Explosive Device Attacks Research Articles

Craniocerebral Gunshot Injuries in Chad: A Study of 44 Cases

Firearm head injuries cause great public health concern because of their severity. They are life-threatening due to intracranial lesions and sepsis risks. This prospective study evaluates the management of craniocerebral wounds in Chad. This is an observational study conducted over a period of 65 months with 44 patients with a ballistic craniocerebral wound (BCW), of which only 7.18% were assessed by neurosurgeons with gunshot wound. The mean age was 30.57 ± 13 years (range:2-60 years). The 21-30 age group was the most affected (31.8%). The sex ratio was 21. A total of 63.6% of cases involved military personnel. The average admission time was 24.95 ± 12 hours (range: 1-72 hours). Explosive device attacks represented 29.5% of cases, of which 53.3% occurred in civilian practice. Point-blank shooting was reported in 70.5% of cases. The entry hole of the projectile was frontal in 40.9%. Intracranial sequestration of the projectile was found in 56.8%. Association of upper limb trauma was found in 9.1% of cases. Brain scans were performed in 95.5% of cases. Surgical treatment was undertaken in 68.18% of cases. The recovery process was marked by brain abscess in 6.8% of cases. Seven deaths were recorded. This study shows that BCW is frequent and mainly affects young male individuals in Chad. Many of the cases were related to improvised explosive device attacks, especially in civilian practice (70.5%). The delay in diagnostic and therapeutic management favors the high rate of sequelae.

Analysis of isolated transverse process fractures sustained during blast-related events.

Personnel have sustained a range of devastating blast injuries during recent conflicts. Previous studies have focused on severe injuries, including to the spine; however, no study has specifically focused on the most common spinal injury-transverse process (TP) fractures. Although their treatment usually requires limited intervention, analysis of TP fractures may help determine injury mechanisms. Data were collected from victims with spinal fractures who were injured in improvised explosive device attacks, from the UK's Joint Theatre Trauma Registry. The level and side of each TP fracture were recorded, as well as associated injuries, whether they were mounted or dismounted, and outcome (survivor or fatality). Most (80%) of the TP fractures were lumbar. More bilateral (both left and right fractures at the same level), and L5 TP fractures, were seen in fatalities than survivors. In the mounted group, lumbar TP fractures were statistically significantly associated with fatality, head injury, noncompressible torso hemorrhage, pelvic injury, and other spinal injuries. In the dismounted group, thoracic TP fractures were associated with head, chest wall, and other spinal injuries; and lumbar TP fractures were associated with pelvic and other spinal injuries. Different injury mechanisms of the TP in the mounted and dismounted groups are likely. Inertial forces acting within the torso due to rapid loading being transferred through the seat, or high intra-abdominal pressures causing the tensile forces acting through the lumbar fascia to avulse the TPs are likely mechanisms in the mounted group. Blunt trauma, violent lateral flexion-extension forces, or rapid flail of the lower extremities causing tension of the psoas muscle, avulsing the TP, are likely causes in the dismounted group. Isolated lumbar TP fractures can be used as markers for more severe injuries, and fatality, in mounted blast casualties. Prognostic and epidemiological, level III.

Modelling improvised explosive device attacks in the West – Assessing the hazard

Improvised Explosive Devices (IEDs) continue to be a terrorist weapon of choice. With increasing pressures on the economies of Western nations, spending on counter-terrorism is subject to greater scrutiny. Homeland security agencies are no longer exempt from government fiscal due diligence, needing to justify how their spending achieves best value-for-money. Probabilistic Risk Assessment (PRA) is a valuable tool that can assist in this endeavour. This paper introduces a PRA model that characterises IED attacks in Western nations, and can be used to assess the risk reduction associated with IED attack countermeasures. When using the model with the START open-source terrorism database we identified that current IED attack countermeasures provide a risk reduction of at approximately 22%, and that terrorists using IEDs in Western nations cannot generally be considered adaptive, with the operational effectiveness of terrorists being approximately 7%.

Benefit of Distributed Security Queuing for Reducing Risks Associated With Improvised Explosive Device Attacks in Airport Terminals

Abstract Brussels Airport ceased operations for 12 days after a coordinated improvised explosive device (IED) attack by suicide bombers in March 2016, demonstrating that critical transport hubs can be disrupted for significant durations by terrorists. Designers of critical infrastructure need to consider countermeasures to such attacks, reducing a target's attractiveness and improving opportunities for business continuity. This can be achieved by considering the cost–benefit of potential countermeasures during the design phase for infrastructure. This paper uses a probabilistic risk assessment (PRA) model for IED attack to assess the costs and benefits of using distributed security queuing at airport terminals. Our results demonstrate that the use of distributed security queuing will offer casualty reductions when used in preference to centralized security queuing. However, when considering the cost–benefit of introducing distributed security queuing, on the basis of a single small to medium IED attack, it is likely that implementing this countermeasure would not be deemed cost-effective from a purely financial perspective, particularly when the threat likelihood is very low.

Spatio-temporal patterns of IED usage by the Provisional Irish Republican Army

In this paper, a unique dataset of improvised explosive device attacks during “The Troubles” in Northern Ireland (NI) is analysed via a Hawkes process model. It is found that this past dependent model is a good fit to improvised explosive device attacks yielding key insights about the nature of terrorism in NI. We also present a novel approach to quantitatively investigate some of the sociological theory surrounding the Provisional Irish Republican Army which challenges previously held assumptions concerning changes seen in the organisation. Finally, we extend our use of the Hawkes process model by considering a multidimensional version which permits both self and mutual-excitations. This allows us to test how the Provisional Irish Republican Army responded to past improvised explosive device attacks on different geographical scales from which we find evidence for the autonomy of the organisation over the six counties of NI and Belfast. By incorporating a second dataset concerning British Security Force (BSF) interventions, the multidimensional model allows us to test counter-terrorism (CT) operations in NI where we find subsequent increases in violence.

사제폭발물의 위험성 및 안전대책에 관한 연구

Abstract Crimes with explosives is one of the mass-destructive crimes that involves the most victims. It is heavily punished under the Korean laws. Mid-eastern area is one of the leading places that are home to improvised explosive device attacks, in the form of religious o r political terrorism because of its convenience of use, production and disguise. Improvised bombs a re permeating into domestic crimes in Korea as their tools. Use of explosive substances are strictly restricted in this country, but it is not impossible to find its information online and to create private explosives with a bit of interest. And they are being traded in the grey market. For this reason, this thes is offers the method of an efficient safety control of explosive substances, which can be used as raw mater ials for improvised explosive devices, in order to protect citizens’lives and properties and to promote n ational security down the road. Key words : Improvised Explosive Device, IED, Terrorism Using E xplosives, Hazardous Chemical Substances

Probabilistic Risk Assessment for Improvised Explosive Device Attacks That Cause Significant Building Damage

AbstractMost vulnerability assessments assume that an improvised explosive device (IED) will reach maximum TNT equivalency, and that the IED will successfully detonate. These assumptions will tend to overestimate actual blast-load effects. The paper develops an IED probabilistic risk-assessment model using a systems model for IED attacks based on the reliability of IEDs and by characterizing the human aspects of an IED attack’s operational effectiveness from existing databases of terrorist incidents. The analysis includes estimates of the probability of threat, hazard, and loss for large commercial buildings in the United States. It was found that annual fatality risk for building occupants is similar to acceptable risk criteria. This suggests that strengthening buildings against progressive collapse may not be warranted unless there is a specific threat against a building.

Using Augmented Reality as a Clinical Support Tool to Assist Combat Medics in the Treatment of Tension Pneumothoraces

This study was to extrapolate potential roles of augmented reality goggles as a clinical support tool assisting in the reduction of preventable causes of death on the battlefield. Our pilot study was designed to improve medic performance in accurately placing a large bore catheter to release tension pneumothorax (prehospital setting) while using augmented reality goggles. Thirty-four preclinical medical students recruited from Morehouse School of Medicine performed needle decompressions on human cadaver models after hearing a brief training lecture on tension pneumothorax management. Clinical vignettes identifying cadavers as having life-threatening tension pneumothoraces as a consequence of improvised explosive device attacks were used. Study group (n = 13) performed needle decompression using augmented reality goggles whereas the control group (n = 21) relied solely on memory from the lecture. The two groups were compared according to their ability to accurately complete the steps required to decompress a tension pneumothorax. The medical students using augmented reality goggle support were able to treat the tension pneumothorax on the human cadaver models more accurately than the students relying on their memory (p < 0.008). Although the augmented reality group required more time to complete the needle decompression intervention (p = 0.0684), this did not reach statistical significance.

Medical Costs of War in 2035: Long-Term Care Challenges for Veterans of Iraq and Afghanistan

War-related medical costs for U.S. veterans of Iraq and Afghanistan may be enormous because of differences between these wars and previous conflicts: (1) Many veterans survive injuries that would have killed them in past wars, and (2) improvised explosive device attacks have caused "polytraumatic" injuries (multiple amputations; brain injury; severe facial trauma or blindness) that require decades of costly rehabilitation. In 2035, today's veterans will be middle-aged, with health issues like those seen in aging Vietnam veterans, complicated by comorbidities of posttraumatic stress disorder, traumatic brain injury, and polytrauma. This article cites emerging knowledge about best practices that have demonstrated cost-effectiveness in mitigating the medical costs of war. We propose that clinicians employ early interventions (trauma care, physical therapy, early post-traumatic stress disorder diagnosis) and preventive health programs (smoking cessation, alcohol-abuse counseling, weight control, stress reduction) to treat primary medical conditions now so that we can avoid treating costly secondary and tertiary complications in 2035. (We should help an amputee reduce his cholesterol and maintain his weight at age 30, rather than treating his heart disease or diabetes at age 50.) Appropriate early interventions for primary illness should preserve veterans' functional status, ensure quality clinical care, and reduce the potentially enormous cost burden of their future health care.

A systems model for probabilistic risk assessment of improvised explosive device attacks

Due to their improvised nature, the variability in the design, manufacture and operation of most improvised explosive devices (IEDs) defy the traditional paradigms used to assess the effectiveness of conventional munitions. Thus, IEDs are complex socio-technical systems to model. To compensate for inadequacies in model design or data deficiencies, expert judgement and subjective probability assignments are often employed. The paper aims to reduce this reliance by developing an IED probabilistic risk assessment model using a systems model for IED attacks based on IED device reliability and characterising the human aspects of IED attack operational effectiveness from existing terrorism databases. This model can then be used to develop an automated model for IED probabilistic risk assessment that can be used towards informing military applications such as operations planning and war-gaming, and civil applications such as security risk management (including event planning), protective construction requirements, and insurance assessments. It was found that the risk of loss (fatalities, property damage) is influenced more by operational aspects (such as target selection, IED placement and attack timing) than the technical aspects of the device design and manufacture.

Vascular Trauma Historical Notes

This article provides a brief historical review of treatment of vascular trauma. Although methods for ligation came into use in the second century, this knowledge was lost during the Dark Ages and did not come back until the Renaissance. Many advances in vascular surgery occurred during the Balkan Wars, World War I, and World War II, although without antibiotics and blood banking, the philosophy of life over limb still ruled. Documenting and repairing both arteries and veins became more common during the Korean and Vietnam conflicts. Increased documentation has revealed that the current conflicts have resulted in more arterial injuries than in previous wars, likely because of improved body armor, improvised explosive device attacks, tourniquet use, and improved medical evacuation time. This brief review emphasizes the great value of mentorship and the legacy of the management of arterial and venous injuries to be passed on.

Tympanic Membrane Perforation After Combat Blast Exposure in Iraq: A Poor Biomarker of Primary Blast Injury

The US military has reported over 10,000 improvised explosive device attacks attributing to over 400 deaths in Iraq in 2005. Otologic blast injury and tympanic membrane (TM) perforation have traditionally been used as a predictor, or biomarker, of serious or occult primary blast injury (PBI). Although combat injuries from the US-Iraq conflict have been described, the utility of TM perforation as a marker of PBI has not. The objective of this study is to determine the incidence of tympanic perforation in patients subject to blast exposures and describe its utility as a biomarker of more serious primary barotrauma, as observed at a US military hospital in Iraq. In our institutional review board-approved study, all patients during a 30-day period who arrived at a tertiary US military hospital in Iraq were evaluated. All patients with blast injures were identified on arrival to the hospital emergency department and were followed up through their hospital course and evacuation to the United States to assure they received proper otolaryngology evaluation and follow-up. Demographic data and manifestations of PBI (TM perforation, pneumothorax, pulmonary contusion, nonpenetrating facial sinus injury, and bowel perforation) and other combat injuries were recorded. The diagnostic tests and clinical examination findings used to identify these complications were also recorded. One hundred sixty-seven patients were enrolled over 30 days. All blast exposures resulted from primary or secondary explosions from munitions used in combat. This included both combatants and civilians. All patients were men. The mean patient age was 28 years (range, 12-55 years). Sixteen percent (27 of 167) of blast-exposed patients had TM perforation. Thirteen of 27 patients with perforations had bilateral perforations. Twelve of 167 patients (7%) had PBI. Six of 12 patients (50%) with PBI had TM perforation. The use of TM perforation as a biomarker for PBI resulted in a sensitivity of 50% (95% CI, 22-78%) and specificity of 87% (95% CI, 81-92%). Both TM perforation and PBI are rare with improvised explosive devices and other explosive devices in the current Iraqi-US conflict. Contrary to previous belief and management guidelines, TM perforation had low sensitivity for serious or occult PBI and was not a good biomarker. On the basis of the findings of this study, the absence of TM perforation does not appear to exclude other serious PBI.