Influenza Vaccine Effectiveness During the 2023/2024 Season: A Test‐Negative Case–Control Study Among Emergency Hospital Admissions With Respiratory Conditions in Northern Ireland

BackgroundWe evaluated the effectiveness of the influenza vaccine programme against infection among emergency hospital admissions with respiratory conditions in Northern Ireland during the 2023/2024 influenza season.MethodsUsing a test-negative design, we compared the odds of vaccination between patients who tested positive (cases) and negative (controls) for laboratory-confirmed influenza, adjusting for confounders. VE was stratified by age group, sex and time since vaccination.ResultsWe included 2368 hospitalised patients, of whom 1740 (73.5%) were influenza positive. Among these, 1703 (97.9%) were influenza A and 37 (2.1%) were influenza B. Of the influenza A-positive specimens, 84 were A(H1), 268 A(H3) and 1351 were untyped influenza A. VE against all laboratory-confirmed influenza was 47.5% (95% CI: 31.3%–60.1%), including 65.2% (95% CI: 44.2%–78.6%) in children aged 2–17, 46% (95% CI: 7.8%–68.2%) in adults 18–64 and 39.5% (95% CI: 4.8%–62.1%) in adults aged 65 and over. VE against infection for influenza A was 45.8% (95% CI: 25.1%–61%) in all age groups, but 64.7% (95% CI: 42.6%–78.6%) among children aged 2–17, 43.9% (95% CI: 3.7%–67.1%) among adults aged 18–64 years old and 39.6% (95% CI: 5%–62.1%) in adults aged ≥ 65 years. Being vaccinated was associated with 44.2% (95% CI: −13.3%-73.1%) and 37.9% (95% CI: 5.5%–59.5%) reduced odds of influenza A(H1) and A(H3)-associated community-acquired emergency admissions. VE against infection for influenza B was 87.2% (95% CI: 43.1%–98.3%). VE was highest within 2–8 weeks of vaccination at 67.5% (95% CI: 42.7%–81.7%) and declined to 41.2% (95% CI: 14.8%–59.5%) at 9–16 weeks.ConclusionsInfluenza vaccines provided protection against influenza-associated illness across age groups during the 2023/2024 influenza season

Nutramara - Marine Functional Foods Research Initiative (MFFRI/07/01)

Final report of projectThe NutraMara – Marine Functional Foods Research Initiative was conceived by Sea Change - A Marine Knowledge, Research and Innovation Strategy for Ireland 2007-2013. The goal was to develop a collaborative funding mechanism that would create new research capacity and build the capabilities required to maximise the potential of Ireland’s extensive marine bioresources. By supporting a strong interdisciplinary research team, capable of exploring marine animals and plants as a sustainable source of materials for use as functional ingredients and foods, the vision for NutraMara was to position Ireland to the fore in use of marine bioresources as health beneficial ingredients. Commencing in 2008 and supported by funds of €5.2 million from the Marine Institute and the Department of Agriculture, Food and the Marine, the research programme was led by Teagasc as the head of a multi-institutional consortium. The NutraMara consortium comprises marine bioresources and bioscience expertise, with food science and technology expertise from University College Cork; University College Dublin; the National University of Ireland Galway; the University of Limerick and Ulster University. Research effort was directed towards exploring Ireland’s marine bioresources – including macro- and microalgae, finfish and shellfish from wild and cultured sources: and discards from processing fish as sources of novel ingredients with bioactive characteristics. This discovery activity involved the collection of over 600 samples from 39 species of algae and fish and the analysis of 5,800 extracts, which resulted in 3,000 positive “hits” for bioactivity. The NutraMara consortium has built a strong research capacity to identify, characterise and evaluate marine-origin bioactives for use as/in functional foods. It further built the capacity to develop model foods enhanced with these marine-origin functional ingredients; providing insights to the processing challenges associated with producing functional ingredients from marine organisms. The consortium was actively engaged in research activities designed to identify and assess bioactive compounds from available marine resources, including polyphenols, proteins/peptides, amino acids, polysaccharides, polyunsaturated fatty acids and materials with antioxidant, probiotic or prebiotic properties. A key component of NutraMara’s activities was the development of human capital. The recruitment of M.Sc. and PhD students and their integration within a dynamic research environment that has strong links to industry, provided lasting expertise and capabilities, which are relevant to the needs of Ireland’s food and marine sectors. NutraMara research led to the awarding of eighteen PhDs and recruitment of 21 post-doctoral researchers over the eight year research programme. In excess of 80 peer reviewed publications resulted from this research and more publications are planned. A further 100 posters and conference presentations were also delivered by NutraMara researchers and Principal Investigators. The development and implementation of training and exchange programmes aimed at providing early stage researchers with inter-disciplinary skills that are critical to their development as researchers, enhanced the research capacity of institutions, the industry sectors and the country as a whole. Principal Investigators involved in leading the NutraMara research programme have secured additional research grants of almost €6 million from national and international sources and are engaged in extensive research collaboration involving marine and food research expertise; an activity which did not exist prior to NutraMara. The dissemination of knowledge and transfer of research results to industry were key activities in the research programme. The research outputs and visibility of NutraMara activity nationally resulted in 10 companies engaging in research and development activity with the consortium. Regular workshops and conferences organised by NutraMara attracted close to five hundred participants from Ireland and overseas. Members of the NutraMara core PI group have contributed to the formulation of new national foods and marine research policy and national research agenda, both during the national prioritisation exercise and in sectoral research strategies. This final project report describes the process by which research targets were identified, and the results of extensive screening and evaluation of compounds extracted from marine bioresources. It also highlights the development of new protocols designed to extract compounds in ways that are food friendly. Evaluating the functional properties, bioactivity and bioavailability of high potential marine compounds involved in vitro and in vivo testing. Pilot animal and human intervention studies yielded further insight to the potential and challenges in developing marine functional ingredients. As a result of work completed within the NutraMara consortium, Ireland is well positioned to continue to contribute to the development of ingredients derived from marine organisms and in doing so support the on-going development of Ireland’s food sector.Marine Institut

Standardised proformas improve patient handover: Audit of trauma handover practice

<p>Abstract</p> <p>Background</p> <p>The implementation of the European Working Time Directive has meant the introduction of shift patterns of working for junior doctors. Patient handover between shifts has become a necessary part of practice in order to reduce the risk of medical errors. Data handed over between shifts are used to prioritise clinical jobs outstanding, and to create theatre lists. We present a closed-loop audit of handover practice to assess whether standardised proformas improve clinical data transfer between shifts during handover in our Orthopaedic Unit.</p> <p>Methods</p> <p>We collected data handed over between shifts for a period of one week at our department. The data were in the form of hand written data on plain paper used to assist verbal handover. Data were analysed and a standardised handover sheet was trialled. After feedback from juniors the sheet was revised and implemented. A re-audit, of handover data, was then undertaken using the revised standardised proforma during a period of 1 week.</p> <p>Results</p> <p>Forty-eight patients were handed over in week 1 while 55 patients were handed over during re-audit. The standardised proformas encouraged use of pre-printed patient labels which contained legible patient identifiers, use of labels increased from 72.9% to 93.4%. Handover of outstanding jobs increased from 31.25% to 100%. Overall data handed over increased from 72.6% to 93.2%. Handover of relevant blood results showed little improvement from 18.8% to 20.7%</p> <p>Conclusion</p> <p>This audit highlights the issue of data transfer between shifts. Standardised proformas encourage filling of relevant fields and increases the data transferred between shifts thereby reducing the potential for clinical error cause by shift patterns.</p

Evaluation of Ankle Tightrope Syndesmosis Fixation

ABSTRACT Introduction Ankle sprains are among the most common of bone and joint injuries. Historically, distal tibiofibular syndesmotic injuries have been treated using syndesmotic metal screws to prevent diastasis. However, the use of screws meant that physiological micro-movement between the tibia and fibula was lost which often results in loosening and breaking of the screws. Tightrope fixation was a new technique that has been developed to overcome these complications and allowed some degree of flexibility similar to that offered by natural ligaments. The aim of our study was to evaluate such injuries. Materials and methods We conducted a retrospective study reviewing all clinical records of cases of patients with injuries of the distal tibofibular syndesmosis treated with the ankle tightrope (Arthrex Inc) in our institution between January 2008 and January 2011. Results A total of 42 patients were reviewed. We encountered five cases with complications (12%). Of those: three required removals due to prominent knot, one soft-tissue irritation and one with uncomplicated wound infection. Conclusion Our study, one of the largest so far evaluating complications of tightrope fixation, demonstrates that one in eight patients treated with tightrope will experience complication. How to cite this article Al-azzani WAK, Sabah T, Paringe V, O'Doherty D. Evaluation of Ankle Tightrope Syndesmosis fixation. J Foot Ankle Surg (Asia-Pacific) 2014;1(1):1-4. </jats:sec

Conceptual design of future aircraft structures incorporating dynamic loading

The aviation industry’s progression toward unconventional, highly-integrated aircraft configurations, which are likely to experience dissimilar loading to conventional Tube-And-Wing aircraft, challenges the capabilities of existing conceptual design methodologies. The structural design process is driven by inertial loading resulting from static, quasi-static and transient load events which define performance requirements for aircraft structures. The impact of aero-elastic responses to dynamic load events on the structural design of the aircraft is poorly understood for unconventional airframe-propulsion system configurations. Modelling and analysis strategies which directly resolve dynamic loads early in the design process at a whole aircraft level facilitate investigation of the impact of dynamic loading on structural performance requirements, permitting rapid investigation of interdependencies and interactions which may exist between the aircraft and propulsion system. This paper details development of a flexible modelling and analysis framework, which leverages existing aero-elastic analysis and optimisation capability in commercially available software, for application during conceptual design. The framework is intended to be sufficiently generic to permit application to a range of aircraft configurations proposed for the 2050 timeframe. Dynamic analyses are incorporated in an optimization loop via generation of equivalent static loads (which capture applied aerodynamic and internal structural loads) through a proprietary python tool. A reference Tube-And-Wing aircraft for which significant public domain data exists (Boeing 777-200LR) is used to validate and benchmark framework performance.<br/

Concurrent and future risk of endometrial cancer in women with endometrial hyperplasia: A systematic review and meta-analysis

BACKGROUND:To inform treatment decisions in women diagnosed with endometrial hyperplasia, quantification of the potential for concurrent endometrial cancer and the future risk of progression to cancer is required. METHODS:We identified studies up to September 2018 that reported on the prevalence of concurrent cancer (within three months of endometrial hyperplasia diagnosis), or the incidence of cancer, identified at least three months after hyperplasia diagnosis. Random-effects meta-analyses produced pooled estimates and 95% confidence intervals (CIs). RESULTS:A total of 36 articles were identified; 15 investigating concurrent and 21 progression to cancer. In pooled analysis of 11 studies of atypical hyperplasia, the pooled prevalence of concurrent endometrial cancer was 32.6% (95% CI: 24.1%, 42.4%) while no studies evaluated concurrent cancer in non-atypical hyperplasia. The risk of progression to cancer was high in atypical hyperplasia (n = 5 studies, annual incidence rate = 8.2%, 95% CI 3.9%, 17.3%) and only one study reported on non-atypical hyperplasia (annual incidence rate = 2.6%, 95% CI: 0.6%, 10.6%). CONCLUSIONS:Overall, a third of women with atypical hyperplasia had concurrent endometrial cancer, although the number of studies, especially population-based, is small. Progression to cancer in atypical hyperplasia was high, but few studies were identified. Population-based estimates are required, in both atypical and non-atypical hyperplasia patients to better inform treatment strategies