%). Simulated motions were comparable in both phases. CONCLUSIONS Simulated motion was not associated with a significant difference in surgical performance or deck motion, suggesting that this simulator replicates the conditions experienced during surgery at sea on the U.S. Naval Ship Brunswick. However, Surgical TLX scores were dramatically different between the two phases, suggesting increased workload at sea, which may be the result of time at sea, the stress of travel, or other factors. Surgical performance was not affected by sea state in either phase. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail [email protected] Periodontal ligament fibroblasts (PDLFs) play a vital role in periodontal regeneration. Parathyroid hormone (PTH) is important in catabolic regulation on osteoclasts; it also has anabolic effects on hard tissue formation. Using an in vitro wound repopulation model, this study investigated the effect of continual intermittent administration of PTH on PDLFs wound repopulation. Methods and Materials PDLFs were grown in 12-well plates and divided into 0 (control), 5, 10, 20, 40, and 80 nM of PTH treatments. A 3-mm wound was created on confluent and synchronized cells. Six PTH treatments were initiated using serum-free medium with supplements. Cell repopulation was measured at four time points 5, 10, 15, and 20 days. RESULTS A 5% increase wound repopulation showed an enhancement on day 10 for all treatment groups as compared to control groups. On days 15 and 20, treatment groups showed a decrease in proliferation and migration compared to controls with significant decreases at concentrations of 40 and 80 nM. CONCLUSION Continual intermittent treatment with PTH has the potential to enhance proliferation and migration of PDLFs for wound repopulation at early time points. A dose-dependent correlation was seen with a positive trend on day 10 while a significant decrease on day 20. © The Author 2020. Published by Oxford University Press Association of Military Surgeons of the United States. All rights reserved. For permissions, please e-mail [email protected].