Assessment of the Effectiveness of Combat Eyewear Protection Against Blast Overpressure.

It is unclear whether combat eyewear used by U. S. Service members is protective against blast overpressures (BOPs) caused by explosive devices. Here, we investigated the mechanisms by which BOP bypasses eyewear and increases eye surface pressure. We performed experiments and developed three-dimensional (3D) finite element (FE) models of a head form (HF) equipped with an advanced combat helmet (ACH) and with no eyewear, spectacles, or goggles in a shock tube at three BOPs and five head orientations relative to the blast wave. Overall, we observed good agreement between experimental and computational results, with average discrepancies in impulse and peak-pressure values of less than 15% over 90 comparisons. In the absence of eyewear and depending on the head orientation, we identified three mechanisms that contributed to pressure loading on the eyes. Eyewear was most effective at 0 deg orientation, with pressure attenuation ranging from 50 (spectacles) to 80% (goggles) of the peak pressures observed in the no-eyewear configuration. Spectacles and goggles were considerably less effective when we rotated the HF in the counter-clockwise direction around the superior-inferior axis of the head. Surprisingly, at certain orientations, spectacles yielded higher maximum pressures (80%) and goggles yielded larger impulses (150%) than those observed without eyewear. The findings from this study will aid in the design of eyewear that provides better protection against BOP.

A multi-centre randomised trial comparing ultrasound vs mammography for screening breast cancer in high-risk Chinese women.

BACKGROUND: Chinese women tend to have small and dense breasts and ultrasound is a common method for breast cancer screening in China. However, its efficacy and cost comparing with mammography has not been evaluated in randomised trials. METHODS: At 14 breast centres across China during 2008-2010, 13 339 high-risk women aged 30-65 years were randomised to be screened by mammography alone, ultrasound alone, or by both methods at enrollment and 1-year follow-up. RESULTS: A total of 12 519 and 8692 women underwent the initial and second screenings, respectively. Among the 30 cancers (of which 15 were stage 0/I) detected, 5 (0.72/1000) were in the mammography group, 11 (1.51/1000) in the ultrasound group, and 14 (2.02/1000) in the combined group (P=0.12). In the combined group, ultrasound detected all the 14 cancers, whereas mammography detected 8, making ultrasound more sensitive (100 vs 57.1%, P=0.04) with a better diagnostic accuracy (0.999 vs 0.766, P=0.01). There was no difference between mammography and ultrasound in specificity (100 vs 99.9%, P=0.51) and positive predictive value (72.7 vs 70.0%; P=0.87). To detect one cancer, the costs of ultrasound, mammography, and combined modality were $7876, $45 253, and $21 599, respectively. CONCLUSIONS: Ultrasound is superior to mammography for breast cancer screening in high-risk Chinese women.

Volumetric productivity improvement for endoglucanase of Trichoderma pseudokoingii S-38.

AIMS: The objective of this study was to design an economically feasible process for endoglucanase (EG) production. METHODS AND RESULTS: Trichoderma pseudokoingii S-38 EG synthesis was studied. Initially, either glucose at 2.5, 5 or 10 g l-1, or cellulose powder (CF11) at 5 g l-1 was used as the sole carbon source. The results showed that enzyme synthesis and biomass formation were closely correlated, and both were affected by the carbon source. To improve EG volumetric product efficiency, a new technique was developed. Glucose and CF11 (2.5 and 5 g l-1, respectively) were used as initial carbon source, and glucose was added at 2.5 g l-1 day-1. EG activity, volumetric and specific EG productivities were 6.17 IU l-1, 53 IU l-1 h-1 and 114.3 IU (g cell protein)-1 h-1, respectively. Batch production in a 2-l laboratory fermenter confirmed the advantage of the technique. The product contained 10.86 IU ml-1 EG activity in 88 h. The volumetric and specific EG productivities were 123.4 IU l-1 h-1 and 177.8 IU (g cell protein)-1 h-1, respectively. CONCLUSIONS: These results suggest that optimization of the ratio of glucose to CF11 for balancing the induction and growth rate in the production of EG may lead to technical and economical benefits. SIGNIFICANCE AND IMPACT OF THE STUDY: A new technique was developed for the production of EG which improves both the volumetric product efficiency and the specific activity.

[Cost-effectiveness analysis of Beijing Fangshan cardiovascular prevention program in 1992 - 1997].

OBJECTIVE: To determine whether a community-based cardiovascular disease (CVD) intervention program, undertaken over six years, was cost-effective. METHODS: Based on Beijing Fangshan Cardiovascular Disease Comprehensive Prevention Program, the cost for intervention and expenditure saved from caring for CVD in the communities with intervention from 1992 to 1997 were calculated, and cost-effectiveness analysis was performed using disability-adjusted life years (DALYs) gained as an indicator of effectiveness. RESULTS: The cost for one DALY gained reduced gradually from 1992 to 1997, with an average ratio of cost to effectiveness of four to one (4:1). It cost annually 1,586.00, 1,380.20, -2,350.80, -905.30, -1,495.60 and -1,766.70 RMB yuan for one life-year saved, from 1992 to 1997 respectively, in a gradually decreasing trend with the increase in length of intervention. After intervention for two years, ratio of cost to effectiveness has become negative since 1994, which meant a positive benefit from intervention. Sensitivity analysis showed that ratio of cost to effectiveness was little sensitive to the changes in discount rate, weight of age and increase in cost of hospitalization for stroke and coronary heart disease, which reflected its reliability. CONCLUSION: Community-based comprehensive intervention for CVD in rural population is cost-effective.

[Assessment of nutrition in dialysis patients and chronic uremic patients].

Multiple methods were used to assess the nutritional status of 40 uremic non-dialysis or dialysis patients in order to improve their living quality as well as to provide scientific basis for nutritional treatment. The investigation of diet diaries revealed that the ratio of animal protein over total protein in food was greater in uremic dialysis patients treated with either hemodialysis or peritoneal dialysis than in the uremic non-dialysis patients (P < 0.01, P < 0.05); the daily intake of total protein in each of three groups was lower than the recommended amount. The anthropometric measurement showed: decreased muscle protein store occurred in 35% of the dialysis patients and 80% of the uremic non-dialysis patients. Serum albumin measurement revealed that hemodialysis patients had much higher level than that of peritoneal dialysis patients (P < 0.01). 50% of the hemodialysis patients, 80% of the peritoneal dialysis patients and 60% of the uremic non-dialysis patients had lower level of serum albumin than normal. Evaluation of nutritional status of hemodialysis patients and peritoneal dialysis patients by means of urea production found that 65% of the hemodialysis patients and 37.5% of the peritoneal dialysis patients were in a status of negative nitrogen balance. According to the results of all the measurements, 58% of the dialysis patients had malnutrition of various degrees.