Item Metadata onlyRedefining Bioavailability through Migrant Egg Donors in Spain(Sage Journals, 2023-03-18) Nahman, Michal; Weis, ChristinaThis article utilises feminist technoscience studies’ notions of bodily ‘materialisation’ and ‘ontological choreographies’, offering a cyborg feminist account of ‘bioavailability’ as embodied becomings, rather than a fixed ontological state of being. Drawn from 2 years’ ethnographic study in in vitro fertilisation clinics in Spain with migrant women who provided eggs to the cross-border in vitro fertilisation industry, this work explores how global understandings of race and inequalities, clinical practices and women’s own emotional and physical labours collectively produce bioavailability. Through examples from observations and interviews in in vitro fertilisation clinics, we examined women’s embodied stories to understand the ways in which bioavailability becomes. The article demonstrates a novel way in which to think about ‘bioavailability’, a concept which has already been of enormous use to the social sciences since its introduction by Lawrence Cohen. We examine recent configurations of bodily extraction in the reproduction–migration nexus that help us rethink the concept of bioavailability. Item EmbargoEmerging “repronubs” and “repropreneurs”: Transnational surrogacy in Ghana, Kazakhstan, and Laos(Sage Journals, 2022-06-03) Whittaker, Andrea; Gerrits, Trudie; Weis, ChristinaIn this article, we offer an analysis of the development of “repronubs”: less-known locations offering small-scale, niche cross-border gestational surrogacy or surrogacy services for a regional market. This analytical category of “repronubs” is useful to describe the formation of the industry from small local sites to those offering cross-border services. Based on our work in these locations, we compare the markets, regulatory contexts, and organization of the industry in Ghana, Kazakhstan, and Laos, focusing on the “repropreneurs” or surrogacy facilitation agents as pivotal in the emergence of these sites. These “repronubs” highlight the surrogacy trade between countries of the Global South and are established next to or instead of the more well-known North–South destinations. We document how surrogacy itself is increasingly stratified between higher cost and better-regulated environments such as in certain states of the United States or Canada and lower cost, less well regulated, and regionally focused environments in the settings we describe. These locations are characterized by poor or liberal regulations, the existence of local in vitro fertilization (IVF) expertise, and the emergence of local repropreneurs driving the trade using their social networks. The growth of demand from China and the growing affluent middle class in Africa is creating further markets for such regional “nubs.” Studying surrogacy in such locations is made difficult by the secrecy and confidentiality surrounding it. Item Metadata onlyStruggling to manage: A constructivist grounded theory of hoarding behaviours(Wiley, 2023-07-05) Ruby‐Granger, Victoria; Wilde, David; Seymour‐Smith, Sarah; Zysk, EvaHoarding behaviours can cause numerous problems including health risks, family conflict, and removal of children and pets from the home. Hoarding research typically adopts a cognitive‐behavioural framework and uses quantitative methods; we aimed to further understand the development of hoarding behaviour from a qualitative perspective. Constructivist grounded theory methods were employed across two phases of data collection via semi‐structured interviews with participants identifying as exhibiting hoarding behaviours. Provisional categories were developed in phase one; further data analysis in phase two helped to establish our grounded theory. The theoretical core is a struggle to manage possessions and life, including life transitions such as moving to a new home and starting or finishing university. ‘Struggling to manage’ incorporates emotional struggles with possessions and the impacts of personal trauma and overwhelming life events. A further category, ‘Trying to overcome hoarding’ incorporates participants' efforts to manage and overcome their hoarding. Findings highlight the importance of viewing hoarding in a holistic context. Item Metadata onlySerum Albumin in Health and Disease: From Comparative Biochemistry to Translational Medicine(MPDI, 2023-09-06) Belinskaia, D. A.; Jenkins, R. O.; Goncharov, V. A. Item EmbargoSocial Science Research and Sickle Cell Disorders(Springer, 2023-09-14) Berghs, Maria; Ebenso, BasseySocial science research on sickle cell disorders (SCD), recessively inherited blood conditions, have come of age in the last twenty years from being invisible, neglected, racialized, and mainly medical in focus, to one that is now a global social science priority. In this chapter, an overview is given of sickle cell disorders and the sickle cell trait and why they are important to social science research. It is noted how social science research has had to engage in decolonization of research to uncover and make visible an invisible history as well as to assess policy decisions, like screening, in the present. Theoretical developments are presented but it is noted that social science research on SCD even in theory always has to deal with issues of “race” - even in future developments. Item EmbargoPhilosophical and practical challenges of Ubuntu: Application to decolonial activism and conceptions of personhood and disability(Routledge, 2023-12-19) Berghs, MariaIn this chapter, an explanation is given of the concept of Ubuntu or Unhu which is a Southern-African humanist and ethical worldview. From the Zulu language, it is often translated as “a person is a person through other persons” and as such is both a description of diversity and also a normative ethical claim about how we should live. In the popular consciousness, people associate Ubuntu with South Africa’s Truth and Reconciliation Commission (TRC) but it has been gaining ground in decolonial activism and also has a rich history in the African continent. Despite this history, there have been present issues with the philosophical and practical application of Ubuntu and its acceptance. This chapter examines why and tries to find an answer for how Ubuntu could become part of efforts of activism linked to understanding wider and more diverse conceptions of ‘rights’ and ecology. Item Open AccessAn investigation into the impact of diet and lifestyle on the management of lipoedema(Elsevier, 2022-04-05) Jin, Yannan; Benzine, Rawdha; Dunford, Louise; Fetzer, Sharie; Warrilow, MaryObjectives Lipoedema is a chronic fat disorder involving an excessive abnormal deposition of subcutaneous fat in the thighs, legs, hips and buttocks mainly (Wounds UK, 2017). The importance of healthy eating in lipoedema management has been recognised (Wounds UK, 2017), yet dietary guidelines specific for lipoedema are lacking (Bertsch et al., 2020). The study aimed to investigate the self-reported dietary and lifestyle impact on lipoedema management among a representative lipoedema population in the UK. Methods The study used an online questionnaire that consisted of multiple-choice and open-response questions to collect data on symptoms and diagnostic status of lipoedema and self-reported dietary and lifestyle impact on lipoedema management among participants. The questionnaire was constructed using the Survey Monkey software. The active online survey link was sent to Lipoedema UK's members and contacts via e-mail and also made accessible via the study flyer advertised on Lipoedema UK's website and newsletters. Ethical approval was obtained from the De Montfort University Faculty Research Ethics Committee of Health and Life Sciences prior to the study. Participants had given their consents before starting the survey. Data collection was anonymous. Data were analysed using SPSS v26.0. Results The results showed that 165 out of 257 participants (66.3%) had tried diet as a mean to improve their lipoedema symptoms in the past. Anti-inflammatory diet was reported to be one of the three most effective diets that improved their symptoms (either single or multiple). The other two diets were ketogenic diet and rare adipose disorder diet. Noticeably, 95% of the 257 participants were classified as either overweight or obese based on their Body Mass Index (BMI) measure. And 20% of the participants who tried weight loss diets had found improvements in their lipoedema conditions. Conclusions The study results will help inform the development of future research on finding a dietary solution to effective lipoedema management for the UK lipoedema population. Funding Sources De Montfort University funded the recruitment of a Research Assistant to support part of the data analysis work. Item Open AccessEditorial: Rising stars in nutrition and inflammation(Frontiers, 2023-04-14) Dong, Honglin; Jin, YannanInflammation occurs in acute and chronic disease states and interplays with one's nutritional status. Low-grade systemic inflammation has implications in the pathophysiology of age-related health issues and the major chronic diseases including cardiovascular disease, type 2 diabetes mellitus, Alzheimer's disease, and many types of cancer (1). High-fat diet (HFD) has shown to increase pro-inflammatory parameters including plasma high-sensitive C-reactive protein (hs-CRP), prostaglandin E2 (PGE2), thromboxane B2 (TXB2), and leukotriene B4 (LTB4) (2), whereas anti-inflammatory effects are reported among nutrients and phytochemicals such as fiber, unsaturated fatty acids, flavonoids, carotenoids, and certain dietary patterns (e.g, plant-based diet) through reducing hs-CRP, interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) and other biochemical markers of inflammation (3, 4). The Research Topic aims to collect recent evidence and improve our knowledge and understanding on the research area in the nutrition and inflammation. This collection includes eight papers. The paper by Dai et al. using a fish model, demonstrated that HFD significantly increased TNF-α, IL-6, and monocyte chemoattractant protein-1 contents in the intestine, liver, and plasma. The authors further found HFD reduced the number of goblet cells, disturbed the mucin 2 secretion and thus LPS escapes the intestinal epithelial cells barrier via a transcellular pathway with the assistance of CD36. Chen et al. conducted a retrospective analysis of 5,173 patients with acute ischemic stroke (AIS) at a hospital in China between 2013 and 2021. The patients with stroke-associated pneumonia (SAP, n = 897) had a significant lower albumin to globulin ratio (A/G) compared with non-SAP (n = 4,276; 1.12 ± 0.22 vs. 1.27 ± 0.23, P < 0.001). The patients with a lower A/G ( ≤ 1.09) had a higher risk of SAP (OR = 1.96, 95% CI, 1.56–2.46, P < 0.001) compared with patients with a A/G of 1.25–1.39. The authors indicated that appropriate measures to prevent SAP need to take for AIS patients with a low A/G and nutritional interventions to improve the A/G on the outcome of AIS and SAP should be investigated. Dong et al. conducted a pilot randomized controlled trial investigating the influence of vitamin D supplementation on immune function of healthy aging people (55–85 years). The study showed vitamin D3 supplementation at 1,000 IU/day for 12 weeks significant increased plasma 25(OH)D levels compared with the control group, however, no effect was observed on phagocytic activity of granulocytes and monocytes, TNF, IL-6, and lymphocyte subsets apart from significantly decreased plasma creatinine concentrations, though 43% of the participants were vitamin D deficiency [25(OH)D < 25 nmol/L] at baseline. Higher dose of vitamin D supplementation might be needed for the future study. Fan et al. reviewed the diagnostic use of the extracellular vesicles (EVs) in edible plants for different diseases such as neurodegenerative disease, and their therapeutic potentials for treating chronic diseases, such as stroke and Alzheimer's disease. Other novel aspects of EVs' application include their use as vehicles for safe drug delivery including genes and RNA drugs, due to their efficient transport through physiological barriers, such as the blood-brain barrier, and their high biocompatibility, low toxicity and immunogenicity. Research work continues in further exploring EVs' use as bioactive-substance delivery nanoplatforms and in anti-inflammatory treatments to meet the stringent demands of current clinical challenges. Oxidative stress with systemic inflammation accounts for the development of age-related inflammatory diseases (inflammaging). Labarrere and Kassab in their review explored the mechanisms of glutathione (GSH) on its roles as an antioxidant in reducing the body's oxidation and inflammation associated with chronic inflammatory diseases and SARS-CoV-2 infection. A synergy of an adequate GSH redox status and 25-hydroxyvitamin D levels showed to further enhance immunity and diminish the adverse clinical consequences of COVID-19, particularly evident in African American communities. Further research is needed to investigate the efficacy of using GSH alone or together with other nutritional adjunctives on all types of inflammatory diseases. Another antioxidant, epigallocatechin-3-gallate (EGCG), the main bioactive tea polyphenol was investigated in treating atopic dermatitis (AD) in an experiment with mice by Han et al. The authors formulated EGCG nanoparticles (EGCG-NPs) to investigate the bioavailability of EGCG to rescue cellular injury following the inhibition of necroptosis after AD. They found that EGCG-NPs elicited a significant amelioration of AD symptoms, a significant reduction in the expression of TNF-α, interferon-γ, interleukin-4 (IL-4), IL-6, and interleukin-17A, and inhibition of necroptosis rather than apoptosis in 2,4-dinitrochlorobenzene-induced AD. The authors concluded that EGCG-NPs represents a promising drug-delivery strategy for AD treatment by maintaining the Th1/Th2 balance and targeting necroptosis. A review by Thirunavukarasu et al. discussed the roles of vitamin A in a wide range of physiological systems, particularly the significant roles in vision and T-cell mediated inflammation. A particular focus was given to the evidence on the nutritional treatment of age-related macular degeneration (AMD) and Stargardt Disease (STGD). The authors explored the key mechanisms which is proposed to be mediated by T-cells interacting with dietary vitamin A derivatives and the gut microbiome. The altered microbiome has been observed in AMD and STGD patients, leading to an emerging direction of research in the interactions of vitamin A and pro-vitamin A with the gut-eye immunological axis. Jin and Arroo explored the in vivo evidence on the protective effects of flavonoids and carotenoids against diabetic complications. An overview of the recent preclinical and clinical data showed the potentials of both groups of phytochemicals for further development into novel drugs/therapies for treating diabetes and its complications. Yet their bioavailability, safety and tolerability need to be further investigated via long-term randomized controlled trials. Such evidence is warranted before confident clinical applications. The above results represent new relevant data on nutrition and inflammation. We expect this research collection will trigger more original research in this important research area to further explore the anti-inflammatory potentials of nutrients, polyphenols and dietary patterns. Item Metadata only Item Metadata onlyP18-028-23 An Investigation Into the Nutritional Profile of School Dinners Served Among School Pupils at the City of Leicester, UK(Oxford University Press, 2023-07-22) Jin, Yannan; Khan, Sairah; Agbanusi, Lisa; Plater, JoanneTitle: An investigation into the nutritional profile of school lunches served among school pupils at the City of Leicester, UK Sairah Khan, Sue Johnston, Lisa Agbanusi, Joanne Plater, Yannan Jin Objectives Developing healthy dietary behaviours in early years of life is pivotal in preventing childhood obesity and its related health complications. To date, understanding is lacking regarding the daily nutritional intake from school lunches, as the key meal on school days, among pupils in the UK. The study aimed to investigate the nutritional profile of school lunches served among primary school children aged 5 and 11 years old in the City of Leicester. Study methods Two primary schools at the City of Leicester participated in this study. Photographs of pupils’ school lunches served on plates and their age and gender information were anonymously collected. The nutritional content of each pupil’s lunch was analysed using the UK Food Portion-Size Guide and the nutrition analysis software Nutritics®. The nutritional quality of pupil’s lunches was evaluated against the UK Eatwell Guide and the UK Dietary Reference Values (DRV) for energy and nutrient intakes, based on the assumption that pupils’ lunch contributes to one-third of their daily food and nutritional intakes. Data were statistically analysed using One-Sample T Test, SPSS v28.0. Results 89 pupils aged between 5 and 10 years completed the study. Overall, pupils presented a significantly inadequate energy intake from their school lunches (P = 0.000), with a mean deficit of 174.7 kcal (SD = 150.2) when comparing to their respective DRVs. Similarly, suboptimal intakes of a few key micronutrients were also observed, including vitamin D (M = 3.1 µg; SD = 0.6) (P = 0.000); folate (M = 4.5 µg; SD = 17.8) (P = 0.019); vitamin B2 (M = 0.1 mg; SD = 0.1) (P = 0.000); iron (M = 0.8 mg; SD = 0.9) (P = 0.000); zinc (M = 0.9 mg; SD = 1.0) (P = 0.000) and calcium (M = 54.6 mg; SD = 77.0) (P = 0.000). Pupil’s protein and vitamin C intakes were sufficient with a respective surplus of 6.4 ± 8.3 g (P = 0.000) and 3.0 ± 8.3 mg (P = 0.001) over their individual recommended intake levels. Conclusion The study findings provide a latest evidence base for the development of future dietary and policy interventions for tackling the obesity and health inequality issues among children at both regional and national levels. Item Metadata onlyP07-029-23 Profiling the Nutritional Quality of Packed Lunch Boxes Among Primary School Children in Leicester, UK(Elsevier, 2023-07-27) Jin, Yannan; Winter, Chloe; Agbanusi, Lisa; Sheerin, Karen; Plater, JoanneProfiling the nutritional quality of packed lunchboxes among primary school children in Leicester, UK. Chloe Winter1, Lisa Agbanusi2, Jane Gadsby3, Karen Sheerin4, Joanne Plater5, Yannan Jin1. Objectives The study aimed to investigate the nutritional profile of packed lunchboxes among primary school pupils in Leicester, UK. Study methods Ethics approval was obtained at De Montfort University prior to data collection. Three primary schools at the City of Leicester took part in this study. Photographs of pupils’ own lunch boxes and their age and gender information were anonymously collected. The nutritional content of each lunchbox was analysed using the UK Food Portion-Size Guide and the nutrition analysis software Nutritics®. The nutritional profile of lunchboxes was evaluated against the UK Eatwell Guide and the UK Dietary Reference Values (DRV) for energy and nutrient intakes, based on the assumption that pupils’ lunch contributes to one-third of their daily food and nutritional intakes. Data were statistically analysed using One-Sample T Test, SPSS v28.0. Results In total, 32 pupils aged between 5 and 11 years completed the study. On average, pupils had a significantly inadequate energy intake from their packed lunches (P = 0.035), with a mean deficit of 86.5 kcal (SD = 238.3) when comparing to their respective DRVs. Contrastingly, pupils had an excessive intake of saturated fat (Mean = 34.4% of total energy; SD = 25.5), significantly above 11% as the maximum recommended level (P = 0.000). The average consumption of fruit and vegetables (F&V) from packed lunches was 0.58 portions (SD = 0.85), almost three times less than the recommended intake per main meal, i.e. 1.67 portions (P = 0.000), estimated based on the 5-A-Day recommendation. Besides, 58% of the pupils did not have any F&V at lunch. Conclusion The study revealed the suboptimal nutritional intake of school pupils from their packed lunchboxes in the City of Leicester, which could help explain the high childhood obesity rate in Leicestershire. This first-hand information will help inform the development of future interventions (educational and nutritional) for tackling the dietary and obesity issues among children at both regional and national levels. Fund source The study was not funded. Item Metadata onlyP31-028-23 Sensory Perception of Food and Its Influence on Snacking Behaviours Among Adults Residing in the UK(Elsevier, 2023-07-27) Jin, Yannan; Johnson, Hannah; Cook, StephanieSensory perception of food and its influence on snacking behaviours among adults residing in the UK Hannah Johnson1, Stephanie Cook1, Yannan Jin1 1 De Montfort University Objectives Understanding the factors driving food overconsumption is key to tackling the worldwide obesity issue. The link of body weight status with sensory preferences of foods (e.g. sweet and fatty foods) has been suggested, but remains inconclusive as to mixed evidence thus far. The socio-demographic factors’ potential influence on food choices further increases the complexity of the unsolved puzzle. The study aimed to look at the sensory perception of foods and snacking behaviours among adults of different socio-demographic characteristics and body weight statuses in the UK. Study methods It was a cross-sectional study. An online survey was used to determine the participants’ socio-demographic information (age, sex and occupation), Body Mass Index (BMI), sensory-attribute’s liking (e.g. taste and texture) of 45 snack items, frequency of eating snacks (salty, sweet, bitter, sour and savoury) using a 5-point Likert-scale (1 never to less than once a week – 5 more than 3 times a day), and their perceived importance of the appearance, smell, taste and texture of snacks in determining how much they eat, using a 5-point Likert-scale (1 not at all important – 5 extremely important). Data were analysed using Mann-Whitney U test and Kruskal-Wallis Test, SPSS v28.0. Results 56 participants (Mean age 44.6 y; SD 16.2) completed the survey (17 males and 39 females). Their BMI ranged from 15.8 to 39.9 kg/m2 (Mean 27.3, SD 5.6) and was classified into four groups, including underweight (N = 2); normal-weight (N = 22); overweight (N = 16) and obese (N = 16). The results showed that gender variation existed in the frequency of snack intakes including salty (U = 205, P = 0.012, r = 0.3) and bitter (U = 223, P = 0.025, r = 0.3). The frequency of sour-snack intake significantly differed between normal-weight and obese groups (H (3) = 10.3, P = 0.023). Age tended to exert a notable influence on almost all types of snack-intakes, including sweet (H (5) = 12.9, P = 0.024); bitter (H (5) = 11.0, P = 0.049); salty (H (5) = 18.7, P = 0.004) and sour (H (5) = 15.3, P = 0.009). Conclusion Demographic characteristics and body weight status were evidently shown to interplay with individuals’ food preferences and intake behaviours. The growing knowledge in this research area will benefit the future exploration in finding personalised solutions to prevent and manage adulthood obesity. Fund source The study was not funded. Item Metadata onlyThe effect of diet on improving lipoedema symptoms.(European Society of Lymphology, 2023-10-06)Title: The effect of diet on improving lipoedema symptoms. Yannan Jin1*,Sharie Fetzer2, Mary Warrilow2, Rawdha Benzine1, Louise Dunford3 1 Leicester School of Allied Health Sciences, De Montfort University 2 Lipoedema UK 3 Warwick Medical School, the University of Warwick Objectives Lipoedema is a chronic fat disorder involving an excessive abnormal deposition of subcutaneous fat in the thighs, legs, hips and buttocks mainly (Wounds UK, 2017). The importance of healthy eating in lipoedema management has been recognised (Wounds UK, 2017), yet dietary guidelines specific for lipoedema are lacking (Bertsch et al., 2020). The study aimed to investigate the self-reported dietary effect on improving lipoedema symptoms among a representative lipoedema population in the UK. Study methods The study used an online questionnaire that consisted of multiple-choice and open-response questions to collect data on symptoms and diagnostic status of lipoedema and self-reported dietary and lifestyle impact on lipoedema management among participants. The questionnaire was developed using the Survey Monkey software. An active online survey link was sent to Lipoedema UK’s members and contacts via e-mail and also made accessible via the study flyer advertised on Lipoedema UK’s website and newsletters. Ethical approval was obtained from the De Montfort University Faculty Research Ethics Committee of Health and Life Sciences prior to the study. Participants had given their consents before starting the survey. Data collection was anonymous. Data were analysed using SPSS v26.0. Results Out of 165 participants who had used diets for improving their lipoedema symptoms, 52% (86 participants) experienced positive effects. Anti-inflammatory (AI) and ketogenic diets were reported to be the most effective diets that improved lipoedema symptoms (either single or multiple). Notably, AI diet appeared to alleviate more lipoedema symptoms compared to ketogenic diet, including heavy and painful legs, thick swollen legs, tiredness and lack of energy, difficulty in losing weight, anxiety and cold skin, whereas the latter only influenced the most on painful legs and tiredness and lack of energy. The positive effects of each diet lasted for 4-6 months on average, among those who experienced them. Conclusion The study results will help inform the development of future research on finding a dietary solution to effective lipoedema management for the UK lipoedema population. Fund source De Montfort University funded the recruitment of a Research Assistant to support part of the data analysis work. Item Open AccessIntegrated Community Cardiac Clinic for the Assessment of Cardiovascular Disease in Severely Mentally Ill Patients(International Journal of Medical Science and Health Research, 2023-08-20) Ghosh, Sudip; Harrison, Samantha; Moseley, Caroline; Goulding, Emma; Read, JulieCardiovascular disease (CVD) accounts for ~20% of physical comorbidity amongst people diagnosed with severe mental illness (SMI), and people of all ages have reduced life expectancy compared to the general population. 69 patients on our SMI register were invited to attend a one-stop cardiac assessment clinic in the general practice setting between June 2021 and March 2022. The consultation included a CV risk assessment which consisted of detailed CV history and examination including10 year CV risk assessment, blood panel work-up and electrocardiography (ECG). 42 patients (61%) attended the clinics. Mean age of the patients were 38.9 ± 3.9 years (range 22-63). The mean 10 year-CV risk using the QRISK2 tool was 11.4 ± 6.7%. Only 5 patients were on statin therapy at presentation in clinic. 24 patients (57%) were diabetic with mean HbA1c of 53 ± 2.7 Mmol/L. 39 out of the 42 patients smoked. Mean body mass index was 34.5 ± 1.9 with mean blood pressure at 132 ± 13/ 87 ± 21 mmHg. Mean LDL was 2.9 ± 1.1 mg/dl. 6 patients reported ECG abnormalities suggestive of ischaemic changes and were referred to cardiology for further work-up. 2 patients have now undergone percutaneous coronary intervention with stent placement and the remaining 4 patients are receiving medical management. All patients with high QRISK2 scores have been offered statin therapy. Given the shortened life span of people with SMI, and the considerable contribution of CVD to earlier mortality, the data support more thorough screening and effective management of major cardiovascular risk factors within the community setting. Item Open AccessAlbumin Is a Component of the Esterase Status of Human Blood Plasma(MDPI, 2023-06-20) Belinskaia, D. A.; Voronina, P. A.; Popova, P. I.; Voitenko, N. G.; Shmurak, V. I.; Vovk, M. A.; Baranova, T. I.; Batalova, A. A.; Korf, E. A.; Avdonin, P. V.; Jenkins, R. O.; Goncharov, N. V.The esterase status of blood plasma can claim to be one of the universal markers of various diseases; therefore, it deserves attention when searching for markers of the severity of COVID-19 and other infectious and non-infectious pathologies. When analyzing the esterase status of blood plasma, the esterase activity of serum albumin, which is the major protein in the blood of mammals, should not be ignored. The purpose of this study is to expand understanding of the esterase status of blood plasma and to evaluate the relationship of the esterase status, which includes information on the amount and enzymatic activity of human serum albumin (HSA), with other biochemical parameters of human blood, using the example of surviving and deceased patients with confirmed COVID-19. In experiments in vitro and in silico, the activity of human plasma and pure HSA towards various substrates was studied, and the effect of various inhibitors on this activity was tested. Then, a comparative analysis of the esterase status and a number of basic biochemical parameters of the blood plasma of healthy subjects and patients with confirmed COVID-19 was performed. Statistically significant differences have been found in esterase status and biochemical indices (including albumin levels) between healthy subjects and patients with COVID-19, as well as between surviving and deceased patients. Additional evidence has been obtained for the importance of albumin as a diagnostic marker. Of particular interest is a new index, [Urea] x [MDA] x 1000/(BChEb x [ALB]), which in the group of deceased patients was 10 times higher than in the group of survivors and 26 times higher than the value in the group of apparently healthy elderly subjects. Item Open AccessThe Effect of Vitamin D Supplementation on Muscle Mass, Muscle Strength and Muscle Function in the Elderly: A Systematic Review and Meta-Analysis(Aging Medicine and Healthcare, 2023-07-28) Ghosh, Sudip; Harrison, SamanthaSarcopenia, the age-related loss of muscle mass, strength, and function is associated with falls and increased mortality. It is becoming a major public health concern due to its increase in prevalence, affecting over fifty million people worldwide. Due to the rising elderly population, this is expected to rise to over 200 million people by 2050. Mounting evidence supports the role of vitamin D in the stimulation of skeletal muscle fibre proliferation and differentiation. Therefore, vitamin D supplementation has the potential to prevent muscle loss and thus sarcopenia. Data from twenty-six randomised controlled trials including 6481 participants were summarised to investigate the effects of vitamin D supplementation on muscle mass, strength, and function in the form of balance, gait speed, and chair stand tests in the elderly population (≥60 years old). Results revealed that vitamin D supplementation had a significant positive effect on muscle mass (standardised mean difference (SMD) 0.27; 95% confidence intervals (CI) 0.12-0.42; P <0.001) and muscle strength (SMD 0.34; 95% CI -0.01 - 0.69; P=0.05). No significant effects were found for balance (SMD -0.06; 95% CI -0.19-0.08; P=0.40), gait speed (SMD 0.17; 95% CI -0.08–0.43; P=0.18), or chair stand tests (SMD 0.04; 95% CI -0.31–0.40; P=0.81) as markers for muscle function. These results suggest that vitamin D supplementation could have potential as a widely accessible cost effective intervention for reducing sarcopenia. However, further studies are required to evaluate optimum modalities such as dose and treatment duration. Item Open AccessRefreshing the emergency medicine research priorities(BMJ, 2023-07-25) Cottey, Laura; Shanahan, Thomas; Gronlund, Toto; Whiting, Caroline; Sokunbi, Moses; Carley, Simon; Smith, JasonThe priorities for UK emergency medicine research were defined in 2017 by a priority setting partnership coordinated by the Royal College of Emergency Medicine in collaboration with the James Lind Alliance (JLA). Much has changed in the last 5 years, not least a global infectious disease pandemic and a significant worsening of the crisis in the urgent and emergency care system. Our aim was to review and refresh the emergency medicine research priorities. Item Open AccessAwareness and Knowledge of Antimicrobial Resistance, Antimicrobial Stewardship and Barriers to Implementing Antimicrobial Susceptibility Testing among Medical Laboratory Scientists in Nigeria: A Cross-Sectional Study(MDPI, 2023-04-26) Huang, Sheng; Eze, UkpaiBackground: Antimicrobial resistance (AMR) is now considered one of the greatest global health threats. This is further compounded by a lack of new antibiotics in development. Antimicrobial stewardship programmes can improve and optimize the use of antibiotics, thereby increasing the cure rates of antibiotic treatment and decreasing the problem of AMR. In addition, diagnostic and antimicrobial stewardships in the pathology laboratories are useful tools to guide clinicians on patient treatment and to stop the inappropriate use of antibiotics in empirical treatment or narrow antibiotics. Medical Laboratory Scientists are at the forefront of performing antibiotics susceptibility testing in pathology laboratories, thereby helping clinicians to select the appropriate antibiotics for patients suffering from bacterial infections. Methods: This cross-sectional study surveyed personal antimicrobial usage, the knowledge and awareness on AMR, and antimicrobial stewardship, as well as barriers to antimicrobial susceptibility testing among medical laboratory scientists in Nigeria using pre-tested and validated questionnaires administered online. The raw data were summarized and exported in Microsoft Excel and further analyzed using IBM SPSS version 26. Results: Most of the respondents were males (72%) and 25–35 years old (60%). In addition, the BMLS degree was the highest education qualification most of the respondents (70%) achieved. Of the 59.2% of the respondents involved in antibiotics susceptibility testing, the disc diffusion method was the most commonly used (67.2%), followed by PCR/Genome-based detection (5.2%). Only a small percentage of respondents used the E-test (3.4%). The high cost of testing, inadequate laboratory infrastructure, and a lack of skilled personnel are the major barriers to performing antibiotics susceptibility testing. A higher proportion of a good AMR knowledge level was observed in male respondents (75%) than females (42.9%). The knowledge level was associated with the respondent’s gender (p = 0.048), while respondents with a master’s degree were more likely to possess a good knowledge level of AMR (OR: 1.69; 95% CI: 0.33, 8.61). Conclusion: The findings of this study indicate that Nigerian medical laboratory scientists had moderate awareness of AMR and antibiotic stewardship. It is necessary to increase investments in laboratory infrastructure and manpower training, as well as set up an antimicrobial stewardship programme to ensure widespread antibiotics susceptibility testing in hospitals, thereby decreasing empirical treatment and the misuse of antibiotics. Item Open AccessInfertility, reproductive timing and ‘cure’ in families affected by Turner Syndrome(Social Science & Medicine, 2023-06-02) Fearon, KrissThis article discusses the influence of a chromosome condition affecting women’s reproductive capacity, Turner Syndrome (TS), on affected women’s social timing, examining the strategic decisions that are made within families in relation to reproduction, to navigate these disruptions. Based on photo elicitation interviews with 19 women with TS and 11 mothers of girls with TS in the UK, it presents findings from an under-researched topic, TS and reproductive choices. In a social context where motherhood is not only desirable, but expected (Suppes, 2020), the social imaginary of infertility anticipates a future of unhappiness and rejection, an undesirable condition that should be avoided. Accordingly, mothers of girls with TS often expect that their daughter will want to have children. Infertility diagnosed in childhood has a distinctive impact on reproductive timing, as future options may be anticipated for years. This article uses the concept of ‘crip time’ (Kafer, 2013) to explore how women with TS and mothers of girls with TS experience temporal misfitting based on a childhood diagnosis of infertility, and manage, resist and re-frame this to minimise stigma. The ‘curative imaginary’ (Kafer, 2013), a social norm where disabled people are expected to desire a cure for their condition, is used as an analogy for infertility, describing how mothers of girls with TS respond to social pressure to plan for their daughter’s reproductive future. These findings may be useful both for families navigating childhood infertility and practitioners who support them. This article demonstrates the cross-disciplinary potential of applying disability studies concepts to the context of infertility and chronic illness, where concepts shed new light on the dimensions of timing and anticipation in this context, improving our understanding of the lived experience of women with TS, and how they view and use reproductive technologies.