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Efficacy and safety of antioxidants and dietary therapies for epilepsy : an umbrella meta-analysis
Get PDFBackground: Epilepsy is a prevalent chronic neurological disorder. A substantial proportion of patients develop drug-resistant epilepsy. Existing antiepileptic drugs are associated with adverse effects and demonstrate limited efficacy in refractory cases. Oxidative stress plays a critical role in the pathogenesis of epilepsy. Antioxidants such as vitamin D, vitamin E, and melatonin, as well as dietary therapies like the ketogenic diet, have garnered attention as potential adjunctive treatments. However, existing studies exhibit significant controversy and heterogeneity. Objective: To evaluate the efficacy and safety of antioxidants and dietary therapies in the treatment of epilepsy, and to provide evidence-based support for clinical decision-making. Methods: Systematic searches were conducted in PubMed, Web of Science, Embase, and the Cochrane Library. Eighteen eligible meta-analyses were selected for umbrella review based on predefined criteria. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated using random-effects or fixed-effects models. Heterogeneity was assessed using the I2 statistic, and evidence quality was evaluated with the AMSTAR 2 tool. Results: Dietary therapies—particularly the Low Glycemic Index Treatment (LGIT)—significantly increased the likelihood of achieving ≥50% (RR: 1.95; 95% CI: 1.58–2.33) and ≥90% (RR: 3.33; 95% CI: 1.51–5.14) seizure reduction. However, dietary therapies were ineffective in achieving seizure freedom (RR: 0.68; 95% CI: 0.00–1.36). In subgroup analyses of ≥50% seizure reduction, antioxidants did not demonstrate significant efficacy. Both antioxidants and dietary therapies significantly increased the overall incidence of adverse events (RR: 1.56; 95% CI: 1.19–1.92). Specifically, the ketogenic diet elevated the risks of dyslipidemia (RR: 3.56; 95% CI: 2.00–5.11), weight loss (RR: 4.80; 95% CI: 3.43–6.17), constipation (RR: 3.02; 95% CI: 1.55–4.48), and kidney stones (RR: 5.24; 95% CI: 3.73–6.74). Melatonin was ineffective in reducing seizure frequency (RR: 0.30; 95% CI: 0.00–0.63). Considerable heterogeneity was observed across studies. Conclusion: Dietary therapies—notably LGIT—demonstrate clear efficacy in reducing seizure frequency but do not facilitate seizure freedom. Current evidence does not support the use of antioxidants as effective adjunctive therapy for epilepsy. These interventions, particularly the ketogenic diet, are associated with increased risks of adverse effects, necessitating careful benefit–risk assessment in clinical application. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251166437, identifier: CRD420251166437
DJ Encounter : Invitation to the aesthetic turn in management education
No full textThis piece is inspired by aesthetic and arts-based practices in management education, a field which aims to deepen and broaden forms of knowing, and knowledge beyond the theoretical. We propose, animate and offer the aesthetic metaphor of educators as ‘DJs’ using ‘DJ sets’. Just as DJs master the adaptation of aspects of volume, tempo, resonance, and variety of mixes on a turntable to co-create the musical experience with the crowd, educators use practices that layer and juxtapose different teaching methods allowing for the educator’s and student’s intentions, beliefs, ideas and experiences to shape the learning experience directing them to underexplored, new places. We introduce the DJ metaphor for educators and provide examples as to how educationalists in business and management can create highly impactful teaching and learning spaces and practices, with a view of inviting the reader to embrace the aesthetic turn in their educational practic
From City‐Builder to Geogame : A Geodesign Process for Participatory Urban Planning
No full textCity‐building games (CBGs) have a long history of focusing on societal simulation and urban management gameplay, including The Sumerian Game (1964), Micropolis, later named SimCity (1989), and Utopia: Creation of a Nation (1991). In this article, we present the outcomes of a pilot study through which we have developed an innovative process that transfers CBGs’ gameplay actions into real‐world planning systems. To evaluate the interplay between CBG simulation and the real world, we delivered workshops to 140 young people and adults to design their local community in South Lancaster, UK, using Cities: Skylines I and II. A novel approach using GIS and machine learning tools was developed to analyse young people’s planning decisions and needs in the area, focusing on the act of “play” within the game. These analytical tools, which involved the semantic classification of game imagery, yielded insights into land‐use decisions. Through game updates released during the study of Cities: Skylines II, we explored new analytical potential and established a process to extract gameplay results that provide additional urban block and street‐level tools for analysis, from CBG to geogame. The limitations of these approaches include the “black box” nature of the game and its planning model, such as zoning and focus on car‐based infrastructure. However, Cities: Skylines has a large player community and strong potential to turn into a geogame in support of real‐world planning and consultation, engaging communities. This article contributes to the literature with a novel and replicable process and case study. When geogames are applied to real‐world problems, the result is a demonstration of the ability of simulations to inform real‐world decisions
G. Tunnicliffe-Wilson’s contribution to the Discussion of ’New tools for network time series with an application to COVID-19 hospitalisations’ by Nason et al
Get PDFUnlocking Innovation : The Role of Intrapreneurial Teams in Overcoming Organisational Inertia
No full textElectromyography of the Sternocleidomastoid and Forearm Muscles During Laparoscopic Surgery (LS) and Robot-Assisted Laparoscopic Surgery (RALS)
No full textIntroduction Minimally invasive surgery (MIS), including robot-assisted laparoscopic surgery (RALS) and laparoscopic surgery (LS), has become a key method of conducting abdominal surgery. It has transformed surgical practise but has put surgeons at greater risk of musculoskeletal injury, potentially shortening careers. The use of surface electromyography (EMG) offers an objective method of quantifying muscular demand in surgery. This thesis aimed to evaluate EMG activity in key muscle groups of surgeons during RALS and LS, to determine differences in ergonomic risk and consider the scope of EMG as a tool to measure muscular demand within MIS. Methods A scoping review of the literature was conducted to synthesise current evidence of the use of EMG within the field of MIS. In total 96 unique studies were included with an identified lack of research in the comparison between RALS and LS in terms of muscular activation. An experimental study investigated the sternocleidomastoid and forearm muscle groups in surgeons when comparing RALS and LS using normalised EMG muscular activation as the primary measure. Results The literature indicated that EMG was a well-utilised and versatile tool within this field, with a heavy focus being placed on investigating muscular demand within LS but less so on RALS, simulated tasks and the comparison between RALS and LS. The experimental study suggested that there was no obvious acute difference in the sternocleidomastoid and forearm muscles when comparing RALS and LS, almost half of the variation in muscle activity between groups was due to surgeon variability and there was consistently higher muscle activation in the sternocleidomastoid compared to the forearm muscles. Conclusion EMG is a reliable tool for measuring muscular demand in minimally invasive surgeons. Evidence may suggest that RALS reduces muscular demand compared to LS in some muscles, but evidence is mixed and requires future meta-analyses and longitudinal studies to clarify any ergonomic benefits
Women’s experience of Postpartum Emotional Distress (PPED) during the COVID-19 pandemic in the UK.
No full textBackground Understanding postpartum emotional distress in the context of the COVID-19 pandemic is important from both theoretical and practical clinical perspectives as it can inform future support for women experiencing PPED during a pandemic. Considering this, the purpose of the present inquiry was to explore women’s experiences of postpartum emotional distress (PPED) after giving birth during the COVID-19 pandemic in the UK. Methods The first study is a systematic scoping review of studies that investigated various forms of PPED during the COVID-19 pandemic. The aim was to explore which forms of PPED were researched, the range of methodological approaches used, the limitations of these studies as well as suggested future direction for further research. The methodology for evidence search, synthesis, and reporting of findings was guided by a framework developed by Arksey and O'Malley (2005) and The Joanna Briggs Institute’s guidelines (Aromataris, 2020) for scoping reviews. The second study was a qualitative exploration of women’s experiences of PPED during the Covid-19 pandemic in the UK. In this study, PPED was defined as “an unpleasant emotional state which is more intense than is usual for the new mother and lasts most of the day nearly every day for at least a couple of weeks and starts within the first few months after childbirth.” A critical realist approach guided the research process. The data was collected using semi-structured interviews. Purposeful sampling was used to select participants for the study following criteria which included: women over the age of 18 years, who delivered a full-term, healthy, and singleton baby during the COVID-19 pandemic in the UK, experienced PPED, now in a state of recovery residing in UK and are fluent in speaking English. The data was analysed using Reflexive Thematic Analysis (RTA) to explore the women’s perspective of PPED after giving birth during the COVID-19 pandemic to understand the essence of their experience. Findings The scoping review provided an overview of 29 papers that were used to explore postpartum emotional distress (PPED) during COVID-19 in the UK. In particular, it highlighted the trend to focus on exploring depression and anxiety and ignoring other forms of PPED. It also shows the tendency of researchers to use a quantitative approach to study PPED during the COVID-19 pandemic which in terms of numbers was almost double the studies that used qualitative or mixed-method approaches and hence dominate the research field. The findings of this review helped to identify a gap in the literature and provided a context within which the strengths and limitations of the second study were evaluated. The qualitative study revealed 12 sub-themes which were organised into 4 over-arching themes which were: 1. The emotional range of PPED, 2. The Missing Village, 3. Relying on the online virtual village, and 4. PPED changes you as a person. The findings indicate that women’s lived experience of PPED is not limited to the experience of anxiety and mood disorder for the reason that postpartum women experience a broad range of emotional states and their responses to these emotional states are also varied and wide-ranging. The impact of the COVID-19 pandemic on the emotional state of postpartum women as well as on their response to their emotional state is evident. Moreover, the findings demonstrate that women would have experienced PPED irrespective of the pandemic but dealing with the postpartum stressors and their emotional state of distress would likely have been less complicated and more manageable. Conclusion PPED needs to be explored and understood as a multifaceted phenomenon that involves wide-ranging emotional states and the reaction to these emotional states which are varied. Moreover, the impact of the COVID-19 pandemic on postpartum mental health is significant and such contextual factors need to be understood to better support women
Corpus methods for linguistic analysis
No full textThis chapter aims to introduce corpus linguistics as a scientific method for both the theoretical and applied analysis of written and spoken language data. It first provides key definitions in corpus linguistics (e.g., corpus, token, type, annotation, metadata) and introduces different types of corpora, describing the core features (e.g., representativeness, balance, sampling) to consider when building/selecting a corpus. In addition to well-known general corpora like the British National Corpus (which represents British English used in a wide range of communicative contexts), the chapter also describes specialized corpora that contain, for example, transcripts of second language speech, multilingual data, register-specific or topic-specific texts. It then provides an overview of key techniques in corpus linguistics (e.g., frequency counts, concordances, collocations) which allow both quantitative and qualitative analysis of linguistic data. These techniques demonstrate the wide range of applications of corpus methods, for instance, to inform research in stylistics, forensic linguistics, language acquisition, and discourse analysis. The chapter includes a case study that analyses second language production to illustrate corpus techniques, freely available tools, and how to report corpus findings. Challenges in the application of corpus methods to linguistic analysis are identified (e.g., selecting/building a representative corpus, processing and annotating data, ethical issues and copyright) and possible solutions are outlined