74638 research outputs found
Sort by
The birth trauma earthquake: A qualitative investigation of first-time mothers who perceived their birth as traumatic
No full textProblem Pregnancies can be anxiety-provoking, and birth which includes complications or deviations from expectations can be perceived as traumatic. Background The perception of birth as traumatic is inherently subjective and the salience of aspects contributing to the perception of birth trauma amongst first-time mothers may differ. Further, risk factors have not included the voices of women from minority ethnic backgrounds, who are known to experience higher-levels of discrimination whilst in receipt of healthcare. Aim To contribute to the understanding of experiences of birth which are perceived as traumatic by women. Methods Semi-structured interviews (N = 16) were undertaken in May-June 2024 with mothers who had perceived their first birth to be traumatic; and analysed using Grounded Theory. Findings ‘The Birth Trauma Earthquake’ theory was comprised of six themes: ‘Morbid Fixations’; ‘Grieving the Birth They Never Had’; ‘Changing Relationships’; ‘The ‘Hysterical’ Labouring Woman’; ‘Transactional Care’; and ‘Diminishing Their Own Experiences’. Discussion Perceiving birth as traumatic was seen as a catalyst for rippling after-effects, with widespread impact both personally, and in their experience of healthcare professionals. Women were observed to have engaged in what may be perceived as maladaptive coping strategies to contain and control the associated shockwaves. Conclusion Maternity care should be comprehensive and compassionate, fostering resilience in the aftermath of the earthquake, but more importantly prepare and reduce the propensity for it. These findings provide an insight into the lived experience of those who have perceived birth to be traumatic, with implications for informing future methods to prevent and mitigate associated impacts
Insights into the Biochemical and Immune Mechanisms in Drug-Induced Liver Injury Pathogenesis.
No full textDILI is the leading cause of drug failure in clinical trials and withdrawal from the market. Certain intrinsic mechanisms of injury have been characterized such as the direct cytotoxicity exerted by NAPQI, a reactive metabolite of acetaminophen. However, presentation of DILI is highly heterogeneous with several idiosyncratic presentations being observed in patients. Such manifestations are often linked to aberrant immune activation although the biochemical mechanisms directing such responses currently evade complete understanding. This review consolidates current literature findings into potential mechanisms of immune-mediated DILI as well as risk factors which may polarize both the liver itself and certain individuals toward a drug-reactive phenotype. Current theories implicate neoantigen formation as a result of the generation of drug-protein adducts by both parent drugs and reactive metabolites. Responses to such adducts can be restricted to the presence of certain HLA alleles though these associations are identified through epidemiological means rather than mechanistic investigations. Further, susceptibility to DILI can be linked to nuance in the T-cell responses to HLA displayed antigens where basal levels of effector molecules and inflammation as well as the presence of liver resident immune cells, such as natural killer T-cells, can augment drug-specific immune responses
Mitigating high return water temperatures in CO₂ heat pumps for legacy district heating networks
No full textTranscritical CO₂ heat pumps are a promising, environmentally friendly technology for decarbonizing space and water heating. However, their performance deteriorates at high central heating return water temperatures, which are common in existing building stock and legacy district-heating networks and can limit retrofit viability. This deterioration is primarily due to higher throttling losses, which increase in proportion to the square of the temperature lift. This study presents and evaluates a novel large-scale transcritical CO₂ heat pump system that combines parallel compression with an indirect auxiliary heat-recovery cycle, in which the auxiliary heat pump recovers heat from the return water stream before it enters the CO₂ gas cooler. In a case study, the system was developed for a district heating network and delivers a total heating capacity of 600 kW and aims to enhance both energy efficiency and cost effectiveness under varying return water temperature conditions. The parallel compression CO₂ system with auxiliary heat recovery achieved a 26% increase in COP over the conventional parallel compression system at a return water temperature of 50 °C. Moreover, the improvement increased further at elevated return water temperatures, underscoring the benefits of auxiliary heat recovery under such operating conditions. The analysis shows that the proposed system significantly reduces throttling losses, resulting in enhanced energy efficiency, particularly at high return water temperatures (e.g., 55 °C), and offers operational flexibility at lower return temperatures. Exergy analysis showed that the total exergy destruction decreases from 259 kW in the conventional parallel compression system to 159.9 kW with auxiliary heat recovery, primarily due to reduced expansion-valve and compressor losses. The results offer practical insights for designing district heating networks with large-scale CO2 heat pumps and contribute to both advanced thermodynamic modeling and site-specific feasibility planning for next-generation low-carbon heating systems
Asymmetric Jeopardy through Dissonant Ties: An Extension of Brands and Kilduff’s “Multiplex Jeopardy”
No full textLocal electron transfer in RuNi alloy catalysts for selective hydrogenolysis of lignin-derived C−O bonds
Full text linkSelective hydrogenolysis of C−O bonds in lignin offers a promising pathway for biomass valorization but remains challenging due to competing aromatic ring hydrogenation. Herein, we report an efficient RuNi alloy catalyst synthesized via a solvent-free microwave-assisted pyrolysis strategy that enables highly selective hydrogenolysis of C−O bonds in lignin-derived benzyl phenyl ether (BPE). A volcano-type dependence of catalytic performance on the Ru/Ni ratio was observed, with the optimized Ru2Ni2/MgAl2Ox catalyst achieving 99.5% conversion and 84.2% hydrogenolysis selectivity for BPE under mild conditions (160 °C, 4 h), corresponding to a 1.7-fold enhancement in hydrogenolysis rate compared to monometallic Ru. The catalyst further demonstrated broad applicability toward diverse lignin-relevant ether linkages, including 4-O-5 (85.2% selectivity) and β-O-4 bonds (72.8% selectivity). Comprehensive characterization combined with DFT calculations reveal that electron transfer from Ni to Ru (1.27 e−) drives the formation of the RuNi alloy with a Niδ+‐Ruδ− electronic structure, which regulates adsorption and bond activation simultaneously. The tailored electronic structure suppresses benzene ring adsorption, reducing the BPE adsorption energy to −3.30 eV, while enhancing local electron transfer (0.154 e−) within the Niδ+-Ruδ−-O configuration to weaken the C−O bond and accelerate hydrogenolysis. This work provides a promising strategy for the rational design of alloy catalysts via electronic structure modulation toward the selective hydrogenolysis of lignin-derived ethers
Teaching Student Veterinary Professionals About Pharmacovigilance: A Survey of UK Veterinary Educators
Full text linkAdverse drug event (ADE) reports submitted by veterinary professionals are essential for monitoring the safety and efficacy of marketed veterinary products. Despite this, the majority of veterinary ADEs are not reported. Further education on the topic of pharmacovigilance has been widely explored in human healthcare as a potential facilitator for reporting. To guide design of an enhanced pharmacovigilance curriculum for veterinary professionals, a better understanding of student veterinary professional pharmacovigilance training is required. Therefore, we investigated the current UK pharmacovigilance curriculum through a survey of veterinary educators. In total, there were 17 responses from UK-based training providers, six relating to undergraduate veterinary surgeon training and 11 relating to training in veterinary nursing. All students received some pharmacovigilance training, which appeared to be largely didactic in nature. A total of 29.4% of respondents indicated that students are provided the opportunity to submit a practice ADE report. Exploration of the knowledge, attitudes, and perceptions of students with regards to this training would be useful in assessing quality and opportunities for enhancement. Development of shared resources which provide students with access to ‘real world’ examples of ADEs would support development of practical skills in identifying, managing, and reporting ADEs
Long-term adverse multi-system health outcomes of gestational diabetes mellitus: an analysis of real-world cohort data
Full text linkBackground: There is emerging evidence that gestational diabetes mellitus (GDM) increases the risk of multi-system long-term complications such as cancer and autoimmune disease, however this evidence is scarce and conflicting. Therefore, we aim to explore the long-term health implications of GDM. Methods: We performed analyses using TriNetX in women ≥ 18 years who had a birth. Four cohorts were generated with a reference and GDM arm, and PSM 1:1 for factors including age, BMI, and cohort-specific risk factors. The cohort sizes were metabolic n = 72,014, cancer n = 88,131, autoimmune n = 96,110, and gynaecological n = 94,945. Results: GDM increased the risk of 5-year incident clinical outcomes: metabolic: T2D (HR 18.42, p < 0.0001), hypertriglyceridemia (HR 2.47, p < 0.0001), obesity (HR 1.89, p < 0.0001), and sleep apnoea (HR 1.83, p < 0.0001); cancer: thyroid cancer (HR 1.34, p = 0.036); autoimmune: type 1 diabetes (HR 12.32, p < 0.001), Grave's disease (HR 1.57, p=<0.0001), and psoriasis (HR 1.25, p = 0.007); and gynaecological PCOS (HR 1.97, p < 0.0001), uterine fibroids (HR 1.29, p < 0.0001), and endometriosis (HR 1.16, p = 0.018). At 10 years, there was a significantly increased risk of the composite 13 adiposity-related cancers (HR 1.18, p = 0.008). Conclusion: Women with GDM are at risk of a myriad of long-term adverse health outcomes meriting targeted early intervention and long-term post-partum monitoring
Residents’ perspectives on a community health worker-delivered household air pollution prevention programme pilot in Eldoret, Kenya: a qualitative evaluation
Full text linkBackground: Household air pollution (HAP), from the use of polluting fuels for cooking, heating, and lighting, poses significant health and environmental risks, particularly in low-resource settings. The Community Household Air Pollution Prevention Programme (CHAP-PP) integrated a ‘household air pollution, health, and prevention’ module into Kenyan national Community Health Worker training, involving household-based education, awareness-raising, and discussions around air pollution, health, and clean energy. Objectives: This evaluation examined residents’ perspectives on the programme, considering impacts on energy use and HAP exposures in the context of wider experiences and providing recommendations for improvement. Methods: This qualitative descriptive study used semi-structured interviews and one focus group discussion with purposively selected household representatives, analysed using reflexive thematic analysis. Results: Residents welcomed the programme, reporting enhanced knowledge around HAP-related risks, harm mitigation practices (e.g. improved ventilation), and clean fuels. The latter enabled clean fuel adoption for some, but residual challenges remained. Using the COM-B (Capability-Opportunity-Motivation-Behaviour) model we considered how the programme influenced communities’ clean fuel uptake. Participants proposed solutions to financial barriers precluding clean fuel use including subsidies, value-added tax removal, and ‘pay-as-you-go’ schemes for liquefied petroleum gas, some of which have since been implemented. Conclusions: The CHAP-PP programme was felt to be successful, increasing HAP awareness and supporting harm mitigation and transitions to cleaner cooking. Findings have informed module rollout nationally and contributed to Kenya’s HAP prevention strategy. Ongoing efforts aim to improve affordability and scale clean cooking solutions, with future evaluations planned to assess long-term impacts on energy use and health outcomes.\
In Vitro Ocular Cytotoxicity of BEE Venom in ARPE-19, NTM5, HCET, and HCEC-12 Cell Lines.
Full text linkBee venom (BV) is a complex natural secretion of Apis mellifera with documented anti-inflammatory, antimicrobial, and anticancer properties. Despite its therapeutic potential, safety concerns remain due to its strong cytotoxic effects, particularly in sensitive tissues such as the eye. In this study, we evaluated the composition and ocular cytotoxicity of purified BV obtained from the Muğla ecotype of Apis mellifera anatoliaca. High-performance liquid chromatography with variable wavelength detection (HPLC-VWD) confirmed the presence of three principal components; melittin (71.08 ± 0.33%), phospholipase A₂ (12.98 ± 0.27%), and apamin (3.02 ± 0.25%) at retention times consistent with reference standards. Cytotoxicity was assessed in four human ocular cell lines: ARPE-19 (retinal pigment epithelium), NTM5 (trabecular meshwork), HCE-T (corneal epithelium), and HCEC-12 (corneal endothelium), using MTT viability assays and live/dead staining over 24 h and 48 h. BV exerted strong, dose and time dependent cytotoxic effects across all cell lines, with ARPE-19 and NTM5 cells exhibiting the highest sensitivity. IC₅₀ values were 22.36 µg/mL (24 h) and 12.55 µg/mL (48 h) in ARPE-19, and 20.78 µg/mL (24 h) and 13.07 µg/mL (48 h) in NTM5 cells. By contrast, HCEC-12 and HCE-T cells displayed moderate sensitivity, with IC₅₀ values between 29 and 34 µg/mL. These findings highlight tissue-specific differences in BV susceptibility. While BV may offer therapeutic promise, its narrow safety margin in ocular cells underscores the importance of controlled delivery strategies to minimize toxicity. This study provides foundational data for evaluating the ocular safety profile of BV and informs future translational applications
Access Repository Dashboard
Do you manage University of Liverpool Research Archive? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!