Unintended Exchange of Target Vessels for Celiac Trunk and Superior Mesenteric Artery Branches in Complex Endovascular Aortic Repair.

PURPOSE: The treatment of thoracoabdominal aortic aneurysms (TAAAs) using branched endovascular aortic repair (BEVAR) is safe and effective. During deployment, the superior mesenteric artery (SMA) branch can unintentionally open into the celiac trunk (CT) ostium and switched catheterization of the SMA from the CT branch and the CT from the SMA branch can be used as an alternative technique in these cases. This study aimed to investigate the outcome of exchanging the intended target vessels (TVs) for the CT and SMA branches during BEVAR. MATERIALS AND METHODS: A single-center retrospective analysis of patients with TAAAs who underwent BEVAR, using off-the-shelf or custom-made devices (CMDs), with an unintended exchange of TVs for the CT and SMA branches was performed. RESULTS: Between 2014 and 2023, 397 patients were treated with BEVAR for TAAA. Eighteen (4.5%) of those patients were treated with an exchange of TVs for the CT and SMA branches. T-branch was used in 9 cases (50%) and the remaining patients were treated with CMDs. Twelve patients were treated electively, 3 were symptomatic and 3 presented with rupture. Of 36 mesenteric TVs in those 18 patients, 34 (94%) were catheterized successfully, including all 18 SMAs and 16 of the 18 CTs. No branch stenosis or occlusion of the switched mesenteric TVs was detected during follow-up. During 30-day follow-up, 3 patients died and during a median follow-up of 3 (interquartile range [IQR]: 1-15) months 3 more patients died. None of the deaths or the 2 unintended reinterventions was induced by the mesenteric TV exchange. The median hospital stay was 14 (IQR: 9-22) days with a median of 4 (IQR: 2-11) days at the intensive care unit. CONCLUSION: The exchange of the mesenteric TVs for the CT and SMA branches during BEVAR with off-the-shelf and CMD endografts is feasible with good TV patency and freedom from TV-related reinterventions. This alternative technique should be considered in selected cases when direct catheterization via the intended branch is deemed more time-consuming or not feasible. CLINICAL IMPACT: This is the first description of using an exchange of target vessels for the celiac trunk and the superior mesenteric artery branches in patients with thoracoabdominal aortic aneurysms undergoing BEVAR, using off-the-shelf or custom-made devices. The high success rate as well as the good clinical results without any branch stenosis or occlusion during follow-up highlight the feasibility of this alternative technique. It could help in challenging cases when catheterization of the intended target vessels is not possible or too time consuming, resulting in higher success rates of BEVAR and better clinical results.

Promoting Sustainable Development Goals by Optimizing City-Level Solar Photovoltaic Deployment in China.

Solar photovoltaic (PV) installations, which enable carbon neutrality, are expected to surge in the coming decades. This growth will support sustainable development goals (SDGs) via reductions in power-generation-related environmental emissions and water consumption while generating new jobs. However, where and to what extent PVs should be utilized to support SDGs must be thoroughly addressed. Here, we use multiple PV deployment scenarios to compare the benefits of PVs and related SDGs progress in 366 prefectural-level cities in China. We developed an assessment framework that integrates a PV allocation model, an electricity system optimization model, and a benefit assessment approach. We identify vast differences in PV distribution and electricity transmission and elucidate trade-offs and synergies among the SDGs under various PV implementation scenarios. The water conservation-oriented scenario yields substantial carbon reduction, air pollutant mitigation, and water saving cobenefits, leading to the greatest SDGs improvements. Prioritizing employment creation enhances job-relevant SDGs but inhibits environmental resource benefits. SDGs in less developed cities present greater progress across all scenarios. This study highlights the need to consider spatial heterogeneity and the potential trade-offs between different SDGs and regions when designing energy transition strategies.

'Golden Ratio Yoshimura' for meta-stable and massively reconfigurable deployment.

Yoshimura origami is a classical folding pattern that has inspired many deployable structure designs. Its applications span from space exploration, kinetic architectures and soft robots to even everyday household items. However, despite its wide usage, Yoshimura has been fixated on a set of design constraints to ensure its flat foldability. Through extensive kinematic analysis and prototype tests, this study presents a new Yoshimura that intentionally defies these constraints. Remarkably, one can impart a unique meta-stability by using the Golden Ratio angle ([Formula: see text]) to define the triangular facets of a generalized Yoshimura (with [Formula: see text], where [Formula: see text] is the number of rhombi shapes along its cylindrical circumference). As a result, when its facets are strategically popped out, a 'Golden Ratio Yoshimura' boom with [Formula: see text] modules can be theoretically reconfigured into [Formula: see text] geometrically unique and load-bearing shapes. This result not only challenges the existing design norms but also opens up a new avenue to create deployable and versatile structural systems.This article is part of the theme issue 'Origami/Kirigami-inspired structures: from fundamentals to applications'.

Level of perceived social support, and associated factors, in combat-exposed (ex-)military personnel: a systematic review and meta-analysis.

PURPOSE: Combat deployment increases exposure to potentially traumatic events. Perceived social support (PSS) may promote health and recovery from combat trauma. This systematic review and meta-analysis aimed to synthesize studies investigating the level of PSS and associated factors among (ex-)military personnel who served in the Iraq/Afghanistan conflicts. METHODS: Five electronic databases were searched in August 2023 and searches were restricted to the beginning of the Iraq/Afghanistan conflicts in 2001. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A quality assessment was carried out, and a meta-analysis and narrative synthesis were performed. RESULTS: In total, 35 papers consisting of 19,073 participants were included. Of these, 31 studies were conducted in the United States (US) and 23 were cross-sectional. The pooled mean PSS score was 54.40 (95% CI: 51.78 to 57.01). Samples with probable post-traumatic stress disorder had a lower mean PSS score (44.40, 95% CI: 39.10 to 49.70). Approximately half of the included studies (n = 19) investigated mental health in relation to PSS, whilst only four explored physical health. The most frequently reported risk factors for low PSS included post-traumatic stress disorder, depression and anxiety, whilst post-traumatic growth and unit support were protective factors. CONCLUSION: Higher levels of PSS were generally associated with more positive psychosocial and mental health-related outcomes following deployment. PSS should be targeted in psychosocial interventions and education programmes. Future research should investigate PSS in (ex-)military personnel across other countries and cultures, based on the lack of studies that focused on PSS in countries outside of the US.

Modified upside-down technique with Gore tapered iliac limbs for isolated iliac artery aneurysms.

PURPOSE: To describe the off-label use of tapered iliac limbs for the treatment of isolated iliac aneurysms with proximal landing zone significantly larger than distal landing zone. TECHNIQUE: Inversion of a Gore Excluder tapered leg (W. L. Gore & Associates Inc, Flagstaff, Arizona) with a modified upside-down technique is described. The endoprosthesis, with the olive at the tip of the releasing system previously cut, is inserted in a tip-to-tip fashion into a 15 Fr introducer sheath. The graft is released inside the introducer. An 18 Fr introducer sheath is advanced up to the proximal sealing zone. Following the removal of the 18 Fr dilator, the 15 Fr introducer with the pre-released graft is inserted co-axially into the 18 Fr introducer. A pre-cut 15 Fr dilator is brought up to the endograft and used as a pusher. A pull-back maneuver of the co-axial system, countertractioning with the dilator maintained in position, allows the delivery of the endograft. CONCLUSION: This technique might offer a feasible option in case of endovascular exclusion of isolated iliac artery aneurysms with significant landing zone diameter mismatch. Extracorporeal inversion is time-saving and could be safer in terms of graft damage and infection.

Deep learning segmentation of organs-at-risk with integration into clinical workflow for pediatric brain radiotherapy.

PURPOSE: Radiation therapy (RT) of pediatric brain cancer is known to be associated with long-term neurocognitive deficits. Although target and organs-at-risk (OARs) are contoured as part of treatment planning, other structures linked to cognitive functions are often not included. This paper introduces a novel automatic segmentation tool specifically designed for the unique challenges posed by pediatric patients undergoing brain RT, as well as its seamless integration into the existing clinical workflow. METHODS AND MATERIALS: Images of 47 pediatric brain cancer patients aged 1 to 20 years old and 33 two-year-old healthy infants were used to train a vision transformer, UNesT, for the segmentation of five brain OARs. The trained model was then incorporated to clinical workflow via DICOM connections between a treatment planning system (TPS) and a server hosting the trained model such that scans are sent from TPS to the server, automatically segmented, and sent back to TPS for treatment planning. RESULTS: The proposed automatic segmentation framework achieved a median dice similarity coefficient of 0.928 (frontal white matter), 0.908 (corpus callosum), 0.933 (hippocampi), 0.819 (temporal lobes), and 0.960 (brainstem) with a mean ± SD run time of 1.8 ± 0.67 s over 20 test cases. CONCLUSIONS: The pediatric brain segmentation tool showed promising performance on five OARs linked to neurocognitive functions and can easily be extended for additional structures. The proposed integration to the clinic enables easy access to the tool from clinical platforms and minimizes disruption to existing workflow while maximizing its benefits.

Inactive nurses' willingness to return to active nursing during the COVID-19 pandemic: A qualitative study.

AIMS: To investigate factors that influence the willingness of inactive nurses to return to nursing in a crisis situation and to identify aspects that need to be considered with regard to a possible deployment. DESIGN: A deductive and inductive qualitative content analysis of semi-structured focus group interviews. METHODS: Semi-structured focus group interviews with inactive or marginally employed nurses, nurses who have been inactive for some time and nursing home managers in October and November 2021. The participating inactive nurses had declared their willingness for a deployment during the COVID-19 pandemic or not. Data were analysed using qualitative content analysis. RESULTS: Communication was seen as essential by the participants for an informed decision for or against a temporary return to nursing and to potential or actual deployments. To make them feel safe, inactive nurses need to know what to expect and what is expected of them, for example, regarding required training and responsibilities. Considering their current employment status, some flexibility in terms of deployment conditions is needed. A remaining attachment to care can trigger a sense of duty. Knowledge of (regular) working conditions in nursing can lead to both a desire to support former colleagues and a refusal to be exposed to these conditions again. CONCLUSION: Past working experiences and the current employment situation play a major role in the willingness of inactive nurses to return to nursing in a crisis situation. Unbureaucratic arrangements must be provided for those who are willing to return. SUMMARY STATEMENT: What already is known - In crisis situations, not every inactive nurse is willing or able to return to nursing and therefore, the 'silent reserve' may not be as large as suspected. What this paper adds - Inactive nurses need to know what to expect and what is expected of them for their decision regarding a return to active patient care during a crisis situation. Implications for practice/policy - Inactive nurses need to be informed and should be offered free training and refresher courses to ensure patient safety. IMPACT: This research shows that the group of inactive nurses are not a silent workforce which can be activated anytime. Those who are able and willing to return to direct patient care in crisis situations need the best possible support - during and between crises. REPORTING METHOD: This study adhered to COREQ guidelines. NO PATIENT OR PUBLIC CONTRIBUTION: The involvement of patients or members of the public did not apply for the study, as the aim was to gain insight into the motivations and attitudes of the group of inactive nurses.

Selective placement of novel compression suture technique to reduce pacemaker implantation rate following surgical aortic valve replacement with rapid deployment INTUITY valve.

OBJECTIVE: The use of RDV in SAVR is associated with risk of conduction abnormality requiring PPM implantation, when compared to conventional bioprosthetic valves. We aimed to evaluate the outcome after selective placement of annular compression sutures during surgical aortic valve replacement (SAVR) using Intuity rapid deployment valve (RDV). METHODS: This is a retrospective study of prospectively enrolled patients receiving SAVR using Intuity RDV. Selective placement of commissural compression suture was assessed for all patients based on their annular morphology. Outcomes including operative mortality, rate of pacemaker rate, paravalvular leak and change in trans-valvular pressure gradient were analyzed. RESULTS: 56 consecutive patients underwent SAVR with the INTUITY RDV at our institution from January 2020 to November 2021. The Mean age of our cohort was 69.9 ± 10.6 years with a EuroSCORE II of 3.4 ± 2.4%. 28.6% (16/56) of patients had notable conduction abnormalities pre-operatively, which included atrial fibrillation and left/right bundle branch block. Compression sutures were selectively applied in 19/56 (33.9%) patients. Of which, 13 were bicuspid aortic valve. Post-operatively, we observed no conduction abnormality requiring PPM implantation. In addition, only 3 of the 56 (5.4%) had any degree of paravalvular leak on post-operative echocardiography (all ≤ mild). The mean reduction in trans-valvular gradient was 29.9 mmHg and the mean pressure gradient at 1 month and 1 year follow-up were 9.3 ± 3.6 mmHg and 10.2 ± 4.1 mmHg, respectively. CONCLUSIONS: Selective placement of compression suture helps to avoid unnecessary oversizing, which may reduce the risk of paravalvular leak and post-operative PPM implantation.

Deployment of Constellation with Different Inclinations Using the Nodal Precession and Thrust.

Strategy selection is critical for constellation deployment missions, both in terms of energy consumption and time cost. The different effects of impulse thrust and continuous thrust on orbit elements lead to a different choice of strategy. With impulse thrust, constellation types are differentiated according to high and medium-low inclinations. Constellations with high inclination are deployed using a strategy that controls the inclination. Constellations with medium-low inclination are deployed using a strategy that controls the semi-long axis. With continuous thrust, constellations are classified according to high, medium, and low inclination. High inclination constellations are deployed with a strategy of controlling inclination. Medium inclination constellations are deployed with a strategy that controls the semi-long axis. Low inclination constellations are deployed with a strategy of directly applying continuous thrust.

The Impact of an Automation System Built with Jenkins on the Efficiency of Container-Based System Deployment.

This paper evaluated deployment efficiency by comparing manual deployment with automated deployment through a CI/CD pipeline using Jenkins. This study involved moving from a manual deployment process to an automated system using Jenkins and experimenting with both deployment methods in a real-world environment. The results showed that the automated deployment system significantly reduced the deployment time compared to manual deployment and significantly reduced the error rate. Manual deployment required human intervention at each step, making it time-consuming and prone to mistakes, while automated deployment using Jenkins automated each step to ensure consistency and maximized time efficiency through parallel processing. Automated testing verified the stability of the code before deployment, minimizing errors. This study demonstrates the effectiveness of adopting a CI/CD pipeline and shows that automated systems can provide high efficiency in real-world production environments. It also highlights the importance of security measures to prevent sensitive information leakage during CI/CD, suggesting the use of secrecy management tools and environment variables and limiting access rights. This research will contribute to exploring the applicability of CI/CD pipelines in different environments and, in doing so, validate the universality of automated systems.

Design and Manufacture of Multifunctional 3-D Smart Skins with Embedded Sensor Networks for Robotic Applications.

An investigation was performed to develop a process to design and manufacture a 3-D smart skin with an embedded network of distributed sensors for non-developable (or doubly curved) surfaces. A smart skin is the sensing component of a smart structure, allowing such structures to gather data from their surrounding environments to make control and maintenance decisions. Such smart skins are desired across a wide variety of domains, particularly for those devices where their surfaces require high sensitivity to external loads or environmental changes such as human-assisting robots, medical devices, wearable health components, etc. However, the fabrication and deployment of a network of distributed sensors on non-developable surfaces faces steep challenges. These challenges include the conformal coverage of a target object without causing prohibitive stresses in the sensor interconnects and ensuring positional accuracy in the skin sensor deployment positions, as well as packaging challenges resulting from the thin, flexible form factor of the skin. In this study, novel and streamlined processes for making such 3-D smart skins were developed from the initial sensor network design to the final integrated skin assembly. Specifically, the process involved the design of the network itself (for which a physical simulation-based optimization was developed), the deployment of the network to a targeted 3D surface (for which a specialized tool was designed and implemented), and the assembly of the final skin (for which a novel process based on dip coating was developed and implemented.).

Deterministic Localization for Fully Automatic Operation: A Survey and Experiments.

With the rapid development of fully automatic operation (FAO) and location-based services, the evaluation criteria of average localization accuracy can no longer meet our demands, in favor of deterministic localization. However, most localization researches modeled localization performance function and enhanced it by minimizing average localization root mean square error (RMSE). The performance degradation in a small region was not considered. In this paper, we present a survey of deterministic localization and analyze the relationship between accuracy and certainty. In this paper, two common solutions of localization enhancement are presented and their localization certainties are discussed. Furthermore, we carry out related localization enhancement experiments in rail transit line and analyze their improvement on deterministic localization. The experimental results show that the overall localization performance is improved, while the deterministic localization requires the stricter solution to promote.

Deployment Protection for Interference of 5G Base Stations with Aeronautical Radio Altimeters.

In this manuscript, we present a novel deployment protection method aimed at safeguarding aeronautical radio altimeters (RAs) from interference caused by fifth-generation (5G) telecommunication base stations (BSs). Our methodology involves an integrated interference model for defining prohibited zones and utilizes power control and angle shutoff methods to mitigate interference. First, to ensure reliable protection, we define both horizontal and vertical prohibited zones and investigate their variations to immunize RA against 5G interference. Second, we validate the effectiveness of the model in various operational scenarios, analyzing the influence of factors such as base station types, antenna parameters, flight altitude, and aircraft attitudes to cover a wide range of real-world scenarios. Third, to mitigate interference, we propose and analyze the power control and angle shutoff methods through simulation for the RMa prohibited zone. Our results demonstrate the efficacy of the deployment protection method in safeguarding RAs from 5G interference, providing guidance for interference protection during civil aviation operations and base station deployment near airports.

Delay-Oriented Roadside Unit Deployment for Highway Intersections in Vehicular Ad Hoc Networks.

Optimizing the deployment of roadside units (RSUs) holds great potential for enhancing the delay performance of vehicular ad hoc networks. However, there has been limited focus on devising RSU deployment strategies tailored specifically for highway intersections. In this study, we introduce a novel probabilistic model to characterize events occurring around highway intersections. By leveraging this model, we analytically determine the expected event reporting delays for both highway segments and intersections. Subsequently, we propose an RSU deployment scheme specifically designed for highway intersections, aimed at minimizing the expected event reporting delay. To implement this scheme, we introduce an innovative algorithm named cooperative walking. Through illustrative examples, we demonstrate that our proposed RSU deployment strategy for highway intersections outperforms the commonly employed uniform RSU deployment scheme and the previously proposed balloon method in terms of delay performance.

Configuration Investigation, Structure Design and Deployment Dynamics of Rigid-Reflector Spaceborne Antenna with Deviation-Angle Panel.

Rigid-reflector spaceborne antennas (RRSAs) are well-suited for high-frequency application scenarios due to their high surface accuracy. However, the low stowing efficiency of RRSAs limits the aperture diameters and further deteriorates the electromagnetic (EM) performances in terms of gain, resolution and sensitivity. After conducting systematic feature analysis with respect to several typical RRSAs, we propose a novel type of RRSA to solve the aforementioned problems. Inspired by the pose adjustment process for a higher stowing efficiency of traditional RRSAs, we also propose a new segmentation scheme of a reflective surface consisting of a deviation-angle panel that facilitates a higher stowing efficiency. Based on this scheme, its corresponding folded configuration is implemented by combining Euler's rotation theorem and the idea of parameter identification. In addition, we also compare the stowing efficiency of different schemes to verify the high stowing efficiency of the configuration. Finally, we perform mechanism/structure design and deployment dynamics to demonstrate that the antenna can be successfully deployed and exhibits excellent deployment quality. The results suggest that the proposed antenna possesses higher stowing efficiency than that of the same kind, with a stable deployment and interference-free process.

An Urban Intelligence Architecture for Heterogeneous Data and Application Integration, Deployment and Orchestration.

This paper describes a novel architecture that aims to create a template for the implementation of an IT platform, supporting the deployment and integration of the different digital twin subsystems that compose a complex urban intelligence system. In more detail, the proposed Smart City IT architecture has the following main purposes: (i) facilitating the deployment of the subsystems in a cloud environment; (ii) effectively storing, integrating, managing, and sharing the huge amount of heterogeneous data acquired and produced by each subsystem, using a data lake; (iii) supporting data exchange and sharing; (iv) managing and executing workflows, to automatically coordinate and run processes; and (v) to provide and visualize the required information. A prototype of the proposed IT solution was implemented leveraging open-source frameworks and technologies, to test its functionalities and performance. The results of the tests performed in real-world settings confirmed that the proposed architecture could efficiently and easily support the deployment and integration of heterogeneous subsystems, allowing them to share and integrate their data and to select, extract, and visualize the information required by a user, as well as promoting the integration with other external systems, and defining and executing workflows to orchestrate the various subsystems involved in complex analyses and processes.

Cerebral regional oxygen saturation as a predictive parameter for preoperative heart failure and delayed hemodynamic recovery in transcutaneous aortic valve implantation: a retrospective cohort study.

This study aimed to investigate the relationship of perioperative cerebral regional oxygen saturation (rSO2) with various preoperative clinical variables and hemodynamic changes during transfemoral transcatheter aortic valve implantation (TAVI) under general anesthesia. We retrospectively analyzed cerebral rSO2 values from left-hemisphere measurements obtained using near-infrared spectroscopy (O3™ regional oximetry) at five time points: pre-induction, the start of the procedure, the start of valve deployment, time of lowest cerebral rSO2 value during valve deployment, and the end of the procedure. This study included 91 patients (60 with balloon-expandable valves and 31 with self-expandable valves). The baseline cerebral rSO2 values were correlated with B-type natriuretic peptide, hemoglobin, fractional shortening, ejection fraction, left ventricular mass index, left ventricular end-systolic diameter, STS risk of mortality, and STS morbidity or mortality. The patients who took longer to recover their systolic blood pressure to 90 mmHg after valve deployment with a balloon-expandable valve (group B) had lower cerebral rSO2 values during deployment compared to patients with faster recovery with balloon-expandable valve (group A) and with self-expandable valve (group C). Baseline cerebral rSO2 is associated with preoperative variables related to cardiac failure and function, and a significant decline during valve deployment may indicate a risk of prolonged hypotension during TAVI.

United States Army Reserve/National Guard soldiers' healthcare experiences, attitudes, and preferences: Differences based on deployment status.

Some United States Army Reserve/National Guard (USAR/NG) soldiers have substantial health needs, which may be service-related, but not necessarily resulting from deployment. However, most USAR/NG members need to have been deployed to qualify for Veterans Administration (VA) benefits. Therefore, many USAR/NG soldiers seek care from civilian healthcare providers (HCPs). Using a subset (N = 430 current/former soldiers) of Operation: SAFETY study data, we used regression models to examine differences in healthcare experiences, attitudes, and preferences by deployment status (never-deployed vs. previously-deployed). Final models controlled for age, sex, rank (enlisted vs. officer), military status (current vs. former military), and RAND SF-36 General Health Score. Over 40% of soldiers agreed that civilian HCPs should ask patients about their military service, but never-deployed soldiers were less likely to report being asked about their service (p < 0.05) or how their service affects their health (p < 0.10). Never-deployed soldiers were also less likely to attribute their health concerns to military service (p < 0.001). Although never-deployed soldiers were more likely to prefer receiving physical (p < 0.05) and mental (p < 0.05) healthcare outside of the VA than previously-deployed soldiers, never-deployed soldiers had low confidence in their HCP's understanding of their needs (49% thought that their civilian HCP did not understand them; 71% did not think that their civilian HCP could address military-related health concerns; 76% thought that their civilian HCP did not understand military culture). Findings demonstrate that although civilian HCPs may be the preferred (and only) choice for never-deployed USAR/NG soldiers, they may need additional support to provide care to this population.

Positive and negative family communication and mental distress: Married service members during a non-combat deployment.

This study examines whether married service member perceptions of positive or negative communication moderate the relationship between how frequently they communicate home during a deployment and their mental distress. Participants included 382 married service members who completed surveys regarding their marital relationships, communication, and mental health while on a non-combat deployment. Though marital satisfaction was not significantly associated with service member reports of their mental distress, perceptions of negative (ß = 4.32, SE = 0.59, p < 0.001) and positive communication (ß = -1.32, SE = 0.57, p < 0.05) were. Further, significant interactions between frequency of communication and the perception of negative (ß = 0.54, SE = 0.13, p < 0.001) and positive (ß = 0.17, SE = 0.07, p < 0.01) communication suggest positive communication may be protective for service members while frequent, negative communication can exacerbate distress. Findings highlight the importance of engaging families in planning and skill building to support healthy communication across the deployment cycle.

Replication and extension of the military family stress model: The after deployment adaptive parenting tools ADAPT4U study.

The military family stress (MFS) model conceptualizes that wartime deployments and post-traumatic stress disorder (PTSD) symptoms are associated with couple, parenting, and child adjustment difficulties. The aim of this study was to replicate and extend the military family stress model by examining the associations among deployment length, PTSD symptoms, marital functioning, parenting practices, and child adjustment in a replication sample of both National Guard and Reserve (NG/R) as well as active-duty service member families. The MFS model is extended to test whether these relationships vary between mothers and fathers. The sample included 208 families enrolled in a randomized controlled trial of a parenting program for military families (94.4% of fathers and 21.6% of mothers were deployed). Replicating the MFS model, we specified parenting, marital quality, and child adjustment as latent variables and conducted multi-group structural equation models. Parenting practices were positively associated with marital quality and child adjustment. PTSD symptoms were negatively associated with marital quality. The indirect effect from PTSD symptoms to parenting practices through marital quality was marginally significant. The indirect effect from marital quality to child adjustment through parenting practices was significant. There were no significant gender differences between the two structural models. This study provides empirical support for the MFS model. Results demonstrate that deployment-related stressors are significantly associated with parent and family functioning. Parenting programs for military families might effectively target similar risk processes among both mothers and fathers.