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Using natural language processing to explore differences in healthcare professionals’ language on Functional Neurological Disorder: a comparative topic and sentiment analysis study
Get PDFBackground: Effective communication is essential for delivering quality healthcare, particularly for individuals with Functional Neurological Disorders (FND), who are often subject to misdiagnosis and stigmatising language that implies symptom fabrication. Variability in communication styles among healthcare professionals may contribute to these challenges, affecting patient understanding and care outcomes. Methods: This study employed natural language processing (NLP) to analyse clinician-to-clinician and clinician-to-patient communication regarding FND. A total of 869 electronic health records (EHRs) were examined to assess differences in language use and emotional tone across various professionals—specifically, neurologists and psychologists—and different document types, such as discharge summaries and letters to general practitioners (GPs). Latent Dirichlet Allocation (LDA) topic modelling and two complementary sentiment models (VADER and Flair) were applied to the corpus. Sentiment analysis was also applied to evaluate the emotional tone of communications. Results: Findings revealed distinct communication patterns between neurologists and psychologists. Psychologists frequently used terms related to subjective experiences, such as “trauma” and “awareness,” aiming to help patients understand their diagnosis. In contrast, neurologists focused on medicalised narratives, emphasising symptoms like “seizures” and clinical interventions, including assessment (“telemetry”) and treatment (“medication”). Sentiment analysis indicated that psychologists tended to use more positive and proactive language, whereas neurologists generally adopted a neutral or cautious tone. Conclusions: These findings highlight differences in communication styles and emotional tones among professionals involved in FND care. The study underscores the importance of fostering integrated, multidisciplinary care pathways and developing standardised guidelines for clinical terminology in FND to improve communication and patient outcomes. Future research should explore how these communication patterns influence patient experiences and treatment adherence
Device-assessed sleep health among older patients with heart failure: a cross-sectional study using actigraphy
Get PDFObjective: Poor sleep is common among patients with heart failure (HF) and is associated with adverse cardiovascular outcomes. The utility of actigraphy in sleep assessment, especially among older adults, remains underexplored. This study aimed to assess sleep health among older adults with HF using actigraphy and explore associations between sleep parameters and cardiac biomarkers, functional performance and quality of life (QoL). Design: A cross-sectional study. Setting: The study was conducted at an outpatient HF clinic within a tertiary cardiology service in a National Health Service hospital in the UK between March and October 2023. Participants: A total of 150 older adults aged ≥65 years with a diagnosis of HF were enrolled. Methods: Participants were given a wrist-accelerometer to wear for 7 days. On Day 0, patients completed a 4-metre walk test (4MWT), handgrip strength test (HGST), Timed Up and Go test (TUGT), Barthel Index (BI), Kansas City Cardiomyopathy Questionnaire (KCCQ-12) and frailty assessment (Clinical Frailty Scale, CFS). Subsequently, they were fitted with an accelerometer, with the device configured to start recording the following day (Day 1). Sleep outcomes were calculated after a 7-day wear period and averaged across valid nights (minimum 3 nights of recording, noon-to-noon with ≥16 hours wear-time). Sleep parameters studied include average sleep efficiency, sleep period time window, sleep duration, sleep onset and wake up time, wake after sleep onset (WASO), sleep interruptions and Sleep Regularity Index (SRI). Inefficient sleep was defined as sleep efficiency <80%. Regression analysis was used to examine associations between sleep parameters and the previously stated tests and assessments, adjusting for age, gender and comorbidities. Outcome measures: The primary outcome measure was sleep efficiency; all other sleep parameters were classified as secondary or exploratory outcomes. Results: Accelerometry data from 145 participants were analysed; 42% had inefficient sleep based on average sleep efficiency across valid nights. These patients had significantly higher plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (p=0.044). No statistically significant difference was noted in 4MWT, HGST, TUGT, BI, KCCQ-12 and CFS between patients with sleep efficiency <80% and those with sleep efficiency ≥80%. Lower sleep efficiency was associated with lower BI scores (adjusted β=0.271, p=0.016) and worse frailty (adjusted β=−0.017, p=0.014). Lower SRI was associated with worse New York Heart Association class (adjusted β=−0.009, p=0.007), BI scores (adjusted β=0.310, p<0.001), frailty (adjusted β=−0.017, p<0.001) and QoL (adjusted β=0.344, p=0.001); longer WASO was associated with slower gait speed (adjusted β=−0.039, p=0.040). Conclusions: Older adults with HF who had inefficient sleep had significantly higher NT-proBNP levels. Lower sleep efficiency was associated with higher functional dependence and frailty. Sleep irregularity was linked to HF symptom load, frailty, functional performance and QoL, while sleep fragmentation was associated with impaired gait speed
Assessing impact of titanium dioxide nanotube incorporation on the glass transition temperature and thermal stability of 3D printed complete denture base resin
Get PDFStatement of problem
The suboptimal thermal and thermomechanical performance of 3-dimensionally (3D) printed complete dentures limits their functional longevity. Whether incorporating titanium dioxide (TiO2) nanotubes (NTs) into 3D printed denture base resins improves their properties is unknown.
Purpose
The purpose of this in vitro study was to evaluate the effects of incorporating TiO2 NTs into 3D printed denture base resin on the glass transition temperature (Tg), thermal stability, and a thermomechanical property (elastic modulus [EM]) as a function of temperature change.
Material and methods
TiO2 NTs (Ø30 to 85 nm×1 to 3 µm) were added to the denture base resin at 0.0 wt% (control), 1.0 wt%, and 2.0 wt%. The Tgs were analyzed using 3 different methods: differential scanning colorimetry (DSC), differential thermal analysis (DTA), and thermomechanical analysis (TMA). Thermal stability was analyzed using thermogravimetric analysis (TGA) and its derivative (DTG). EMs were evaluated using a TMA device. A total of 96 specimens were used during the experiments, including 30 specimens for each test (thermal stability, Tg, and EM), in each subgroup (n=10) and 6 specimens for microscope and composition analyses (n=2). The effective sample size was calculated using G*power 3.1.9.7, and the collected data were analyzed using ANOVA for Tg and repeated-measures ANOVA for thermal stability and EM followed by the Tukey post hoc test (α=.05).
Results
Increasing the TiO2 NTs concentration improved the thermal stability (TGA and DTG) (P<.001) and EM (P<.001) of both the 1.0 wt% and 2.0 wt% nanocomposite groups. The Tg increased significantly in the 1.0 wt% nanocomposite group (P<.001). Additionally, among the 3 different methods for Tg analysis, no significant differences were found (P=.955).
Conclusions
The glass transition temperature, EM, and thermal stability of 3D printed materials improved in the 1.0 wt% group. Additionally, both DSC and DTA were found to be reliable analytic methods for Tg analysis, as they conform with the Tg results from the TMA devices.
Clinical Implications
The improvement in the glass transition temperature, thermal stability, and thermomechanical properties of the 3D printed resin associated with the addition of TiO2 NTs resulted in a denture base that should be able to withstand a wide range of intraoral temperatures during hot meals and drinks and extraoral temperatures during denture cleaning, reducing thermal aging, improving mechanical performance, and prolonging shelf-life
Food formulation: rheological and tribological determinants of oral processing and flavor perception
No full textUnderstanding how food behaves during oral processing requires going beyond its chemical composition to
integrate rheological and tribological determinants that shape texture, mouthfeel, and ultimately flavor
perception. This review examines how viscosity, microstructure, and flow properties govern aroma release and
taste perception across liquid, semi-liquid, solid, and emulsion-based foods, while oral tribology elucidates
lubrication regimes that drive sensations such as creaminess, smoothness, or astringency during mastication and bolus formation. Particular emphasis is placed on the interplay with saliva, whose proteins and physicochemical properties critically modulate lubrication and sensory dynamics. By combining rheological and tribological approaches termed “rheo-tribology” with sensory analysis, this work highlights integrated mechanisms of flavor release, from controlled diffusion in viscous matrices to tribological transitions at oral surfaces. Formulation strategies using hydrocolloids, proteins, fat replacers, and emulsifiers are detailed, showing how textural engineering can tailor perception and consumer acceptance, particularly in plant-based or reformulated products.
Overall, the integration of rheology and tribology provides a comprehensive, physiologically relevant model of
oral processing, offering predictive power for designing sensory-optimized foods that balance nutrition, functionality, and pleasure while addressing current challenges in health-driven reformulation and sustainable food innovation
Smartphone applications for heart failure self-management and the role of the district nurse
No full textAlmost 1 million people in the UK are living with heart failure, which is a progressive and life-limiting condition. Managing symptoms in the community is widely acknowledged as a means of reducing deterioration and hospital admissions. Recent literature suggests that smartphone applications may support this agenda by facilitating symptom monitoring and promoting self-care. However, the evidence base for their long-term clinical effectiveness remains limited, with many studies focusing on feasibility or user engagement rather than outcomes, such as mortality or quality of life. Furthermore, reliance on technology risks exacerbating existing inequalities, as those with poor digital literacy or limited access to smartphones may be excluded. With pressures on the NHS intensifying, district nurses are increasingly positioned as leaders in community-based chronic disease management. However, the expectation that they integrate digital health solutions into practice requires critical consideration of feasibility, ethical implications and the potential unintended consequence of shifting responsibility for care onto service users
Perceptual-cognitive skills in talent development environments: a survey of academy football coaches in the United Kingdom
Get PDFIntroduction: Perceptual-cognitive skills (PCS) are a strong predictor of future expert performance in football. Theoretical and practical knowledge of PCS are important to inform (de)selection and development decisions. Despite their relevance to player development, limited research has explored how coaches working in talent development environments conceptualise and assess PCS in practice. This study aimed to critically examine perceptions of and engagement with PCS identification and assessment among UK academy coaches. Methods: An online survey collected data from 63 academy coaches regarding their understanding and identification of PCS within the age groups they coach. Results: Data indicated agreement between coaches PCS definitions and their importance in player development. However, variations in coaches’ familiarity, confidence, and frequency of PCS identification, alongside differing views on the importance of specific PCS point to potential knowledge and practice gaps. Discussion: Further research is needed to understand and develop interventions that support coaches in enhancing PCS identification and assessment within this overlooked area of player development
On the Hill: Representations and retellings of the Pendle Witches' history within the rural landscape of Lancashire, England
Get PDFIn Pendle, the witch as historical figure is displayed in a variety of ways, becoming ubiquitous to the extent of acting as cipher for a sense of located-ness in the region. In the article, examples of tourist sites and ephemera are analysed alongside site-based research exploring mapped walks, sculptures and performance. By analysing depictions of the history embedded within the landscape, and the ways audiences engage with them, this research will examine the political and gendered implications of using this type of contested, traumatic history as a key component in establishing a local heritage and tourism identity. I argue that the retelling of the events as physically closely located yet historically distant lends them the patina of folk mythology, a process further compounded by the visual and material representations used to illustrate these versions of the story to visitors and locals alike.
Witches are made present in Pendle and have become arguably an unofficial motif for the region where the caricature emblem of the witch is used to signpost walking routes and identify bus operators, and are sold as fridge magnets and novelty stuffed toys. This is contrasted to documentation of sculpture and temporary artworks marking the fourth centenary of the executions. This paper investigates how this historic trauma has been transformed into a multi-layered contemporary legend for local residents, tourists, and arts audiences, whilst also analysing the effect of repackaging this history somewhere between local folk mythology and commercial interest. By combining theories from Heritage Studies, Dark Tourism and Contemporary Legend, I have sought to offer up a means for exploring the material culture relating to the Pendle Witches and how these souvenirs, ephemera and artworks in the landscape connect to ways this legend is communicated today
Testing the feasibility of an intermittent low-energy diet in women with gestational diabetes
Get PDFAims:
The study aimed to assess feasibility, acceptability and safety of an ILED in a randomised controlled trial of ILED vs. best NHS care healthy diet and exercise advice in women with Gestational Diabetes Mellitus (GDM) with body mass index ≥27.5 kg/m2 (≥25 kg/m2 in high-risk minority ethnic groups) in the last trimester of pregnancy.
Methods:
Participants were randomised (1:1) to receive an ILED (1000 kcal on two non-consecutive days of the week with 5 days/week of best NHS care healthy diet and exercise advice) or best NHS care healthy diet and exercise advice 7 days/week from recruitment (24–30 weeks gestation) until delivery (BNC). Primary outcomes were uptake, retention and adherence to the interventions. Maternal and neonatal safety outcomes were explored, and secondary outcomes assessed fidelity of the delivery of the intervention and completeness of study data across all trial participants.
Results:
Participants were randomised to ILED (n = 14) or BNC (n = 12) and 73% (n = 19; ILED n = 10, BNC n = 9) received their allocated intervention. There was low study retention (58%; ILED n = 7; BNC n = 8) and low adherence to the ILED median (IQR) 37% (8%–50%) out of prescribed days; however, the study achieved a feasible uptake rate (31%; n = 26). There were no adverse events specifically related to the ILED.
Conclusion:
Our findings suggest that ILED may not be feasible in the third trimester in people with GDM. Future research should explore alternative interventions and interventions earlier in pregnancy for the prevention and management of GDM.
Trial registration number: NCT0534406
Generative AI Chatbot Prompting for Excellent Customer Service in Tourism
Get PDFThis article explores the impact of prompting on the performance and service quality of artificial intelligence (AI) customer service chatbots, and the relationship between the prompting process and service quality elements. The data were collected in September 2024 from responses generated by three chatbots, each using a range of prompting techniques. The chatbots responded to real customer inquiries collected by the Visit Helsinki customer service office in summer 2020. The results show that prompting has a significant impact on the quality of online customer service that AI chatbots can provide
A qualitative study of enablers and barriers to healthy eating in adults with Charcot Marie Tooth disease using the Theoretical Domains Framework and COM-B model.
Get PDFCharcot-Marie-Tooth disease (CMT) is a progressive neurological disorder affecting the peripheral nervous system, with symptoms such as fatigue, pain and muscle weakness that can hinder engagement in health-promoting behaviours, including healthy eating. This study explored enablers and barriers to healthy eating among adults with CMT, using the Theoretical Domains Framework (TDF) and the COM-B model. Twenty-two semi-structured interviews were conducted with 17 women and 5 men (aged 25-73). Data were analysed using framework analysis. Identified barriers included symptom-related fatigue, particularly during periods of high demand (e.g. workdays), limited lifestyle-focused guidance in routine healthcare interactions and physical environmental constraints. Key enablers comprised meal planning, social support from family and online communities, recognition of the mental and physical benefits of healthy eating and access to resources that helped mitigate physical limitations. These findings provide a foundation for developing evidence-based, context-sensitive dietary interventions tailored to the lived experiences of individuals with CMT