University of Central Lancashire

With the rapid economic growth, China is eager to get sufficient energy supply including oil and gas to support its dynamic national development. However, offshore oil and gas exploration and exploitation inevitably bring environmental risks and potential damages to the ocean. Even without any significant environmental impact during the whole process of petroleum operations, the restoration of the marine environment to the status quo ante after such activities poses a serious challenge to the Chinese government and oil companies operating in China seas. This chapter attempts to assess and analyze China’s relevant laws and regulations governing marine environmental protection against pollution from offshore petroleum activities and their actual effectiveness of implementation. In particular, the paper will deal with in detail how China adopts and implements the relevant regulations and measures on decommissioning of no longer used oil rigs, removal of abandoned offshore oil platforms, and post-abandonment surveys and monitoring to restore and maintain the surrounding marine environment at a healthy level. By examining these laws and regulations, it can be seen whether China’s offshore activities are in line with the requirement of sustainability as well as international standards and under the sound environmental management.

Introduction The evolving landscape of inflammatory bowel disease (IBD) necessitates refining colonoscopic surveillance guidelines. This study outlines methodology adopted by the British Society of Gastroenterology (BSG) Guideline Development Group (GDG) for updating IBD colorectal surveillance guidelines. Methods and analysis The ‘Grading of Recommendations, Assessment, Development and Evaluation’ (GRADE) approach, as outlined in the GRADE handbook, was employed. Thematic questions were formulated using either the ‘patient, intervention, comparison and outcome’ format or the ‘current state of knowledge, area of interest, potential impact and suggestions from experts in the field’ format. The evidence review process included systematic reviews assessed using appropriate appraisal tools. An extensive list of potential outcomes was compiled from literature and expert consultations and then ranked by GDG members. The top outcomes were identified for evidence synthesis in three key areas: utility of surveillance in IBD, quality of bowel preparation and use of advanced imaging techniques in colonoscopy for IBD. Risk thresholding exercises determined specific risk levels for different surveillance strategies and intervals. This approach enabled the GDG to establish precise thresholds for interventions based on relative and absolute risk assessments, directly informing the stratification of surveillance recommendations. Significance of effect sizes (small, moderate, large) will guide the final GRADE assessment of the evidence. Ethics and dissemination Ethics approval is not applicable. By integrating clinical expertise, patient experiences and innovative methodologies like risk thresholding, we aim to deliver actionable recommendations for IBD colorectal surveillance. This protocol, complementing the main guidelines, offers GDGs, clinical trialists and practitioners a framework to inform future research and enhance patient care and outcomes.

Background Return-to-work is a major goal achieved by fewer than 50% stroke survivors. Evidence on how to support return-to-work is lacking. Aims To evaluate the clinical effectiveness of Early Stroke Specialist Vocational Rehabilitation (ESSVR) plus usual care (UC) (i.e. usual NHS rehabilitation) versus UC alone for helping people return-to-work after stroke. Methods This pragmatic, multicentre, individually randomised controlled trial with embedded economic and process evaluations, compared ESSVR with UC in 21 NHS stroke services across England and Wales. Eligible participants were aged ≥18 years, in work at stroke onset, hospitalised with new stroke and within 12-weeks of stroke. People not intending to return-to-work were excluded. Participants were randomised (5:4) to individually-tailored ESSVR delivered by stroke-specialist occupational-therapists for up to 12-months or usual National Health Service rehabilitation. Primary outcome was self-reported return-to-work for ≥2 hours per week at 12-months. Primary and safety analyses were done in the intention-to-treat population. Results Between 1st June-2018, and 7th March-2022, 583 participants (mean age 54.1 years [SD 11.0], 69% male) were randomised to ESSVR (n=324) or UC (n=259). Primary outcome data were available for 454(77.9%) participants. Intention-to-treat analysis showed no evidence of a difference in the proportion of participants returned-to-work at 12-months (165/257[64.2%] ESSVR vs 117/197[59.4%] UC; adjusted odds ratio 1.12 [95%CI 0.8 to 1.87],p=0.3582). There was some indication that older participants and those with more post-stroke impairment were more likely to benefit from ESSVR (interaction p=0.0239 and p=0.0959 respectively). Conclusions To our knowledge, this is the largest trial of a stroke VR intervention ever conducted. We found no evidence that ESSVR conferred any benefits over UC in improving return-to-work rates 12-months post-stroke. Return-to-work (for at least 2 hours per week) rates were higher than in previous studies (64.2% ESSVR versus 59.4% UC) at 12-months and more than double that observed in our feasibility trial (26%). Interpretation of findings was limited by a predominantly mild-moderate sample of participants and the Covid-19 pandemic. The pandemic impacted the trial, ESSVR and UC delivery, altering the work environment and employer behaviour. These changes influenced our primary outcome and the meaning of work in people’s lives; all pivotal to the context of ESSVR delivery and its mechanisms of action. Data access Data available on reasonable request. Registration ISRCTN12464275.

Taylor Dispersion Analysis (TDA) is explored to measure the hydrodynamic sizes of full and half generation PAMAM dendrimers up to generation 4.5 in various buffer solutions. A method was used...

Objective In screening for small‐for‐gestational age ( SGA ) using third‐trimester antenatal ultrasound, there are concerns about the low detection rates and potential for harm caused by both false‐negative and false‐positive screening results. Using a selective third‐trimester ultrasound screening program, this study aimed to investigate the incidence of adverse perinatal outcomes among cases with (i) false‐negative compared with true‐positive SGA diagnosis and (ii) false‐positive compared with true‐negative SGA diagnosis. Methods This prospective cohort study was nested within the UK ‐based DESiGN trial, a prospective multicenter cohort study of singleton pregnancies without antenatally detected fetal anomalies, born at > 24 + 0 to < 43 + 0 weeks' gestation. We included women recruited to the baseline period, or control arm, of the trial who were not exposed to the Growth Assessment Protocol ( GAP ) intervention and whose birth outcomes were known. Stillbirth and major neonatal morbidity were the two primary outcomes. Minor neonatal morbidity was considered a secondary outcome. Suspected SGA was defined as an estimated fetal weight ( EFW ) < 10 th percentile, based on the Hadlock formula and fetal growth charts. Similarly, SGA at birth was defined as birth weight ( BW ) < 10 th percentile, based on UK population references. Maternal and pregnancy characteristics and perinatal outcomes were reported according to whether SGA was suspected antenatally or not. Unadjusted and adjusted logistic regression models were used to quantify the differences in adverse perinatal outcomes between the screening results (false negative vs true positive and false positive vs true negative). Results In total, 165 321 pregnancies were included in the analysis. Fetuses with a false‐negative SGA screening result, compared to those with a true‐positive result, were at a significantly higher risk of stillbirth (adjusted OR ( aOR ), 1.18 (95% CI , 1.07–1.31)), but at lower risk of major ( aOR , 0.87 (95% CI , 0.83–0.91)) and minor ( aOR , 0.56, (95% CI , 0.54–0.59)) neonatal morbidity. Compared with a true‐negative screening result, a false‐positive result was associated with a lower BW percentile (median, 18.1 (interquartile range ( IQR ), 13.3–26.9)) vs 49.9 ( IQR , 30.3–71.7)). A false‐positive result was also associated with a significantly increased risk of stillbirth ( aOR , 2.24 (95% CI , 1.88–2.68)) and minor neonatal morbidity ( aOR , 1.60 (95% CI , 1.51–1.71)), but not major neonatal morbidity ( aOR , 1.04 (95% CI , 0.98–1.09)). Conclusions In selective third‐trimester ultrasound screening for SGA , both false‐negative and false‐positive results were associated with a significantly higher risk of stillbirth, when compared with true‐positive and true‐negative results, respectively. Improved SGA detection is needed to address false‐negative results. It should be acknowledged that cases with a false‐positive SGA screening result also constitute a high‐risk population of small fetuses that warrant surveillance and timely birth. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

The present study examines the interaction between bovine serum albumin (BSA) and dinotefuran utilizing spectroscopic, electrochemical, and computational approaches. The examination of fluorescence spectroscopy demonstrates the formation of a stable complex (protein‐ligand) between dinotefuran and BSA, with a binding coefficient of 3.8 × 10⁸ M⁻¹ and a stoichiometry of 2:1 (dinotefuran to BSA). The presence of static quenching phenomena indicates the creation of a non‐covalent compound. UV spectroscopy and circular dichroism spectroscopy confirm the development of the dinotefuran‐BSA complex. Molecular docking simulations reveal the interaction between dinotefuran and specific amino acid residues of BSA with a binding energy (B.E.) of −5.4 kcal mol⁻¹. The stability of the dinotefuran‐BSA complex is confirmed using molecular dynamics simulations, as evidenced by extracted trajectories. Electrochemical investigations reveal a slow and continuous interaction between dinotefuran and BSA, as indicated by the steady reduction in the intensity of the dinotefuran peak over time. This thorough examination offers unique insights into the molecular interactions between dinotefuran and BSA, providing new perspectives on their binding mechanisms and implications in biological systems.

Background Thoracic spine postural dysfunctions are common postpartum-related health problems, compromising breastfeeding efficacy and quality of life among women. Previous studies have particularly associated these conditions with increased breast sizes in several populations. However, such empirical evidence is scarce in the Nigerian population. Objectives To investigate the relationship among breast size, thoracic-kyphosis, and -spine pain among postpartum Nigerian women. Methods This correlational survey involved 400 consenting postpartum mothers (between 0 and 24 months of postpartum period). Their breast size, thoracic spine posture, and pain were measured using a measuring tape (cm), inclinometer, and Revised Oswestry thoracic spine pain disability questionnaire, respectively. Data were analyzed using descriptive and relevant inferential statistics at p < 0.05. Results The majority of the participants fall under the category of breast cup size B (61.75%), have no history of thoracic spine pain (87.4%), and about half of them (50.2%) have normal thoracic spine posture (low category with values ranging between 20⁰ and 35⁰. Breast size was significantly (r = 0.162, p = 0.001) correlated with thoracic spine posture but showed no significant correlation (r = 0.066, p = 0.622) with thoracic spine pain. Conclusion Increasing breast size is weakly associated with a tendency towards a kyphotic posture of the thoracic spine. Postural education and care around adequate support of the breast with suitable fitting brassieres may help prevent kyphotic deformities. Future research with a randomized control trial and long-term follow-up is recommended to further confirm the causal relationship of these variables.

This comprehensive review addresses the global health challenge of disparities in pancreas transplant access, particularly in low-and middle-income countries (LMICs) compared to high-income countries. Despite advancements in surgical techniques and immunosuppression for procedures like simultaneous pancreas-kidney, pancreas-after-kidney, and pancreas-transplant alone, LMICs face significant challenges, including limited infrastructure, financial constraints, and a shortage of skilled medical professionals. Donation after brain death remains constrained by sociocultural barriers. Region-specific analyses highlight progress in Latin America, Asia, Russia, and South Africa, showcasing the regional disparities in access and outcomes. Future prospects involve minimally invasive surgeries, telemedicine for enhanced post-operative care, international collaborations with organizations like the European Union of Medical Specialists, and robust funding networks to improve organ availability. In conclusion, the review underscores the importance of multifaceted strategies to address economic, sociocultural, and infrastructural barriers, aiming to improve accessibility, quality, and effectiveness of pancreas transplantation services in LMICs.

Background Poverty can have significant impacts on health and wellbeing. However, asking patients about their broader socio-economic circumstances is not routine within primary care consultations. Aim To understand healthcare professionals’ experiences of communicating with patients about their socio-economic circumstances and how a bespoke training programme supported these conversations in routine consultations. Design & setting Healthcare professionals from 30 GP practices across England received training to improve understanding and communication with patients about the ways that poverty impacted their mental health. Method Semi-structured interviews were undertaken with 49 GPs and allied health professionals to understand barriers and enablers to communication around poverty and the impact of the training on their consultation practice. Results Health professionals often lacked confidence in discussing socio-economic issues and welcomed information on how to do this sensitively. Asking questions relating to poverty-related stresses was felt to lead to better understanding around the causes of mental distress, avoidance of problematic assumptions and inappropriate antidepressant prescribing and to enable more coordinated and appropriate support from practice teams. Conclusion Asking patients about their socio-economic circumstances can facilitate provision of appropriate support.

A growth monitoring study (0–7 day of age) was conducted involving 87, one-day old Ross 308 male broilers to evaluate organ weights, bone parameters and ileal transcriptomic profile of broiler chicks as influenced by day 7 bodyweight (BW) grouping. The chicks were raised in a deep-litter house under common controlled environmental conditions and commercial starter diet. Chicks were grouped on day 7 into two distinct BW, super performer (SP) and under performer (UP) with bodyweights >260, and <200 g respectively. Results revealed that the SP chicks had significantly higher bone ash, sodium (Na), phosphorus (P) and rubidium (Rb) concentrations compared to the UP chicks on D7. In contrast, the UP chicks had significantly higher tibial cadmium (Cd), caesium (Cs) and lead (Pb) compared to the SP group; the UP chicks also had proportionally heavier relative gizzard weight than the SP chicks. The ileal transcriptomic data revealed differentially expressed genes (DEG) between the two groups of chicks, with 150 upregulated and 83 down-regulated genes with a fold change of ≥1.25 or ≤ 1.25 in the SP chicks relative to the UP chicks. Furthermore, functional annotation and pathway analysis revealed that some of these DEG were involved in various pathways including calcium signalling, Wnt signalling, cytokine-cytokine receptor interaction and mucin type O-glycan biosynthesis. This study revealed that chicks of the same breed and of uniform environmental and diet management exhibited differences in digestive organ weights, tibial bone characteristics and ileal gene expression that may be related to BW.

University-enterprise collaboration (UEC) is an essential aspect of research and innovation involving cooperation between universities and industry or other organizations. UEC can lead to economic growth, job creation, and enhanced research outcomes. However, the complexity and diversity of UECs present challenges in developing a practical framework that can guide the development and implementation of such collaborations. The aim of this paper is to develop a UEC framework from the key concepts identified in the literature, which can be adapted to various disciplines/contexts. This research paper is part of an ERASMUS+ project, which aims to strengthen enterprise collaboration for resilient communities in Asia (SECRA). The current paper presents the findings of thematic analysis of existing UEC literature and the resultant conceptual framework. Thematic analysis of eligible literature (N = 84) unveiled four themes and thirty-two sub-themes important to UEC. The proposed UEC framework highlights the importance of several structural, cultural, relational, and material themes and their underpinning concepts for developing successful UECs. The findings can inform future research on UECs, guide UEC practice, and provide the foundations for developing successful UECs. However, further research is needed to test the feasibility and validity of the framework in real-world UEC collaborations and to explore the interactions between different themes, sub-themes, and underlying concepts.

Women who are giving birth need to be met with compassion and understanding from healthcare professionals. However, there are growing concerns about the perceived lack of compassion in the delivery of healthcare services in general and maternity care in particular. We conducted 15 qualitative interviews with women who had given birth in Norway within the previous year, asking them to describe their experiences of compassionate care. We aimed to explore what healthcare professionals “do” that is experienced as compassionate. The analysis was informed by Paul Gilbert’s theory of compassion and a concept analysis of compassionate midwifery undertaken by Ménage and colleagues. The compassionate caring actions of healthcare professionals that were identified in the women’s narratives generated five themes: attuning actions, validating actions, contextualizing actions, empowering actions, and small acts of kindness. The findings build on the prior theoretical concepts used for the study and provide a nuanced account of how women perceive compassionate care from healthcare professionals. They could contribute to understanding more of the meaning and nature of compassionate care during childbirth. The analysis indicates the importance of ensuring that compassionate care is at the very core of maternity care services.

Background Health care staff should be given the opportunity to participate in research, but recruiting clinicians via their employing organisation is not always straightforward or quick in the UK. Unlike many countries outside the UK, very low-risk survey, interview or focus group studies can be subject to some of the same governance approval procedures as interventional studies. An exemplar study carried out by the NIHR funded Palliative Care Research Partnership North West Coast is used to highlight the challenges still faced by researchers and health care organisations when setting up a low-risk staff study across multiple NHS and non-NHS sites. Methods A study database was created and information was collected on the first point of contact with the clinical site, Health Research Authority (HRA) and local organisational approval times, time from trust or hospice agreement to the first survey participant recruited and overall site survey recruitment numbers. Descriptive statistics (median, range) were used to analyse these data. Results Across participating NHS trusts, it took a median of 147.5 days (range 99–195) from initial contact with the local collaborator to recruitment of the first survey participant and hospice sites mirrored these lengthy timescales (median 142 days, range 110–202). The lengthiest delays in the HRA approval process were the period between asking NHS trusts to assess whether they had capacity and capability to support the research and them granting local agreement. Local approval times varied between trusts and settings which may indicate organisations are applying national complex guidance differently. Conclusions There is the potential for HRA processes to use more NHS resources than the research study itself when recruiting to a low-risk staff study across multiple organisations. There is a need to reduce unnecessary administrative burden and bureaucracy to give clinicians and research staff more opportunities to participate in research, and to free up NHS R&D departments, research nurses and clinicians to focus on more demanding and patient focused research studies. Hospices need standardised guidance on how to assess the risk of being involved in low-risk research without adopting the unnecessarily complex systems that are currently used within the NHS.

Objectives Several studies demonstrated the benefits of omega-3 fatty acids supplementation in chronic kidney disease (CKD) patients. The objective of this study was to investigate the effect of omega-3 fatty acids supplementation in body composition, specifically on the lean body mass and fat mass in hemodialysis patients. Methods In this randomized, double-blind, placebo-controlled clinical trial, a total of 120 end-stage renal disease (ESRD) patients were randomly allocated into two groups. The intervention group has taken three grams of omega-3 fatty acids daily while the placebo group received three grams of medium chain triglycerides (MCT) as a placebo for a total of 2 months. The changes in the body mass index (BMI) and body composition (fat mass, muscle, and visceral fat) were assessed at baseline and following the intervention. Results No significant difference was found in the mean of BMI, FAT, muscle, and visceral fat in the intervention group compared to the control group after the intervention. After two months of omega-3 fatty acid supplementation, the study found no statistically significant impact of omega-3 fatty acids supplementation on various indices of body composition. The effect of ω-3 supplementation in reducing visceral fat was close to significant (p=0.08). Conclusions This study suggests that there is currently inadequate evidence to support the effect of omega-3 fatty acid supplementation in improving anthropometric measurements in patients with CKD, except a partial effect on visceral fat. Further large-scale and long-term clinical trials are needed to confirm the present results.

Background: Workplace violence has a significant impact on patients, families, and staff safety. Workplace violence can produce traumatic results for those involved; the importance of preventive measures needs to be paramount in health service policy and process. Health care staff are required to document their experiences of violent incidents after every occasion, usually via an incident reporting system, which allows for a free text description of the event. There is a lack of understanding of how health care staff document reports of violence and how they explain the events. Methods: This study aims to determine the circumstances surrounding workplace violent events as documented by health care staff. The four-step Review, Extract, Analyze, and Document (READ) approach to document analysis was used to examine workplace violence incident reports over 12 months (September 2021–September 2022) in a tertiary referral hospital. Findings: Six categories of workplace violence were found: (a) “Escalation Dynamics”—patterns and progression of how violence incidents intensify; (b) “Warning Behaviors”—verbal or non-verbal signals that may foreshadow physical violence if not addressed; (c) “Authoritative Institutional Interventions”—how aggression correlates to protocols involving security personnel or law enforcement; (d) “Care Delivery Methods”—how certain treatment procedures and approaches might inadvertently elicit violence; (e) “Situational Stressors”—external circumstances or changes that act as triggers for violence; and (f) “Unprovoked triggers”—sudden and seemingly unprovoked violent outbursts. Conclusions and application to practice: Workplace violence in health care is a multifaceted interplay of events with the nurse involved in all aspects of the process. These findings can be used by occupational health nurses in education and policy development. The findings can be used to focus education on how violent incidents may escalate and provide more opportunities for de-escalation by health care staff.

This paper presents the first systematic review and meta‐analysis on cross‐linguistic correlations between sign language and spoken/written language competences in bilingual d/Deaf learners. A total of 202 effect sizes were identified based on 70 independent samples that appeared in 52 studies from 1981 to 2023 (N = 3570). The effect sizes involved seven sign language correlates (e.g., fingerspelling, phonological awareness [PA], lexico‐semantic knowledge) and eight spoken/written language correlates (e.g., PA, lexico‐semantic knowledge, word reading, reading comprehension). Estimated mean correlations of 26 cross‐linguistic relationships ranged from r = 0.322 (p < 0.001) for sign language PA and reading comprehension to r = 0.645 (p < 0.001) for fingerspelling and word reading. Among other moderators, age/grade (elementary, secondary, vs. university/adult), signer status (native vs. non‐native), program type (bilingual vs. Total Communication/SimCom), and task type (passage vs. sentence comprehension) either showed significant moderation effects or resulted in differing size (small, medium vs. large) in the correlation coefficients among subgroups of primary studies. The meta‐analytic findings lend support to the legitimate application of linguistic interdependence, common underlying proficiency, cross‐linguistic transfer facilitation, and their associated constructs to the educational development of signing/bimodal bilingual learners. The moderator analysis results, in particular, have shed light on the conditioning of linguistic interdependence and transfer and expanded current understandings about the complexity of the issue and its practical implications in bilingual deaf education.