Journal of the American College of Surgeons
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Multicenter Study Observational Study
Whole Blood Resuscitation and Association with Survival in Injured Patients with an Elevated Probability of Mortality.
Low-titer group O whole blood (LTOWB) resuscitation is becoming common in both military and civilian settings and may represent the ideal resuscitation intervention. We sought to characterize the safety and efficacy of LTOWB resuscitation relative to blood component resuscitation. ⋯ Early LTOWB resuscitation is safe but not independently associated with survival for the overall enrolled population. When patients were selected with an elevated probability of mortality based on prehospital injury characteristics, LTOWB was independently associated with a lower risk of mortality starting at 4 hours after arrival through 28 days after injury.
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Randomized Controlled Trial
Real-Time Augmented Reality Annotation for Surgical Education During Laparoscopic Surgery: Results from a Single-Center Randomized Controlled Trial and Future Aspects.
We developed an interactive augmented reality tool (HoloPointer) that enables real-time annotation on a laparoscopy monitor for intraoperative guidance. This application operates exclusively via verbal commands and head movements to ensure a sterile workflow. ⋯ The majority of trainees improved their surgical performance using the HoloPointer in elective laparoscopic cholecystectomies, and the rate of classic but potentially misleading corrections was noticeably reduced. The HoloPointer has the potential to improve education in minimally invasive surgery.
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In the past 20 years of the Global War on Terror, the US has seen substantial improvements in its system of medical delivery in combat. However, throughout that conflict, enemy forces did not have parity with the weaponry, capability, or personnel of the US and allied forces. War against countries like China and Russia, who are considered near-peer adversaries in terms of capabilities, will challenge battlefield medical care in many different ways. ⋯ The team has extensive experience in medicine, surgery, austere environments, conflict zones, and building partner nation capacities. This article compares and contrasts the healthcare systems of this war against the systems used during the Global War on Terror. The lessons learned here could help the US anticipate challenges and successfully plan for the provision of medical care in a future conflict against an adversary with capabilities close to its own.