INTRODUCTION: The ongoing conflict in Ukraine from Russian invasion presents a critical challenge to medical planning in the context of multi-domain battle against a peer adversary deploying conventional weapon systems. The potential escalation of preventable morbidity and mortality, reaching a scale unprecedented since World War II, underscores the paramount importance of effective phases of care from Point of Injury (PoI)/Point of Wounding (PoW) or Point of Exposure (PoE) to Role 1 (R1) and Role 2 (R2) echelons of care.The NATO Vigorous Warrior (VW) Live Exercise (LIVEX) serves as a strategic platform for NATO and its partners, providing an opportunity to challenge operational concepts, experiment, innovate life-saving systems, and foster best practices across the Alliance. MATERIALS AND METHODS: This study delineates the strategic application of the VW LIVEX platform for the adaptation of the computational simulation software Simulation for the Assessment and Optimization of Medical Disaster Management (SIMEDIS) within the context of Large-Scale Combat Operations (LSCO). The SIMEDIS computer simulator plays a pivotal role by furnishing real-time insights into the evolving injury patterns of patients, employing an all-hazards approach. This simulator facilitates the examination of temporal shifts in medical timelines and the ramifications of resource scarcity against both morbidity and mortality outcomes. The VW LIVEX provides a unique opportunity for systematic validation to evaluate the results of the computer simulator in a realistic setting and identify gaps for future concepts of operations. RESULTS: We report the process and methodologies to be evaluated at the VW LIVEX in far forward and retrospective medical support operations. Using the SIMEDIS simulator, we can define battlefield scenarios for varied situations including artillery, drone strikes, and Chemical, Biological, Radiological, Nuclear, and explosive (CBRNe) attacks. Casualty health progressions versus time are dependent on each threat. Mortality is computed based on the concepts found in Tactical Combat Casualty Care (TCCC) of "self-aid"/"buddy-aid" factoring in the application or absence of definitive traumatic hemorrhage control and on the distribution policy of victims to medical treatment facilities through appropriate Command and Control (C2) ("Scoop and Run" versus "Stay and Play"). The number of medical supplies available along with the number of transport resources and personnel are set and are scalable, with their effect on both morbidity and mortality quantified.Concept of Medical Operations can be optimized and interoperability enhanced when shared data are provided to C2 for prospective medical planning with retrospective data. The SIMEDIS simulator determines best practices of medical management for a myriad of injury types and tactical/operational situations relevant to policy making and battlefield medical planning for LSCO. CONCLUSIONS: The VW LIVEX provides a Concept Development and Experimentation platform for SIMEDIS refinement and conclusive insights into medical planning to reduce preventable morbidity and mortality. Recommending further iterations of similar methodologies at other NATO LIVEXs for validation is crucial, as is information sharing across the Alliance and partners to ensure best practice standards are met.
- MeSH
- Humans MeSH
- Computer Simulation * trends standards statistics & numerical data MeSH
- Warfare statistics & numerical data MeSH
- Military Medicine methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Ukraine MeSH
- Keywords
- dynamický skluzný šroub, metoda konečných prvků,
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- Finite Element Analysis MeSH
- Biomechanical Phenomena MeSH
- Financing, Organized MeSH
- Femoral Neck Fractures surgery MeSH
- Hip Fractures surgery MeSH
- Bone Screws MeSH
- Middle Aged MeSH
- Humans MeSH
- Orthopedic Procedures methods MeSH
- Computer Simulation statistics & numerical data utilization MeSH
- Postoperative Complications epidemiology MeSH
- Prospective Studies MeSH
- Reoperation statistics & numerical data MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Fracture Fixation, Internal methods statistics & numerical data MeSH
- Outcome and Process Assessment, Health Care statistics & numerical data MeSH
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- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
Cíl: V príspevku studujeme vlastnosti stochastické varianty nervového obvodu pro prostorové slyšení navržené v [1]. Metody: Zajímá nás vliv jitteru na celkovou výkonnost obvodu, výkonnost definujeme jako cas obvodu potrebný pro dosažení spolehlivého odhadu ITD. Výsledky: Zjistili jsme, že vztah mezi výkonností a jitterem je nelineární a odhadli rozpetí hodnot pro správnou funkci obvodu. Výsledku bylo dosaženo pocítacovými simulacemi. Závery: Usuzujeme, že pro hodnoty jitteru existuje horní mez, nebo pocet neuronu potrebných na kompenzaci roste exponenciálne k velikosti jitteru a od urcitých hodnot se stává nerealistickým z pohledu fyziologie.
Objectives: Additional properties of the stochastic neural circuit model suggested in [1] were studied. Methods: The performance of the whole circuit when the system employs a different jitter was studied by extensive simulations. By performance we mean the time needed to obtain a reliable estimate of ITD. Results: It was found that the relation between jitter and performance is nonlinear and we estimated a plausible range of jitter values for the model. Conclusion: To conclude, there exists an upper bound of the timing jitter since the number of neurons needed to compensate the injected noise grows exponentially and above certain jitter values becomes unrealistically high.
- Keywords
- medial superior olive (MSO), stochastický model, interaural time difference (ITD),
- MeSH
- Financing, Organized MeSH
- Humans MeSH
- Synaptic Transmission MeSH
- Computer Simulation statistics & numerical data utilization MeSH
- Hearing Tests methods statistics & numerical data utilization MeSH
- Statistics as Topic MeSH
- Check Tag
- Humans MeSH
- MeSH
- Data Interpretation, Statistical MeSH
- Kinesiology, Applied methods utilization MeSH
- Humans MeSH
- Skiing physiology statistics & numerical data MeSH
- Computer Simulation statistics & numerical data utilization MeSH
- Athletic Injuries prevention & control MeSH
- Efficiency physiology MeSH
- Check Tag
- Humans MeSH
