Injury Severity Score coding: Data analyst v. emerging m-health technology

Background. The cost of Abbreviated Injury Scale (AIS) coding has limited its utility in areas of the world with the highest incidence of trauma. We hypothesised that emerging mobile health (m-health) technology could offer a cost-effective alternative to the current goldstandard AIS mechanism in a high-volume trauma centre in South Africa.Methods. A prospectively collected sample of consecutive patients admitted following a traumatic injury that required an operation during a 1-month period was selected for the study. AISs and Injury Severity Scores (ISSs) were generated by clinician-entered data using an m-health application (ISS eTHR) as well as by a team of AIS coders at Vancouver General Hospital, Canada (ISS VGH). Rater agreements for ISSs were analysed using Bland-Altman plots with 95% limits of agreement (LoA) and kappa statistics of the ISSs grouped into ordinal categories. Reliability was analysed using a two-way mixed-model intraclass correlation coefficient (ICC). Calibration and discrimination of univariate logistic regression models built to predict in-hospital complications using ISSs coded by the two methods were also compared.Results. Fifty-seven patients were managed operatively during the study period. The mean age of the cohort was 27.2 years (range 14 - 62), and 96.3% were male. The mechanism of injury was penetrating in 93.4% of cases, of which 52.8% were gunshot injuries. The LoA fell within –8.6 - 9.4. The mean ISS difference was 0.4 (95% CI –0.8 - 1.6). The kappa statistic was 0.53. The ICC of the individual ISS was 0.88 (95% CI 0.81 - 0.93) and the categorical ISS was 0.81 (95% CI 0.68 - 0.87). Model performance to predict in-hospital complications using either the ISS eTHR or the ISS VGH was equivalent.Conclusions. ISSs calculated by the eTHR and gold-standard coding were comparable. Emerging m-health technology provides a costeffective alternative for injury severity scoring

A study on the abundance and species diversity of cynipid wasps (Hym.: Cynipidae) in West Azerbaijan province, Iran

The induced galls by oak gall wasps were collected from various oak forests of Iranian province of West Azerbaijan in the regions of Ghabre-Hossein, Mir-Abad, Vavan, Shalmash, Rabat and Dar-Ghabr during from April to November 2009. The optimum number of samples was found to be 40 oak trees. In each tree, as a sampling unit, all of the existing galls were counted. The species richness of oak gall wasps in the West Azerbaijan province was measured and the parameters such as Simpsonâs, Shannonâs H', and Sorensen similarity indexes were calculated. In this study, 35 species of oak gall wasps on the oak tree species of Quercus infectoria, Q. brantii and Q. libani were identified. Most galls were observed on Q. infectoria. All of the collected oak gall wasp species belonged to the genera Andricus Hartig, Cynips L., Neuroterus Hartig, Biorhiza Westwood, Pseudoneuroterus Kinsey, Chilaspis Mayr and Aphelonyx Mayre. The genus Andricus included 23 species of oak gall wasps. The highest Simpson and Shannon indexes were recorded for the spring galls of Mir-Abad and for the fall galls of Ghabre-Hossein and Dar-Ghabr regions. The Sorensen similarity index reached its peak for the spring galls (sexual generation of oak gall wasps) of Ghabre-Hossein and Mir-Abad and for the fall galls (asexual generation of oak gall wasps) of Ghabre-Hossein and Dar-Ghabr. The distribution of oak species and subspecies, and geographical and climatic aspects are believed to be among the key factors for the species diversity of oak gall wasps

Injury Severity Score coding: Data analyst v. emerging m-health technology

Background. The cost of Abbreviated Injury Scale (AIS) coding has limited its utility in areas of the world with the highest incidence of trauma. We hypothesised that emerging mobile health (m-health) technology could offer a cost-effective alternative to the current gold-standard AIS mechanism in a high-volume trauma centre in South Africa.Methods. A prospectively collected sample of consecutive patients admitted following a traumatic injury that required an operation during a 1-month period was selected for the study. AISs and Injury Severity Scores (ISSs) were generated by clinician-entered data using an m-health application (ISS eTHR) as well as by a team of AIS coders at Vancouver General Hospital, Canada (ISS VGH). Rater agreements for ISSs were analysed using Bland-Altman plots with 95% limits of agreement (LoA) and kappa statistics of the ISSs grouped into ordinal categories. Reliability was analysed using a two-way mixed-model intraclass correlation coefficient (ICC). Calibration and discrimination of univariate logistic regression models built to predict in-hospital complications using ISSs coded by the two methods were also compared.Results. Fifty-seven patients were managed operatively during the study period. The mean age of the cohort was 27.2 years (range 14 - 62), and 96.3% were male. The mechanism of injury was penetrating in 93.4% of cases, of which 52.8% were gunshot injuries. The LoA fell within –8.6 - 9.4. The mean ISS difference was 0.4 (95% CI –0.8 - 1.6). The kappa statistic was 0.53. The ICC of the individual ISS was 0.88 (95% CI 0.81 - 0.93) and the categorical ISS was 0.81 (95% CI 0.68 - 0.87). Model performance to predict in-hospital complications using either the ISS eTHR or the ISS VGH was equivalent.Conclusions. ISSs calculated by the eTHR and gold-standard coding were comparable. Emerging m-health technology provides a cost-effective alternative for injury severity scoring.

Effects of annealing treatment prior to cold rolling on delayed fracture properties in ferrite-austenite duplex lightweight steels

Tensile properties of recently developed automotive high-strength steels containing about 10 wt pct of Mn and Al are superior to other conventional steels, but the active commercialization has been postponed because they are often subjected to cracking during formation or to the delayed fracture after formation. Here, the delayed fracture behavior of a ferrite-austenite duplex lightweight steel whose microstructure was modified by a batch annealing treatment at 1023 K (750 A degrees C) prior to cold rolling was examined by HCl immersion tests of cup specimens, and was compared with that of an unmodified steel. After the batch annealing, band structures were almost decomposed as strong textures of {100}aOE (c) 011 > alpha-fibers and {111}aOE (c) 112 > gamma-fibers were considerably dissolved, while ferrite grains were refined. The steel cup specimen having this modified microstructure was not cracked when immersed in an HCl solution for 18 days, whereas the specimen having unmodified microstructure underwent the delayed fracture within 1 day. This time delayed fracture was more critically affected by difference in deformation characteristics such as martensitic transformation and deformation inhomogeneity induced from concentration of residual stress or plastic strain, rather than the difference in initial microstructures. The present work gives a promise for automotive applications requiring excellent mechanical and delayed fracture properties as well as reduced specific weight.ope

Abu-Sahl al-Masihi (died circa 1010 AD): The Persian physician in the early medieval era

In the early medieval era, in the time which is called the Islamic Golden Age, medicine flourished through the practice of Persian physicians (9th to 12th century AD). Abu-Sahl al-Masihi (died circa 1010 AD) was one of the physicians in that period who had great influence on the progress of medicine by his own writings as well as his influence on great scholars like Biruni and Avicenna as their teacher. He was a polymath and had many writings in various fields of science, in particular medical sciences. Some of his manuscripts in medicine were Al-Mia fil-Tibb (Book of the Hundred), Kitab al-Teb al-Koli (The General Medicine), Ezhar al-Hekmat Allah Ta�ala fi Khalgh al-Ensan (God�s Mystery on the Creation of Man), Resalat al-Adwiya (Treatise of Drugs), Osool Elm Nabz (the Principles of Pulse), and Resala f ī Taḥqiq Amral-Wabaʾ (On the determination of the matter of infectious diseases). As a sign of his impact in Persian medicine, many later physicians (until 19th century) referred to and cited his works in their manuscripts several times. © The Author(s) 2018