Suchergebnisse

Major causes of facial combat injuries include blasts, high-velocity/high-energy missiles, and low-velocity missiles. High-velocity bullets fired from assault rifles encompass special ballistic properties, creating a transient cavitation space with a small entrance wound and a much larger exit wound. There is no dispute regarding the fact that primary emergency treatment of ballistic injuries to the face commences in accordance with the current advanced trauma life support (ATLS) recommendations; the main areas in which disputes do exist concern the question of the timing, sequence, and modes of surgical treatment. The aim of the present study is to present the treatment outcome of high-velocity/high-energy gunshot injuries to the face, using a protocol based on the experience of a single level I trauma center. A group of 23 injured combat soldiers who sustained bullet and shrapnel injuries to the maxillofacial region during a 3-week regional military conflict were evaluated in this study. Nine patients met the inclusion criteria (high-velocity/high-energy injuries) and were included in the study. According to our protocol, upon arrival patients underwent endotracheal intubation and were hemodynamically stabilized in the shock-trauma unit and underwent total-body computed tomography with 3-D reconstruction of the head and neck and computed tomography angiography. All patients underwent maxillofacial surgery upon the day of arrival according to the protocol we present. In view of our treatment outcomes, results, and low complication rates, we conclude that strict adherence to a well-founded and structured treatment protocol based on clinical experience is mandatory in providing efficient, appropriate, and successful treatment to a relatively large group of patients who sustain various degrees of maxillofacial injuries during a short period of time.

Cranio-cerebral gunshots wounds (CCGW) are the most devastating injuries to the central nervous system, especially made by high velocity bullets, the most devastating, severe and usually fatal type of missile injury to the head.Objective: To investigate and compare, using a retrospective study on five cases the clinical outcomes of CCGW. Predictors of poor outcome were: older age, delayed mode of transportation, low admission CGS score with haemodynamic instability, CT visualization of diffuse brain damage, bihemispheric, multilobar injuries with lateral and midline sagittal planes trajectories made by penetrating high velocity bullets fired from a very close range, brain stem and ventricular injury with intraventricular and/or subarachnoid hemorrhage, mass effect and midline shift, evidence of herniation and/or hematomas, high ICP and/or hypotension, abnormal coagulation states on admission or disseminated intravascular coagulation. Less harmful effects were generated by retained missiles, bone fragments with CNS infection, DAI lesions and neuronal damages associated to cavitation, seizures.Material and methods: 5 patients (4 male and 1 female), age ranged 22-65 years, with CCGW, during the period 2004-2009, caused by military conflict and accidental firing. After initial resuscitation all patients were assessed on admission by the Glasgow Coma Scale (GCS). After investigations: X-ray skull, brain CT, Angio-CT, cerebral MRI, SPECT; baseline investigations, neurological, haemodynamic and coagulability status all patients underwent surgical treatment following emergency intervention. The survival, mortality and functional outcome were evaluated by Glasgow Outcome Scale (GOS) score.Results: Referring on five cases we evaluate on a retrospective study the clinical outcome, imagistics, microscopic studies on neuronal and axonal damage generated by temporary cavitation along the cerebral bullet's track, therapeutics, as the review of the literature. Two patients with an admission CGS 9 and 10 survived and three patients with admission CGS score of 3, with severe ventricular, brain stem injuries and lateral plane of high velocity bullets trajectories died despite treatment.Conclusion: CCGW is the most devastating type of missile injury to the head. Aggressive intensive care management in combination with early management with less aggressive meticulous neurosurgical technique, has significantly reduced the mortality and morbidity associated with these injuries, but they still remain unacceptably high. Primary prevention of these injuries remains important, the patient must be monitored closely for possible complications.

The bullet train hurtles toward the industrial city of Taiyuan in northern China, and seemingly within seconds, the modern, smog-soaked Beijing skyline gives way to open fields. David Su is munching on pistachios in the bar car, careful that not a crumb hits his blue foulard scarf, as he heads some 320 miles to reach his early-morning appointment for a private equity firm. Over his shoulder, the Chinese countryside is a disembodied blur: farms and factories receding at the mind-aching speed of 186 miles per hour. High-speed rail may be a contemporary obsession, but it was invented decades ago by a Japanese engineer named Hideo Shima, who demonstrated in 1957 that a lightweight carriage could be made to travel at game-changing speeds by feeding power through a motor straight to each wheel. The irony of Beijing embrace of high-speed trains is clear to those who know the country's history. Adapted from the source document.

In this study, particle image velocimetry (PIV) measurements have been performed extensively on a non-reactive dense diesel spray injected from a single orifice injector, under various injection pressure and steady ambient conditions, in a constant flow chamber. Details of PIV setup for diesel spray measurement without additional seeding are explained first. The measured velocity profiles are compared to those obtained from other similar measurements performed in a different institution, as well as those obtained from a 1D spray model simulation, presenting in both cases a good level of agreement. In addition, the velocity fields under various injection pressures and ambient densities show the dominant effects of these parameters on the behavior of diesel spray. The self-similarity of the transverse cut profiles of axial velocity is evaluated, showing that the measurements are in agreement with the hypothesis of self-similar velocity profiles. Finally, the effect of injection pressure and ambient density on the velocity fluctuations is presented and analyzed as well. While the experimental results presented here could help to understand the complex diesel fuel-air mixing process during injection, they also provide additional spray velocity data for future computational model validation, following the main idea of the Engine Combustion Network. ; This work was sponsored by "Ministerio de Economia y Competitividad" of the Spanish Government in the frame of the Project "Comprension de la influencia de combustibles no convencionales en el proceso de injeccion y combustion tipo diesel", Reference TRA2012-36932. Additionally, the optical equipment used for the project was purchased with funding from Ministerio de Economia y Competitividad FEDER-ICTS-2012-06. ; Payri Marín, R.; Viera-Sotillo, JP.; Wang, H.; Malbec, L. (2016). Velocity field analysis of the high density, high pressure diesel spray. International Journal of Multiphase Flow. 80:69-78. https://doi.org/10.1016/j.ijmultiphaseflow.2015.10.012 ; S ; 69 ; 78 ...

Precast concrete blocks can be used as erosion protection to a surface subjected to high‐velocity water, for example a dam spillway.The paper describes model testing carried out on flat and wedge‐shaped blocks in a purpose‐designed facility at the University of Salford, where an open channel discharge intensity of 0.5 m2/s can be accelerated to a velocity of 7.5 m/s.The failure modes of tied and untied flat concrete blocks have been investigated under different laying and bedding conditions. The model results are compared to the findings from prototype studies. Results from experiments on wedge‐shaped blocks of a Soviet design are also presented and confirm the Russian experience that the wedge shape is inherently stable at large discharges, a block of 100‐m thickness being stable under a discharge intensity of 20 m2/s.

Semi-infinite targets of Ultra-High-Performance Fibre-Reinforced Concrete with various fibre volume fractions were subjected to the high-velocity projectile impact using in-service bullets. In this study, a variety of empirical and semi-analytical models for prediction of the depth of penetration and mass ejection were evaluated with respect to the experimental results. Models for the depth of penetration and spalling mass ejection were revisited and applied both with deformable and nondeformable projectiles parameters. The applicability of the prediction models was assessed through a statistical comparison of values from models with experimental results. The evaluation of the applicability was made through the newly proposed measure of a relative prediction accuracy for model selection and model estimation, which was verified with established statistical accuracy evaluations, such as accuracy ratio, logarithmic standard deviation and correlation coefficient. The best fit to the experimental readings was provided by newer semi-analytical models, which are incorporating additional concrete parameters beside compressive strength while the majority of older models failed to provide sufficient accuracy.

Strategic foresight promotes the enactment of organizationally useful actions and repertoires which enhance the entrepreneurial capabilities of firms embedded in high‐velocity environments.

ObjectiveThe volume and frequency of refreshed data within the [organisation] has increased significantly since the beginning of the COVID-19 pandemic. Therefore, a more efficient data quality (DQ) checking process was necessary.
Approach Having previously developed an automated DQ checking tool, the focus was on re-engineering the process of DQ task allocation and communication of results.
Results 5 analysts were trained in DQ checking. A JIRA workflow tracks the management of data loading. When a dataset is ready for DQ, the Data Manager allocates a ticket to the DQ Lead who then allocates it onto one of the 5 analysts. Via a DQ Slack channel, the analyst is informed and acknowledges receipt of the task. On completion of DQ, the analyst updates the ticket and transfers it to the appropriate workflow stage. Passed DQ tickets are transferred to the Data Manager for data release, whereas failed ones are placed "On Hold". The DQ Lead triages the issues and liaises with relevant parties for resolution, which may require data amendments. On receipt of amended data, the DQ ticket is transferred back to the queue and the analyst is notified to re-check the data.
ConclusionsThe team now complete a high volume of DQ checks efficiently. In 2023, 405 datasets, containing 1716 tables, were quality checked, with the initial DQ taking, on average, 2.6 days.
Implications The improved speed of DQ checking ensures projects access the latest available data whilst maintaining the expected DQ levels, integrity and reputation of the TRE.