Falsification of diplomatic documents - the Affghan papers

Falsification of Diplomatic Documents: The Afghan Papers, Report and Petition of the Newcastle Foreign Affairs Association. Anglo-Afghan wars. Afghan British relationship during the 19th century

Supported progressive resistance training for countering the adverse side effects of prostate cancer treatment

Exercise is recommended for cancer patients due to its positive effects on treatment side effects and quality of life. Currently no structured exercise guidelines for prostate cancer patients exist and most advice is aimed at those receiving androgen deprivation therapy (ADT). The over-arching aim of this thesis is to develop an exercise programme to improve cardiometabolic health in patients treated for prostate cancer, particularly via robot-assisted radical prostatectomy, and assess its effectiveness through a randomised controlled trial. Resistance exercise training has shown via a systematic review and meta-analysis, to be effective for inducing improvements in resting blood pressure, endothelial function, blood biomarkers and aerobic capacity and is a safe mode of exercise in both healthy and clinical populations (Chapter 3). This thesis also demonstrates that some men after robot-assisted radical prostatectomy are at increased risk of cardiovascular disease within ten years of surgery and suffer with clinically significant levels of fatigue (Chapter 4). Furthermore men after robot-assisted radical prostatectomy appear to meet the Government recommended guidelines for aerobic physical activity but not for resistance-based exercise. Patient and public involvement was integral to this thesis with the patients leading on the design and implementation of the exercise programme (Chapter 5). The results of the randomised controlled trial (Chapter 6), demonstrated that resistance exercise training had a clear effect on body composition, aerobic capacity, strength, functional wellbeing and prostate cancer specific quality of life and showed evidence of a favourable reductions in resting blood pressure and some blood biomarkers. Collectively, this thesis provides evidence that resistance exercise training is effective in improving multiple cardiometabolic health benefits in men who have undergone robot-assisted radical prostatectomy whilst being a safe and well-received mode of exercise. Therefore, resistance exercise training can generally be considered a useful adjunct therapy for this patient population

Dielectric barrier plasma discharge exsolution of nanoparticles at room temperature and atmospheric pressure Dataset

The dataset that corresponds to the results reported in the paper are included within this record as an Excel file and with tabs corresponding to each figure. Additional results and raw data underlying this work (full set of microscopy images and size analysis and statistics, high resolution deconvoluted x-ray photoelectron spectra and control magnetic measurements) are available in the Supporting Information (in PDF format) or on request following instructions provided here. This work has been supported by EPSRC through the UK Catalysis Hub (EP/R027129/1) and the Emergent Nanomaterials-Critical Mass Initiative (EP/R023638/1, EP/R023921/1, EP/R023522/1, EP/R008841/1) as well as the Royal Society (IES\R2\212049). F.F. gratefully acknowledges support from the National Research Council of Italy (2020 STM program). I.S.M. acknowledges funding from the Royal Academy of Engineering through a Chair in Emerging Technologies Award entitled “Engineering Chemical Reactor Technologies for a Low-Carbon Energy Future” (Grant CiET1819\2\57). KK acknowledges funding from the Henry Royce Institute (EP/X527257/1)

An observational study of Donor Ex Vivo Lung Perfusion in UK lung transplantation: DEVELOP-UK

Background: Many patients awaiting lung transplantation die before a donor organ becomes available. Ex vivo lung perfusion (EVLP) allows initially unusable donor lungs to be assessed and reconditioned for clinical use. Objective: The objective of the Donor Ex Vivo Lung Perfusion in UK lung transplantation study was to evaluate the clinical effectiveness and cost-effectiveness of EVLP in increasing UK lung transplant activity. Design: A multicentre, unblinded, non-randomised, non-inferiority observational study to compare transplant outcomes between EVLP-assessed and standard donor lungs. Setting: Multicentre study involving all five UK officially designated NHS adult lung transplant centres. Participants: Patients aged ≥ 18 years with advanced lung disease accepted onto the lung transplant waiting list. Intervention: The study intervention was EVLP assessment of donor lungs before determining suitability for transplantation. Main outcome measures: The primary outcome measure was survival during the first 12 months following lung transplantation. Secondary outcome measures were patient-centred outcomes that are influenced by the effectiveness of lung transplantation and that contribute to the health-care costs. Results: Lungs from 53 donors unsuitable for standard transplant were assessed with EVLP, of which 18 (34%) were subsequently transplanted. A total of 184 participants received standard donor lungs. Owing to the early closure of the study, a non-inferiority analysis was not conducted. The Kaplan–Meier estimate of survival at 12 months was 0.67 [95% confidence interval (CI) 0.40 to 0.83] for the EVLP arm and 0.80 (95% CI 0.74 to 0.85) for the standard arm. The hazard ratio for overall 12-month survival in the EVLP arm relative to the standard arm was 1.96 (95% CI 0.83 to 4.67). Patients in the EVLP arm required ventilation for a longer period and stayed longer in an intensive therapy unit (ITU) than patients in the standard arm, but duration of overall hospital stay was similar in both groups. There was a higher rate of very early grade 3 primary graft dysfunction (PGD) in the EVLP arm, but rates of PGD did not differ between groups after 72 hours. The requirement for extracorporeal membrane oxygenation (ECMO) support was higher in the EVLP arm (7/18, 38.8%) than in the standard arm (6/184, 3.2%). There were no major differences in rates of chest radiograph abnormalities, infection, lung function or rejection by 12 months. The cost of EVLP transplants is approximately £35,000 higher than the cost of standard transplants, as a result of the cost of the EVLP procedure, and the increased ECMO use and ITU stay. Predictors of cost were quality of life on joining the waiting list, type of transplant and number of lungs transplanted. An exploratory model comparing a NHS lung transplant service that includes EVLP and standard lung transplants with one including only standard lung transplants resulted in an incremental cost-effectiveness ratio of £73,000. Interviews showed that patients had a good understanding of the need for, and the processes of, EVLP. If EVLP can increase the number of usable donor lungs and reduce waiting, it is likely to be acceptable to those waiting for lung transplantation. Study limitations include small numbers in the EVLP arm, limiting analysis to descriptive statistics and the EVLP protocol change during the study. Conclusions: Overall, one-third of donor lungs subjected to EVLP were deemed suitable for transplant. Estimated survival over 12 months was lower than in the standard group, but the data were also consistent with no difference in survival between groups. Patients receiving these additional transplants experience a higher rate of early graft injury and need for unplanned ECMO support, at increased cost. The small number of participants in the EVLP arm because of early study termination limits the robustness of these conclusions. The reason for the increased PGD rates, high ECMO requirement and possible differences in lung injury between EVLP protocols needs evaluation

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic