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  • Unmanned aerial system integration for monitoring and management of landslide: A case of Dominican Republic

    Reynoso Vanderhorst, Hamlet (International Association for Automation and Robotics in Construction, 2021-11-02)
    The Unmanned Aerial System (UAS), Aerial Robot or Drone has been a multi-purpose tool for professionals, especially for its unknown versatile applications and regardless of its challenges in adoption. In the built environment and the current global situation, the topic of disaster management has grabbed attention from the scientific community, raising questions of cyberspace linking the COVID-19. As a result, the case study shows how UAS is used to evaluate the landslide provoked as cascading effect of a bridge site construction and the digital data required to feed in 2D and 3D a database of urban planning development. The findings reveal that the application of UAS reduced physical inspections, allowed professionals to obtain inaccessible data, and helped to overview the site conditions identifying the cause of the phenomenon. A safety design factor of the critical building of the school in the community to mitigate the landslide hazards at Santa Maria, Dominican Republic was recommended. Future works in 360°evaluation for similar cases in construction are recommended.
  • Application of UAS and revit for pipeline design

    Reynoso Vanderhorst, Hamlet; Heesom, David; Suresh, Subashini; Renukappa, Suresh (Budapest University of Technology and Economics, 2020-07-01)
    The professionals in the vertical and horizontal construction have tested methods to enhance the quality, safety, environmental impact, delivery time and cost control in their works promoted in learning organisations. Automation strategies applying robots and technology has been a focal point in industry of manufacture by its benefits in productivity levels and quality of works, and in some cases, without affecting other factors in a long-term period. The construction industry is playing a predominant economic heading in certain countries. Therefore, the adoption of Unmanned Aerial System (UAS) and Building Information Modelling (BIM) methodology as an automation strategy represent in short and long terms positive economic impact. UAS or drones have been used for cargo and data capturing in the built environment. Nowadays, the construction of infrastructures is the most benefited project from UAS implementations by gathering visual data of cracks, obstructions, energy levels, traffic and current conditions of the projects fulfilling the gap of human risks reduction, speed on data collection, and digitalisation of the real-world along with BIM. However, there is a breach in reliability and awareness on the UAS application cases in the infrastructure sector. The aim of this paper is to present the reasons and the application case of the UAS from the topography department of a Water Supply public organisation. The findings show that the UAS achieved a higher level of productivity and efficiency in the daily pre-construction works for designing pipelines. The case covers sewer identification and georeferencing in rural areas where the satellites were unavailable to show the state accurately. The tool used was an RTK DJI Phantom 4 to survey the site conditions in BIM format. The integration of UAS in BIM showed a higher level of productivity and efficiency in the employee's workflow in terms of data collection contrasting to old-fashion methods.
  • Spiderweb cellular structures manufactured via additive layer manufacturing for aerospace application

    Bari, Klaudio; Bollenbach, Lucie (MDPI, 2022-05-01)
    With increasing the energy costs and aiming for fossil-free Europe, cellular structures could provide a cost-effective tool for saving fuel consumption in aircraft. To achieve this goal, a cellular structure topology is a rapidly growing area of research facilitated by developments in additive layer manufacturing. These low-density structures are particularly promising for their aerospace applications. In this paper, four cellular structure topologies are developed to serve as a vibration damper in small electric aircraft motor, we have compared their performance with the original motor holder in the aircraft. This paper introduces the roadmap of scaffolding concept design and provides a novel concept in vibration damping. Based on the FEA simulation, aluminium 6061T spiderweb-inspired lattices (weight 0.3473 g and porosity 84%) have proven to have the lowest natural resonance and highest yield strength to weight ratio compared to other scaffolding concepts.
  • Efficacy of isatuximab with pomalidomide and dexamethasone in relapsed myeloma: Results of a UK-wide real-world dataset

    Djebbari, Faouzi; Rampotas, Alexandros; Vallance, Grant; Panitsas, Fotios; Basker, Nanda; Sangha, Gina; Salhan, Beena; Karim, Farheen; Al-Kaisi, Firas; Gudger, Amy; et al. (Lippincott, Williams & Wilkins, 2022-12-31)
    Real-world data on the efficacy and tolerability of isatuximab with pomalidomide and dexamethasone (IsaPomDex) in relapsed/refractory myeloma (RRMM) patients have not been reported. In this UK-wide retrospective study, IsaPomDex outcomes were evaluated across 24 routine care cancer centres. The primary endpoint was overall response rate (ORR). Secondary endpoints included progression-free survival (PFS), duration of response (DOR) for patients who achieved an objective response (≥PR), and adverse events (AEs). In a total cohort 107 patients, median follow up (IQR) was 12.1 months (10.1-18.6 months), median age (IQR) was 69 years (61-77). Median (IQR) Charlson Co-morbidity index (CCI) score was 3 (2- 4); 43% had e-GFR<60 ml/min. Median (IQR) number of prior therapies was 3 (3-3). Median (IQR) number of IsaPomDex cycles administered was 7 (3-13). ORR was 66.4%, with responses categorised as ≥VGPR: 31.8%, PR: 34.6%, SD: 15.9%, PD: 15% and unknown 2.8%. Median PFS was 10.9 months. Median DOR was 10.3 months There was no statistical difference in median PFS by age (<65: 10.2 vs. 65-74 13.2 vs. ≥75: 8.5 months, log-rank p=0.4157), by CCI score (<4: 10.2 months vs. ≥4: 13.2, log-rank p=0.6531), but inferior PFS was observed with renal impairment (≥60: 13.2 vs. <60: 7.9 months, log-rank p=0.0408). Median OS was 18.8 months. After a median of 4 cycles, any grade AEs were experienced by 87.9% of patients. The most common ≥G3 AEs were neutropenia (45.8%), infections (18.7%) and thrombocytopenia (14%). Our UK-wide IsaPomDex study demonstrated encouraging efficacy outcomes in the real-world, comparable to ICARIA-MM trial.
  • Heat flux and coolant concentration in hypersonic turbulent flow with transpiration cooling

    Cerminara, Adriano (UK Heat Transfer Conference, 2022-04-06)
    The present contribution shows results from direct numerical simulations (DNS) of a Mach 5 turbulent flow on a flat plate with modelled porous injection at different blowing ratios, representative of a transpiration-cooling system. It is found that the coolant film on the surface is preserved within the calmed region, whereas in the turbulent wedge it decays as a consequence of the wall-normal convective transport. This, in turn, results in the beneficial effect of the blowing ratio on the wall heat flux being relevant within the transitional region, but almost negligible within the turbulent wedge.
  • Germination of Triticum aestivum L.: Effects of soil–seed interaction on the growth of seedlings

    Chaichi, Mehrdad; Nemati, Ahmad; Dadrasi, Amir; Heydari, Moslem; Hassanisaadi, Mohadeseh; Yousefi, Ali Reza; Baldwin, Timothy; Mastinu, Andrea (MDPI, 2022-04-15)
    Seed size, sowing depth, and seed disinfection can affect seed germination and seedling establishment, which, in turn, can directly affect crop growth and yield. The current study was comprised of two experiments, the first of which was conducted in the laboratory, and a second which was performed under glasshouse conditions. The objective of these experiments was to investigate the effects of seed size, sowing depth, and seed disinfection on seed germination and initial seedling growth of selected wheat (Triticum aestivum L.) cultivars. The treatments in laboratory experiment were arranged in a completely randomized design, which included: (Ι) four wheat cultivars (Pishgam, Haydari, Soissons, and Mihan), (ΙΙ) two seed size classes (x &lt; 2.25 mm, and x &gt; 2.25 mm), and two disinfection treatments (no-disinfection and disinfection), (ΙΙΙ) with five replicates. In addition to the aforementioned treatments, the effect of planting depth (4, 6, and 8 cm) was also investigated in the subsequent glasshouse experiment. The best results were obtained at a sowing depth of 4 cm, in the non-disinfected treatment, using large seeds. In contrast, the lowest percentage and speed of seed germination and vigor index were observed in seeds sown at 8 cm depth, in the disinfected seed treatment, using small seeds. Large seeds contain larger nutrient stores which may improve seed germination indices, which would therefore result in improved percentage and speed of seed germination, followed by faster coleoptile and seedling growth, higher seedling dry weight and seed vigor. These data also illustrated that seed disinfection in the Pishgam and Haydari cultivars had inhibitory effects upon coleoptile growth and seedling length, which could be related to the fungicide’s chemical composition. Unlike other cultivars, disinfection did not show a significant effect on the Soissons cultivar. Based on our data, in order to improve both the speed of wheat seed germination and subsequent plant growth and development; it is necessary to select high-quality, large seeds, planted at a specific planting depth, which have been treated with an effective disinfectant; all of which will be specific for the wheat cultivar in question. Overall, the current study has provided useful information on the effect size seed, sowing depth, and disinfection have upon germination characteristics and seedling growth of wheat cultivars, which can form the basis for future field scale trails.
  • Crushing and energy absorption properties of additively manufactured concave thin-walled tubes

    Baroutaji, Ahmad; Arjunan, Arun; Singh, Gurpal; Robinson, John (Elsevier BV, 2022-04-22)
    Developing an innovative protective structure with excellent energy absorption performance is a continuous research effort. The emerging additive manufacturing techniques allow fabricating structures with complex geometrical shapes which have the potential to yield unprecedented energy absorption properties. Accordingly, in this paper, the crush and energy absorption behaviour of new designs, namely Concave Tubes (CTs) featuring inwardly curved sidewalls, is assessed experimentally and compared to that of Standard tubes (STs) featuring straight sidewalls. Tubes with different geometrical configurations, including concave circular (CC), concave square (CS), standard circular (SC), and standard square (SS), are fabricated using the Selective Laser Melting (SLM) process from AlSi10Mg aluminium powder and then crushed axially under quasi-static loading. It was found that the tubes have fractured and developed a splitting deformation mode, instead of progressive buckling, during the axial crushing resulting in relatively low energy absorption performance. The experimental results revealed superior energy absorption performance for the CTs over the STs. A Multi-Attribute Decision Making (MADM) technique known as Complex Proportional Assessment (COPRAS) is used to identify the best design. The COPRAS results show that the CC design is the best energy absorbing tube outperforming all other configurations presented in this paper.
  • The high scholarly value of grey literature before and during Covid-19

    Kousha, Kayvan; Thelwall, Mike; Bickley, Matthew; RIILP, Faculty of Science and Engineering, University of Wolverhampton (Springer Nature, 2022-12-31)
    New academic knowledge in journal articles is partly built on peer reviewed research already published in journals or books. Academics can also draw from non-academic sources, such as the websites of organisations that publish credible information. This article investigates trends in the academic citing of this type of grey literature for 17 health, media, statistics, and large international organisations, with a focus on Covid-19. The results show substantial and steadily increasing numbers of citations to all 17 sites, with larger increases from 2019 to 2020. In 2020, Covid-19 citations to these websites were particularly common for news organisations, the WHO, and the UK Office for National Statistics, apparently for up-to-date information in the rapidly changing circumstances of the pandemic. Except for the UN, the most cited URLs of each organisation were not traditional report-like grey literature but were other types, such as news stories, data, statistics, and general guidance. The Covid-19 citations to most of these websites originated primarily from medical research, commonly for coronavirus data and statistics. Other fields extensively cited some of the non-health websites, as illustrated by social science (including psychology) studies often citing UNESCO. The results confirm that grey literature from major websites has become even more important within academia during the pandemic, providing up-to-date information from credible sources despite a lack of academic peer review. Researchers, reviewers, and editors should accept that it is reasonable to cite this information, when relevant, and evaluators should value academic work that supports these non-academic outputs.
  • Barriers and cost model of implementing unmanned aerial system (UAS) services in a decentralised system: Case of the Dominican Republic

    Reynoso Vanderhorst, Hamlet; Heesom, David; Suresh, Subashini; Renukappa, Suresh; Burnham, Keith J. (Emerald, 2022-05-16)
    Purpose – The aim of this paper is to identify the business barriers that influence cost of implementing UAS and its suitability for a decentralised system. Unmanned Aerial System (UAS), or drone, plays a role of data provider to AEC professionals within a decentralised system. However, exist disappointments in the execution and test of the effectiveness of the UAS. The reasons for these fails are not well elaborated in the literature. Hence, the study investigates the barriers and cost analysis of UAS that can be used for a decentralised case in which the UAS data is useful for multiple stakeholders and provide illustration of the interactions within this approach. Design/methodology/approach – This paper is part of a longitudinal project by utilising a qualitative method of interviewing 24 participants involved in the process of application of drones in the country of the Dominican Republic. The open-ended semi-structured interviews were composed for questions regarding the application of UAS, barriers, and business implications. The data gathered were transcribed and used thematic analysis for its interpretation. Later, conclusions of the barriers of UAS implementation in the organisation were analysed and a cost model was developed to identify a viable scenario. Findings – The paper provides empirical insights about the barriers and economic considerations faced in the implementation process of UAS. In this research were identified: 16 barriers in the implementation process at the management level, 8 types of cases of business relationships, and 13 business models. Furthermore, recommendations in being accountable for the dimensions and recurrent visits to the projects handled by the portfolio of the organisations were made, to prudently invest in this project management tool for construction. Practical implications – The paper includes barriers to consider before implementation, business implications, project examples and cost structure developed. Furthermore, the findings are fit theoretically into the context of a decentralised system. It was understood and contemplated that monitoring in open and outdoor spaces are the suitable approach for UAS implementations for decentralised system. The trend of decentralised autonomous organisations for transparency and efficiency of human tasks provides the foundations of human-robot interactions as well as the role of tokenisation of assets into the cyberspace. Therefore, the paper brings managers and technicians the implications for the future-proofing implementation of UAS. Research Limitations – Blockchain system is supported by UAS data and its tests require skills and resources that were outside of the scope of the main research intend regarding UAS implementation in construction. Word counts limited details in a certain degree. Furthermore, as these technologies are still under development, the assessment of the decentralised system, smart contract, and swarm technology was addressed conceptually and further research are encouraged in this field. Originality/value – This paper provides an overview of the implications of cost and the suitable scenarios for return of investment in the UAS implementation in the current stage of the technology development. In addition, the paper makes reference to decentralised systems, smart contracts and swarm technology as options in which reality capture technologies are essential for construction projects.
  • Nonlinear marine predator algorithm: A cost-effective optimizer for fair power allocation in NOMA-VLC-B5G networks

    Sadiq, Ali Safaa; Dekhordi, Amin Abdollahi; Mirjalili, Seyedali; Pham, Quoc Viet (Elsevier, 2022-05-11)
    This paper is an influential attempt to identify and alleviate some of the issues with the recently proposed optimization technique called the Marine Predator Algorithm (MPA). With a visual investigation of its exploratory and exploitative behavior, it is observed that the transition of search from being global to local can be further improved. As an extremely cost-effective method, a set of nonlinear functions is used to change the search patterns of the MPA algorithm. The proposed algorithm is called Nonlinear Marin Predator Algorithm (NMPA) is tested on a set of benchmark functions. A comprehensive comparative study shows the superiority of the proposed method compared to the original MPA and even other recent meta-heuristics. The paper also considers solving a real-world case study around power allocation in non-orthogonal multiple access (NOMA) and visible light communications (VLC) for Beyond 5G (B5G) networks to showcase the applicability of the NMPA algorithm. NMPA algorithm shows its superiority in solving a wide range of benchmark functions as well as obtaining fair power allocation for multiple users in NOMA-VLC-B5G systems compared with the state-of-the-art algorithms.
  • Sustainable transition towards biomass-based cement Industry: A review

    Kusuma, Ravi Teja; Hiremath, Rahul B.; Rajesh, Pachimatla; Kumar, Bimlesh; Renukappa, Suresh (Elsevier, 2022-05-02)
    Cement manufacturing is a hard-to-abate industrial sector that accounts for 5 to 8% of global anthropogenic emissions. Approximately 80 to 90% of these emissions occur during limestone calcination and fuel combustion processes. Decarbonising these two emission and energy-intensive processes requires a sustained and regenerative supply of low-carbon resources. Unlike other renewables such as solar or wind, biomass is uniquely positioned to abate emissions from fuel combustion and process emissions by substituting clinker with biomass ash. Moreover, bioenergy with carbon capture utilisation or storage offsets the energy penalties and associated emissions due to the deployment of carbon-capturing technologies. The sustainable transition towards biomass-based industry involves multifaceted socio-technical conflicts across bioenergy and cement sectors. This review uncovers opportunities, challenges and interplay involved in the sustainable transition of the cement industry through the lens of circular bioeconomy and multi-level perspective. The review found that 20 to 30% of fossil fuels can be replaced with biofuels without significant capital investments. This can be further enhanced through pre-processing of biomass and process optimisation. Clinker substitution with biomass ash is reported to be in the range of 3 to 80%. To increase the uptake of biomass, key aspects of circular bioeconomy are good starting points for transition at an organisation level, but system-wide change demands policy interventions. The policy intervention points presented in this study will serve as focus areas for practitioners and policy makers.
  • Academic LGBTQ+ terminology 1900-2021: Increasing variety, increasing inclusivity?

    Thelwall, Mike; Devonport, Tracey; Makita, Meiko; Russell, Kate (Routledge, 2022-04-27)
    LGBTQ+ labels and terminology in society embed ideological assumptions and affect who gains community support and protection. In academia, terminology is also needed to help define study objects, methods, and goals. Academics therefore need to choose their words to be both precise and appropriate, adjusting to changes in societal language. This article assesses the evolution of LGBTQ+ terminology in the titles and abstracts of academic journal articles since 1900 to identify the main trends. Based on a search of 74 LGBTQ+ terms in Scopus, LGBTQ+ related journal articles have almost continually increased in prevalence since 1900. In parallel, the concept of homosexuality that dominated early research has almost disappeared, being replaced by the word gay or more specific terms, such as lesbian or bisexual. Transexual terminology has also been supplanted by transgender and trans* terminology. At various points in time other LGBTQ+ terms have emerged with activist, health professional and academic origins. These include multiple acronyms, inclusive phrases, and activity-specific phrases (e.g., men who have sex with men) that are not used by the LGBTQ+ community. Currently, no terminologies are dominant, with this plurality probably reflecting differing research needs.
  • Consensus standards of healthcare for adults and children with inflammatory bowel disease in the UK

    Kapasi, R; Glatter, J; Lamb, CA; Acheson, AG; Andrews, C; Arnott, ID; Barrett, KJ; Bell, G; Bhatnagar, G; Bloom, S; et al. (BMJ, 2019-07-24)
    Objective Symptoms and clinical course during inflammatory bowel disease (IBD) vary among individuals. Personalised care is therefore essential to effective management, delivered by a strong patient-centred multidisciplinary team, working within a well-designed service. This study aimed to fully rewrite the UK Standards for the healthcare of adults and children with IBD, and to develop an IBD Service Benchmarking Tool to support current and future personalised care models. Design Led by IBD UK, a national multidisciplinary alliance of patients and nominated representatives from all major stakeholders in IBD care, Standards requirements were defined by survey data collated from 689 patients and 151 healthcare professionals. Standards were drafted and refined over three rounds of modified electronic-Delphi. Results Consensus was achieved for 59 Standards covering seven clinical domains; (1) design and delivery of the multidisciplinary IBD service; (2) prediagnostic referral pathways, protocols and timeframes; (3) holistic care of the newly diagnosed patient; (4) flare management to support patient empowerment, self-management and access to specialists where required; (5) surgery including appropriate expertise, preoperative information, psychological support and postoperative care; (6) inpatient medical care delivery (7) and ongoing long-term care in the outpatient department and primary care setting including shared care. Using these patient-centred Standards and informed by the IBD Quality Improvement Project (IBDQIP), this paper presents a national benchmarking framework. Conclusions The Standards and Benchmarking Tool provide a framework for healthcare providers and patients to rate the quality of their service. This will recognise excellent care, and promote quality improvement, audit and service development in IBD.
  • The National Endoscopy Database (NED) automated performance reports to improve quality outcomes trial (APRIQOT) randomized controlled trial design

    Catlow, Jamie; Sharp, Linda; Kasim, Adetayo; Lu, Liya; Brookes, Matthew; Lee, Tom; McCarthy, Stephen; Gray, Joanne; Sniehotta, Falko; Deane, Jill; et al. (Thieme Open, 2020-10-21)
    Background and study aims Colonoscopists with low polyp detection have higher post colonoscopy colorectal cancer incidence and mortality rates. The United Kingdom’s National Endoscopy Database (NED) automatically captures patient level data in real time and provides endoscopy key performance indicators (KPI) at a national, endoscopy center, and individual level. Using an electronic behavior change intervention, the primary objective of this study is to assess if automated feedback of endoscopist and endoscopy center-level optimal procedure-adjusted detection KPI (opadKPI) improves polyp detection performance. Methods This multicenter, prospective, cluster-randomized controlled trial is randomizing NHS endoscopy centres to either intervention or control. The intervention is targeted at independent colonoscopists and each center’s endoscopy lead. The intervention reports are evidence-based from endoscopist qualitative interviews and informed by psychological theories of behavior. NED automatically creates monthly reports providing an opadKPI, using mean number of polyps, and an action plan. The primary outcome is opadKPI comparing endoscopists in intervention and control centers at 9 months. Secondary outcomes include other KPI and proximal detection measures at 9 and 12 months. A nested histological validation study will correlate opadKPI to adenoma detection rate at the center level. A cost-effectiveness and budget impact analysis will be undertaken. Conclusion If the intervention is efficacious and cost-effective, we will showcase the potential of this learning health system, which can be implemented at local and national levels to improve colonoscopy quality, and demonstrate that an automated system that collects, analyses, and disseminates real-time clinical data can deliver evidence- and theory-informed feedback.
  • Living with ulcerative colitis study (LUCY) in England: A retrospective study evaluating healthcare resource utilisation and direct healthcare costs of postoperative care in ulcerative colitis

    Brookes, Matthew; Waller, J; Cappelleri, JC; Modesto, I; Dibonaventura, MD; Bohm, N; Mokgokong, R; Massey, O; Wood, R; Bargo, D; et al. (BMJ, 2020-09-16)
    Objective Ulcerative colitis (UC) is a lifelong, relapsing-remitting disease. Patients non-responsive to pharmacological treatment may require a colectomy. We estimated pre-colectomy and post-colectomy healthcare resource utilisation (HCRU) and costs in England. Design/Method A retrospective, longitudinal cohort study indexing adult patients with UC undergoing colectomy (2009-2015), using linked Clinical Practice Research Datalink/Hospital Episode Statistics data, was conducted. HCRU, healthcare costs and pharmacological treatments were evaluated during 12 months prior to and including colectomy (baseline) and 24 months post-colectomy (follow-up; F-U), comparing baseline/F-U, emergency/elective colectomy and subtotal/full colectomy using descriptive statistics and paired/unpaired tests. Results 249 patients from 26 165 identified were analysed including 145 (58%) elective and 184 (74%) full colectomies. Number/cost of general practitioner consultations increased post-colectomy (p<0.001), and then decreased at 13-24 months (p<0.05). From baseline to F-U, the number of outpatient visits, number/cost of hospitalisations and total direct healthcare costs decreased (all p<0.01). Postoperative HCRU was similar between elective and emergency colectomies, except for the costs of colectomy-related hospitalisations and medication, which were lower in the elective group (p<0.05). Postoperative costs were higher for subtotal versus full colectomies (p<0.001). At 1-12 month F-U, 30%, 19% and 5% of patients received aminosalicylates, steroids and immunosuppressants, respectively. Conclusion HCRU/costs increased for primary care in the first year post-colectomy but decreased for secondary care, and varied according to the colectomy type. Ongoing and potentially unnecessary pharmacological therapy was seen in up to 30% of patients. These findings can inform patients and decision-makers of potential benefits and burdens of colectomy in UC.
  • What next for gastroenterology and hepatology trainee networks? Lessons from our surgical colleagues

    Segal, J; Widlak, M; Ingram, RJM; Brookes, MJ; Arasaradnam, R; Department of Gastroenterology, The Hillingdon Hospital, Uxbridge, UK. (BMJ, 2021-03-11)
  • Iron therapy in inflammatory bowel disease

    Kumar, Aditi; Brookes, Matthew; The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK. (MDPI, 2020-11-12)
    The most common complication seen in inflammatory bowel disease (IBD) patients is iron deficiency anaemia (IDA). Symptoms such as chronic fatigue can be as debilitating to IBD patients as pathological symptoms of abdominal pain and diarrhoea. Recognising and correcting anaemia may be as important as managing IBD symptoms and improving overall quality of life. Thus, iron replacement should be commenced the moment IDA is identified. Although intravenous iron is now considered standard treatment for IBD patients in Europe, oral iron still appears to be the preferred option. Advantages of oral iron include greater availability, lower costs and ease of applicability. However, its multitude of side effects, impact on the microbiome and further exacerbating IBD activity can have consequences on patient compliance. The newer oral iron formulations show promising safety and efficacy data with a good side effect profile. Intravenous iron formulations bypass the gastrointestinal tract absorption thereby leading to less side effects. Multiple studies have shown its superiority compared to oral formulations although its risk for hypersensitivity reactions continue to lead to clinician hesitancy in prescribing this formulation. This article provides an updated review on diagnosis and management of IDA in IBD patients, discussing the newer oral and intravenous formulations.
  • Questions and answers on iron deficiency treatment selection and the use of intravenous iron in routine clinical practice

    Richards, T; Breymann, C; Brookes, Matthew; Lindgren, S; Macdougall, IC; McMahon, LP; Munro, MG; Nemeth, E; Rosano, GMC; Schiefke, I; et al. (Taylor & Francis, 2021-01-10)
    Iron deficiency is a common cause of morbidity and can arise as a consequence or complication from many diseases. The use of intravenous iron has increased significantly in the last decade, but concerns remain about indications and administration. Modern intravenous iron preparations can facilitate rapid iron repletion in one or two doses, both for absolute iron deficiency and, in the presence of inflammation, functional iron deficiency, where oral iron therapy is ineffective or has not worked. A multidisciplinary team of experts experienced in iron deficiency undertook a consensus review to support healthcare professionals with practical advice on managing iron deficiency in gastrointestinal, renal and cardiac disease, as well as; pregnancy, heavy menstrual bleeding, and surgery. We explain how intravenous iron may work where oral iron has not. We provide context on how and when intravenous iron should be administered, and informed opinion on potential benefits balanced with potential side-effects. We propose how intravenous iron side-effects can be anticipated in terms of what they may be and when they may occur. The aim of this consensus is to provide a practical basis for educating and preparing staff and patients on when and how iron infusions can be administered safely and efficiently.Key messages Iron deficiency treatment selection is driven by several factors, including the presence of inflammation, the time available for iron replenishment, and the anticipated risk of side-effects or intolerance. Intravenous iron preparations are indicated for the treatment of iron deficiency when oral preparations are ineffective or cannot be used, and therefore have applicability in a wide range of clinical contexts, including chronic inflammatory conditions, perioperative settings, and disorders associated with chronic blood loss. Adverse events occurring with intravenous iron can be anticipated according to when they typically occur, which provides a basis for educating and preparing staff and patients on how iron infusions can be administered safely and efficiently.
  • The dietary practices and beliefs of British South Asian people living with inflammatory bowel disease: a multicenter study from the United Kingdom

    Crooks, B; Misra, R; Arebi, N; Kok, K; Brookes, Matthew; McLaughlin, J; Limdi, JK; Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. (Korean Association for the Study of Intestinal Diseases, 2021-01-06)
    Background/Aims: Epidemiological associations have implicated factors associated with Westernization, including the Western diet, in the development of inflammatory bowel disease (IBD). The role of diet in IBD etiopathogenesis, disease control and symptom management remains incompletely understood. Few studies have collected data on the dietary habits of immigrant populations living with IBD. Our aim was to describe the dietary practices and beliefs of British South Asians with IBD. Methods: A 30-item questionnaire was developed and consecutively administered to 255 British South Asians with IBD attending gastroenterology clinics in the United Kingdom. Results: Fifty-one percent of participants believed diet was the initiating factor for their IBD and 63% felt diet had previously triggered disease relapse. Eighty-nine percent avoided certain dietary items in the belief that this would prevent relapse. The most commonly avoided foods and drinks were spicy and fatty foods, carbonated drinks, milk products, alcohol, coffee, and red meat. A third of patients had tried a whole food exclusion diet, most commonly lactose or gluten-free, and this was most frequently reported amongst those with clinically active IBD (P=0.02). Almost 60% of participants avoided eating the same menu as their family, or eating out, at least sometimes, to prevent IBD relapse. Conclusions: British South Asians with IBD demonstrate significant dietary beliefs and food avoidance behaviors with increased frequency compared to those reported in Caucasian IBD populations. Studies in immigrant populations may offer valuable insights into the interaction between diet, Westernization and cultural drift in IBD pathogenesis and symptomatology.
  • Intravenous iron is non-inferior to oral iron regarding cell growth and iron metabolism in colorectal cancer associated with iron-deficiency anaemia

    Al-Hassi, HO; Ng, O; Evstatiev, R; Mangalika, M; Worton, N; Jambrich, M; Khare, V; Phipps, O; Keeler, B; Gasche, C; et al. (Springer, 2021-07-01)
    Oral iron promotes intestinal tumourigenesis in animal models. In humans, expression of iron transport proteins are altered in colorectal cancer. This study examined whether the route of iron therapy alters iron transport and tumour growth. Colorectal adenocarcinoma patients with pre-operative iron deficiency anaemia received oral ferrous sulphate (n = 15), or intravenous ferric carboxymaltose (n = 15). Paired (normal and tumour tissues) samples were compared for expression of iron loading, iron transporters, proliferation, apoptosis and Wnt signalling using immunohistochemistry and RT-PCR. Iron loading was increased in tumour and distributed to the stroma in intravenous treatment and to the epithelium in oral treatment. Protein and mRNA expression of proliferation and iron transporters were increased in tumours compared to normal tissues but there were no significant differences between the treatment groups. However, intravenous iron treatment reduced ferritin mRNA levels in tumours and replenished body iron stores. Iron distribution to non-epithelial cells in intravenous iron suggests that iron is less bioavailable to tumour cells. Therefore, intravenous iron may be a better option in the treatment of colorectal cancer patients with iron deficiency anaemia due to its efficiency in replenishing iron levels while its effect on proliferation and iron metabolism is similar to that of oral iron treatment.

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