The purpose of the present paper was to analyze the efficiency of an abbreviated, albeit objective posturographic test as an indicator of fatigue. Posturography was measured in 10 healthy adults (age 18-33 years, male/female 7/3). Baseline posturographic measurements were taken for each subject. Later, a shorter (3-min) posturographic test was administered 12 times during 25 h of sleep deprivation. This was correlated with subjective assessment of fatigue using a questionnaire and cognitive performance assessed with a reaction time test (Psychomotor Vigilance Test). Although showing significant individual differences, the score of the abbreviated posturographic examination, normalized to each subject's baseline performance ('fatigue index') had a pronounced circadian pattern with a peak of instability in the early morning hours. Fatigue index was highly correlated with the cognitive test ( r = 0.80-0.90). A substantial, albeit weaker correlation was found between the fatigue index and the subjective fatigue scores ( r = 0.59-0.75). Fourier spectral analysis showed that low median sway (0.10-0.50 Hz), considered to be an expression of vestibular control, was most affected by fatigue. The study demonstrates that cognitive deterioration caused by fatigue can be objectively predicted by an abbreviated postural test of ≤ 3 min. This test is promising to be valid, reliable, and practicable, while being significantly correlated with physiological markers and validated cognitive measures of fatigue obtained by substantially more time-consuming and less convenient methods.

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In MCIs occurring in remote areas, policy makers should consider revising the current evacuation plan so that only immediate unstable casualties should be transferred to the closest primary hospital. On site Advanced Life Support (ALS) should be administered to non-severe casualties until they can be evacuated directly to tertiary care hospitals. First responders must be trained to provide ALS to non-severe casualties until evacuation resources are available.

Despite careful selection, allergic rhinitis is still a very common disease in pilots and may pose a risk of acute sinusitis. The lower prevalence of acute sinusitis in combat than in transport pilots with rhinitis may be explained by vasoconstriction due to psychological and physiological stress during flight missions.

Previous knowledge of patient diagnoses and resource needs allow the identification and quantification of deficiencies and problems identified in clinical decision making, resource utilisation and incident management.