11237 research outputs found
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Schistosomiasis and ruptured ectopic pregnancy: a case report
No full textSchistosomiasis is a parasitic disease mainly prevalent in tropical and subtropical areas, especially in poor settings without adequate sanitation and access to clean water. It is caused by trematode parasites living within the veins of their human host, where they mate and produce fertilized eggs. The eggs are either shed into the environment through feces or urine, or are retained in host tissues where they induce inflammation and then die. The genital form is caused by Schistosoma haematobium and affects both the urinary and genital tracts in up to 75% of infected individuals, both male and female. Female genital schistosomiasis is a challenging and potentially lethal condition and may affect the whole genital tract leading to a wide range of urinary, sexual, and reproductive health problems. The main reasons leading women to health services are infertility and genital nonspecific symptoms including vaginal discharge, pruritus, pelvic pain, dyspareunia, and haematuria. Other severe complications caused by schistosomiasis include increased risk of HIV and HPV infection, genital ulcers, miscarriage, and ectopic pregnancy. We report in the present case study a 23-year-old female with schistosomiasis and ruptured ectopic tubal pregnancy successfully managed in a low-income setting.</p
The essential role of the physiotherapy profession in incretin-based weight loss
No full textObesity is a global health concern requiring multidisciplinary approaches for effective management. Incretin-based pharmacotherapies, such as glucagon-like peptide 1 receptor agonists, have demonstrated significant weight loss outcomes, yet their impact on body composition remains underexplored. Evidence indicates that weight loss with these medications may lead to disproportionate fat-free mass loss, heightening risks of sarcopenia and sarcopenic obesity, which are associated with frailty, comorbidities, and reduced functionality. Exercise, particularly resistance training, has proven effective in preserving fat-free mass and optimising long-term weight maintenance. Physiotherapists are uniquely positioned, as one of the largest professions within the Allied Healthcare Professional workforce, their expertise in exercise prescription, rehabilitation, and behaviour change, has the potential to address these challenges. However, concerningly, much of the guidance around the prescription of glucagon-like peptide 1 receptor agonists fails to mention the inclusion of physiotherapists in the patient management team, and the impact that they can have on clinical outcomes. This debate article argues for the inclusion of physiotherapy within interdisciplinary teams managing patients on incretin-based pharmacotherapy to optimise their efficacy and promote healthier weight loss.</p
Palliative sedation at the end of life: practical and ethical considerations
No full textSedation is commonly used at the end of life; however, there are several practical and ethical considerations for its use. It is important to identify any treatable causes for agitation prior to initiating medication. The drug, dose and route of administration may vary according to the indication for treatment, and specialist advice or supervision may be required. There are a number of ethical and cultural considerations relevant to the use of palliative sedation, which must also be understood to ensure best practice in this area.</p
Identification of Pathways That Drive Myofibroblast Transformation in Hypertrophic Scars
No full textHypertrophic scars (HTS) are a common complication of burn injuries and are characterized by excessive dermal fibrosis driven by the transformation of resident dermal fibroblasts to profibrotic myofibroblasts. Although single cell and bulk RNA transcriptomics analysis of HTS and normal skin tissue samples were performed previously, transcriptomics of the transformation of fibroblasts to myofibroblasts has not been studied. Here, we report the data obtained from RNA sequencing of fibroblasts before and after exposure to transforming growth factor beta 1 (TGF-β1) and highlight the pathways that are up- and down-regulated during myofibroblast transformation. Our results suggest increased cellular signalling and rewiring, proliferative surge, immune-like and metabolic reprogramming, and delayed structural remodelling as four groups of events during the transformation of human primary dermal fibroblasts to myofibroblasts.</p
Three-dimensional numerical study on different fuels of ammonia-hydrogen/syngas combustion with various operating conditions in the BERL combustor
No full textThe current study presents a numerical analysis of the impact of burning a blend of NH3-H2 with syngas in a 300 kW swirl-stabilized BERL combustor, which traditionally operates on methane. The study continues previous research that compared syngas combustion with natural gas, extending the discussion to the novelty relationship between syngas, a common fossil fuel, and greener fuels such as ammonia–hydrogen blends. The predictions reveal differences in the flame structure influenced by the quarl angle and inlet air swirl number. Results present closely compatible trends, though with different parameter variations where quarl angle and swirl number are 20° and 0.56, respectively, for Syngas, while for the NH3-H2 mixture they are 10° and 0.8. CHEMKIN PRO was employed to analyze emissions produced for both fuels, accounting for residence time impact. Additionally, the study evaluates the influence of air staging and flow gas recirculation within the burner on the reduction of combustion generated NOx emissions to approximately 180 ppm for syngas and 550 ppm for ammonia–hydrogen mixture.</p
The Right to Authorship in AI generated works
No full textIn the era dominated by digital platforms, knowledge workers grapple with challenges concerning the value of their work, copyright, distribution, and authorship. Urgent questions arise on the devaluation of human creative work through AI interventions and the lack of harmonization in the meaning of authorship under copyright laws across different jurisdictions. How do existing legal frameworks adapt to the nuances of AI-generated content, and to what extent do they safeguard the integrity and dignity of human-authored works and value? As AI contributes to creative processes, who holds authorship and subsequently ownership in generative works, and how can this be reconciled with traditional notions of creativity and intellectual property? What do we understand by creativity in a work environment where artificial and human intelligence are increasingly integrated. This paper responds to these questions. The primary focus lies in navigating the intricacies of AI-generated work versus human-generated work, especially considering the complexities of authorship within UK, EU, and US legal frameworks.</p
Unmet Health and Social Care Needs Among Obese Older Adults in England: A Mixed-Methods Analysis
No full textBackground: The increasing prevalence of obesity among older adults in England poses significant challenges to health and social care systems, where obesity is found to be associated with a higher risk of chronic diseases, functional impairments, and diminished wellbeing. Despite much existing research, there is a paucity of studies exploring the specific health and social care needs of obese older adults, focusing on their unmet care and support. This study aims to investigate the impact of obesity on health and social care needs among adults aged 50 and above in England.Methods: A mixed-methods approach was employed. Quantitative data were derived from the English Longitudinal Study of Ageing (ELSA) and analysed using SPSS to assess associations between Body Mass Index (BMI), health status, and social care utilisation. Qualitative data were collected through semi-structured interviews with overweight and obese older adults recruited from a National Health Service (NHS) General Practice surgery. Narrative analysis was conducted to identify themes related to unmet care needs.Results: Quantitative analysis revealed a positive correlation between higher BMI and increased functional impairments, as well as greater reliance on social care services. Qualitative findings highlighted several unmet needs among obese older adults, including emotional support deficits, social isolation, and inadequate access to tailored health and social care services. Participants expressed feelings of being a burden and reported barriers to engaging in social and recreational activities.Study Contribution: A new conceptual framework has been developed that maps unmet care needs, whether needs are expressed or unexpressed, and whether they’re being met or ignored. It helps visualise “care invisibility” in a system that often assumes people will ask for help, but it’s not only about physical limitations, but also about feeling invisible, being judged, or excluded, and that is widening the gap between care demand and service provision.Conclusions: Obesity significantly exacerbates health and social care challenges for older adults in England. The study underscores the necessity for integrated, holistic approaches that address both the physical and psychosocial aspects of care for this population. Policymakers and healthcare providers should consider implementing targeted interventions that encompass emotional support, social engagement opportunities, and customised care plans to effectively meet the complex needs of obese older adults.</p
Coronary stent migration after bailout stenting in type A acute aortic dissection: the impact of haematoma absorption
No full textA 75-year-old female presented with type A acute aortic dissection, with computed tomography showing concomitant ostial left main stem (LMS) compression by an extra-coronary haematoma. This corresponded to anterior ST-segment elevation and severe antero-septal wall hypokinesis. Before emergency surgery, coronary angiography (CAG) and intravascular ultrasound (IVUS) confirmed occlusive luminal narrowing of the ostial LMS to the proximal left anterior descending artery (LAD) due to extending extra-coronary haematoma (Panels A and B; arrows indicate lumen compression).</p
Attachment theory as a framework to understand youth sport coaches' caring behaviours within the coach-youth athlete relationship
No full textThis programme of research set out to explore attachment theory as a framework for understanding the affective behaviours of youth sports coaches within the coach-youth athlete relationship. It sought to do this through a set of three linked studies located within the paradigmatic domain of critical realism. Study 1 contextualised the research by exploring the vista of the attachment orientations of the competitive and elite youth coaching community. This was achieved through the use of the Experience in Close Relationships – Relationship Structure questionnaire (ECR-RS), which determined the coaches’ attachment orientations. Findings demonstrated that almost half of the coaches have the potential to struggle with their emotional regulation under stress. Study 2 built on the contextualising work of study 1 by exploring the narratives of attachment amongst youth sport coaches, in order to understand their impact on the coach-youth athlete relationship. The study adopted a qualitative approach, using story completion as a method of data collection, then examined through dialogical narrative analysis. The study used a comparative approach designed to generate two sets of stories through two differing attachment trigger events. The findings suggest that attachment orientation does play a role in presentation of affective care within the coach-youth athlete relationship but that socio-cultural narratives have the power to not only mute these antecedent behaviours, but promote alternative behaviours in their place. Following on from these findings, Study 3 developed an 8-week intervention aimed at exploring the potential to enhance a coach’s secure-base attachment behaviour (a part of the attachment system that promotes affective behaviour) through supraliminal secure-base priming. Data was collected through semi-structed interviews and analysed using realist thematic analysis. The findings highlight the influence that the attachment orientation has on a participant’s receptiveness to any potential modification to that orientation. While securely attached individuals are receptive to the priming process and so demonstrate an enhancement in their feelings of care, the insecure-avoidantly attached are subject to the emotionally defensive nature of their orientation, which avoids emotional engagement, reducing their receptiveness to the priming process. This research demonstrates that there is real utility in the application of attachment theory to the study the of coach-youth athlete relationship and in its potential to help understand how to enhance the quality of those relationships.</p
Endotoxin tolerance in an in vitro model of macrophages co-cultured with epithelial cells
No full textLung macrophages are the sentinel cells of the respiratory system and have been implicated in a number of chronic inflammatory respiratory disorders. The inflammatory and functional responses of macrophages are governed by signals from their micro-environment. Despite this, they are often studied in isolation in vitro. Recent clinical studies have suggested that respiratory macrophages have impaired functions such as phagocytosis in chronic obstructive pulmonary disease (COPD), and it is hypothesised that endotoxin tolerance (ET) may be involved in the dysfunction of these macrophages. To investigate this, an in vitro system of macrophages co-cultured with respiratory epithelial cells was developed to better represent the normal physiology of respiratory innate immunity. This co-culture system was used to investigate the influence of epithelial cells on complex macrophage biology such as inflammatory responses, induction of ET, and phagocytosis. The epithelial cells were able to regulate the inflammatory responses from single and repeated LPS challenges, and also increase phagocytosis by contributing to the uptake of bacteria and by activating otherwise un-responsive macrophages. In addition, this co-culture system was used to develop and investigate complex protocols of ET induction. It was demonstrated that ET is induced via a “Switch” mechanism that requires the presence of LPS to induce ET but not extended exposure. Furthermore, it was found that the ET inducing stimulus does not need to be removed in order to demonstrate tolerance. In addition, ET suppressed phagocytosis in these models, contrary to what is observed in the literature. After the development of ET models, primary COPD disease state material was used to investigate the implications of ET in COPD. It was demonstrated that gram negative respiratory bacteria can induce ET, and that the ET profiles produced by COPD cells vary compared to healthy controls. These results suggest that the induction of ET in COPD patients may occur too readily, resulting in insufficient clearance of colonised bacteria. However, further investigation is required. In conclusion, this study highlights the importance of studying macrophages in a more physiologically representative system in vitro, and also identifies previously unidentified features of ET, including potential implications in COPD.</p
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