• Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss

      Kirwan, Richard; orcid: 0000-0003-4645-0077; email: r.p.kirwan@2018.ljmu.ac.uk; McCullough, Deaglan; orcid: 0000-0002-9882-9639; Butler, Tom; orcid: 0000-0003-0818-1566; email: t.butler@chester.ac.uk; Perez de Heredia, Fatima; orcid: 0000-0002-2537-3327; Davies, Ian G.; orcid: 0000-0003-3722-8466; Stewart, Claire; orcid: 0000-0002-8104-4819 (Springer International Publishing, 2020-10-01)
      Abstract: The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
    • Sarcopenia estimation using psoas major enhances P-POSSUM mortality prediction in older patients undergoing emergency laparotomy: cross-sectional study.

      Simpson, Gregory; orcid: 0000-0002-9779-1747; email: gregorysimpson@doctors.org.uk; Wilson, Jeremy; Vimalachandran, Dale; McNicol, Frances; Magee, Conor (2021-04-21)
      Emergency laparotomy is a considerable component of a colorectal surgeon's workload and conveys substantial morbidity and mortality, particularly in older patients. Frailty is associated with poorer surgical outcomes. Frailty and sarcopenia assessment using Computed Tomography (CT) calculation of psoas major area predicts outcomes in elective and emergency surgery. Current risk predictors do not incorporate frailty metrics. We investigated whether sarcopenia measurement enhanced mortality prediction in over-65 s who underwent emergency laparotomy and emergency colorectal resection. An analysis of data collected prospectively during the National Emergency Laparotomy Audit (NELA) was conducted. Psoas major (PM) cross-sectional area was measured at the L3 level and a ratio of PM to L3 vertebral body area (PML3) was calculated. Outcome measures included inpatient, 30-day and 90-day mortality. Statistical analysis was conducted using Mann-Whitney, Chi-squared and receiver operating characteristics (ROC). Logistic regression was conducted using P-POSSUM variables with and without the addition of PML3. Nine-hundred and forty-four over-65 s underwent emergency laparotomy from three United Kingdom hospitals were included. Median age was 76 years (IQR 70-82 years). Inpatient mortality was 21.9%, 30-day mortality was 16.3% and 90-day mortality was 20.7%. PML3 less than 0.39 for males and 0.31 for females indicated significantly worse outcomes (inpatient mortality 68% vs 5.6%, 30-day mortality 50.6% vs 4.0%,90-day mortality 64% vs 5.2%, p < 0.0001). PML3 was independently associated with mortality in multivariate analysis (p < 0.0001). Addition of PML3 to P-POSSUM variables improved area under the curve (AUC) on ROC analysis for inpatient mortality (P-POSSUM:0.78 vs P-POSSUM + PML3:0.917), 30-day mortality(P-POSSUM:0.802 vs P-POSSUM + PML3: 0.91) and 90-day mortality (P-POSSUM:0.79 vs P-POSSUM + PML3: 0.91). PML3 is an accurate predictor of mortality in over-65 s undergoing emergency laparotomy. Addition of PML3 to POSSUM appears to improve mortality risk prediction.
    • Scalability of resonant motor-driven flapping wing propulsion systems

      Nabawy, Mostafa R. A.; orcid: 0000-0002-4252-1635; email: mostafa.ahmednabawy@manchester.ac.uk; Marcinkeviciute, Ruta (The Royal Society, 2021-09-22)
      This work aims to develop an integrated conceptual design process to assess the scalability and performance of propulsion systems of resonant motor-driven flapping wing vehicles. The developed process allows designers to explore the interaction between electrical, mechanical and aerodynamic domains in a single transparent design environment. Wings are modelled based on a quasi-steady treatment that evaluates aerodynamics from geometry and kinematic information. System mechanics is modelled as a damped second-order dynamic system operating at resonance with nonlinear aerodynamic damping. Motors are modelled using standard equations that relate operational parameters and AC voltage input. Design scaling laws are developed using available data based on current levels of technology. The design method provides insights into the effects of changing core design variables such as the actuator size, actuator mass fraction and pitching kinematics on the overall design solution. It is shown that system efficiency achieves peak values of 30–36% at motor masses of 0.5–1 g when a constant angle of attack kinematics is employed. While sinusoidal angle of attack kinematics demands more aerodynamic and electric powers compared with the constant angle of attack case, sinusoidal angle of attack kinematics can lead to a maximum difference of around 15% in peak system efficiency.
    • Scholar, gentleman and player: a tribute to Eric Dunning

      Malcolm, Dominic; orcid: 0000-0002-5898-2911; Waddington, Ivan; orcid: 0000-0002-5311-9967 (Informa UK Limited, 2020-09-14)
    • -Selective olefination of fluoroarenes with alkynes using CO

      Spencer, Andrew R A; Korde, Rishi; Font, Marc; Larrosa, Igor; orcid: 0000-0002-5391-7424 (2020-03-31)
      Over the last few decades C-H olefination has received significant interest, due to the importance and usefulness of aryl olefins both as synthetic targets and intermediates. While a wide range of -olefination protocols have been developed, only a small number of -olefinations are currently available. Importantly, the most common approach to -olefination, using a large -directing template, is not suitable for substrates such as fluorobenzenes, which cannot be derivatised. We report that the -selective olefination of fluoroarenes can be achieved the use of CO as a traceless directing group, which can be easily installed and removed in a one-pot process. Furthermore, this approach avoids the use of stoichiometric Ag(i)-salts, commonly used in C-H olefinations, and affords complete - over / -regioselectivity. [Abstract copyright: This journal is © The Royal Society of Chemistry.]
    • Selling the news: Distributing Wrexham's newspapers, 1850-1914

      Peters, Lisa; Skinner, Katherine; University of Chester (Oak Knoll Press & The British Library, 2009-07)
      This book chapter discusses how Wrexham's newspapers developed a reliable distribution service through north and mid Wales and parts of Cheshire and Shropshire. The role of agents and how their location reflected a newspaper's circulation area is particuarly discussed.
    • Sequencing therapies in Hodgkin lymphoma.

      Phillips, Elizabeth H; email: beth.phillips@manchester.ac.uk; Collins, Graham P; Cwynarski, Kate (2021-08)
    • Severity of the COVID‐19 pandemic in India

      Imai, Katsushi S.; orcid: 0000-0001-7989-8914; email: Katsushi.Imai@manchester.ac.uk; Kaicker, Nidhi; Gaiha, Raghav (2021-05-18)
      Abstract: The main objective of this study is to identify the socioeconomic, meteorological, and geographical factors associated with the severity of COVID‐19 pandemic in India. The severity is measured by the cumulative severity ratio (CSR)—the ratio of the cumulative COVID‐related deaths to the deaths in a pre‐pandemic year—its first difference and COVID infection cases. We have found significant interstate heterogeneity in the pandemic development and have contrasted the trends of the COVID‐19 severities between Maharashtra, which had the largest number of COVID deaths and cases, and the other states. Drawing upon random‐effects models and Tobit models for the weekly and monthly panel data sets of 32 states/union territories, we have found that the factors associated with the COVID severity include income, gender, multi‐morbidity, urbanization, lockdown and unlock phases, weather including temperature and rainfall, and the retail price of wheat. Brief observations from a policy perspective are made toward the end.
    • Sex and age-specific survival and life expectancy in a free ranging population of Indri indri (Gmelin, 1788)

      Rolle, F.; Torti, V.; Valente, D.; De Gregorio, C.; Giacoma, C.; orcid: 0000-0002-8429-7723; Von Hardenberg, A. (Informa UK Limited, 2021-07-22)
    • “Sex isn’t everything”: views of people with experience of psychosis on intimate relationships and implications for mental health services

      White, Rebecca; email: rebecca.white@manchester.ac.uk; Haddock, Gillian; Varese, Filippo; Haarmans, Maria (BioMed Central, 2021-06-14)
      Abstract: Background: The experience of psychosis and associated discrimination can be a barrier to forming and maintaining romantic relationships. Sexual health interventions within mental health services often focus on contraception and reducing risk. There are no known studies that seek to understand what support, if any, people who experience psychosis want regarding psychosocial aspects of intimate relationships. Methods: To address this gap in the literature, qualitative data was collected to investigate how people with experience of psychosis conceptualise romantic relationships and what support they would like in this area of their lives. Semi-structured interviews were conducted with 10 mental health service users (four women, six men) with experience of psychosis. Interviews were analysed from a critical realist social constructionism perspective using thematic analysis. Results: Stigma was a prominent theme, described as impacting numerous aspects of romantic relationships. Power imbalance within services meant participants were wary of having conversations about relationships with professionals and identified a therapeutic alliance as a prerequisite. However, abusive relationships were highlighted as a needed area for support by services. Conclusion: Services should be trauma-informed and help those in abusive relationships. The power and autonomy of people with experience of psychosis should be maintained in any discussions or interventions regarding intimate relationships. A strong therapeutic alliance is essential for any work in this area.
    • Sexual minority prevalence and attitudes within the British horseracing industry

      Letts, David; orcid: 0000-0003-1541-3118; email: d.letts.19@unimail.winchester.ac.uk (SAGE Publications, 2020-11-01)
      This article utilises the theories of Inclusive Masculinity and Organisational Cultural Lag to provide the first comprehensive exploration of sexual minority inclusion in the British horseracing industry. The study employs a quantitative approach, involving a survey distributed to two mixed-gender populations within the sport: jockeys (n = 149) and non-athlete stakeholders (n = 308). Results indicate that approximately one fifth of jockeys selected a response other than ‘straight’, while less than 4% of the population of jockeys and stakeholders would view a sexual minority colleague ‘very negatively’. However, despite the relatively high proportion of sexual minority individuals working within the industry, and the positive attitudinal responses towards having a sexual minority colleague, only one of the 149 jockeys surveyed identified as a sexual minority and were publicly ‘out’.
    • Sexuality and the human rights of persons with dementia

      Peisah, Carmelle; Ayalon, Liat; Verbeek, Hilde; Benbow, Susan M.; Wiskerke, Esther; Rabheru, Kiran; Sorinmade, Oluwatoyin
      We explore barriers to enjoyment of human rights to sexuality of persons with dementia and remedies for addressing these. Enjoyment of sexuality is contingent upon actualisation of rights to dignity, autonomy, respect for will and preferences, abuse safeguarding and equitable access to highest standards of sexual health. Persons with dementia living at home or in care face systemic barriers to enjoyment of sexuality fuelled by ageism, apathy and ignorance, compounded by complex legal barriers in relation to consent. Such challenges can be tackled with awareness raising and education of care staff, families and physicians, including training for capacity assessment with dimensional, non-categorical conceptualisation of capacity, leaving room for supported decision-making. These measures, together with strengthened legislative and human rights frameworks to cater to the specific needs of older people, may allow people to live well with dementia and exercise their human rights to enjoy sexuality in a safe and lawful manner.
    • Shifting attention between modalities: Revisiting the modality-shift effect in autism.

      Poole, Daniel; orcid: 0000-0002-7399-2499; email: daniel.poole@manchester.ac.uk; Miles, Eleanor; Gowen, Emma; Poliakoff, Ellen (2021-04-30)
      Selective attention to a sensory modality has been observed experimentally in studies of the modality-shift effect - a relative performance benefit for targets preceded by a target in the same modality, compared to a different modality. Differences in selective attention are commonly observed in autism and we investigated whether exogenous (automatic) shift costs between modalities are increased. Autistic adults and neurotypical controls made speeded discrimination responses to simple visual, tactile and auditory targets. Shift costs were observed for each target modality in participant response times and were largest for auditory targets, reflective of fast responses on auditory repeat trials. Critically, shift costs were similar between the groups. However, integrating speed and accuracy data using drift-diffusion modelling revealed that shift costs in drift rates (reflecting the quality of information extracted from the stimulus) were reduced for autistic participants compared with neurotypicals. It may be that, unlike neurotypicals, there is little difference between attention within and between sensory modalities for autistic people. This finding also highlights the benefit of combining reaction time and accuracy data using decision models to better characterise selective attention in autism.
    • Shingles, Zostavax vaccination and risk of developing dementia: a nested case-control study-results from the UK Biobank cohort.

      Lophatananon, Artitaya; orcid: 0000-0003-0550-4657; Mekli, Krisztina; Cant, Rachel; Burns, Alistair; Dobson, Curtis; Itzhaki, Ruth; Muir, Kenneth; orcid: 0000-0001-6429-988X; email: kenneth.muir@manchester.ac.uk (2021-10-08)
      To investigate the association between shingles and dementia, and between Zostavax vaccination and dementia. Nested case-control study. Data were drawn from the UK Biobank cohort study with a total of 228 223 participants with Hospital Episodes Statistics and primary care linkage health records. The analyses included 2378 incident dementia cases and 225 845 controls. Inclusion criteria for incident cases were a dementia diagnosis 3 years or more after the first assessment date derived from all sources including International Classification of Diseases (ICD)-10, ICD-9, self-report and primary care linkage records. Subjects with no dementia code from all sources were coded as controls. Both shingles and Zostavax vaccination were investigated for their association with dementia risk. There was a small but non-significant increase in the risk of dementia in subjects with shingles diagnosed 3 years or more prior to dementia diagnosis (OR: 1.088 with 95% CI: 0.978 to 1.211). In those subjects who had had Zostavax vaccination, the risk of dementia significantly decreased (OR: 0.808 with 95% CI: 0.657 to 0.993). A history of shingles was not associated with an increased risk of dementia. In subjects who were eligible for the immunisation and vaccinated with Zostavax, we saw reduced risk of developing dementia. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
    • Simulating Topological Robustness of Fano Resonance in Rotated Honeycomb Photonic Crystals

      Hajivandi, J.; Kaya, E.; Edwards, G.; Kurt, H.
      The Fano resonance with a distinctive ultra-sharp, asymmetric line shape and high quality factor, is a widely occurring phenomena, that has a large variety of optical, plasmonic and microwave manifestations. In this paper, we explore the characteristic robustness of a Fano resonance mode, which is topologically protected by engineering a band inversion, induced by breaking the mirror symmetry of a two-dimensional honeycomb photonic crystal (HPC), associated with C 6 point group symmetry. Dark and bright topological edge modes appear in the band gap which arise when Dirac cone is opened up. Destructive and constructive interference of the dark and bright modes leads to the asymmetric line shape of the Fano resonance. The Fano resonance is very sensitive to the material changes and structural perturbations. This property can be applied to obtain new sensor designs. Here we demonstrate that the topological Fano resonance mode preserves its asymmetric, ultra-sharp line shape in the presence of the disorder, defects and cavities.The stability of the Fano resonance mode has useful optical device applications such as in low threshold lasers, and extremely precise interferometers.
    • Simulating topological robustness of Fano resonance in rotated Honeycomb photonic crystals

      Hajivandi, J.; Kaya, E.; Edwards, G.; Kurt, H. (Elsevier, 2021-07-08)
      The Fano resonance with a distinctive ultra-sharp, asymmetric line shape and high quality factor, is a widely occurring phenomena, that has a large variety of optical, plasmonic and microwave manifestations. In this paper, we explore the characteristic robustness of a Fano resonance mode, which is topologically protected by engineering a band inversion, induced by breaking the mirror symmetry of a two-dimensional honeycomb photonic crystal (HPC), associated with C 6 point group symmetry. Dark and bright topological edge modes appear in the band gap which arise when Dirac cone is opened up. Destructive and constructive interference of the dark and bright modes leads to the asymmetric line shape of the Fano resonance. The Fano resonance is very sensitive to the material changes and structural perturbations. This property can be applied to obtain new sensor designs. Here we demonstrate that the topological Fano resonance mode preserves its asymmetric, ultra-sharp line shape in the presence of the disorder, defects and cavities.The stability of the Fano resonance mode has useful optical device applications such as in low threshold lasers, and extremely precise interferometers.