Suchergebnisse

INTRODUCTION: The armed conflict in the Kivu province of the Democratic Republic of Congo has caused close to 12,000 deaths. One of the most lethal weapons in armed conflicts is the high explosive hand grenade. The study aimed to describe the epidemiology, presentation, and outcomes of hand grenade blast injuries (HGBI) in the Kivu province. METHODS: In this case series, the authors present 2017 to 2020 HGBI admissions at a Congolese trauma center. Measures of central tendency and spread were computed for continuous data. Complication and mortality rates were equally computed. Admission-to-discharge data were disaggregated by the body part injured and by complication status and visualized using time-to-event curves. RESULTS: Thirty-eight HGBI patients aged 31.4 (range 17–56) years were included in the study. Twenty-six (68.4%) were male and the patients were admitted 1.8 days post-injury on average. The patients were hemodynamically stable at admission; 84.2% received the antitetanic vaccine, 21.1% received broad-spectrum antibiotics, and all were debrided (100.0%). The complication rate was 13.2%, and the most common complication was anemia (7.9%). In addition, the mortality rate was 2.6%. The median admission-to-discharge time was 17.0 (range 4–71) days, and it was prolonged in patients with lower extremity injuries (23.0 days). CONCLUSION: HGBIs cause avertable death and disability in the Kivu regions. These data suggest that the burden of HGBIs can be reduced with appropriate preventive and health systems strengthening interventions.

"Rough sex" can be considered an act of sexual violence that is consensual or non-consensual, often resulting in bodily harm and in rare cases, fatalities. The rough sex defense is typically advanced by male perpetrators in an effort to portray a sexual encounter as consensual, to avoid criminal sanctions for causing injury or death. Public attitudes toward this defense are often reflected on social media following high profile cases and appear to echo dominant discourses that reinforce widely held sexual violence stereotypes. Therefore, this study aims to deconstruct public attitudes surrounding the rough sex defense. Namely, how female victims/survivors and male perpetrators of sexual violence are constructed online, whilst exploring the wider implications upon society. NVivo12 NCapture software was used to collect a sample of 1000 tweets mentioning the terms "rough sex" or "rough sex defense." Data were examined using Feminist Critical Discourse Analysis (FCDA), underpinned by a social constructionist perspective, to elicit emergent discourses. Findings indicate that Twitter allowed women to resist harmful victim-blaming discourses and constrained binary identities. Opposingly, men were constructed as sexually entitled predators, yet resisted these subject positions by advocating support for male victims/survivors. Additional analyses examine account holders' constructions of British Parliamentarians (MP's) and their campaigns against the rough sex defense. These constructions demonstrated a cultural, heteronormative and victim-blaming understanding of sexual violence, which calls for legislative clarity.

Chronic low-level blast exposure has been linked with neurological alterations and traumatic brain injury (TBI) biomarkers. Impaired smooth-pursuit eye movements (SPEM) are often associated with TBI. The purpose of this study was to determine whether long-term operators of low-level blast exposure or high-caliber weapons use displayed oculomotor behaviors that differed from controls. Twenty-six members of an elite military unit performed a computerized oculomotor testing task using an eye tracker and completed a concussion assessment questionnaire. The participants were split into a blast exposure group and control group. The blast exposure group had a history of exposure to low-level blasts or high-caliber weapon use. The results revealed significant differences in SPEM, saccades, and fixations between the blast exposure group and control group. The blast exposure group's eye movements were slower, stopped at more frequent points when following a target, traveled further from the target in terms of both speed and direction, and showed higher rates of variation and inefficiency. Poor oculomotor behavior correlated with a higher symptom severity on the concussion assessment questionnaire. Military special operators exposed to long-term low-level blasts or high-caliber weapons usage displayed an impaired oculomotor behavior in comparison to controls. These findings further our understanding of the impact of long-term low-level blast exposure on the oculomotor behavior of military special operators and may inform practical implications for military training.

Exertional heat stroke (EHS) is a life-threatening illness and an enduring problem among athletes, military servicemen and -women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.

On February 9, 2022, the International Court of Justice (ICJ) rendered its judgment on the reparations phase of the Armed Activities (DRC v. Uganda) case which related to the Democratic Republic of Congo's (DRC) claims against Uganda arising from the Second Congo War.1 The judgment concluded a case which had all the hallmarks of a landmark: an exceptionally large-scale, protracted, and complex armed conflict, a key actor as the respondent, and virtually unfettered material jurisdiction of the Court. As a reminder, in 1999, the Court was seised with DRC's claims against Uganda arising from the (then ongoing) Second Congo War. Similar claims against Rwanda and Burundi failed before reaching the merits stage. In 2005, the Court rendered its judgment on the merits declaring Uganda responsible for violating the principle of non-use of force and non-intervention by the acts of its own forces and by supporting armed groups in the DRC.2 The Court also found Uganda responsible for breaches of international humanitarian law and international human rights law, and for plundering DRC's natural resources.3 The Court concluded that Uganda had to make reparation to the DRC for the injury caused by its internationally wrongful acts and enjoined the parties to enter into negotiations for that purpose.4 After almost ten years of sporadic and fruitless discussions, in 2015, the DRC brought the case back to the Court for conclusive resolution.

Patient safety is a system that must be implemented in hospitals. This is done by the government in an effort to prevent patient safety incidents from occurring. Based on the Lumenta report (2008) that in Indonesia from 145 reported incidents of near-injury (KNC) as many as 47.6% cases, unwanted events (KTD) as many as 46.2% cases, and others as many as 6.2% cases. . The KTD rate at Raden Mattaher Hospital in 2016 was 10 cases, increasing to 13 cases in 2017 and decreasing to 7 cases in 2018. Many factors affect the implementation of patient safety, namely internal and external factors. The purpose of this study was to determine the factors associated with the implementation of 6 patient safety goals at Raden Mattaher Hospital Jambi. The design of this study used a cross-sectional study. The number of samples in this study were 80 nurses with proportional random sampling technique. The analysis used was univariate and bivariate analysis with Chi-square and Wilcoxon tests. The results of the analysis show that the average age is 33.19 years and the length of work is 9.39 years. A total of 71.2% are female, 82.5% have vocational education, 68.8% have sufficient knowledge, 56.2% are positive and 65% of respondents do not apply the 6 patient safety goals. The results of the bivariate analysis showed that there was a relationship between age, length of work and attitude with the implementation of the 6 patient safety goals.

Abstract

Introduction
Postoperative cerebellar mutism syndrome (pCMS) consists of three types of symptoms (motoric, linguistic, and neurobehavioral) in patients with posterior fossa pathologies. The evolutional mechanism of this high cognitive syndromic complex from cerebellar origin remains unconfirmed. Previous studies analyzing CMS patients mostly focused on the association between structural abnormalities that occur during CMS, of which proximal efferent cerebellar pathway (pECP) injury appears to be the most common pathogenesis. However, structural imaging may not be sensitive enough to determine the dynamic course of CMS, since the symptomatology is primarily an output of cerebral operation.


Method
We took a network approach in a child during her course of development and recovery of the pCMS. On the other hand, a network neuroscience approach using a mathematical model to extract information from functional imaging to generate interregional connectivity provides abundant evidence that the cerebellum is influential in modulating cerebral functions.


Result
This study applied a network approach to children with pCMS. An individual cerebrocerebellar functional network analysis using graph theory was then performed to determine the network dynamics during CMS. Cross-validation of clinical neurophysiology and functional neuroscience suggested the critical role of the pECP within CMS from the network analysis.


Conclusion
The employed approach was therefore useful in determining the complex clinical symptoms using individual functional network analysis, which bridges the gap between structural neuroimaging and clinical neurophysiology.

Profiles of physical workload in sports are useful to optimize performance and reduce the risk of injury. The aim of the study was to investigate physical workload in 10 elite bandy players by describing acceleration, deceleration, and high-intensity skating during bandy match-play. During 13 home matches, 10 male elite bandy players wore a GPS unit to measure changes in the total distance, total distance skating in two speed zones, and total distance of acceleration and deceleration. A within-subject design was used to measure changes over time during match-play by comparing first and second halves as well as comparisons for consecutive 15 min intervals. No significant differences were observed for high-intensity or very high-intensity acceleration and deceleration for comparisons by halves or for 15-min intervals. For comparisons by halves, a significant time-dependent effect was observed on very fast skating (1337.6 m vs. 1160.9 m), sprint skating (300.0 m vs. 272.0 m), low-intensity acceleration (342.7 m vs. 333.0 m), and total distance covered (10,916.9 m vs. 10,450.3 m). These variables, along with low-intensity deceleration, were also significant for the 15 min interval comparisons. The results show that there is no time-dependent reduction in high-intensity acceleration and deceleration in elite bandy match-play. However, elite bandy players do not maintain the distance of high-intensity skating throughout a whole match.

AbstractThis paper clarifies Merleau-Ponty's original account of "higher-order" cognition as fundamentally embodied and enacted. Merleau-Ponty's philosophy inspired theories that deemphasize overlaps between conceptual knowledge and motor intentionality or, on the contrary, focus exclusively on abstract thought. In contrast, this paper explores the link between Merleau-Ponty's account of motor intentionality and his interpretations of our capacity to understand and interact productively with cultural symbolic systems. I develop my interpretation based on Merleau-Ponty's analysis of two neuropathological modifications of motor intentionality, the case of the brain-injured war veteran Schneider, and a neurological disorder known as Gerstmann's syndrome. Building on my analysis of Schneider's sensorimotor compensatory performances in relation to his limitations in the domains of algebra, geometry, and language usage, I demonstrate a strong continuity between the sense of embodiment and enaction at all these levels. Based on Merleau-Ponty's interpretations, I argue that "higher-order" cognition is impaired in Schneider insofar as his injury limits his sensorimotor capacity to dynamically produce comparatively more complex differentiations of any given phenomenal structure. I then show how Merleau-Ponty develops and specifies his interpretation of Schneider's intellectual difficulties in relation to the ambiguous role of the body, and in particular the hand, in Gerstmann's syndrome. I explain how Merleau-Ponty defends the idea that sensorimotor and quasi-representational cognition are mutually irreducible, while maintaining that symbol-based cognition is a fundamentally enactive and embodied process.

The coronavirus crisis has been extremely disruptive for the international passenger transportation market. It has also triggered a major legal disruption in the field of passenger rights. In recent decades, the focus of air passenger policy has largely shifted from safety to rights in case of delay and cancellation, a change predominantly induced by the EU. COVID-19 has led to a major paradigm shift, with safety again becoming the number one policy target. Passengers have a wide range of tools to enforce their rights to timely travel and these remedies have made an effective contribution to a reduction in delays and cancellations in air transport. Passengers' remedies in case of unsafe transport seem largely limited to the possibility of bringing an action in case of bodily injury, lésion corporelle, based on the Montreal Convention (MC). This contribution aims firstly to evaluate the effectiveness of this remedy as a preventive tool for increasing passenger safety. Secondly, it aims to assess the impact of COVID-19 on existing passenger rights in respect of cancellation and delay, as well as the impact of existing passenger rights policy on airlines' operational margin for enhanced safety management. Based on this analysis, we aim to make recommendations for a more effective model for the protection of passengers' safety, while at the same time embedding safety in the existing passenger rights policy instead of overriding it. Sommaire: La crise du coronavirus a extrêmement perturbé le marché du tra

AbstractThe Storm Section (Sturmabteilung, or SA) was organized throughout the Weimar Republic as a paramilitary force entrusted with the 'fight for the streets' during the so‐called 'time of struggle' (Kampfzeit). To offset the potentially paralyzing effects of activism entailing risks of injury or death, the leaders of the movement devised and implemented an insurance system, which was retained throughout the following years. This insurance system smoothed the way for the most radical uncivility to hold sway without restriction during the final years of the Republic. Starting from late 1926, the National Socialist mechanism for overcoming the barriers to participation in violent activities that could potentially involve a high cost was to introduce an insurance system to facilitate their activists' willingness to 'sacrifice' themselves. The visceral anti‐Semitism of the Nazis was central to the negotiations and agreements reached with different insurers. The Nazis introduced an insurance policy for their activists that would cover them while carrying out their obligations as militants in the 'fight' against Social Democrats and, more often, Communists. By lowering the potential costs of participation in a high‐risk instance of activism, the insurance system contributed to stoking a 'latent civil war' in the German streets during the final years of the Republic. Relaying on archival and other primary sources and looking at them from a collective action perspective, this paper delves into the history of the SA insurance system, as well as on its functions.

Background: Neurosurgery is a field where time from the incident to get treatment is very crucial. In low-income countries, the referral system is not well developed. In our country, a proper referral system is in the initial phase of development. We conducted a study assessing the number of visits a neurosurgery patient made before finally reaching to our center.Methods: This is a prospective observational study involving seventy patients, conducted at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Demographic characteristics, neurological diagnosis, and numbers of other centers the patients visited and outcome at discharge and in one month was assessed.Results: Thirty-five (50%) patients were males. Thirty-three (47.1%) patients were admitted due to head injury and 13 (18.5%) were diagnosed with subarachnoid hemorrhage. Surgery was done in 32 (45.7%) patients. Fifty-three (75.7%) patients were transferred from other hospitals. Out of 53 patients, 30 (56.6%) and 17 (32%) had visited to one and two hospitals respectively. Unavailability of the neurosurgery facility was the main reason (77.4%) for the transfer. Overall mortality was 12.9%. The trend for mortality and length of hospital stay was higher in the group who visited other centers before coming to us than those who came directly.Conclusions: Visiting multiple hospitals where there is no neurosurgical service available is an important reason for delay. There is a need to develop neurosurgical facilities in the different parts of the country along with establishment of an effective referral mechanism.Keywords: Delay; Nepal; neurosurgery; outcome; prospective study

Vaccines are so far proven to be safe, although related adverse events cannot be excluded. The urgency for COVID-19 vaccines determined a dilution of the general expectations of safety and efficacy of vaccination (from safe and effective to safe and effective enough). In many countries, a no-fault program was established to compensate individuals who experienced serious vaccine-related injuries. The impressive number of administrations worldwide and the legal indemnity afforded to manufacturers of approved vaccines that cannot be pursued for compensation fed the debate about the availability of a compensation model for COVID-19 vaccine-related injuries. Several European countries have long introduced a system, Vaccine Injury Compensation Programs, to compensate people who suffer physical harm because of vaccination. In Europe, COVID-19 vaccination is strongly recommended for the general population and in many states is declared mandatory for healthcare workers. In 1992, Italy edited Law no. 210 providing legal protection for individuals who reported injuries after mandatory and recommended vaccinations as a no-fault alternative to the traditional tort system. Despite its recommended nature, COVID-19 vaccination is excluded from the no-fault model in several European states, and the Italian government is called to provide clear and firm instructions for the management of the many requests for compensation. The authors provide an overview of the existing compensation models in Europe and analyse available legislative proposals.

This study determined the effects of child abuse on the girl-child in a rural community of Rivers State. This paper specifically considered impaired child development, physical and psychological effects. Study design adopted was descriptive survey. The study population was 852 and sample size of 187 derived. A multi-stage sampling procedure was adopted. The questionnaire was used as the instrument for data collection with a reliability index of 0.70. The findings of the study revealed persistent delay in starting school, poor school attendance, inadequate cognitive ability and dropping out of school as the developmental side effects of girl-child abuse. Increased juvenile delinquency in physical injury and recurring body scar were the major physical effects of girl-child abuse; possible entry into a condition of depression, likely rejection by family or loved ones and 'low self-esteem' were the notable effects of girl-child abuse. Therefore, the study recommended that parents/guardians should be advised to avoid acts that will result in girl-child abuse; parents and guardians need to protect their children against any form of child abuse in order to remain free of the mental and physical adverse health effects; and there should be interventions on the part of government, NGOs or individuals in a bid to prevent child abuse on a girl-child. Keywords: Child abuse, girl-child, effects, impaired development, rural community

Over the years, leaked fluids from aircraft have caused severe deterioration of airfield pavement. The combined effect of hot exhaust from the auxiliary power unit of military aircraft and spilt aviation oils have caused rapid pavement spalling. If the disintegrated concreted pieces caused by spalling are sucked into the jet engine, they may cause catastrophic damage to the aircraft engine or physical injury to maintenance crews. This study investigates the effectiveness of incorporating hybrid fibres into ordinary concrete to improve the residual mechanical and thermal properties to prevent spalling damage of pavement. Three fibre-reinforced concrete samples were made with micro steel fibre and polyvinyl alcohol fibre with a fibre content of zero, 0.3%, 0.5% and 0.7% by volume fraction. These samples were exposed to recurring high temperatures and aviation oils. Tests were conducted to measure the effects of repeated exposure on the concrete's mechanical, thermal and chemical characteristics. The results showed that polyvinyl alcohol fibre-, steel fibreand hybrid fibre-reinforced concrete suffered a 52%, 40% and 26.23% of loss of initial the compressive strength after 60 cycles of exposure to the conditions. Moreover, due to the hybridisation of concrete, flexural strength and thermal conductivity was increased by 47% and 22%. Thus, hybrid fibrereinforced concrete performed better in retaining higher residual properties and exhibited no spalling of concrete.