Three-tiered approach for standard information requirements for polymers requiring registration under REACH.

Polymers are a very large class of chemicals comprising often complex molecules with multiple functions used in everyday products. The EU Commission is seeking to develop environmental and human health standard information requirements (SIRs) for man-made polymers requiring registration (PRR) under a revised Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) Regulation. Conventional risk assessment approaches currently used for small molecules may not apply to most polymers.

Expert Consensus Panel Recommendations for Selection of the Optimal Supraglottic Airway Device for Inclusion to the Medic's Aid Bag.

Introduction: Airway obstruction is the second leading cause of potentially survivable death on the battlefield. The Committee on Tactical Combat Casualty Care (CoTCCC) has evolving recommendations for the optimal supraglottic airway (SGA) device for inclusion to the medics' aid bag.

Methods: We convened an expert consensus panel consisting of a mix of 8 prehospital specialists, emergency medicine experts, and experienced combat medics, with the intent to offer recommendations for optimal SGA selection.

Age-specific survival rates, causes of death, and allowable take of golden eagles in the western United States.

In the United States, the Bald and Golden Eagle Protection Act prohibits take of golden eagles (Aquila chrysaetos) unless authorized by permit, and stipulates that all permitted take must be sustainable. Golden eagles are unintentionally killed in conjunction with many lawful activities (e.g.

How electrospray potentials can disrupt droplet microfluidics and how to prevent this.

A pressure-resistant microfluidic glass chip that integrates a packed-bed HPLC column, a droplet generator and a monolithic electrospray emitter is presented. This approach enables a seamless coupling of chip-HPLC and droplet microfluidics with ESI-MS detection. For the electrical contacting of the emitter, an electrode was integrated into the channel, which reaches up to the emitter tip.

Development of chitosan/Spirulina sp. blend films as biosorbents for Cr and Pb removal.

Chitosan film, Spirulina sp. film and its blend were developed as biosorbents to remove Cr and Pb ions from aqueous solutions. The kinetic study and the pH effect on biosorption efficiency were evaluated to comprehend the interactions between the ions and biosorbents.

External Soft-Tissue Hemostatic Clamp Compared to a Compression Tourniquet as Primary Hemorrhage Control Device in Pilot Flow Model Study.

Introduction: Acute blood loss represents a leading cause of death in both civilian and battlefield trauma, despite the prioritization of massive hemorrhage control by well-adopted trauma guidelines. Current Tactical Combat Casualty Care (TCCC) and Tactical Emergency Casualty Care (TECC) guidelines recommend the application of a tourniquet to treat life-threatening extremity hemorrhages. While extremely effective at controlling blood loss, the proper application of a tourniquet is associated with severe pain and could lead to transient loss of limb function impeding the ability to self-extricate or effectively employ weapons systems.

Surface enhanced Raman spectroscopy in microchip electrophoresis.

Coupling microchip capillary electrophoresis to surface enhanced Raman spectroscopy (MCE-SERS) combines the high separation power of capillary electrophoresis with the capability to obtain vibrational fingerprint spectra for compound identification. Raman spectroscopy is a structurally descriptive and label-free detection method which is particularly suited for chemical analysis because it is non-destructive and allows the identification of analytes. However, it suffers from poor sensitivity and sometimes even requires acquisition times far longer than the typical peak width of electrophoretic separations.

The effect of surgical approach on gait mechanics after total hip arthroplasty.

Background: Few studies have compared the biomechanical outcomes of different surgical approaches for hip arthroplasty. The purpose of this study was to compare hip, pelvic, and trunk kinematics and kinetics between individuals who underwent a posterior or anterolateral approach.

Methods: Forty-five individuals between 40 and 80 years old underwent motion analysis during overground gait prior to hip arthroplasty and 3 months after surgery.

Seamless Combination of High-Pressure Chip-HPLC and Droplet Microfluidics on an Integrated Microfluidic Glass Chip.

We introduce an approach for the integration of high performance liquid chromatography and droplet microfluidics on a single high-pressure resistant microfluidic glass chip. By coupling these two functionalities, separated analyte bands eluting from the HPLC column are fractionated into numerous droplets in a continuous flowing oil phase. The compartmentalization of the HPLC-eluate in a segmented flow was performed with droplet sizes of approximately 1 nL and with droplet frequencies reaching up to 45 Hz.

Molecular Virologic and Clinical Characteristics of a Chikungunya Fever Outbreak in La Romana, Dominican Republic, 2014.

Since emerging in Saint Martin in 2013, chikungunya virus (CHIKV), an alphavirus transmitted by the Aedes aegypti mosquito, has infected approximately two million individuals in the Americas, with over 500,000 reported cases in the Dominican Republic (DR). CHIKV-infected patients typically present with a febrile syndrome including polyarthritis/polyarthralgia, and a macropapular rash, similar to those infected with dengue and Zika viruses, and malaria. Nevertheless, many Dominican cases are unconfirmed due to the unavailability and high cost of laboratory testing and the absence of specific treatment for CHIKV infection.

Tactical Study of Care Originating in the Prehospital Environment (Tacscope): Acute Traumatic Coagulopathy on the Contemporary Battlefield.

Background: Uncontrolled major hemorrhage and delayed evacuation remain substantial contributors to potentially survivable combat death, along with mission, environment, terrain, logistics, and hostile action. Life-saving interventions and the onset of acute traumatic coagulopathy (ATC) may also contribute.

Objective: Analyze US casualty records from the DoD Trauma Registry, using International Normalized Ratio (INR) of 1.

Chip-based electrochromatography coupled to ESI-MS detection.

In this study, we present the coupling of chip-based electrochromatography to MS using a glass chip with a monolithically integrated nanoelectrospray emitter. As separation column, an acrylate-based porous polymer monolith is implemented into the glass chip by photopolymerization. For the establishment and development of this method, we used a test mixture detectable with both fluorescence and ESI-MS.

Analysis of Prehospital Documentation of Injury-Related Pain Assessment and Analgesic Administration on the Contemporary Battlefield.

In addition to life-saving interventions, the assessment of pain and subsequent administration of analgesia are primary benchmarks for quality emergency medical services care which should be documented and analyzed. Analyze US combat casualty data from the Department of Defense Trauma Registry (DoDTR) with a primary focus on prehospital pain assessment, analgesic administration and documentation. Retrospective cohort study of battlefield prehospital and hospital casualty data were abstracted by DoDTR from available records from 1 September 2007 through 30 June 2011.

Military-to-civilian translation of battlefield innovations in operative trauma care.

Background: Historic improvements in operative trauma care have been driven by war. It is unknown whether recent battlefield innovations stemming from conflicts in Iraq/Afghanistan will follow a similar trend. The objective of this study was to survey trauma medical directors (TMDs) at level 1-3 trauma centers across the United States and gauge the extent to which battlefield innovations have shaped civilian practice in 4 key domains of trauma care.

Performance of Junctional Tourniquets in Normal Human Volunteers.

Background: Inguinal bleeding is a common and preventable cause of death on the battlefield. Four FDA-cleared junctional tourniquets (Combat Ready Clamp [CRoC], Abdominal Aortic and Junctional Tourniquet [AAJT], Junctional Emergency Treatment Tool [JETT], and SAM Junctional Tourniquet [SJT]) were assessed in a laboratory on volunteers in order to describe differential performance of models.

Objective: To examine safety and effectiveness of junctional tourniquets in order to inform the discussions of device selection for possible fielding to military units.

Prediction of the percolation threshold and electrical conductivity of self-assembled antimony-doped tin oxide nanoparticles into ordered structures in PMMA/ATO nanocomposites.

Electrical percolation in nanocomposites consisting of poly(methyl methacrylate) (PMMA) and antimony tin oxide (ATO) nanoparticles was investigated experimentally using monosize and polydisperse polymer particles. The nanocomposites were fabricated by compression molding at 170 °C. The matrix PMMA was transformed into space filling polyhedra while the ATO nanoparticles distributed along the sharp edges of the matrix, forming a 3D interconnected network.

Testing of junctional tourniquets by military medics to control simulated groin hemorrhage.

Background: Junctional hemorrhage is a common cause of death on the battlefield, but there is no documented direct comparison for the use of junctional tourniquet models by US medics. The purpose of this testing is to assess military medic experience with the use of junctional tourniquets in simulated out-of-hospital trauma care.

Methods: Nine medics (seven men and two women) used four different junctional tourniquets: Combat Ready Clamp™ (CRoC™; http://www.

Risk management analysis of air ambulance blood product administration in combat operations.

Background: Between June-October 2012, 61 flight-medic-directed transfusions took place aboard U.S. Army Medical Evacuation (medevac) helicopters in Afghanistan.

Evaluation of Contingency Telemedical Support to Improve Casualty Care at a Simulated Military Intermediate Resuscitation Facility: The EM-ANGEL Study.

Objective: We sought to determine whether Contingency Telemedical Support (CTS) improves the success rate and efficiency of primary care providers performing critical actions during simulated combat trauma resuscitation. Critical actions included advanced airway, chest decompression, extremity hemorrhage control, hypothermia prevention, antibiotics and analgesics, and hypotensive resuscitation, among others.

Background: Recent studies report improved survival associated with skilled triage and treatment in the out-of-hospital/preoperative phase of combat casualty care.

Freeze-dried plasma at the point of injury: from concept to doctrine.

While early plasma transfusion for the treatment of patients with ongoing major hemorrhage is widely accepted as part of the standard of care in the hospital setting, logistic constraints have limited its use in the out-of-hospital setting. Freeze-dried plasma (FDP), which can be stored at ambient temperatures, enables early treatment in the out-of-hospital setting. Point-of-injury plasma transfusion entails several significant advantages over currently used resuscitation fluids, including the avoidance of dilutional coagulopathy, by minimizing the need for crystalloid infusion, beneficial effects on endothelial function, physiological pH level, and better maintenance of intravascular volume compared with crystalloid-based solutions.

Management of Open Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02.

During the recent United States Central Command (USCENTCOM) and Joint Trauma System (JTS) assessment of prehospital trauma care in Afghanistan, the deployed director of the Joint Theater Trauma System (JTTS), CAPT Donald R. Bennett, questioned why TCCC recommends treating a nonlethal injury (open pneumothorax) with an intervention (a nonvented chest seal) that could produce a lethal condition (tension pneumothorax). New research from the U.

"Fluidless" resuscitation with permissive hypotension via impedance threshold device therapy compared with normal saline resuscitation in a porcine model of severe hemorrhage.

Background: One approach to improve outcomes after trauma and hemorrhage is to follow the principles of permissive hypotension by avoiding intravascular overpressure and thereby preventing dislodgement of platelet plugs early in the clotting process. We hypothesized that augmentation of negative intrathoracic pressure (nITP) by treatment with an impedance threshold device would improve hemodynamics without compromising permissive hypotension or causing hemodilution, whereas aggressive fluid resuscitation with normal saline (NS) would result in hemodilution and SBPs that are too high for permissive hypotension and capable of clot dislodgement.

Methods: Thirty-four spontaneously breathing anesthetized female pigs (30.

Analysis of remote trauma transfers in South Central Texas with comparison with current US combat operations: results of the RemTORN-I study.

Background: This study aimed to analyze demographic, epidemiologic, temporal, and outcome data from an integrated trauma registry of patients undergoing initial stabilization and transfer within a mature domestic trauma network; compare data with a companion subset from the Department of Defense Trauma Registry. Texas Trauma Service Area-P is composed of 25 counties, 15 rural Level IV trauma centers (no acute care surgery), and two Level I trauma centers.

Methods: This study has a retrospective cohort design.