The Ballistics Case Study of the Enrica Lexie Incident

On February 15, 2012 off the Indian coast of Kerala, in position 091702N-0760180E by the oil tanker Enrica Lexie, flying the Italian flag, bursts of 5.56 x45 caliber shots were fired from assault rifles AR/70 Italian-made Beretta towards the Indian fisher boat St. Anthony. The shots that hit the St. Anthony fishing boat were six, of which two killed the Indian fishermen Ajesh Pink and Valentine Jelestine. From the analysis concerning the kinematic engagement of the two ships and from the autopsy and ballistic results of the Indian judicial authorities it is possible to reconstruct the trajectories of the six aforementioned shots. This essay reconstructs the trajectories of the six shots that cannot be of direct shooting but have undergone a rebound on the water. The investigation carried out scientifically demonstrates the rebound of the blows on the water, the gyrostatic deviation due to the rebound and the tumbling effect always due to the rebound as regards intermediate ballistics. In consideration of the four shots that directly impacted the fishing vessel, the current examination proves, with scientific value, that the trajectories could not be downwards but upwards. Also, the trajectory of two shots that hit to death the two fishermen could not be downwards but only upwards. In fact, this paper demonstrates, with scientific value: The loss of speed of the projectiles due to the rebound on the water; The tumbling effect in the ballistic medium within the two victims; The permanent cavities subject to the injury ballistics and the related ballistic trauma that prevented homeostasis causing bleeding in one case; The thermo-hardening deformation of the bullet found in Valentine Jelestine's skull; The upward and non-downward trajectories. The paper constitutes a tool in forensic ballistics in that it manages to reconstruct, from the final spot of the projectiles fired, all phases of ballistics like the internal one of the weapons that fired, the intermediate one, the terminal one and the penetrative structural one. In general terms the ballistics reconstruction is based on measurable parameters whose entity is contained with certainty within a lower and upper limit. Therefore, quantities that refer to angles, speed, impact energy and firing position of the shooter can be identified within the aforementioned limits. Finally, the investigation into the internal bullet track, obtained from any autopsy examination, offers a significant “lesson learned” but overall a starting point to contain or mitigate bleeding as a rescue from future gunshot wounds.

A Study to Evaluate the Effectiveness of Simulation on Anaesthetic Non-Technical Skills in the Management of Major Trauma Patients

Background: Dynamic, challenging instances during the management of major trauma patients requires optimal team intervention to ensure patient safety and effective crisis management. These factors highlight the importance of increased awareness in both technical and non-technical skills (NTS) training. Simulation based training (SBT) is an effective tool that replicates and teaches the required clinical skills, resulting in teamwork improvement, better patient safety, and care. Aims: This study investigates change in NTS, during the management of major trauma patients, using SBT. We also investigated the relationship between NTS performance and participation in previous NTS workshop (NTSW), years of experience, previous simulation (PS), previous exposure to major trauma patient management (MTPM) and group size. Methods: NTS behaviours were assessed by a single rater using previously validated framework for observing and rating Anaesthetists’ Non-Technical Skills (ANTS) for anaesthetists and Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) for anaesthetic nurses during SBT. Two anaesthetists (one senior, one junior) together with one to four registered anaesthetic nurses formed 17 teams. The SBT consisted of 3 major trauma scenarios: 1) Major haemorrhage following multiple stab wounds to the torso, 2) Traumatic brain injury complicated by unanticipated difficult intubation, and 3) Penetrating neck injury with major haemorrhage, complicated by a failed intubation. The scores of each NTS category for each scenario are evaluated for significance in change and used to correlate whether NTS during the simulation were affected by previous NTSW, PS, previous exposure to MTPM and group size. Results: The resulting anaesthetists and anesthetic nurses’ p-values were < 0.05 indicating a significant improvement in all NTS resulting from score differences between scenarios 1 & 2 and 1 & 3. Anaesthetists’ NTS categories were not influenced by PS, previous NTSW, and exposure to MTPM. However, anaesthetic nurses NTS categories were influenced by PS, exposure to MTPM but not by NTSW. Conclusions: SBT has shown to be effective in improving the NTS for both anaesthetists and anaesthetic nurses. This enhances safety and team performance for MTPM. The impact of SBT in the clinical environment for patient management and safety warrants further research.

From Victim to Ethical Agent: Oscar Wilde's The Ballad of Reading Gaol as Post-Traumatic Writing

Faced with a sudden, unexpected, and overwhelming event, the individual's normal cognitive processing may cease to function, trapping the psyche in "speechless terror", while images, feelings and sensations are experienced with emotional intensity. Unable to master such situation, the individual becomes a trauma victim who will be susceptible to traumatic recollections like intrusive thoughts, flashbacks, and repetitive re-living of the primal event in a way that blurs the distinction between past and present, and forecloses the future. Trauma is timeless, repetitious, and contagious; a trauma observer could fall prey to "secondary victimhood". Central to the process of healing the psychic wounds in the aftermath of trauma is verbalizing the traumatic experience (i.e., putting it into words) – an act which provides a chance for assimilation, testimony, and reevaluation. In light of this paradigm, this paper proposes a reading of Oscar Wilde's The Ballad of Reading Gaol, written shortly after his release from prison, as a post-traumatic text which traces the disruptive effects of the traumatic experience of Wilde's imprisonment for homosexual offences and the ensuing reversal of fortune he endured. Post-traumatic writing demonstrates the process of "working through" a trauma which may lead to the possibility of ethical agency in the form of a "survivor mission". This paper draws on fundamental concepts and key insights in literary trauma theory which is characterized by interdisciplinarity, combining the perspectives of different fields like critical theory, psychology, psychiatry, psychoanalysis, history, and social studies. Of particular relevance to this paper are the concepts of "vicarious traumatization" and "survivor mission", as The Ballad of Reading Gaol was written in response to Wilde's own prison trauma and the indirect traumatization he experienced as a result of witnessing the execution of a fellow prisoner whose story forms the narrative base of the poem. The Ballad displays Wilde's sense of mission which leads him to recognize the social as well as ethical implications of personal tragedy. Through a close textual analysis of The Ballad of Reading Gaol within the framework of literary trauma theory, the paper aims to: (a) demonstrate how the poem's thematic concerns, structure and rhetorical figures reflect the structure of trauma; (b) highlight Wilde's attempts to come to terms with the effects of the cataclysmic experience which transformed him into a social outcast; and (c) show how Wilde manages to transcend the victim status and assumes the role of ethical agent to voice a critique of the Victorian penal system and the standards of morality underlying the cruelties practiced against wrong doers and to solicit social action.

Identification of Active Phytocomponents in the Ethyl Acetate Extract of Glycosmis pentaphylla Retz. DC by Using GC-MS

Glycosmis pentaphylla is one of the medicinally important plants belonging to the family Rutaceae, commonly known as “Anam or Panal” in Tamil. Traditionally, leaves are useful in fever, hepatopathy, eczema, skin disease, helminthiasis, wounds, and erysipelas. The fruits are sweet and are useful in vitiated conditions of vata, kapha, cough, and bronchitis. The roots are good for facial inflammations, rheumatism, jaundice, and anemia. The preliminary phytochemical investigations indicated the presence of alkaloids, terpenoids, flavonoids, tannins, sugar, glycoside, and phenolic compounds. In the present study, the root part of Glycosmis pentaphylla was used, and the root was collected from Western Ghats of South India. The root was sun/shade dried and pulverized to powder in a mechanical grinder. The powder was successively extracted with various solvents, and the ethyl acetate extract of Glycosmis pentaphylla has been subjected to the GC-MS analysis. Amongst the 46 chemical constituents identified from this plant, three major phytoconstituents were reported for the first time. Marmesin, a furanocumarin compound with the chemical structure 7H-Furo (3,2-G) (1)Benzopyran-7-one,2,3–dihydro–2 - (1-Hydroxy-1methylethyl)-(s) is one of the three compounds identified for the first time at the concentration of 11-60% in ethyl acetate extract of Glycosmis pentaphylla. Others include, Beta.-Fagarine (4.71%) and Paverine (13.08%).

Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

The article represents the results of clinical researches of composite herbal medicinal product based on essential oils of Sedum plants growing in Kazakhstan in commercial reserves at the territory of Kazakhstan. The results of comparative analysis are represented in obstetric-gynecologic practice during combined therapy for postnatal complications, inflammatory infiltrates in the area of surgical wounds including wounds after caesarean section.

Preparation and in vitro Bactericidal and Fungicidal Efficiency of NanoSilver/Methylcellulose Hydrogel

In this work we describe the preparation of NanoSilver/methylcellulose hydrogel containing silver nanoparticles (NPs) for topical bactericidal applications. Highly concentrated dispersion of silver NPs as high as of 5g/L of silver with diameter of 10nm was prepared by reduction of AgNO3 via strong reducing agent NaBH4. Silver NPs were stabilized by addition of sodium polyacrylate in order to prevent their aggregation at such high concentration. This way synthesized silver NPs were subsequently incorporated into methylcellulose suspension at elevated temperature resulting in formation of NanoSilver/methylcellulose hydrogel when temperature cooled down to laboratory conditions. In vitro antibacterial activity assay proved high bactericidal and fungicidal efficiency of silver NPs alone in the form of dispersion as well as in the form of hydrogel against broad spectrum of bacteria and yeasts including highly multiresistant strains such as methicillin-resistant Staphylococcus aureus. A very low concentrations of silver as low as 0.84mg/L Ag in as-prepared dispersion gave antibacterial performance. NanoSilver/methylcellulose hydrogel showed antibacterial action at the lowest used silver concentration equal to 25mg/L. Such prepared NanoSilver/methylcellulose hydrogel represent promising topical antimicrobial formulation for treatment of burns and wounds.

Fusion of Colour and Depth Information to Enhance Wound Tissue Classification

Patients with diabetes are susceptible to chronic foot wounds which may be difficult to manage and slow to heal. Diagnosis and treatment currently rely on the subjective judgement of experienced professionals. An objective method of tissue assessment is required. In this paper, a data fusion approach was taken to wound tissue classification. The supervised Maximum Likelihood and unsupervised Multi-Modal Expectation Maximisation algorithms were used to classify tissues within simulated wound models by weighting the contributions of both colour and 3D depth information. It was found that, at low weightings, depth information could show significant improvements in classification accuracy when compared to classification by colour alone, particularly when using the maximum likelihood method. However, larger weightings were found to have an entirely negative effect on accuracy.

Microorganisms Isolated from Surgical Wounds Infection and Treatment with Different Natural Products and Medications

Surgical site infections (SSIs) are the most common nosocomial infection in surgical patients resulting in significant increases in postoperative morbidity and mortality. The commonly causative bacteria developed resistance to virtually all antibiotics available. The aim of this study was to isolation and identification the most common bacteria that cause SSIs in Medical Research Institute, and to compare their sensitivity to selected group of antibiotics and natural products (garlic, oregano, olive, and Nigella sativa oils). The isolated pathogens collected from infected surgical wounds were identified, and their sensitivities to the antibiotics commonly available for clinical use, and also to the different concentrations of the used natural products were investigated. The results indicate to the potential therapeutic effect of the tested natural products in treatment of surgical wound infections.

The Effect of Electrical Stimulation Intensity on VEGF Expression and Biomechanical Properties during Wound

We evaluated the effect of sensory (direct current (DC), 600μA) and motor (monophasic current, pulse duration 300μs, 100 Hz, 2.5-3mA) intensities of cathodal electrical stimulation (ES) current to release VEGF and biomechanical properties of wound. 54 male Sprague-dawley rats were randomly assigned into one control and two experimental groups. A full thickness skin incision was made on animals- dorsal region. The experimental groups received ES for 1h/day and every other day. VEGF expression was measured in skin on the 7th day after surgical incision and tensile strength was measured on 21st day. On the 7th day, the values of skin VEGF in the sensory group were significantly greater than those of the other groups (p < 0.05). Sensory and Motor intensity stimulation, can not improve the biomechanical properties of the repaired wounds. It seems the mechanical environment induced by sensory and motor intensity of electrical stimulation, could not simulate the role of normal daily stress and strain to maturation of collagen fibers and their cross links. Further work is needed to determine the relationship between VEGF expression after ES and its effect on tensile strength of healed wound.

Injuries Related to Kitesurfing

Participation in sporting activities can lead to injury. Sport injuries have been widely studied in many sports including the more extreme categories of aquatic board sports. Kitesurfing is a relatively new water surface action sport, and has not yet been widely studied in terms of injuries and stress on the body. The aim of this study was to get information about which injuries that are most common among kitesurfing participants, where they occur, and their causes. Injuries were studied using an international open web questionnaire (n=206). The results showed that many respondents reported injuries, in total 251 injuries to knee (24%), ankle (17%), trunk (16%) and shoulders (10%), often sustained while doing jumps and tricks (40%). Among the reported injuries were joint injuries (n=101), muscle/tendon damages (n=47), wounds and cuts (n=36) and bone fractures (n=28). Also environmental factors and equipment can influence the risk of injury, or the extent of injury in a hazardous situation. Conclusively, the information from this retrospective study supports earlier studies in terms of prevalence and site of injuries. Suggestively, this information should be used for to build a foundation of knowledge about the sport for development of applications for physical training and product development.

Assessment of Photodynamic Therapy for Staphylococcus Aureus Infected Wounds using Diffuse Reflectance Spectrometry

In this paper we evaluated the efficacy of photodynamic treatment of infected wounds on pig animal model by diffuse reflectance spectrometry. The study was conducted on fifteen wounds contaminated with Staphylococcus aureus bacteria that were incubated for 30 min with methylene blue solution (c = 3.3 x 10-3 M) and exposed to laser radiations (λ = 670 nm, P = 15 mW) for 15 min. The efficiency of photodynamic inactivation of bacteria was evaluated by microbiological exams and diffuse reflectance spectrometry. The results of the microbiological exams showed that the bacterial concentration has decreased from 6.93±0.138 logCFU/ml to 3.12±0.108 logCFU/ml. The spectral examination showed that the diffuse reflectance of wounds contaminated with Staphylococcus aureus has decreased from 5.06±0.036 % to 3.36±0.025 %. In conclusion, photodynamic therapy is an effective method for the treatment of infected wounds and there is a correlation between the CFU count and diffuse reflectance.

Wound Healing Effect of Ocimum sanctum Leaves Extract in Diabetic Rats

Delayed wound healing in diabetes is primarily associated with hyperglycemia, over-expression of inflammatory marker, oxidative stress and delayed collagen synthesis. This unmanaged wound is producing high economic burden on the society. Thus research is required to develop new and effective treatment strategies to deal with this emerging issue. Our present study incorporates the evaluation of wound healing effects of 50% ethanol extract of Ocimum sanctum (OSE) in streptozotocin (45mg/kg)-induced diabetic rats with concurrent wound ulcer. The animals showing diabetes (Blood glucose level >140 and

Dynamics of Blood Aminoacids in the Wounds- Treatment of Cows with Hydrocele Ointment

This article introduces the actual problem that is а study of proposed by the authors Hydrocele ointment in amino acids’ metabolism of cows’ blood in inflammation of traumatic origin. Hydrocele ointment has shown a positive effect on inflammatory process and amino acids’ metabolism of animals treated with the drug. Amino acid levels reached physiological parameters on the 10th day after treatment; in the control group this parameter was higher than normal.

A Comparison on Healing Effects of an Ayurvedic Preparation and Silver Sulfadiazine on Burn Wounds in Albino Rats

To compare Healing Effects of an Ayurvedic Preparation and Silver Sulfadiazine on burn wounds in Albino Rats. Methods: Albino rats– 30 male / female rats weighing between 150-200 g were used in the study. They were individually housed and maintained on normal diet and water ad libitum. Partial thickness burn wounds were inflicted, on overnight-starved animals under pentobarbitone (30mg/kg, i.p.) anaesthesia, by pouring hot molten wax at 80oC into a plastic cylinder of 300 mm2 circular openings placed on the shaven back of the animal. Apart from the drugs under investigation no local/ systemic chemotherapeutic cover will be provided to animals. All the animals were assessed for the percentage of wound contraction, signs of infection, scab formation and histopathological examination. Results: Percentage of wound healing was significantly better in the test ointment group compared to the standard. Signs of infection were observed in more animals in the test ointment group compared to the standard. Scab formation also took place earlier in the test ointment group compared to standard. Epithelial regeneration and healing profile was better in the test ointment compared to the standard. Moreover the test ointment group did not show any raised margins in the wound or blackish discoloration as was observed in silver sulfadiazine group. Conclusion: The burn wound healing effect of the ayurvedic ointment under study is better in comparison to standard therapy of silver sulfadiazine. The problem of infection encountered with the test ointment can be overcome by changing the concentrations and proportions of the ingredients in the test ointment which constitutes the further plan of the study.

Canonical PSO based Nanorobot Control for Blood Vessel Repair

As nanotechnology advances, the use of nanotechnology for medical purposes in the field of nanomedicine seems more promising; the rise of nanorobots for medical diagnostics and treatments could be arriving in the near future. This study proposes a swarm intelligence based control mechanism for swarm nanorobots that operate as artificial platelets to search for wounds. The canonical particle swarm optimization algorithm is employed in this study. A simulation in the circulatory system is constructed and used for demonstrating the movement of nanorobots with essential characteristics to examine the performance of proposed control mechanism. The effects of three nanorobot capabilities including their perception range, maximum velocity and respond time are investigated. The results show that canonical particle swarm optimization can be used to control the early version nanorobots with simple behaviors and actions.