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[PMID]:29362795
[Au] Autor:Foa EB; McLean CP; Zang Y; Rosenfield D; Yadin E; Yarvis JS; Mintz J; Young-McCaughan S; Borah EV; Dondanville KA; Fina BA; Hall-Clark BN; Lichner T; Litz BT; Roache J; Wright EC; Peterson AL; STRONG STAR Consortium
[Ad] Endereço:Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia.
[Ti] Título:Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial.
[So] Source:JAMA;319(4):354-364, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Effective and efficient treatment is needed for posttraumatic stress disorder (PTSD) in active duty military personnel. Objective: To examine the effects of massed prolonged exposure therapy (massed therapy), spaced prolonged exposure therapy (spaced therapy), present-centered therapy (PCT), and a minimal-contact control (MCC) on PTSD severity. Design, Setting, and Participants: Randomized clinical trial conducted at Fort Hood, Texas, from January 2011 through July 2016 and enrolling 370 military personnel with PTSD who had returned from Iraq, Afghanistan, or both. Final follow-up was July 11, 2016. Interventions: Prolonged exposure therapy, cognitive behavioral therapy involving exposure to trauma memories/reminders, administered as massed therapy (n = 110; 10 sessions over 2 weeks) or spaced therapy (n = 109; 10 sessions over 8 weeks); PCT, a non-trauma-focused therapy involving identifying/discussing daily stressors (n = 107; 10 sessions over 8 weeks); or MCC, telephone calls from therapists (n = 40; once weekly for 4 weeks). Main Outcomes and Measures: Outcomes were assessed before and after treatment and at 2-week, 12-week, and 6-month follow-up. Primary outcome was interviewer-assessed PTSD symptom severity, measured by the PTSD Symptom Scale-Interview (PSS-I; range, 0-51; higher scores indicate greater PTSD severity; MCID, 3.18), used to assess efficacy of massed therapy at 2 weeks posttreatment vs MCC at week 4; noninferiority of massed therapy vs spaced therapy at 2 weeks and 12 weeks posttreatment (noninferiority margin, 50% [2.3 points on PSS-I, with 1-sided α = .05]); and efficacy of spaced therapy vs PCT at posttreatment. Results: Among 370 randomized participants, data were analyzed for 366 (mean age, 32.7 [SD, 7.3] years; 44 women [12.0%]; mean baseline PSS-I score, 25.49 [6.36]), and 216 (59.0%) completed the study. At 2 weeks posttreatment, mean PSS-I score was 17.62 (mean decrease from baseline, 7.13) for massed therapy and 21.41 (mean decrease, 3.43) for MCC (difference in decrease, 3.70 [95% CI,0.72 to 6.68]; P = .02). At 2 weeks posttreatment, mean PSS-I score was 18.03 for spaced therapy (decrease, 7.29; difference in means vs massed therapy, 0.79 [1-sided 95% CI, -∞ to 2.29; P = .049 for noninferiority]) and at 12 weeks posttreatment was 18.88 for massed therapy (decrease, 6.32) and 18.34 for spaced therapy (decrease, 6.97; difference, 0.55 [1-sided 95% CI, -∞ to 2.05; P = .03 for noninferiority]). At posttreatment, PSS-I scores for PCT were 18.65 (decrease, 7.31; difference in decrease vs spaced therapy, 0.10 [95% CI, -2.48 to 2.27]; P = .93). Conclusions and Relevance: Among active duty military personnel with PTSD, massed therapy (10 sessions over 2 weeks) reduced PTSD symptom severity more than MCC at 2-week follow-up and was noninferior to spaced therapy (10 sessions over 8 weeks), and there was no significant difference between spaced therapy and PCT. The reductions in PTSD symptom severity with all treatments were relatively modest, suggesting that further research is needed to determine the clinical importance of these findings. Trial Registration: clinicaltrials.gov Identifier: NCT01049516.
[Mh] Termos MeSH primário: Terapia Implosiva/métodos
Militares/psicologia
Psicoterapia/métodos
Transtornos de Estresse Pós-Traumáticos/terapia
[Mh] Termos MeSH secundário: Adulto
Campanha Afegã de 2001-
Feminino
Seres Humanos
Guerra do Iraque 2003-2011
Modelos Lineares
Masculino
Índice de Gravidade de Doença
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21242


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[PMID]:29400029
[Au] Autor:Kacouchia NB; N'Gattia KV; Kouassi-Ndjeundo J; Vroh Bi TS; Yoda M; Kouassi YM; Badou E; Ampoh YJ; Kouassi A; Buraima F; Tanon-Anoh MJ; Kouassi B
[Ti] Título:[Hearing disorders at the candidates of the National Gendarmerie's competition, Ivory Coast].
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(3):109-12, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Objective: Detect the hearing deficiencies of the candi­da­tes of the gendarmerie's competition. Material and method: Pros­pec­tive study realized over 3 years (2008-2010), in the ENT service of the Gendarmerie to Agban (Abidjan). Examination included an otoscopy and a pure tone audiometry. Results: On 23121 candidates, 1245 had a plug of earwax (5.4%). They were aged from 18 to 25 years old (average age: 22.85 years). Eardrum was pathological in 0.5 % of the cases. Prevalence of hearing loss was 1.5%. Hearing loss included sensorineural hearing loss (56.7%), deafness of transmission (29.4%) and mixed deafness (13.9%). Deafness was unilateral in 79.8% and bilateral in 20.2%. Conclusion: Result of audio­gram will be useful for tracking or assessing cases of noise-induced hearing loss attributable to military service.
[Mh] Termos MeSH primário: Perda Auditiva/diagnóstico
Perda Auditiva/epidemiologia
Militares
[Mh] Termos MeSH secundário: Adolescente
Adulto
Audiometria de Tons Puros
Costa do Marfim/epidemiologia
Seres Humanos
Masculino
Otoscopia
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


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[PMID]:29498497
[Ti] Título:Progress towards poliomyelitis eradication: Nigeria, January­December 2017.
[Ti] Título:Progrès vers l'éradication de la poliomyélite au Nigéria, janvier-décembre 2017..
[So] Source:Wkly Epidemiol Rec;93(9):97-104, 2018 Mar 02.
[Is] ISSN:0049-8114
[Cp] País de publicação:Switzerland
[La] Idioma:eng; fre
[Mh] Termos MeSH primário: Erradicação de Doenças
Programas de Imunização
Poliomielite/prevenção & controle
Vacina Antipólio Oral/administração & dosagem
Poliovirus/imunologia
[Mh] Termos MeSH secundário: Seres Humanos
Lactente
Militares
Nigéria/epidemiologia
Poliomielite/epidemiologia
Poliomielite/transmissão
Segurança
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Poliovirus Vaccine, Oral)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180303
[St] Status:MEDLINE


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[PMID]:29420187
[Au] Autor:Berger Z; Rubenstein LS; DeCamp M
[Ad] Endereço:Johns Hopkins School of Medicine, Division of General Internal Medicine, Baltimore, MA, USA.
[Ti] Título:Clinical care and complicity with torture.
[So] Source:BMJ;360:k449, 2018 02 02.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Cumplicidade
Médicos/ética
Tortura/legislação & jurisprudência
[Mh] Termos MeSH secundário: Ética Médica
Guias como Assunto
Direitos Humanos/legislação & jurisprudência
Seres Humanos
Militares
Responsabilidade Social
Tortura/ética
Tortura/estatística & dados numéricos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k449


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[PMID]:28466972
[Au] Autor:Madsen T; Sadowa Vedtofte M; Nordentoft M; Ravnborg Nissen L; Bo Andersen S
[Ad] Endereço:Psychiatric Center Copenhagen, Copenhagen University Hospital, Hellerup, Denmark.
[Ti] Título:Comparing post-deployment mental health services utilization in soldiers deployed to Balkan, Iraq and Afghanistan.
[So] Source:Acta Psychiatr Scand;135(6):564-572, 2017 06.
[Is] ISSN:1600-0447
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Insight on how different missions have impacted rates of mental health service (MHS) utilization is unexplored. We compared postdeployment MHS utilization in a national cohort of first-time deployed to missions in Balkan, Iraq, and Afghanistan respectively. METHODS: A prospective national cohort study of 13 246 first-time deployed in the period 1996 through 2012 to missions in Balkan area, Iraq, or Afghanistan respectively. Soldiers 'MHS utilization was also compared with a 5:1 sex-, age-, and calendar year-matched never-deployed background population. Postdeployment utilization of MHS was retrieved from national coverage registers. Using Cox survival analyses, participants were followed and compared with regard to receiving three different types of psychiatric services: (i) admission to psychiatric hospital, (ii) psychiatric outpatient contact, and (iii) prescriptions of psychotropics. RESULTS: Utilizing of psychiatric outpatient services and psychotropics was significantly higher in first-time deployed to Iraq and Afghanistan compared with deployed to Balkan. However, the rate of postdeployment admission to psychiatric hospital did not differ between missions. Postdeployment rates of psychiatric admission and psychiatric outpatient treatment were significantly higher in Afghanistan-deployed personnel compared with the background population. CONCLUSIONS: Utilization of MHS differed significantly between mission areas and was highest after the latest mission to Afghanistan.
[Mh] Termos MeSH primário: Campanha Afegã de 2001-
Guerra do Iraque 2003-2011
Serviços de Saúde Mental/utilização
Militares/psicologia
[Mh] Termos MeSH secundário: Adulto
Península Balcânica
Dinamarca/epidemiologia
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Militares/estatística & dados numéricos
Modelos de Riscos Proporcionais
Estudos Prospectivos
Guerra
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1111/acps.12736


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[PMID]:28368719
[Au] Autor:Bermejo JL; García-Massó X; Paillard T; Noé F
[Ad] Endereço:a Department of physical activity and sport sciences , University of Valencia , Valencia , Spain.
[Ti] Título:Fatigue does not conjointly alter postural and cognitive performance when standing in a shooting position under dual-task conditions.
[So] Source:J Sports Sci;36(4):429-435, 2018 Feb.
[Is] ISSN:1466-447X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This study investigated the effects of fatigue on balance control and cognitive performance in a standing shooting position. Nineteen soldiers were asked to stand while holding a rifle (single task - ST). They also had to perform this postural task while simultaneously completing a cognitive task (dual task - DT). Both the ST and DT were performed in pre- and post-fatigue conditions. In pre-fatigue, participants achieved better balance control in the DT than in the ST, thus suggesting that the increased cognitive activity associated with the DT improves balance control by shifting the attentional focus away from a highly automatised activity. In post-fatigue, balance control was degraded in both the ST and DT, while reaction time was enhanced in the first minutes following the fatiguing exercise without affecting the accuracy of response in the cognitive task, which highlights the relative independent effects of fatigue on balance control and cognitive performance.
[Mh] Termos MeSH primário: Cognição/fisiologia
Fadiga/fisiopatologia
Armas de Fogo
Militares/psicologia
Equilíbrio Postural/fisiologia
Análise e Desempenho de Tarefas
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1080/02640414.2017.1313443


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[PMID]:29424991
[Au] Autor:Budanova EI; Bogomolov AV
[Ti] Título:[Description of the life quality of contracted servicemen].
[So] Source:Gig Sanit;95(7):627-32, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:There are presented results of a comprehensive study of the life quality of representatives of three reference groups of servicemen on contract: cadets of military high schools (n = 400), contracted servicemen of the units of power ministries and departments (n = 453), common soldiers and junior commanders (n = 357). The study was executed with the aid of the public survey, the performing of both psychological and functional load tests. This work is notable for the complexation of indices which characterize socio-hygienic, psychological and medical aspects of the life quality, life values, life satisfaction, and specific features of the military profession. Results of the study, which differ from the prior investigation by inclusion of indices characterizing the specific features of military-professional activity, lifestyle and spirituality, for the first time made it possible to assess the life quality related to health, taking into account the axiological values in life and important needs of the studied population. Changes in the life quality indices of contract servicemen were shown to be more sensitive to changes in their health than the traditional clinical-laboratory and instrumental data, which allows to recommend a wide practical use of the monitoring the life quality for professional selection and medical support of the military service, including the implementation of measures on optimization of psychological climate in military units, and the personification of the complex of therapeutic-recreational measures. The results allow us to recommend to military medical commissions of military commissariats in the call of citizens for military service under contract to carry out studies of quality and lifestyle of recruits for the early detection of groups of risk for their health. The program of in-depth medical examinations of military-contract there is recommended to include research aimed at identifying adverse social and hygienic factors of service and living conditions, psychopathological personality traits, rehabilitation and psychological climate in a military collective, execution of a personalized set of therapeutic measures.
[Mh] Termos MeSH primário: Atitude Frente à Saúde
Nível de Saúde
Militares
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Indicadores Básicos de Saúde
Seres Humanos
Masculino
Medicina Militar/métodos
Medicina Militar/estatística & dados numéricos
Militares/psicologia
Militares/estatística & dados numéricos
Psicologia Militar/métodos
Psicologia Militar/estatística & dados numéricos
Federação Russa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


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[PMID]:29420006
[Ti] Título:Semper Hi-Tech.
[So] Source:J AHIMA;88(5):72, 2017 05.
[Is] ISSN:1060-5487
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Registros Eletrônicos de Saúde
Militares
[Mh] Termos MeSH secundário: Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE


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[PMID]:28746705
[Au] Autor:Ursano RJ; Kessler RC; Naifeh JA; Herberman Mash H; Fullerton CS; Bliese PD; Zaslavsky AM; Ng THH; Aliaga PA; Wynn GH; Dinh HM; McCarroll JE; Sampson NA; Kao TC; Schoenbaum M; Heeringa SG; Stein MB; Army Study to Assess Risk and Resilience in Servicemembers (STARRS) Collaborators
[Ad] Endereço:Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
[Ti] Título:Risk of Suicide Attempt Among Soldiers in Army Units With a History of Suicide Attempts.
[So] Source:JAMA Psychiatry;74(9):924-931, 2017 Sep 01.
[Is] ISSN:2168-6238
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Mental health of soldiers is adversely affected by the death and injury of other unit members, but whether risk of suicide attempt is influenced by previous suicide attempts in a soldier's unit is unknown. Objective: To examine whether a soldier's risk of suicide attempt is influenced by previous suicide attempts in that soldier's unit. Design, Setting, and Participants: Using administrative data from the Army Study to Assess Risk and Resilience in Servicemembers (STARRS), this study identified person-month records for all active-duty, regular US Army, enlisted soldiers who attempted suicide from January 1, 2004, through December 31, 2009 (n = 9650), and an equal-probability sample of control person-months (n = 153 528). Data analysis was performed from August 8, 2016, to April 10, 2017. Main Outcomes and Measures: Logistic regression analyses examined the number of past-year suicide attempts in a soldier's unit as a predictor of subsequent suicide attempt, controlling for sociodemographic features, service-related characteristics, prior mental health diagnosis, and other unit variables, including suicide-, combat-, and unintentional injury-related unit deaths. The study also examined whether the influence of previous unit suicide attempts varied by military occupational specialty (MOS) and unit size. Results: Of the final analytic sample of 9512 enlisted soldiers who attempted suicide and 151 526 control person-months, most were male (86.4%), 29 years or younger (68.4%), younger than 21 years when entering the army (62.2%), white (59.8%), high school educated (76.6%), and currently married (54.8%). In adjusted models, soldiers were more likely to attempt suicide if 1 or more suicide attempts occurred in their unit during the past year (odds ratios [ORs], 1.4-2.3; P < .001), with odds increasing as the number of unit attempts increased. The odds of suicide attempt among soldiers in a unit with 5 or more past-year attempts was more than twice that of soldiers in a unit with no previous attempts (OR, 2.3; 95% CI, 2.1-2.6). The association of previous unit suicide attempts with subsequent risk was significant whether soldiers had a combat arms MOS or other MOS (ORs, 1.4-2.3; P < .001) and regardless of unit size, with the highest risk among those in smaller units (1-40 soldiers) (ORs, 2.1-5.9; P < .001). The population-attributable risk proportion for 1 or more unit suicide attempts in the past year indicated that, if this risk could be reduced to no unit attempts, 18.2% of attempts would not occur. Conclusions and Relevance: Risk of suicide attempt among soldiers increased as the number of past-year suicide attempts within their unit increased for combat arms and other MOSs and for units of any size but particularly for smaller units. Units with a history of suicide attempts may be important targets for preventive interventions.
[Mh] Termos MeSH primário: Militares/psicologia
Tentativa de Suicídio/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Campanha Afegã de 2001-
Estudos de Casos e Controles
Feminino
Seres Humanos
Guerra do Iraque 2003-2011
Masculino
Razão de Chances
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1001/jamapsychiatry.2017.1925


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[PMID]:29342191
[Au] Autor:Clarke SB; Deighton K; Newman C; Nicholson G; Gallagher L; Boos CJ; Mellor A; Woods DR; O'Hara JP
[Ad] Endereço:Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds, United Kingdom.
[Ti] Título:Changes in balance and joint position sense during a 12-day high altitude trek: The British Services Dhaulagiri medical research expedition.
[So] Source:PLoS One;13(1):e0190919, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Postural control and joint position sense are essential for safely undertaking leisure and professional activities, particularly at high altitude. We tested whether exposure to a 12-day trek with a gradual ascent to high altitude impairs postural control and joint position sense. This was a repeated measures observational study of 12 military service personnel (28±4 years). Postural control (sway velocity measured by a portable force platform) during standing balance, a Sharpened Romberg Test and knee joint position sense were measured, in England (113m elevation) and at 3 research camps (3619m, 4600m and 5140m) on a 12-day high altitude trek in the Dhaulagiri region of Nepal. Pulse oximetry, and Lake Louise scores were also recorded on the morning and evening of each trek day. Data were compared between altitudes and relationships between pulse oximetry, Lake Louise score, and sway velocity were explored. Total sway velocity during standing balance with eyes open (p = 0.003, d = 1.9) and during Sharpened Romberg test with eyes open (p = 0.007, d = 1.6) was significantly greater at altitudes of 3619m and 5140m when compared with sea level. Anterior-posterior sway velocity during standing balance with eyes open was also significantly greater at altitudes of 3619m and 5140m when compared with sea level (p = 0.001, d = 1.9). Knee joint position sense was not altered at higher altitudes. There were no significant correlations between Lake Louise scores, pulse oximetry and postural sway. Despite a gradual ascent profile, exposure to 3619 m was associated with impairments in postural control without impairment in knee joint position sense. Importantly, these impairments did not worsen at higher altitudes of 4600 m or 5140 m. The present findings should be considered during future trekking expeditions when developing training strategies targeted to manage impairments in postural control that occur with increasing altitude.
[Mh] Termos MeSH primário: Altitude
Pesquisa Biomédica
Articulação do Joelho/fisiologia
Montanhismo
Equilíbrio Postural
Propriocepção
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Militares
Nepal
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190919



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