scholarly journals Triaged treatment-based conventional weapon combat wound classification code design and injury spectrum statistical analysis

2020 ◽  
Author(s):  
BO PENG ◽  
Shuo Liu ◽  
Fei Pan ◽  
Zhen He ◽  
Tan-shi Li
Keyword(s):  
Emergency Treatment ◽  
Mass Casualty ◽  
Three Dimensions ◽  
Code Design ◽  
Classification Code ◽  
Treatment Techniques ◽  
High Incidence ◽  
Wound Classification ◽  
Combat Casualties ◽  
Fatal Injuries

Abstract Purpose To provide evidence for the rapid and efficient classification of combat casualties while simultaneously determining the types of high-incidence fatal injuries that require emergency treatment to support the triage of combat wounds in mass casualty situations. Methods The three-tiered treatment echelon consisting of battlefield on-site first aid, emergency treatment, and early treatment was used to design an expanded combat wound classification code system according to the differential needs of combat wound treatment. Three dimensions of evaluation indicators consisting of likelihood, importance, and suitability were established and an optimized quasi-HHI index was used for the normalization and ranking of expert survey results. Results We obtained exhaustive combinations from the massive number of combat wound factors in combat wound classification codes, constructed injury spectrum frameworks within the different treatment echelons, and identified high-incidence fatal injuries in different treatment echelons. Conclusions Our combat wound classification codes achieved good results in terms of having higher classification speed and accuracy than traditional methods. The high incidence fatal injuries identified by the constructed combat wound spectrum can provide guidance and support when used for the improvement of treatment techniques and upgrading equipment in the Chinese People’s Liberation Army.

scholarly journals Triaged Treatment-Based Conventional Weapon Combat Wound Classification Code Design and Injury Spectrum Statistical Analysis

2020 ◽  
Vol 185 (11-12) ◽  
pp. e2032-e2038
Author(s):  
Bo Peng ◽  
Shuo Liu ◽  
Lei Xu ◽  
Zhen He
Keyword(s):  
Emergency Treatment ◽  
Hospital Staff ◽  
First Aid ◽  
Mass Casualty ◽  
Classification Systems ◽  
Coding System ◽  
Traditional Methods ◽  
Vast Number ◽  
High Incidence ◽  
Wound Classification

Abstract Introduction We create an expandable combat wound classification coding system and a stratified standardized combat wound injury spectrum to support triage according to the treatment echelon and to provide the basis for the rapid and efficient classification of combat casualties. The coding system simultaneously assists in identifying injuries with a high incidence of fatality that require emergency treatment, and provides a framework for the triage of combat wounds in mass casualty situations. Materials and Methods The three-tiered treatment echelon consisting of battlefield on-site first aid, emergency treatment, and early treatment was used to design an expanded combat wound classification coding system according to the differential needs of combat wound treatment. The Herfindahl−Hirschman Index (HHI) index was used as the key indicator for injury spectrum ranking and was applied to select the key anatomical structures that require the highest priority treatment in the three treatment echelons. The combat wound classification codes were based on the results of consultations with selected experts and results from the HHI index calculations. The use of the classification codes at the battlefield on-site first aid stage and emergency treatment stage was evaluated in exercises to test and compare the effectiveness of the classification codes against current classification systems. Results We obtained exhaustive combinations from the vast number of combat wound factors in combat wound classification codes, constructed injury spectrum frameworks within the different treatment echelons, and identified injuries with a high-incidence of fatality in each of the treatment echelons. Compared with traditional methods, the time spent on coding was reduced and classification accuracy was improved when using the new classification codes, which led to improved efficiency of classification and a reduced workload for hospital staff. Conclusions The combat wound classification codes that were established through the HHI index and expert consultations achieved good results in terms of having higher classification speed and accuracy than traditional methods. This means they could be used to identify injuries with a high-incidence of fatality and provide guidance to improve the efficiency of treatment among all treatment echelons in the army.

A Case Study of the High-speed Train Crash Outside Santiago de Compostela, Galicia, Spain

2016 ◽  
Vol 31 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Rebecca Forsberg ◽  
José Antonio Iglesias Vázquez
Keyword(s):  
High Velocity ◽  
High Speed ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
High Speed Train ◽  
Publication Type ◽  
Santiago De Compostela ◽  
Train Speed ◽  
Fatal Injuries

AbstractIntroductionThe worldwide use of rail transport has increased, and the train speeds are escalating. Concurrently, the number of train disasters has been amplified globally. Consequently, railway safety has become an important issue for the future. High-velocity crashes increase the risk for injuries and mortality; nevertheless, there are relatively few studies on high-speed train crashes and the influencing factors on travelers’ injuries occurring in the crash phase. The aim of this study was to investigate the fatal and non-fatal injuries and the main interacting factors that contributed to the injury process in the crash phase of the 2013 high-velocity train crash that occurred at Angrois, outside Santiago de Compostela, Spain.MethodsHospital records (n=157) of all the injured who were admitted to the six hospitals in the region were reviewed and compiled by descriptive statistics. The instant fatalities (n=63) were collected on site. Influencing crash factors were observed on the crash site, by carriage inspections, and by reviewing official reports concerning the approximated train speed.ResultsThe main interacting factors that contributed in the injury process in the crash phase were, among other things, the train speed, the design of the concrete structure of the curve, the robustness of the carriage exterior, and the interior environment of the carriages. Of the 222 people on board (218 passengers and four crew), 99% (n=220) were fatally or non-fatally injured in the crash. Thirty-three percent (n=72) suffered fatal injuries, of which 88% (n=63) died at the crash site and 13% (n=9) at the hospital. Twenty-one percent (n=32) of those admitted to hospital suffered multi-trauma (ie, extensive, severe, and/or critical injuries). The head, face, and neck sustained 42% (n=123) of the injuries followed by the trunk (chest, abdomen, and pelvis; n=92; 32%). Fractures were the most frequent (n=200; 69%) injury.ConclusionA mass-casualty incident with an extensive amount of fatal, severe, and critical injuries is most probable with a high-velocity train; this presents prehospital challenges. This finding draws attention to the importance of more robust carriage exteriors and injury minimizing designs of both railway carriages and the surrounding environment to reduce injuries and fatalities in future high-speed crashes.ForsbergR, VázquezJAI. A case study of the high-speed train crash outside Santiago de Compostela, Galicia, Spain. Prehosp Disaster Med. 2016;31(2);163–168.

scholarly journals Treatment of severe depression – non-pharmacological aspects

2001 ◽  
Vol 7 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Richard Porter ◽  
Keith Linsley ◽  
Nicol Ferrier
Keyword(s):  
Electroconvulsive Therapy ◽  
Emergency Treatment ◽  
Severe Depression ◽  
Previous Article ◽  
Therapeutic Interventions ◽  
Severe Morbidity ◽  
Safe Treatment ◽  
High Incidence

Depression, in its severest forms, causes severe morbidity, has a high incidence of mortality and requires emergency treatment. In a previous article in this journal (Porter & Ferrier, 1999), we discussed the emergency treatment of severe depression by pharmacological means and electroconvulsive therapy (ECT). Here, we will discuss the contribution of non-pharmacological aspects of management to fast, effective and safe treatment of severe depression. We will also complete our review of this subject by examining the efficacy of some emerging therapeutic interventions for severe depression.

High-resolution scanning electron microscopy (HRSEM) of mitochondria from various rat tissues

1988 ◽  
Vol 46 ◽  
pp. 14-15
Author(s):  
P.J. Lea ◽  
M.J. Hollenberg
Keyword(s):  
Electron Microscopy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Rat Hepatocytes ◽  
Three Dimensions ◽  
Objective Lens ◽  
Rat Tissues ◽  
Thin Sections ◽  
Reconstruction Methods ◽  
Scanning Electron

Our current understanding of mitochondrial ultrastructure has been derived primarily from thin sections using transmission electron microscopy (TEM). This information has been extrapolated into three dimensions by artist's impressions (1) or serial sectioning techniques in combination with computer processing (2). The resolution of serial reconstruction methods is limited by section thickness whereas artist's impressions have obvious disadvantages.In contrast, the new techniques of HRSEM used in this study (3) offer the opportunity to view simultaneously both the internal and external structure of mitochondria directly in three dimensions and in detail.The tridimensional ultrastructure of mitochondria from rat hepatocytes, retinal (retinal pigment epithelium), renal (proximal convoluted tubule) and adrenal cortex cells were studied by HRSEM. The specimens were prepared by aldehyde-osmium fixation in combination with freeze cleavage followed by partial extraction of cytosol with a weak solution of osmium tetroxide (4). The specimens were examined with a Hitachi S-570 scanning electron microscope, resolution better than 30 nm, where the secondary electron detector is located in the column directly above the specimen inserted within the objective lens.

Inelastic Electron Scattering from Valence Electrons in Aluminum

1976 ◽  
Vol 34 ◽  
pp. 462-463
Author(s):  
P. E. Batson ◽  
C. H. Chen ◽  
J. Silcox
Keyword(s):  
Electron Scattering ◽  
Single Scattering ◽  
Three Dimensions ◽  
Inelastic Electron ◽  
Weak Beam ◽  
Scattering Spectrum ◽  
Valence Electrons ◽  
Diffraction Patterns ◽  
Electronic Scattering

We wish to report in this paper measurements of the inelastic scattering component due to the collective excitations (plasmons) and single particlehole excitations of the valence electrons in Al. Such scattering contributes to the diffuse electronic scattering seen in electron diffraction patterns and has recently been considered of significance in weak-beam images (see Gai and Howie) . A major problem in the determination of such scattering is the proper correction for multiple scattering. We outline here a procedure which we believe suitably deals with such problems and report the observed single scattering spectrum.In principle, one can use the procedure of Misell and Jones—suitably generalized to three dimensions (qx, qy and #x2206;E)--to derive single scattering profiles. However, such a computation becomes prohibitively large if applied in a brute force fashion since the quasi-elastic scattering (and associated multiple electronic scattering) extends to much larger angles than the multiple electronic scattering on its own.

Advantages of Complementary Stereo Images as Viewed with the Low-Temperature Field-Emission SEM

1992 ◽  
Vol 50 (2) ◽  
pp. 1314-1315
Author(s):  
William P. Wergin ◽  
Eric F. Erbe
Keyword(s):  
Fold Increase ◽  
Horizontal Displacement ◽  
Three Dimensions ◽  
Stereo Image ◽  
Stereo Pair ◽  
Sem Micrograph ◽  
Left And Right ◽  
The Common ◽  
The Brain ◽  
Pair Analysis

The eye-brain complex allows those of us with normal vision to perceive and evaluate our surroundings in three-dimensions (3-D). The principle factor that makes this possible is parallax - the horizontal displacement of objects that results from the independent views that the left and right eyes detect and simultaneously transmit to the brain for superimposition. The common SEM micrograph is a 2-D representation of a 3-D specimen. Depriving the brain of the 3-D view can lead to erroneous conclusions about the relative sizes, positions and convergence of structures within a specimen. In addition, Walter has suggested that the stereo image contains information equivalent to a two-fold increase in magnification over that found in a 2-D image. Because of these factors, stereo pair analysis should be routinely employed when studying specimens.Imaging complementary faces of a fractured specimen is a second method by which the topography of a specimen can be more accurately evaluated.

The observation of defects on (100) CdTe surfaces by chemical etching

1992 ◽  
Vol 50 (2) ◽  
pp. 1424-1425
Author(s):  
M.E. Lee
Keyword(s):  
Single Crystal ◽  
Grain Boundaries ◽  
Single Crystals ◽  
Chemical Etching ◽  
Crystalline Perfection ◽  
Crystalline Defects ◽  
High Incidence ◽  
Crystallographic Defects ◽  
Cdznte Substrates ◽  
Device Technology

The crystalline perfection of bulk CdTe substrates plays an important role in their use in infrared device technology. The application of chemical etchants to determine crystal polarity or the density and distribution of crystallographic defects in (100) CdTe is not well understood. The lack of data on (100) CdTe surfaces is a result of the apparent difficulty in growing (100) CdTe single crystal substrates which is caused by a high incidence of twinning. Many etchants have been reported to predict polarity on one or both (111) CdTe planes but are considered to be unsuitable as defect etchants. An etchant reported recently has been considered to be a true defect etchant for CdTe, MCT and CdZnTe substrates. This etchant has been reported to reveal crystalline defects such as dislocations, grain boundaries and inclusions in (110) and (111) CdTe. In this study the effect of this new etchant on (100) CdTe surfaces is investigated.The single crystals used in this study were (100) CdTe as-cut slices (1mm thickness) from Bridgman-grown ingots.

convergent-beam diffraction from surfaces

1987 ◽  
Vol 45 ◽  
pp. 30-33
Author(s):  
J. A. Eades ◽  
A. E. Smith ◽  
D. F. Lynch
Keyword(s):  
Reciprocal Lattice ◽  
Three Dimensional ◽  
Grazing Incidence ◽  
Three Dimensions ◽  
Plane Figure ◽  
Transmission Electron ◽  
Convergent Beam ◽  
Beam Patterns ◽  
Beam Diffraction

It is quite simple (in the transmission electron microscope) to obtain convergent-beam patterns from the surface of a bulk crystal. The beam is focussed onto the surface at near grazing incidence (figure 1) and if the surface is flat the appropriate pattern is obtained in the diffraction plane (figure 2). Such patterns are potentially valuable for the characterization of surfaces just as normal convergent-beam patterns are valuable for the characterization of crystals.There are, however, several important ways in which reflection diffraction from surfaces differs from the more familiar electron diffraction in transmission.GeometryIn reflection diffraction, because of the surface, it is not possible to describe the specimen as periodic in three dimensions, nor is it possible to associate diffraction with a conventional three-dimensional reciprocal lattice.

3-D reconstruction and analysis of mammalian mitotic spindle structure

1992 ◽  
Vol 50 (1) ◽  
pp. 578-579
Author(s):  
Kent McDonald ◽  
David Mastronarde ◽  
Rubai Ding ◽  
Eileen O'Toole ◽  
J. Richard McIntosh
Keyword(s):  
Cross Sections ◽  
Mitotic Spindle ◽  
Experimental Studies ◽  
Video Camera ◽  
Three Dimensions ◽  
Mitotic Spindles ◽  
Black And White ◽  
Reconstruction Methods ◽  
Spindle Structure ◽  
Tissue Culture Line

Mammalian spindles are generally large and may contain over a thousand microtubules (MTs). For this reason they are difficult to reconstruct in three dimensions and many researchers have chosen to study the smaller and simpler spindles of lower eukaryotes. Nevertheless, the mammalian spindle is used for many experimental studies and it would be useful to know its detailed structure.We have been using serial cross sections and computer reconstruction methods to analyze MT distributions in mitotic spindles of PtK cells, a mammalian tissue culture line. Images from EM negatives are digtized on a light box by a Dage MTI video camera containing a black and white Saticon tube. The signal is digitized by a Parallax 1280 graphics device in a MicroVax III computer. Microtubules are digitized at a magnification such that each is 10-12 pixels in diameter.

Five-Dimensional Microscopy using Widefield-Deconvolution: Practical Considerations and Biological Applications

1996 ◽  
Vol 54 ◽  
pp. 268-269
Author(s):  
W.F. Marshall ◽  
K. Oegema ◽  
J. Nunnari ◽  
A.F. Straight ◽  
D.A. Agard ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
High Speed ◽  
Laser Scanning ◽  
Ccd Camera ◽  
Image Plane ◽  
Time Lapse ◽  
Laser Scanning Confocal Microscopy ◽  
Three Dimensions ◽  
Excitation Light ◽  
Cooled Ccd

The ability to image cells in three dimensions has brought about a revolution in biological microscopy, enabling many questions to be asked which would be inaccessible without this capability. There are currently two major methods of three dimensional microscopy: laser-scanning confocal microscopy and widefield-deconvolution microscopy. The method of widefield-deconvolution uses a cooled CCD to acquire images from a standard widefield microscope, and then computationally removes out of focus blur. Using such a scheme, it is easy to acquire time-lapse 3D images of living cells without killing them, and to do so for multiple wavelengths (using computer-controlled filter wheels). Thus, it is now not only feasible, but routine, to perform five dimensional microscopy (three spatial dimensions, plus time, plus wavelength).Widefield-deconvolution has several advantages over confocal microscopy. The two main advantages are high speed of acquisition (because there is no scanning, a single optical section is acquired at a time by using a cooled CCD camera) and the use of low excitation light levels Excitation intensity can be much lower than in a confocal microscope for three reasons: 1) longer exposures can be taken since the entire 512x512 image plane is acquired in parallel, so that dwell time is not an issue, 2) the higher quantum efficiently of a CCD detect over those typically used in confocal microscopy (although this is expected to change due to advances in confocal detector technology), and 3) because no pinhole is used to reject light, a much larger fraction of the emitted light is collected. Thus we can typically acquire images with thousands of photons per pixel using a mercury lamp, instead of a laser, for illumination. The use of low excitation light is critical for living samples, and also reduces bleaching. The high speed of widefield microscopy is also essential for time-lapse 3D microscopy, since one must acquire images quickly enough to resolve interesting events.

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