Stature and mitigation systems affect the risk of leg injury in vehicles attacked under the body by explosive devices

A finite-element (FE) model, previously validated for underbody blast (UBB) loading, was used here to study the effect of stature and of mitigation systems on injury risk to the leg. A range of potential UBB loadings was simulated. The risk of injury to the leg was calculated when no protection was present, when a combat boot (Meindl Desert Fox) was worn, and when a floor mat (IMPAXXTM), which can be laid on the floor of a vehicle, was added. The risk of injury calculated indicates that the floor mat provided a statistically significant reduction in the risk of a major calcaneal injury for peak impact speeds below 17.5 m/s when compared with the scenarios in which the floor mat was not present. The risk of injury to the leg was also calculated for a shorter and a taller stature compared to that of the nominal, 50th percentile male anthropometry; shorter and taller statures were constructed by scaling the length of the tibia of the nominal stature. The results showed that there is a higher risk of leg injury associated with the short stature compared to the nominal and tall statures, whereas the leg-injury risk between nominal and tall statures was statistically similar. These findings provide evidence that the combat boot and the floor mat tested here have an attenuating effect, albeit limited to a range of possible UBB loads. The effect of stature on injury has implications on how vehicle design caters for all potential anthropometries and indeed gender, as women, on average, are shorter than men. The results from the computational simulations here complement laboratory and field experimental models of UBB, and so they contribute to the improvement of UBB safety technology and strategy

Technical note: Validation of an automatic recording system to assess behavioural activity level in sheep (Ovis aries)

The welfare of an individual can be assessed by monitoring behavioural changes, such as inactivity, that may indicate injury or disease. In this study we validated the Actiwatch Mini® activity monitor (AM) for automatic recording of behavioural activity levels of nine Texel ewes. The AM devices were attached to collars placed around the necks of the ewes. AM recordings were taken at 25 second intervals for 21 consecutive days and in addition, direct behavioural observations made on days 9–13. AM recordings were compared with direct behavioural observations to investigate whether different levels of behaviour activity could be distinguished by the AM. Six different behaviours were matched to the activity scores recorded by the AM which were low activity (lying ruminating, lying), medium activity (standing, standing ruminating, and grazing) and high activity behaviours (walking). There were differences in the activity scores for all three scores. However, higher levels of accuracy in distinguishing between activity levels were achieved when combining high and medium activity level behaviours. This method of capturing data provides a practical tool in studies assessing the impact of disease or injury. For example, assessing the effects of lameness on the activity level of sheep at pasture, without the presence of an observer influencing behaviour.The authors thank the staff at the farm, at which data were collected, for supporting the study and for taking good care of the animals. This study was part of a project funded by the EU VII Framework programme Animal Welfare Indicators (Grant no. FP7-KBBE-2010-4) who had no involvement in the study design, data collection, data analysis or writing of the report. The Actiwatches’ were provided to AJM through funding from CHDI Foundation, Inc.This is the author accepted manuscript. The final version is available from Elsevier at http://www.sciencedirect.com/science/article/pii/S0921448815001455

Variations of training load, monotony, and strain and dose-response relationships with maximal aerobic speed, maximal oxygen uptake, and isokinetic strength in professional soccer players

This study aimed to identify variations in weekly training load, training monotony, and training strain across a 10-week period (during both, pre- and in-season phases); and to analyze the dose-response relationships between training markers and maximal aerobic speed (MAS), maximal oxygen uptake, and isokinetic strength. Twenty-seven professional soccer players (24.9±3.5 years old) were monitored across the 10-week period using global positioning system units. Players were also tested for maximal aerobic speed, maximal oxygen uptake, and isokinetic strength before and after 10 weeks of training. Large positive correlations were found between sum of training load and extension peak torque in the right lower limb (r = 0.57, 90%CI[0.15;0.82]) and the ratio agonist/antagonist in the right lower limb (r = 0.51, [0.06;0.78]). It was observed that loading measures fluctuated across the period of the study and that the load was meaningfully associated with changes in the fitness status of players. However, those magnitudes of correlations were small-to-large, suggesting that variations in fitness level cannot be exclusively explained by the accumulated load and loading profile

A large outbreak of Legionnaires’ Disease in an industrial town in Portugal

Background We describe the investigation and control of an outbreak of Legionnaires’ disease in Portugal in October, November and December 2014. Methods Confirmed cases were individuals with pneumonia, laboratory evidence of Legionella pneumophila serogroup 1 and exposure, by residence, occupational or leisure to the affected municipalities. 49 possible sources were reduced to four potential sources, all industries with wet cooling system, following risk assessment. We geo-referenced cases’ residences and the location of cooling towers defining four study areas 10 km buffer centered on each cooling tower system. We compared the number of cases with expected numbers, calculated from the outbreak's attack rates applied to 2011 census population. Using Stones’ Test, we tested observed to expected ratios for decline in risk, with distance up to 10 km four directions. Isolates of Legionella pneumophila were compared using molecular methods. Results We identified 403 cases, 377 of which were confirmed, 14 patients died. Patients became ill between 14 October and 2 December. A NE wind and thermal inversion were recorded during the estimated period of exposure. Disease risk was highest in people living south west from all of the industries identified and decreased with distance (p < 0.001). 71 clinical isolates demonstrated an identical SBT profile to an isolate from a cooling tower. Whole genome sequencing identified an unusual L. pneumophila subsp. fraseri serogroup 1 as the outbreak causative strain, and confirmed isolates’ relatedness. Conclusions Industrial wet cooling systems, bacteria with enhanced survival characteristics and a combination of climatic conditions contributed to the second largest outbreak of Legionnaires’ disease recorded internationally.info:eu-repo/semantics/publishedVersio

Two-Higgs Leptonic Minimal Flavour Violation

We construct extensions of the Standard Model with two Higgs doublets, where there are flavour changing neutral currents both in the quark and leptonic sectors, with their strength fixed by the fermion mixing matrices $V_{CKM}$ and $V_{PMNS}$. These models are an extension to the leptonic sector of the class of models previously considered by Branco, Grimus and Lavoura, for the quark sector. We consider both the cases of Dirac and Majorana neutrinos and identify the minimal discrete symmetry required in order to implement the models in a natural way.Comment: 25 pages. No figure

Structure-Based High-Throughput Epitope Analysis of Hexon Proteins in B and C Species Human Adenoviruses (HAdVs)

Human adenoviruses (HAdVs) are the etiologic agent of many human infectious diseases. The existence of at least 54 different serotypes of HAdVs has resulted in difficulties in clinical diagnosis. Acute respiratory tract disease (ARD) caused by some serotypes from B and C species is particularly serious. Hexon, the main coat protein of HAdV, contains the major serotype-specific B cell epitopes; however, few studies have addressed epitope mapping in most HAdV serotypes. In this study, we utilized a novel and rapid method for the modeling of homologous proteins based on the phylogenetic tree of protein families and built three-dimensional (3D) models of hexon proteins in B and C species HAdVs. Based on refined hexon structures, we used reverse evolutionary trace (RET) bioinformatics analysis combined with a specially designed hexon epitope screening algorithm to achieve high-throughput epitope mapping of all 13 hexon proteins in B and C species HAdVs. This study has demonstrated that all of the epitopes from the 13 hexon proteins are located in the proteins' tower regions; however, the exact number, location, and size of the epitopes differ among the HAdV serotypes

An experimentally validated finite element model of the lower limb to investigate the efficacy of blast mitigation systems

Improvised explosive devices (IEDs) used in the battlefield cause damage to vehicles and their occupants. The injury burden to the casualties is significant. The biofidelity and practicality of current methods for assessing current protection to reduce the injury severity is limited. In this study, a finite-element (FE) model of the leg was developed and validated in relevant blast-loading conditions, and then used to quantify the level of protection offered by a combat boot. An FE model of the leg of a 35 years old male cadaver was developed. The cadaveric leg was tested physically in a seated posture using a traumatic injury simulator and the results used to calibrate the FE model. The calibrated model predicted hindfoot forces that were in good correlation (using the CORrelation and Analysis or CORA tool) with data from force sensors; the average correlation and analysis rating (according to ISO18571) was 0.842. The boundary conditions of the FE model were then changed to replicate pendulum tests conducted in previous studies which impacted the leg at velocities between 4 and 6.7 m/s. The FE model results of foot compression and peak force at the proximal tibia were within the experimental corridors reported in the studies. A combat boot was then incorporated into the validated computational model. Simulations were run across a range of blast-related loading conditions. The predicted proximal tibia forces and associated risk of injury indicated that the combat boot reduced the injury severity for low severity loading cases with higher times to peak velocity. The reduction in injury risk varied between 6 and 37% for calcaneal minor injuries, and 1 and 54% for calcaneal major injuries. No injury-risk reduction was found for high severity loading cases. The validated FE model of the leg developed here was able to quantify the protection offered by a combat boot to vehicle occupants across a range of blast-related loading conditions. It can now be used as a design and as an assessment tool to quantify the level of blast protection offered by other mitigation technologies

Thalamic deep brain stimulation for neuropathic pain after amputation or brachial plexus avulsion.

OBJECT: Fifteen hundred patients have received deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy over the last half-century, but few during the last decade. Deep brain stimulation for neuropathic pain has shown variable outcomes and gained consensus approval in Europe but not the US. This study prospectively evaluated the efficacy at 1 year of DBS for phantom limb pain after amputation, and deafferentation pain after brachial plexus avulsion (BPA), in a single-center case series. METHODS: Patient-reported outcome measures were collated before and after surgery, using a visual analog scale (VAS) score, 36-Item Short-Form Health Survey (SF-36), Brief Pain Inventory (BPI), and University of Washington Neuropathic Pain Score (UWNPS). RESULTS: Twelve patients were treated over 29 months, receiving contralateral, ventroposterolateral sensory thalamic DBS. Five patients were amputees and 7 had BPAs, all from traumas. A postoperative trial of externalized DBS failed in 1 patient with BPA. Eleven patients proceeded to implantation and gained improvement in pain scores at 12 months. No surgical complications or stimulation side effects were noted. In the amputation group, after 12 months the mean VAS score improved by 90.0% ± 10.0% (p = 0.001), SF-36 by 57.5% ± 97.9% (p = 0.127), UWNPS by 80.4% ± 12.7% (p < 0.001), and BPI by 79.9% ± 14.7% (p < 0.001). In the BPA group, after 12 months the mean VAS score improved by 52.7% ± 30.2% (p < 0.001), SF-36 by 15.6% ± 30.5% (p = 1.000), UWNPS by 26.2% ± 40.8% (p = 0.399), and BPI by 38.4% ± 41.7% (p = 0.018). Mean DBS parameters were 2.5 V, 213 microseconds, and 25 Hz. CONCLUSIONS: Deep brain stimulation demonstrated efficacy at 1 year for chronic neuropathic pain after traumatic amputation and BPA. Clinical trials that retain patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series