Should patients receive 23-valent pneumococcal vaccination more than once?

No patient-oriented evidence supports pneumococcal revaccination of any patient (high-risk or otherwise). Antibody levels may be augmented by revaccination; however, the clinical efficacy of revaccination, even among high-risk patients, is unknown. Revaccination is recommended by the Advisory Committee on Immunization Practices (ACIP) in certain circumstances. (strength of recommendation [SOR]: C, expert opinion based on physiology/bench research). Revaccination once appears to be safe, especially if provided 5 years or more after primary vaccination (SOR: B, based upon consistent results of cohort studies and nonrandomized prospective trials)

Impaired glucose tolerance or newly diagnosed diabetes mellitus diagnosed during admission adversely affects prognosis after myocardial infarction: An observational study

Objective To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI). Research Design and Methods Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on predischarge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE. Results Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06–2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42–3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points. Conclusion Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention

Evaluation of heat transfer at the cavity-polymer interface in microinjection moulding based on experimental and simulation study

YesIn polymer melt processing, the heat transfer coefficient (HTC) determines the heat flux across the interface of the polymer melt and the mould wall. The HTC is a dominant parameter in cooling simulations especially for microinjection moulding, where the high surface to volume ratio of the part results in very rapid cooling. Moreover, the cooling rate can have a significant influence on internal structure, morphology and resulting physical properties. HTC values are therefore important and yet are not well quantified. To measure HTC in micromoulding, we have developed an experimental setup consisting of a special mould, and an ultra-high speed thermal camera in combination with a range of windows. The windows were laser machined on their inside surfaces to produce a range of surface topographies. Cooling curves were obtained for two materials at different processing conditions, the processing variables explored being melt and mould temperature, injection speed, packing pressure and surface topography. The finite element package Moldflow was used to simulate the experiments and to find the HTC values that best fitted the cooling curves, so that HTC is known as a function of the process variables explored. These results are presented and statistically analysed. An increase in HTC from the standard value of 2500 W/m2C to values in the region 7700 W/m2C was required to accurately model the observations.EPSR

Towards the analytic characterization of micro and nano surface features using the Biharmonic equation

YesThe prevalence of micromoulded components has steadily increased over recent years. The production of such components is extremely sensitive to a number of variables that may potentially lead to significant changes in the surface geometry, often regarded as a crucial determinant of the product¿s functionality and quality. So far, traditional large-scale quality assessment techniques have been used in micromoulding. However, these techniques are not entirely suitable for small scales . Techniques such as Atomic Force Mi- croscopy (AFM) or White Light Interferometry (WLI) have been used for obtaining full three-dimensional profiles of micromoulded components, pro- ducing large data sets that are very difficult to manage. This work presents a method of characterizing surface features of micro and nano scale based on the use of the Biharmonic equation as means of describing surface profiles whilst guaranteeing tangential (C1) continuity. Thus, the problem of rep- resenting surface features of micromoulded components from massive point clouds is transformed into a boundary-value problem, reducing the amount of data required to describe any given surface feature.The boundary conditions needed for finding a particular solution to the Biharmonic equation are extracted from the data set and the coefficients associated with a suitable analytic solution are used to describe key design parameters or geometric properties of a surface feature. Moreover, the expressions found for describ- ing key design parameters in terms of the analytic solution to the Biharmonic equation may lead to a more suitable quality assessment technique for mi- cromoulding than the criteria currently used. In summary this technique provides a means for compressing point clouds representing surface features whilst providing an analytic description of such features. The work is applicable to many other instances where surface topography is in need of efficient representation

Thermal contact resistance in micromoulding.

yesThis work outlines a novel approach for determining thermal contact resistance (TCR) in micromoulding. The proposed technique aims to produce TCR predictions with known confidence values and combines experimental evidence (temperature fields and contact angle measurements) with various mathematical modelling procedures (parametric representation of surfaces, finite element analysis and stochastic processes). Here, emphasis is made on the mathematical aspects of the project. In particular, we focus on the description of the parametric surface representation technique based on the use of partial differential equations, known as the PDE method, which will be responsible for characterizing and compressing micro features in either moulds or surface tools.EPSR

Successful use of axonal transport for drug delivery by synthetic molecular vehicles

We report the use of axonal transport to achieve intraneural drug delivery. We constructed a novel tripartite complex of an axonal transport facilitator conjugated to a linker molecule bearing up to a hundred reversibly attached drug molecules. The complex efficiently enters nerve terminals after intramuscular or intradermal administration and travels within axonal processes to neuron cell bodies. The tripartite agent provided 100-fold amplification of saturable neural uptake events, delivering multiple drug molecules per complex. _In vivo_, analgesic drug delivery to systemic and to non-targeted neural tissues was greatly reduced compared to existing routes of administration, thus exemplifying the possibility of specific nerve root targeting and effectively increasing the potency of the candidate drug gabapentin 300-fold relative to oral administration