Identical fracture patterns in combat vehicle blast injuries due to improvised explosive devices; a case series

Abstract Background In November 2008, a surgical team from the Red Cross Hospital Beverwijk, the Netherlands, was deployed in Afghanistan for three months to attend in the army hospital of Kandahar. During their stay, four incidents of armored personnel carriers encountering an improvised explosive device were assessed. In each incident, two soldiers were involved, whose injuries were strikingly similar. Case presentation The described cases comprise paired thoracic vertebral fractures, radial neck fractures, calcaneal fractures and talar fractures. Moreover, the different types of blast injury are mentioned and related to the injuries described in our series. Acknowledging the different blast mechanisms is important for understanding possible injury patterns. Conclusion From this case series, as well as the existing literature on injury patterns caused by blast injuries, it seems appropriate to pay extra attention to bodily areas that were injured in other occupants of the same vehicle. Obviously, the additional surveillance for specific injuries should be complementary to the regular trauma work-up (e.g., ATLS).</p

Increased copulation duration does not necessarily reflect a proportional increase in the number of transferred spermatozoa

Post-copulatory sexual selection research tends to focus on the numerous adaptations that have evolved to increase the chances of donated spermatozoa fertilizing oocytes. Even though fertilization obviously directly depends on the presence of sufficient, viable spermatozoa, the quantification of the sperm transfer process itself has not received the attention it deserves. Here, we present experimental work on a simultaneously hermaphroditic snail in combination with a review of the literature focussing on the relationship between the duration of copulation and the number of sperm that are transferred. Based on classical work, this relationship is often assumed to be linear, but as we show here this need not be the case. Both our experimental data and the reviewed literature indicate that there are clear instances where the process of sperm transfer is not a linear process, i.e., longer copulation duration does not necessarily imply more transfer of sperm. As we point out, there seems to be a bias in the literature towards investigating this in insects, but other animal groups in which this has been investigated do show similar relationships. To conclude, we discuss how the specific patterns of sperm transfer that have been reported can be biologically interpreted and we caution that simply using copulation duration as a proxy for the number of sperm transferred can be misleading

Learning curve on the TrEndo laparoscopic simulator compared to an expert level

The aim of this study was to determine growth in trainee laparoscopic skill as recorded by the TrEndo laparoscopic simulator during a laparoscopic training course, compared to an expert level. A prospective observational cohort study was conducted between February 1 and November 31, 2010. Trainees in laparoscopic surgery completed a basic laparoscopic suturing task on a laparoscopic box trainer at three successive assessment points during a laparoscopic training course. Experts were assessed only once to define an expert level. The TrEndo recorded four motion analysis parameters (MAPs) individually for each hand and the amount of time taken to complete the suturing task. Seventy-two residents and 56 experts were included in this study. Overall, the amount of time taken on the suturing task and seven out of eight MAPs significantly increased toward an expert level during the course, representing an improvement in task efficiency. During the first training day, the amount of time spent on the suturing task and five out of eight MAPs improved significantly. After the retention period, five out of eight MAPS demonstrated a significant improvement compared to the end of the first training day. Laparoscopic skill of trainees as recorded by the TrEndo laparoscopic simulator grows toward an expert level during a laparoscopic training course in a large and heterogeneous study group. Construct validity of the TrEndo is establishe

Validation of a new box trainer-related tracking device: the TrEndo

Background: There is an increasing demand for structured objective ex vivo training and assessment of laparoscopic psychomotor skills prior to implementation of these skills in practice. The aim of this study was to establish the internal validity of the TrEndo, a motion-tracking device, for implementation on a laparoscopic box trainer. Methods: Face validity and content validity were addressed through a structured questionnaire. To assess construct validity, participants were divided into an expert group and a novice group and performed two basic laparoscopic tasks. The TrEndo recorded five motion analysis parameters (MAPs) and time. Results: Participants demonstrated a high regard for face and content validity. All recorded MAPs differed significantly between experts and novices after performing a square knot. Overall, the TrEndo correctly assigned group membership in 84.7 and 95.7% of cases based on two laparoscopic tasks. Conclusion: Face, content, and construct validities of the TrEndo were established. The TrEndo holds real potential as a (home) training device