This study examined the impact of a period of mental fatigue on manual dexterity, anticipation timing and repeated high intensity exercise performance. Using a randomised, repeated measures experimental design, eight physically trained adults (mean age = 24.8 ± 4.1 years) undertook a 40 minute vigilance task to elicit mental fatigue or a control condition followed by four repeated Wingate anaerobic performance tests. Pre, post fatigue/control and post each Wingate test, manual dexterity (Seconds), coincidence anticipation (absolute error) were assessed. A series of 2 (condition) by 6 (time) ways repeated measures ANOVAs indicated a significant condition by time interactions for manual dexterity time (p = .021) and absolute error (p = .028). Manual dexterity and coincidence anticipation were significantly poorer post mental fatigue compared to control. There were no significant differences in mean power between conditions or across trials (all p > .05).

Background: Augmented reality (AR) is a novel technology with many applications in medical education. Perhaps one of the most beneficial potential applications is to enable better clinical access for students; however, there is limited research into this use. The purpose of this mixed-methods feasibility study was to evaluate the applicability and acceptability of AR in undergraduate and early postgraduate medical education.Methods: Single-group quasi-experimental study design was developed for critical care-themed simulation teaching delivered using Microsoft HoloLens (Microsoft Corporation, Redmond, Washington, United States). Post-test questionnaires were completed including a validated adapted immersive experience questionnaire (AIEQ) and an abridged intrinsic motivation inventory (AIMI). The AIMI focused on the domains of 'interest and enjoyment', and 'value and usefulness'. Following the teaching, focus group interviews with thematic analysis were conducted to evaluate participants' experiences with AR.Results: All 15 participants (100%) completed the AIEQ and AIMI. Co-located airway teaching (i.e., the demonstrator and participants were placed in the same AR environment) was reported as having a moderate level of user immersion (median 72) and a high level of user enjoyment and value (median 52). Thematic analysis revealed four key themes: visual conceptualization for learning, accessibility, varied immersion, and future application.Conclusions: Remote simulation for the management of airways in critical care was found to be acceptable and afforded a high level of enjoyment and value. Similarly, this was reflected in the thematic analysis. However, immersion was rated variably in both AIEQ and thematic analysis. The challenges identified with the application of AR included technical infrastructure and patient consent. AR-enabled education benefits are relevant to a number of clinical teaching areas.

Acute encephalitis can be life-threatening, especially in the immunocompromised population. Viruses are the main infectious agents, with varicella zoster virus (VZV) a common cause. Neuropsychiatric symptoms are well documented, but it is rare for mania to be the only symptom on presentation. Here, we report a case of hypomania in a 31-year-old white British heterosexual man who following investigation was found to be HIV positive and subsequently diagnosed with VZV encephalitis. To date, we are unaware of any similarly reported cases. It is important to raise awareness of atypical HIV presentations to improve clinical outcomes for patients.

Background: Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) has afflicted persons of all ages leading to increase spread of the virus. This study attempts to determine the prevalence of HIV infection among 50 years of age and above over the five years of study in Nnewi, Nigeria. Methods: Males and females who were 50 years and above who underwent HCT in Nnewi between January 2008 to November 2012 were counseled and tested for HIV antibodies after giving an oral consent. Results: Of the 57,090 clients offered HCT, 4384 (7.7%) were 50 years and above while 52,706 (92.3%) were 15-49 years of age. The crude HIV prevalence was 8.2%. HIV infection in the 50-59 years of age was 2.4 times higher than that in the 60 years of age and above. A higher prevalence was observed in females (8.8%) compared with 7.8% in males in our study. No female 75 years and over was found to have HIV infection in our study (0%) while males in the same age group had a prevalence of 3.0%. The prevalence in our study was higher compared to the 2010 ANC sentinel survey (8.7%) in Anambra state. Conclusion: Our findings show that offering HCT routinely is feasible and may increase linkage to HIV care and treatment for many individuals with HIV infections. Routine HCT should be an integral component of any expansion in HIV prevention, care and treatment services in Africa and other settings where the prevalence of HIV is high. House to house HIV testing will improve uptake of testing among

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