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198 The hidden culprit: a lady with epilepsia partialis continua and anaemia
No full textA 73-year-old right-handed woman with alcoholic cirrhosis presented with epilepsia partialis continua, fever, persistent post-ictal confusion and left-sided weakness. Levetiracetam, acyclovir and lacosamide were started, with early investigations showing normocytic anaemia (haemoglobin 85 g/L) but normal cerebrospinal fluid (CSF) white cell count and protein, and negative viral PCR. Brain MRI revealed multifocal T2 hyperintensities with restricted diffusion in right temporal, right frontal, and occipital white matter. Video EEG suggested moderate encephalopathy without epileptiform activity.
While confusion and seizures improved, the weakness and anaemia persisted beyond four weeks. Negative autoimmune and paraneoplastic screens and PET-CT excluded malignancy. Repeat MRI showed persistent lesions with volume loss. Extended investigations for atypical infection revealed positive serum parvovirus B19 IgM and PCR, though CSF parvovirus PCR was negative. The patient received intravenous methylprednisolone followed by five days of intravenous immunoglobulin. She was discharged after 13 weeks, with improved left-sided weakness, controlled seizures, and haemoglobin of 110 g/L.
This case highlights the importance of screening for atypical infections in immunocompromised patients with encephalitis. Parvovirus B19 should be considered when unexplained anaemia and neurological involvement coexist. Interestingly, CSF can be normal in parvovirus infection. She demonstrated clinical improvement and hematologic stability, illustrating the value of prompt diagnosis
Periosteal Electrical Dry Needling Efficacy in Knee Osteoarthritis: A Systematic Review
No full textPurpose of Review
Osteoarthritis is a “wear and tear” injury characterized by degeneration of articular cartilage, formation of osteophytes, microfractures, and sclerosis. These physiological changes result in joint pain, stiffness, and deformity. One potential treatment for this is periosteal electrical dry needling.
Recent Findings
We performed a systematic search for studies in PubMed, Google Scholar, Embase, and Cochrane. Sources published from 2014 to the present were eligible for inclusion in the review. After an initial search, 48 studies were identified, 22 of which were duplicates that were subsequently removed. The remaining 26 were filtered by title and abstract, resulting in six studies approved for final analysis. Of the six, four found significant improvement in pain and mobility after dry needling was administered as either an adjuvant or stand-alone therapy.
Summary
Electrical Dry Needling is a promising treatment for Knee Osteoarthritis. More large-scale randomized control trials are needed to evaluate its efficacy as a stand-alone treatment more fully. This review demonstrates some support for dry needling in alleviating knee pain and immobility. Future studies are needed to examine the long-term effects of dry needling and its comparative efficacy to standard treatment
Acute hypophysitis with pachymeningitis
No full textOften the workup to find the causes of common symptoms can lead to unexpected findings, thereby emphasising the need to keep a broad suspicion and continued search for emerging evidence. In this report, we describe the case of an elderly woman in her late 60s without any comorbidities, who presented with new-onset neck stiffness, progressive headache and continuous fever with no other clue that could lead us to a telltale diagnosis, and in whom the diagnostic staircase ultimately led to the diagnosis of IgG4 hypophysitis and pachymeningitis. Only a prompt clinical suspicion and appropriately timed workup can help in revealing such intricate and uncommon diagnosis among the maze of more common differentials having similar manifestations. Especially in such uncommon scenarios, common aetiologies such as tuberculosis should always be kept in the horizon
Analysis of the Association of Mobile Phone Usage and Hearing Function in Young Adults
Get PDFBackground: The health effects of radiofrequency electromagnetic radiation (RF-EMR), especially 4G and 5G, have been the subject of recent debate. The impact of this technology, particularly the nonthermal biological effects on humans and other animals has been largely ignored and not been comprehensively evaluated. Billions of people use this technology all over the globe today, and a significant percentage of them are in the adolescent age group. Therefore, a minor incidence of any adverse effect on health would be a major public health issue on a long-term basis.
Aim: The current study was designed to determine the association between long-, intermediate-, and/or short-term RF-EMR exposure from mobile phones on hearing ability in vulnerable populations like young adults.
Materials and methods: Seventy-eight young adults (aged 17-24 years) were recruited after obtaining their informed consent. First, a validated questionnaire was used to obtain the extent of phone usage among participants. They were then grouped as long-term, intermediate-term, and short-term users as per the criteria, and later their hearing ability was tested by pure tone audiometry.
Results: Among the 78 participants, 40 (51.28%) were males and 38 (48.71%) were females. Sixty-four (82.05%) of the participants responded that the right ear was their dominant ear, and for the remaining 14 (17.95%), it was the left ear. Forty-five participants (57.69%) use a 4G phone, while 32 (41.02%) use a 5G, and only one participant (1.28%) uses a 2G phone. Forty-five participants (57.69%) use the phone primarily for texting, while 33 (42.30%) use it to make calls. Fifty-four participants (69.23%) firmly attached the phone over their ears while making/receiving a call, but 24 (30.76%) did not. Fifty-nine participants (75.64%) did not feel any discomfort, but 11 (14.10%) felt a headache, one (1.28%) felt nausea, and seven (8.97%) experienced tinnitus during a call. In audiometry, mild to moderate hearing loss was evident in all three groups of participants at frequencies 250 Hz, 500 Hz, and 1000 Hz. The hearing loss was evident in individuals who have used their phones for more than 30 min/day for five years continuously compared to individuals who have used their phones 30 min/day for four years and/or 30 min/day for less than three years. This pattern was similar in both the right and left ears. Ear dominance did not play a significant role in influencing hearing loss in participants. However, significant hearing loss was found in 4G phone users compared to 5G phone users at 250 Hz and 500 Hz but not with frequencies between 1000 Hz and 8000 Hz particularly in the left ear. Moreover, irrespective of the participant's per-day average call duration, the hearing loss was evident at frequencies 250-1000Hz in both the left and right ears compared to other frequencies.
Conclusion: Long-term mobile phone use led to mild to moderate hearing loss, at frequencies 250 Hz, 500 Hz, and 1000 Hz. Ear dominance did not play a significant role in influencing hearing loss in participants. However, significant hearing loss was found in 4G phone users compared to 5G phone users at 250 Hz and 500 Hz but not with other frequencies. Further research is required to validate these results and understand RF-EMR effects on hearing in vulnerable populations like young adults
‘Empowering connections’: developing a coach mentoring framework
Get PDFMentoring has often been advocated as a method of harnessing the influential power of experience through guidance, observation, and reflective practice, allowing coaches to become better equipped to deal with the uncertain nature of coaching. Although much of the discourse on mentoring is set in a positive light, it continues to lack conceptual clarity, with no current universal definition available. Aligned to this, specific research into the programme at the heart of this study, also highlights the need for both wider, and more contextual research. Therefore, with this research being conducted into an established programme, broadly pragmatic research methods were adopted to ensure the research was sensitive to the social, historical and political context of the enquiry.
The purpose of study one was to investigate the mentoring process from the mentee’s perspective. Employing a questionnaire, the results of the study indicated a lack of clarity and understanding of the role of the mentor/mentee relationship in supporting coaching practice. Hence, building on the outcome of study one, study two interviewed four key managers within The FA with responsibility for mentoring to explore how they conceptualized the role of mentors in supporting coach development. The outcome of this study indicated an emphasis on ensuring mentors build healthy rapport with mentees to help provide clarity and understanding of the mentors role in supporting the grassroots coach. Clearly, a conceptual gap appeared to exist between what mentees were experiencing and what The FA were aiming to deliver. Consequently, study three created and presented an applied mentoring framework to support mentors in defining their role and help mentees understand the mentor/mentee relationship. Using a Delphi Study approach, the mentoring framework was shared with an independent panel of mentoring experts who provided constructive critical feedback to shape and help develop the mentoring process in context. As a consequence of this research, the mentoring framework is now employed by the FA to support the delivery of the national FA mentoring programme.
To support the research and findings further, a reflexive thread, and my own personal narrative is highlighted via the text, sketches and doodles to help the reader navigate my thoughts, reflections, and experiences on this research journey
How affinity with places affects the indirect experience of climate extreme weather events
Get PDFWhen news media talk about climate change, they often report on extreme weather in places around the world. One factor that may explain perceptions of such reports and reactions to them is people’s relationships with affected places. We test a framework of place affinity, as indicated by several place beliefs, to describe these people-place relationships. Based on previous research and two pilot studies, we employed a three-condition between-participants experiment to test whether place affinity helps explain reactions to news reports. Participants (N = 972) were either shown one of two reports on extreme flooding events in high-affinity and low-affinity countries or a general article on climate change and flooding (control condition). Reading about extreme weather in a high-affinity place invoked stronger emotional reactions than for other conditions. There were no differences in risk perception, policy support or behaviour between conditions. Participants’ open responses to news articles provided evidence of emotion-focused, problem-focused and meaning-focused strategies, as well as an absence of emotion-regulation. Our study thus contributes to the literature by testing our theoretical framework of place affinity and by investigating factors shaping the effectiveness of climate coverage
Sustainable Hydrogen Production from Plastic Waste: Optimizing Pyrolysis for a Circular Economy
Get PDFHydrogen is a clean, non-polluting fuel and a key player in decarbonizing the energy sector. Interest in hydrogen production has grown due to climate change concerns and the need for sustainable alternatives. Despite advancements in waste-to-hydrogen technologies, the efficient conversion of mixed plastic waste via an integrated thermochemical process remains insufficiently explored. This study introduces a novel multi-stage pyrolysis-reforming framework to maximize hydrogen yield from mixed plastic waste, including polyethylene (HDPE), polypropylene (PP), and polystyrene (PS). Hydrogen yield optimization is achieved through the integration of two water–gas shift reactors and a pressure swing adsorption unit, enabling hydrogen production rates of up to 31.85 kmol/h (64.21 kg/h) from 300 kg/h of mixed plastic wastes, consisting of 100 kg/h each of HDPE, PP, and PS. Key process parameters were evaluated, revealing that increasing reforming temperature from 500 °C to 1000 °C boosts hydrogen yield by 83.53%, although gains beyond 700 °C are minimal. Higher reforming pressures reduce hydrogen and carbon monoxide yields, while a steam-to-plastic ratio of two enhances production efficiency. This work highlights a novel, scalable, and thermochemically efficient strategy for valorizing mixed plastic waste into hydrogen, contributing to circular economy goals and sustainable energy transition
Biomechanical assessment of upright birthing positions using marker-based and markerless motion capture systems
No full textUnderstanding the effects of birthing positions on labour is crucial for optimising maternal and foetal outcomes. Upright positions are encouraged but their biomechanics are not fully understood. Biomechanical changes during labour can make certain positions more or less favourable depending on individual physical characteristics. Understanding these factors is essential for tailoring strategies that enhance maternal comfort and facilitate labour. This study aimed to quantify the biomechanics of seven common upright birthing positions, comparing their biomechanical characteristics and evaluating the sensitivity and accuracy of marker-based and markerless motion capture systems. Fifteen healthy, non-pregnant women performed seven upright birthing positions. Hip, pelvis, and trunk kinematics were assessed using a 9-camera marker-based system and an 8-camera markerless system. Significant biomechanical differences were found between birthing positions. The “squat” position showed the most hip flexion and abduction, “B-Ball” had the greatest anterior pelvic tilt, and “all-fours” exhibited the most posterior tilt. For the trunk, “upright” led to the most extension, and “elbows bent knees” showed the most flexion. The markerless system aligned well with the marker-based system in the coronal and transverse planes but lacked sensitivity in the sagittal plane. This study highlights the biomechanical differences in upright birthing positions and emphasises the need for personalised birthing strategies. Understanding labour biomechanics is crucial for improving maternal and foetal well-being and reducing complications. By providing comprehensive and evidence-based information, women can make informed decisions about their birthing positions, enhancing outcomes and lowering the risk of maternal and neonatal complications globally
A New Era for Maternal and Child Nutrition Implementation Science Research and Program Evaluation
Get PDFEnhancing trace DNA recovery from disposable face masks: insights from the COVID-19 era and beyond
No full textTrace DNA plays a pivotal role in forensic investigations, serving as a critical tool for linking suspects to criminal activities. During the COVID-19 pandemic, disposable face masks emerged as key items of forensic interest, particularly in cases where suspects used them to conceal their identities. This study evaluates the efficiency of two trace DNA collection methodologies—cotton swabbing and tapelifting—for recovering DNA from face masks. Samples were collected from 50 masks worn by suspects in robbery cases, utilizing the Copan cotton swab (150 C) and the SceneSafe Fast™ minitape (K545). Statistical analysis revealed that minitapes (MT) significantly outperformed cotton swabs (CS), yielding higher DNA concentrations (mean MT: 0.41 ng/µL, CS: 0.17 ng/µL; p < 0.05) and recovering more complete DNA profiles, including full single (FS) and full mixed (FM) profiles (p < 0.05). These findings highlight the superior efficiency of MT, particularly for recovering trace DNA from small or fabric-like surfaces. The study underscores the importance of selecting optimal collection methods in forensic investigations, especially for modern evidence types such as face masks. Recommendations include the routine adoption of minitapes in casework involving face masks and further research into their efficacy on other mask types and under varied environmental conditions. This research offers valuable insights to refine trace DNA recovery strategies, enhancing the reliability of forensic evidence