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Penetrating chest trauma from a "less lethal" bean bag in the United States: a case report

  • Gloria Sanin;Gabriel Cambronero;Megan E. Lundy;William T. Terzian;Martin D. Avery;Samuel P. Carmichael II;Maggie Bosley
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.421-424
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    • 2023
  • This case report presents the case of a 49-year-old man who presented to our level I trauma center after sustaining injuries in an altercation with local law enforcement in which he was shot with a less lethal bean bag and tased. In a primary survey, a penetrating left supraclavicular wound was noted in addition to a taser dart lodged in his flank. No other traumatic findings were noted in a secondary survey. Given hemodynamic stability, completion imaging was obtained, revealing a foreign body in the left lung, a left open clavicle fracture, a C5 tubercle fracture, a possible grade I left vertebral injury, and a left first rib fracture. Soft tissue gas was seen around the left subclavian and axillary arteries, although no definitive arterial injury was identified. The bean bag projectile was embedded in the parenchyma of the left lung on cross-sectional imaging. The patient underwent thoracotomy for removal of the projectile and hemostasis. A thoracotomy was chosen as the operative approach due to concerns about significant bleeding upon foreign body removal. A chest tube was placed and subsequently removed on postoperative day 5. The patient was discharged on postoperative day 7. At a 2-week outpatient follow-up visit, the patient was doing well. This case report is the first to describe this outcome for a drag-stabilized bean bag. Although law enforcement officers utilize bean bag projectiles as a "less lethal" means of crowd control and protection, these ballistics pose significant risk and can result in serious injury.

Effects of Enzyme Treatment and Skin Contact Time on the Characteristics of Dae-hong Peach Wine (대홍복숭아 과실주의 품질 특성에 미치는 효소와 침용 시간의 영향)

  • Bora Lim;Dahye Kim;Ji-Eun Kang;Gui-Jeong Han;Seok-Tae Jeong;Chan-Woo Kim
    • Journal of the Korean Society of Food Culture
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    • v.38 no.6
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    • pp.442-455
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    • 2023
  • This study investigated the effects of pectinase treatment and skin contact time on the quality characteristics of Dae-hong peach wine. Wine was produced with variations in enzyme treatment and skin contact time (1 hour, 2 hours, 1 day, 2 days, and until the completion of fermentation). Enzyme treatment increased the production yield by 6%, as well as ethanol and redness levels, compared to the non-treated control. Volatile components were higher when the skin contact time was 2 hours or 1 day. Results were compared according to enzyme treatment and skin contact time and found to be influenced by methanol and 3-methyl-1-butanol. Enzyme treatment effectively enhanced yields and volatile compound contents. However, skin contact should be concluded a day before 1 day to ensure compliance with methanol legislative requirements. Therefore, our findings show that enzymatic treatment with shorter skin contact time preserves the distinctive characteristics of Dae-hong peaches and ensures the production of safe and flavorful wine.

Estimating the tensile strength of geopolymer concrete using various machine learning algorithms

  • Danial Fakhri;Hamid Reza Nejati;Arsalan Mahmoodzadeh;Hamid Soltanian;Ehsan Taheri
    • Computers and Concrete
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    • v.33 no.2
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    • pp.175-193
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    • 2024
  • Researchers have embarked on an active investigation into the feasibility of adopting alternative materials as a solution to the mounting environmental and economic challenges associated with traditional concrete-based construction materials, such as reinforced concrete. The examination of concrete's mechanical properties using laboratory methods is a complex, time-consuming, and costly endeavor. Consequently, the need for models that can overcome these drawbacks is urgent. Fortunately, the ever-increasing availability of data has paved the way for the utilization of machine learning methods, which can provide powerful, efficient, and cost-effective models. This study aims to explore the potential of twelve machine learning algorithms in predicting the tensile strength of geopolymer concrete (GPC) under various curing conditions. To fulfill this objective, 221 datasets, comprising tensile strength test results of GPC with diverse mix ratios and curing conditions, were employed. Additionally, a number of unseen datasets were used to assess the overall performance of the machine learning models. Through a comprehensive analysis of statistical indices and a comparison of the models' behavior with laboratory tests, it was determined that nearly all the models exhibited satisfactory potential in estimating the tensile strength of GPC. Nevertheless, the artificial neural networks and support vector regression models demonstrated the highest robustness. Both the laboratory tests and machine learning outcomes revealed that GPC composed of 30% fly ash and 70% ground granulated blast slag, mixed with 14 mol of NaOH, and cured in an oven at 300°F for 28 days exhibited superior tensile strength.

Monitoring Posterior Cerebral Perfusion Changes With Dynamic Susceptibility Contrast-Enhanced Perfusion MRI After Anterior Revascularization Surgery in Pediatric Moyamoya Disease

  • Yun Seok Seo;Seunghyun Lee;Young Hun Choi;Yeon Jin Cho;Seul Bi Lee;Jung-Eun Cheon
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.784-794
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    • 2023
  • Objective: To determine whether dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) can be used to evaluate posterior cerebral circulation in pediatric patients with moyamoya disease (MMD) who underwent anterior revascularization. Materials and Methods: This study retrospectively included 73 patients with MMD who underwent DSC perfusion MRI (age, 12.2 ± 6.1 years) between January 2016 and December 2020, owing to recent-onset clinical symptoms during the follow-up period after completion of anterior revascularization. DSC perfusion images were analyzed using a dedicated software package (NordicICE; Nordic NeuroLab) for the middle cerebral artery (MCA), posterior cerebral artery (PCA), and posterior border zone between the two regions (PCA-MCA). Patients were divided into two groups; the PCA stenosis group included 30 patients with newly confirmed PCA involvement, while the no PCA stenosis group included 43 patients without PCA involvement. The relationship between DSC perfusion parameters and PCA stenosis, as well as the performance of the parameters in discriminating between groups, were analyzed. Results: In the PCA stenosis group, the mean follow-up duration was 5.3 years after anterior revascularization, and visual disturbances were a common symptom. Normalized cerebral blood volume was increased, and both the normalized time-topeak (nTTP) and mean transit time values were significantly delayed in the PCA stenosis group compared with those in the no PCA stenosis group in the PCA and PCA-MCA border zones. TTPPCA (odds ratio [OR] = 6.745; 95% confidence interval [CI] = 2.665-17.074; P < 0.001) and CBVPCA-MCA (OR = 1.567; 95% CI = 1.021-2.406; P = 0.040) were independently associated with PCA stenosis. TTPPCA showed the highest receiver operating characteristic curve area in discriminating for PCA stenosis (0.895; 95% CI = 0.803-0.986). Conclusion: nTTP can be used to effectively diagnose PCA stenosis. Therefore, DSC perfusion MRI may be a valuable tool for monitoring PCA stenosis in patients with MMD.

Task Allocation and Path Planning for Multiple Unmanned Vehicles on Grid Maps (격자 지도 기반의 다수 무인 이동체 임무 할당 및 경로 계획)

  • Byeong-Min Jeong;Dae-Sung Jang;Nam-Eung Hwang;Joon-Won Kim;Han-Lim Choi
    • Journal of Aerospace System Engineering
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    • v.18 no.2
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    • pp.56-63
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    • 2024
  • As the safety of unmanned vehicles continues to improve, their usage in urban environments, which are full of obstacles such as buildings, is expected to increase. When numerous unmanned vehicles are operated in such environments, an algorithm that takes into account mutual collision avoidance, as well as static and dynamic obstacle avoidance, is necessary. In this paper, we propose an algorithm that handles task assignment and path planning. To efficiently plan paths, we construct a grid-based map and derive the paths from it. To enable quick re-planning in dynamic environments, we focus on reducing computational time. Through simulation, we explain obstacle avoidance and mutual collision avoidance in small-scale problems and confirm their performance by observing the entire mission completion time (Makespan) in large-scale problems.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

An analysis of problems and countermeasures in the installation of plastic greenhouse on reclaimed lands (간척지에 플라스틱 온실 설치 시의 문제점 분석 및 개선방안)

  • Yu, In-Ho;Ku, Yang-Gyu;Cho, Myeong-Whan;Ryu, Hee-Ryong;Moon, Doo-Gyung
    • Korean Journal of Agricultural Science
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    • v.41 no.4
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    • pp.473-480
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    • 2014
  • Upon setting up a dedicated plastic greenhouse for tomato cultivation developed by the Rural Development Administration on the Gyehwa reclaimed land, this study was aimed at analyzing the problems can be occurred in the installation of plastic greenhouse on reclaimed lands as well as finding out solutions for improvement. A relatively cheaper wooden pile was used in the installation in order to supplement the soft ground conditions. Based on the results of ground investigation of the installation site, both the allowable bearing capacity and pulling resistance of the wooden pile with a diameter of 150 mm and a length of 10 m were computed and came out to be 30.645 kN. It was determined that the values were enough to withstand the maximum compressive force (17.206 kN) and the pullout force (20.435 kN) that are generally applied to the greenhouse footing. There are three problems aroused in the process of greenhouse installation, and the corresponding countermeasures are as follow. First, due to the slightly bent shape of the wooden pile, there were phenomenon such as deviation, torsion, and fracture when driving the pile. This could be prevented by the use of the backhoe (0.2) rotating tongs, which are holding the pile, to drive the pile while pushing to the direction of the driving and fixing it until 5 m below ground and applying a soft vibrating pressure until the first 2 m. Second, there exists a concrete independent footing between the column of the greenhouse and the wooden pile driven to the underground water level. Since it is difficult to accurately drive the pile on this independent footing, the problem of footing baseplate used to fix the column being off the independent footing was occurred. In order to handle with this matter, the diameter of the independent footing was changed from 200 mm to 300 mm. Last, after films were covered in the condition that the reinforcing frame and bracing are not installed, there was a phenomenon of columns being pushed away by the strong wind to the maximum of $11m{\cdot}s^{-1}$. It is encouraged to avoid constructions in winter, and the film covering jobs always to be done after the frame construction is completely over. The height of the independent footing was measured for 9 months after the completion of the greenhouse installation, and it was found to be within the margin of error meaning that there was no subsidence. The extent to the framework distortion and the value of inclinometers as well showed not much alteration. In other words, the wooden pile was designed to have a sufficient bearing capacity.

A Design Education Program for Children's Participation Design - Focused on Eogong 6ho Children's Park in Suwon - (어린이 참여디자인을 위한 디자인 교육 프로그램 연구 - 수원시 어공6호 어린이공원을 사례로 -)

  • Choi, Ju-won;Chung, Soo-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.5
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    • pp.29-41
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    • 2017
  • Recently, citizen participation and user - oriented design are becoming increasingly important in the urban space design process. The Children's Park has also begun to discuss the need to reflect children's opinions and needs as well as existing ways and means of participation to reflect these opinions and ideas. In this study, a design education program for children was constructed and user opinions accessed via this design education were reflected in design and applied to the Children's Park. The training program consists of five weeks of educational programs, textbooks and teaching methods related to existing research, design education for children and participatory design programs. This program was used as a pilot of Eogong-6ho Children 's Park(No. 6 Children's Park), located in Gwonseon-gu, Suwon, and reinterpreted the results of the workshop for 5th grade students at Sunil Elementary School. This design education program is distinguished from other workshop programs on how to organize and operate participating professors and textbooks, and has a program base that can reproduce the entire process. In addition, it is necessary to verify the effects of user participation through research, such as monitoring the use of children's parks after completion, as well as the application of more diverse design methodologies to children's parks and the way they reflect children's opinions.

Study for general characters of dental implant patients and satisfaction level of function by dental interest level (임플란트 환자의 일반적 특성 및 구강관심도에 따른 기능별 만족도 연구)

  • Yoo, Eun-Mi;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.3
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    • pp.456-467
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    • 2009
  • For this study, self-completion survey for 149 implant patients of dental clinics and hospitals in Seoul and Kyunggi areahas been executed in order to provide basic data for increasing patient satisfaction level by effective consultation and various information for the patients who want dental implantation. The conclusion of the study is like below. 1. In terms of demographics of the study, sample size of female patients(n=85) was more than that of male patients(n=64) and patients in their 50s were major age group. When it comes to the educational level, university graduates were 85 and high school graduates were 44. And 132 were married and 6 were single. In the income level, monthly income between KRW 2~4 million was major group(n=59). 2. In the study, patients' most concern was complication or adverse events(n=41), and price(n=39) & annual dental check-up(n=49) were following it. And 80 patients responded that dental health is the most valuable(n=80) and whole body health was following(n=37). In terms of knowledge on dental implant, 100 patients responded 'know just a little', 31 and 13 answered 'generally know' and 'well know' each. 3. As a result of analyzing implant patients' satisfaction level by segment, general satisfaction rate was highest as 4.20, social satisfaction rate was 4.20, psychological function was 4.06 and masticatory function was 3.90. 4. Based on the result of comparing patient satisfaction level by general characters of dental implant patient, chewing function was the highest in the age group of 60s with score of 4.21 and in terms of social function, the group with over KRW 8 million of monthly income showed highest score with 4.54. When it comes to the psychological function, patients in their 70s showed highest satisfaction level with 4.52. In the end, patients in their 70s showed highest score with 4.81 in the overall satisfaction and it was also statistically significant. 5. In the overall satisfaction level by interest in dental health, appearance showed highest score with 4.57 and it was also significantly higher than that of whole body. In the variance by dental knowledge, 'well know' group showed highest score with 4.58, and that of 'just a little' group was 4.33. That means there are correlations between dental knowledge and satisfaction level. 6. As a result of analyzing correlations amongst variances of the study, there were strong positive correlations among them. And there were very significantly positive correlations especially between social and psychological function and between psychological and overall satisfaction level. In conclusion, higher psychological function has strong relations with both social function and overall satisfaction level(p<.001).

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The effects according to the timing of thoracic radiotherapy in limited stage small cell lung cancer (제한병기 소세포폐암에서 흉부 방사선 치료의 도입 시기에 따른 치료 효과의 비교 분석)

  • Park, Sang Ki;Kim, Geun Hwa;Jeong, Seong Su;Shin, Kyoung Sang;Kim, Ae Kyoung;Cho, Hai Jeong;Suhr, Jee Won;Kim, Jae Sung;Cho, Moon June;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.903-915
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    • 1996
  • Background: Combination chemotherapy is now considered to be the cornerstone of small cell lung cancer (SCLC). management but the optimal management of limited SCLC is not well defined. The role of thoracic radiotherapy (TRT) is less well established. Recent meta-analyses reports revealed that TRT combined with chemotherapy produce "good" local control and prolonged survival. But other reports that survival was not changed. The liming, dose, volume and fractionation for TRT with the combined chemotherapy of SCLC remains unsettled. In this study, we analyzed the effects according to the timing of thoracic radiotherapy in limited SCLC. Method: All fifty one patients received cytoxan, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(VPP) every 3 weeks for 6 cycles were randomized prospectively into two groups: concurrent and sequential. 27 patients received 4500cGy in 30 fractions(twice daily 150cGy fractional dose) over 3 weeks 10 the primary site concurrent with the first cycle of VPP(concurrent gorup). 24 patients received 4000 to 5000cGy over 5 or 6 weeks after completion of sixth cycles of chemotherapy(sequential group). Results: 1. Response rates and response duration : Response rates were not significantly different between two groups(p=0.13). But response duration was superior in the concurrent group(p=0.03). 2. Survival duration was nor different between two groups(p=0.33). 3. Local control rate was superior in the concurrent group(p=0.00). 4. Side effects and toxicities: Hematologic toxicities, especially leukopenia, infection and frequency of radiation esophagitis were higher in the concurrent group (p=0.00, 0.03, 0.03). Conclusion: The concurrent use of TRT with chemotherapy failed to improve the survival of limited stage SCLC patients compared with the sequential use of TRT but response duration and local control rate were superior in the concurrent group. Frequency of radiation esophagitis, life threatening hematologic toxicities and infection were more frequent in the concurrent group than sequential group. So, the selection of an optimal schedule of chemotherapy combined with TRT that would lead to a major increase in survival with minimal toxicity is remained to be validated in large scale study in the future.

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