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Clive Cussler's The heist
Charismatic, handsome, and fiercely loyal, Isaac Bell is a no-nonsense private detective at the Van Dorn Detective Agency. Travelling all over early 20th century America in pursuit of justice for his clients, chasing down a steam train in a sports automobile is all in a day's work for Bell. And while he's on the trail of thieves, killers, and sometimes much worse, he'll have to use his every last wit to stay ahead of those he seeks, and to stay alive.
BOOK
Effectiveness of novel facial stretching with structured exercise versus conventional exercise for Bell’s palsy: a single-blinded randomized clinical trial
The purpose of the study was to assess the effects of a novel technique involving facial stretching of the unaffected side along with a structured exercise for the affected side on facial symmetry and facial functions as compared to conventional exercise. A hospital-based parallel-group randomized trial was completed among patients with acute Bell’s palsy in Mangalore, India. Participants were randomized to receive facial stretching and a structured exercise program (experimental group) or the conventional exercise regimen (conventional group). Primary outcomes were facial symmetry and voluntary movement; assessed by the Sunnybrook Facial Grading System (SFGS). Both regimens were given for 3 weeks, with baseline, 10th day, and 20th day assessments. Out of 31 participants screened, 24 were eligible and 12 participants each were assigned to experimental and conventional groups. Change scores revealed greater improvement in the SFGS score (
p
= 0.002) for the experimental group participants. Facial stretching and structured exercise program exhibited promising results in enhancing facial symmetry and function in acute Bell’s palsy when compared to conventional exercise regimen.
Journal Article
Liberty Bell
Young readers will explore this American symbol and learn about its historic significance.
Book
Pain in children with Bell’s palsy: secondary analysis of a randomised controlled trial
ObjectiveTo describe the prevalence and severity of pain experienced by children with Bell’s palsy over the first 6 months of illness and its association with the severity of facial paralysis.MethodsThis was a secondary analysis of data obtained in a phase III, triple-blinded, randomised, placebo-controlled trial of prednisolone for the treatment of Bell’s palsy in children aged 6 months to <18 years conducted between 13 October 2015 and 23 August 2020 in Australia and New Zealand. Children were recruited within 72 hours of symptom onset and pain was assessed using a child-rated visual analogue scale (VAS), a child-rated Faces Pain Score-Revised (FPS-R) and/or a parent-rated VAS at baseline, and at 1, 3 and 6 months until recovered, and are reported combined across treatment groups.ResultsData were available for 169 of the 187 children randomised from at least one study time point. Overall, 37% (62/169) of children reported any pain at least at one time point. The frequency of any pain reported using the child-rated VAS, child-rated FPS-R and parent-rated VAS was higher at the baseline assessment (30%, 23% and 27%, respectively) compared with 1-month (4%, 0% and 4%, respectively) and subsequent follow-up assessments. At all time points, the median pain score on all three scales was 0 (no pain).ConclusionsPain in children with Bell’s palsy was infrequent and primarily occurred early in the disease course and in more severe disease. The intensity of pain, if it occurs, is very low throughout the clinical course of disease.Trial registration numberACTRN12615000563561.
Journal Article
Quantum strangeness : wrestling with Bell's Theorem and the ultimate nature of reality
Northern Ireland physicist John Stewart Bell's possible understanding of quantum theory.
Book
Agreement between face-to-face and photograph and video assessments in children with Bell’s palsy: secondary analysis of a randomised controlled trial
ObjectiveBell’s palsy is a sudden unilateral weakness of the facial muscles due to idiopathic lower motor neuron palsy of cranial nerve VII. We set out to determine the level of agreement in the severity of facial palsy based on the House-Brackmann scale between face-to-face assessment by clinicians, and independent clinician assessment of photographs and videos.DesignSecondary analysis of children enrolled in a triple blind, randomised controlled trial assessing recovery rates following steroid treatment versus placebo for Bell’s palsy who had photographs and videos recorded initially and at subsequent reviews.Setting11 centres in Australia and New Zealand.PatientsChildren with Bell’s palsy.Interventions and main outcome measuresStandardised photographs and videos were independently reviewed for facial function using the House-Brackmann scale and compared with face-to-face assessment.ResultsA total of 175 participants had photos and videos of sufficient quality, with 399 separate assessments available. Mean age was 10 years and 51% were female. Intraclass correlation of House-Brackmann scores between face-to-face assessment and the photo and video reviewers for full recovery (House-Brackmann score=1) ranged from 0.67 to 0.76 at 1 month and 0.60 to 0.76 at 6 months.ConclusionsA comparison of facial function using the House-Brackmann scale between face-to-face clinician assessment and remote photography and video assessment by independent clinicians indicated a high level of agreement between the two assessments in terms of return to normal. Children may have their facial function assessed remotely in clinical and research settings if necessary.Trial registration numberACTRN1261500056356
Journal Article
The etiology of Bell’s palsy: a review
Bell’s palsy is the most common condition involving a rapid and unilateral onset of peripheral paresis/paralysis of the seventh cranial nerve. It affects 11.5–53.3 per 100,000 individuals a year across different populations. Bell’s palsy is a health issue causing concern and has an extremely negative effect on both patients and their families. Therefore, diagnosis and prompt cause determination are key for early treatment. However, the etiology of Bell’s palsy is unclear, and this affects its treatment. Thus, it is critical to determine the causes of Bell’s palsy so that targeted treatment approaches can be developed and employed. This article reviews the literature on the diagnosis of Bell’s palsy and examines possible etiologies of the disorder. It also suggests that the diagnosis of idiopathic facial palsy is based on exclusion and is most often made based on five factors including anatomical structure, viral infection, ischemia, inflammation, and cold stimulation responsivity.
Journal Article