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Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Antonella Sferra, Fabiana Fattori, Teresa Rizza, Elsabetta Flex, Emanuele Bellacchio, Alessandro Bruselles, Stefania Petrini, Serena Cecchetti, Massimo Teson, Fabrizia Restaldi, Andrea Ciolfi, Filippo M Santorelli, Ginevra Zanni, Sabina Barresi, Claudia Castiglioni, Marco Tartaglia, Enrico Bertini
Microtubules participate in fundamental cellular processes, including chromosomal segregation and cell division, migration, and intracellular trafficking. Their proper function is required for correct central nervous system development and operative preservation, and mutations in genes coding tubulins, the constituting units of microtubules, underlie a family of neurodevelopmental and neurodegenerative diseases, collectively known as "tubulinopathies", characterized by a wide range of neuronal defects resulting from defective proliferation, migration, and function...
March 14, 2018: Human Molecular Genetics
Giuseppe Marulli, Giovanni Maria Comacchio, Marco Schiavon, Alessandro Rebusso, Marco Mammana, Davide Zampieri, Egle Perissinotto, Federico Rea
OBJECTIVES: Minimally invasive techniques seem to be promising alternatives to open approaches in the surgical treatment of early-stage thymoma, although there are controversies because of lack of data on long-term results. The aim of the study was to evaluate the surgical and oncological results after robotic thymectomy for early-stage thymoma compared to median sternotomy. METHODS: Between 1982 and 2017, 164 patients with early-stage thymoma (Masaoka I and II) were operated on by median sternotomy (108 patients) or the robotic approach (56 patients)...
March 13, 2018: European Journal of Cardio-thoracic Surgery
Henry T Peng, Catherine Tenn, Oshin Vartanian, Shawn G Rhind, Jerzy Jarmasz, Homer Tien, Andrew Beckett
Introduction: Tactical Combat Casualty Care (TCCC) training imposes psychophysiological stress on medics. It is unclear whether these stress levels vary with the training modalities selected. It is also unclear how stress levels could have an impact on medical performance and skill uptake. Materials and Methods: We conducted a pilot study to compare the effects of live tissue (LT) with a high-fidelity patient simulator (SIM) on the level of stress elicited, performance, and skill uptake during battlefield trauma training course in an operating room (OR) and in a simulated battlefield scenario (field)...
March 14, 2018: Military Medicine
Steven M Falowski, Ashwini Sharan, James McInerney, Darren Jacobs, Lalit Venkatesan, Filippo Agnesi
BACKGROUND: Spinal cord stimulation (SCS) is a common intervention for managing intractable pain. Generally, leads are implanted in a minimally invasive procedure with verbal feedback regarding the location and nature of generated paresthesias by active stimulation; in this way their optimal location can be confirmed. However, lead placement under general anesthesia can have additional benefits. OBJECTIVE: To investigate the outcomes of awake vs asleep lead placement procedures...
March 14, 2018: Neurosurgery
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Rachel A Hoopsick, D Lynn Homish, Paul T Bartone, Gregory G Homish
Background: Much research has focused on stress related to deployments; however, a substantial proportion of soldiers never deploy. In a study of 1.3 million veterans, suicide risk was higher among veterans who had never deployed. Thus, not being deployed may have an impact on soldiers' well-being; however, no measures exist to assess emotions regarding non-deployment. We aimed to develop and test an original measure of non-deployment emotions. Methods: We examined the Non-Deployment Emotions (NDE) questionnaire, a novel four-item measure of guilt, unit value, unit camaraderie, and unit connectedness in a sample of never-deployed male and female US Army Reserve/National Guard (USAR/NG) soldiers (N = 174)...
March 14, 2018: Military Medicine
Laura Miller, Gerardo J Pacheco, Jud C Janak, Rose C Grimm, Nicole A Dierschke, Janice Baker, Jean A Orman
Background: Military working dogs (MWDs) are a major asset in the theater of operations. Their unique abilities make them ideal for tasks such as tracking, patrol, and scent detection. MWDs deployed to a war zone are exposed to harsh environments and battlefield dangers that increase their risk of disease, injuries, and death. Although canines have been used extensively in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), no published studies have reported detailed causes of death among MWDs deployed to these conflicts...
March 14, 2018: Military Medicine
Michael Z L Zhu, Andrew Martin, Andrew D Cochrane, Julian A Smith, Amanda G Thrift, Gerard K Harrop, Jennifer P Ngo, Roger G Evans
Background: Acute kidney injury (AKI) is common after cardiac surgery and profoundly affects postoperative mortality and morbidity. There are no validated methods to assess risk of AKI intraoperatively. Methods: We determined the association between postoperative AKI and intraoperative urinary oxygen tension (PO2), measured via a fiber optic probe in the tip of the urinary catheter, in 65 patients undergoing high-risk cardiac surgery requiring cardiopulmonary bypass (CPB)...
March 14, 2018: Nephrology, Dialysis, Transplantation
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
Konstadinos Plestis, Oleg Orlov, Vishal N Shah, Joshua Wong, Matthew Thomas, Alon Aharon, Cinthia Orlov, Georgia Panagopoulos, Scott Goldman
OBJECTIVES: Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS: A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Robert Dziedzic, Tomasz Marjanski, Franciszek Binczyk, Joanna Polanska, Wioletta Sawicka, Witold Rzyman
OBJECTIVES: The video-assisted thoracoscopic surgery (VATS) approach has become a standard for the treatment of early-stage non-small-cell lung cancer (NSCLC). Recently published meta-analyses proved the benefit of VATS versus thoracotomy for overall survival (OS) and reduction of postoperative complications. The aim of this study was to compare early outcomes, long-term survival and rate of postoperative complications of the VATS approach versus thoracotomy. METHODS: In this retrospective cohort study, we analysed 982 individuals who underwent surgical resection for Stage I-IIA NSCLC between 2007 and 2015...
March 14, 2018: European Journal of Cardio-thoracic Surgery
Matthieu Picher, Kerstin Bücker, Thomas LaGrange, Florian Banhart
We implement a parametric study with single electron pulses having a 7 ns duration to find the optimal conditions for imaging, diffraction, and electron energy-loss spectroscopy (EELS) in the single-shot approach. Photoelectron pulses are generated by illuminating a flat tantalum cathode with 213 nm nanosecond laser pulses in a 200 kV transmission electron microscope (TEM) with thermionic gun and Wehnelt electrode. For the first time, an EEL spectrometer is used to measure the energy distribution of single nanosecond electron pulses which is crucial for understanding the ideal imaging conditions of the single-shot approach...
March 13, 2018: Ultramicroscopy
Edna M S Oliveira, Francisco R Silva, Crislânia C O Morais, Thiago Mielle B F Oliveira, Carlos A Martínez-Huitle, Artur J Motheo, Cynthia C Albuquerque, Suely S L Castro
This study investigated the anodic oxidation of phenolic wastewater generated by cashew-nut processing industry (CNPI) using active (Ti/RuO2 -TiO2 ) and inactive (boron doped diamond, BDD) anodes. During electrochemical treatment, various operating parameters were investigated, such as current density, chemical oxygen demand (COD), total phenols, O2 production, temperature, pH, as well as current efficiency and energy consumption. After electrolysis under optimized working conditions, samples were evaluated by chromatography and toxicological tests against L...
February 9, 2018: Chemosphere
Sijie Ge, Sujing Wang, Qiang Xu, Thomas Ho
Emergency shutdowns of chemical plants (ESCP) inevitably generate intensive and huge amounts of VOCs and NOx emissions through flaring that can cause highly localized and transient air pollution events with elevated ozone concentrations. However, quantitative studies of regional ozone impact due to ESCP, in terms of how ESCP would affect and to what extent ESCP could impact, are still lacking. This paper reports a systematic study on regional air quality impact from an olefin plant emergency shutdown due to the sudden failure of its cracked gas compressor (CGC)...
March 7, 2018: Chemosphere
S R Geed, Sachin Prasad, M K Kureel, R S Singh, B N Rai
The isolated microbial Alcaligenes sp. S3 from the agricultural field was used for the biodegradation of synthetic wastewater containing atrazine. This study was conducted in an alternating aerobic-anoxic lab scale pilot plant. The performance of continuously operated pilot plant was evaluated in three different phases with varying atrazine concentration. The best performance of plant was observed in phase-II. The atrazine (200 mg/L) having COD value 1356 mg/L was used with varying flow rate and 90.56% COD removal was obtained at a flow rate of 300 mL/h on 122th day of operation...
March 13, 2018: Journal of Environmental Management
Hamid Reza Rajabi, Fatemeh Karimi, Hossein Kazemdehdashti, Leila Kavoshi
In this research, a sono-assisted chemical precipitation method was developed for a quick and efficient water-based synthesis of zinc sulfide (ZnS) quantum dots (QDs), in room temperature. ZnS QDs as pure and doped with some transition metal ions (such as Cu2+ , Mn2+ , Ag+ ) were prepared in the presence of l-cysteine, as capping agent. In comparison with the previous conventional methods, applying the ultrasonic irradiation provides a significant decrease in the reaction time. In comparison with previous reported conventional chemical QD synthesis methods, the required time for a complete synthesis in the presence of ultrasonic irradiations was significantly reduced to a period as short as 15 min, in a temperature of 40 °C...
February 22, 2018: Journal of Photochemistry and Photobiology. B, Biology
Tahereh Shojaeimehr, Farshad Rahimpour, Michael Schwarze, Jens-Uwe Repke, Hamid Reza Godini, Günter Wozny
The present study evaluates the capability of ion exclusion chromatography (IEC) of short chain aliphatic carboxylic acids using a cation exchange column (8% sulfonated cross-linked styrene-divinylbenzene copolymer) in different experimental conditions. Since one of the prerequisites to the development of an efficient carboxylic acid separation process is to obtain the optimum operational conditions, response surface methodology (RSM) was used to develop an approach to evaluate carboxylic acids separation process in IEC columns...
March 8, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Ya'nan Liu, Na Liu, Yuning Chen, Weifeng Zhang, Ruixiang Qu, Qingdong Zhang, Tzungyu-Shih, Lin Feng, Yen Wei
Food waste water is one of the most urgent environmental problems for the close connection between food and our daily life. Herein, we use a simple hydrothermal method to prepare a highly efficient catalyst-CeO2 /Co3 O4 compound on the stainless steel mesh, aiming for food waste water treatment. Possessing the superhydrophilic property and catalytic ability under ultraviolet light, CeO2 /Co3 O4 coated mesh has successfully processed three representative contaminants in food wastewater, which are soybean oil (food oil), AR (food dye) and VA (food flavor) simultaneously with an one-step filtration...
March 9, 2018: Water Research
Jason M Lindo, María Padilla-Romo
This study considers the effects of the kingpin strategy, an approach to fighting organized crime in which law-enforcement efforts focus on capturing the leaders of criminal organizations, on community violence in the context of Mexico's drug war. Newly constructed historical data on drug-trafficking organizations' areas of operation at the municipality level and monthly homicide data allow us to control for a rich set of fixed effects and to leverage variation in the timing of kingpin captures to estimate their effects...
February 21, 2018: Journal of Health Economics
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