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To report the type and severity of ocular injuries sustained by the survivors of a bomb-loaded explosion that occurred in Mogadishu, Somalia on December 28, 2019. The recorded data included age, gender, wounded eye, initial examination of ocular injuries and associated systemic injuries, initial visual acuity, anterior and posterior segment examinations. The type of injury (open vs closed globe), the injured zone of the globe, and the presence of a relative afferent pupil defect were evaluated in all cases where possible. After the explosion, ocular injuries were detected in 28 of 114 patients in our hospital. Thirty-two eyes of 28 patients were included in the study. The mean age was 32.4±6.7 years. The number of open-globe injuries was more than that of closed-globe injuries (26 vs 6; 81.25% vs 18.75%, respectively). Zone 1 was the most affected zone in open-globe injuries (18/26 eyes, 61.6%), followed by Zone 3 in six (23%) patients and Zone 2 in four (15.4%) patients. Sixteen open-globe injuries were laceration type (61.5%) and 10 (38.5%) were rupture type. An intraocular foreign body was detected in eight (30.8%) eyes with open-globe injuries. A total of 28 patients had 11 (39.3%) isolated eye injuries, whereas 17 (60.7%) had concomitant systemic injuries. The frequency of blast-related ocular injuries is increasing. Today, the increase in the use of vehicle-borne improvised explosives in terrorist-related explosions leads to more frequent and serious ocular injuries.

\"When Brian Castner, an Iraq War vet, learns that his friend and EOD brother Matt has been killed by an IED in Afghanistan, he goes to console Matt's widow, but he also begins a personal investigation. Is the bomb maker who killed Matt the same man American forces have been hunting since Iraq, known as the Engineer? In this nonfiction thriller Castner takes us inside the manhunt for this elusive figure, meeting maimed survivors, interviewing the forensics teams who gather post-blast evidence, the wonks who collect intelligence, the drone pilots and contractors tasked to kill\"--Dust jacket flap.

ABSTRACT Objective: To describe orthopaedic injury profile in mass casualties due to anti-personnel improvised explosive device(AP-IED) blast at Muzaffarbad, Azad Jammu and Kashmir. Study Design: Retrospective descriptive case study of a single incident. Place and Duration of Study: The orthopaedic injury profile suffered by victims of anti-personnel improvised explosive device blast in 9th Muharram religious procession on 27th December, 2009 just in front of main gate of H.H. Sheikh Khalifa Bin Zayed Hospital, also called CMH Muzaffarabad. Methodology: A total of 82 mass casualties were evacuated to the Accident and Emergency Department. There were 9 fatalities. Seven were found dead on triage, whereas 2 died during resuscitation. Seventy three injured victims were included in this study. Results: Seventy three injured victims(51 males: 22 females) survived this anti-personnel improvised explosive device blast. Thirty nine victims were admitted and 2 died within 72 hours due to complications of polytrauma, making overall mortality to be 13.4%. Twenty eight emergency surgical procedures were done in 24 patients(32.8%). Limb fractures were present in 53.4% victims. Lower limb fractures in 56.75%, upper limb fractures in 29.73%. Most common upper limb fracture involved humerus(18.92%). Traumatic amputations were present in 7(9.59%) victims. Conclusion: The effects of anti-personnel improvised explosive device blast are both physically and psychologically devastating. Extremity injuries are prevalent in victims, by far. By appreciating associated injury profile, the treating physicians and surgeons are primed to deal with life and limb threatening injuries of unfortunate victims.

The US and its Coalition partners concluded combat operations in Iraq in August 2010. Rather surprisingly, little empirical evidence exists as to the factors that contributed to the ebb and flow in levels of violence and the emergence and disappearance of hot spots of hostilities during the campaign. Building upon a tradition of criminology scholarship, recent work demonstrates that Improvised Explosive Device (IED) attacks are clustered in space and time and that these trends decay in a manner similar to that observed in the spread of disease and crime. The current study extends this work by addressing a key potential correlate of these observed patterns across Iraq—namely, the timing and location of a variety of Coalition counterinsurgency (COIN) operations. This is achieved by assessing the co-evolving space-time distributions of insurgency and counterinsurgency in the first 6 months of 2005. To do so, we employ a novel analytic technique that helps us to assess the sequential relationship between these two event types. Our analyses suggest that the number of COIN operations that follow insurgent IED attacks (moderately) exceeds expectation (assuming that events are independent) for localities in the vicinity of an attack. This pattern is more consistent than is observed for the relationship in the opposite direction. The findings also suggest that less discriminatory COIN operations are associated with an elevated occurrence of subsequent insurgency in the vicinity of COIN operations in the medium to long term, whilst for more discriminatory and capacity-reducing COIN operations the reverse appears to be true.

In the aftermath of the London ‘7/7’ attacks in 2005, UK government agencies required the development of a quick-running tool to predict the weapon and injury effects caused by the initiation of a person borne improvised explosive device (PBIED) within crowded metropolitan environments. This prediction tool, termed the HIP (human injury predictor) code, was intended to: — assist the security services to encourage favourable crowd distributions and densities within scenarios of ‘sensitivity’; — provide guidance to security engineers concerning the most effective location for protection systems; — inform rescue services as to where, in the case of such an event, individuals with particular injuries will be located; — assist in training medical personnel concerning the scope and types of injuries that would be sustained as a consequence of a particular attack; — assist response planners in determining the types of medical specialists (burns, traumatic amputations, lungs, etc.) required and thus identify the appropriate hospitals to receive the various casualty types. This document describes the algorithms used in the development of this tool, together with the pertinent underpinning physical processes. From its rudimentary beginnings as a simple spreadsheet, the HIP code now has a graphical user interface (GUI) that allows three-dimensional visualization of results and intuitive scenario set-up. The code is underpinned by algorithms that predict the pressure and momentum outputs produced by PBIEDs within open and confined environments, as well as the trajectories of shrapnel deliberately placed within the device to increase injurious effects. Further logic has been implemented to transpose these weapon effects into forms of human injury depending on where individuals are located relative to the PBIED. Each crowd member is subdivided into representative body parts, each of which is assigned an abbreviated injury score after a particular calculation cycle. The injury levels of each affected body part are then summated and a triage state assigned for each individual crowd member based on the criteria specified within the ‘injury scoring system’. To attain a comprehensive picture of a particular event, it is important that a number of simulations, using what is substantively the same scenario, are undertaken with natural variation being applied to the crowd distributions and the PBIED output. Accurate mathematical representation of such complex phenomena is challenging, particularly as the code must be quick-running to be of use to the stakeholder community. In addition to discussing the background and motivation for the algorithm and GUI development, this document also discusses the steps taken to validate the tool and the plans for further functionality implementation.

Motivated by experiences of coalition military forces in Iraq and Afghanistan, we analyze the allocation of route clearance teams (RCTs) to search for and neutralize improvised explosive devices (IEDs) on roadways traveled by military convoys. We model the interaction of a single RCT and a single convoy operating over a given roadway. Our goal is to reduce IED risk by improving coordination between the RCT and the convoy. We treat the distribution of IEDs along the road prior to the passage of the RCT as a non-homogeneous Poisson process. The RCT finds and clears IEDs according to a Bernoulli process. Enemy forces may emplace (reseed) additional IEDs in the temporal gap between the RCT clearance sweep and the arrival of the convoy. IED risk is defined as the expected number of IEDs encountered by the convoy. We identify certain characteristics of optimal RCT schedules including: the shape of the IED intensity function and the speed of reseeding substantially dictate the RCT schedule that minimizes IED risk; the more rapid the IED reseeding, the more critical is conformance to the optimal RCT schedule; an RCT having inferior detection probability, by employing superior scheduling can sometimes reduce convoy risk more than a less well scheduled RCT with superior detection probability; a discretized highway version of the problem can be efficiently optimized. We also briefly discuss applications of this model to the more complex problem of allocating several RCTs to protect a number of convoys scheduled to travel on a network of highways.

Given the frequent use of improvised explosive devices (IEDs) around the world, the study of traumatic blast injuries is of increasing interest. The ear is the most common organ affected by blast injury because it is the body's most sensitive pressure transducer. We fabricated a blast chamber to re-create blast profiles similar to that of IEDs and used it to develop a reproducible mouse model to study blast-induced hearing loss. The tympanic membrane was perforated in all mice after blast exposure and found to heal spontaneously. Micro-computed tomography demonstrated no evidence for middle ear or otic capsule injuries; however, the healed tympanic membrane was thickened. Auditory brainstem response and distortion product otoacoustic emission threshold shifts were found to be correlated with blast intensity. As well, these threshold shifts were larger than those found in control mice that underwent surgical perforation of their tympanic membranes, indicating cochlear trauma. Histological studies one week and three months after the blast demonstrated no disruption or damage to the intra-cochlear membranes. However, there was loss of outer hair cells (OHCs) within the basal turn of the cochlea and decreased spiral ganglion neurons (SGNs) and afferent nerve synapses. Using our mouse model that recapitulates human IED exposure, our results identify that the mechanisms underlying blast-induced hearing loss does not include gross membranous rupture as is commonly believed. Instead, there is both OHC and SGN loss that produce auditory dysfunction.

BACKGROUND: Explosions are not exclusive to battlefields; they also represent a global security concern that affects all societies worldwide. This study aims to elucidate the effects of injuries caused by explosions with multiple mechanisms, which clinicians may encounter at any time, particularly in the context of military personnel. Furthermore, the clinical characteristics of these injuries were examined. METHODS: A total of 7,865 patient files evaluated between 2008 and 2017 by the Forensic Medicine Department of Gulhane Medical Faculty, Health Sciences University, were subjected to retrospective review. The study encompassed a total of 906 cases presenting with blast injuries. Medical records and health reports of these cases were reviewed and analyzed in terms of age- and gender-specific incidence, military ranks, type of explosion, origin of explosion, wound types, affected body areas, and sequelae. RESULTS: The findings of this study indicate that blast injuries predominantly affect young males, particularly those in the military. The most common etiological factor identified was terrorism. Blast injuries were found to occur most frequently in non-vehicular pedestrians and were primarily caused by improvised explosive devices and landmines. Blast injuries most commonly resulted in multiple-site injuries with a shrapnel effect and frequently required surgical intervention. Despite all treatments, 53.4% of explosion-related injuries resulted in long-term sequelae. CONCLUSION: The results of this study demonstrate that explosion-related injuries present a significant and complex problem. Blasts affect multiple body systems and cause severe injuries. Understanding the impact of explosions on the human body can help develop strategies to minimize or possibly eliminate serious injuries, particularly in explosion incidents encountered by security forces. Keywords: Explosion; military personnel; forensic medicine. AMAC: Patlamalar yalnizca savas alanlarina ozgu olmayip; ayni zamanda dunya capinda tum toplumlari etkileyen kuresel bir guvenlik sorununu temsil etmektedir. Bu calisma, ozellikle askeri personel baglaminda, klinisyenlerin her an karsilasabilecegi, coklu mekanizmalara sahip patlamalarin neden oldugu yaralanmalarin etkilerini aydinlatmayi amaclamaktadir. Ayrica, bu yaralanmalarin klinik ozellikleri de incelenmistir. GEREC VE YONTEM: Saglik Bilimleri Universitesi Gulhane Tip Fakultesi Adli Tip Anabilim Dali Gulhane Askeri Tip Fakultesi tarafindan 2008-2017 yillari arasinda degerlendirilen toplam 7865 hasta dosyasi retrospektif olarak incelenmistir. Calismamizda patlama sonucu yaralanan toplam 906 vaka degerlendirilmistir. Olgularin tibbi kayitlari ve saglik raporlari incelenerek yas ve cinsiyete gore gorulme sikligi, askeri rutbeleri, patlama tipi, patlamanin kaynagi, yara tipleri, etkilenen vucut bolgesi ve sekel lezyonlar acisindan analiz edilmistir. BULGULAR: Bu calisma, patlama yaralanmalarinin agirlikli olarak genc erkekleri, ozellikle de askeri personeli etkiledigini gostermektedir. Tespit edilen en yaygin etiyolojik faktor terorizmdi. Patlama yaralanmalarinin en sik arac disi yayalarda meydana geldigi ve cogunlukla el yapimi patlayicilar ve mayinlarindan kaynaklandigi tespit edildi. Patlama yaralanmalarinin cogunlukla sarapnel etkisi ile coklu bolge yaralanmalarina neden oldugu ve siklikla cerrahi mudahale gerektirdigi tespit edildi. Tum tedavilere ragmen patlama yaralanmalarinin %53.4'unun sekel biraktigi goruldu. SONUC: Calismamizin sonuclari, patlama yaralanmalarinin onemli ve karmasik bir sorun oldugunu ortaya koymaktadir. Patlamalar birden fazla vucut sistemini etkilemekte ve ciddi yaralanmalara neden olmaktadir. Patlamalarin insan vucudunu nasil etkilediginin anlasilmasi, ozellikle guvenlik guclerinin karsilastigi patlama olaylarinda ciddi yaralanmalari en aza indirecek veya muhtemel ortadan kaldiracak planlarin gelistirilmesine yardimci olabilir. Anahtar sozcukler: Adli tip; patlama; askeri personel.

There is an ongoing forensic and security need for rapid, on-scene, easy-to-use, non-invasive chemical identification of intact energetic materials at pre-explosion crime scenes. Recent technological advances in instrument miniaturization, wireless transfer and cloud storage of digital data, and multivariate data analysis have created new and very promising options for the use of near-infrared (NIR) spectroscopy in forensic science. This study shows that in addition to drugs of abuse, portable NIR spectroscopy with multivariate data analysis also offers excellent opportunities to identify intact energetic materials and mixtures. NIR is able to characterize a broad range of chemicals of interest in forensic explosive investigations, covering both organic and inorganic compounds. NIR characterization of actual forensic casework samples convincingly shows that this technique can handle the chemical diversity encountered in forensic explosive investigations. The detailed chemical information contained in the 1350–2550 nm NIR reflectance spectrum allows for correct compound identification within a given class of energetic materials, including nitro-aromatics, nitro-amines, nitrate esters, and peroxides. In addition, the detailed characterization of mixtures of energetic materials, such as plastic formulations containing PETN (pentaerythritol tetranitrate) and RDX (trinitro triazinane), is feasible. The results presented illustrate that the NIR spectra of energetic compounds and mixtures are sufficiently selective to prevent false-positive results for a broad range of food-related products, household chemicals, raw materials used for the production of home-made explosives, drugs of abuse, and products that are sometimes used to create hoax improvised explosive devices. However, for frequently encountered pyrotechnic mixtures, such as black powder, flash powder, and smokeless powder, and some basic inorganic raw materials, the application of NIR spectroscopy remains challenging. Another challenge is presented by casework samples of contaminated, aged, and degraded energetic materials or poor-quality HMEs (home-made explosives), for which the spectral signature deviates significantly from the reference spectra, potentially leading to false-negative outcomes.