Leicester College

Background Electronic (e-)alerts for rising serum creatinine values are increasingly used as clinical indicators of acute kidney injury (AKI). The aim of this study was to investigate to what degree AKI episodes, as identified using e-alerts, correlated with coding for AKI in the hospital record for a national cohort of hospitalised children and examine whether coding corresponded with 30-day mortality after an AKI episode. Methods A cross-section of AKI episodes based on alerts issued for children under 18 years in England during 2017 were linked to hospital records. Multivariable logistic regression was used to examine patient and clinical factors associated with AKI coding. Agreement between coding and 30-day mortality was examined at hospital level. Results 6272 AKI episodes in 5582 hospitalised children were analysed. Overall, coding was poor (19.7%). Older age, living in the least deprived quintile (odds ratio (OR) 1.4, 95% Confidence Interval (CI) 1.1, 1.7) and higher peak AKI stage (stage 1 reference; stage 2 OR 2.0, 95% CI 1.7, 2.4; stage 3 OR 8.6, 95% CI 7.1, 10.6) were associated with higher likelihood of coding in the hospital record. AKI episodes during birth admissions were less likely to be coded (OR 0.4, 95% CI 0.3, 0.5). No correlation was seen between coding and 30-day mortality. Conclusions The proportion of AKI alert-identified episodes coded in the hospital record is low, suggesting under-recognition and underestimation of AKI incidence. Understanding the reasons for inequalities in coding, variation in coding between hospitals and how alerts can enhance clinical recognition is needed.

Over the last few decades the pharmaceutical industry has generated a vast corpus of knowledge on the safety and efficacy of drugs. Much of this information is contained in toxicology reports, which summarise the results of animal studies designed to analyse the effects of the tested compound, including unintended pharmacological and toxic effects, known as treatment-related findings. Despite the potential of this knowledge, the fact that most of this relevant information is only available as unstructured text with variable degrees of digitisation has hampered its systematic access, use and exploitation. Text mining technologies have the ability to automatically extract, analyse and aggregate such information, providing valuable new insights into the drug discovery and development process. In the context of the eTRANSAFE project, we present PretoxTM (Preclinical Toxicology Text Mining), the first system specifically designed to detect, extract, organise and visualise treatment-related findings from toxicology reports. The PretoxTM tool comprises three main components: PretoxTM Corpus, PretoxTM Pipeline and PretoxTM Web App. The PretoxTM Corpus is a gold standard corpus of preclinical treatment-related findings annotated by toxicology experts. This corpus was used to develop, train and validate the PretoxTM Pipeline, which extracts treatment-related findings from preclinical study reports. The extracted information is then presented for expert visualisation and validation in the PretoxTM Web App. Scientific Contribution While text mining solutions have been widely used in the clinical domain to identify adverse drug reactions from various sources, no similar systems exist for identifying adverse events in animal models during preclinical testing. PretoxTM fills this gap by efficiently extracting treatment-related findings from preclinical toxicology reports. This provides a valuable resource for toxicology research, enhancing the efficiency of safety evaluations, saving time, and leading to more effective decision-making in the drug development process.

Islamic activities are described and determined through fiqh (jurisprudential) rules and ethical postulates (akhlāq). These features identify the morality of Islam as oriented to equity and as socially embedded, which directly contributes to Islamic normativity. It is such features and peculiarities that distinguish the Islamic religion from others. However, with the emergence of modernity “Islamic” prefix has been used primarily as a marketing tool for differentiating existing conventional products from others on the basis of a purported Islamic association. One example is the Islamic financial industry that has increasingly been surrendering its aspirational forms and value system for commercial gains. In understanding this observed convergence of Islamic business activities towards conventional Eurocentric ones, we assess the result as compromising religious ideals for the sake of economic gains. Another example is Islamic education, which traditionally was delivered through civil society institutions (madrasas, kuttāb, ḥalaqāt (teaching circles) in mosques, organised schools, etc.) that were drivers of disseminating religious norms and values in the community. These educational platforms were regulated by religious authorities (ʿulamāʾ and shuyūkh) who were in charge of the selection of scholars and curriculum. However, the contemporary approach to Islamic education through social media compromises its quality as it has become unregulated and is now driven by individuals who utilise social platforms for influencing and promoting their persoanl agenda through selling cheap stories to the masses. This research, suggests that for religion, in this case Islam, to remain a robust influential factor in shaping the behaviour of individuals and communities, the causes for the commercialisation of religiosity for the sake of material benefits should be explored and highlighted. To provide evidence, data was collected from the existing literature to identify the causes and effects of commercialisation of religion in the everyday life of Muslims in Western communities. This was then used to generate a critical discourse on these trends in relation to the initial moral claims of the Islamic religion which have been compromised. The study refers to systemic theory in locating its arguments; and employs critical discourse analysis as its operational method.

In February 2023, we convened the first workshop dedicated to queer bibliography. The scholarship showcased during the symposium and emerging from it was and is significant, but perhaps at least of equal importance has been the development of a vibrant, supportive intellectual and practice-based community that has coalesced around this area. Such was the importance of this experience and meeting place that by consensus what was intended as a one-off workshop has inaugurated an annual, international movable conference. In this article, we reflect on how the workshop and its arrangement responds and relates to queer and feminist critiques of higher education. Starting from marginal and precarious positions, we consider how we worked to build a safe space for discussion and to foster a community of care. We reflect on how together, as well as producing scholarship, we endeavored to practice radical openness and create the conditions for queer thriving.

Background The recycling or decomposition of plastic waste poses challenges due to its non‐organic nature. As a consequence of the unregulated production of plastic goods, a substantial quantity of plastic garbage has been generated. There is an increasing demand for sustainable substitutes for synthetic petrochemical‐derived plastic products. The utilization of cake molds made from plastic materials has become increasingly prevalent and they have become widely employed household items. Bio‐based bowls have the potential to serve as viable alternatives to their plastic counterparts. This study involved the fabrication of a bio‐based healthy edible bowl mold using natural ingredients, including multigrain flour, refined flour (maida), jaggery, flaxseed, and fenugreek essential oil. A nutrient‐rich edible bowl was developed by using different weight percentages (ranging from 0% to 10%) of wheat bran (WB). Result The addition of WB to the nutritious bowl resulted in the lowest levels of water absorption and oil absorption compared with the control group. The enhanced nutritional bowl demonstrated notable antioxidant activity. The inclusion of wheat bran resulted in a further enhancement of antioxidant action, with an approximate increase of 28% observed. The protein value of the nutritious bowl came to be 13.17 g/0.1 kg of protein. It was also revealed from an early soil degradation test that the bowl that was created exhibited biodegradability. Conclusion The findings of this study offer a potentially viable method for developing a more sustainable substitute for cake molds/bowls made from plastic materials. © 2024 Society of Chemical Industry.

This study examines the impact of incorporating nano-hBN nanofiller and varying the stacking sequences of natural fibers with steel wire mesh on the load-bearing and tribological properties of hybrid composites. The Sisal/Jute/Banana/Mesh/Sisal/Jute/Banana (NC4) combination demonstrated relatively high tensile strength (67 MPa), modulus (0.72 GPa), flexural strength (80 MPa), and impact strength (63 KJ/m³). Among all configurations, the NC4 composite exhibited the lowest surface energy and water absorption, underscoring the influence of fiber type and stacking sequence on these properties. The addition of hexagonal boron nitride (hBN) nanoparticles to the NC4 composite resulted in a maximum enhancement of tensile and flexural strength by 27% and 20%, respectively. Tribological characterization revealed that increasing the normal load significantly elevated volumetric wear in NC4 composites, while hBN-reinforced composites demonstrated superior wear resistance. The incorporation of hBN nanoparticles, particularly at 3 wt%, reduced volumetric wear by up to 47% compared to NC4 composites. Similarly, hBN nanoparticles effectively decreased the coefficient of friction (COF) by up to 30%. SEM analysis indicated that hBN nanoparticles mitigated fiber pull-out, matrix fractures, and adhesive wear, thereby enhancing the overall wear resistance of the composites. In conclusion, the addition of hBN nanoparticles improves the mechanical and tribological characteristics of these hybrid composites.

Aims To assess the cost‐effectiveness of the Cessation of Smoking Trial in Emergency Department (COSTED) intervention compared with signposting to local stop smoking service (SSS) from the National Health Service (NHS) and personal social services (PSS) perspective. Design, setting and participants This was a two‐group, multi‐centre, pragmatic, individually randomized controlled trial set in six Emergency Departments (EDs) in urban and rural areas in the United Kingdom. Adult (≥ 18 years) daily smokers (at least one cigarette or equivalent per day) but not daily e‐cigarette users, with carbon monoxide reading ≥ 8 parts per million, attending the ED ( n = 972) were included. The intervention consisted of provision of an e‐cigarette starter kit plus brief smoking cessation advice and referral to a local SSS. Control was an information card on how to access local SSS. Measurements Intervention costs included costs of training and delivery. Control costs included costs of printing information cards. Costs of smoking cessation and health‐care services were estimated based on quantities reported by participants and unit costs extracted from secondary sources. The effects were measured by quality‐adjusted life years (QALYs) derived from EQ‐5D‐5L. Other outcomes were smoking cessation measures. The primary outcome was incremental cost‐effectiveness ratio (ICER), which was calculated by dividing the difference in costs by the difference in QALYs between groups. Findings The mean intervention costs were £48 [standard error (SE) = £0] per participant and the mean control costs were £0.2 (SE = £0) per participant. Using regression estimates, total costs were £31 [95% confidence interval (CI) = –£341 to £283] higher and 6‐month QALYs were 0.004 (95% CI = –0.004 to 0.014) higher in the intervention group than in the control group. The ICER was calculated at £7750 (probability of cost‐effective at range £20 000–30 000: 72.2–76.5%). Conclusions The UK Cessation of Smoking Trial in Emergency Department (COSTED) intervention (provision of an e‐cigarette starter kit plus brief smoking cessation advice) was cost‐effective compared with signposting to local stop smoking services under the current recommendations of the maximum acceptable thresholds.

Dietary fibre improves glycaemic control in type 2 diabetes, but its therapeutic role in women with diabetes in pregnancy is unclear. We assessed the effect of dietary fibre on markers of glycaemic control in women with diabetes in pregnancy. Methods We searched four databases (Cochrane Library, MEDLINE, Embase and Web of Science) to identify RCTs exploring the effect of dietary fibre, high‐fibre diets or fibre supplementation on fasting blood glucose (FBG), 2‐h postprandial blood glucose (PBG) and requirement for insulin therapy, among other glycaemic makers in pregnant women with diabetes. Data were pooled for each outcome to calculate change from baseline mean (SD) and overall mean difference (MD) between control and intervention groups. Results Of 1462 identified studies, data from 20 eligible trials containing 1061 participants were pooled. On meta‐analysis, a higher fibre intake was associated with reduced FBG (MD: −0.35 mmol/L, 95% CI: −0.53, −0.18, p < 0.01), PBG (MD: −0.90 mmol/L, 95% CI: −1.39, −0.40, p < 0.01) and requirement for insulin (OR: 0.24, 95% CI: 0.13, 0.46, p < 0.01). There was significant heterogeneity for FBG and PBG (>90%), attributable to differences in Intervention type for PBG (Dietary Approach to Stop Hypertension [DASH] diet, low glycaemic index, supplement; p < 0.01) and study duration (for FBG: p = 0.002; not for PBG). Studies were mostly scored as high risk of bias due to lack of blinding (Cochrane Risk of Bias Tool v.2.0). Conclusion High‐quality dietary intervention studies in pregnancy are lacking. Our results suggest that high‐fibre diets improve fasting and postprandial glycaemia and reduce the likelihood of requiring insulin in women with diabetes in pregnancy.

The marginalisation of children globally is frequently justified by appeal to medical, developmental science. While childhood has increasingly become recognised as a social construct, this research has focused largely on education and legal structures, leaving this medicalisation unexamined. This essay closes that gap by examining the medicalisation of childhood and the contribution of the medical system to adult power. These are approached in separate sections. The first portion of this essay addresses the theoretical and rhetorical manner in which children are medicalised, using Piaget's theories as examples of a trend to over‐state the universality of childhood deficiencies and assume adult competences. Latour's work on the scientific black‐box is combined with Halliday's assessment of scientific language to examine how these theories are transformed from specific psychological findings, into assumed objective truths, carrying disenfranchising assumptions about children into public discourse. The essay's second part examines the practical role of the medical system in mobilising adultist discourses and disempowering children, through the operation of scientific management. This is built up from discussions of childbirth and adolescence to wider issues of medical power as it permeates educational, legislative and media spaces through Samuel's concept of biocertification. Finally, these two parts meet in highlighting the role of medicalisation in maintaining the hegemony of adult power through its veil of objectivity and expansive reach. I contend anthropological works referenced throughout the essay show that medicalised narratives of childhood are insufficient but culturally contingent and thus open to revision.

Introduction People with HIV (PWH) are at an increased risk of developing cardiovascular disease (CVD) compared to HIV‐negative individuals. We sought to evaluate the adherence to medications for CVD in PWH and identify factors associated with non‐adherence to these medications. Methods We conducted a cross‐sectional study at the University Hospitals of Leicester NHS Trust between 16 April 2019 and 8 November 2022. We recruited consecutive PWH, who were attending a routine follow‐up outpatient appointment and were prescribed at least one medication for CVD. In addition, we included urinary adherence results of patients with samples collected as part of routine clinical care. We used liquid chromatography–tandem mass spectrometry (LC–MS/MS) to assess if their prescribed medications (antihypertensives, diuretics, beta‐blockers, lipid‐lowering agents, antiplatelets, anticoagulants, antidiabetic medications) were present in the participant's urine sample. Multivariable models were used to identify demographic or clinical features that were associated with non‐adherence. Results A total of 162 PWH were included in the analysis. Median age was 55 [interquartile range (IQR): 50–61] years, 63% were male, average time living with HIV was 15 years (IQR: 11–19) and the majority (98%) had an undetectable HIV viral load. In approximately one‐third of patients (59/162), at least one prescribed medication of interest was not detected in urine. Non‐adherence to lipid‐lowering agents was common (35/88, 40%). On multivariable logistic regression, the number of prescribed cardiovascular medications, was associated with medication non‐adherence [medication non‐adherence, per one medication increase: adjusted odds ratio (95% confidence interval) = 1.78 (1.34–2.36); p < 0.001]. Conclusion We found sub‐optimal adherence to medications for CVD in PWH. In order to maximize the clinical benefit of statin therapy in PWH, factors requiring consideration include: improved medication adherence, awareness of polypharmacy, educational interventions and quantitative assessment of sub‐optimal adherence through chemical adherence testing.

Objectives Shared Decision Making (SDM) has potential to support Pulmonary Rehabilitation (PR) decision-making when patients are offered a menu of centre- and home-based options. This study sought to evaluate the feasibility and acceptability of a three-component PR SDM intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD) and PR healthcare professionals. Methods Participants were recruited from Dec 2021–Sep 2022. Healthcare professionals attended decision coaching training and used the consultation prompt during consultations. Individuals received the Patient Decision Aid (PtDA) at PR referral. Outcomes included recruitment capability, data completeness, intervention fidelity, and acceptability. Questionnaires assessed patient activation and decisional conflict pre and post-PR. Consultations were assessed using Observer OPTION-5. Optional interviews/focus groups were conducted. Results 13% of individuals [n = 31, 32% female, mean (SD) age 71.19 (7.50), median (IQR) MRC dyspnoea 3.50 (1.75)] and 100 % of healthcare professionals (n = 9, 78% female) were recruited. 28 (90.32%) of individuals completed all questionnaires. SDM was present in all consultations [standardised scores were mean (SD) = 36.97 (21.40)]. Six healthcare professionals and five individuals were interviewed. All felt consultations using the PtDA minimised healthcare professionals’ bias of centre-based PR, increased individuals’ self-awareness of their health, prompted consideration of how to improve it, and increased involvement in decision-making. Discussion Results indicate the study processes and SDM intervention is feasible and acceptable and can be delivered with fidelity when integrated into the PR pathway.

With the growing awareness of environmental issues, natural fiber composites have emerged as a viable substitute for conventional polymer composites. The usage of natural fiber reinforced with nano fillers composites has increased significantly in recent years, especially in the building, automotive, and aerospace industries. This research explores the effect of nano‐silica in tribological, thermal behavior, water diffusion properties and biodegradation of flax fabric/phenol‐formaldehyde hybrid composites. We have fabricated the hybrid composites utilizing compression molding technique. The results showed that after reaching the lowest value for 4 nanosilica (NS), the volumetric wear rose when the addition of nano‐silica was increased. However, the volumetric wear decreased as the weight percentage of nano‐silica improved. At lower sliding speeds (1 m/s), the VW value is between 0.06782 and 0.05455 cm ³ , but at higher sliding speeds (3 m/s), it is roughly 0.09253–0.06187 cm ³ . The thermal stability was improved for 1 NS, 2 NS, and 3 NS is 1.20%, 1.64%, and 0.71%, respectively. At three different temperatures (30, 60, and 90°C) the impact of nano‐silica on the water diffusion behavior of PF‐flax fabric hybrid composites was examined. 2 NS showed the least amount of water sorption. it was noted that the three coefficients—Diffusion, Sorption, and Permeation‐were all declining when compared to PF‐flax fabric composites devoid of nano‐silica following computing the Arrhenius values, the free energy change was always negative, indicating the spontaneity of sorption in non‐reinforced samples. The tensile strength of every composite in this investigation was marginally changed by the water aging process.

The phase transformation and microstructural evolution of Sn–Ag solder alloys under heat treatment, with a focus on the Ag3Sn phase, were investigated to address the need for reliable lead-free solder alternatives in electronic packaging. Initially, the solder alloy exhibited a fine eutectic structure with well-dispersed Ag3Sn particles and a polycrystalline grain structure devoid of any strong crystallographic texture. Following heat treatment, significant microstructural changes were observed, including the coarsening of the Ag3Sn phase and the development of a preferred grain orientation, suggesting recrystallization and grain growth. XRD analysis revealed a decrease in the intensity of the Sn phase peaks and an increase in the coarseness of the Ag3Sn peaks post-heat treatment, indicating phase evolution and redistribution of silver within the alloy. The EBSD results supported the SEM findings, showing elongation and growth of grains and a shift in texture. These changes imply that heat treatment can significantly alter the mechanical properties of Sn–Ag solders, particularly affecting creep resistance and hardness due to the evolution of anisotropic mechanical properties. The study provides essential insights into the selection and optimization of solder materials for high-reliability applications in the electronics industry.