The Department of Clinical Sciences and Nutrition has an experienced team of researchers, with an international reputation. Their main research themes are Public Health Nutrition and Physical Activity, Cardiometabolic Health, and Clinical Practice.

Collections in this community

Recent Submissions

  • “Some People Sit, Some People Stand, That’s Just What We Do ”: a Qualitative Exploration of Sit-Stand Desk Use in Naturalistic Settings

    Deery, Elizabeth; Buckley, John; Morris, Michael; Kennedy, Lynne; Ulster University; Keele University; University of Chester; Qatar University (Springer, 2024-03-11)
    Prolonged sedentary behaviour is associated with poor health. Office-based workers spend much of the working day sitting. Sit-stand desks have become a popular intervention, but real-life experiences of the value of sit-stand desks remain relatively unexplored outside of research-led interventions. A qualitative study was therefore undertaken to explore real-life experiences, including perceived barriers, and facilitators of using sit-stand desks. Six focus-group interviews were undertaken with a total of 34 desk-based employees in North-West England. Interviews were transcribed and analysed using thematic analysis. Three main themes emerged: The Sedentary Office, Motivators, and The Active Office. The Sedentary Office highlighted participants’ frustration with an increasingly sedentary office environment. Motivators to reducing sitting time were knowledge of the health consequences of prolonged sitting, previous (ill) health, and the potential benefits expected. The Active Office highlighted the importance of control, choice, enhanced interaction with colleagues, and the benefits associated with moving more and enhancing an overall sense of workplace wellbeing. Perceived benefits, facilitators, and barriers - experienced and observed – from sit-stand desk use in the real world were examined, thus contributing to important discussions of transferability. Overall, the study shed light on the perceived facilitators, benefits, and drawbacks of sit-stand desk work whilst also giving evidence of the real-world acceptability and research translation of sit-stand desk use. Future research should examine this in multiple contexts and should explore implications of an increasing prevalence in home working.
  • Exploring Puffed Rice as a Novel Ink for 3D Food Printing: Rheological Characterization and Printability Analysis

    Park, Bo-Ram; No, Junhee; Oh, Hyeonbin; Park, Chan-Soon; You, Kwan-Mo; Chewaka, Legesse S.; National Institute of Agricultural Science, Korea; Kyungpook National University; University of Chester (Elsevier, 2024-09-07)
    This study introduces a novel approach by using puffed rice (PR) as a sustainable and innovative ink for 3D food printing. Due to gelatinization and dextrinization, PR saw notable water absorption and solubility gains, with a modest viscosity uptick from 39.2 to 49.9 RVU, sharply contrasting Native rice (NR)'s jump from 128.9 to 167.8 RVU, emphasizing PR's minimal retrogradation. Gelatinized rice (GR) demonstrates similar stability in viscosity changes as PR, yet it requires more water and extended processing times for gelatinization. Conversely, PR's puffing process, which eliminates the need for water, offers quicker preparation and notable environmental benefits. Rheological analysis at 25% PR concentration reveals an optimal balance of viscosity (η, 897.4 Pa s), yield stress (τy, 2471.3 Pa), and flow stress (τf, 1509.2 Pa), demonstrating superior viscoelastic properties that facilitate enhanced printability and shape fidelity. Texture Profile Analysis outcomes reveals that PR significantly enhances key textural properties including hardness, adhesiveness, and springiness at this specific concentration. These findings highlight PR's potential as an eco-friendly and efficient ink choice for 3D-printed food products, providing enhanced performance and sustainability compared to GR and NR.
  • A Multi-Dimensional Sustainable Diet Index (SDI) for Ghanaian Adults Under Transition: The RODAM Study

    Okekunle, Akinkunmi P.; Nicolaou, Mary; De Allegri, Manuela; Meeks, Karlijn A. C.; Osei-Kwasi, Hibbah; Stockemer, Julia; de-Graft Aikins, Anna; Agbemafle, Isaac; Bahendeka, Silver; Boateng, Daniel; et al. (BioMed Central, 2024-10-01)
    The sustainability of diets consumed by African populations under socio-economic transition remains to be determined. This study developed and characterized a multi-dimensional Sustainable Diet Index (SDI) reflecting healthfulness, climate-friendliness, sociocultural benefits, and financial affordability using individual-level data of adults in rural and urban Ghana and Ghanaian migrants in Europe to identify the role of living environment in dietary sustainability. Methods: We used cross-sectional data from the multi-centre Research on Obesity and Diabetes among African Migrants Study (N = 3169; age range: 25–70 years). For the SDI construct (0–16 score points), we used the Diet Quality Index-International, food-related greenhouse gas emission, the ratio of natural to processed foods, and the proportion of food expenditure from income. In linear regression analyses, we estimated the adjusted ß-coefficients and 95% confidence intervals (CIs) for the differences in mean SDI across study sites (using rural Ghana as a reference), accounting for sociodemographic and lifestyle factors. Results: The overall mean SDI was 8.0 (95% CI: 7.9, 8.1). Participants in the highest SDI-quintile compared to lower quintiles were older, more often women, non-smokers, and alcohol abstainers. The highest mean SDI was seen in London (9.1; 95% CI: 8.9, 9.3), followed by rural Ghana (8.2; 95% CI: 8.0, 8.3), Amsterdam (7.9; 95% CI: 7.7, 8.1), Berlin (7.8; 95% CI: 7.6, 8.0), and urban Ghana (7.7; 95% CI: 7.5, 7.8). Compared to rural Ghana, the differences between study sites were attenuated after accounting for age, gender and energy intake. No further changes were observed after adjustment for lifestyle factors. Conclusion: The multi-dimensional SDI describes four dimensions of dietary sustainability in this Ghanaian population. Our findings suggest that living in Europe improved dietary sustainability, but the opposite seems true for urbanization in Ghana.
  • The effect of vitamin D supplementation on markers of insulin resistance in women with polycystic ovarian syndrome: a systematic review

    Kohlhoff, Georgia; Kirwan, Richard; Mushtaq, Sohail; University of Chester; Liverpool John Moores University (Springer, 2024-09-14)
    Insulin resistance (IR) is a common pathology in women with polycystic ovarian syndrome (PCOS) involved in increased rates of cardiometabolic disease such as diabetes and cardiovascular disease. Low serum vitamin D is often associated with insulin resistance but there is no consensus on whether vitamin D supplementation can ameliorate markers of IR in PCOS. We assessed evidence on the effects of vitamin D supplementation (≥ 1000 IU/day), without the use of additional supplements or other pharmacological treatments known to affect IR, on markers of IR and glycemic control in women with PCOS. A systematic search was conducted using PubMed, Medline and Web of Science databases from January 2000 up to November 2023. Randomized controlled trials that assessed the effects of vitamin D supplementation in women with PCOS, on fasting glucose, fasting insulin, glycated haemoglobin (HbA1c) or homeostatic model assessment for insulin resistance (HOMA-IR) were included. 9 studies were identified. Study populations ranged from 28 to 180 participants, with mean ages ranging from 22 to 30 years. Daily vitamin D doses ranged from 1714-12,000 IU. Of the included studies, 3 reported statistically significant reductions in fasting glucose, 2 reported reductions in fasting insulin, 2 reported reductions in HOMA-IR, none reported reductions in HbA1c and 5 reported no differences in any of the relevant outcomes. In conclusion, in RCTs of vitamin D supplementation in women with PCOS, the majority of studies do not report statistically significant improvements in fasting glucose, fasting insulin, HbA1c or HOMA-IR. However, as a minority of studies report some statistically significant results, further investigation may be warranted. PROSPERO ID: CRD42023486144. [Abstract copyright: © 2024. The Author(s).]
  • The Efficacy of Ketamine for Acute and Chronic Pain in Patients with Cancer: A Systematic Review of Randomized Controlled Trials

    Azari, Leila; Hemati, Homa; Tavasolian, Ronia; Shahdab, Sareh; Tomlinson, Stephanie M.; Bobonis Babilonia, Margarita; Huang, Jeffrey; Tometich, Danielle B.; Turner, Kea; Saleh Anaraki, Kimia; et al. (MDPI, 2024-08-06)
    Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. We conducted a literature review in MEDLINE, EMBASE, and Scopus from 1 January 1982 to 20 October 2023. Abstracts were screened against inclusion criteria, and eligible studies underwent a full-text review. Data was extracted from the included studies, and a framework analysis approach summarized the evidence regarding ketamine’s use in patients with cancer. A total of 21 randomized clinical trials were included, and the quality of all the included studies was good or fair. Significant improvements in pain scores and reduced morphine consumption were consistently observed with intravenous ketamine administration for postoperative pain control, particularly when combined with other analgesics such as morphine. Ketamine was less effective when used as an analgesic for chronic pain management, with several studies on neuropathic pain or chemotherapy-induced neuropathy finding minimal significant effect on reduction of pain scores or morphine requirements. The efficacy of ketamine in pain management appears to depend on factors such as dosage, route of administration, and patient population.
  • Assessment of performance of the profilers provided in the OECD QSAR toolbox for category formation of chemicals

    Aljallal, Mohammed A.; Chaudhry, Qasim; Price, Nicholas R.; Saudi Food and Drug Authority; University of Chester; The Food and Environment Research Agency (Nature Research, 2024-08-07)
    Growing restrictions and bans on animal testing for chemical safety assessment under different regulations have led to an increasing use of alternative methods. Read-across is one of the major approaches used for this purpose, which relies on the identification of toxicological hazards of a data-poor or untested (target) chemical from data on other already-tested (source) similar chemicals. This requires the target substance to be first assigned to a group or category of ‘similar’ chemicals. The ‘similarity’ may be in terms of structural features alone, or in combination with certain rules that are based on mechanistic and/or toxicological aspects. In this regard, the OECD QSAR toolbox—a major free-access in silico platform—is widely used to derive toxicity predictions for a range of (eco) toxicological endpoints. The Toolbox allows the user to identify a set of similar chemicals (analogues) by computational ‘profilers’ that incorporate different structural alerts, or a combination of structural alerts and physicochemical and/or toxicokinetic rules relevant to a specific toxicological endpoint. The overall aim of this study was to assess the performance of the in silico profilers provided in the OECD QSAR Toolbox for reliability for identifying chemical analogues for category formation in a number of high-quality databases on mutagenicity, carcinogenicity, and skin sensitisation. The study also aimed to identify the reasons for any limitations in the performance of the profilers, and propose ways to improve their overall accuracy. The results showed that whilst some structural alerts are fit-for-purpose as such within the acceptable limits, others need refinement or a consideration for their possible exclusion from the profiler. Such refinements are imperative for a reliable use of the profilers in read-across and grouping/categorisation for classification, labelling and risk assessment of chemicals.
  • Evaluating the Stability and Digestibility of Long-Chain Omega-3 Algal Oil Nanoemulsions Prepared with Lecithin and Tween 40 Emulsifiers Using an In Vitro Digestion Model

    Zhou, Qiqian; Lane, Katie E.; Li, Weili; University of Chester; Liverpool John Moores University (MDPI, 2024-07-29)
    The health benefits of long-chain omega-3 polyunsaturated fatty acid (LCn-3PUFA) intake have been well documented. However, currently, the consumption of oily fish (the richest dietary source of LCn-3PUFA) in the UK is far below the recommended level, and the low digestibility of LCn-3PUFA bulk oil-based supplements from triglyceride-based sources significantly impacts their bioavailability. LCn-3PUFA-rich microalgal oil offers a potential alternative for populations who do not consume oily fish, and nanoemulsions have the potential to increase LCn-3PUFA digestibility and bioavailability. The aims of this study were to produce stable algal oil-in-water nanoemulsions with ultrasonic technology to increase DHA digestibility, measured using an in vitro digestion model. A nanoemulsion of LCn-3PUFA algal oil was developed with 6% w/w emulsifiers: lecithin (LE) or an equal ratio of Tween 40 (3%) and lecithin (LTN) (3%), 50% w/w, algal oil and 44% w/w water using rotor–stator and ultrasound homogenization. The in vitro digestion experiments were conducted with a gastric and duodenal digestion model. The results showed the creation of nanoemulsions of LCn-3PUFA algal oils offers potentially significant increases in the bioavailability of DHA in the human body. The increase in digestibility can be attributed to the smaller particle size of the nanoemulsions, which allows for higher absorption in the digestive system. This showed that the creation of nanoemulsions of LCn-3PUFA algal oils offers a potentially significant increase in the bioavailability of DHA in the human body. The LE and LTN nanoemulsions had average droplet sizes of 0.340 ± 0.00 µm and 0.267 ± 0.00 µm, respectively, but the algal oil mix (sample created with same the components as the LTN nanoemulsion, hand mixed, not processed by rotor–stator and ultrasound homogenization) had an average droplet size of 73.6 ± 6.98 µm. The LTN algal oil nanoemulsion was stable in the gastric and duodenal phases without detectable destabilization; however, the LE nanoemulsion showed signs of oil phase separation in the gastric phase. Under the same conditions, the amount of DHA digested from the LTN nanoemulsion was 47.34 ± 3.14 mg/g, compared to 16.53 ± 0.45 mg/g from the algal oil mix, showing DHA digestibility from the LTN nanoemulsion was 2.86 times higher. The findings of this study contribute to the insight of in vitro DHA digestion under different conditions. The stability of the LTN nanoemulsion throughout digestion suggests it could be a promising delivery system for LCn-3PUFAs, such as DHA, in various food and pharmaceutical applications.
  • The experiences of a therapeutic relationship between dietitians and patients in UK eating disorder treatment: A qualitative study

    Robertson, Nicole; Davies, Luke; University of Chester (Wiley, 2024-06-25)
    Objective: Dietitians have a central role in eating disorder (ED) treatment, however few studies exist investigating therapeutic aspects of dietetic care and factors influencing the dietitian‐patient relationship. To address the gap, this study aimed to use a qualitative description approach to explore the experiences of delivering and receiving dietetic care in ED treatment in the UK. Method: Semi‐structured interviews were conducted with 6 specialist ED dietitians and focus groups with 11 recovered ED patients. Interviews were transcribed and inductive thematic analysis was performed to identify key themes describing the data. Results: Six key themes were generated: (1) Building trust, (2) Appropriate timing, (3) Adapting, (4) Dietitians as experts, (5) Boundaries, and (6) Difficult relationships. Participants highlighted the importance of building trust and considering nutritional risk and readiness in treatment approach. Patients expressed a desire for dietitians to have experience in EDs, facilitating understanding of their illness. However, dietitians identified the nature of EDs making their role challenging at times. Discussion: This study described various factors affecting dietetic care in EDs and provided a valuable insight into patients' perceptions of treatment. The findings support advancements in ED dietitians' knowledge and understanding, helping to enhance quality of care.
  • A 12-week double-blind randomised controlled trial investigating the effect of dietary supplementation with 125 µg/day vitamin D in adults with asthma

    Mushtaq, Sohail; Watkins, Stephanie; Harrison, Tanja; University of Chester (Cambridge University Press, 2024-05-16)
    Vitamin D deficiency has previously been linked to higher rates of exacerbation and reduced lung function in asthmatics. Previous randomised controlled trials (RCT) investigating the effect of vitamin D supplementation have mainly focussed on children with asthma. Trials involving adults have typically used bolus dosing regimes and the main outcomes have been patient focussed without investigating underlying inflammation. The present study aimed to conduct a 12-week placebo-controlled RCT administering a daily 5000 IU (125 µg) vitamin D3 supplement to adults with mild to moderate asthma. A total of 32 participants were randomised to receive either the 5000 IU vitamin D3 supplement or an identical matching placebo. The primary outcome of the study was lung function measured by ratio of FEV1:FVC (effect size 2.5) with secondary outcomes including asthma symptoms and inflammatory biomarkers. There was a small but statistically significant higher increase in the mean (± SD) ratio of FEV1: FVC from baseline to post-intervention in the vitamin D group (+ 0.05 ± 0.06) compared to the placebo group (+ 0.006 ± 0.04, p = 0.04). There was no effect of the intervention on asthma control test scores, or the inflammatory biomarkers measured. There was a moderate, significant association between baseline plasma 25(OH)D concentration and baseline plasma IL-10 (r = 0.527, p = 0.005) and TNF-α (r = -0.498. p = 0.008) concentrations. A daily vitamin D3 supplement led to slightly improved lung function in adult asthmatics and may be a useful adjunct to existing asthma control strategies, particularly for individuals with suboptimal vitamin D status.
  • Yellow Stickers: A mixed methods study exploring household food poverty experiences, in the UK

    Fallows, Stephen; Brannigan, Angela (University of Chester, 2023-07)
    Background: As more and more British people struggle to make ends meet and turn to food banks to feed themselves, food poverty has become a serious and growing public health concern in the United Kingdom (UK). There is a clear need for effective policies and interventions to prevent and alleviate food poverty. Aim: This thesis aimed to explore household food poverty experiences in order to develop an understanding of the current nature and vulnerability of food poverty in the UK. The research findings inform policy and practice in improving food and nutrition security for those most vulnerable. Methods: A sequential exploratory mixed methods design was adopted for this thesis, where the qualitative phase of data collection and analysis informed the quantitative phase. The first qualitative phase of the study was conducted in Greater Manchester and comprised of two exploratory investigations, in which in-depth interviews were carried out. The first study explored food poverty experiences, and coping practices from forty-two food insecure householders visiting food banks, food pantries, and community centres. The second study explored the perspectives of twenty-six frontline service providers on the local nature and vulnerability of food poverty along with programme responses to alleviate food hardships. The interviews were examined using thematic analysis. The findings generated from these two studies informed the development of the quantitative follow-up study. This study examined the prevalence and risk factors of food insecurity among single mother households using secondary data from the Family Resources Survey (2019/20). Descriptive statistics and multi-logistic analyses were used to analyse the quantitative data. Key findings: The findings from study 1, revealed that food insecure householders often employ multiple coping practices such as resourceful shopping and budgeting practices, cutting back on food quality and intake, and seeking support from food banks, family or friends. Regardless, regular and extended disruptions in food access and eating were commonly reported because of limited money. In study 2, frontline service providers described cost-of-living gaps in working wages and welfare benefits, exacerbated by rising living costs were driving local food poverty issues. Single mother families and single men, were found to be disproportionately accessing food banks compared to other households. Although, food banks have grown substantially in response to rising need and they provide immediate relief from hunger for a few days, there was a deep sense of shame associated with accessing them. Moreover, food banks like other community food aid programmes have limited ability to reduce and prevent food poverty since they do not address the driving factors behind income poverty. In the third study, high levels of food insecurity were found among single mother households. Thirty percent of single mother households were classified as being food insecure, however, in households with three or more children this rose to 41 percent. Conclusions: The findings in this thesis highlight serious food security concerns for welfare recipients and low waged workers. It is a particular salient problem among single mothers and their children who experience high levels of food insecurity. Given the adverse health and social consequences of food poverty the government should prioritise and lead on this issue through policy initiatives and legislation that tackle income poverty alongside efforts that support and strengthen third sector responses in alleviating food poverty in the UK.
  • The experiences of dietary acculturation of international students in an ethnically un-diverse city and its impact on dietary health

    Ellahi, Basma; Osei-Kwasi, Hibbah; Fallows, Stephen; Nwaugochi, Ifeanyi E. (University of Chester, 2023-08)
    Background: Dietary acculturation occurs when people, including students, move to a new host country and their habitual diet changes. Several factors impact international students’ dietary acculturation, including the diversity of the area. Students’ eating habits are reported to be poorer in less ethnically diverse areas where access to their cultural foods may be limited. However, these settings provide a unique opportunity to study the processes (influencers, challenges, and enablers) for eating a culturally acceptable healthy diet in the host country. This study explores the immediate and longitudinal experiences of dietary acculturation for international students in a university and city with low ethnic diversity. Methods: Using an interpretivist design, data were collected longitudinally, at baseline (0-2 months), at six months and one year of sojournment from a purposive sample of international students studying at a university location in the northwest of England, United Kingdom. Focus groups, one-to-one interviews and diet diaries were utilised respectively across the year, progressively focussing the discussion on the lived experience of accessing a healthy and culturally acceptable diet and dietary acculturation. The data were transcribed verbatim and analysed using an inductive thematic approach with the guide of hermeneutic phenomenology. Analysis at baseline, six months, and one year was undertaken, followed by a trajectory analysis to understand the impact of studying and living in a city with little ethnic diversity on international students’ food and health experiences. Results: The analysis shows that international students at the University struggled with adjusting to British cuisine and culture, leading to irregular eating habits that impacted mental health and well-being. The study found that inadequate assistance from the University with regard to diet played a significant role. Over the course of the three phases of the study, participants had limited opportunities to access a broad assortment of foods due to the constrained availability, accessibility, and affordability of familiar options in both the University cafeteria and the city of Chester. Trajectory analysis findings highlight four central issues in accessing culturally acceptable healthy diets at a university located in a less ethnically diverse area: i) the capability and capacity to cook for one’s self; ii) orientation, catering menus, and lack of support from the institution; iii) accessing community support networks; iv) the need to improve cultural awareness, acceptance, and inclusion. The lack of social support, inclusion, and the feeling of no sense of belonging were critical determinants of the student’s experiences. Perceived discriminatory experiences contributed to poorer mental health among participants and performance in their studies. This study suggests that it is imperative to fully grasp the importance of on-campus catering to the dietary requirements of international students for food offerings and menus in this setting. Such inclusion can go a long way towards creating a sense of belonging and promoting integration within universities that have low levels of ethnic diversity. Furthermore, the study sheds light on the development of segregation apparent in classroom settings and academic progress, which begins to perpetuate in higher education and may continue into everyday life. Conclusion: The availability of familiar food is crucial for maintaining a healthy diet, directly affecting one’s well-being. Through promoting inclusivity and a sense of belonging, we can address the negative impact on mental health that comes with feeling disconnected. The lack of availability of culturally acceptable ethnic foods was key, and students reported feelings of exclusion linked to being unable to obtain what they would like to eat easily. Wider community support from friends, family, and local organisations was crucial in developing healthier dietary habits and, crucially, a sense of community and settling. By supporting students in this way, we help them have a positive journey of acculturation, leading to overall success. Therefore, the University in this study needs to create activities and programmes that could bring balance to the entire student population’s dietary experiences. This would promote belongingness within the student group, according to the findings of this study. In addition, this thesis emphasises the importance of university leaders acknowledging the presence of perceived discrimination and implementing an actionable plan with measurable objectives that fosters inclusivity. This research has shown the importance of inclusivity, belonging, and integration for the dietary acculturation experiences of international students who live in a less diverse city. Whilst the research is undertaken in one such city, their findings are applicable to similar settings.
  • Optimal omegas – barriers and novel methods to narrow omega-3 gaps. A narrative review

    Derbyshire, Emma J.; Birch, Catherine S.; Bonwick, Graham A.; English, Ashley; Metcalfe, Phil; Li, Weili; Nutritional Insight Limited, London; AgriFood X Limited, York; HTC Group Limited, Cheshire; Efficiency Technologies Limited, Milton Keynes; University of Chester (Frontiers Media, 2024-02-02)
    Dietary intakes of omega-3 long chain polyunsaturated fatty acids (O3LC-PUFAs) such as eicosapentaenoic and docosahexaenoic acid are central to development and health across the life course. O3LC-PUFAs have been linked to neurological development, maternal and child health and the etiology of certain non-communicable diseases including age-related cognitive decline, cardiovascular disease, and diabetes. However, dietary inadequacies exist in the United Kingdom and on a wider global scale. One predominant dietary source of O3LC-PUFAs is fish and fish oils. However, growing concerns about overfishing, oceanic contaminants such as dioxins and microplastics and the trend towards plant-based diets appear to be acting as cumulative barriers to O3LC-PUFAs from these food sources. Microalgae are an alternative provider of O3LC-PUFA-rich oils. The delivery of these into food systems is gaining interest. The present narrative review aims to discuss the present barriers to obtaining suitable levels of O3LC-PUFAs for health and wellbeing. It then discusses potential ways forward focusing on innovative delivery methods to utilize O3LC-PUFA-rich oils including the use of fortification strategies, bioengineered plants, microencapsulation, and microalgae.
  • The efficacy and safety of ketamine for depression in patients with cancer: A systematic review

    Azari, Leila; Hemati, Homa; Tavasolian, Ronia; Shahdab, Sareh; Tomlinson, Stephanie M.; Bobonis Babilonia, Margarita; Huang, Jeffrey; Tometich, Danielle B.; Turner, Kea; Jim, Heather S. L.; et al. (ElsevierAsociación Española de Psicología Conductual, 2023-12-15)
    Management of depression in the oncology population includes supportive psychotherapeutic interventions with or without psychotropic medication, which take time to demonstrate effectiveness. Fast-acting interventions, like ketamine, can provide a rapid antidepressant effect; however, there has been limited research on effects of ketamine among cancer patients. The objective of this review is to provide an overview of research on the efficacy and safety of ketamine on depression in patients with cancer. We reviewed the published literature in MEDLINE® (via PubMed®), EMBASE, and Scopus from 1 January 1982 to 20 October 2022. We screened the retrieved abstracts against inclusion criteria and conducted a full-text review of eligible studies. Following extraction of data from included studies, we used a framework analysis approach to summarize the evidence on using ketamine in patients with cancer. All 5 included studies were randomized clinical trials conducted in inpatient settings in China. In all included studies ketamine was administered intravenously. Three studies used only racemic ketamine, and two studies used both S-ketamine and racemic ketamine. All included studies reported ketamine a tolerable and effective drug to control depression symptoms. Included studies showed administration of sub-anesthesia ketamine significantly improves postoperative depression among patients with cancer. [Abstract copyright: © 2023 The Author(s).]
  • Development of a novel dietary assessment tool for vitamin D and the in vivo and in vitro effects of supplementation on asthma

    Mushtaq, Sohail; Harrison, Tanja; Watkins, Stephanie (University of Chester, 2023-09)
    Vitamin D is a secosteroid hormone with the essential role of maintaining calcium and phosphorus homeostasis to support bone metabolism. Furthermore, vitamin D has also been shown to have important immunomodulatory functions, which have been linked to inflammatory diseases such as asthma. In the UK, 18.8% of the general population are vitamin D deficient during the winter. In 2016, SACN proposed recommendations that adults in the UK consume 400 IU (10 μg) vitamin D day-1. Health and disease are linked to diet and nutrition therefore, assessing food intake is crucial. A food frequency questionnaire (FFQ) captures habitual food intake with a lower participant burden compared to alternative methods. Validation of a FFQ requires comparison of nutrient biomarkers with another method of dietary assessment. The first study in this thesis recruited 50 healthy volunteers to assess the agreement between a four-day food diary and a newly designed vitamin FFQ to measure dietary intake of vitamin D. Participants provided a blood sample for plasma analysis of 25(OH)D concentrations. Results of this study showed a strong correlation between vitamin D intake recorded by the FFQ and the food diary (r = 0.609, p < 0.0001) within 95% limits of agreement. Our analysis suggested that this FFQ is a useful and rapid tool for researchers and health professionals to assess vitamin D dietary intakes in UK adults. Vitamin D deficiency is linked to asthma in adults and associated with reduced lung function. Clinical trials investigating the effect of vitamin D supplementation have mainly focussed on asthmatic children and trials carried out in adults have used bolus dosing. The aim of chapter 3 was to conduct a 12-week randomised placebo-controlled trial investigating the effect of daily 5000 IU vitamin D supplementation on lung function and inflammation in 32 adults with mild to moderate asthma. The intervention resulted in a significant increase in the mean (± SD) ratio of FEV1: FVC from baseline (week 0) to post-intervention (week 12) in the vitamin D group (+ 0.05 ± 0.06) compared to the placebo group (+ 0.006 ± 0.04, p = 0.04). This dosing strategy at a level above current UK recommendations may be a useful adjunct to existing asthma control strategies. The Calu-3 cell line has been used as a model of asthma and the aim of chapter 4 was to investigate the effect of calcitriol and 25(OH)D treatment of Calu-3 cell cultures on cell proliferation and secretion of inflammatory biomarkers. Incubation of cultures for 24 and 72 hours respectively, with 50nM (p = 0.002; p < 0.0001), 100nM (p = 0.004; p = 0.007) and 200nM (p = 0.002; p < 0.0001) 25(OH)D resulted in significantly decreased proliferation compared to an untreated control. No effect was observed with calcitriol treatment. To our knowledge, this is the first in vitro study using the Calu-3 cell line to show differing effects of vitamin D metabolites. The findings from this thesis are clinically relevant in the UK in a population that is at increased risk of vitamin D deficiency during the winter months. The new tool designed and validated will facilitate easier measurement of vitamin D dietary intakes and the clinical trial and in vitro work have provided novel insights to patient outcomes and underlying mechanisms of the benefit of vitamin D supplementation to asthma patients.
  • Cucumeropsis mannii seed oil protects against bisphenol A-induced hepatotoxicity by mitigating inflammation and oxidative stress in rats

    Aja, Patrick M.; Chukwu, Chinecherem A.; Paul-Chima, Ugwu O.; Ale, Boniface A.; Agu, Peter C.; Deusdedi, Tusubira; Chukwu, Darlington C.; Ani, Onyedika G.; Ekpono, Ezebuilo U.; Ogwoni, Hilary A.; et al. (Oxford University Press, 2023-10-20)
    OBJECTIVES This study looked at how CMSO affected male Wistar albino rats' liver damage caused by bisphenol A. METHODS The standard HPLC method was used to assess the CMSO's phenolic content. Then, six (n = 8) groups of forty-eight (48) male Wistar rats (150 20 g) each received either CMSO or olive oil before being exposed to BPA for 42 days. Groups: A (one milliliter of olive oil, regardless of weight), B (BPA 100 mg/kg body weight (BW)), C (CMSO 7.5 mg/kg BW), D (CMSO 7.5 mg/kg BW + BPA 100 mg/kg BW), E (CMSO 5.0 mg/kg BW + BPA 100 mg/kg BW), and F (CMSO 2.5 mg/kg BW + BPA 100 mg/kg BW). KEY FINDINGS A surprising abundance of flavonoids, totaling 17.8006 10.95 g/100 g, were found in the HPLC data. Malondialdehyde, liver enzymes, reactive oxygen species, total bilirubin, and direct bilirubin levels were all significantly elevated by BPA (p 0.05). Additionally, nuclear factor-B, interleukin-6, interleukin-1, tumor necrosis factor, and histological alterations were all considerably (p 0.05) caused by BPA. The altered biochemical markers and histology were, however, noticeably recovered by CMSO to a level that was comparable to the control. CONCLUSION Due to the abundance of flavonoid components in the oil, CMSO protects the liver from BPA-induced hepatotoxicity by lowering oxidative stress and inflammatory reactions.
  • FTIR and Rheology study of Alginate samples: Effect of Radiation

    Mollah, Mohammad Z. I.; Faruque, Mohammad R. I.; Bradley, David; Khandaker, Mayeen U.; Al-Assaf, Saphwan; Universiti Kebangsaan Malaysia; Institute of Radiation and Polymer Technology; Sunway University; University of Surrey; Daffodil International University; University of Chester (Elsevier, 2022-09-04)
    Two well characterised alginate samples with high and low M/G ratio were subjected to radiation decontamination dose at 15 kGy. Subsequently, a number of techniques were used to determine the effect of radiation on the gelling properties. These techniques include: (GPC-MALLS) gel permeation chromatography linked to a multi-angle laser light scattering and refractive index detector for the determination of molecular weight and distribution. To observe the mechanics, the deformation with flow of α-β alginates rheological measurements in the dynamic oscillation modes, and distinguish the functional group of the samples along with identifying the M/G ratio for quantitative determination of mannuronic and guluronic acid, the FTIR techniques were performed respectively. The results showed clear reduction in the molecular weight following irradiation which was also accompanied by a loss of the gelling properties as well as clear reduction intensity of FTIR peak at 1080-1400 cm -1 for carboxylic group, OH-bonding obtained at 1030 cm-1 (1026 and 1028 cm-1) while the weak signal and skeletal region is attributed at >2800 and < 700 cm-1 respectively. A sample (n = 1; H120L) is homopolyguluronic enriched (820 cm-1 in fingerprint region) with small amount of mannuronic acid fraction. Sample (n = 2; LFR-5/60) is heteropolyguluronic acid enriched in presence of tiny amount guluronic acid (814 cm-1 peak) i.e. comparatively high G to M in this fraction but %G is lower than n = 1. The rheological parameter storage modulus (G′ ) and loss modulus (G”) were noticed higher with the constant frequency mode, a solid-like nature gels was obtained with increasing the frequency in a certain time of relaxation. The gelling properties of the samples calculated is M/G < 1 which able to make hard and rigid gel. Thus, radiation effects for rheology and FTIR in case of functional group distribution was significant.
  • Exploring the perceived influence of social media use on disordered eating in nutrition and dietetics students

    Law, Rebecca; Jevons, Emily; University of Chester (Wiley, 2023-07-20)
    Background: Social media use (SMU) is increasingly widespread. More recently, SMU has been associated with increases in disordered eating; however, few qualitative studies have explored this issue in nutrition and dietetics students specifically, where susceptibility to disordered eating may be particularly high. The present study therefore aimed to investigate the perceived impact of SMU on disordered eating in nutrition and dietetics students. Methods: One‐to‐one, in‐depth, semi‐structured interviews were conducted with nutrition and dietetics students from universities across the UK. Interviews explored students’ views on the potential influence of SMU on their eating‐related thoughts, feelings and behaviours. Data were thematically analysed to identify key themes. Results: The findings suggested that SMU may provide students with a useful tool for the exploration of new recipes, ingredients and health‐related information, thus enabling them to improve their eating behaviour and diet quality. However, students also showed high levels of objective awareness regarding the problems associated with SMU, including the presence of misinformation, body image dissatisfaction, social pressures and disordered eating. Interestingly, despite enabling them to detect sources of misinformation, students also discussed the negative impact that their course had on their eating habits, suggesting course content may be an additional risk factor for the development of disordered eating for this particular group. Conclusions: Future research should investigate ways to mitigate the negative impact of SMU and course content on disordered eating in nutrition and dietetics students.
  • A comprehensive review on food hydrocolloids as gut modulators in the food matrix and nutrition: The hydrocolloid-gut-health axis

    Ağagündüz, Duygu; Özata-Uyar, Gizem; Kocaadam-Bozkurt, Betül; Özturan-Şirin, Ayçıl; Capasso, Raffaele; Al-Assaf, Saphwan; Özoğul, Fatih; Gazi University; Erzurum Technical University; Aydın Menderes University; University of Naples Federico II; University of Chester; Cukurova University (Elsevier, 2023-07-15)
    Background Food hydrocolloids are versatile natural food ingredients, which can be authentically present in food matrices or can be added as functional food ingredients and/or food additives. All hydrocolloids are common in industrial use with enhancers of viscosity, emulsifiers, coating, gelling agents, stabilizing agents and/or thermodynamic stability providers. While safety issues of hydrocolloids in the food industry have been discussed until now, research has turned to their effects on gut modulation, human health and wellbeing. Scope and approach This review focuses on a comprehensive discussion of certain food hydrocolloids in gut modulation and their potential interaction with health through gut modulation. Key findings and conclusions Novel literature suggests that certain food hydrocolloids could substantially change the range and structure of the microbiota of the gut and the primary bioactive metabolites. Besides, hydrocolloids show important outcomes on gut microbiota because of their physicochemical and structural properties. Moreover, they may have various impacts, and the mechanisms of gut microbiota activity are quite diverse depending on their polymeric structure and source. Despite some discrepancies and divergences in their impacts on the gut microbiota-health axis, their reassuring outcomes on health are mainly associated with their prebiotic or prebiotic-like effects. In this way, it can directly/indirectly affect host health. Therefore, while investigating the possible health and safety effects of the use of hydrocolloids in the form of food additives, it may be useful to investigate the benefits and side effects on the gut.
  • Nano‐delivery systems as a promising therapeutic potential for epilepsy: Current status and future perspectives

    Movahedpour, Ahmad; Taghvaeefar, Rasul; Asadi‐Pooya, Ali‐Akbar; Karami, Yousof; Tavasolian, Ronia; Khatami, Seyyed H.; Soltani Fard, Elahe; Taghvimi, Sina; Karami, Neda; Rahimi Jaberi, Khojaste; et al. (Wiley Open Access, 2023-07-14)
    Epilepsy is a common chronic neurological disorder caused by aberrant neuronal electrical activity. Antiseizure medications (ASMs) are the first line of treatment for people with epilepsy (PWE). However, their effectiveness may be limited by their inability to cross the blood–brain barrier (BBB), among many other potential underpinnings for drug resistance in epilepsy. Therefore, there is a need to overcome this issue and, hopefully, improve the effectiveness of ASMs. Recently, synthetic nanoparticle‐based drug delivery systems have received attention for improving the effectiveness of ASMs due to their ability to cross the BBB. Furthermore, exosomes have emerged as a promising generation of drug delivery systems because of their potential benefits over synthetic nanoparticles. In this narrative review, we focus on various synthetic nanoparticles that have been studied to deliver ASMs. Furthermore, the benefits and limitations of each nano‐delivery system have been discussed. Finally, we discuss exosomes as potentially promising delivery tools for treating epilepsy.
  • 3D hydrogel/ bioactive glass scaffolds in bone tissue engineering: Status and future opportunities

    Aldhaher, Abdullah; Shahabipour, Fahimeh; Shaito, Abdullah; Al-Assaf, Saphwan; Elnour, Ahmed; Sallam, El Bashier; Teimourtash, Shahin; Elfadil, Abdelgadir A.; Sharif University of Technology; Mashhad University of Medical Science; Shahid Beheshti University of Medical Sciences; Qatar University; University of Chester; University of Malaysia Pahang-UMP; Freelance Global and Public Health Expert (FGPHE), Sudan; McMaster University; Al-Neelain University (Elsevier, 2023-07-05)
    Repairing significant bone defects remains a critical challenge, raising the clinical demand to design novel bone biomaterials that incorporate osteogenic and angiogenic properties to support the regeneration of vascularized bone. Bioactive glass scaffolds can stimulate angiogenesis and osteogenesis. In addition, natural or synthetic polymers exhibit structural similarity with extracellular matrix (ECM) components and have superior biocompatibility and biodegradability. Thus, there is a need to prepare composite scaffolds of hydrogels for vascularized bone, which incorporates bioactive glass to improve the mechanical properties and bioactivity of natural polymers. In addition, those composites' 3-dimensional (3D) form offers regenerative benefits such as direct doping of the scaffold with ions. This review presents a comprehensive discussion of composite scaffolds incorporated with BaG, focusing on their effects on osteo-inductivity and angiogenic properties. Moreover, the adaptation of the ion-doped hydrogel composite scaffold into a 3D scaffold for the generation of vascularized bone tissue is exposed. Finally, we highlight the future challenges of manufacturing such biomaterials.

View more