• A brief report of the epidemiology of obesity in the inflammatory bowel disease population of Tayside, Scotland

      Steed, Helen; Walsh, Shaun; Reynolds, Nigel (Karger Publishers, 2009-12-17)
      Aim: Obesity in inflammatory bowel disease (IBD), particularly Crohn’s disease (CD), has previously been considered unusual (3%). CD patients who are obese tend to have increased perianal complications and a higher level of disease activity on an annual basis. Obesity in Scotland has been documented to have increased over the last decade, and over half all men and women in Scotland are now considered to be overweight. This study aims to assess obesity prevalence in the IBD community in Tayside, Scotland. Methods: All IBD patients (n = 1,269) were considered for inclusion. Inclusion criteria required a weight measurement taken from the preceding 12 months and a height measurement within the last decade. 489 patients were included in the analysis. Results: 18% of the Tayside IBD population were obese in comparison to approximately 23% of the Scottish population on a whole. A further 38% of patients were over-weight, the same percentage as the general population. In the overweight and obese ulcerative colitis patients there were higher levels of surgery, but the converse was true in the CD group, where the normal-weight group had the highest levels of surgery. There were significantly more obese men and women with CD than with ulcerative colitis (P = 0.05). Conclusion: Obesity prevalence has increased in IBD patients. This is significant because of the known increased levels of postoperative complications, perianal disease and requirement for more aggressive medical therapy. Research needs to be done to look at the effects of obesity on the co-morbid associations of other diseases with IBD, in particular colorectal cancer, and to ascertain whether or not screening frequency should be altered depending on BMI.
    • AmpliTaq Gold improves short tandem repeat amplifications of highly degraded DNA

      Hummel, Susanne; Burger, Joachim; Rameckers, Jens; Lassen, Cadja; Schmerer, Wera; Herrmann, Bermd (PE Biosystems, 1996-01-01)
    • Investigating future pharmacists' understanding of vaccines and myths surrounding vaccination

      Zahid, Sidrah; Morrissey, Hana; Ball, Patrick (Innovare Academic Sciences, 2020-09-18)
      Objective: The United Kingdom has lost its measles, mumps and rubella free status due to a decline in vaccination uptake. There are several beliefs such as safety concern and media influence that discourage people from having vaccinations. To identify gaps in knowledge of vaccination within 3rd year pharmacy students, and to observe whether they can spot myths about vaccines, in particular the measles, mumps and rubella vaccine. Methods: A questionnaire-based approach was used after gaining ethical approval which included a range of open and closed questions. Results: None of the participants could identify the six common myths reported by the World Health Organisation and 40% failed to accurately identify the type of vaccine of the measles, mumps and rubella vaccine. There were clear gaps in knowledge on vaccines in participants particularly from black, Asian and minority ethnic group participants compared to white students. Educating participants about the myths could have positive future implications on their scientific knowledge when they work as pharmacists. Conclusion: Many students did not accurately identify the myths surrounding vaccines and were provided informative leaflets to enhance their scientific knowledge. The gaps in knowledge identified, demonstrates that further teaching sessions should be implemented to cover the grey areas, allowing them to appropriately recommend vaccinations in the future.
    • COVID-19 in haematology patients: A multi-centre West Midlands clinical outcomes analysis on behalf of West Midlands Research Consortium

      Morrissey, Hana; Ball, Patrick; Mandal, Anandadeep; Nevill, Alan; Paneesha, Shankara; Basu, Supratik; Karim, Farheen; Imran, Mohammed; Phillips, Neil; Khawaja, Jahanzeb; et al. (Wiley-Blackwell, 2021-12-31)
    • Survey of nurses’ knowledge and practice regarding medication administration using enteral tubes

      Tillott, Harry; Barrett, Diane; Ruan, Jingjing; Li, Vincent; Merrick, Sue; Steed, Helen; Morrissey, Hana; Ball, Patrick (Wiley, 2020-09-20)
      Aim and objectives The aim was to identify the practice variation of the individual practitioners in medications’ formulation modification for patients using enteral feeding tubing; to support health practitioners involved in this process. Background Blockage of enteral tubes is a common problem that can sometimes be resolved but may require replacement of the tube. Medications are a common culprit. Design A survey of 73 registered nurses’ practices around medication administration via enteral feeding tubes. Methods A questionnaire study was undertaken within a district general hospital across a broad variety of wards to explore nurses’ experiences of medication administration via enteral tubes. The study is reported in accordance with the SQUIRE 2.0 guidelines from the EQUATOR network. Results Seventy‐three nurses responded. Twenty‐six percent reported never checking about drug modification for administration via a tube, 12% check every time and 61% when unsure about a new drug. The volume of fluid flushes administered after medication ranged from 7.5‐150mls. Seventy‐one percent of participants reported stopping feed when medications are required, varying from 1‐60 minutes. Sixty percent had experienced a blocked tube and 52% the tube being removed for these reasons. The clinical nurse specialist was the commonest first point of call to help. Staff named 15 medications as the most problematic to administer, lactulose and omeprazole were the top two. Conclusions Practice varies significantly amongst nurses around medication administration. Theoretically this may contribute to blocked tubes and excessive fluid administration to some patients. Barriers to medication administration were thematically grouped into: time, difficulty modifying medication, medication interactions and knowledge. Areas identified to support staff include training, devices to crush medications, medication suitability, multidisciplinary approach to streamline care and quick reference guides. Relevance to clinical practice Health professionals may use these results to reduce and ultimately avoid problems with administering medications through feeding tubes. Organisations may use these results to develop their local practice pathways for prescribing, dispensing and training around administration of medications through enteral tubes. In a community setting, this paper may improve the awareness of patients, caregivers and prescribers of the possible implications of tubing blockages.
    • Performance evaluation of analytical methods for parameters extraction of photovoltaic generators

      Anani, Nader; Ibrahim, Haider (MDPI AG, 2020-09-15)
      This paper presents a succinct exploration of several analytical methods for extracting the parameters of the single-diode model (SDM) of a photovoltaic (PV) module under standard test conditions (STC). The paper investigates six methods and presents the detailed mathematical analysis leading to the development of each method. To evaluate the performance of these methods, MATLAB-based software has been devised and deployed to generate the results of each method when used to extract the SDM parameters of various PV test modules of different PV technologies. Similar software has also been developed to extract the same parameters using well-established numerical and iterative techniques. A comparison is subsequently made between the synthesized results and those obtained using numerical and iterative methods. The comparison indicates that although analytical methods may involve a significant amount of approximations, their accuracy can be comparable to that of their numerical and iterative counterparts, with the added advantage of a significant reduction in computational complexity, and without the initialization and convergence difficulties, which are normally associated with numerical methods.
    • The hidden burden of community enteral feeding on the emergency department

      Barrett, D; Li, V; Merrick, S; Murugananthan, A; Steed, Helen (Wiley, 2021-03-31)
      Abstract Background Enteral feeding tubes are associated with their most serious complications in the days and weeks after insertion, but there is limited published data in the literature on late complications and the implications for the healthcare service. Methods Retrospective observational study of attendances to a UK hospital emergency department with enteral tube complications as the primary reason for attendance. Results Over 24 months 139 attendances were recorded. Dislodged tubes and blocked tubes accounted for the majority of complications and subsequent admissions, with a mixture of enteral tube types being associated with both. Thirty-five percent were admitted and the average healthcare cost per attendance was $1071. Conclusions Enteral tube complications can place a hidden burden on the patient, on ED and on healthcare costs. More work on education and supporting carers to resolve problems themselves could reduce the burden on busy emergency departments.
    • The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass

      Arndtz, Katherine; Steed, Helen; Hodson, James; Manjunath, Srikantaiah; Gastroenterology Department, Walsall Manor Hospital (Katherine Arndtz, Srikantaiah Manjunath). (Hellenic Society of Gastroenterology, 2016-01-08)
      BACKGROUND:This study aimed to assess the endoscopic burden of bariatric surgical procedures at our trust. This is an enhanced parallel study to "The Hidden Endoscopic burden of Roux-en-Y Gastric Bypass" published in Frontline Gastroenterology in 2013 incorporating the data for sleeve gastrectomy and comparison with Roux-en-Y gastric bypass (RYGB). METHODS:This is a retrospective study that included 211 patients undergoing sleeve gastrectomy over a 34-month period. We utilized previously collected data for the RYGB patient cohort which included 553 patients over a 29-month period. We searched our hospital endoscopic database for patients who underwent post-operative endoscopy for indications related to their surgery. RESULTS:16.6% of the sleeve gastrectomy patients required post-operative endoscopy, of whom 11.4% underwent therapeutic procedures. This compares to 20.4% of the RYGB cohort of whom 50.4% needed therapeutic procedures (P<0.001). 1.9% of sleeve gastrectomy patients encountered a post-operative staple line leak and collectively required 29 endoscopic procedures. One patient also developed stricturing (0.47%) requiring 18 pneumatic dilatations. 11.4% of the RYGB cohort developed an anastomotic stricture requiring 57 balloon dilatation procedures. To date, these procedures have accumulated an equivalent cost of €159,898 in endoscopy tariffs, or €177 per RYGB and €373 per sleeve gastrectomy performed. CONCLUSIONS:Bariatric surgery can have significant implications in terms of patient morbidity and financial cost. Having a local bariatric surgery service increases the demand for endoscopic procedures in our hospital, both in investigating for and dealing with post-operative complications. Provision of extra resources and expertise needs to be taken into account.
    • The effects of ligand charge, orientation and size on the binding of potential inhibitors for aldehyde dehydrogenase

      Magee, Caroline A; Peterson, Larryn W; Cafiero, Mauricio; Selner, Emma F (Elsevier, 2020-05-20)
      l-DOPA, used as a therapy for patients with Parkinson’s disease, is transformed into needed dopamine in the brain. This dopamine can then be deactivated via metabolism by a series of enzymes, including aldehyde dehydrogenase (ALDH). The targeted inhibition of the ALDH enzyme may help to prolong l-DOPA therapy. A series of potential inhibitors has been studied via ab initio models using a crystal-structure of the ALDH enzyme with an inhibitor bound in its active site (PDB ID: 4WP7). The positions of novel dopaminergic derivatives were optimized in the active site using M062X/6-31G with implicit solvation and relaxed amino-acid side-chains. This work examines different single molecule orientations, as well as double molecule configurations. Various sizes of ligands were also studied. Interaction energies between the ligands and the protein were calculated using M062X with the 6–311 + G* basis set. Some potential inhibitors show promising results such as the LP and CAM series.
    • Undergraduate women empowering women in computational chemistry: three perspectives

      Evans, Rebecca; Perchik, Madison; Magee, Caroline; Cafiero, Mauricio (Wiley, 2020-06-25)
      The undergraduate computational chemistry research group headed by Mauricio Cafiero at Rhodes College has a history of including, promoting, and supporting women in this predominantly male field. Alums of this research group from 2004 to 2019 include nine M.Ds, two science researchers, two Ph.D.s, one secondary teacher, two pharmacists, a physical therapist, two nurses, six current medical school students, and five current science graduate students. They have produced 18 peer‐reviewed publications with female undergraduate first authors and over 100 conference presentations, including 9 international conference presentations. While Professor Cafiero does all he can to support these students, he attributes the continuous success of the group in recruiting, retaining, and supporting these women to the students themselves. The students' success and visibility on campus helps to recruit new students. The heavy presence of women in this group provides a strong support system for women who may otherwise feel isolated in a male‐dominated field; and these support groups provide models and support for women to overcome common obstacles that women in science face. We will profile three recent graduates who will discuss how the above points affected them during their time in the research group and discuss their experience in the context of some literature on women in Science, Technology, Engineering and Mathematics.
    • Results from the first English stool bank using faecal microbiota transplant as a medicinal product for the treatment of Clostridioides difficile infection

      McCune, VL; Quraishi, MN; Manzoor, S; Moran, CE; Banavathi, K; Steed, H; Massey, DCO; Trafford, GR; Iqbal, TH; Hawkey, PM; et al. (Elsevier BV, 2020-03-16)
      © 2020 Background: Faecal Microbiota Transplant (FMT) has improved outcomes for the treatment of Clostridioides difficile infection (CDI) compared to antibiotic therapy. FMT is classified as a medicinal product in the United Kingdom, similar to the USA and Canada, limiting supply via stool banks without appropriate licencing. In the largest UK cohort to date, we describe the clinical outcomes for 124 patients receiving FMT for recurrent or refractory CDI and present a framework to produce FMT as a licenced medicinal product. Methods: Anonymous unrelated healthy donors, screened via health assessment and microbiological testing donated stool. In aerobic conditions FMT aliquots were prepared for immediate use or frozen storage, following a production framework developed to comply with Good Manufacturing Practice. Outcome measures were clinical response to FMT defined as resolution of diarrhoea within seven days and clinical cure defined as response without diarrhoea recurrence at 90 days. Findings: Clinical response was 83·9% (95% CI 76·0%–90·0%) after one treatment. Clinical cure was 78·2% (95% CI 67·4%–89·0%) across the cohort. Refractory cases appeared to have a lower initial clinical response rate compared to recurrent cases, however at day 90 there were no differences observed between these groups. Interpretation: The methodology developed here enabled successful licencing of FMT by The Medicines and Healthcare products Regulatory Agency as a medicinal product. This has widened the availability of FMT in the National Health Service via a stool bank and can be applied in other centres across the world to improve access to safe and quality assured treatments.
    • Patients with gastrointestinal irritability after TGN1412-induced cytokine 2 storm displayed selective expansion of gut-homing αβ and γδ T-cells

      McCarthy, Neil; Stagg, Andrew; Price, Claire; Mann, Elizabeth; Gellatly, Nichola; Al-Hassi, Hafid; Knight, Stella; Panoskaltsis, Nicki (Springer Nature, 2020-12-31)
      Following infusion of the anti-CD28 superagonist monoclonal antibody TGN1412, three of six previously healthy, young male recipients developed gastrointestinal irritability associated with increased expression of ‘gut-homing’ integrin β7 on peripheral blood αβT-cells. This subset of patients with intestinal symptoms also displayed a striking and persistent expansion of putative Vδ2+ 7 γδT-cells in the circulation which declined over a two-year period following drug infusion, concordant with subsiding gut symptoms. These data demonstrate that TGN1412-induced gastrointestinal symptoms were associated with dysregulation of the ‘gut-homing’ pool of blood αβ and γδT11 cells, induced directly by the antibody and/or arising from the subsequent cytokine storm.
    • Biomolecular interaction simulation of supramolecular topologies of organometallic assemblies of Bi(V) with antibiotic Tetracycline Amoxicillin drugs and their experimental activities evaluation

      Kumar, Rajiv; Gulia, Kiran; Chandra, Mina; Aggarwal, Anil K.; Kumar, Anil; Mittan, Sandeep; Mishra, Parashuram (Integrated Science, 2019-09-30)
      Antibiotic drugs i.e. tetracycline and amoxicillin, were used mixed ligands (ML), for designing, architecturing, tailoring and synthesis for synthesis of supramolecular topologies of organometallic assemblies of Bi(V), represented as OMCs‐Bi(V), having O5 set for bonding. Molecular models were proposed as a standard to judge specific interactions in topologies of molecules of ML and derived organometallic assemblies. In OMCs‐Bi(V), on chelation, polarity of Bi(V) get reduced to great extent due to overlap of ML orbital. As a result, delocalization of π‐electrons density clouds get spread over the surface of chelating ring and enhances penetration power of OMCs‐Bi(V) into lipid membranes. This influenced binding with enzyme sites in microorganisms. Some electron set for bonding groups present in ligands moieties display extensive biological activity that may be responsible for increase in hydrophobic character and liposolubility of supramolecular topologies of organometallic of assemblies; ultimately enhanced biological activity of OMCs‐Bi(V).
    • Modelling of hydraulic fracturing process by coupled discrete element and fluid dynamic methods

      Marina, Sousani; Imo-Imo, Eshiet Kenneth; Derek, Ingham; Mohamed, Pourkashanian; Yong, Sheng (Springer Science and Business Media LLC, 2014-04-17)
      A three-dimensional model is presented and used to reproduce the laboratory hydraulic fracturing test performed on a thick-walled hollow cylinder limestone sample. This work aims to investigate the implications of the fluid flow on the behaviour of the micro-structure of the rock sample, including the material strength, its elastic constants and the initialisation and propagation of fractures. The replication of the laboratory test conditions has been performed based on the coupled Discrete Element Method (DEM) and Computational Fluid Dynamics scheme. The numerical results are in good agreement with the experimental data, both qualitatively and quantitatively. The developed model closely validates the overall behaviour of the laboratory sample, providing a realistic overview of the cracking propagation towards total collapse as well as complying with Lame’s theory for thick-walled cylinders. This research aims to provide some insight into designing an accurate DEM model of a fracturing rock that can be used to predict its geo-mechanical behaviour during Enhanced Oil Recovery applications.
    • An off-site construction readiness maturity model for the Indian construction sector

      Rana, Muhammad Qasim; Arif, Mohammed; Goulding, Jack; Sawhney, Anil; Bendi, Deepthi (Emerald, 2021-12-31)
      Purpose This paper presents an Off-Site Construction (OSC) readiness maturity model for assessing the readiness of off-site construction in the Indian construction sector. Design/Methodology/Approach The research was conducted in three stages. The first stage consisted of a detailed literature review to document 17 different variables affecting the OSC adoption in India. In stage two, 15 semi-structured interviews were carried out where the participants were asked to refine those variables for the Indian context and define what would be different levels of attainment. In the third stage, another set of 5 semi-structure interviews was performed to validate the maturity levels and definitions. Findings A three-level OSC readiness maturity model is presented for discussion. This describes 17 variables at different levels of maturity. Practical Implications The proposed OSC readiness maturity model guides construction practitioners in India through a structured process to enable them to assess their OSC readiness in the market. This assessment enables them to evaluate and benchmark their processes through the strategic and operational phases. The maturity model also identifies the areas of concern and the scope for further development or change to secure the optimal advantage of OSC methods. Originality/Value The research produced a model to assess the readiness of off-site construction adoption in the Indian construction sector. Although the model has been applied to the Indian construction sector, it can easily be modified to accommodate other OSM contexts.
    • Are the Mascarene frog (Ptychadena mascareniensis) and Brahminy blind snake (Indotyphlops braminus) really alien species in the Seychelles?

      Williams, Rhiannon; Gower, David; Labisko, Jim; Morel, Charles; Bristol, Rachel; WILKINSON, MARK; Maddock, Simon (British Herpetological Society, 2020-12-31)
    • Parenteral provision of micronutrients to pediatric patients: an international expert consensus paper

      Hardy, Gil; Wong, Theodoric; Morrissey, Hana; Anderson, Collin; Moltu, Sissel J; Poindexter, Brenda; Lapillonne, Alexandre; Ball, Patrick A; Ipanema Research Trust, Auckland, New Zealand. (Wiley, 2020-08-07)
      INTRODUCTION:Micronutrients (vitamins and trace elements) are essential to all nutrition. For children and neonates who are dependent upon nutrition support therapies for growth and development, the prescribed regimen must supply all essential components. This paper aims to facilitate interpretation of existing clinical guidelines into practical approaches for the provision of micronutrients in pediatric parenteral nutrition. METHODS:An international, interdisciplinary expert panel was convened to review recent evidence-based guidelines and published literature to develop consensus- based recommendation on practical micronutrient provision in pediatric parenteral nutrition. RESULTS:The guidelines and evidence have been interpreted as answers to 10 commonly asked questions around the practical principles for provision and monitoring of micronutrients in pediatric patients CONCLUSION: Micronutrients are an essential part of all parenteral nutrition and should be included in the pediatric nutrition therapy care plan.
    • Geographical forwarding algorithm based video content delivery scheme for internet of vehicles (IoV)

      Sadiq, Ali Safaa; Ghafoor, Kayhan Zrar; Ke, Chih-Heng (IEEE, 2020-07-31)
      An evolved form of Vehicular Ad hoc Networks (VANET) has recently emerged as the Internet of Vehicles (IoV). Though, there are still some challenges that need to be addressed in support IoV applications. The objective of this research is to achieve an efficient video content transmission over vehicular networks. We propose a balanced video-forwarding algorithm for delivering video-based content delivery scheme. The available neighboring vehicles will be ranked to the vehicle in forwarding progress before transmitting the video frames using proposed multi-score function. Considering the current beacon reception rate, forwarding progress and direction to destination, in addition to residual buffer length; the proposed algorithm can elect the best candidate to forward the video frames to the next highest ranked vehicles in a balanced way taking in account their residual buffer lengths. To facilitate the proposed video content delivery scheme, an approach of H.264/SVC was improvised to divide video packets into various segments, to be delivered into three defined groups. These created segments can be encoded and decoded independently and integrated back to produce the original packet sent by source vehicle. Simulation results demonstrate the efficiency of our proposed algorithm in improving the perceived video quality compared with other approaches
    • Sexing sub-adult human remains with osteological and DNA-analysis based methodology

      Deutschmann, Frauke MN; Schmerer, Wera Margarete (2012-04-20)
    • Genetic analysis of historical human remains – what ancient bones can tell if one asks the right questions…

      Hunt, Emilia; Clemson, Emms; Rice, David; Schmerer, Wera Margarete (2016-03-14)