Ulster Hospital

Bowel movement hygiene is an essential life skill. Autistic children can have difficulties attaining this skill. There is limited research exploring postbowel movement hygiene (PBMH) and autism. This study explores factors of PBMH for autistic children. An online survey was developed, included open and closed questions, and distributed via Facebook groups. It was completed by N = 74 parents. Descriptive statistics and thematic analysis were used to analyze the data. Statistically significant correlations were found between variables related to the sensory and motor aspects of PBMH, scared of sitting on toilet and refusal to engage in PBMH (p ≤ 0.5). Four qualitative themes were identified: toilet paper, difficulties in reaching the bottom, health related factors, and successful strategies used by parents. Future research is needed to strengthen the validity of these findings and produce practice guidelines for occupational therapists working in this area.

Background: Unstable intertrochanteric femur fractures in elderly osteoporotic patients are associated with high morbidity and mortality. While internal fixation remains the standard treatment, fixation failure and prolonged immobilisation are frequent concerns. Primary cemented bipolar hemiarthroplasty offers the potential for immediate stability and early mobilisation, reducing postoperative complications.Methods: This prospective study included 30 elderly patients (>60 years) with unstable intertrochanteric fractures treated with primary cemented bipolar hemiarthroplasty from June 2021 to August 2024. Functional and radiological outcomes were assessed using the Harris Hip Score and radiograph at regular intervals.Results: The mean operative time was 81 minutes with an average blood loss of 361.03 ml. Full weight-bearing was achieved at a mean of 3.2 days postoperatively. At one year, 76% of patients demonstrated fair to excellent outcomes on the Harris Hip Score. Limb length discrepancy (<2 cm) was noted in 10 cases, primarily due to prosthetic subsidence from calcar loss. The overall mortality rate was 16.6%, with all deaths occurring due to causes unrelated to surgery. No cases of dislocation were observed.Conclusion: Primary cemented bipolar hemiarthroplasty is a safe and effective option for managing unstable intertrochanteric femur fractures in elderly osteoporotic patients. It allows early mobilisation, restores function, and minimises complications related to prolonged recumbency. Larger comparative studies with longer follow-up are needed to further validate its long-term efficacy over internal fixation.

This work investigates the performance of a circular antenna using Firat-based circular fractal modeling. A circular mathematical description suitable for Firat's fractal model is presented, based on previous studies. Two frequencies were chosen for study, 2 GHz and 4 GHz, with 4 iterations applied to both antennas. Reflection coefficient was measured and compared with simulations, where a maximum difference of 3.72% was achieved, and a minimum of 1.94%, between the results. Measured miniaturization factors are analyzed to assess the feasibility of the Firat fractal. The results demonstrate the potential for miniaturization, with maximum factor values of 25.43%.

Background Bio-banding has been used to moderate disparities in maturity status between youth players of the same chronological age to support development. Aim The purpose of this study was to investigate male youth rugby union players’ perceptions of bio-banded training compared to chronological age grouping. Subjects and methods Fifty-four U16 players participated in games-based bio-banded training before completing an eight-item Likert scale questionnaire, with the option of providing an explanation for each response. Aligning with typical peak height velocity (PHV) categories, maturity banding was based upon percentage of predicted adult height (i.e. circa-PHV ≤95% and post-PHV ≥96%). A series of one-sample and Welch’s t-tests were used to analyse quantitative data, and qualitative data were assessed using an inductive thematic analysis. Results Irrespective of maturity status, the majority of players perceived they understood and enjoyed most aspects of the bio-banding format and believed they were less likely to get injured compared to chronological age grouping. Both maturity groups perceived bio-banding facilitated superior psychosocial capacities and offered a greater technical and tactical challenge, whilst circa-PHV and post-PHV players perceived bio-banding as less and more physically challenging than chronological age grouping, respectively. Conclusion The results suggest using bio-banded grouping for training, as an adjunct to chronological age grouping, may positively contribute to the holistic development of male youth players in rugby union irrespective of maturity status.

Stroke lysis, or thrombolysis, is a time-sensitive intervention for acute ischemic stroke, but careful distinction from stroke mimics is essential to avoid inappropriate treatment. Zolpidem, a non-benzodiazepine hypnotic, is generally regarded as having low dependence potential; however, prolonged or high-dose use can result in withdrawal syndromes, including seizures. We report the case of a 46-year-old woman presenting with acute left upper limb weakness and facial sensory changes, initially managed as a stroke lysis call. She was outside the lysis window and had initial negative neuroimaging. Within 24 hours, she developed recurrent generalized seizures requiring intravenous lorazepam. Subsequent collateral history revealed chronic high-dose zolpidem use (50-200 mg daily), discontinued abruptly, confirming a diagnosis of zolpidem withdrawal seizure. The patient was successfully treated with a benzodiazepine taper and discharged with community mental health and substance misuse follow-up. This case emphasizes the importance of thorough medication history-taking in stroke evaluations, as withdrawal syndromes can closely mimic acute cerebrovascular events. It is also interesting to note that zolpidem can increase the risk of strokes.

The use of fibular free flaps has become widespread in the reconstruction of large bony defects in the trauma and head and neck cancer patient with a high success rate. These surgeries can take a prolonged period of time, and oftentimes a break in surgery may be necessary, at which point the free flap may be vulnerable to iatrogenic damage. In this short communication, we describe a technique we regularly use at such an interval to protect the fibular free flap following soft tissue dissection and osteotomy but prior to its ligation and transfer up to the head for anastomosis, with the aim of minimising the risk of undue force being applied to the flap or any kinking or occluding of the pedicle.

Abstract Automated text classification is a fundamental research topic within the legal domain as it is the foundation for building many intelligent legal solutions. There is a scarcity of publicly available legal training data and these classification algorithms struggle to perform in low data scenarios. Text augmentation techniques have been proposed to enhance classifiers through artificially synthesised training data. In this paper we present and evaluate a combination of rule-based and advanced generative text augmentation methods designed to create additional training data for the task of classification of legal contracts. We introduce a repurposed CUAD contract dataset, modified for the task of document level classification, and compare a deep learning distilBERT model with an optimised support vector machine baseline for useful comparison of shallow and deep strategies. The deep learning model significantly outperformed the shallow model on the full training data (F1-score of 0.9738 compared to 0.599). We achieved promising improvements when evaluating the combined augmentation techniques on three reduced datasets. Augmentation caused the F1-score performance to increase by 66.6%, 17.5% and 2.6% for the 25%, 50% and 75% reduced datasets respectively, compared to the non-augmented baseline. We discuss the benefits augmentation can bring to low data regimes and the need to extend augmentation techniques to preserve key terms in specialised domains such as law.