[Measures to preserve the mental health of sailors when working on autonomous surface vessels].

Currently, all sectors of the national economy are subject to rapid processes of digital transformation, which requires the restructuring of both production processes and the improvement of the personnel selection system. The field of maritime transport is no exception, which has recently been focused on the active development of autonomous maritime shipping. The introduction of autonomous ships into operation radically changes the working conditions of ship crew members, including due to a significant reduction in their number. As a result, in the near future, seafarers will be forced not only to work in difficult conditions caused by maritime specifics, but also to experience the additional impact of a limited ship crew. The lack of necessary skills and training among current ship crew members to work in the new realities, as well as the high risk of impairment of their mental health, shows the objective need to find new approaches to the training and selection of seafarers. In order to develop recommendations for improving the rules for training, recruiting and selecting seafarers to work in conditions of a limited ship crew, the article studied regulations and levels of autonomy of sea surface vessels. A survey was conducted among active sailors, which made it possible to identify key problems on the stated issues, and also studied the types of temperament, personality and accentuation.

Internet-Guided Cognitive Behavioral Therapy for Insomnia Among Patients With Traumatic Brain Injury: A Randomized Clinical Trial.

Importance: Many military service members and veterans report insomnia after sustaining traumatic brain injury (TBI). Limitations of first-line treatment, cognitive-behavioral therapy for insomnia (CBT-I), include availability of qualified clinicians, low completion rates, and cost. Objective: To investigate the feasibility and efficacy of internet-guided CBT-I (eCBT-I) in military service members and veterans with insomnia and a history of TBI. Design, Setting, and Participants: This randomized clinical trial of fully remote internet-based interventions and evaluations was conducted from September 1, 2020, to June 30, 2021, with 3 months of follow-up. Participants included a volunteer sample of military service members and veterans aged 18 to 64 years with a history of mild TBI/concussion and at least moderately severe insomnia defined as an insomnia severity index (ISI) score of greater than 14 and Pittsburgh Sleep Quality Index of greater than 4. Self-reported race, ethnicity, and educational level were generally representative of the US military. Data were analyzed from October 21, 2021, to April 29, 2024. Intervention: Internet-based CBT-I delivered over 6 weekly lesson modules with assigned homework activities. Main Outcomes and Measures: The prespecified primary outcome measure was change in ISI score over time. Prespecified secondary outcome measures included self-reported measures of depression symptoms, posttraumatic stress disorder (PTSD) symptoms, sleep quality, migraine impact, and fatigue. Results: Of 204 people screened, 125 were randomized 3:1 to eCBT-I vs online sleep education, and 106 completed baseline evaluations (83 men [78.3%]; mean [SD] age, 42 [12] years). Of these, 22 participants (20.8%) were Hispanic or Latino and 78 (73.6%) were White. Fifty participants completed postintervention evaluations, and 41 completed the 3-month follow-up. Baseline mean (SD) ISI scores were 19.7 (4.0) in those randomized to eCBT-I and 18.9 (5.0) in those randomized to sleep education. After intervention, mean (SD) ISI scores were 13.7 (5.6) in those randomized to eCBT-I and 16.6 (5.7) in those randomized to sleep education. The difference in the extent of reduction in ISI scores between groups was 3.5 (95% CI,-6.5 to -0.4 [P = .03]; Cohen d, -0.32 [95% CI, -0.70 to -0.04]). In the eCBT-I group, the extent of insomnia improvement correlated with the extent of depressive symptom improvement (Spearman ρ = 0.68 [P < .001]), PTSD symptoms (ρ = 0.36 [P = .04]), sleep quality (ρ = 0.54 [P = .001]), and fatigue impact (ρ = -0.58 [P < .001]) but not migraine-related disability. Conclusions and Relevance: The findings of this randomized clinical trial suggest that fully remote eCBT-I was moderately feasible and effective for self-reported insomnia and depression symptoms in military service members and veterans with a history of TBI. There is great potential benefit for eCBT-I due to low availability and cost of qualified CBT-I clinicians, although optimization of completion rates remains a challenge. Future studies may use home-based objective sleep assessments and should increase study retention. Trial Registration: ClinicalTrials.gov Identifier: NCT04377009.

Sexually transmitted infections among active component members of the U.S. Armed Forces, 2015-2023.

This report summarizes incidence rates and trends of sexually transmitted infections (STIs) from 2015 through 2023 among active component service members of the U.S. Armed Forces. The data compiled for this report are derived from the medical surveillance of chlamydia, gonorrhea, and syphilis as nationally notifiable diseases. Case data for 2 additional STIs, human papilloma virus (HPV) and genital herpes simplex virus (HSV), are also presented. The crude total case rates of chlamydia and gonorrhea initially rose by an average of 6.7% and 9.8% per year, respectively, until 2019. From 2020 onwards, rates steadily declined. By 2023, chlamydia rates had dropped by approximately 39%, while gonorrhea rates had fallen by more than 40% for female, and 19% for male, service members. Initially syphilis increased, on average, 10% annually from 2015 to 2019, then declined in 2020, but resumed its upward trend through 2023, nearly doubling the 2015 rate in 2023. The total crude annual incidence rates of genital HPV and HSV exhibited downward trends in general over the surveillance period, decreasing by 30.7% and 24.7%, respectively. Age- and gender-adjusted case rates for chlamydia, gonorrhea, and syphilis remain elevated within the U.S. Armed Forces compared to the general U.S. population, which may be due to factors that include mandatory STI screening, more complete reporting, incomplete adjustment for age distribution, and inequitable comparisons between the military active duty and general U.S. populations. Social restrictions enacted during the COVID-19 pandemic may have contributed to declines in true case rates and screening coverage.

Oxygen Saturation Curve Analysis in 2298 Hypoxia Awareness Training Tests of Military Aircrew Members in a Hypobaric Chamber.

We aim to provide reference values for military aircrews participating in hypoxia awareness training (HAT). We describe several parameters with potential biomedical interest based on selected segments and slopes of the changes in oxygen saturation (SatO2) during a standard HAT. A retrospective analysis of 2298 records of the SatO2 curve was performed, including 1526 military men aged 30.48 ± 6.47 years during HAT in a hypobaric chamber. HAT consisted of pre-oxygenation at 100% and an ascent to 7620 m, followed by O2 disconnection starting the phase of descent of SatO2 until reaching the time of useful consciousness (TUC), and finally reconnection to 100% O2 in the recovery phase. Using an ad hoc computational procedure, the time taken to reach several defined critical values was computed. These key parameters were the time until desaturation of 97% and 90% (hypoxia) after oxygen mask disconnection (D97/D90) and reconnection (R97/R90) phases, the time of desaturation (TUC-D97) and hypoxia (TUC-D90) during disconnection, the total time in desaturation (L97) or hypoxia (L90), and the slopes of SatO2 drop (SDSAT97 and SDSAT90) and recovery (SRSAT97). The mean of the quartiles according to TUC were compared by ANOVA. The correlations between the different parameters were studied using Pearson's test and the effect size was estimated with ω2. Potentially useful parameters for the HAT study were those with statistical significance (p < 0.05) and a large effect size. D97, D90, R97, and R90 showed significant differences with small effect sizes, while TUC-D97, TUC-D90, L97, L90, and SDSAT97 showed significant differences and large effect sizes. SDSAT97 correlated with TUC (R = 0.79), TUC-D97 (R = 0.81), and TUC-D90 (R = 0.81). In conclusion, several parameters of the SatO2 curve are useful for the study and monitoring of HAT. The SDSAT97 measured during the test can estimate the TUC and thus contribute to taking measures to characterize and protect the aircrew members.

Quantitative pupillometry as a biomarker for prediction of return to play in mild traumatic brain injury: a Military Traumatic Brain Injury Initiative study.

OBJECTIVE: This study aimed to determine the validity of quantitative pupillometry to predict the length of time for return to full activity/duty after a mild traumatic brain injury (mTBI) in a cohort of injured cadets at West Point. METHODS: Each subject received baseline (T0) quantitative pupillometry, in addition to evaluation with the Balance Error Scoring System (BESS), Standardized Assessment of Concussion (SAC), and Sport Concussion Assessment Tool 5th Edition Symptom Survey (SCAT5). Repeat assessments using the same parameters were conducted within 48 hours of injury (T1), at the beginning of progressive return to activity (T2), and at the completion of progressive return to activity protocols (T3). Pupillary metrics were compared on the basis of length of time to return to full play/duty and the clinical scores. RESULTS: The authors' statistical analyses found correlations between pupillometry measures at T1, including end-initial diameter and maximum constriction velocity, with larger change and faster constriction predicting earlier return to play. There was also an association with maximum constriction velocity at baseline (T0), predicting faster return to play. CONCLUSIONS: The authors conclude that that pupillometry may be a valuable tool for assessing time to return to duty from mTBI by providing a measure of baseline resiliency to mTBI and/or autonomic dysfunction in the acute phase after mTBI.

Prevalence of smoking among national military service recruits in UAE.

Background: According to the various screening programs conducted, the prevalence of tobacco use among UAE Nationals is high. A considerable increase is also seen in various forms of smoking is seen among young military men during deployment which results in loss of physical health, less productivity, readiness and increased health care utilization. Also smokers are more likely to develop other addictions and chronic medical conditions. Aim: To estimate the prevalence of smoking among national military service recruits in the United Arab Emirates and to find its relation with various factors: socio-demographics, lifestyle, comorbidities, and military environment. Methods: A cross sectional study was conducted amongst national service recruits selected by random stratification through a self-administered anonymized questionnaire which was distributed to a final sample of 369 patients. Data was analyzed using SPSS version 16. Chi square, percentage and frequencies were used to present the data where applicable. A p < 0.05 was considered to be significant. Results: The prevalence of smoking among national military service recruits was 41.6%. As the level of education increased the prevalence of smoking decreased. Smokers with insufficient income, divorced or widowed recruits tend to smoke more as against single and married recruits. Smoking rates were decreased in those who exercise regularly. There was a significant relationship between smoking status and chronic diseases. Smoker gatherings inside military campus encouraged initiation of smoking or its continuity. About half of the smokers were not satisfied with environment at military facilities. Conclusion: Smoking has high prevalence among national service military recruits. For this reason, a goal directed future plan toward screening of smokers among recruits and assigning them to smoking cessation clinics and educational seminars prior to joining the national service is the need of the hour.

Spinal Cord Stimulator Inequities Within the US Military Health System.

OBJECTIVES: Although studies have described inequities in spinal cord stimulation (SCS) receipt, there is a lack of information to inform system-level changes to support health care equity. This study evaluated whether Black patients exhaust more treatment options than do White patients, before receiving SCS. MATERIALS AND METHODS: This retrospective cohort study included claims data of Black and non-Latinx White patients who were active-duty service members or military retirees who received a persistent spinal pain syndrome (PSPS) diagnosis associated with back surgery within the US Military Health System, January 2017 to January 2020 (N = 8753). A generalized linear model examined predictors of SCS receipt within two years of diagnosis, including the interaction between race and number of pain-treatment types received. RESULTS: In the generalized linear model, Black patients (10.3% [8.7%, 12.0%]) were less likely to receive SCS than were White patients (13.6% [12.7%, 14.6%]) The interaction term was significant; White patients who received zero to three different types of treatments were more likely to receive SCS than were Black patients who received zero to three treatments, whereas Black and White patients who received >three treatments had similar likelihoods of receiving a SCS. CONCLUSIONS: In a health care system with intended universal access, White patients diagnosed with PSPS tried fewer treatment types before receiving SCS, whereas the number of treatment types tried was not significantly related to SCS receipt in Black patients. Overall, Black patients received SCS less often than did White patients. Findings indicate the need for structured referral pathways, provider evaluation on equity metrics, and top-down support.

Development of Chronic Pain Conditions Among Women in the Military Health System.

Importance: The incidence of chronic pain has been increasing over the last decades and may be associated with the stress of deployment in active-duty servicewomen (ADSW) as well as women civilian dependents whose spouse or partner served on active duty. Objective: To assess incidence of chronic pain among active-duty servicewomen and women civilian dependents with service during 2006 to 2013 compared with incidence among like individuals at a time of reduced combat exposure and deployment intensity (2014-2020). Design, Setting, and Participants: This cohort study used claims data from the Military Health System data repository to identify ADSW and dependents who were diagnosed with chronic pain. The incidence of chronic pain among individuals associated with service during 2006 to 2013 was compared with 2014 to 2020 incidence. Data were analyzed from September 2023 to April 2024. Main Outcomes and Measures: The primary outcome was the diagnosis of chronic pain. Multivariable logistic regression analyses were used to adjust for confounding, and secondary analyses were performed to account for interactions between time period and proxies for socioeconomic status and combat exposure. Results: A total of 3 473 401 individuals (median [IQR] age, 29.0 [22.0-46.0] years) were included, with 644 478 ADSW (18.6%). Compared with ADSW in 2014 to 2020, ADSW in 2006 to 2013 had significantly increased odds of chronic pain (odds ratio [OR], 1.53; 95% CI, 1.48-1.58). The odds of chronic pain among dependents in 2006 to 2013 was also significantly higher compared with dependents from 2014 to 2020 (OR, 1.96; 95% CI, 1.93-1.99). The proxy for socioeconomic status was significantly associated with an increased odds of chronic pain (2006-2013 junior enlisted ADSWs: OR, 1.95; 95% CI, 1.83-2.09; 2006-2013 junior enlisted dependents: OR, 3.05; 95% CI, 2.87-3.25). Conclusions and Relevance: This cohort study found significant increases in the diagnosis of chronic pain among ADSW and civilian dependents affiliated with the military during a period of heightened deployment intensity (2006-2013). The effects of disparate support structures, coping strategies, stress regulation, and exposure to military sexual trauma may apply to both women veterans and civilian dependents.

Linked Exposures Across Databases: an exposure common data elements aggregation framework to facilitate clinical exposure review.

Understanding the health outcomes of military exposures is of critical importance for Veterans, their health care team, and national leaders. Approximately 43% of Veterans report military exposure concerns to their VA providers. Understanding the causal influences of environmental exposures on health is a complex exposure science task and often requires interpreting multiple data sources; particularly when exposure pathways and multi-exposure interactions are ill-defined, as is the case for complex and emerging military service exposures. Thus, there is a need to standardize clinically meaningful exposure metrics from different data sources to guide clinicians and researchers with a consistent model for investigating and communicating exposure risk profiles. The Linked Exposures Across Databases (LEAD) framework provides a unifying model for characterizing exposures from different exposure databases with a focus on providing clinically relevant exposure metrics. Application of LEAD is demonstrated through comparison of different military exposure data sources: Veteran Military Occupational and Environmental Exposure Assessment Tool (VMOAT), Individual Longitudinal Exposure Record (ILER) database, and a military incident report database, the Explosive Ordnance Disposal Information Management System (EODIMS). This cohesive method for evaluating military exposures leverages established information with new sources of data and has the potential to influence how military exposure data is integrated into exposure health care and investigational models.

A machine of the same: Repetition in the foundational discourse of the Argentinean "being" (1976-1983).

Using the example of the military regime in Argentina (1976-1983) and relevant archival materials, this article demonstrates the prerequisite of exalted language in constructing an enemy and how a discursive 'machine of the same' was put into operation. The author argues that what made this operation unique is its structure of repetition that stimulated "the tendency to merge" what is "foreigner-to-the-ego", and the "enemy outside" into a single concept in the Argentinian national psyche.As a theoretical lens, the author examines the military regime's language through Freud's understanding of groups and civilization and Laplanche's proposition that cultural narratives in the form of mytho-symbolic explanations help us translate the sexual drive and offer a "solution" to the helplessness of the infant-adult.The author further claims that at other times a cultural narration functions as an anti-translation device when set against the emergence of a new net of significations. The nation's founding narrative of an Occidental-Spanish-Catholic "being" that first effaced its indigenous origins and then its Arabic and Jewish inheritance was brought back by the military regime as a mytho-symbolic narration that formed a shield against the repressed remnants of the enigmatic message pressing for a new translation.

Lifespan of Splints in a Sample of German Soldiers Hospitalised with Post-traumatic Stress Disorder (PTSD) in Combination with Sleep Bruxism and Painful Temporomandibular Disorder (TMD).

PURPOSE: This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. MATERIALS AND METHODS: One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. RESULTS: TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). CONCLUSION: The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.

Evaluation of mortality among Marines, Navy personnel, and civilian workers exposed to contaminated drinking water at USMC base Camp Lejeune: a cohort study.

BACKGROUND: Drinking water at U.S. Marine Corps Base (MCB) Camp Lejeune, North Carolina was contaminated with trichloroethylene and other industrial solvents from 1953 to 1985. METHODS: A cohort mortality study was conducted of Marines/Navy personnel who, between 1975 and 1985, began service and were stationed at Camp Lejeune (N = 159,128) or MCB Camp Pendleton, California (N = 168,406), and civilian workers employed at Camp Lejeune (N = 7,332) or Camp Pendleton (N = 6,677) between October 1972 and December 1985. Camp Pendleton's drinking water was not contaminated with industrial solvents. Mortality follow-up was between 1979 and 2018. Proportional hazards regression was used to calculate adjusted hazard ratios (aHRs) comparing mortality rates between Camp Lejeune and Camp Pendleton cohorts. The ratio of upper and lower 95% confidence interval (CI) limits, or CIR, was used to evaluate the precision of aHRs. The study focused on underlying causes of death with aHRs ≥ 1.20 and CIRs ≤ 3. RESULTS: Deaths among Camp Lejeune and Camp Pendleton Marines/Navy personnel totaled 19,250 and 21,134, respectively. Deaths among Camp Lejeune and Camp Pendleton civilian workers totaled 3,055 and 3,280, respectively. Compared to Camp Pendleton Marines/Navy personnel, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for cancers of the kidney (aHR = 1.21, 95% CI: 0.95, 1.54), esophagus (aHR = 1.24, 95% CI: 1.00, 1.54) and female breast (aHR = 1.20, 95% CI: 0.73, 1.98). Causes of death with aHRs ≥ 1.20 and CIR > 3, included Parkinson disease, myelodysplastic syndrome and cancers of the testes, cervix and ovary. Compared to Camp Pendleton civilian workers, Camp Lejeune had aHRs ≥ 1.20 with CIRs ≤ 3 for chronic kidney disease (aHR = 1.88, 95% CI: 1.13, 3.11) and Parkinson disease (aHR = 1.21, 95% CI: 0.72, 2.04). Female breast cancer had an aHR of 1.19 (95% CI: 0.76, 1.88), and aHRs ≥ 1.20 with CIRs > 3 were observed for kidney and pharyngeal cancers, melanoma, Hodgkin lymphoma, and chronic myeloid leukemia. Quantitative bias analyses indicated that confounding due to smoking and alcohol consumption would not appreciably impact the findings. CONCLUSION: Marines/Navy personnel and civilian workers likely exposed to contaminated drinking water at Camp Lejeune had increased hazard ratios for several causes of death compared to Camp Pendleton.

Psychophysiological responses to a multimodal physiotherapy program in fighter pilots with flight-related neck pain: A pilot trial.

BACKGROUND: The physical and cognitive demands of combat flying may influence the development and persistence of flight-related neck pain (FRNP). The aim of this pilot study was to analyse the effect of a multimodal physiotherapy program which combined supervised exercise with laser-guided feedback and interferential current therapy on psychophysiological variables in fighter pilots with FRNP. METHODS: Thirty-one fighter pilots were randomly assigned to two groups (Intervention Group: n = 14; Control Group: n = 17). The intervention consisted of 8 treatment sessions (twice per week) delivered over 4 weeks. The following primary outcomes were assessed: perceived pain intensity (Numeric Pain Rating Scale-NPRS) and Heart Rate Variability (HRV; time-domain, frequency-domain and non-linear variables). A number of secondary outcomes were also assessed: myoelectric activity of the upper trapezius and sternocleidomastoid, pain catastrophizing (Pain Catastrophizing Scale-PCS) and kinesiophobia (TSK-11). RESULTS: Statistically significant differences (p≤0.05) within and between groups were observed for all outcomes except for frequency domain and non-linear HRV variables. A significant time*group effect (one-way ANOVA) in favour of the intervention group was found for all variables (p<0.001). Effect sizes were large (d≥0.6). CONCLUSIONS: The use of a multimodal physiotherapy program consisting of supervised exercise with laser-guided feedback and interferential current appears to show clinical benefit in fighter pilots with FRNP. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05541848.

Inner ear decompression sickness after a routine dive and recompression chamber drill.

Inner ear decompression sickness (IEDCS) is an uncommon diving-related injury affecting the vestibulocochlear system, with symptoms typically including vertigo, tinnitus, and hearing loss, either in isolation or combination. Classically associated with deep, mixed-gas diving, more recent case series have shown that IEDCS is indeed possible after seemingly innocuous recreational dives, and there has been one previous report of IEDCS following routine hyperbaric chamber operations. The presence of right-to-left shunt (RLS), dehydration, and increases in intrathoracic pressure have been identified as risk factors for IEDCS, and previous studies have shown a predominance of vestibular rather than cochlear symptoms, with a preference for lateralization to the right side. Most importantly, rapid identification and initiation of recompression treatment are critical to preventing long-term or permanent inner ear deficits. This case of a U.S. Navy (USN) diver with previously unidentified RLS reemphasizes the potential for IEDCS following uncomplicated diving and recompression chamber operations - only the second reported instance of the latter.

Intelligibility of Natively and Nonnatively Produced English Speech Presented in Noise to a Large Cohort of United States Service Members.

PURPOSE: A corpus of English matrix sentences produced by 60 native and nonnative speakers of English was developed as part of a multinational coalition task group. This corpus was tested on a large cohort of U.S. Service members in order to examine the effects of talker nativeness, listener nativeness, masker type, and hearing sensitivity on speech recognition performance in this population. METHOD: A total of 1,939 U.S. Service members (ages 18-68 years) completed this closed-set listening task, including 430 women and 110 nonnative English speakers. Stimuli were produced by native and nonnative speakers of English and were presented in speech-shaped noise and multitalker babble. Keyword recognition accuracy and response times were analyzed. RESULTS: General(ized) linear mixed-effects regression models found that, on the whole, speech recognition performance was lower for listeners who identified as nonnative speakers of English and when listening to speech produced by nonnative speakers of English. Talker and listener effects were more pronounced when listening in a babble masker than in a speech-shaped noise masker. Response times varied as a function of recognition score, with longest response times found for intermediate levels of performance. CONCLUSIONS: This study found additive effects of talker and listener nonnativeness when listening to speech in background noise. These effects were present in both accuracy and response time measures. No multiplicative effects of talker and listener language background were found. There was little evidence of a negative interaction between talker nonnativeness and hearing impairment, suggesting that these factors may have redundant effects on speech recognition. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26060191.

Virtual fit assessment of U.S. army body armor using NASA spacesuit techniques.

Fit and accommodation are critical design goals for a body armor system to maximize Soldiers' protection, comfort, mobility, and performance. The aim of this study is to assess fit and accommodation of body armor plates for the US Army. A virtual fit assessment technique, developed, validated, and deployed by NASA for spacesuit design, was adopted for this work. Specifically, 3D manikins of the Soldier population were overlaid virtually with geometrically similar surrogates of the armor plates. Trained subject matter experts with the US Army and NASA manually assessed the fit of the armor plates to manikins using a computer visualization tool and selected the appropriate plate size and position. A prediction model was built from the assessment data to predict the plate size from an arbitrary body shape and the resultant patterns of body-to-plate contact were quantified. The outcome indicated a unique trend of the plate sizes covarying with anthropometry. More pronouncedly, when the overlap between the body tissue and armor plate was quantified, female Soldiers are likely to experience a 25 times larger body-to-plate contact volume and 6.5 times larger contact depth than males on average, due to sex-based anthropometric differences. Overall, the prediction model and contact patterns provided key metrics for virtual body armor fit assessments, of which the locations, patterns, and magnitudes can help to improve sizing and fit of body armor systems, as previously demonstrated for NASA spacesuit design.