assessment

Introduction: There has been growing interest in determining the influence of post-operative immobilization posture and rehabilitation protocol on healing rates and clinical outcomes. Current consensus calls for the use of an immobilization device post-operatively, which commonly comes in the form of a standard sling or an abduction brace with the arm positioned in varying degrees of abduction. There is a lack of high-level evidence in the literature to recommend one type of immobilization device or arm position over another. Objectives: This study aimed to summarize the current clinical and biomechanical evidence for the optimal postoperative positioning and bracing of the arm following arthroscopic rotator cuff repair. Methods: A comprehensive search of the electronic databases EMBASE, MEDLINE, and PubMed was performed using a combination of the following keywords and medical subject heading (MeSH) terms: ‘arthroscopic’, ‘rotator cuff repair’, ‘sling’, ‘brace’ and ‘immobilization’. This systematic review was conducted following the Preferred Reporting for Systematic Reviews and Meta-analysis (PRIMSA) guidelines. Two reviewers performed an independent assessment of the methodological quality of each eligible clinical study using the Methodological Index for Non-Randomized Studies (MINORS).Results: Based on current biomechanical evidence, placement of the arm into an abducted position following rotator cuff repair was found to be favorable. An abduction angle of 30° was associated with lower strain on the repair while maintaining appropriate contact pressure at the footprint. However, the use of an abduction brace did not result in a clinically significant improvement in long-term PROM, ROM, and re-tear rates when compared to a traditional sling in clinical studies.Conclusion: Despite observing favorable outcomes with abduction bracing after rotator cuff repair in biomechanical studies these findings were not reproduced in clinical studies. However, current clinical studies are comprised of small sample sizes, varying tear sizes, and significant heterogeneity in both, the degree of abduction and forearm rotation. Future studies should be directed towards prospectively investigating the effect of immobilization position among patients with similar rotator cuff tear sizes.

Dentistry is a challenging and demanding physical profession, and this impacts not only the quality of the task outcomes but also the professional’s quality of life. The nature of dentistry demands prolonged static and awkward seated postures, frequent motions, positioning struggles, and working distances to the oral cavity for strategic procedure management, which become cumulative challenges over the working days, prone to discomfort, pain, or injuries, and musculoskeletal disorders for the operator.The limitations of the naked eye in dentistry, particularly in terms of visual information and resolution, underscore the need for visual aids. These aids are crucial for achieving the precision required for accurate procedures. Also, visual aids, such as magnifying loupes and the operative microscope, have been in the market for a while, and their proper use has shown ergonomic benefits that promote a neutral working posture and changes in work practice-oriented to control unbalanced awkward posture and motions.In this study, the Rapid Upper Limb Assessment RULA compares the posture between naked-eye dentistry, conventional loupes, and operative microscope, and with the observational assessment, determine the risk of developing musculoskeletal disorders and the need for priority of change. The Rodgers muscle fatigue analysis RMFA is used to predict fatigue in the muscular regions of the body during specific dental tasks.

Introduction: Nutrition is increasingly recognized as a key component of optimal sports performance. On the other hand, insufficient and continuous food intake can compromise athletic performance and success where Nutritional Knowledge can play a leading role.Methods: One hundred and three youth athletes from 6 different clubs belonging to the District, Honor, and National Championship participated in this study. To assess Nutritional Knowledge, consumption of alcohol and tobacco the Abridged Nutrition for Sport Knowledge Questionnaire was applied.Results: The percentage of Nutritional Knowledge obtained in the District Championship was 31.25%, in the Honors it was 35.56% and in the National Championship it was 35.02%. No significant differences were found between the Nutritional Knowledge of athletes. In turn, there were statistical differences in the consumption of alcohol and tobacco among the athletes of the 3 Championships, with the District division having the highest percentage of smokers (100%) and alcohol consumers (42.6%).Conclusion: It is essential to increase the Nutritional Knowledge observed in these young athletes since it can have an influential role in their food choices.

A significant obstacle to agricultural productivity that jeopardizes the availability of food is crop diseases and farmer livelihoods by reducing crop yields. Traditional visual assessment methods for disease diagnosis are effective but complex, often requiring expert observers. Recent advancements in deep learning indicate the potential for increasing accuracy and automating disease identification. Developing accessible diagnostic tools, such as web applications leveraging CNNs, can provide farmers with efficient and accurate disease identification, especially in regions with limited access to advanced diagnostic technologies. The main goal is to develop a productive system that can recognize tomato plant diseases. The model was trained on a collection of images of healthy and damaged tomato leaves from PlantVillage using transfer learning techniques. The images from the dataset were cleansed by resizing them from 256 × 256 to 224 × 224 to match the dimensions used in pre-trained models using min-max normalization. An evaluation of VGG16, VGG19, and DenseNet121 models based on performance accuracy and loss value for 7 categories of tomatoes guided the selection of the most effective model for practical application. VGG16 achieved 84.54% accuracy, VGG19 achieved 84.62%, and DenseNet121 achieved 98.28%, making DenseNet121 the chosen model due to its highest performance accuracy. The web application development based on the DenseNet121 architecture was integrated using the Django web framework, which is built on Python. This enables real-time disease diagnosis for uploaded images of tomato leaves. The proposed system allows early detection and diagnosis of tomato plant diseases, helping to mitigate crop losses. This supports sustainable farming practices and increases agricultural productivity.

Chronic obstructive pulmonary disease (COPD) is associated with numerous comorbidities, including muscle involvement which consists of changes in the structure and function of peripheral and respiratory muscles. Ultrasound can provide a non-invasive assessment of muscle damage. Ultrasound assessment of the quadriceps contractility index (Qci) is feasible, rapid, simple, and reliable. Numerous studies have demonstrated that Qci is linked to the severity of COPD, clinical symptoms, and respiratory muscle activity. Furthermore, ultrasound makes it possible to observe the dynamics of the diaphragm by measuring its amplitude, its contraction speed, and the duration of each contraction phase. Ultrasound examination of muscle damage in COPD could constitute a promising new tool to assess the severity of the disease.

Pseudotumoral calcinosis (CPT) is a condition characterized by the deposition of calcium phosphate crystals in the periarticular tissues, forming large calcified masses. Although the pathophysiology of CPT is not fully understood, an increase in the calcium-phosphate product beyond the precipitation threshold and severe hyperparathyroidism appear to play a significant role. Treatment remains controversial, with surgical excision often recommended. We report a case of CPT in a 74-year-old diabetic patient undergoing chronic hemodialysis who experienced progressively worsening pain in the left hip for six months, along with mobility difficulties. A CT scan revealed a calcified mass on the posterior thigh, likely explaining the electric shock-like pain, as well as compression of the superficial femoral artery causing decubitus pain resembling critical limb ischemia. The biological assessment showed elevated calcium-phosphate levels and hyperparathyroidism. Surgical excision is not indicated due to the mass’s proximity to vascular and nerve structures. This case highlights the diagnostic and therapeutic challenges of CPT, emphasizing the need for iterative angioplasties, considering that this condition is rare in chronic hemodialysis patients with calcified periarticular masses.

The SARS-CoV-2 pandemic, which began in late 2019, initially manifested with acute respiratory symptoms, including bilateral pneumonia, and later emerged as a systemic disease. This brief report assesses changes in the clinical profiles of psychiatric outpatients before, during, and after the pandemic’s most severe periods, focusing on mood, anxiety, and cognitive symptoms. Data from a private psychiatric facility in Rome reveal that both pandemic-related stressors and SARS-CoV-2 infection itself may contribute to enduring affective and cognitive symptoms in both older and younger adult subgroups. Notably, during the pandemic, older patients showed elevated psychopathology scores (BPRS-24) compared to younger individuals. In the post-pandemic period, younger adults exhibited increased positive symptoms on the PANSS Positive subscale, suggesting a gradual worsening in symptoms post-pandemic ( = 0.47). Cognitive assessments (MMSE and PM38) further highlighted fluctuating performance over time, with older adults showing two distinct declines during the pandemic and in 2024. This work underscores the importance of sustained mental health interventions to address the pandemic’s psychosocial and neuroinflammatory legacy. This perspective also considers new data on the CNS effects of “toxin-like peptides” synthesized by microbiome bacteria.

Neurotoxicity is increasingly recognized as a critical factor impacting long-term health, with growing evidence linking it to both neurodevelopmental and neurodegenerative diseases. Pesticides, widely used in agriculture and industry, have emerged as significant contributors to neurotoxic risk, given their capacity to disrupt key neurodevelopmental processes at low exposure levels. As conventional animal models present limitations in interspecies translation, human-derived neuron-based in vitro screening strategies are urgently needed to assess potential toxicants accurately. Human-induced pluripotent stem cells (hiPSCs) offer an innovative and scalable source for human-specific neuronal models that complement traditional animal-based approaches and support the development of predictive assays for neurotoxicity. Recent various stem cell models, including 2D cultures, 3D organoids, and microfluidic systems, are now available, advancing predictive neurotoxicology by simulating key aspects of human neural development and function. With the integration of High-Throughput (HT) and High-Content (HC) screening methodologies, these hiPSC-based systems enable efficient, large-scale evaluation of chemical effects on neural cells, enhancing our ability to detect early biomarkers of neurotoxic effects. Identifying early biomarkers of neurotoxic is essential to developing therapeutic interventions before irreversible damage occurs. This is particularly crucial in the context of developmental neurotoxicity, where early exposure to toxicants can have lifelong consequences. This review specifically presents an in-depth overview of the current progress in hiPSC-derived neural models and their applications in neurotoxicity testing, with a specific focus on their utility in assessing pesticide-induced neurotoxicity. Emphasizing future research priorities, we highlight the potential of these models to transform predictive toxicology, offering more human-relevant assessments and advancing the field toward a more precise evaluation of environmental neurotoxicants.

Background: Clinical education is an important component of physiotherapy education programs. It provides insights to the students in the fields of physiotherapy practice, develops leadership, and enhances their clinical skills in patient assessment, examination, diagnosis, treatment, planning, and intervention selection. The dimension of physiotherapy education is in the developing phase in Nepal. For further growth, the experience and the perception of the students are very important. Through this, the facilitators and barriers in physiotherapy clinical education need to be recognized. Therefore, this study aimed to explore the facilitators and barriers in physiotherapy clinical education in Nepal from a student’s perspective.Objectives: The main objective of this study was to identify the perception of physiotherapy undergraduate students about their clinical education and to find out the facilitators and barriers in clinical education.Methods: A qualitative research using focused group discussion was conducted. Ethical considerations were taken from respective departments and IRC approval was taken. BPT 3rd year, 4th year, and intern students of KUSMS were called to participate in the study. After the consent from the participants, focus groups of 6 participants (2 participants from each 3rd year, 4th year, and intern) were formed. In five FGDs, data saturation was observed and no further FGDs were conducted. FGDs were collected with audio tape recordings. The data were transcribed verbatim and translated into the English language. Then data coding was done and themes and sub-themes were generated from the codes.Results: Through the transcribed and translated data, seven themes were generated which were clinical education, student expectation, student attitude and behavior, roles and responsibilities of clinical educators, exposure, resources, and miscellaneous. These headings explained the perception of facilitators and barriers.Conclusion: The facilitators and barriers to physiotherapy clinical education were identified through student’s perspectives. These findings should be considered while preparing the guiding document for clinical education to enhance the quality of education.

Background: Atrial fibrillation (A-Fib) poses a significant clinical challenge, particularly in the elderly and those with hypertension. If A-Fib represents one stage in the spectrum of electrical degeneration caused by aging-induced remodeling of the left atrial wall, catheter ablation is not an essential treatment. The efficacy of Vaughan Williams Class IC drug in preventing the progression of multiple premature atrial contractions (mPAC) toward paroxysmal atrial fibrillation (PAF) and A-Fib in the earlier stage of histological change was investigated.Method and results: Group A (4 patients with mPAC) and Group B (9 patients with PAF) were treated with Class IC drugs. Treatment outcomes were compared between these two Groups and Group C (8 patients with chronic A-Fib). Follow-up assessments were performed to evaluate the maintenance of sinus rhythm. All mPAC patients maintained sinus rhythm during the follow-up period. In the PAF group, 8 out of 9 patients maintained their sinus rhythm. Conclusion: Early treatment with Class IC drugs shows promise in preventing the progression of A-Fib and maintaining sinus rhythm in patients with mPAC and PAF. These findings highlight the potential role of pharmacological therapy in delaying the onset of A-Fib, thereby improving clinical outcomes and reducing the need for invasive procedures such as ablation.

Cardiac arrhythmias are frequent complications of the consumption of toxic substances, including cannabis, which can be fatal.We report in this case a patient who developed a cardiac arrhythmia-type focal atrial tachycardia a few moments after the consumption of an important dose of cannabis but which reduced spontaneously and without having administered any medication or an external electric shock.All the rest of the etiological assessment of this arrhythmia was negative and the arrhythmia was linked to the consumption of cannabis which is known to cause these complications.

Background: Sickle cell anaemia (SCA) in children demonstrates a broad range of clinical manifestations and serious complications. Assessment of disease severity in specific populations is necessary to plan services and optimise care. Aim: To describe the clinical severity of SCA and associated sociodemographic and clinical factors in children in Gambia.Methods: The presence of lifetime complications was confirmed by history and review of medical charts. We determined clinical severity using a validated scoring system and related the severity to sociodemographic and clinical factors.Results: In 130 study participants, ages ranged from 5 to 15 years with a mean (SD) age of 9.74 (2.81) years. Eleven (8.5%) children had had acute chest syndrome, 7 (5.4%) avascular necrosis of the femoral head, 6 (4.6%) gallstones, 5 (3.8%) stroke and 1 (0.8%) priapism over their lifetime. Disease severity was classified as mild in 108 (83.1%) children, moderate in 17 (13.1%) and severe in 5 (3.8%). Age, age at diagnosis, sex, ethnicity, social class, and treatment with hydroxyurea was not significantly correlated with SCA clinical severity (P values 0.10-0.84).Conclusion: The high proportion of children with mild disease may be due to the high prevalence of Senegalese β-haemoglobin haplotype in the Senegambia subregion. However, the presence of moderate or severe disease in almost 1 in 5 children calls for concerted efforts in SCD care in this region.

Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary.Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics.Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis.Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.

Cardiovascular Diseases (CVDs) remain a major global health concern, necessitating accurate and comprehensive diagnostic techniques. Traditional medical imaging modalities, such as CT angiography, PET, MRI, and ultrasound, provide crucial but limited information when used independently. Image fusion techniques integrate complementary modalities, enhance visualization, and improve diagnostic accuracy. This paper presents a theoretical study of advanced image fusion methods applied to cardiovascular imaging. We explore wavelet-based, Principal Component Analysis (PCA), and deep learning-driven fusion models, emphasizing their theoretical underpinnings, mathematical formulation, and potential clinical applications. The proposed framework enables improved coronary artery visualization, cardiac function assessment, and real-time hemodynamic analysis, offering a non-invasive and highly effective approach to cardiovascular diagnostics.MSC Codes: 68U10,94A08,92C55,65T60,62H25,68T07.

The integration of deep learning and genetic analysis has transformed the assessment of elite sports performance, particularly in competitive swimming. This study examines the fusion of deep learning techniques with DNA markers, physiological biometrics, and performance analytics to enhance the prediction and optimization of swimmer performance. A structured dataset comprising genetic sequences, physiological parameters, and biomechanical attributes was utilized to train a neural network model capable of categorizing swimmers based on genetic predisposition and athletic potential. The model achieved high classification accuracy, demonstrating a strong link between genetic markers, physiological traits, and competitive swimming outcomes. The findings emphasize the potential of AI-driven analytics in talent identification, customized training adaptations, and injury prevention. Furthermore, the study highlights the effectiveness of deep learning in analyzing complex genomic and physiological data to generate meaningful insights for performance enhancement. While the results validate the feasibility of using genetic and AI-based models for performance prediction, further studies are needed to broaden dataset diversity, integrate epigenetic influences, and test the model across varied athlete populations. This research contributes to the expanding field of AI-driven sports science and provides a solid foundation for incorporating genomics with deep learning to enhance elite athletic performance.

Multiple stab wounds are a critical forensic indicator, frequently linked to violent assaults, homicides, or self-inflicted injuries. These penetrating injuries result from sharp-edged weapons such as knives, daggers, or other pointed instruments. The depth, size, and severity of the wounds depend on factors including the type of weapon used, the force applied, and the anatomical location of impact. Forensic examination of stab wounds is essential in determining the manner of death—homicidal, suicidal, or accidental. Detailed analysis of wound characteristics, such as depth, trajectory, and associated injuries, aids in crime scene reconstruction. Additionally, identifying defensive wounds can indicate victim resistance, further supporting forensic interpretations. A meticulous forensic autopsy, including weapon analysis and internal organ assessment, is crucial in establishing the cause of death. These findings play a vital role in medico-legal investigations, providing key forensic evidence that supports legal proceedings and ensures justice.