How valid are IMS DA summary statistics of children's vaccination status?

Purpose: Accurate recording of immunisation status is essential for the evaluation of any immunization program. In September 2006, 7 Valent Pneumococcal Conjugate Vaccination (PCV7) was introduced into the UK’s routine childhood immunisation programme. This study validated the PCV7 immunization status of children aged 2 years recorded in the IMS Disease Analyses database. / Methods: The PCV7 vaccination uptake rate for children born in 2008 in the IMS DA database was calculated. A sample of 173 of the 2497 children not recorded as vaccinated was identified and a questionnaire was sent to each of their General Practitioners to ascertain the child’s true PCV7 vaccination status. / Results: In the IMS DA data of 15,237 children born in 2008, 12,740 (83.6%) had a vaccination record of PCV7. One hundred and eleven of the 167 questionnaires sent to the child’s general practitioners were returned, giving an adjusted response rate of 111/167 (66.5%). Based on the general practitioners’ responses, 71 (64%) of these children were fully vaccinated according to their General Practitioner’s records making the revised estimated vaccination rate for this cohort 94.1%. / Conclusion: This validation study has shown that caution is needed if using historical IMS patient-level data to analyse the effectiveness of PCV7 as there is a potential under-recording of immunization leading to underrepresentation of vaccination rates by approximately ten per cent. Coverage of other vaccines may also be underestimated in the IMS database

Inducible Clindamycin Resistance among Staphylococci Isolated from Burn Patients

Clindamycin has been used successfully to treat pneumonia and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. However, inducible clindamycin resistance has been described as a cause of treatment failure of such infections. A total of 159 staphylococcal isolates from different clinical specimens from burn patients in Tripoli Burn Center were tested for inducible clindamycin resistance by the disk-diffusion induction test. Inducible clindamycin resistance was detected in 66.2% of 65 methicillin-resistant S. aureus isolates and in none of 55 methicillin-sensitive S. aureus, 10 methicillin-resistant coagulase negative staphylococci and 29 methicllin-sensitive coagulase negative staphylococci isolates. In our setting, clindamycin can be used for the treatment of infections due to staphylococci, but we recommend that staphylococci isolates, particularly methicillin-resistant S. aureus, are tested by the D-test before treatment

The application of electrical resistance measurements to water transport in lime–masonry systems

The paper describes an experimental determination of impedance spectroscopy derived resistance measurements to record water transport in lime–masonry systems. It strongly supports the use of Sharp Front theory and Boltzmann’s distribution law of statistical thermodynamics to corroborate the data obtained. A novel approach is presented for the application of impedance measurements to the water transport between freshly mixed mortars and clay brick substrates. Once placed, fresh mortar is dewatered by brick and during this time the volume fraction water content of the mortar is reduced. An equation is derived relating this change in water content to the bulk resistance of the mortar. Experimental measurements on hydraulic lime mortars placed in contact with brick prisms confirm the theoretical predictions. Further, the results indicate the time at which dewatering of a mortar bed of given depth is completed. The technique has then potential to be applied for in situ monitoring of dewatering as a means of giving insight into the associated changes in mechanical and chemical properties

A new LPF-based grid frequency estimation for the SOGI filter with improved harmonic rejection

This paper proposes a new method for the estimation of the grid voltage frequency using a low-pass filter (LPF) approach. The estimated frequency is used to tune a second order generalized integrator (SOGI) filter commonly used for grid monitoring purposes and applications requiring parameter estimation from the grid. A first-order LPF is used first for the estimation that behaves identically to the reported normalized SOGI-FLL. A second-order LPF is proposed instead to overcome this circumstance. The behavior of this approach is dynamically analyzed and a linearized model useful for design purposes is derived. The behavior of the proposed system is checked with simulations, showing that the model matches well with the real system and has a smoother transient response to step frequency perturbations and also a better rejection to harmonic distortion than previous approaches.Peer ReviewedPostprint (published version

Factors affecting the water retaining characteristics of lime and cement mortars in the freshly-mixed state

Desorptivity, the parameter which quantifies water retaining ability, has been determined for freshly-mixed natural hydraulic lime and cement mortars using a modified American Petroleum Institute pressure cell. The results show how greatly this ability depends on hydraulicity. Mix composition is also highly significant: smaller proportion of sand, larger grain size of sand and higher proportion of mix water all decrease the water retaining ability. In practice water is abstracted due to the capillary pressure of the masonry unit and the results presented are discussed in terms of typical capillary pressures exerted by clay facing brick. Changes in desorptivity also occur with elapsed time from mixing. The most hydraulic mortars become less water retaining for about 90 min after mixing and then, gradually more water retaining

The prevalence and the clinical characteristics of metabolic syndrome patients admitted to the cardiac care unit

AbstractObjectivesMetabolic syndrome (MetS) is a group of multiple cardiovascular risk factors, including dysglycemia, central obesity, high cholesterol, and hypertension. Cardiovascular disease is one of the most common complications of MetS. Recent studies showed that prevalence of MetS among patients admitted with acute coronary syndrome was as high as 46%.DesignWe conducted a cross-sectional study of 203 patients at the two main hospitals in Ta’if, Saudi Arabia. Patients older than 18years who were admitted to the Cardiac Care Unit (CCU) between the months of August 2013 and June 2014 were asked to participate. MetS diagnosis was made based on the International Diabetes Federation definition.ResultsA total of 203 patients participated, with 59.1% male and 40.9% were female. The mean age was 60.9 years with a mean body mass index of 28.97kg/m2 and a mean waist circumference of 95.45cm. The prevalence of MetS was 47.8%, primarily among obese female patients who reported sedentary lifestyles. Additionally, MetS patients were more likely to be admitted with heart failure (p<0.05) and more likely to have moderate-to-severe left-ventricular hypertrophy (LVH; p<0.05) relative to non-MetS patients.ConclusionOf the patients admitted to the CCU, 47.8% had MetS, with those patients likely to be female and obese. Furthermore, MetS patients were more likely to be admitted with heart failure and suffer from moderate-to-severe LVH