Hull Lifesaving Museum

Abstract Background Perianal Crohn’s disease (pCD) is a morbid condition with a prevalence of approximately 20% in patients within 10 years of diagnosis of Crohn’s disease (CD) (1). The changing global epidemiology of inflammatory bowel disease (IBD) suggests that the rising incidence of CD, particularly in areas with currently low prevalence, may translate into an increased future burden of pCD (2). Given the significant impact this condition has on patient quality of life, a Priority Setting Partnership (PSP) was established to define the top 10 priorities for future research into pCD, with an aim to develop a coordinated and inclusive research agenda, and anticipate future global needs. Methods The PSP was conducted in collaboration with the James Lind Alliance (JLA) using standardised JLA methodology. An initial survey was circulated to gather unanswered research questions from key stakeholders globally. From this, a longlist of 51 summary questions was formed. A second survey asked stakeholders to prioritise the 51 summary questions, and the highest ranking 19 questions were taken into the final workshop. During the final workshop, a panel of people with lived or professional experience of pCD ranked the top 10 research priorities, in a process facilitated by JLA advisors using Nominal Group Technique. Results 1200 individual research uncertainties were submitted by over 464 respondents, representing 30 countries. The majority of responses were from the United Kingdom (19%), the Netherlands (14%), Portugal (13%), the United States (US) (11%) and Brazil (9%). Patients provided 58% of responses, with 20% of responses coming from lower and middle-income countries according to the World Bank Criteria. From the 51 summary questions that were developed from these responses, the Top 10 research priorities were established in the final workshop (Figure 1). Themes that were identified in the Top 10 included elucidating the underlying causes of pCD, improving strategies for early diagnosis, determining predictors of quality of life, and advancing therapeutic approaches and quality of life across the full spectrum of disease. Conclusion This Global pCD PSP marks an importance advance towards stakeholder-driven, focused research in pCD, providing a roadmap for researchers, clinicians and funders to align future research with patient and clinician priorities.

Abstract Background Switch of Infliximab from intravenous (IV) to subcutaneous (SC) route in inflammatory bowel disease is reported to produce higher drug levels but impact on (ADAs) is not known. Furthermore, the impact of cessation of concomitant immunomodulators (IMMs) following switch on trough levels or development of ADAs is also not evaluated so far. We aimed to study the impact of cessation of IMMs following switch of infliximab from IV to SC route on ADAs status and determine relationship with HLA-DQA1*05 status. Methods Consecutive patients who participated in a planned switch programme were prospectively included. HLA status was determined at initiation of Infliximab as part of standard screening in our unit. Clinical, biomarker and pharmacokinetic data were collected pre-switch, and at 8 weekly intervals post switch. Trough levels and ADAs status in patients who discontinued or reduced the dose of IMMs were compared with those who remained or continued same dose on IMMs. We also evaluated the impact of HLA status on development of ADAs post switch. Results A total of 274 patients (M: F = 1.1:1), Median age at diagnosis 33 years (2-76), UC/CD (123/151) who completed at least 8 weeks follow up were included. Median duration of follow up was 28 weeks. 124 patients (45.3%) were on concomitant IMMs and 107 (40.4%) was HLADQA1*05 positive. The mean infliximab trough level prior to switch was 7.30 µg/mL which increased 8 weeks post switch to 15.05 µg/mL (p < 0.001). The enhancement of levels persisted at 40 weeks (15.74 µg/mL) and at week 90 (15.26 µg/mL). 74 patients (27%) were positive for ADAs before switch; in 16 patients (22%) the ADAs disappeared at 8 weeks and in further 8 (total 33%) by 40 weeks. In total antibody titre reduced or become negative in 47 patients (63.5%), static in 6 patients (8.1%) but increased in 21 patients (28.4%); only 3 had significant neutralizing antibodies with low trough levels. 28 of the 124 patients (23%) had IMMs discontinued, and dose reduced in further 8 patients. The overall de-escalation rate was 29%, and HLA did not significantly impact trough levels or ADA development. Eleven patients (4.0%) switched back to IV due to personal preference and 2 (0.7%) were switched out of class due to secondary loss of response. Drug persistence with SC switch was 95.3%. Conclusion Switch from IV to SC infliximab is effective in maintaining and enhancing trough levels with positive impact on reducing ADAs and in some cases lead to disappearance of anti-drug antibodies. It is feasible to de-escalate concomitant IMMs in a considerable proportion of patients following switch irrespective of the HLA status. This data needs confirmation from the ongoing randomised controlled trial MINIMISE (ISRCTN95420128) Conflict of interest: Dr. Al-Dujaily, Hashem: No conflict of interest Fitzgerald, Abbie-Lei: No conflict of interest Mcbride, Jodie: No conflict of interest Robertson, Hayley: No conflict of interest Talbot, Alison: No conflict of interest Messiha, Maged: No conflict of interest Thomas, Mithun: No conflict of interest Whitehead, Emma: No conflict of interest Sebastian, Shaji: Grant: Takeda, Tillots pharma, Biogen, Pfizer, Abbvie, Johnson & Johnson, Olympus -Odin Vision Personal Fees: Tillots, Johnson & Johnson, Olympus Odin Vision, AbbVie, Takeda, Merck, Pharmacosmos, Amgen, Eli Lilly, BMS, Odin Vision Non-financial Support: Tillots, Takeda, AbbVie, Celltrion, Johnson & Johnson, Eli Lilly, Alphasigma, Ferring Pharma

Biokol har länge använts som jordförbättrare och har på senare år fått ökad uppmärksamhet för sina tillämpningar inom lantbruk, industri och som kolsänka. År 2022 stod lantbruket för cirka 14 % av Sveriges territoriella växthusgasutsläpp, varav hälften av detta utgjordes av metan från idisslande djur.Denna förstudie undersökte biokolets potential som fodertillsats till idisslande djur, för att minska metanutsläpp och samtidigt bidra till förbättrad djurhälsa, stallmiljö och efterföljande gödseleffekter. Studien har samlat aktörer från lantbruk, forskning och biokolsproduktion för att kartlägga förutsättningar, hinder och affärsmodeller för användningen. Detta för att lägga grunden för kommande fortsättningsprojekt.En del i förstudien var att studera relevanta regelverk och certifieringar, från EU:s och Sveriges foderlagstiftning till certifieringssystem som European Biochar Certificate (EBC) och svenska kolkreditsystem. Det kan konstateras att det saknas direkta regulatoriska hinder för användning av biokol som fodertillsats.En annan viktig del var att sammanställa befintlig litteratur samt utforma en idé för ett framtida vetenskapligt djurförsök. I nuläget saknas det studier i Sverige som undersöker biokolets påverkan på metanutsläpp hos idisslare. De studier som finns från andra delar av världen visar varierande resultat, vilket gör det svårt att dra entydiga vetenskapliga slutsatser. Slutsatsen från litteraturstudien är att biokol kan ha en potential att minska metanutsläppen, vilket då kan minska klimatpåverkan från kött- och mejeriproduktion.För att kunna validera effekterna av biokol som fodertillsats krävs fortsatt forskning, vetenskapliga försök och utveckling av affärsmodeller som gynnar hela värdekedjan. Förstudien visar att en väg framåt är möjlig men förutsätter fortsatt kunskapsuppbyggnad och konkret samverkan mellan forskning, biokolproduktion, lantbruk och livsmedelsindustri. Ett naturligt nästa steg är ett vetenskapligt och nationellt förankrat försök genomfört i tre steg: i laboratoriemiljö, småskaligt på försöksgård samt fältförsök i större skala.

Background: Inappropriate intravenous (IV) fluid prescribing is a common and preventable source of morbidity in hospitalised patients. Maintenance fluids should meet daily physiological requirements without causing electrolyte imbalances or fluid overload. National Institute for Health and Care Excellence (NICE) guidelines recommend hypotonic, balanced solutions tailored to patient weight.Aim: This study aims to evaluate adherence to NICE IV fluid prescribing guidelines in a district general hospital's general surgery department, implement targeted interventions, and assess impact through re-audit.Methods: A three-phase quality improvement project using the Plan-Do-Study-Act (PDSA) cycle was conducted. Phase 1 involved retrospective analysis of IV maintenance fluid prescriptions for emergency laparotomy patients (n = 21). Phase 2 introduced a new default fluid (0.45% NaCl + 0.15% KCl + 5% dextrose), delivered teaching sessions, and disseminated prescribing guidance. Phase 3 was a re-audit (n = 20) conducted one month post-intervention.Results: Pre-intervention, only 9.5% of patients received fluids in line with NICE guidance. Sodium and chloride intake exceeded recommended levels by over 200%, while potassium provision was 83% below target. Post-intervention, appropriate prescribing increased to 45%, with reductions in sodium (by 165%) and chloride (by 128%) administration, and improved potassium and dextrose provision.Conclusion: A multidisciplinary intervention significantly improved adherence to fluid prescribing guidelines, reduced electrolyte excess, and enhanced patient safety. Sustained improvement requires trust-wide policy development, consistent education, and broader implementation across departments.

This volume, the proceedings of a Docklands History Group Symposium held at the Museum of London in March 2013, brings us up to date with the state of knowledge of the London whaling trade. There i...

Leaching barley straw has been found to eliminate reactor slagging and fluidised bed agglomeration under continuous gasification.

We report the fabrication of a solution-processed n-type Thin Film Transistor (TFT) with current on/off ratios of 104, a turn-on voltage (VON) of 1.2 V and a threshold voltage (VT) of 6.2 V. The TFT incorporates an insoluble and intractable dielectric layer (k = 7–9) prepared in situ from solution-processed and then photopolymerised ligand-stabilised, inorganic/organic TiO2 nanorods. A solution processed zinc oxide (ZnO) layer acts as the semiconductor. The new surface-modified TiO2 nanorods were synthesised using a ligand replacement process with a monolayer coating of photopolymerisable 10-undecynylphosphonic acid (10UCYPA) to render them both soluble in common organic solvents and be photopolymerisable using UV-illumination after having been deposited on substrate surfaces from solution and drying.

This work reports the surface modification of sawdust particles with silane-modified alumina nanoparticles and polydimethylsiloxane to create smart micron-sized adsorbents for separation of surfactant-stabilized emulsions. A very fine polysiloxane network (<12 nm) was created on the surface of alumina nanoparticles which were then uniformly coated on the surface of sawdust particles to create a hierarchical film with thickness < 500 nm. The composite particles were then coated with polydimethylsiloxane to create a stable superhydrophobic absorbent with water contact angle > 150° and thermal stability up to 200 °C. The adsorbent is wet by oil and can be used to separate surfactant-stabilized emulsions under mechanical agitation. The adsorbent was able to remove most of the oil content from the emulsions; the optical transmittance of emulations increased from 0 to ca. 90% after separation, and optical microscopy images showed very low traces of oil in the filtrate.

ABSTRACTThis study identifies the ethical pathways of chief audit executive reporting lines that describe internal auditing relationships with different authorities in the organization (e.g. the board of directors, audit committee, chief executive officer, and chief financial officer). The literature has placed importance of these lines as determinants for the objectivity and independence of internal auditing. Recent studies have reported inconsistent findings regarding whether reporting to high authority is the optimal reporting line compared to reporting to low authority. For this reason, there is a need for further investigation. Thus, this study harnesses the strengths and weaknesses of three ethical pathways in a decision-making model (described as the Ethical Process Thinking Model). In this way, we provide an explanation of the complex situations of internal audit reporting line in reality. The findings highlight that individuals’ different perceptions and judgments, as well as information signals can lead to different reporting lines (decision choices). The three dominant ethical pathways (i.e. preference-based, rule-based and principle-based) advance the literature by providing a clearer picture for practitioners, researchers and regulators to facilitate independence and objectivity requirements.

We have developed highly efficient antimicrobial nanocarriers for berberine (BRB) based on shellac nanoparticles (NPs) which were surface-functionalised with a surface active polymer, Poloxamer 407 (P407), and the cationic surfactant octadecyltrimethylammonium bromide (ODTAB). These shellac nanocarriers were produced in a two-step process which involves: (i) a pH change from aqueous ammonium shellac solution using P407 as a steric stabilizer in the presence of berberine chloride, and (ii) addition of ODTAB to yield shellac nanocarriers of cationic surface. We determined the BRB encapsulation efficiency and release profiles from such nanocarriers. We explored the antimicrobial action of these nanocarriers at different stages of their preparation which allowed us gain better understanding how they work, fine tune their design and reveal the impact of the nanoparticle coatings on to its antimicrobial effect. The antimicrobial action of BRB loaded within such shellac NPs with cationic surface functionality was examined on three different microorganisms, C. reinhardtii, S. cerevisiae and E. coli and compared with the effect of free BRB as well as non-coated BRB-loaded nanocarriers at the same BRB concentrations. We found that the cationic surface coating of the shellac NPs strongly amplified the efficiency of the encapsulated BRB across all tested microorganisms. The effect was attributed to the increased attraction between the ODTAB-coated BRB-loaded NPs and the anionic surface of the cell walls which delivers locally high BRB concentration. This nanotechnological approach could lead to more effective antimicrobial and disinfecting agents, dental formulations for plaque control, wound dressings, antialgal/antibiofouling formulations and antifungal agents.