quality

Anxiety is also a very common disorder, both in patients and their family members. Anxiety and stress can compromise the quality of life of cancer patients and their families. Feelings of anxiety and anguish can occur at various times of the disease path: during screening, waiting for test results, at diagnosis, during treatment or at the next stage due to concern about relapses. Anxiety and distress can affect the patient’s ability to cope with diagnosis or treatment, frequently causing reduced adherence to follow-up visits and examinations, indirectly increasing the risk of failure to detect a relapse, or a delay in treatment; and anxiety can increase the perception of pain, affect sleep, and accentuate nausea due to adjuvant therapies. Failure to identify and treat anxiety and depression in the context of cancer increases the risk of poor quality of life and potentially results in increased disease-related morbidity and mortality [1]. From all this we deduce the need and importance of dedicated psychological and psychiatric support for these patients within the Breast Unit. The fact that the psycho-oncologist who is dedicated to the care of patients with breast cancer must be an integrated figure in the multidisciplinary team of the Senological Center and not an external consultant is enshrined in the same European Directives that concern the legislation concerning the requirements that a Breast Unit must have in order to be considered a Full Breast Unit (Wilson AMR, et al. 2013).One of the most complex situations you find yourself dealing with is communication with the patient. This communication is particularly complex in two fragile subpopulations that are represented by women. [Menditto L. T (Tirannie) Cancer of the Breast. Am J Psychol & Brain Stud, 2023; 1(1):26-30].

In the realm of dental surgery, implants are essential for replacing missing teeth. To facilitate implant placement, techniques such as bone grafting and sinus lifts are utilized to augment the volume of atrophied alveolar bone in candidates for dental implants. Typically, patients undergo a period of recovery following bone grafts before proceeding with implant placement. This study investigates the efficacy of Cone Beam Computed Tomography (CBCT) in measuring the residual bone volume and assessing bone quality after the healing phase. A texture analysis was conducted on CBCT scans from 42 patients requiring maxillary sinus lift reconstruction. These patients were categorized into two groups based on the type of grafting material used: Xenograft or allograft. The study analyzed the distribution of various texture parameters and conducted a Mann-Whitney U test to identify significant statistical differences between the groups. Results indicated non-normal distributions for specific variables such as Area_S(1,0) and S(1,0)SumOfSqs, while others like S(1,0)Entropy displayed normal distributions. The findings revealed no significant statistical differences in the primary outcomes between the xenograft and allograft groups. However, the average values of the gray shades of pixels in the allograft group were statistically significantly higher compared to the xenograft group, suggesting differences in bone texture post-procedure.

Gynecological laparoscopy has to be analyzed also in the context of complications that occur during the surgical procedures. Complications occur daily. For this reason, emphasis should be placed on lifelong continuous education and training. Given the risks and complications we face, we must be trained to deal with them. This improves the safety of laparoscopic operations. Without such certainty, gynecological laparoscopy would not be the method of choice in a minimally invasive approach. This requires significant commitment, effort, and responsibility. In this way, we provide our patients with the best and highest quality healthcare service. Likewise, with such an approach, the frequency of complications is reduced to a minimum. New perspectives and possibilities are associated with the application of robotic surgery.

Aquaculture may simply be referred as “Underwater Agriculture.”India is a major maritime state and an important aquaculture- based country in the worldhaving major aquaculture activitiesin the production of Carp from Freshwater,Shrimp from Brackish water, etc. Feed requirements of fish vary in quantity and quality according to the feeding habits, physiological stages of the species and environmental variations viz., temperature; amount and type of natural food availability in the culture system.A nutritious and cheap feed is a pre requested for profitable aquaculture. Though, use of commercially available feed is in practice in many countries. The feed cost consumes more Than half of running expenditure. Therefore, the search of nutritionally well-balanced feed Prepared from very cheap locally available ingredients in progress in all the aqua farming countries. In the present study, an attempt has been made to well-balanced nutritious feed Particularly from the locally available cheaper ingredients. The objectives of the present study are: to assess the effect of feed on the growth of finfish and shellfish in the laboratory, to prepare the conventional feed with traditional ingredients and to check the effect of feed on the growth performance of ornamental fish - Guppy, Poecilia reticulata.

Rheumatic heart disease persists as a significant concern in developing regions, often resulting in multivalvular heart conditions. Treatment options are limited, though percutaneous transvenous mitral commissurotomy effectively addresses rheumatic mitral stenosis. Non-surgical interventions for aortic stenosis include balloon aortic valvotomy and Transcatheter aortic valve replacement (TAVR), tailored to patient factors like age and comorbidities.We describe two cases of Rheumatic multivalvular disease which were managed non-surgical. The first case is a pioneering procedure performed on a young patient combined percutaneous transvenous mitral commissurotomy with balloon aortic valvotomy, guided by 4-dimensional transoesophageal echocardiography (4D TEE). This represents the first documented instance in medical literature, showcasing the potential of integrated interventions and advanced imaging techniques. In the second challenging case involving a heavily calcified, retrovirus, and Hepatitis B positive 55-year-old, a staged approach was adopted, involving percutaneous transvenous mitral commissurotomy followed by Transcatheter aortic valve replacement (TAVR). Despite complexities, this sequential strategy demonstrates the adaptability of transcatheter techniques in managing complex valvular pathologies. These cases highlight the evolving landscape of interventional cardiology and underscore the importance of tailored, multidisciplinary approaches in optimizing outcomes for patients with rheumatic heart disease and multivalvular involvement, especially in resource-limited settings. Further exploration and dissemination of such innovative strategies hold promise for enhancing cardiac care quality and expanding treatment options globally.

Introduction: Total hip arthroplasty is a procedure widely performed in orthopedics, as it is capable of restoring function in the hips, severely affected by orthopedic diseases, such as osteoarthritis and consequently reducing pain and restoring function. Objective: To identify the effects of physical therapy in the postoperative period of total hip arthroplasty. Method: This is an integrative review, of an exploratory and descriptive nature, carried out between January and May 2024 and guided by the recommendations of the Joanna Brigs Institute. The Pubmed, LILACS, and SciELO databases were used. The following descriptors were used for the search procedure: “Physiotherapy and hip arthroplasty”. For the operationalization of the search, the Boolean descriptor “AND” was used to cross the descriptors. Articles were included in randomized clinical trials, published in full, without restriction of language and/or year of publication, which dealt with the theme addressed and that responded to the objective of the study. On the other hand, editorial letters, any type of literature review, articles unavailable at the time of search, abstracts and/or full articles published in annals of scientific events, preprints, and articles without abstracts were excluded. Results: After searches in the databases, 108 articles were identified on the platforms, subsequently, all had their titles and abstracts read, then 58 articles were excluded for not meeting the eligibility criteria, leaving 50 articles carefully read in full, after complete reading, only 7 articles composed the final sample. Final considerations: based on the reading and analysis of the articles that were previously selected, it was observed that there is no pre-established protocol among the authors for the postoperative period of hip arthroplasty, but that physical therapy techniques associated with therapist support and an early start are responsible for improving functionality, quality of life, pain reduction and increased muscle strength.

Background: To assess the association between neurocognitive functioning, adaptive functioning, and health-related quality of life (HRQoL), in Children and Young Adults with Severe Chronic Kidney Disease (CKD).Methods: We included patients with severe CKD (stages 4 and 5), aged 8-30 years, on different therapy modalities (pre-dialysis, dialysis, and transplanted) and healthy controls matched on age, sex, and parental education. All patients and healthy controls performed tasks to assess neurocognitive functioning (WISC/WAIS and a comprehensive neuropsychological test battery), and completed questionnaires to assess adaptive functioning (WFIRS or WHODAS) and HRQoL (PedsQL). Group differences were explored using MANCOVA. Mediation analyses were done to explore whether the relation between neurocognitive functioning and HRQoL was mediated by adaptive functioning. Results: 28 patients with severe CKD and 21 healthy matched controls were included. CKD patients had worse HRQoL (p < .001) than healthy controls. Adaptive functioning problems increased with age in the CKD patient group but not in the healthy control group (significant interaction effect: p = .024). Significant mediation effects were found, where impaired adaptive functioning mediated the relation between both low estimated Full Scale Intelligence Quotient (eFSIQ) and worse Processing Speed & Working Memory, and impaired HRQoL (eFSIQ: 95% confidence interval = .01-.58; Processing Speed & Working Memory: 95% confidence interval = 2.31-16.36).Conclusion: We found that impaired neurocognitive functioning is associated with worse HRQoL, which is conditional to impaired adaptive functioning. Especially towards young adulthood problems in adaptive functioning are more likely to be reported than when patients are younger.

The outbreak of COVID-19 has created an unprecedented situation that has accelerated online education in areas like nephrology, which are traditionally served by onsite training. Efforts to educate clinicians remotely provide convenience and flexibility but may leave many open questions when it comes to how well-trained professionals maybe after completing their programs online. This review paper has emphasized the deleterious effects of online nephrology education and identified a number of ways in which it can be problematic such as lack of hands-on training, less patient interface, lack of proper supervision, and inconsistent quality of programs. The ability to make a difference, however, is further restricted by technological barriers and resource constraints. Whilst these programs tend to focus on creating knowledgeable graduates, they often fail to provide the clinical exposure necessary for preparedness. Hybrid programs - which combine online courses with clinical training in person are required to deliver high-quality nephrology care.

The aspects that affect the well-being of patients after neurosurgery are diverse. While most contemporary research argues that well-being is multidimensional and related to how individuals, communities, and societies feel when they are successful, there is no single agreed-upon definition [1]. Well-being is defined in the Oxford Dictionary as the state of feeling healthy and happy (Cambridge Dictionary). Well-being is a term used synonymously with a wide range of concepts including self-esteem, self-efficacy, self-determination, resilience, quality of life, improved mood, positive mental health, life satisfaction, and value [2]. 

Pushing forward with leveraging water resources, promoting international cooperation, and ensuring transparency in deep-sea mining operations. There is also a concern about where to discharge the toxins of unpurified water. Artificial Intelligence has created a dominance in the applications field with a totally automated system.Out of a thorough analysis completed with indicators, satellite radar, and A Journals, there are 30 years of research and 8 years of monitored testing to achieve accuracy and relevance. The patents in place are, Oceanic Mining System (4446636), Flexible Solar Skin in Combination with an Airplane (4768738), Cargo Torpedo (4421050), Oceanic seaplow system (4398362), and previous articles like “Is Extracting Lithium and deep-sea mining more sustainable?”, “AI as a Means of Water Purification Protection”, “Global Water Distribution”, and “Can Deep Sea Water be Processed into Potable Water and Distributed into the Middle East’?To report some ballpark numbers on the proposal and how we would navigate these projects, there will be an exact location of where the plant will be built as well as a water/salinity report of the water being treated. There are still issues with analyzing the cost of desalination compared to other alternatives. Deep Sea Water proves to be a higher quality water and the investment is well worth it. The surveys lean toward clients preferring the International Standards Operating Procedure. All recipients agree there should be a sense of urgency on water shortages. Currently, AI has proven to be a vital asset in eliminating biases and expenses.

Cognitive impairment has been increasingly observed among patients with anxiety disorders and major depressive disorders impacting their normal daily functioning as well as quality of life. A multitude of evidence suggests that the most affected cognitive abilities are memory, attention, perception, and executive functioning in patients with anxiety and depression. Impairment in these higher-order cognitive functions can be attributed to age, education, diet, hormonal changes, stress, and prolonged use of drugs/alcohol/ medicines. To address the issues related to cognitive impairment various non-pharmacological therapeutic modalities such as Cognitive remediation approaches viz; cognitive rehabilitation, cognitive stimulation, and cognitive training; Audio-visual entrainment; mindfulness-based interventions; and neurofeedback have come into play in recent years. It is imperative to understand that the ability to test, measure, and monitor cognitive performance along with implementing cognitive remediation approaches viz; cognitive stimulation, cognitive training, etc. across the lifespan helps in early identification, accessing treatments faster, staying healthy for longer, and improving overall quality of life. This article discusses a case study of a client suffering from generalized anxiety disorder and moderate depression who after undergoing and following a novel therapeutic approach, ‘The Cognitome Program’ has shown credible improvement in cognitive abilities, along with a prominent reduction in the symptoms of anxiety, depression, and better psychological and physical well-being. Guided by the concept of neuroplasticity and cognitive plasticity, our innovative neuroscientific holistic program- ‘The Cognitome Program’ empowers unlocking hidden cognitive potential using cutting-edge methodologies and personalized strategies.

Background: Cervical Cancer poses a significant global health challenge, especially in lowresource settings. It is a significant health problem worldwide, with over half a million new cases diagnosed each year, accounting for approximately 6.6% of all gynecological Cancer cases and over 300,000 deaths each year. In Zambia, it is the leading cause of mortality and morbidity among women. The number of cases has increased by approximately 40%. This study explored the lived experiences of Cervical Cancer patients undergoing chemotherapy at the Cancer Diseases Hospital in Lusaka, Zambia, focusing on their subjective experiences. By examining their journeys through chemotherapy, the study aimed to highlight the subtle complexities in which treatment impacts patients’ lives and well-being.  Methods and procedures: Employing a qualitative descriptive phenomenological study design, in-depth interviews were conducted with 10 participants with diverse demographics. The sample size was determined by data saturation and saturation was reached at 10. Ethical protocols were ensured, and Study approval was obtained from UNZABREC and the National Health Research Authority. Thematic analysis was conducted on audio-recorded interviews with cervical cancer patients, ensuring confidentiality and accuracy while discerning significant patterns and themes in their narratives. Results/findings: Emotional experiences ranged from anxiety to gratitude. Psychological challenges encompassed coping mechanisms, stress management, emotional adjustments, and treatment-related fears. Socially, community support, workplace accommodations, and healthcare provider roles were key. Physical experiences revealed side effects managed through coping strategies. Financial challenges significantly impacted individuals and families.  Conclusions and recommendations: The study revealed that cervical cancer patients undergoing chemotherapy face complex challenges spanning emotional, psychological, social, physical, and financial domains, underscoring the imperative for comprehensive patient-centered care. Recommendations suggest focusing on financial aid for cancer patients and tackling treatment expenses and insurance issues. The Cancer Diseases Hospital should establish multidisciplinary teams for holistic care, and enhance patient education efforts. Nurses should adopt strategies integrating cultural competence and patient-centered care to address diverse challenges during chemotherapy. These aim to enhance the well-being and care quality of Cervical Cancer patients.

This paper reviews the transformative impact of Artificial Intelligence (AI) on civil engineering. It explores AI's fundamental concepts and its applications across structural analysis, construction management, transportation, geotechnical engineering, and sustainability. The review highlights AI's role in automating tasks, predicting outcomes, and optimizing designs throughout project lifecycles. Recent advancements in AI-driven technologies for structural health monitoring, predictive maintenance, and risk assessment are discussed, along with challenges like data quality and model interpretability. Future trends such as autonomous construction and digital twins are examined, emphasizing the need for continued research and interdisciplinary collaboration. In conclusion, this paper offers insights for leveraging AI to address evolving challenges and opportunities in civil engineering, fostering innovation, sustainability, and resilience in infrastructure development.

A case study of a non-COPD (Chronic Obstructive Pulmonary Disease) patient with congenital kyphoscoliosis to see the effect of pulmonary rehabilitation after 36 sessions given for chest disease in Kuwait with signs and symptoms, physical capacity, functional level, and Quality of life.

Pure Red Cell Aplasia (PRCA) is a well-recognized complication of Major ABO-incompatible allogeneic stem cell transplantation. It is featured by anemia, Reticulocytopenia, and the absence of erythroblasts in a normal-appearing bone marrow biopsy. The mechanism for PRCA is presumed to be the persistence of recipient isoagglutinins, produced by residual host B lymphocytes or plasma cells, which probably interfere with the engraftment of donor erythroid cells. Several risk factors for PRCA have been reported, such as the presence of Anti-A Isoagglutininsbefore transplantation, reduced intensity conditioning, absence of Graft Versus Host Disease (GVHD), sibling donor and Cyclosporin A(CsA) as GVHD prophylaxis. PRCA is not a barrier to going ahead with Hematopoietic Stem Cell Transplantation (HSCT). There are many therapeutic options however few recover spontaneously, among the available options include high-dose steroids, Erythropoietin(EPO), Plasma exchange, Donor lymphocyte Infusion (DLI), treatment with Rituximab, Bortezomib, Daratumumab and tapering or discontinuation of immunosuppression. All these options have variable success in the literature ranging from 30% - 70%, Non-responders become red cell transfusion dependent and their quality of life is impaired. We are reporting a novel therapeutic option, Ibrutinib as an armamentarium in treating the PRCA post-HSCT, which works by blocking the Bruton Tyrosine Kinase (BTK) pathway thereby inhibiting the host B cell isoagglutinins production and good clinical response.

Introduction: Childhood obesity is one of the current themes of medical research, being considered not so much a multidimensional condition but primarily a real problem of worldwide interest.The aim of our randomized study was to evaluate and compare the effects of physical exercise associated with an educational program on clinical-functional status in overweight and obese children.Material and method: Participants were children hospitalized, through the emergency service, in the Pediatric Department, Craiova Municipal Clinical Hospital, between June and November 2023. 93 overweight and obese children, aged between 2 and 16 years, were evaluated (clinical, paraclinical and functional) by a multidisciplinary team and randomized into the control group (group C – 63 children) and the study group (group S – 30 children). After the resolution of the acute digestive or respiratory disease, the children in group S underwent a program to restore their functional status, based on educational measures (following the 5-2-1-0 rule) and physical exercises, for 12 weeks. Anthropometric data were measured (height, weight, body mass index); physical performance wasevaluated by gait analysis (we used the BTS G – WALK / BTS G – SENSOR 2 system, BTS Bioengineering Corp, Italy) with the determination of four parameters – the Timed Up-and-Go (TUG) test, the symmetry index, the walking test six minutes (6 MWT) and walking cadence or average cadence (steps/min) in both groups of children.The results were obtained by analyzing the differences in values obtained in the two moments T1 (initial) and T2 (after three months). The proportion of girls and boys was approximately equal within obesity class in each study group. Although we did not obtain statistically significant differences between the monitored parameters, between the two groups, for the two evaluation moments, the children in Group S had a clearly favorable evolution for physical performance parameters, whose average value was improved in T2. Anthropometric data did not change.Conclusion: The present study confirms the effectiveness of the multimodal (educational-kinetic) program for the physical performance of overweight/obese children. The sustained running of the program at home, with the involvement of the family and the school environment, is essential for the well-being of these children, with a favorable impact on the quality of life later.

This study assesses air pollution in Sichuan Province, China, from January 2019 to December 2023 using Copernicus Sentinel-5P satellite data. The analysis reveals distinct seasonal variations in levels of Carbon Monoxide (CO), Nitrogen Dioxide (NO₂), Sulfur Dioxide (SO₂), and Ozone (O₃), with urban areas experiencing higher concentrations due to industrial and vehicular emissions. CO and O₃ frequently exceeded WHO guidelines, particularly in winter and summer, indicating significant health risks. While most pollutant levels remained within safety limits, the findings highlight the importance of continuous monitoring and targeted mitigation strategies to improve air quality and safeguard public health, especially in urban environments.

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.

Introduction: Cognitive impairment is defined as a new deficit in at least two areas of cognitive functioning. These may include disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. It has been shown that cognitive impairment is associated with the severity of kidney disease. Methods: The study was a descriptive research design, with participants purposively sampled from the general chronic kidney disease population which included haemodialysis and peritoneal dialysis patients at Steve Biko Academic Hospital in Pretoria, Gauteng Province, South Africa. Hundred and fifty-one participants (76 hemodialysis & 75 peritoneal dialysis patients), 58% were males, and 42% were females aged 19-61 years. To establish the prevalence of cognitive impairment by testing the level of cognition the Mini-Mental State Examination was utilized to provide a brief screening test to quantitatively assess the cognitive abilities and cognitive changes of patients while on dialysis. Results: Ninety-nine percent (99%) of the recruited population reported no cognitive impairment, irrespective of dialysis modality, demographic characteristics, and socio-economic status. Conclusion: Despite the findings highlighting that the majority of the chronic kidney disease population at Steve Biko Academic Hospital reported no cognitive impairment, it is crucial to increase awareness of the potential effects of cognitive impairment on daily activities, quality of life, and treatment adherence. Early detection and management of cognitive impairment can significantly impact the quality of life and adherence to treatment among these patients. Further research is needed to understand the prevalence and impact of cognitive impairment in different populations and to develop effective interventions for its prevention and management.

Purpose of the study:  To evaluate the performance of Best Practice Recommendation (BPR) compliance in reporting abdominal aortic aneurysm findings on imaging, comparing the results before and after its deployment.Methods: Best Practice Recommendations for AAA were deployed in 2020 at a large radiology practice site. Reports between January 2018 through October 2022 were reviewed, representing studies read prior to and subsequent to the implementation of the reporting standards. Cases of abdominal aortic aneurysms ≥ 2.6 cm were counted by year. Adherence to the BPR for each year was calculated as [total number of confirmed cases of ≥ 2.6 cm AAAs with compliant reports] * 100 / [the total number of confirmed ≥ 2.6 cm AAAs]. A secondary analysis was performed to determine whether there was a statistically significant difference in the proportion of BPR-compliant reports for AAA cases before (from 2018 to 2019) and after (from 2020 to 2022) BPR deployment using a chi-square test. Results: From January 2018 to December 2022, there were 8,693 reports referencing AAA. After excluding cases of suspected AAA (N = 2,131), confirmed AAAs with indeterminate sizes (N = 103), and confirmed AAAs with sizes < 2.6 cm (N = 85), the number of AAA cases ≥ 2.6 cm in size was 6,374. Concordance with the BPR standards for the remaining cases with sizes ≥ 2.6 cm were 1.6% and 4.1% in 2018 and 2019, respectively. Post-implementation of BPRs, there was a substantial improvement in guideline adherence to 32.1%, 84.3%, and 83.6% in 2020, 2021, and 2022, respectively. In general, the proportion of BPR-compliant reports of AAA cases in the pre-deployment (3.6%) period statistically differs (p - value < 0.0001) from those in the post-deployment period (73.9%)Conclusion: Adherence to reporting standards increased after the BPR deployment in 2020. The inclusion of management recommendations in the radiology report when AAA is identified is a simple and cost-effective way of improving outcomes for patients with AAAs through appropriate follow-up treatment.