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Atypical Presentation of Cat‐Scratch Disease in a 30‐Year‐Old Female: A Case Study
Get PDFCat‐scratch disease (CSD) is a zoonotic infection caused by the Gram‐negative bacterium Bartonella henselae , typically transmitted through the scratch or bite of a cat. This case report highlights an atypical presentation of CSD in a 30‐year‐old female pet groomer with prolonged fever, fatigue, and axillary lymphadenopathy. The patient's diagnosis was confirmed through histopathological findings of necrotizing granulomas and subsequent improvement after targeted antibiotic therapy with azithromycin. The case emphasizes the diagnostic challenges posed by atypical presentations of CSD, especially in regions with high cat exposure. This case also underscores the importance of considering CSD in the differential diagnosis of febrile lymphadenopathy and highlights the efficacy of antibiotic therapy in symptom resolution
“Our Landscape Is Its Own Monument”: Using “Muscle Memory” to Make Home Space in Alien Environments in the Work of Jade de Montserrat: Spaces in Transit
No full textVernacular black culture is often an unwritten one. Contemporary Black British artist Jade de Montserrat uses her own body in movement or stasis as cipher for personal and communal memory, to inhabit the gestures of her ancestors. She employs “muscle memory” to embody earlier black presences in her performances, and as a feminist artist, articulates the context of exploitative patriarchal relationships that have spectacularised and objectified the Black female body over the centuries. Her non-metropolitan British background, being brought up in rural Yorkshire, is an anomaly in a context where the urban and London-centric nature of debates about Blackness continue to have hegemonic power. In 2015 she made a film triptych, Clay, Peat, Cage, in collaboration with fellow Yorkshire filmmakers Webb-Ellis. In these films, she references and artistically reimagines her upbringing, narrating a rural and Northern Black culture in Britain and showing its connection to Black Atlantic dynamics to be as vibrant as in the metropole. Each film demonstrates different aspects of embodied Black history, from fugitivity to imprisonment, from violence to homemaking and from alienation to panoptical surveillance. Also fundamental to her praxis is her text-based watercolour Her Movement Creates a Muscle Memory (2016–2017), which etches out the words against a painterly background and indicates her belief that bodies carry traumatic histories so that memory is as much physical as mental. Her image of the “stripped migrant” illustrates the problematics of transporting diasporic cultures across geographies in the context of enslavement. For African Atlantic people, spaces in transit / spaces in stasis are often one and the same, confining and limiting freedom of expression and unhoming black presence. Montserrat’s work explores performative ownership of land that was unequally distributed and denied to black, female and working-class people, and invokes routes through its mobile mode, featuring her African diasporan body moving through the landscape—conjuring such black vernacular haunters of the British landscape as the itinerant fugitive slave James Johnson. This chapter investigates how Montserrat’s praxis uses her body to remember and conjure black presence in British landscapes where it has been hitherto marginalised and sometimes completely forgotten
Silent threats: awareness and attitudes to communication of SUDEP among neurologists in India: a cross-sectional study
Get PDFBackground
International guidelines unequivocally endorse the importance and need to discuss Sudden Unexpected Death in Epilepsy (SUDEP) with people with epilepsy (PWE). India is a country accounting for a sixth of all global epilepsy burden. Despite this little is known of Indian neurologists’ knowledge and attitudes to SUDEP.
Objective
To explore India Neurologists awareness and attitudes to SUDEP communication to PWE.
Methods
A cross-sectional online survey of Likert response questions using validated themes, was circulated among the neurology fraternity, India. Non-discriminatory exponential snowballing technique leading to convenience non-probability sampling was used. The inquiry involved SUDEP-related topics including the awareness, knowledge, need for and importance of counselling. A comparison with other epilepsy risk counselling was made. Descriptive statistics were used for analysis.
Results
Of 275 consenting participants, a majority were male (76 %), had over 5 years of practice (63 %), were private practitioners (61 %) and working in urban areas (99 %). Almost all participants (98 %) knew of SUDEP. A fifth (20 %) counselled most or all PWE of SUDEP compared to 90 % discussing risks from daily activities, 89 % driving risk and 38 % psychiatric concerns. There were significant differences to the likelihood of SUDEP counselling being undertaken based on formal epilepsy training (p < 0.001) familiarity with SUDEP guidelines (p < 0.001), and SUDEP risk factors knowledge (p < 0.001). Further training for SUDEP risk and communication was requested by 90 %.
Conclusion
While most Indian neurologists have SUDEP awareness there is a significant gap in communication of SUDEP risks to PWE. Virtual training and education could help bridge the knowledge gap
Bridging the digital divide: artificial intelligence as a catalyst for health equity in primary care settings
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Health inequalities remain one of the most pressing challenges in contemporary healthcare, with primary care serving as both a gateway to services and a potential source of disparities. Artificial intelligence (AI) technologies offer unprecedented opportunities to address these inequities through enhanced diagnostic capabilities, improved access to care, and personalised interventions.
Objective
This comprehensive narrative review aimed to synthesise current evidence on AI applications in primary care settings, specifically targeting health inequality reduction and identifying both opportunities and barriers for equitable implementation.
Method
Following PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we employed a systematic approach to literature identification, selection, and synthesis across seven electronic databases covering literature from 2020 to 2024. Of 1,247 initially identified studies, 89 met inclusion criteria with 52 providing sufficient data quality for evidence synthesis.
Results
The review identified promising applications such as AI-powered risk stratification algorithms that improved hypertension control in low-income populations, telemedicine platforms reducing geographic barriers in rural communities, and natural language processing tools facilitating care for non-native speakers. However, significant challenges persist, including algorithmic bias that may perpetuate existing inequities, the digital divide excluding vulnerable populations, and insufficient representation in training datasets. Current evidence suggests that whilst AI holds transformative potential for advancing health equity, successful implementation requires intentional co-design with affected communities, robust bias mitigation strategies, and comprehensive digital literacy programmes.
Conclusion
Future research must prioritise equity-centred AI development, longitudinal outcome studies in diverse populations, and policy frameworks ensuring responsible deployment. However, careful consideration of unintended consequences, including potential overdiagnosis, erosion of human clinical judgement, and inadvertent exclusion of vulnerable populations, is essential to prevent AI from exacerbating existing health disparities. The paradigm shift towards equity-first AI design represents a critical opportunity to leverage technology for social justice in healthcare
Illuminating the black box: Explainable AI for enhanced customer behavior prediction and trust
Get PDFArtificial intelligence is increasingly used in business, particularly for predicting customer actions, which has improved forecasting accuracy. However, powerful machine learning models are often complex "black boxes," hiding the reasons behind predictions. This lack of visibility limits actionable insights, complicates meeting regulations like GDPR's 'right to explanation,' and makes building trust with customers and others difficult. Explainable Artificial Intelligence (XAI) addresses this by making AI models more understandable. This paper looks at applying XAI methods to customer behavior prediction (CBP) models. We evaluated model-agnostic XAI techniques, including SHAP and Permutation Feature Importance, on high-performing Gradient Boosting and Deep Learning models. These models were trained on real customer transaction and interaction data. Our analysis focused on predictive performance and the quality of explanations provided by XAI. We found that while complex models often predict better, XAI successfully revealed the key features and interactions influencing their predictions. This yielded insights into the reasons for customer actions. Our work shows how XAItransforms black box predictions into clear, usable intelligence. This helps businesses improve personalization, refine marketing, manage risk, and build customer relationships through openness and confidence. This research contributes to applying XAI, specially for understanding and predicting customer actions
The Impact of Dynamic Social Norms Messages on Motivation to Participate in Organised Colorectal Cancer-Screening Programmes: Evidence from an Online Experiment
No full textBackground: Studies have shown that presenting information about positive trends in peer behaviour can have a greater impact on individual behaviour than simply communicating their current behaviour. In a web-based experiment, we investigated whether highlighting a positive trend in the uptake of the English bowel cancer screening programme (BSCP) influences the intentions of men and women who initially had low intentions.Methods: We recruited 1,194 men and women aged 25–49 who had no previous diagnosis of bowel cancer and no experience with the BSCP. These individuals, who had indicated low intentions to participate in screening, were selected from a survey panel. They were randomly assigned to one of four experimental conditions: (1) a control group without a normative message, (2) a group receiving a standard static social norms message communicating current uptake, (3) a group receiving a dynamic social norms message stating that screening participation has been increasing, and (4) a group receiving an extended dynamic social norms message combining a dynamic with a static social norm message. We measured the impact of these messages on their intentions to complete a screening test when invited, their perceived informativeness of the messages, and their active interest in learning more about bowel cancer and the screening test.Results: None of the messages influenced intentions in the unadjusted regression; however, the extended dynamic social norms message significantly increased screening intentions compared to the control condition in the adjusted regression. Analysis of changes in intentions before and after the manipulation revealed that both dynamic social norms messages positively influenced changes in the unadjusted regression, while all three messages had a positive impact in the adjusted regression. None of the messages affected active interest or the perceived informativeness of the provided information.Conclusion: Dynamic social norms messages, which highlight the positive trend in screening participation combined with the current uptake rate have the potential to enhance screening intentions
Living up to obligations through the International Red Cross? A critique of states’ attempts to shift obligations when addressing missing persons
Get PDFThe article identifies and explains a phenomenon whereby states attempt to shift their responsibility in relation to missing persons and their families to the International Red Cross. This has dual effect: firstly, it leads to rightlessness of the missing and their families, and secondly, it diminishes the obligations of the states, which are the duty bearers. The attempted shift does not, however, lead to the International Red Cross becoming a duty bearer, despite undertaking crucial actions in the analyzed area. Two case studies, relating to two distinct types of missing persons, are used to illustrate the phenomenon: persons who disappeared during the conflict in Cyprus between 1963 and 1974, and migrants going missing in the Mediterranean
A Pilot for Validation of the Eco-System of Extremist Violence Conceptual Model Using Practitioner Perceptions
Get PDFThe Eco-System of Extremist Violence (ES-EV) is a preliminary conceptual model to aid with the risk formulation of extremist violence. The approach complementing established risk assessments originated from clinician's need for guidance to navigate mental health issues in radicalised forensic populations, as well as the overlap of their risk factors with general non-extremist violence. The ES-EV is based on a variety of multi-methodological studies but awaits validation. Out of 80 international professionals, such as psychologists and law enforcement, attending a seven hour online training, 39 completed pre- and post-surveys. These included ratings of their confidence, overall knowledge, knowledge about specific risk factors, and competence regarding general risk assessment and the assessment of extremist violence specifically. The post-survey also offered the opportunity for qualitative feedback on the ES-EV. Paired t-tests yielded significant positive changes for all radicalisation-related indexes (p < .001), with large effect sizes (d = -1.52 to -1.72). This was mirrored by three themes derived from the reflexive thematic analysis: (1) strengths of the ES-EV, (2) limitations of the ES-EV, and (3)
recommendations for application. The findings not only offer preliminary evidence for the utility of the ES-EV but also show the improvement participants experienced by understanding extremist violence in the wider group-based violence bracket. This is especially important, as the initial knowledge and competence indices
were a standard deviation lower than for general violence, highlighting the need for training in the field. The study lends further credibility to the use of the ES-EV in practice.
This study is the first to examine the utility of the ES-EV with practitioners, inviting future independent exploration
Acetylenic Fatty Acids and Stilbene Glycosides Isolated from Santalum yasi Collected from the Fiji Islands
Get PDFIn our continuing search for new anticancer and/or antimicrobial compounds from natural products we screened for these activities in bark and leaf extracts of sandalwood plants collected from the Fiji Islands and found Santalum yasi to be the most active. Resulting chemical workup enabled the isolation and structural characterization of a new acetylenic acid, methyl (E)-octadec-6-en-8-ynoate (1), and an atropisomeric stilbene glycoside (4) (Yasibeneoside) together with six known compounds: 11,13-octadecadien-9-ynoic acid (2), methyl octadeca-9,11-diynoate (3), gaylussacin (5) chrysin-7-beta-monoglucoside (6), neoschaftoside (7), and chrysin-6-C-glucoside-8-C-arabinoside (8). Compound 1 (18:2 (6t, 8a) is an example of an 6, 8 acetylenic system containing the trans double bond at C-6 and the triple bond at C-8 which is reported here for the first time. All molecular structure elucidations and dereplications were performed using spectroscopic techniques including 2D NMR and HRMS-MS/MS spectrometry. Methyl (E)-octadec-6-en-8-ynoate showed moderate activity with an IC50 of 91.2 ug/mL against the cancer human breast adenocarcinoma cell line MCF-7