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ChesterRep is the University of Chester's institutional repository and an online platform designed to collate, store, and aid discoverability of research carried out at the university to the wider research community

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  • Jesus in an age of enlightenment: Radical gospels from Thomas Hobbes to Thomas Jefferson. By Jonathan C.P Birch

    Greenaway, Jonathan; University of Chester
    A review of Jesus in an Age of Enlightenment: Radical Gospels from Thomas Hobbes to Thomas Jefferson by Jonathan C.P Birch
  • Art and Solidarity

    Adams, Jeff; University of Chester
    In many countries state support for the arts is declining, for both the arts in general and for the arts in education specifically. The creative and critical thinking that often accompanies the arts is a significant asset for schools in these turbulent times. The increased social awareness and co-operation that arises from the creative juxtaposition of people from different cultures brought together under the auspices of the arts, and who are prepared to overcome traditional differences through a common endeavour, is a form of creative solidarity.
  • Terahertz reading of ferroelectric domain wall dielectric switching

    Zhang, Man; Chen, Zhe; Yue, Yajun; Chen, Tao; Yan, Zhongna; Jiang, Qinghui; Yang, Bin; Eriksson, Mirva; Tang, Jianhua; Zhang, Dou; et al.
    Ferroelectric domain walls (DWs) are important nano scale interfaces between two domains. It is widely accepted that ferroelectric domain walls work idly at terahertz (THz) frequencies, consequently discouraging efforts to engineer the domain walls to create new applications that utilise THz radiation. However, the present work clearly demonstrates the activity of domain walls at THz frequencies in a lead free Aurivillius phase ferroelectric ceramic, Ca0.99Rb0.005Ce0.005Bi2Nb2O9, examined using THz time domain spectroscopy (THz-TDS). The dynamics of domain walls are different at kHz and THz frequencies. At low frequencies, domain walls work as a group to increase dielectric permittivity. At THz frequencies, the defective nature of domain walls serves to lower the overall dielectric permittivity. This is evidenced by higher dielectric permittivity in the THz band after poling, reflecting decreased domain wall density. An elastic vibrational model has also been used to verify that a single frustrated dipole in a domain wall represents a weaker contribution to the permittivity than its counterpart within a domain. The work represents a fundamental breakthrough in understanding dielectric contributions of domain walls at THz frequencies. It also demonstrates that THz probing can be used to read domain wall dielectric switching.
  • Jesus in an Age of Enlightenment: Radical Gospels from Thomas Hobbes to Thomas Jefferson. By Jonathan C.P Birch

    Greenaway, Jonathan; orcid: 0000-0001-5636-7707 (Oxford University Press (OUP), 2021-02-07)
  • Clinical, humanistic, and economic burden of severe hemophilia B in the United States: Results from the CHESS US and CHESS US+ population surveys.

    Burke, Tom; Asghar, Sohaib; orcid: 0000-0001-8276-0131; O'Hara, Jamie; Sawyer, Eileen K; Li, Nanxin; email: n.li@uniqure.com (2021-03-20)
    Hemophilia B is a rare congenital bleeding disorder that has a significant negative impact on patients' functionality and health-related quality of life. The standard of care for severe hemophilia B in the United States is prophylactic factor IX replacement therapy, which incurs substantial costs for this lifelong condition. Accurate estimates of the burden of hemophilia B are important for population health management and policy decisions, but have only recently accounted for current management strategies. The 'Cost of Severe Hemophilia across the US: a Socioeconomic Survey' (CHESS US) is a cross-sectional database of medical record abstractions and physician-reported information, completed by hematologists and care providers. CHESS US+ is a complementary database of completed questionnaires from patients with hemophilia. Together, CHESS US and CHESS US+ provide contemporary, comprehensive information on the burden of severe hemophilia from the provider and patient perspectives. We used the CHESS US and CHESS US+ data to analyze the clinical, humanistic, and economic burden of hemophilia B for patients treated with factor IX prophylaxis between 2017 and 2019 in the US. We conducted analysis to assess clinical burden and direct medical costs from 44 patient records in CHESS US, and of direct non-medical costs, indirect costs, and humanistic burden (using the EQ-5D-5L) from 57 patients in CHESS US+. The mean annual bleed rate was 1.73 (standard deviation, 1.39); approximately 9% of patients experienced a bleed-related hospitalization during the 12-month study period. Nearly all patients (85%) reported chronic pain, and the mean EQ-5D-5L utility value was 0.76 (0.24). The mean annual direct medical cost was $614,886, driven by factor IX treatment (mean annual cost, $611,971). Subgroup analyses showed mean annual costs of $397,491 and $788,491 for standard and extended half-life factor IX treatment, respectively. The mean annual non-medical direct costs and indirect costs of hemophilia B were $2,371 and $6,931. This analysis of patient records and patient-reported outcomes from CHESS US and CHESS US+ provides updated information on the considerable clinical, humanistic, and economic burden of hemophilia B in the US. Substantial unmet needs remain to improve patient care with sustainable population health strategies.

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