• Graphene nanocoating provides superb long-lasting corrosion protection to titanium alloy.

      Malhotra, Ritika; email: ritika.m@nus.edu.sg; Han, Yingmei; email: e0005491@u.nus.edu; Nijhuis, Christian A; email: c.a.nijhuis@utwente.nl; Silikas, Nikolaos; email: nikolaos.silikas@manchester.ac.uk; Castro Neto, A H; email: c2dhead@nus.edu.sg; Rosa, Vinicius; email: denvr@nus.edus.sg (2021-08-19)
      The presence of metallic species around failed implants raises concerns about the stability of titanium alloy (Ti-6Al-4V). Graphene nanocoating on titanium alloy (GN) has promising anti-corrosion properties, but its long-term protective potential and structural stability remains unknown. The objective was to determine GN's anti-corrosion potential and stability over time. GN and uncoated titanium alloy (Control) were challenged with a highly acidic fluorinated corrosive medium (pH 2.0) for up to 240 days. The samples were periodically tested using potentiodynamic polarization curves, electrochemical impedance spectroscopy and inductively coupled plasma-atomic emission spectroscopy (elemental release). The integrity of samples was determined using Raman spectroscopy, X-ray photoelectron spectroscopy, atomic force microscopy and scanning electron microscopy. Statistical analyses were performed with one-sample t-test, paired t-test and one-way ANOVA with Tukey post-hoc test with a pre-set significance level of 5%. There was negligible corrosion and elemental loss on GN. After 240 days of corrosion challenge, the corrosion rate and roughness increased by two and twelve times for the Control whereas remained unchanged for GN. The nanocoating presented remarkably high structural integrity and coverage area (>98%) at all time points tested. Graphene nanocoating protects titanium alloy from corrosion and dissolution over a long period while maintaining high structural integrity. This coating has promising potential for persistent protection of titanium and potentially other metallic alloys against corrosion. [Abstract copyright: Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.]
    • Graphene oxide integrated silicon photonics for detection of vapour phase volatile organic compounds

      Leo Tsui, H. C.; Alsalman, Osamah; Mao, Boyang; Alodhayb, Abdullah; Albrithen, Hamad; Knights, Andrew P.; Halsall, Matthew P.; Crowe, Iain F.; email: iain.crowe@manchester.ac.uk (Nature Publishing Group UK, 2020-06-12)
      Abstract: The optical response of a graphene oxide integrated silicon micro-ring resonator (GOMRR) to a range of vapour phase Volatile Organic Compounds (VOCs) is reported. The response of the GOMRR to all but one (hexane) of the VOCs tested is significantly higher than that of the uncoated (control) silicon MRR, for the same vapour flow rate. An iterative Finite Difference Eigenmode (FDE) simulation reveals that the sensitivity of the GO integrated device (in terms of RIU/nm) is enhanced by a factor of ~2, which is coupled with a lower limit of detection. Critically, the simulations reveal that the strength of the optical response is determined by molecular specific changes in the local refractive index probed by the evanescent field of the guided optical mode in the device. Analytical modelling of the experimental data, based on Hill-Langmuir adsorption characteristics, suggests that these changes in the local refractive index are determined by the degree of molecular cooperativity, which is enhanced for molecules with a polarity that is high, relative to their kinetic diameter. We believe this reflects a molecular dependent capillary condensation within the graphene oxide interlayers, which, when combined with highly sensitive optical detection, provides a potential route for discriminating between different vapour phase VOCs.
    • Graphene Oxide Nanosheets Interact and Interfere with SARS‐CoV‐2 Surface Proteins and Cell Receptors to Inhibit Infectivity

      Unal, Mehmet Altay; Bayrakdar, Fatma; Nazir, Hasan; Besbinar, Omur; Gurcan, Cansu; Lozano, Neus; Arellano, Luis M.; Yalcin, Süleyman; Panatli, Oguzhan; Celik, Dogantan; et al. (2021-05-14)
      Abstract: Nanotechnology can offer a number of options against coronavirus disease 2019 (COVID‐19) acting both extracellularly and intracellularly to the host cells. Here, the aim is to explore graphene oxide (GO), the most studied 2D nanomaterial in biomedical applications, as a nanoscale platform for interaction with SARS‐CoV‐2. Molecular docking analyses of GO sheets on interaction with three different structures: SARS‐CoV‐2 viral spike (open state – 6VYB or closed state – 6VXX), ACE2 (1R42), and the ACE2‐bound spike complex (6M0J) are performed. GO shows high affinity for the surface of all three structures (6M0J, 6VYB and 6VXX). When binding affinities and involved bonding types are compared, GO interacts more strongly with the spike or ACE2, compared to 6M0J. Infection experiments using infectious viral particles from four different clades as classified by Global Initiative on Sharing all Influenza Data (GISAID), are performed for validation purposes. Thin, biological‐grade GO nanoscale (few hundred nanometers in lateral dimension) sheets are able to significantly reduce copies for three different viral clades. This data has demonstrated that GO sheets have the capacity to interact with SARS‐CoV‐2 surface components and disrupt infectivity even in the presence of any mutations on the viral spike. GO nanosheets are proposed to be further explored as a nanoscale platform for development of antiviral strategies against COVID‐19.
    • Groundwater Arsenic-Attributable Cardiovascular Disease (CVD) Mortality Risks in India

      Wu, Ruohan; email: ruohan.wu@postgrad.manchester.ac.uk; Xu, Lingqian; email: lingqian.xu@postgrad.manchester.ac.uk; Polya, David A.; orcid: 0000-0002-7484-6696; email: david.polya@manchester.ac.uk (MDPI, 2021-08-17)
      Cardiovascular diseases (CVDs) have been recognized as the most serious non-carcinogenic detrimental health outcome arising from chronic exposure to arsenic. Drinking arsenic contaminated groundwaters is a critical and common exposure pathway for arsenic, notably in India and other countries in the circum-Himalayan region. Notwithstanding this, there has hitherto been a dearth of data on the likely impacts of this exposure on CVD in India. In this study, CVD mortality risks arising from drinking groundwater with high arsenic (>10 μg/L) in India and its constituent states, territories, and districts were quantified using the population-attributable fraction (PAF) approach. Using a novel pseudo-contouring approach, we estimate that between 58 and 64 million people are exposed to arsenic exceeding 10 μg/L in groundwater-derived drinking water in India. On an all-India basis, we estimate that 0.3–0.6% of CVD mortality is attributable to exposure to high arsenic groundwaters, corresponding to annual avoidable premature CVD-related deaths attributable to chronic exposure to groundwater arsenic in India of between around 6500 and 13,000. Based on the reported reduction in life of 12 to 28 years per death due to heart disease, we calculate value of statistical life (VSL) based annual costs to India of arsenic-attributable CVD mortality of between USD 750 million and USD 3400 million.
    • Group eye movement desensitization and reprocessing interventions in adults and children: A systematic review of randomized and nonrandomized trials

      Kaptan, Safa Kemal; orcid: 0000-0002-4709-6543; email: safa.kaptan@manchester.ac.uk; Dursun, Busra Ozen; orcid: 0000-0003-0869-5022; Knowles, Mark; Husain, Nusrat; orcid: 0000-0002-9493-0721; Varese, Filippo; orcid: 0000-0001-7244-598X (2021-01-15)
      Abstract: This review systematically synthesized existing literature on group protocols of eye movement desensitization and reprocessing (EMDR) therapy for treating a range of mental health difficulties in adults and children. We conducted database searches on PsychINFO, EMBASE, MEDLINE, Web of Science, The Cochrane Library and Francine Shapiro Library up to May 2020, using PRISMA guidelines. Studies were included if they used at least one standardized outcome measure, if they present a quantitative data on the effect of group EMDR protocols on mental health difficulties and if they were published in English. Twenty‐two studies with 1739 participants were included. Thirteen studies examined EMDR Integrative Group Treatment Protocol (IGTP), four studies examined EMDR Group Traumatic Episode Protocol (G‐TEP), four studies EMDR Integrative Group Treatment Protocol for Ongoing Traumatic Stress and one study considered EMDR Group Protocol with Children. Of the 22 studies included, 12 were one‐arm trials and 10 were two‐arm trials. We assessed risk of bias using a revised Tool to Assess Risk of Bias in Randomized Trials (ROB 2) and Risk of Bias in Nonrandomized Studies of Interventions (ROBINS‐I). Overall, the results suggested that Group EMDR protocols might be an effective tool in improving a wide range of mental health‐related outcomes including posttraumatic stress disorder (PTSD), depression and anxiety. However, the included studies are limited to methodological challenges. The limitations and future directions are discussed.
    • Guerre d’Algérie Le sexe outragé

      Obergöker, Timo (Informa UK Limited, 2019-08-23)
    • Gut thinking and eye tracking: evidence for a central preference heuristic

      Thoma, Volker; Rodway, Paul; orcid: 0000-0002-7667-6782; Tamlyn, Guy (Informa UK Limited, 2021-09-01)
    • H,

      Cabello-Lobato, Maria Jose; Schmidt, Christine K; orcid: 0000-0002-8363-7933; email: christine.schmidt@manchester.ac.uk; Cliff, Matthew J; orcid: 0000-0002-7482-0234; email: matthew.cliff@manchester.ac.uk (2021-06-25)
      DNA double-strand breaks (DSBs) represent the most cytotoxic DNA lesions, as-if mis- or unrepaired-they can cause cell death or lead to genome instability, which in turn can cause cancer. DSBs are repaired by two major pathways termed homologous recombination and non-homologous end-joining (NHEJ). NHEJ is responsible for repairing the vast majority of DSBs arising in human cells. Defects in NHEJ factors are also associated with microcephaly, primordial dwarfism and immune deficiencies. One of the key proteins important for mediating NHEJ is XRCC4. XRCC4 is a dimer, with the dimer interface mediated by an extended coiled-coil. The N-terminal head domain forms a mixed alpha-beta globular structure. Numerous factors interact with the C-terminus of the coiled-coil domain, which is also associated with significant self-association between XRCC4 dimers. A range of construct lengths of human XRCC4 were expressed and purified, and the 1-164 variant had the best NMR properties, as judged by consistent linewidths, and chemical shift dispersion. In this work we report the H,  N and C backbone resonance assignments of human XRCC4 in the solution form of the 1-164 construct. Assignments were obtained by heteronuclear multidimensional NMR spectroscopy. In total, 156 of 161 assignable residues of XRCC4 were assigned to resonances in the TROSY spectrum, with an additional 11 resonances assigned to His-Tag residues. Prediction of solution secondary structure from a chemical shift analysis using the TALOS + webserver is in good agreement with the published X-ray crystal structures of this protein.
    • Haemoglobin and Hematinic Status Before and After Bariatric Surgery over 4 years of Follow-Up

      Shipton, Michael J.; Johal, Nicholas J.; Dutta, Neel; Slater, Christopher; Iqbal, Zohaib; Ahmed, Babur; Ammori, Basil J.; Senapati, Siba; Akhtar, Khurshid; Summers, Lucinda K. M.; et al. (Springer US, 2020-09-01)
      Abstract: Purpose: Bariatric surgery is associated with deficiencies of vitamins and minerals, and patients are routinely advised supplements postoperatively. We studied prevalence of vitamin B12, folate and iron deficiencies and anaemia before and after bariatric surgery over 4 years of follow-up. Materials and Methods: We performed a retrospective cohort analysis of 353 people with obesity, including 257 (72.8%) women, who underwent gastric bypass (252, 71.4%) or sleeve gastrectomy (101, 28.6%) at our National Health Service bariatric centre in Northwest England. Results: At baseline, mean (standard error) age was 46.0 (0.6) years, body mass index 53.1 (0.4) kg/m2, serum vitamin B12 400.2 (16.4) pg/L, folate 7.7 (0.2) μg/L, iron 12.0 (0.3) μmol/L, ferritin 118.3 (8.4) μg/L and haemoglobin 137.9 (0.8) g/L. Frequency of low vitamin B12 levels reduced from 7.5% preoperatively to 2.3% at 48 months (P < 0.038). Mean folate levels increased from baseline to 48 months by 5.3 μg/L (P < 0.001) but frequency of low folate levels increased from 4.7% preoperatively to 10.3% (P < 0.048). Ferritin levels increased from baseline to 48 months by 51.3 μg/L (P < 0.009). Frequency of low ferritin levels was greater in women (39.1%) than in men (8.9%) at baseline (P < 0.001) and throughout the study period. Haemoglobin was low in 4.6% of all patients at baseline with no significant change over the study period. Conclusion: There were notable rates of haematinic insufficiencies in bariatric surgical candidates preoperatively. Our study lends further support to regular supplementation with vitamin B12, folic acid, and iron in people undergoing bariatric surgery.
    • Haemoglobin and Hematinic Status Before and After Bariatric Surgery over 4 years of Follow-Up

      Shipton, Michael J.; Johal, Nicholas J.; Dutta, Neel; Slater, Christopher; Iqbal, Zohaib; Ahmed, Babur; Ammori, Basil J.; Senapati, Siba; Akhtar, Khurshid; Summers, Lucinda K. M.; et al. (Springer US, 2020-09-01)
      Abstract: Purpose: Bariatric surgery is associated with deficiencies of vitamins and minerals, and patients are routinely advised supplements postoperatively. We studied prevalence of vitamin B12, folate and iron deficiencies and anaemia before and after bariatric surgery over 4 years of follow-up. Materials and Methods: We performed a retrospective cohort analysis of 353 people with obesity, including 257 (72.8%) women, who underwent gastric bypass (252, 71.4%) or sleeve gastrectomy (101, 28.6%) at our National Health Service bariatric centre in Northwest England. Results: At baseline, mean (standard error) age was 46.0 (0.6) years, body mass index 53.1 (0.4) kg/m2, serum vitamin B12 400.2 (16.4) pg/L, folate 7.7 (0.2) μg/L, iron 12.0 (0.3) μmol/L, ferritin 118.3 (8.4) μg/L and haemoglobin 137.9 (0.8) g/L. Frequency of low vitamin B12 levels reduced from 7.5% preoperatively to 2.3% at 48 months (P < 0.038). Mean folate levels increased from baseline to 48 months by 5.3 μg/L (P < 0.001) but frequency of low folate levels increased from 4.7% preoperatively to 10.3% (P < 0.048). Ferritin levels increased from baseline to 48 months by 51.3 μg/L (P < 0.009). Frequency of low ferritin levels was greater in women (39.1%) than in men (8.9%) at baseline (P < 0.001) and throughout the study period. Haemoglobin was low in 4.6% of all patients at baseline with no significant change over the study period. Conclusion: There were notable rates of haematinic insufficiencies in bariatric surgical candidates preoperatively. Our study lends further support to regular supplementation with vitamin B12, folic acid, and iron in people undergoing bariatric surgery.
    • Halogens in Eclogite Facies Minerals from the Western Gneiss Region, Norway

      Hughes; orcid: 0000-0002-4363-8675; email: lewis.hughes@manchester.ac.uk; Cuthbert; orcid: 0000-0002-1029-6357; email: simon.cuthbert@agh.edu.pl; Quas-Cohen; email: alexandra.quas-cohen@postgrad.manchester.ac.uk; Ruzié-Hamilton; orcid: 0000-0002-2802-8123; email: lorraine.ruzie@manchester.ac.uk; Pawley; orcid: 0000-0002-3022-3235; email: alison.pawley@manchester.ac.uk; Droop; email: giles.droop@gmail.com; Lyon; email: Ian.Lyon@manchester.ac.uk; Tartèse; email: romain.tartese@manchester.ac.uk; Burgess; orcid: 0000-0001-7674-8718; email: ray.burgess@manchester.ac.uk (MDPI, 2021-07-14)
      Ultra-high-pressure (UHP) eclogites and ultramafites and associated fluid inclusions from the Western Gneiss Region, Norwegian Caledonides, have been analysed for F, Cl, Br and I using electron-probe micro-analysis, time-of-flight secondary ion mass spectrometry and neutron-irradiated noble gas mass spectrometry. Textures of multi-phase and fluid inclusions in the cores of silicate grains indicate formation during growth of the host crystal at UHP. Halogens are predominantly hosted by fluid inclusions with a minor component from mineral inclusions such as biotite, phengite, amphibole and apatite. The reconstructed fluid composition contains between 11.3 and 12.1 wt% Cl, 870 and 8900 ppm Br and 6 and 169 ppm I. F/Cl ratios indicate efficient fractionation of F from Cl by hydrous mineral crystallisation. Heavy halogen ratios are higher than modern seawater by up to two orders of magnitude for Br/Cl and up to three orders of magnitude for I/Cl. No correlation exists between Cl and Br or I, while Br and I show good correlation, suggesting that Cl behaved differently to Br and I during subduction. Evolution to higher Br/Cl ratios is similar to trends defined by eclogitic hydration reactions and seawater evaporation, indicating preferential removal of Cl from the fluid during UHP metamorphism. This study, by analogy, offers a field model for an alternative source (continental crust) and mechanism (metasomatism by partial melts or supercritical fluids) by which halogens may be transferred to and stored in the sub-continental lithospheric mantle during transient subduction of a continental margin.
    • Halokinetic modulation of sedimentary thickness and architecture: A numerical modelling approach

      Cumberpatch, Zoë A.; orcid: 0000-0001-8253-8418; email: zoe.cumberpatch@manchester.ac.uk; Finch, Emma; Kane, Ian A.; Pichel, Leonardo M.; Jackson, Christopher A.‐L.; Kilhams, Ben A.; Hodgson, David M.; Huuse, Mads (2021-07-03)
      Abstract: Subsurface salt flow can deform overlying strata and influence contemporaneous sedimentary systems. Studying salt‐sediment interactions is challenging in the subsurface due to poor imaging adjacent to salt, and in the field due to the dissolution of halite. Discrete Element Modelling provides an efficient and inexpensive tool to model stratigraphy and deformation around salt structures, which is advantageous over other modelling techniques as it realistically recreates brittle processes such as faulting. Six 2D experiments were run representing 4.6 Myr to determine the effect of salt growth on syn‐kinematic stratigraphy. Halokinetic deformation of stratigraphic architecture was assessed by varying sediment input rates through time. Results show the realistic formation and evolution of salt‐related faults which define a zone of halokinetic influence ca. 3 times the width of the initial diapir. Outside of this, early diapiric and syn‐kinematic stratigraphy are undeformed. Within this zone, syn‐kinematic strata are initially isolated into primary salt withdrawal basins, onlapping and thinning towards the salt‐cored high. In most models, syn‐kinematic strata eventually thin across and cover the diapir roof. Thinning rates are up to six times greater within 350 m of the diapir, compared to further afield, and typically decrease upwards (with time) and laterally (with distance) from the diapir. Outputs are compared to a subsurface example from the Pierce field, UK North Sea, which highlights the importance of considering local fluctuations in diapir rise rate. These can create stratigraphic architectures that may erroneously be interpreted to represent increases/decreases in sedimentation rate. Exposed examples, such as the Bakio diapir, northern Spain, can be used to make inferences of the expected depositional facies, below model resolution. Our models aid the prediction of sedimentary unit thickness and thinning rates and can be used to test interpretations arising from incomplete or low‐resolution subsurface and outcrop data when building geological models for subsurface energy.
    • Harnessing repeated measurements of predictor variables for clinical risk prediction: a review of existing methods

      Bull, Lucy M.; orcid: 0000-0002-3926-3030; email: lucy.bull@manchester.ac.uk; Lunt, Mark; Martin, Glen P.; Hyrich, Kimme; Sergeant, Jamie C. (BioMed Central, 2020-07-09)
      Abstract: Background: Clinical prediction models (CPMs) predict the risk of health outcomes for individual patients. The majority of existing CPMs only harness cross-sectional patient information. Incorporating repeated measurements, such as those stored in electronic health records, into CPMs may provide an opportunity to enhance their performance. However, the number and complexity of methodological approaches available could make it difficult for researchers to explore this opportunity. Our objective was to review the literature and summarise existing approaches for harnessing repeated measurements of predictor variables in CPMs, primarily to make this field more accessible for applied researchers. Methods: MEDLINE, Embase and Web of Science were searched for articles reporting the development of a multivariable CPM for individual-level prediction of future binary or time-to-event outcomes and modelling repeated measurements of at least one predictor. Information was extracted on the following: the methodology used, its specific aim, reported advantages and limitations, and software available to apply the method. Results: The search revealed 217 relevant articles. Seven methodological frameworks were identified: time-dependent covariate modelling, generalised estimating equations, landmark analysis, two-stage modelling, joint-modelling, trajectory classification and machine learning. Each of these frameworks satisfies at least one of three aims: to better represent the predictor-outcome relationship over time, to infer a covariate value at a pre-specified time and to account for the effect of covariate change. Conclusions: The applicability of identified methods depends on the motivation for including longitudinal information and the method’s compatibility with the clinical context and available patient data, for both model development and risk estimation in practice.
    • Haunting, ruination and encounter in the ordinary Anthropocene: storying the return Florida’s wild flamingos

      Fredriksen, Aurora; orcid: 0000-0003-4287-3443; email: aurora.fredriksen@manchester.ac.uk (SAGE Publications, 2021-03-21)
      In the spring of 2006 wild flamingos returned to Florida, though not to the places their kind had inhabited 100 years and more ago at the southern edge of the Everglades and the Florida Keys. Instead this group of flamingos alighted 80 miles northward in Palm Beach County’s Stormwater Treatment Area 2 (STA-2), a human-made facility for filtering anthropogenic pollutants from storm runoff. This paper takes the return of wild flamingos to Florida as a case for thinking through haunting, ruination and encounters in what I call ‘the ordinary Anthropocene’: the ongoing, everyday more-than-human relationships, actions and less-than-planetary assemblages through which the Anthropocene is sensed and lived. After setting out a case for thinking with haunting, ruination and encounter as a way of making sense in the ordinary Anthropocene, I trace three interwoven narrative threads that unspool from the encounter with the STA-2 flamingos: First, I trace the transfiguration of living wild flamingos into idealised symbols of tropical dreamworlds over the 20th century. This leads me sideways to the present-absence of flamingos in the mid-century writings of Rachel Carson and through her backwards to John J. Audubon and the genocidal ruinations of the 19th century as they flicker in the margins of his ornithological writings. I end by returning to the present, to the encounter with STA-2 flamingos in the ongoing moment of living with others in the late capitalist ecologies of south Florida. The conclusion considers what might be taken forward, into the uncertain future, from this telling.
    • Have (R)-[

      Chauveau, Fabien; orcid: 0000-0002-4177-741X; email: chauveau@cermep.fr; Becker, Guillaume; orcid: 0000-0002-1714-0267; Boutin, Hervé; orcid: 0000-0002-0029-5246; email: herve.boutin@manchester.ac.uk (2021-08-13)
      The prototypical TSPO radiotracer (R)-[ C]PK11195 has been used in humans for more than thirty years to visualize neuroinflammation in several pathologies. Alternative radiotracers have been developed to improve signal-to-noise ratio and started to be tested clinically in 2008. Here we examined the scientific value of these "(R)-[ C]PK11195 challengers" in clinical research to determine if they could supersede (R)-[ C]PK11195. A systematic MEDLINE (PubMed) search was performed (up to end of year 2020) to extract publications reporting TSPO PET in patients with identified pathologies, excluding studies in healthy subjects and methodological studies. Of the 288 publications selected, 152 used 13 challengers, and 142 used (R)-[ C]PK11195. Over the last 20 years, the number of (R)-[ C]PK11195 studies remained stable (6 ± 3 per year), but was surpassed by the total number of challenger studies for the last 6 years. In total, 3914 patients underwent a TSPO PET scan, and 47% (1851 patients) received (R)-[ C]PK11195. The 2 main challengers were [ C]PBR28 (24%-938 patients) and [ F]FEPPA (11%-429 patients). Only one-in-ten patients (11%-447) underwent 2 TSPO scans, among whom 40 (1%) were scanned with 2 different TSPO radiotracers. Generally, challengers confirmed disease-specific initial (R)-[ C]PK11195 findings. However, while their better signal-to-noise ratio seems particularly useful in diseases with moderate and widespread neuroinflammation, most challengers present an allelic-dependent (Ala147Thr polymorphism) TSPO binding and genetic stratification is hindering their clinical implementation. As new challengers, insensitive to TSPO human polymorphism, are about to enter clinical evaluation, we propose this systematic review to be regularly updated (living review). [Abstract copyright: © 2021. The Author(s).]
    • ‘He didn’t really talk about it’: the (re)construction and transmission of a Free French past

      Millington, Chris; Millington, Richard; orcid: 0000-0002-1324-9521 (Informa UK Limited, 2021-12-21)
    • HE4 as a Biomarker for Endometrial Cancer

      Behrouzi, Roya; email: rbehrouzi@doctors.org.uk; Barr, Chloe E.; email: Chloe.Barr@mft.nhs.uk; Crosbie, Emma J.; orcid: 0000-0003-0284-8630; email: Emma.Crosbie@manchester.ac.uk (MDPI, 2021-09-23)
      There are currently no blood biomarkers in routine clinical use in endometrial carcinoma (EC). Human epididymis protein 4 (HE4) is a glycoprotein that is overexpressed in the serum of patients with EC, making it a good candidate for use as a diagnostic and/or prognostic biomarker. HE4 is correlated with poor prognostic factors, including stage, myometrial invasion and lymph node metastases, which means it could be used to guide decisions regarding the extent of surgery and need for adjuvant therapy. Serum HE4 has also shown promise for predicting responses to progestin therapy in early-stage EC. The use of algorithms and indices incorporating serum HE4 and other biomarkers, including clinical and imaging variables, is an area of increasing interest. Serum HE4 levels rise with age and renal dysfunction, which may affect the interpretation of results. This review covers the evidence supporting the use of HE4 as an EC biomarker for diagnosis, prognosis, recurrence monitoring, and prediction of therapy response. The evidence for combining serum HE4 with other biomarkers, including clinical and imaging variables, its value as a biomarker in other biofluids and potential challenges of its clinical use are also discussed.
    • Health and healthcare in North Korea: a retrospective study among defectors

      Lee, Hayoung; Robinson, Courtland; Kim, Jaeshin; McKee, Martin; Cha, Jiho; orcid: 0000-0003-1212-5671; email: jiho.cha@manchester.ac.uk (BioMed Central, 2020-06-29)
      Abstract: Background: To gain insights into the socio-economic and political determinants of ill health and access to healthcare in North Korea. Methods: A retrospective survey using respondent-driven sampling conducted in 2014–15 among 383 North Korean refugees newly resettling in South Korea, asking about experiences of illness and utilization of healthcare while in North Korea, analyzed according to measures of political, economic and human rights indicators. Results: Although the Public Health Act claims that North Korea provides the comprehensive free care system, respondents reported high levels of unmet need and, among those obtaining care, widespread informal expenditure. Of the respondents, 55.1% (95%CI, 47.7–63.7%) had received healthcare for the most recent illness episode. High informal costs (53.8%, 95%CI, 45.1–60.8%) and a lack of medicines (39.5%, 95%CI, 33.3–47.1%) were reported as major healthcare barriers resulting in extensive self-medication with narcotic analgesics (53.7%, 95%CI, 45.7–61.2%). In multivariate logistic regressions, party membership was associated with better access to healthcare (Adjusted OR (AOR) = 2.34, 95%CI, 1.31–4.18), but household income (AOR = 0.40, 95%CI 0.21–0.78) and informal market activity (AOR = 0.29, 95%CIs 0.15–0.50) with reduced access. Respondents who could not enjoy political and economic rights were substantially more likely to report illness and extremely reduced access to care, even with life-threatening conditions. Conclusions: There are large disparities in health and access to healthcare in North Korea, associated with political and economic inequalities. The scope to use these findings to bring about change is limited but they can inform international agencies and humanitarian organizations working in this unique setting.
    • Health impacts of daily weather fluctuations: Empirical evidence from COVID-19 in U.S. counties.

      Emediegwu, Lotanna E; email: lotanna.emediegwu@manchester.ac.uk (2021-04-24)
      The emergence of the novel coronavirus has necessitated immense research efforts to understand how several non-environmental and environmental factors affect transmission. With the United States leading the path in terms of case incidence, it is important to investigate how weather variables influence the spread of the disease in the country. This paper assembles a detailed and comprehensive dataset comprising COVID-19 cases and climatological variables for all counties in the continental U.S. and uses a developed econometric approach to estimate the causal effect of certain weather factors on the growth rate of infection. The results indicate a non-linear and significant negative relationship between the individual weather measures and the growth rate of COVID-19 in the U.S. Specifically, the paper finds that a 1 °C rise in daily temperature will reduce daily covid growth rate in the U.S. by approximately 6 percent in the following week, while a marginal increase in relative humidity reduces the same outcome by 1 percent over a similar period. In comparison, a 1 m/s increase in daily wind speed will bring about an 8 percent drop in daily growth rate of COVID-19 in the country. These results differ by location and are robust to several sensitivity checks, so large deviations are unexpected. [Abstract copyright: Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.]