Microneedle technology for immunisation: Perception, acceptability and suitability for paediatric use

Objective: To examine published research which explores the perception and acceptability of microneedle technology for immunisation and to investigate the suitability of this technology for paediatric use. Methods: A series of keywords and their synonyms were combined in various combinations and permutations using Boolean operators to sequentially search four databases (PubMed, Web of Science, Embase and CINAHL). Following removal of duplications and irrelevant results, 12 research articles were included in the final literature review. Results: The opinions of patients, parents, children and healthcare professionals (HCP) were collated. A positive perception and a high level of acceptability predominated. Conclusion: Microneedle technology research has been focussed on demonstrating efficacy with minimal focus on determining HCP/public perception and acceptability for paediatric use, exemplified by the paucity of studies presented in this review. Commercial viability will depend on HCP/public acceptability of microneedle technology. An effort must be made to identify the barriers to acceptance and to overcome them by increasing awareness and education in stakeholder groups pertaining to the paediatric population

The success of microneedle-mediated vaccine delivery into skin

Microneedles (MNs) are designed to specifically target the outermost, skin barrier layer, the stratum corneum, creating transient pathways for minimally invasive transcutaneous delivery. It is reported that MNs can facilitate delivery without stimulating the pain receptors or damaging blood vessels that lie beneath, thus being perceived as painless and associated with reduced bleeding. This immunocompetence of the skin, coupled with its ease of access, makes this organ an attractive vaccination site. The purpose of this review was to collate primary scientific literature pertaining to MN-mediated in vivo vaccination programmes. A total of 62 original research articles are presented, compiling vaccination strategies in 6 different models (mouse, rat, guinea pig, rabbit, pig, macaque and human). Vaccines tested span a wide range of viral, bacterial and protozoan pathogens and includes 7 of the 13 vaccine-preventable diseases, as defined by the WHO. This review highlights the paucity of available clinical trial data. MN-delivered vaccines have demonstrated safety and immunogenicity in pre-clinical models and boast desirable attributes such as painless administration, thermostability, dose-sparing capacity and the potential for self-administration. These advantages should contribute to enhanced global vaccine access

Clinical stakeholders' opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units : an international Delphi study

Peer reviewedPublisher PD

Radio Sources in Galaxy Clusters at 28.5 GHz

We present serendipitous detections of radio sources at 28.5 GHz (1 cm), which resulted from our program to image thermal Sunyaev-Zeldovich (SZ) effect in 56 galaxy clusters. We find 64 radio sources with fluxes down to 0.4 mJy, and within 250 arcseconds from the pointing centers. The spectral indices (S ~ \nu^-\alpha) of 54 sources with published low frequency flux densities range from -0.6 to 2 with a mean of 0.77, and a median of 0.84. Extending low frequency surveys of radio sources towards galaxy clusters CL 0016+16, Abell 665, and Abell 2218 to 28.5 GHz, and selecting sources with 1.4 GHz flux density greater than 7 mJy to form an unbiased sample, we find a mean spectral index of 0.71 and a median of 0.71. We find 4 to 7 times more sources predicted from a low frequency survey in areas without galaxy clusters. This excess cannot be accounted for by gravitational lensing of a background radio population by cluster potentials, indicating most of the detected sources are associated with galaxy clusters. For the cluster Abell 2218, the presence of unsubtracted radio sources with 28.5 GHz flux densities less than 0.5 mJy, can only contribute to temperature fluctuations at a level of 10 to 25 \muK. The corresponding error due to radio point source contamination in the Hubble constant derived through a combined analysis of 28.5 GHz SZ images and X-ray emission observations ranges from 1% to 6%.Comment: 18 pages, 8 figures, to appear in April 1998 issue of A

Acceptability of microneedle-patch vaccines: A qualitative analysis of the opinions of parents

Vaccines incorporated into microneedle-based patch platforms offer advantages over conventional hypodermic injections. However, the success and clinical utility of these platforms will depend on its acceptance among stakeholders. Minimal focus has been placed on determining parents' acceptability of microneedle-patch vaccines intended for paediatric use. This qualitative study probes the perceived acceptability of microneedle technology for paediatric vaccination in a parent population. Focus groups (n=6) were convened through purposive sampling of Cork city primary schools. Discussions were audio-recorded, transcribed verbatim, anonymised, independently verified and analysed by thematic analysis, with constant comparison method applied throughout. The opinions of 32 parents were included. All participants declared that their children were fully vaccinated. Five core themes were identified and defined as: (i) concern, (ii) suitability for paediatric use, (iii) potential for parental administration, (iv) the role of the healthcare professional and (v) special populations. Drivers for acceptance include; concerns with current vaccines and vaccination programmes; attributes of microneedle-patch (reduced pain, bleeding, fear and increased convenience) and endorsement by a healthcare professional. Barriers to acceptance include; lack of familiarity, concerns regarding feasibility and suitability in paediatrics, allergic potential, inability to confirm delivery and potential reduction in vaccine coverage. This is the first study to explore parental acceptance of microneedle-patch vaccines. Capturing the opinions of parents, the ultimate decision makers in paediatric vaccination, is crucial in the understanding of the eventual uptake of microneedle technology and therefore adds to literature currently available. This study has revealed that even "vaccine-acceptors"; parents who agree with, or do not question vaccination, will question the safety and efficacy of this novel method. Participants in this study remained tentative. However, the study has also revealed that endorsement by healthcare professionals could reduce this tentativeness, thereby identifying the role of healthcare professionals in disseminating information and providing support to parents. An increased awareness of developments in microneedle technology is needed to permit informed decision-making by parents

Risk-based inspection as a cost-effective strategy to reduce human exposure to cysticerci of Taenia saginata in low-prevalence settings

Taenia saginata cysticercus is the larval stage of the zoonotic parasite Taenia saginata, with a life-cycle involving both cattle and humans. The public health impact is considered low. The current surveillance system, based on post-mortem inspection of carcasses has low sensitivity and leads to considerable economic burden. Therefore, in the interests of public health and food production efficiency, this study aims to explore the potential of risk-based and cost-effective meat inspection activities for the detection and control of T. saginata cysticercus in low prevalence settings

Multiwavelength Monitoring of the BL Lacertae Object PKS 2155-304 in May 1994. II. The IUE Campaign

PKS 2155-304, the brightest BL Lac object in the ultraviolet sky, was monitored with the IUE satellite at ~1 hour time-resolution for ten nearly uninterrupted days in May 1994. The campaign, which was coordinated with EUVE, ROSAT, and ASCA monitoring, along with optical and radio observations from the ground, yielded the largest set of spectra and the richest short time scale variability information ever gathered for a blazar at UV wavelengths. The source flared dramatically during the first day, with an increase by a factor ~2.2 in an hour and a half. In subsequent days, the flux maintained a nearly constant level for ~5 days, then flared with ~35% amplitude for two days. The same variability was seen in both short- and long-wavelength IUE light curves, with zero formal lag (~<2 hr), except during the rapid initial flare, when the variations were not resolved. Spectral index variations were small and not clearly correlated with flux. The flux variability observed in the present monitoring is so rapid that for the first time, based on the UV emission alone, the traditional Delta L/Delta t limit indicating relativistic beaming is exceeded. The most rapid variations, under the likely assumption of synchrotron radiation, lead to a lower limit of 1 G on the magnetic field strength in the UV emitting region. These results are compared with earlier intensive monitoring of PKS 2155-304 with IUE in November 1991, when the UV flux variations had completely different characteristics.Comment: 45 pages, Latex, 11 PostScript figures, to appear in The Astrophysical Journa

Atmospheric phase correction using CARMA-PACS: high angular resolution observations of the FU Orionis star PP 13S*

We present 0".15 resolution observations of the 227 GHz continuum emission from the circumstellar disk around the FU Orionis star PP 13S*. The data were obtained with the Combined Array for Research in Millimeter-wave Astronomy (CARMA) Paired Antenna Calibration System (C-PACS), which measures and corrects the atmospheric delay fluctuations on the longest baselines of the array in order to improve the sensitivity and angular resolution of the observations. A description of the C-PACS technique and the data reduction procedures are presented. C-PACS was applied to CARMA observations of PP 13S*, which led to a factor of 1.6 increase in the observed peak flux of the source, a 36% reduction in the noise of the image, and a 52% decrease in the measured size of the source major axis. The calibrated complex visibilities were fitted with a theoretical disk model to constrain the disk surface density. The total disk mass from the best-fit model corresponds to 0.06 M_⊙, which is larger than the median mass of a disk around a classical T Tauri star. The disk is optically thick at a wavelength of 1.3 mm for orbital radii less than 48 AU. At larger radii, the inferred surface density of the PP 13S* disk is an order of magnitude lower than that needed to develop a gravitational instability

Retrospective evaluation of hyperproteinorrachia without pleocytosis (albuminocytologic dissociation) and survival in dogs

Abstract: Background: Hyperproteinorrachia (raised cerebrospinal fluid total protein [CSF‐TP]) without pleocytosis (HP) (also known as albuminocytologic dissociation) is identified in dogs with different neurologic diseases. However, the association between survival and increased CSF‐TP is unknown. Objectives: (a) Identify conditions commonly associated with HP in dogs and (b) investigate whether higher CSF‐TP concentrations or other relevant factors are associated with 1‐year survival. Methods: This is a retrospective study that identified dogs with HP (Cisternal CSF‐TP >0.30 g/L, Lumbar CSF‐TP >0.45 g/L with total nucleated cell concentrations [TNCCs] and RBC counts within RIs) from 2008 to 2019: recording signalment, weight, vital parameters, inflammation, neuroanatomic localization, CSF‐TP, sampling site, final diagnosis, etiologic classification, and 1‐year survival. Corrected CSF‐TP was calculated as CSF‐TP minus 0.3 (cisternal) or 0.45 (lumbar or unknown). Descriptive statistics were produced, CSF‐TP differences between groups (eg, neuroanatomic localizations) were evaluated using the Mann‐Whitney U test or Kruskal‐Wallis test (post‐hoc testing). The Cox proportional hazards model was used for survival data. Statistical significance was set at a P 0.05). Neoplasia, after adjustment for age, was the only variable associated with a worse survival (P = 0.01 HR: 2.08 (95% CI: 1.65‐39.2). CSF‐TP was not associated with age (P > 0.05). Conclusions: HP in dogs is associated with a wide range of conditions; the most common conditions are neoplasia, MUO, and IVDD. Higher CSF‐TP levels do not correlate with a worse 1‐year survival; however, they do correlate with neoplastic lesions

Embodied Knowledge: Writing Researchers’ Bodies Into Qualitative Health Research

After more than a decade of postpositivist health care research and an increase in narrative writing practices, social scientific, qualitative health research remains largely disembodied. The erasure of researchers’ bodies from conventional accounts of research obscures the complexities of knowledge production and yields deceptively tidy accounts of research. Qualitative health research could benefit significantly from embodied writing that explores the discursive relationship between the body and the self and the semantic challenges of writing the body by incorporating bodily details and experiences into research accounts. Researchers can represent their bodies by incorporating autoethnographic narratives, drawing on all of their senses, interrogating the connections between their bodily signifiers and research processes, and experimenting with the semantics of self and body. The author illustrates opportunities for embodiment with excerpts from an ethnography of a geriatric oncology team and explores implications of embodied writing for the practice of qualitative health research