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"Lawrence, J. M."
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Role of Ursodeoxycholic Acid in the Prevention of Gallstones Formation in Bariatric Patients—a Systematic Review and Meta-Analysis of Randomised Trials
The aim of this meta-analysis was to assess whether treatment with ursodeoxycholic acid (UDCA) in patients who have undergone bariatric surgery reduces gallstone formation. A systematic literature search was performed using electronic databases (MEDLINE, Embase, CENTRAL, Web of Science, PROSPERO, Google Scholar and the WHO International Clinical Trials Registry platform). RCTs without restrictions on study language, year, status of publication and patient’s age were used. Pooled risk ratios were calculated using a random-effects model. Subgroup analyses for drug dose, duration and procedure types were performed. Sensitivity analyses and a summary of findings table were generated to assess the robustness and the level of evidence provided, respectively. Fourteen trials were included (3619 patients, 2292 in UDCA vs 1327 in control group). Procedures included SG, RYGB, OAGB, AGB and Gastroplasty. UDCA dose ranged from 300 to 1200 mg per day. Gallstone formation occurred in 19.3% (8.3% in UDCA vs 38.1% in the control group). UDCA significantly reduced the risk of gallstone formation (14 trials, 3619 patients; RR 0.27, 95% CI 0.18–0.41; P < 0.001). UDCA significantly reduced the risk of symptomatic gallstone disease (6 trials, 2458 patients; RR 0.30, 95% CI 0.21–0.43; P < 0.001). No subgroup difference was found for different doses, duration and type of procedure performed. Oral UDCA treatment significantly reduces the risks of developing gallstones in postoperative bariatric patients from 38 to 8%. The use of 500 to 600 mg UDCA for 6 months is effective and should be implemented in all patients post-bariatric surgery.
Journal Article
A typology of North Sea oil and gas platforms
Since the commercial exploitation of marine oil and gas reserves began in the middle of the twentieth century, extensive networks of offshore infrastructure have been installed globally. Many of the structures are now nearing the end of their operational lives and will soon require decommissioning, generating renewed interest in their environmental impacts and in the ecological consequences of their removal. However, such work requires selection of a subsample of assets for surveying; censuses of the entire ‘population’ in any given jurisdiction are practically impossible due to their sheer number. It is important, therefore, that the selected sample is sufficiently representative of the population to draw generalized conclusions. Here, a formal clustering methodology, partitioning around medoids, was used to produce a typology of surface-piercing oil and gas platforms in the North Sea. The variables used for clustering were hydrocarbon product, operational state, platform design and material, and substructure weight. Assessing intra-cluster variability identified 13 clusters as the optimum number. The most important distinguishing variable was platform type, isolating floating platforms first, then concrete gravity-based and then fixed steel. Following clustering, a geographic trend was evident, with oil production more prevalent in the north and gas in the south. The typology allows a representative subset of North Sea oil and gas platforms to be selected when designing a survey, or an assessment of the representativeness of a previously selected subset of platforms. This will facilitate the efficient use of the limited funding available for such studies.
Journal Article
The experience of revolution in Stuart Britain and Ireland : essays for John Morrill
\"This volume ranges widely across the social, religious and political history of revolution in seventeenth-century Britain and Ireland, from contemporary responses to the outbreak of war to the critique of the post-regicidal regimes; from royalist counsels to Lilburne's politics; and across the three Stuart kingdoms. However, all the essays engage with a central issue - the ways in which individuals experienced the crises of mid seventeenth-century Britain and Ireland and what that tells us about the nature of the Revolution as a whole. Responding in particular to three influential lines of interpretation - local, religious and British - the contributors, all leading specialists in the field, demonstrate that to comprehend the causes, trajectory and consequences of the Revolution we must understand it as a human and dynamic experience, as a process. This volume reveals how the understanding of these personal experiences can provide the basis on which to build up larger frameworks of interpretation\"-- Provided by publisher.
Book
Kondo quasiparticle dynamics observed by resonant inelastic x-ray scattering
Effective models focused on pertinent low-energy degrees of freedom have substantially contributed to our qualitative understanding of quantum materials. An iconic example, the Kondo model, was key to demonstrating that the rich phase diagrams of correlated metals originate from the interplay of localized and itinerant electrons. Modern electronic structure calculations suggest that to achieve quantitative material-specific models, accurate consideration of the crystal field and spin-orbit interactions is imperative. This poses the question of how local high-energy degrees of freedom become incorporated into a collective electronic state. Here, we use resonant inelastic x-ray scattering (RIXS) on CePd
3
to clarify the fate of all relevant energy scales. We find that even spin-orbit excited states acquire pronounced momentum-dependence at low temperature—the telltale sign of hybridization with the underlying metallic state. Our results demonstrate how localized electronic degrees of freedom endow correlated metals with new properties, which is critical for a microscopic understanding of superconducting, electronic nematic, and topological states.
The fate of high-energy degrees of freedom, such as spin-orbit interactions, in the coherent state of Kondo lattice materials remains unclear. Here, the authors use resonant inelastic x-ray scattering in CePd
3
to show how Kondo-quasiparticle excitations are renormalized and develop a pronounced momentum dependence, while maintaining a largely unchanged spin-orbit gap.
Journal Article
The Effect of Pre-operative Exercise Intervention on Patient Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis
This systematic review aimed to assess the effect of a pre-operative exercise intervention on short- and long-term health and clinical outcomes for adult patients undergoing bariatric surgery (BS). We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), SPORTDiscus and reference lists of relevant papers, through March 2021. Five randomised controlled trials were included (
n
= 199 patients). Modest increases in cardiorespiratory fitness (VO
2max
) were found at both pre-operative (0.73 mL kg
−1
min
−1
,
P
≤ 0.001) and maximum follow-up time points (0.98 mL kg
−1
min
−1
,
P
≤ 0.04). There was no significant effect of an exercise intervention on percentage total weight loss (%TWL). Pre-operative exercise can induce significant short- and long-term improvements in fitness in individuals with obesity. There is insufficient evidence to determine whether pre-operative training impacts other post-operative clinical outcomes.
Graphical abstract
Journal Article
Medical Therapies for Uterine Fibroids – A Systematic Review and Network Meta-Analysis of Randomised Controlled Trials
Uterine fibroids are common, often symptomatic and a third of women need repeated time off work. Consequently 25% to 50% of women with fibroids receive surgical treatment, namely myomectomy or hysterectomy. Hysterectomy is the definitive treatment as fibroids are hormone dependent and frequently recurrent. Medical treatment aims to control symptoms in order to replace or delay surgery. This may improve the outcome of surgery and prevent recurrence.
To determine whether any medical treatment can be recommended in the treatment of women with fibroids about to undergo surgery and in those for whom surgery is not planned based on currently available evidence.
Two authors independently identified randomised controlled trials (RCT) of all pharmacological treatments aimed at the treatment of fibroids from a list of references obtained by formal search of MEDLINE, EMBASE, Cochrane library, Science Citation Index, and ClinicalTrials.gov until December 2013.
Two authors independently extracted data from identified studies.
A Bayesian network meta-analysis was performed following the National Institute for Health and Care Excellence-Decision Support Unit guidelines. Odds ratios, rate ratios, or mean differences with 95% credible intervals (CrI) were calculated.
A total of 75 RCT met the inclusion criteria, 47 of which were included in the network meta-analysis. The overall quality of evidence was very low. The network meta-analysis showed differing results for different outcomes.
There is currently insufficient evidence to recommend any medical treatment in the management of fibroids. Certain treatments have future promise however further, well designed RCTs are needed.
Journal Article