Search

Background Inequities in palliative and end-of-life care access exist, with evidence of lower uptake of these services among people from the British Muslim community. Little research exists exploring the experiences of British Muslims with palliative care needs and their families during the pandemic or before.Aim To coproduce peer research exploring the experiences of British Muslims with palliative care needs and their families during the COVID-19 pandemic.Design A collaborative peer research interview study. Peer researchers were recruited and trained to undertake qualitative interviewing. Data were analysed using reflective thematic analysis.Setting/participants 3 peer researchers conducted 11 telephone interviews (10 in English and 1 in Urdu) between August and September 2021 with 12 participants (5 people with palliative care needs and 7 family carers).Results Four themes were identified: (1) issues in accessing healthcare exacerbated by the COVID-19 pandemic, (2) the impact on family carers, (3) variation in support from community groups and (4) social and information exclusion. The COVID-19 pandemic exacerbated existing challenges to accessing healthcare services for British Muslims with palliative care needs. Family members experienced the cumulative impact of supporting people with palliative needs while also advocating for and supporting them to access the care they required. Language barriers, digital exclusion and uncertainly about how to access information, in addition to the apparent lack of consideration of important festivals in the Muslim calendar in the implementation of policies around lockdowns, culminated in a sense of exclusion from COVID-19-related policies and messaging for this population.Conclusions These findings support the need to involve people from diverse backgrounds in the design and delivery of healthcare services and policies. Learning from this unique time in our histories should be used to shape future delivery of culturally aware and inclusive care.

Accidental injuries in the pediatric population are common. The response to injury also differs owing to anatomical and physiological differences in children. While such injuries carry a risk of lifelong morbidity, some cases may follow a benign course despite their distressing appearance. We report two cases of accidentally incurred penetrating trauma in the pediatric population with unusual objects, including a pencil and a toy wheel. Despite their intracranial extension, neither of the patients exhibited any discernible neurological deficits. Penetrating brain injuries require early removal and meticulous perioperative care to minimize the risk of long-term adverse neurological events in children.

Abstract Background Penetrating trauma to the brain is a rare mode of self-harm in individuals with depressive psychosis. It may have variable presentations ranging from intact neurological status to non-survivable damage and the subjects may be surprisingly apathetic to pain. It is even unusual for such an injury to have an excellent prognosis despite coming late to clinical attention. Case presentations We report two cases of patients with psychotic depression who attempted suicide by hammering nails into their heads. On imaging, deep penetration within the brain parenchyma was noted; however, neither case had any neurological deficit or symptoms attributable to brain trauma. Conclusions Self-inflicted penetrating brain injuries with peculiar objects such as nails are rarely encountered in practice. They need prompt management for their removal and addressing the underlying mental health illnesses.

Obesity is one of the most pressing healthcare concerns of the twenty-first century. Obesity prevalence has risen dramatically in recent decades, and in 2016, more than 1.9 billion adults were overweight (BMI ≥ 25 kg/m2) and 650 million were obese (BMI ≥ 30 kg/m2). About 50% of the world’s population is anticipated to be obese/overweight within the next decade. Obesity is a major risk factor for a variety of non-communicable diseases, including type 2 diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, and a variety of malignancies. Obesity has emerged as a substantial risk factor for hospitalization and death from viral respiratory infections such as influenza A and the ongoing pandemic SARS-CoV-2. Several independent studies have indicated that obese/overweight patients are at a higher risk of severe disease and death from these respiratory diseases. Excess fat, particularly visceral fat, contributes to the development of a variety of metabolic disorders, including persistent systemic inflammation and decreased immunological function. As a result, the immunological response to infectious pathogens is weakened, resulting in poorer outcomes post-infection. Additionally, the poor lung mechanics associated with obesity may increase the risk of more serious respiratory infections. In this review, we address the likely mechanism(s) that predispose obese people to severe diseases caused by viral respiratory infections.

Placenta-derived stem cells (PDSCs), due to unique traits such as mesenchymal and embryonic characteristics and the absence of ethical constraints, are in a clinically and therapeutically advantageous position. To aid in stemness maintenance, counter pathophysiological stresses, and withstand post-differentiation challenges, stem cells require elevated protein synthesis and consequently augmented proteostasis. Stem cells exhibit source-specific proteostasis traits, making it imperative to study them individually from different sources. These studies have implications for understanding stem cell biology and exploitation in the augmentation of therapeutic applications. Here, we aim to identify the primary determinants of proteotoxic stress response in PDSCs. We generated heat-induced dose-responsive proteotoxic stress models of three stem cell types: placental origin cells, the placenta-derived mesenchymal stem cells (pMSCs), maternal origin cells, the decidua parietalis mesenchymal stem cells (DPMSCs), and the maternal–fetal interface cells, decidua basalis mesenchymal stem cells (DBMSCs), and measured stress induction through biochemical and cell proliferation assays. RT-PCR array analysis of 84 genes involved in protein folding and protein quality control led to the identification of Hsp70 members HSPA1A and HSPA1B as the prominent ones among 17 significantly expressed genes and with further analysis at the protein level through Western blotting. A kinetic analysis of HSPA1A and HSPA1B gene and protein expression allowed a time series evaluation of stress response. As identified by protein expression, an active stress response is in play even at 24 h. More prominent differences in expression between the two homologs are detected at the translational level, alluding to a potential higher requirement for HSPA1B during proteotoxic stress response in PDSCs.

Introduction Culturally appropriate interventions to promote COVID-19 health protective measures among Black and South Asian communities in the UK are needed. We aim to carry out a preliminary evaluation of an intervention to reduce risk of COVID-19 comprising a short film and electronic leaflet.Methods and analysis This mixed methods study comprises (1) a focus group to understand how people from the relevant communities interpret and understand the intervention’s messages, (2) a before-and-after questionnaire study examining the extent to which the intervention changes intentions and confidence to carry out COVID-19 protective behaviours and (3) a further qualitative study exploring the views of Black and South Asian people of the intervention and the experiences of health professionals offering the intervention. Participants will be recruited through general practices. Data collection will be carried out in the community.Ethics and dissemination The study received Health Research Authority approval in June 2021 (Research Ethics Committee Reference 21/LO/0452). All participants provided informed consent. As well as publishing the findings in peer-reviewed journals, we will disseminate the findings through the UK Health Security Agency, NHS England and the Office for Health Improvement and Disparities and ensure culturally appropriate messaging for participants and other members of the target groups.

Laser melting of steel based metal matrix composite composes of steel St 316 and St 4130 with 15% WC carbide particles is considered and the meltpool size, due to variation of laser pulse parameter and the number density of WC particles, is simulated. Laser pulse parameter is introduced to modify the laser pulse intensity distribution at the irradiated surface; in which case, increasing laser pulse parameter results in the laser peak intensity shift from the irradiated spot centre towards the irradiated spot edge. An experiment was carried out to validate the predictions of particle distribution in the irradiated region. It is found that predictions of the particle distribution in the resolidified meltpool agree well with the experimental data. Increasing laser pulse parameter lowers the maximum temperature significantly in the meltpool and modifies the meltpool geometry and reduces the meltpool size. Increasing the number density of WC particles lowers slightly the maximum temperature and the depth of the meltpool, which is attributed to the high melting temperature of WC particles as they remain in the solid phase in the meltpool. [ABSTRACT FROM AUTHOR]

Laser consecutive pulse heating of a moving thin slab is considered and temperature field in the irradiated region is predicted. The influence of the duty cycle and the irradiated spot diameter on temperature rise is examined in details. A numerical model incorporating the final element method (FEM) model is introduced to predict temperature filed inside the irradiated substrate material. It is found that the effect of duty cycle on temperature rise is significant; in which case, increasing duty cycle results in attainment of high temperature at the irradiated surface. Increasing irradiated spot diameter enhances temperature rise at the irradiated spot centre. In this case, heat diffusion is suppressed by the attainment of low temperature gradient in the radial direction and the internal energy gain by the substrate material due to absorption of the incident radiation enhances temperature rise at the surface. Local melting occurs for low duty cycles, which in turn results in wavy appearance of the melted region along the laser scanning direction at the surface. Increasing duty cycle and irradiated spot diameter enhances the melt width size at the surface. The consecutive laser pulses gives rise to temperature rippling at the irradiated surface, which is more pronounced for low duty cycles and small irradiated spot diameter. [ABSTRACT FROM AUTHOR]

Abstract The disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.