Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatological condition affecting individuals aged >50 years. There have been rare reports of PMR and other vasculitides developing within 3 months of influenza vaccination. Influenza is a major public health issue associated with seasonal increased mortality and intensified health care service use. Annual vaccination is the most effective intervention to prevent influenza, especially in elderly individuals. We report a severe “flare” of PMR in a 70-year-old patient after receiving the adjuvanted trivalent influenza vaccine, as recommended by the Joint Committee on Vaccination and Immunisations for this age group in the UK National Health Service in 2018-2019. The adverse event (AE) could be interpreted as the newly described autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) as both PMR and ASIA display hyperactive immune responses. Caution is warranted in the use of vaccine adjuvants in patients with PMR with pre-existing imbalance of B and T cell homeostasis. Rare AEs are important to individuals, and personalized medicine means we should move away from “one size fits all” for vaccines, as well as for therapeutics

Exact solutions and equi-dosing regimen regions for multi-dose pharmacokinetics models with transit compartments

Compartmental models which yield linear ordinary differential equations (ODEs) provide common tools for pharmacokinetics (PK) analysis, with exact solutions for drug levels or concentrations readily obtainable for low-dimensional compartment models. Exact solutions enable valuable insights and further analysis of these systems. Transit compartment models are a popular semi-mechanistic approach for generalising simple PK models to allow for delayed kinetics, but computing exact solutions for multi-dosing inputs to transit compartment systems leading to different final compartments is nontrivial. Here, we find exact solutions for drug levels as functions of time throughout a linear transit compartment cascade followed by an absorption compartment and a central blood compartment, for the general case of n transit compartments and M equi-bolus doses to the first compartment. We further show the utility of exact solutions to PK ODE models in finding constraints on equi-dosing regimen parameters imposed by a prescribed therapeutic range. This leads to the construction of equi-dosing regimen regions (EDRRs), providing new, novel visualisations which summarise the safe and effective dosing parameter space. EDRRs are computed for classical and transit compartment models with two- and three-dimensional parameter spaces, and are proposed as useful graphical tools for informing drug dosing regimen design

THE EFFECT OF STRENGTH TRAINING ON THE KINEMATICS OF THE GOLF SWING

Despite the wide acceptance of resistance training in other sports, use of such programs in golf is a relatively new concept; consequently there is a lack of research addressing the effects of these programs on golfing performance. The few studies addressing this issue have used golf-specific programs (Lephart et al, 2007) these can require specialist equipment and can be more difficult to follow. Outcome measures in these studies have shown that strength training improves performance measures i.e. distance the ball is carried yet neglected details of the coordination of the golfer themselves (Fletcher and Hartwell, 2004). The aim of this study was to identify how a simple combined general resistance and plyometric program effects golf swing kinematics

An assessment of construction labour productivity in Malaysia

The construction industry is one of major strategic importance. Its level of productivity has a significant effect on national economic growth. The analysis of published census/biannual surveys of construction by the Department of Statistics of Malaysia shows that Malaysia managed to achieve construction labour productivity growth between 1996 and 2005 despite increases in cost per employee. The decrease in unit labour costs is attributed to the value added improvement per worker through the increase in capital intensity. The marginal decline in capital productivity is due to the gestation period and the overcapacity of the industry. The civil engineering sub-sector recorded the highest labour productivity and is the most labour competitive in terms of unit labour cost and added value per labour cost. The residential sub-sectors recorded greatest change in the productivity indicators between 1996 and 2005

Interaction between lateral sorting in river bends and vertical sorting in dunes

Sediment is sorted in river bends under the influence of gravity that pulls the heavier grains downslope and secondary flow that drags the finer grains upslope. Furthermore, when dunes are present, sediment is also sorted vertically at the dune lee side. However, sorting functions are poorly defined, since the relation to transverse bed slope and the interaction between lateral and vertical sorting is not yet understood for lack of data under controlled conditions. The objective of this study is to describe lateral sorting as a function of transverse bed slope and to gain an understanding of the interaction between lateral and vertical sorting in river bends. To this end, experiments were conducted with a poorly sorted sediment mixture in a rotating annular flume in which secondary flow intensity can be controlled separately from the main flow velocity, and therefore transverse bed slope towards the inner bend and dune dimensions can be systematically varied. Sediment samples were taken along cross‐sections at the surface of dune troughs and dune crests, and over the entire depth at the location of dune crests (bulk samples), which enabled comparison of the relative contribution of vertical sorting by dunes to lateral sorting by the transverse bed slope. The data show that lateral sorting is always the dominant sorting mechanism in bends, and bulk samples showed minor effects of vertical sorting by dunes as long as all grain‐size fractions are mobile. An empirical bend sorting model was fitted that redistributes the available sediment fractions over the cross‐section as a function of transverse bed slope. Comparison with field data showed that the model accurately reproduces spatially‐averaged trends in sorting at the bend apex in single‐thread channels. The bend sorting model therefore provides a better definition of bend sorting with conservation of mass by size fraction and adds to current understanding of bend sorting. The implication for numerical modelling is that bend sorting mechanisms can be modelled independently of dunes, allowing the application of the active layer concept