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Supervising providers who that believed 80 to 100% of their medics had completed TCCC training had more confidence in their medic's TCCC abilities. With TCCC, a recognized lifesaver on the battlefield, continued training and utilization of TCCC concepts are paramount for deploying personnel. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.INTRODUCTION In 2008, it was reported that 19.5% of service members previously deployed experienced a mild traumatic brain injury (mTBI). Fifty-seven percent of those did not seek medical care. It was suggested that concerns with seeking care involved confidentiality and career issues. Objective This study addressed mTBI history, medical treatment history, and stigmas associated with mTBI/concussion. MATERIALS AND METHODS An anonymous questionnaire was developed. Data collection occurred throughout March 2018 in conjunction with Brain Injury Awareness Month activities. RESULTS All 5,174 volunteers were Army; 86% male; 87% were between 18 and 34 years old; 89% had less then 14 years in the military; 35% had a combat deployment; and 10% reported having one or more mTBIs in their military careers. Of the Soldiers who reported a concussion, 52% sought medical care. Of those not seeking care, 64% reported they did not think the injury required care, followed by 18% fearing negative impact on their career. Twenty-eight percent who experienced an mTBI versus 11% who have not reported that there is a stigma associated with an mTBI. CONCLUSIONS Soldiers sometimes failed to report their suspected concussions and did not seek medical care. Educational efforts may increase reporting of and medical screening for potentially concussive events. Future research to determine the ramifications of unreported and untreated mTBIs/concussions is recommended. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.INTRODUCTION Whole-body vibration training (WBVT) may benefit individuals with difficulty participating in physical exercise. The objective was to explore the effects of WBVT on circulating stem/progenitor cell (CPC) and cytokine levels. METHODS Healthy male subjects each performed three activities randomly on separate days (1) standing platform vibration, (2) repetitive leg squat exercise; and (3) in combination. Pre- and post-activity blood samples were drawn. Cell populations were characterized using flow cytometry. Biomarkers were analyzed using enzyme-linked immunosorbent assays. RESULTS CPC levels increased significantly 21% with exercise alone (1465 ± 202-1770 ± 221 cells/mL; P = 0.017) and 33% with vibration alone in younger participants (1918 ± 341-2559 ± 496; P = 0.02). Angiogenic CPCs increased 39% during combined activity in younger (633 ± 128-882 ± 181; P = 0.05). Non-angiogenic CPCs increased 42% with vibration alone in younger (1181 ± 222-1677 ± 342; P = 0.04), but 32% with exercise alone in older participants (801 ± 251-1053 ± 325; P = 0.05). With vibration alone, anti-inflammatory cytokine interleukin-10 increased significantly (P  less then  0.03), although inflammatory interleukin-6 decreased (P = 0.056); tumor necrosis factor-alpha (P  less then  0.01) and vascular endothelial growth factor levels increased (P  less then  0.005), which are synergistically pro-angiogenic. CONCLUSIONS WBVT may have positive vascular and anti-inflammatory effects. WBVT could augment or serve as an exercise surrogate in warfighters and others who cannot fully participate in exercise programs, having important implications in military health. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.INTRODUCTION Proper jump-landing neuromuscular control is crucial in mitigating lower-extremity musculoskeletal injuries. The presence of fatigue, especially in extreme environments, may degrade dynamic postural stability (DPS) and result in lower-extremity injuries. This study aimed to evaluate the influence of moderate intensity exercise in hot (HOT) and temperate (TEMP) ambient temperatures and residual effects of a previous bout on DPS during a single-legged jump-landing. It was hypothesized that the participants would display worse DPS after HOT compared to TEMP. METHODS Six recreationally active young males (16.8 ± 0.7 year, 1.88 ± 0.12 m, 83.8 ± 19.8 kg) completed two, 60-minute bouts of exercise with 60 minutes of rest between bouts in both HOT (35°C) and TEMP (22.2°C). Heart rate and core body temperature (Tc) were monitored continuously, and DPS was assessed before and after each bout. RESULTS The DPS time and condition effects were not identified (p > 0.05), but HOT elicited some notable (d > 0.20) increases in heart rate, Tc, and DPS compared to TEMP. CONCLUSIONS The DPS decrements varied between subjects suggesting individual-specific etiology. Repeated bouts of exercise in HOT may place an individual at a greater risk for injury than TEMP if proper prevention strategies are not used. © The Association of Military Surgeons of the United States 2020.INTRODUCTION The role of the Emergency Medicine (EM) physician in the U.S. military continues to expand, and current Accreditation Council for Graduate Medical Education general training requirements do not optimally prepare military EM graduates to be successful in postresidency operational assignments. https://www.selleckchem.com/products/jhu395.html To address this gap, the Naval Medical Center San Diego EM residency program introduced a Military Unique Curriculum (MUC) culminating in a capstone event, the Joint Emergency Medicine Exercise (JEMX). METHODS Part of an approved Quality Improvement project, annual survey results from 2012 to 2017 evaluated graduate opinion on the strengths and weaknesses of the MUC. We describe a pilot project conceived by tri-service EM physicians to evaluate the feasibility of the JEMX. RESULTS Forty-eight graduate residents responded to surveys, 18 of which were administered pre-MUC implementation. With a 100% response rate from graduate residents, overall trends showed greater perceived readiness for postresidency operational assignments after MUC implementation.