Hendriksenabildtrup5562

Our hospital began work on formulating its own critical care air transport team (CCATT) and patient transfer unit (PTU) in 2007. A total of 293 patients have been evacuated by air using the various models of the PTU from April 2008 to February 2017. This study has been undertaken to formulate a protocol for activation of CCATT for aeromedical evacuation that best suits our setup keeping in view the availability of electromedical equipment, manpower and aircrafts.

The study is a cross-sectional study involving patients who were air evacuated between January 2010 to February 2017. Statistical analysis tests were performed to compare and analyze the two scoring systems to find out the sensitivity and specificity of the two scoring systems and to find out the degree of agreement.

The data using each scoring system were compared with actual requirement of CCATT based on recommendation of team leader of each CCATT mission and available data of each patient. It was observed that the old scoring system showed poor agreement with kappa coefficient of 0.162. The new scoring system based on modified early warning physiological score showed good agreement with kappa coefficient of 0.895.

CCATT can be activated by peripheral medical echelons based on objective criteria rather than subjective ones so that optimal use of resources can be carried out not only in peace time but also during mass casualty scenarios such as natural calamities or war.

CCATT can be activated by peripheral medical echelons based on objective criteria rather than subjective ones so that optimal use of resources can be carried out not only in peace time but also during mass casualty scenarios such as natural calamities or war.

To analyze the epidemiology of hospitalized ocular injuries occurring in counter insurgency and proxy war environment in a forward area of northern India over a period of 13 years.

Retrospective observational study of medical records was performed of 458 patients with ocular injuries primarily treated at zonal referral hospital of Indian Army between January 1992 and December 2004.

A total of 559 eyes with ocular injuries were studied. The average age of the victims was 30 years. In 77% cases, injuries were sustained by army personnel and remaining by paramilitary forces. Of all cases, 86.5% cases were due to combat-related (militant action), of which 93.9% cases were caused by splinters from munitions. Among the eyes injured due to militant action, 60.36% were open globe injuries, 31.19% were closed globe injuries and 8.45% were isolated adnexal injuries. Among the eyes injured, 76.33% of the eyes with open globe injuries owing to militant action had perforating injuries, whereas in closed globe injuries, 47.74% eyes had corneal foreign body. Among eyes with open globe injuries, Corneo-scleral, scleral and corneal lacerations were seen in 45%, 28% and 27% eyes respectively. 15.75% of eyes with ocular injuries underwent eviscerations.

The study reveals that splinter eye injuries from munitions were the most common cause of ocular morbidity in counter insurgency and proxy war. Implementation of use of protective glasses by the personnel deployed in such hostile environment and strict compliance of preventive measures would be effective in saving eyes and also medical and economic resources.

The study reveals that splinter eye injuries from munitions were the most common cause of ocular morbidity in counter insurgency and proxy war. Implementation of use of protective glasses by the personnel deployed in such hostile environment and strict compliance of preventive measures would be effective in saving eyes and also medical and economic resources.

High-velocity missile injuries are commonly encountered in war or war-like situations. Aggressive resuscitation, early evacuation to neurosurgical center, and application of neurosurgical principles remain tenets of success.

The spectrum of injuries and clinical profile of 14 such cases with craniocerebral missile injuries managed at our center in the northern sector were included. Site of injury, GCS at presentation, associated injuries, surgical intervention, duration of hospitalization, and recovery of the patient were analyzed.

Five patients had sustained gunshot wounds, and nine patients had sustained shrapnel injuries. Thirteen patients were deeply comatose, and one patient was conscious.The entry wound was in frontal lobe in eight patients, and in four patients, it was inthefaciocranial area. Ten patients had Glasgow Coma Scale (GCS) less than 8at presentation. Surgical intervention was required in 13 patients, including 11 decompressive craniectomies and anterior skull base repair in four patien and rehabilitation.A Military Physician is expected to fulfill the dual role of a humane physician and a patriotic soldier. But both these professions are principally very different from each other, a soldier above all is supposed to have utmost loyalty towards his country and protect national security at all costs. Whereas a doctor has moral obligations towards his patients and is required to treat ill or wounded irrespective of caste, creed, or nationality. Military physicians bridge these two professions based on the principles of humanity, impartiality, and neutrality. The present paper attempts to explore the challenges faced by military physicians in adhering to professional ethos especially during an armed conflict and provides an overview of various regulations and declarations in vogue for guiding military physicians in times of ethical and obligatory dilemmas.The aim of the present study is to enhance the performance of a microbial fuel cell (MFC) design by making simple interventions. Specifically, terracotta "t" and mullite "m" ceramics are tested as membranes while carbon veil and carbon cloth are used as electrodes. In the case of "m" cylinders different dimensions are examined (m ID 30 mm x height 11.5 mm; sm ID 18 mm x height 18 mm). The units operated continuously with urine as the feedstock. The best performing is the sm type (60-100 μW), followed by the t type (40-80 μW) and the m type (20-40 μW). Polarisation experiments indicated that activated carbon on the anode enhances the power output (t 423 μW, sm 288 μW). Similarly, the increase of the surface area and the addition of stainless steel mesh on the cathode improves the power performance for the "sm" and the "t" units. Furthermore, it is shown that the design with the smaller internal diameter, performs better and is more stable through time.How major crustal-scale seismogenic faults nucleate and evolve in crystalline basements represents a long-standing, but poorly understood, issue in structural geology and fault mechanics. Here, we address the spatio-temporal evolution of the Bolfin Fault Zone (BFZ), a >40-km-long exhumed seismogenic splay fault of the 1000-km-long strike-slip Atacama Fault System. The BFZ has a sinuous fault trace across the Mesozoic magmatic arc of the Coastal Cordillera (Northern Chile) and formed during the oblique subduction of the Aluk plate beneath the South American plate. Seismic faulting occurred at 5-7 km depth and ≤ 300°C in a fluid-rich environment as recorded by extensive propylitic alteration and epidote-chlorite veining. Ancient (125-118 Ma) seismicity is attested by the widespread occurrence of pseudotachylytes. Field geologic surveys indicate nucleation of the BFZ on precursory geometrical anisotropies represented by magmatic foliation of plutons (northern and central segments) and andesitic dyke swarms (southern segment) within the heterogeneous crystalline basement. Seismic faulting exploited the segments of precursory anisotropies that were optimal to favorably oriented with respect to the long-term far-stress field associated with the oblique ancient subduction. The large-scale sinuous geometry of the BFZ resulted from the hard linkage of these anisotropy-pinned segments during fault growth.Titanium and its alloys are the most used biomaterials for orthopedic and dental applications. However, up to 10% of these medical devices still fail, mostly due to implant loosening and suboptimal integration at the implant site. The biomaterial surface plays a critical role in promoting osseointegration, which can reduce the risk of device failure. In this study, we propose a novel surface modification on titanium to improve osteogenic differentiation by depositing manganese-containing bioactive glass (BG) on TiO2 nanotube arrays. The surfaces were characterized by scanning electron microscopy, energy dispersive X-ray spectrometer, contact angle goniometry, and X-ray photoelectron spectroscopy. Cell toxicity, viability, adhesion, and proliferation of adipose-derived stem cells on the surfaces were investigated up to 7 days. To evaluate the osteogenic properties of the surfaces, alkaline phosphatase activity, total protein, osteocalcin expression, and calcium deposition were quantified up to 28 days. The results indicate that TiO2 nanotube arrays modified with BG promote cell growth and induce increased osteocalcin and calcium contents when compared to unmodified TiO2 nanotube arrays. The deposition of manganese-containing bioactive glass onto TiO2 nanotubes demonstrates the ability to enhance osteogenic activity on titanium, showing great potential for use in orthopedic and dental implants.Levels of total mercury were measured in tissue of six species of migratory fish (alewife, American shad, blueback herring, rainbow smelt, striped bass, and sea lamprey), and in roe of American shad for two consecutive years collected from the Penobscot River or its estuary. The resultant mercury levels were compared to reference doses as established in the U.S. Environmental Protection Agency (EPA) Integrated Risk Information System and wildlife values. Mercury concentrations ranged from 4 μg/kg ww in roe to 1040 μg/kg ww in sea lamprey. Sea lamprey contained the highest amounts of mercury for both seasons of sampling. Current health advisories are set at sufficient levels to protect fishers from harmful consumption of the fish for mercury alone, except for sea lamprey. Based upon published wildlife values for mink, otter, and eagle, consumption of rainbow smelt, striped bass, or sea lamprey poses a risk to mink; striped bass and sea lamprey to otter; and sea lamprey to eagle. For future consideration, the resultant data may serve as a reference point for both human health and wildlife risk assessments for the consumption of anadromous fish. U.S. EPA works with federally recognized Tribes across the nation greatly impacted by restrictions on sustenance fishing, to develop culturally sensitive risk assessments.As the volume of digital data is growing exponentially and computational methods are advancing rapidly, network analysis is an increasingly important analytical tool to understand social life. This paper revisits the rich history of network analysis in geography and uses insights from that history to review contemporary computational social science. Based on that analysis, we synthesize the distinctive qualities of what we term geographical network analysis. Geographical network analysis presumes that networks are situated, construed through meaning, and reflect power relations. Instead of pursuing parsimonious explanations or universal theories, geographical network analysis strives to understand how uneven networks develop across space and within place through a constant back and forth between abstraction and contextualization. Drawing on the articles in this special issue, this paper illustrates how geographical network analysis can be put to work.