Rethinking the tiered trauma team response: A case-series study in a regional trauma centre.

Objective: To reduce perceived unnecessary resource use, we modified our tiered trauma response. If a patient was not physiologically compromised, surgical registrar attendance was not mandated. We investigated the effect of this change on missed injury, unplanned representation to ED, diagnostic imaging rates and staff satisfaction.

Providers' utilization and perceptions of warfarin dosing algorithms.

Introduction: Warfarin dosing algorithms have proven beneficial in increasing time within therapeutic range (TTR) and decreasing adverse events associated with out-of-range international normalized ratios (INRs). Despite widespread availability, providers' utilization and perceptions of warfarin algorithms in real-world practice are unclear. Identifying perceptions and barriers to algorithm use may help attempts to improve warfarin therapy management.

Laparoscopic harvest of the gastro-omental free flap for reconstruction after total pharyngolaryngectomy: Operative technique.

Circumferential defects following salvage pharyngolaryngectomy present significant challenges in reconstructive surgery. The gastro-omental free flap has been shown to reduce the incidence of major fistula and catastrophic complications. The current technique for harvest of the flap requires laparotomy, which is potentially associated with significant post-operative complications.

Optimization of oar blade design for improved performance in rowing.

The aim of the present study was to find a more optimal blade design for rowing performance than the Big Blade, which has been shown to be less than optimal for propulsion. As well as the Big Blade, a flat Big Blade, a flat rectangular blade, and a rectangular blade with the same curvature and projected area as the Big Blade were tested in a water flume to determine their fluid dynamic characteristics at the full range of angles at which the oar blade might present itself to the water. Similarities were observed between the flat Big Blade and rectangular blades.

A mathematical model of the oar blade - water interaction in rowing.

Our aim was to present a mathematical model of rowing and sculling that allowed for a comparison of oar blade designs. The relative movement between the oar blades and water during the drive phase of the stroke was modelled, and the lift and drag forces generated by this complex interaction were determined. The model was driven by the oar shaft angular velocity about the oarlock in the horizontal plane, and was shown to be valid against measured on-water mean steady-state shell velocity for both a heavyweight men's eight and a lightweight men's single scull.

A fluid dynamic investigation of the Big Blade and Macon oar blade designs in rowing propulsion.

The purpose of this investigation was to examine the fluid dynamic characteristics of the two most commonly used oar blades: the Big Blade and the Macon. Scaled models of each blade, as well as a flat Big Blade, were tested in a water flume using a quasi-static method similar to that used in swimming and kayaking research. Measurement of the normal and tangential blade forces enabled lift and drag forces generated by the oar blades to be calculated over the full range of sweep angles observed during a rowing stroke.

The influence of stretcher height on the mechanical effectiveness of rowing.

The aim of the present study was to determine the effect of varying the height of the foot stretcher on the mechanical effectiveness of rowing. Ten male university level rowers rowed maximally for 3 minutes 30 seconds on a modified Concept 2 rowing ergometer. Each participant completed one trial at three foot stretcher heights.

The role of osteogenic index, octahedral shear stress and dilatational stress in the ossification of a fracture callus.

The exact mechanism by which mechanical stimulus regulates the healing process of a bone fracture is not understood. This has led to the development of several hypotheses that predict the pattern of differentiation of tissue during healing that may arise from characteristic fields of stress or strain at the fracture. These have so far remained unproved because data on stress fields in actual fracture tissue have been unavailable until recently.

The biomechanical environment of a bone fracture and its influence upon the morphology of healing.

The mechanism by which mechanical stimulus of reparative tissues directs the pattern of healing of a bone fracture is not understood. Several hypotheses have been developed that predict the ossification pattern during healing for a given ambient mechanical environment. These have remained unproved because of the absence of data on stress fields in the reparative tissue of real fractures.

Modeling signal loss in surficial marine sediments containing occluded gas.

The presence of occluded gas in inland lakes, harbor muds, and surficial marine sediments is well documented. Surficial gassy sediments cause underlying beds to be acoustically impenetrable to seismic surveys; therefore, the modeling of signal loss arising from mudline reflection and transmission absorption is of particular interest. The Anderson and Hampton [J.

Is the stability of a tibial fracture influenced by the type of unilateral external fixator?

OBJECTIVE: To examine whether the type of unilateral external fixator significantly influences the stability of a tibial fracture. DESIGN: Inter-fragmentary displacements were measured during walking while the fractures were stabilized, first with one type of fixator then with another. BACKGROUND: It is commonly claimed that one type of fixator exerts a different influence on mechanical stability at a fracture in comparison with another.