Construction and application of time-effect assessment database for experiments on war-traumatized animals : Emergency and Critical Care Medicine

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Construction and application of time-effect assessment database for experiments on war-traumatized animals

Wang, Junkanga,b; Wang, Jinga,b; Zhang, Honglianga,b; Guo, Chengyua,c; Wang, Yanbiaod; Lu, Binga,b; Feng, Congb,∗; Pan, Feib,∗; Li, Tanshib,∗

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Emergency and Critical Care Medicine 2(4):p 219-224, December 2022. | DOI: 10.1097/EC9.0000000000000030
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Abstract

Introduction

With changes in war forms caused by the application of high-tech weapons and equipment, characteristics of modern war trauma have undergone major changes.[1,2] The war trauma database can provide an evidence-based foundation for the development of service theories for modern war trauma treatment, innovation of treatment technologies, research and development of medical equipment and devices, formulation of standards and specifications, etc.[3] The North Atlantic Treaty Organization troops represented by the U.S. Army have established a more complete war trauma registration database and also fully seized the opportunity of weapon tests to accumulate many wound animal experiment data, all of which provides the data foundation built on evidence-based analysis for war trauma treatment.[4,5] Since the Chinese People’s Liberation Army (PLA) has not participated in a large-scale war for over 30 years, and most of the existing data come from the PLA Counterattack Against Vietnam in Self-Defense, it is difficult to obtain high-quality war injury data related to modern wars.[6] In this case, it is an important development direction to utilize data for experiments on war-traumatized animals to supplement the existing war trauma data so as to provide true and reliable data support for research on war trauma treatment in the future.[7,8] With the significant advantages of accuracy, reliability, security, and data management, the database provides important support for the networked, systematic, standardized, and dynamic management of the experiment data.[9] This paper fully discusses methods for construction and application of the time-effect assessment database for experiments on war-traumatized animals featuring reasonable structure design, rich data resources and convenient use, so as to provide a reference for the development of the PLA’s war trauma database.

Data and methods

Demand analysis

PLA has collected a large amount of precious and true war injury data in previous wars, most of which are kept in the archive rooms or medical records rooms of respective combat troops. These data are of great significance for the PLA to summarize the war injury experience and improve the medical support capability. However, there are still 2 major contradictions in the full use of these data. First, there was a shortage of basic war trauma data. The existing data are incomplete in integrity, insufficient in quantity, and poor in quality; hence they can only meet the needs of qualitative research. Effectively, it is difficult for them to meet the needs of quantitative research and obtain a high-quality conclusion. The second is the inconsistency between experience and existing data. Since the combat mode and war injury composition nowadays have undergone tremendous changes, data PLA owns are unable to support research on the modern war trauma treatment in the information era.[10] To tackle the above 2 major issues, experiments on war-traumatized animals are carried out to further discuss the characteristics and dose–response relationship of weapon injuries. Moreover, its good correspondence with the human injury effect can be used to further supplement the research on the protection and treatment of weapon injuries.[11]

In order to ensure integrity, accuracy, and high efficiency of data collection during the experiments on war-traumatized animals, the electronic information technologies are fully utilized to design the requirements for building the time-effect assessment database for experiments on war-traumatized animals, the core architecture ideograph shown in Figure 1.[12] The required functions of this database shall include the following: being able to be linked with a variety of monitoring, checking and inspection equipment, and realizing real-time automatic data capture; having the built-in standardized forms for basic information of animal experiments, experimental conditions, weapons, pathological histochemistry, and experiment record, etc., which can be filled in and modified; real-time store and display of structured and unstructured data, checking data automatically, and alarming abnormal values; retrieving and querying data, inquiring the relevant data as required, and sorting and exporting the required data in the form of EXCEL and in the format convenient for analysis by the statistic software; automatically recognizing and importing the raw data, and improving cross import of the standardized experiment data between different experiments; the function of database organizational management and being able to achieve delicacy management of different permissions of personnel from different institutions.

F1
Figure 1:
Core architecture ideograph of time-effect assessment database for experiments on war traumatized animals of database.

Module design

Modular function design is carried out to meet the general requirements for experiments on war-traumatized animals by using the greatest common divisor of the basic processes and methods of experiments on war-traumatized animals. After full consideration, the final time-effect assessment database for experiments on war-traumatized animals contains 6 modules in 25 types of data items in total: data acquisition, data storage, data display, data retrieval, data export, and organizational management modules. The functional architecture diagram of the time-effect assessment database for experiments on war-traumatized animals is shown in Figure 2. The data acquisition module is used for the unified and standardized acquisition of data resources and realizes real-time, standard, and standardized data acquisition. The data storage module is used for real-time retrieval and stable storage of structured and unstructured data. The data display module utilizes computer graphics and other technologies to visualize the data. The data retrieval module can retrieve information through a variety of retrieval modes and customized conditions. The data export module can export the searched and filtered data to Excel to facilitate statistical analysis and processing. The organizational management module realizes various types of organizational management functions.

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Figure 2:
Functional architecture diagram of time-effect assessment database for experiments on war traumatized animals tecture of database.

Architecture design

Software architecture. The database software architecture is designed according to the database design principles of usability, reliability, security, and scalability. The most commonly used 3-tier architecture development technology can make the work division of all developers clearer. Different developers can develop the database at the same time according to the respective work division and reduce the coupling relationship between all layers, preventing crashes in all databases. The 3-tier architecture design divides the functional modules of the entire system into the following layers: user interface (UI), business logic layer (BLL), and data access layer (DAL). All layers can have access to each other; in this case, the goal of “high cohesion and low coupling” can be achieved with the structure diagram shown in Fig. 3.

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Figure 3:
Structure diagram of time-effect assessment database platform for experiments on war traumatized animals.
  1. UI: The interface displayed to the user, which is mainly used to convey and feedback user requirements, is equipped with an operation interface and is capable of inputting and outputting the system data.
  2. BLL: The core layer of the entire system, which mainly makes a logical judgment regarding specific issues, implements specific operations and bridges the UI and the DAL.
  3. DAL: This layer is mainly used for database access. It has no capability to make logical judgments and only achieves real-time feedback of the operation results to the BLL.

Program structure. The traditional client/server architecture (C/S architecture) can give full play to the processing capability of the client and connect to a dedicated server through a small local area network for data management and interaction. The browser/server architecture (B/S architecture) is a new network architecture after the rise of the Internet. Its biggest advantage is that users can access a server with a browser without installing special software. Based on the stored data type, application scenario, and functional division of the database, after comprehensive analysis of the advantages and disadvantages of each program structure, the B/S architecture is selected, and the server is installed with common databases such as SQL Server, Oracle, and MYSQL. After the browser is connected to the server, the browser can interact with the database under the management of the background through the standard communication protocol and ensure consistency of the access behaviors of all browsers.

Compilation and debugging

According to the conclusion on demand analysis for the construction of a time-effect assessment database for experiments on war-traumatized animals in the early stage, research and development (R&D) engineers determine the business and functions of each system, and design system prototypes and UI interfaces after reasonable segmentation of the contents of each module. At the same time, another batch of R&D engineers carry out preliminary design, build the communication protocols between the inspection instruments and the database, perform the structure design of the database table, and use the programming language to carry out synchronous development pursuant to all development requirements established in the early stage. After all functional modules are built, the testers must design the test cases, use the simulation data to perform relevant simulation, form, and feedback the test log, and submit a change request. According to the test log and the test result report, the R&D personnel fix bugs, and the testers track and retest defects until debugging is completed.

Results

Data acquisition

The information acquisition module is one of the core contents of a database. Data acquisition was standardized and normalized by formulating a unified data resource classification and acquisition process. The collected structured and unstructured data are divided into basic information, weapon information, operation records, anesthesia information, and other information types, as shown in Table 1.

Table 1 - Database Information Type
Information Type Content Description
Basic information Number, group, strain, gender, age, length, and weight
Weapon information Name, type, characteristics, and injury distance
Operation record Anesthesia, injury, disposal, monitoring, examination, and anatomy
Anesthesia information Preoperative conditions, anesthesia methods, and anesthesia recovery
Vital signs Heart rate, blood pressure, respiration, pulse, and body temperature
Monitoring data Monitor, hemodynamic monitoring, and end tidal carbon dioxide
Inspection data Coagulation, thromboelastogram, blood gas, blood biochemistry, blood routine, and urine routine
Image data Operation record image, anatomical image, ultrasound, and computed tomography
Pathological Autopsy and pathological histochemistry
 immunohistochemistry
Molecular biology Immune factors
Experimental record Injury records, event records, and pricing information

For various information that cannot be automatically obtained or imported from instruments, a structured design of forms is carried out according to the experimental demands. Standardized data acquisition is performed by entering, checking, adding, etc., and entry dictionary items are added to make data entry faster. At the same time, according to different experimental requirements in multiple scenarios, the system currently integrates 18 kinds of monitoring and inspection equipment, including equipment for routine blood tests, routine urine tests, blood biochemistry, plasma coagulation, thromboelastography, and blood gas analysis. During the experiments, it can collect vital signs, monitoring, inspection, and image data, all of which can be directly pushed from the terminal to the database through a standardized communication protocol. In this case, these data are directly stored in the database, which can avoid loss of authenticity and accuracy of scientific research data caused by data misoperation, artificial modification, and other behaviors, so as to ensure that the experimental data are true and valid.

Data storage

The data in the existing database are mainly divided into structured and unstructured data. The structured data are stored by constructing a form with a certain logic and order, while the unstructured data produced during the experiments are stored in conventional formats such as JPG and BMP and professional image formats such as DICOM. The data saved by conventional formats such as JPG and BMP mainly come from experimental photos and scanning pictures for pathological histochemical slices and videos. Such image data support local uploading and are archived and stored by connecting with the experimental animal number. In the later stage, they can be retrieved, viewed, and exported based on animal numbers. For medically dedicated image data saved by DICOM, data sources mainly come from ultrasound, computed tomography, and other inspection equipment. This system can browse and adjust image data by analyzing the DICOM data format. The names of the database forms and explanations are listed in Table 2.

Table 2 - Name of Database Form and Explanation
Form Name Explanation
Animal Basic information
Injury weapon Weapon information
Operation record Operation record information
Anesthesia Anesthesia information
Vital sign Basic vital signs data
CO2 monitor End tidal carbon dioxide
Monitor original Data acquisition of monitor equipment
Picco original Hemodynamic monitoring
Blood gas index Arterial blood gas analysis results
Blood routine Blood routine analysis result
Biochemical indicators Blood biochemical test results
Thromboelastogram Thromboelastography analysis results
Urinalysis Urine routine analysis results
Pee original Urine volume monitoring data

Data display

The data display displays abstract data in the database in a visible or readable form by means of computer graphics and other technologies. It is mainly divided into direct data display, graphic display, and other forms. Through data visualization, the data can be conveyed clearly and effectively, and the relationship between data can be visually displayed in an expression form that is easier to understand, so as to quickly understand the information contained in the data as a whole and notice the relationship that has never been encountered before.

Data retrieval and export

Powerful data retrieval and export functions are required for the massive data collected during the animal experiments. The database operating system can support many retrieval modes, retrieve information by customizing the query field, select the field query range and value range, and export the retrieved and filtered data to Excel. The data format should be convenient for direct analysis and utilization in professional statistical analysis software such as SPSS and SAS.

Organizational management

Organizational management, aimed at achieving systematic and standardized management of the database, is mainly divided into institution management, personnel management, permission management, menu management, etc. Figure 4 presents a schematic diagram of the organizational management architecture of the time-effect assessment database for experiments on traumatized animals. The corresponding permissions are adjusted hierarchically and dynamically according to different institution and personnel categories to adapt to the database usage permissions in different scenarios. Among them, personnel are mainly classified as system administrators, project team administrators, data entry staff, access personnel, etc. The system administrator can implement hierarchical, graded, and classified permission management by restricting user permission trees at different levels so that the personnel of different categories can “add, delete, modify and check” different data contents and record all data operations, so as to improve data credibility and security. Menu management is mainly used to adjust some basic settings of the database to adapt to the habits of different users.

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Figure 4:
Schematic diagram of organizational management architecture of database.

Real application of database

PLA has established a time-effect assessment database for experiments on war-traumatized animals, applied experiments on war-traumatized animals preliminarily in 2020, which collected a total of over 100 pieces of detailed data falling into four war trauma models, and established 86 sets of forms with a total of over 80 million pieces of data. The database has the characteristics of diversified data categories, large volume, high regulation degree, etc., and contains most of the information on changes in the trauma state of experimental animals from genetic information at birth to molecular biology research. At the same time, in response to the problems and vulnerabilities found in the actual use process, dozens of adjustments and corrections have been made to meet convenience. Steady progress has also been made in the entry, verification, and storage of past data for experiments on war-traumatized animals.

Discussion

Based on the analysis of domestic and foreign war trauma databases as well as the database for experiments on war-traumatized animals, and in view of bottlenecks and difficulties in the process of recording the data of experiments on war-traumatized animals in PLA, this research proposes a complete customizable scheme for the construction and application of the time-effect assessment database for experiments on war-traumatized animals.[5,13] Finally, developers developed a time-effect assessment database for experiments on war-traumatized animals, which is network-based, information-based, flexible, and expandable. Many monitoring and inspection instruments are directly connected to the database, or the text data can be automatically imported by formatting, which can effectively solve problems such as loss of the authenticity and accuracy of scientific research data caused by data misoperation, artificial modification, etc. In addition, it provides an important reference for normalizing and standardizing the construction of a database for experiments on war-traumatized animals and also provides platform support for the big data time-effect assessment and analysis of experiments on war-traumatized animals in the future.

War trauma databases at home and abroad are rapidly developing. As early as 1999, the U.S. Army began to build a wound data and munitions effectiveness team database to store the war trauma data of 7989 wounded during the Vietnam War.[7] In the 1990s, the U.S. Army started to build the navy-marine corps combat trauma registry, which contained the wound information of the majority of the wounded in Iraq and Afghanistan wars.[14] Afterwards, in order to further enhance the positive role of evidence-based medicine in war trauma treatment, the U.S. Army began to construct the joint theater trauma system (JTTS) and the joint theater trauma registry (JTTR) in 2003, both of which together acted as a unified trauma data acquisition and storage system.[4] In 2006, the U.S. Army upgraded JTTS to the joint trauma system (JTS), and JTTR was also upgraded to the Department of Defense Trauma Registry (DoDTR).[15] In 2006, the British army built a theater-deployed operational emergency department attendance register (OPEDAR) system that can be used for recording, summarizing, and backtracking of the front-line war trauma data, so as to record and save the war trauma data.[16] At the same time, during experiments on war-traumatized animals in many foreign laboratories, databases are built to facilitate saving, analysis, and utilization of the data for these experiments, which provide a prospective exploration basis for revision of war trauma treatment standards.[11,17] China seldom explores this field. Chen Jing’s team of the Third Military Medical University has built a war trauma experiment data management system that systematically manages part of the structured data generated in field experiments and laboratories.[18] Yang Chunxia et al. explored and built an experimental database of weapon-caused biological damage effects, achieving systematic recording of biological damage caused by weapons.[19] However, most of these studies aimed to save and archive the existing data and fail to realize real-time recording and storage. Thus, war trauma data are limited in terms of type. Most of the existing research findings on war trauma treatment come from summaries of previous war trauma data and clinical experience. However, in the face of increasing cruelty of wars, constant use of new technology weapons and evolving war forms, the existing treatment experience may not fully meet the needs of war trauma treatment in the future. However, it is of an urgent need to obtain more assessment data regarding killing effects of new-technology weapons and treatment effects of new technologies from animal experiments.[20] Therefore, the research on war trauma treatment in future wars will gradually develop from a summary of past war experience data to a combination of experience summary, clinical test, animal experiment, digital model simulation, etc.[21] By building an animal experiment database with standard data and available for query and analysis, these important data of war traumatized animals are subject to systematic and standardized management. In this case, the database can provide complete, true, and reliable big data support for relevant researches, and lay a certain foundation for subsequent computer simulation analysis and application.[22,23]

In summary, the data in the time-effect assessment database are objective, accurate, and detailed, providing a basic data platform for promoting research on war trauma time-effect assessment, and can meet the needs of time-effect assessment of war trauma treatment. However, the animal models in the database are still relatively limited at present, and the number of animals is far from meeting the requirements of big data analysis. After basic requirements, such as data acquisition, storage, and analysis, new quantitative methods will be developed using technologies such as artificial intelligence and big data analysis. Mathematical model analyses based on clinical tests, animal experiments, and computer simulation data will become the main goals, requirements, and high-priority tasks in the next stage.[24,25]

Conflict of interest statement

The authors declare no conflicts of interest.

Author contributions

Wang J, Pan F, Feng C, and Li T participated in the conception and design of this study. Wang J, Wang J, Zhang H, and Guo C wrote the manuscript. Wang J and Wang Y participated in data analysis. Feng C and Li T were in charge of proofreading the text. All the authors were involved in the interpretation of the results. All authors have read and approved the final manuscript.

Funding

This work was supported by the 13th Five-year Plan Military Key Discipline Construction project (A350109), the National Key Research and Development Program of China (2019YFF0302300), the Military Project of Biosafety Research (19SWAQ28), the National Defense Science and Technology Innovation Zone (19-163-12-ZT-006-008-08), the National Natural Science Fund (82072200), and the PLA Hospital Science and Technology Project (2020-YQPY-002, 2019XXMBD-016, 2019XXJSYX20, ZH19016).

Ethical approval of studies and informed consent

This research belongs to the database system construction and therefore does not require the ethical approval of studies and informed consent.

Acknowledgements

We thank Xiaoxu Gao and Yang Shen for their support in the database code writing.

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Keywords:

Animal experiment; Database design; War trauma

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