A Single, Multimodal Exercise Tolerance Test Can Assess Combat Readiness in Army-ROTC Cadets: A Brief Report

The Army Combat Fitness Test (ACFT) is a multi-event assessment battery designed to determine the combat readiness of U.S. Army personnel. However, for Reserve Officers' Training Corps (ROTC) programs the logistical demands of collegiate life make repeated administration of the ACFT challenging. The present study sought to design and evaluate a single, multimodal exercise tolerance test (METT) capable of serving as a time-efficient proxy measure of combat readiness.

METHODS

Using a formal instrument design process, we constructed the METT to mimic the demands of the ACFT and assessed its reliability, validity, and responsiveness.

RESULTS

The METT demonstrates minimal measurement error (i.e., a 2% coefficient of variation), concurrent validity with the ACFT (R2 = 0.327, F = 10.67, p < 0.001), the ability to classify cadets who may be at-risk for failing the ACFT (X2 = 8.16, p = 0.017, sensitivity = 0.878, specificity = 0.667), and appropriate change following a training intervention (5.69 ± 8.9%).

CONCLUSIONS

The METT has the potential to provide a means to monitor progress, identify areas for improvement, and guide informed decision-making regarding individualization of cadet combat training plans.

Change-Event Steals "Athlete" from "College Athlete": Perceived Impact and Depression, Anxiety, and Stress

Introduction

This research sought to establish the impact of the change-event of COVID-19 on college athletes and members of other campus groups (eg, marching band, eSports, Reserve Officers Training Corps). The specific purpose was to assess the perceived impact and impact on mental health (eg, depression, anxiety, and stress).

Methods

The survey battery presented a total of 37 items. Demographic, sport or group-specific, and academic-related questions were included alongside the assessment of psychological well-being coming from the Depression Anxiety Stress Scale-21.

Results

There were 249 participants completing some or all of the survey battery. It is notable that 172 participants (69.1%) indicated “a lot has changed”. Common one-word responses to the experience surrounding this change-event were feeling disappointment, upset, frustrated, sadness, annoyance, and depression. Life events that conjured similar magnitude of emotion included significant injury, surgery, and losing a loved one. There were no differences by sport for the depression subscale, but 110 participants reported elevated scores and females had a higher mean depression subscale score compared with males. Differences between sports for the anxiety subscale were negated when evaluating Bonferroni correction for multiple tests, but 69 participants reported elevated scores and females had a higher mean anxiety subscale score compared with males. There was no difference by sport for the stress subscale, but 77 participants reported elevated scores and females had a higher mean stress subscale score compared with males.

Discussion

Authors urge the campus and athletics community to be diligent in monitoring the holistic wellness of college athletes and members of other campus groups. Mainly, we contend it is important to consider that COVID-19 is a significant and widespread change-event, and other change-events are known to have significant impact. We should consider that COVID-19 may be acutely and longitudinally impactful to the American college student.

ON THE HEXON BASES OF LIVER TISSUE UNDER NORMAL AND CERTAIN PATHOLOGICAL CONDITIONS

The results above reported lead to the conclusion that while in the degenerating cells chemical changes are taking place tending toward a diminution of the hexon bases as a whole, they affect the arginin especially. One may picture the process either as a partial or as a complete breaking down of certain proteid. material more or less rich in hexon bases, leaving behind. proteid matter poorer in bases. The meaning of these changes is, however, obscure, and with the limited number of known facts bearing upon the subject, it would seem idle even to attempt to formulate an hypothesis to explain them. Certain work of other investigators is, however, suggestive in this connection. Kossel and Dakin, for instance, as illustrated by their work upon the simple proteid body clupein, found that a partial destruction of the proteid molecule, involving the arginin group, is brought about by a ferment furnished by the animal organism. When subjected to the hydrolytic action of a mineral acid, clupein yields arginin in considerable abundance. But if the clupein is first acted upon by the ferment arginase found in the liver, and then subjected to acid hydrolysis, the yield of arginin is appreciably diminished. Among the cleavage products in the latter instance are the components of arginin, namely, omithin and urea. It would seem, therefore, as if the ferment had loosened the union between the omithin and urea in the arginin group, so that upon subsequent hydrolysis a diminution of arginin resulted. In the cases studied by me, it may be that the conditions were favorable for some such ferment action as that above described, and hence the relatively low yield of arginin. No attempt, however, was made to ascertain if omithin were present in the urine. Its presence there would seem not wholly unlikely when one considers the diminished power of oxidation of the phosphorus-poisoned cell, although Thompson has shown that arginin or omithin when administered to a healthy dog as food or by hypodermic injection is eliminated for the most part as urea, no ornithin being found. There might seem to be a conflict between this view and the results recently published by Wohlgemuth, but it must be borne in mind that the influences at work causing the breaking down of the proteid molecule are probably quite diverse in character. Wohlgemuth has recently shown for the first time that a diamino acid may actually find its way into the urine in phosphorus poisoning. He found arginin in the urine not only in rabbits poisoned with phosphorus but also in a patient suffering from phosphorus poisoning. On the other hand, he was unable to find lysin in the urine. This fact is of especial interest in view of the evidence set forth in this paper that the arginin base is lost to the proteid molecule more rapidly than the lysin base. The correspondence between the findings in the liver and in the urine is thus a close one. How much of the arginin liberated from the proteid molecule may find its way into the urine is of course uncertain. It seems reasonable to suppose that a portion of the base is acted upon by the arginase ferment in the manner already described. Of the seventeen to eighteen cleavage products of the proteid molecule thus far isolated, the hexon bases are among the most stable. One or more of these bases have been found in practically all proteid matter thus far investigated; in fact arginin is so uniformly present that Kossel has made the suggestion that it is the kernel of the proteid molecule. At all events, the question may be asked, whether, if the influences at work in the altered liver tissue were of a general character causing a diminution of the hexon bases, the monoamino acid groups would not suffer even a greater diminution; and since the pathological condition is undoubtedly associated with impaired oxidation, their presence should not be expected in the urine. As a matter of fact, Ignatowski found considerable quantities of monoamino acids in the urine of patients suffering from gout, pneumonia, and leukaemia, though under normal conditions no monoamino acids were found in the urine, indeed, not even after the subcutaneous injection of glycokoll. Furthermore, the loosening of the amino acids from the proteid molecule is suggested by the fact that Taylor found such acids in the liver of a patient who died from a hepatic disease of obscure etiology, but which he was inclined to attribute to chloroform poisoning. Taylor found not only leucin and tyrosin in the liver, but also arginin, a fact not without interest in view of the diminished arginin content found in the livers of the chloroformed dogs after acid hydrolysis. Moreover, the falling off of the hexon bases under the conditions studied seems quite in accordance with some results recently reported by Levene. He has shown that certain cleavage products obtained by the action of mineral acids upon self-digested pancreas, spleen, and liver, are much diminished when compared with the products obtained from the fresh glands. The lysin and arginin of the digested liver, for example, showed a diminution of over 50 per cent. It is now well established that in course of the process of aseptic autolysis, the proteids of the liver cell undergo decomposition into simpler substances, and Jacoby showed that during life autolysis may go on in portions of the liver in which the circulation has been hindered. But of greater significance still in this connection, is the observation made by Jacoby on the autolytic changes in the liver during phosphorus poisoning. He found that when the normal liver substance is permitted to autolyse the solution of the liver substance is a slow one. On the other hand, under similar conditions the liver of a phosphorus-poisoned animal undergoes rapid and almost complete solution. The difference in the behavior of the normal and damaged liver points to an increase of normal ferment action in the case of the poisoned organ. It thus seems reasonable to suppose that in phosphorus poisoning we have during life an exaggerated breaking down of the proteid molecule associated with an over-action of certain ferments, and among them probably arginase. The pathological process in the liver during life may, therefore, be thought of as proceeding in the same general direction as the process of post-morten autolytic decomposition. By means of further studies along lines indicated in this paper, it should be possible to gain a deeper insight into numerous pathological processes. The changes in amyloid degeneration are among those which promise to be better understood through the application of the new methods of chemical analysis. Moreover, it cannot be doubted that pharmacology as well as toxicology has much to gain from a study of what happens to the proteid molecule under the influence of poisons.