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The results show no sign of effects of 24-hour daylight on sleep and cognitive performance. The impact of these findings on the theoretical connection of light to sleep and performance are discussed, as well as the practical implications for management of sleep while in the field.

Introduction The Accreditation Council for Graduate Medical Education stipulates that residents should participate in scholarly activity. As of 2019 that verbiage will be changed to, “Residents must participate in scholarship.” However, scholarly activity is not clearly defined. We set out to define our graduation research requirement in a measurable way and structure a research curriculum that better prepared residents to conduct scholarly activity. Materials and Methods This study compares resident scholarly output in several categories before and after the initiation of a revised research curriculum and graduation requirement. Scholarly activity was measured by comparing the production of Pubmed Indexed (PMID) publications, online publications, and conference presentations of two Emergency Medicine Residency classes. The intervention class was represented by the class of 2018 which exposed 16 residents to the new curriculum and graduation requirement for the full three years of their residency. The comparison class was represented by the class of 2015 which exposed 16 residents to the old curriculum and old graduation requirement. The old graduation requirement and curriculum were undefined. The new requirement involved two options, participate in original research starting from the process of question formulation and carried through manuscript drafting or publishing at first author PMID of any kind. The new curriculum involved monthly journal clubs, two annual deep dives, and an 8-day Intern Research Course modeled after the Emergency Medicine Basic Research Skills workshop sponsored by the American College of Emergency Physicians. In addition to the new curriculum, several new leadership positions were created at both the staff and resident level that solely focused on the promotion of scholarly activity. In addition to creating a culture within the department that encouraged scholarship, these overlapping leadership positions also helped create continuity in a program that could easily be hampered by frequent staff turnover due to new military assignments and military deployments. Results Resident scholarly activity in the form of PMIDs increased from 4 to 22. The production of online publications was 0 and 12, respectively. There were 2 and 11 conference presentations, respectively. Conclusion Resident scholarly activity increased following the institution of a new research curriculum and graduation requirement.

Sudden, painless vision loss in patients with stroke risk factors is suspect for central retinal artery occlusion (CRAO), an ophthalmic emergency that in addition to ocular treatment warrants a thorough neurologic and vascular evaluation. In addition to the high risk of concurrent stroke, carotid artery stenosis and occlusion is often overlooked during the initial evaluation. Here we report a case of CRAO with concurrent ipsilateral complete left internal carotid artery (ICA) occlusion and right ICA critical narrowing, dissection and pseudoaneurysm, which subsequently improved with prompt hyperbaric oxygen therapy.

Background Hemorrhage is the leading cause of death in trauma patients with most fatalities occurring before reaching a higher level of care—this applies to both the civilian setting and the military combat setting. Hemostatic resuscitation with increased emphasis on blood transfusion while limiting use of crystalloids has become routine in trauma care. However, the prehospital setting—especially in combat—presents unique challenges with regard to storage, transport, and administration. We sought to evaluate available technology on the market for storage and administration technology that is relevant to the prehospital setting. Study design and methods We conducted a market review of available technology through subject–matter expert inquiry, reviews of published literature, reviews of Federal Drug Administration databases, internal military publications, and searches of Google. Results We reviewed and described a total of 103 blood transporters, 22 infusers, and 6 warmers. Conclusions The risk of on‐scene fatality in trauma patients and recent developments in trauma care demonstrate the need for prehospital transfusion. These transfusions have been logistically prohibited in many operations. We have reviewed the current commercially available equipment and recommended pursuit of equipment that improves accessibility to field transfusion. Current technology has limited applicability for the prehospital setting and is further limited for the military setting.