quality

Crohn's disease is a chronic syndrome of the gastrointestinal tract that produces idiopathic inflammation. Approximately half of the patients develop abscesses and/or fistulas throughout their history that are located, mainly, in the perianal region. Current treatments are based on individualized plans that generally use combined pharmacology for symptomatic relief based on glucocorticoids, immunosuppressants or immunomodulators, antibiotics, anti-inflammatories, probiotics, and antibodies, or surgical therapies such as intestinal resections or ostomizations (colostomy and ileostomy) that tend to cause notable side effects in a considerable percentage of patients and a significant decrease in their quality of life.Perianal fistulas consist of abnormal tracts, inflammatory tunnels, or chronic tracts of granular tissue that connect two surfaces lined with epithelium, have an external hole in the skin that borders the anus, and an internal hole located inside it around the anal canal, rectus and sphincters. Treatment is a complex process that requires a multidisciplinary approach and the combination of several treatments. In the short term, the goal is to drain abscesses, reduce inflammatory and infectious processes, guard the fistulous tract with seton or lax lines, facilitate patency, and hinder new formations. In the long term, a total cure and the avoidance of complications that require surgery or the creation of intestinal stomas are pursued.For this reason, new effective remedies with fewer adverse effects continue to be investigated, one of the most promising being the use of mesenchymal stem cells for the regeneration and cure of perianal fistulas and the remission of symptoms. The present bibliographic review delves into this new therapy and analyzes the current state of the situation regarding its efficacy and safety.

Introduction: PCOS is a common cause of female infertility. Although PCOS patients are characterized by producing an increased number of oocytes, they are often of poor quality, leading to lower fertilization, cleavage, and implantation and higher miscarriage rates.Aims: The present study aims to identify the effect of various PCOS phenotypes on oocyte competence in an ART cycle.Settings and design: A retrospective observational study. Methods and material: The study group included 102 women with PCOS as a main cause of infertility. Data was collected over a period of one year (2017-18). These women were divided into four groups on basis of PCOS phenotypes (A-D) and the relevant clinical data and the ART outcome were noted. Statistical analysis was done using SPSS statistical package. Data presented as mean ± SD which was compared using the ANOVA test. A p - value < 0.05 was considered statistically significant.Results: Out of 102 PCOS women, 23.52% women had phenotype A, 11.76% had phenotype B, and 45.09% and 19.60% had phenotype C & D respectively. Good quality embryos formed (p - value 0.01) were lower in Group B vs. other groups. However, clinical pregnancy rates were comparable in all groups.Conclusion: The reproductive potential of women with PCOS varies with the oocyte health and it largely depends on PCOS phenotype. Women with PCOS phenotype B might have poor IVF/ICSI outcomes with regard to the number of oocytes retrieved and embryos formed. PCO morphology might carry an advantage with regards to the number of oocytes retrieved and better quality embryos. It seems that hyperandrogenism in combination with chronic anovulation is associated with poor oocyte competence and hence, a negative impact on embryo quality and clinical pregnancy rate. Further studies with a larger sample size are required to further support it.Key messages: Oocyte competence in various PCOS phenotypes.

The SARS-CoV-2 (COVID-19) pandemic outbreak has led to some lockdowns and changed human mobility and lifestyle in this country. Mashhad, one of the most polluted cities in Iran has experienced critical air pollution conditions in recent years. In the present study, the potential relationships between air quality conditions (such as popular index and criteria air pollutant concentration) and COVID-19 cases and deaths were investigated in Mashhad, Iran. To do that, the Long Short-Term Memory (LSTM) based hybrid deep learning architecture was implemented on AQI, meteorological data (such as temperature, sea level pressure, dew points, and wind speed), traffic index and impact number of death, and active cases COVID-19 from March 2019 to March 2022 in Mashhad. The results reveal the LSTM model could predict the AQI accurately. The lower error between the real and predicted AQI, including MSE, MSLE, and MAE is 0.0153, 0.0058, and 0.1043, respectively. Also, the cosine similarity between predicted AQI and real amounts of it is 1. Moreover, in the first peak of the pandemic (Aug 2021), we have the minimum amount of AQI. Meanwhile, by increasing the number of active cases and death and by starting lockdown, because the traffic is decreased, the air quality is good and the amount of AQI related to PM2.5 is 54.68. Furthermore, the decrease the active cases and death in pandemic causes a significant increase in AQI, which is 123.52 in Nov 2021, due to a decline in lockdowns, resumption of human activities, and probable temperature inversions. 

Background: Control of increased athrogenic index of plasma and lipid parameters in the early stage of diabetes mellitus helps diabetic patients to improve their quality of life and treatment outcomes. Limited studies were conducted on the assessment of dyslipidemia and its correlation with clinical and anthropometric variables among diabetes patients but no study was conducted on the correlation of the athrogenic index of plasma with anthropometric measurements among diabetes patients in this study area. The objective of this study was to assess the correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Compressive specialized hospital, Northeast Ethiopia.Methods: Institution-based comparative cross-sectional study was conducted from August 2020 to June 2021. A total of 250 diabetic and healthy control respondents were included in the study with convenience sampling. Semi-structured questionnaire of a modified WHO stepwise Approach to Surveillance for chronic disease was used to collect data. Finally, descriptive statistics and correlation analysis were conducted to assess the correlation between variables. A P-value of less than 0.05 was declared as the level of significance.Results: Athrogenic Index of Plasma, Triglyceride to High-density Lipoprotein Ratio, Very-Low-Density Lipoprotein, systolic blood pressure, diastolic blood pressure, triglyceride, waist circumference, WHtR and BMI were statistically significantly higher among type 2 DM groups. There was a significant positive linear correlation between triglycerides and waist circumference, between TG / HDL and WHtR, and between cholesterol and WHtR, but a significant negative linear correlation between HDL and waist circumference among the Type 2 DM group. Systolic blood pressure and pulse showed a significant positive linear correlation with WC, BMI, and WHtR among diabetics groups only. Our study showed that the pattern of lipid abnormalities observed among DM patients was high AIP in 68%, moderate AIP in 16% and all four groups of hyperlipidemia were found in 9% of diabetic patients. All lipid profiles showed a significant very strong positive linear correlation with AIP, but DHL has a significant very strong negative linear correlation with AIP among type 2 DM groups.Conclusion: The proportions of high athrogenic index of plasma and lipid profile disorders were higher in DM patients compared to healthy controls. Dyslipidemia and a high athrogenic index of plasma had a considerable correlation with anthropometric measurements and clinical outcomes of type II DM patients. DM patients who have a higher athrogenic index of plasma and higher lipid parameters should be strictly followed based on their anthropometric measurements.

An established side-effect of neck dissection (ND) for head and neck (HNC) tumour management includes shoulder dysfunction (SD), which can impact quality of life (QOL). Shoulder strength and range of movement (ROM) are key parameters to be monitored in SD. However, such evaluations are not routinely conducted in the clinical setting. The aim of this study was to evaluate objectively the impact of ND on shoulder functions. Methods: This is a pilot exploratory study in a tertiary cancer centre. Five participants with unilateral ND and advanced HNC, completed the study. Outcome measures consisted of self-reported QOL questionnaires, C2–T1 dermatomes and shoulder ROM and strength testing. Data was collected at baseline, 1.5-months after surgery and 6-months after diagnosis (after adjuvant treatment completion). Results: Most outcome measures on the surgically affected side were negatively impacted post-operatively, with varied recovery seen at follow-up. Sensory loss was noted at C3–4 dermatome levels. Shoulder ROM and strength was reduced on the surficial side for all participants, with some recovery after six months except for two participants.Conclusion: Results of SD after ND are diverse and unique to each patient. Findings from this pilot study indicate that regular rehabilitation/exercise may facilitate recovery of shoulder function post HNC surgery. However, customised rehabilitation may yield better outcomes. Future studies with a larger sample are indicated to validate the findings of this study.

Pretreatments and drying are commonly used before drying tomatoes to inactivate enzymes, improve the drying process, and improve the quality of dried tomato powders. In this review, the effects of different pretreatments (osmotic solutions), dehydration methods, and packaging materials on the quality attributes of tomato powder were summarized. These include pretreatments and osmotic agent solutions (potassium metabisulfite, calcium chloride, sodium metabisulphite, ascorbic acid, citric acid, sodium chloride, and sodium benzoate), thermal blanching (steam blanching and hot water) and non-thermal-processes-like-freezing, sulfuring, etc. and drying methods (oven, sun, and indirect solar dryer). The tomato powders were dried to preserve, store, and transport them. Drying implies not only physical changes, which the consumer can easily detect through visual inspection but also chemical modifications. These are responsible for alterations in color, flavor, and nutritional value, which compromise the overall quality of the final tomato powder. Maximum lycopene, vitamin A, and C contents were found in freeze-dried and direct sundried than samples dried using other methods at low drying temperatures. Freeze driers showed in keeping the nutritional quality of tomato powder with a combination of different pretreatments. Different pretreatments including osmotic agent solutions have their own merits and demerits for the final tomato powder. To overcome the drawbacks of nutritional quality, non-thermal pretreatment categories may be a better alternative to thermal blanching, and more fundamental research is required for better design and scale-up.

The aim of this work is to report some interesting references and documents related to the mRNA vaccine. Every cited reference can act as an instrument to better understand what some independent researchers find: this work is mainly focused on the public debate related presence/absence of graphene derivates in some vaccine vials for COVID-19. Relevant classic articles White Papers or other kinds of a document are useful instruments to better clarify some crucial aspects of this infectious disease, its epidemiology and the efficacy of the measure adopted (preventive, therapeutic, or vaccine).If the reviewed article show an intrinsic recognized international value other kinds of source like a White Paper or other documents can be of interest to generate hypotheses or to open public discussion on crucial topics. For this reason, it is useful to use this method also in the discussion related to impurity profiles in new innovative bio-pharmaceuticals like the mRNA vaccine. The fact that this product was introduced with an emergency authorization, whit reduced the time of experimentation and due to the lack of official quality information related to some raw materials used authorizes us to use also this method.Even if the international official regulatory agency does not find this substance in the control for release of the lots it is interesting to more deeply investigate what funded by an independent researcher in some vials of vaccine or sample patient’s blood after vaccination. This reference even if not a smoking gun the same can stimulate the reasoning about the general concept involved. It is needed, to read this work, to consider the intrinsic limitation of some of the study research reported (White Paper) or the other documents.

Neurological disorders are a significant cause of mortality and disability across the world. The current aging population and population expansion have seen an increase in the prevalence of neurological and psychiatric disorders such as anxiety, bipolar disorder, depression, epilepsy, multiple sclerosis and schizophrenia. These pose a significant societal burden, especially in low - and middle-income countries. Many neurological disorders have complex mechanisms and lack definitive cures; thus, improving our understanding of them is essential. The pathophysiology of neurological disorders often includes inflammation, mitochondrial dysfunction and oxidative stress. Oxidative stress processes, especially the generation of reactive oxygen species, are key mechanisms in the development of neurological disorders. Oxidative stress refers to an imbalance between the production of reactive oxygen species and antioxidants that can counteract them. Through their impacts on the pathophysiology of neurological disorders, nutrients with anti-inflammatory, neuroprotective and antioxidative properties have been suggested to prevent or mitigate these disorders. Certain vitamins, minerals, polyphenols and flavonoids may have therapeutic effects as adjuvant treatments for neurological disorders. Diet quality is also a risk factor for some neurological and psychiatric disorders and addressing nutritional deficiencies may alleviate symptoms. Therefore, optimizing nutritional intake may represent a potential treatment or prevention strategy. This review summarizes a selection of promising nutrients for the prevention and amelioration of neurological disorders to provide a summary for scientists, clinicians and patients, which may improve understanding of the potential benefits of nutrients in the treatment of neurological disorders.

Many advances have been made in recent years in the development of hearing and cochlear implants. These use acoustic and electrical stimulation technologies to improve speech intelligibility for the hearing impaired. However, for cochlear prostheses, the results are not very promising and vary from one patient to another. Certain technical and sometimes physiological problems have limited the expected performances of these devices, especially for children and the elderly. These problems include cochlear malformation and ossification of the auditory channels. This led us to reduce the number of electrodes in order to allow quality deep insertion while preserving the low-frequency acoustic bands of the operated patient.

Objective: To evaluate the effects on quality of life and body composition of a Ketogenic Diet (KD) in a woman with Charcot-Marie-Tooth (CMT) disease. Methods: Physical (PCS) and mental (MCS) health conditions were evaluated with the SF-36 questionnaire; dual-energy x-ray absorptiometry was used to determine body composition; parameters were determined at baseline and after 12 weeks of KD.Results: At baseline PCS and MCS were 20.6 and 20.7 respectively with 37.9% fat mass. After 12 weeks SF-36 values significantly improved: PCS 55 and MCS 66.1 with 33.9% fat mass. Conclusion: KD improved the patient’s quality of life and decreased fat mass. Further studies will be needed to better elucidate the beneficial effects of KD among people with CMT.

Chronic thromboembolic pulmonary hypertension is a notoriously underdiagnosed cause of severe pulmonary hypertension. It is a form of precapillary pulmonary hypertension (PH) that results from intraluminal thrombus organization and fibrous formation which ultimately results in the complete obliteration of pulmonary arteries, resulting in increased pulmonary vascular resistance which leads to the development of pulmonary hypertension and as a result right heart failure. The mechanism involves the narrowing of the pulmonary artery which increases blood pressure within the lungs and impairs blood flow which increases the workload of the right side of the heart ultimately causing right heart failure. Pulmonary hypertension can also cause arrhythmias, blood clots, and bleeding in the lungs. Even though CTEPH is a deadly condition, among all forms of pulmonary hypertension, CTEPH is the only curable form. Echocardiography is the initial assessment tool for suspected PH. A right heart catheterization may be performed to confirm the presence of pulmonary hypertension. Confirmation of CTEPH requires a V/Q scan. Although ventilation/perfusion scintigraphy has a major role in the evaluation of patients with suspected CTEPH, nowadays CTA chest is being used widely as it produces much better-quality images compared to V/Q scan. Without treatment, the prognosis is very poor. Out of three treatment modalities such as; pulmonary endarterectomy (PEA) surgery, balloon pulmonary angioplasty (BPA), and medical therapy, surgery is the gold standard. The physician must be familiar with the disease entity, early diagnosis, and appropriate treatment to improve survival. Here we present a literature review on this topic.

Saliva is produced by and secreted from salivary glands. It is an extra-cellular fluid, 98% water, plus electrolytes, mucus, white blood cells, epithelial cells, enzymes, and anti-microbial agents. Saliva serves a critical role in the maintenance of oral, dental, and general health and well-being. Hence, alteration(s) in the amount/quantity and/or quality of secreted saliva may induce the development of several oro-dental variations, thereby the negatively-impacting overall quality of life. Diverse factors may affect the process of saliva production and quantity/quality of secretion, including medications, systemic or local pathologies and/or reversible/irreversible damage. Herein, chemo- and/or radio-therapy, particularly, in cases of head and neck cancer, for example, are well-documented to induce serious damage and dysfunction to the radio-sensitive salivary gland tissue, resulting in hypo-salivation, xerostomia (dry mouth) as well as numerous other adverse Intra-/extra-oral, medical and quality-of-life issues. Indeed, radio-therapy inevitably causes damage to the normal head and neck tissues including nerve structures (brain stem, spinal cord, and brachial plexus), mucous membranes, and swallowing muscles. Current commercially-available remedies as well as therapeutic interventions provide only temporary symptom relief, hence, do not address irreversible glandular damage. Further, despite salivary gland-sparing techniques and modified dosing strategies, long-term hypo-function remains a significant problem. Although a single governing mechanism of radiation-induced salivary gland tissue damage and dysfunction has not been yet elucidated, the potential for synergy in radio-protection (mainly, and possibly -reparation) via a combinatorial approach of mechanistically distinct strategies, has been suggested and explored over the years. This is, undoubtfully, in parallel to the ongoing efforts in improving the precision, safety, delivery, and efficacy of clinical radiotherapy protocols/outcomes, and in designing, developing, evaluating and optimizing (for translation) new artificial intelligence, technological and bio-pharmaceutical alternatives, topics covered in this review.

The terms urotherapy and urotherapist are often mentioned in the literature, but their origins and meanings are less well-known. Objective: To describe the background and development of the concept of urotherapy in pediatric care and the profession of urotherapist.Methods: Data has been searched for in Medline PubMed and selection has been limited to papers important for the purpose.Results: Understanding of urinary bladder function was developed in the 1970’s, mainly due to new urodynamic methods opened up for possible treatment options. Standard urotherapy is a concept developed in the 1980’s and aims to treat dysfunction by helping the patient to learn to understand bladder function and then practice certain techniques in order to normalize it. To succeed, guidance and support are needed from a skilled urotherapist. In Scandinavian and German-speaking countries, quality-assured training for urotherapists at the university level is available.Conclusion: Urotherapy standard therapy is a non-invasive treatment recommended as the first-choice treatment for lower urinary tract disorders. However, we must have requirements as to what knowledge a urotherapist needs to have, and training has to be certified and be at the university level.

A large systematic review and meta-regression analysis found that sperm counts all over the world appeared to be declining rather than stabilizing. The decline in male sperm counts does not necessarily translate to a decline in male fertility. The cause of declining sperm counts remains unknown; however, several potential causative factors have been identified: 1. Chronic diseases: diabetes mellitus, hypertension; hyperlipidemia, hyperuricemia and skin Diseases & metabolic syndrome. 2. Environmental factors: bisphenol a; phthalates; heavy metals and heat. 3. Lifestyle: obesity, diet, tobacco, alcohol, marijuana, stress, reduced sleep & sedentary life. Addressing these causes is required to stop or decrease male fertility decline. Action to improve semen quality such as prevention & treatment of chronic disease, decreasing unhealthy lifestyle behaviors such as smoking, poor diet, or lack of physical activity & eliminating toxic environmental chemicals.

The main focus of this study concentrates on evaluating the quality of groundwater in and around the zone of pattamadai where the production of the mat in this region is a landmark industry, which is using dyes in a larger volume. The primary work starts with the collection of water samples from 13 boreholes and 13 hand-dug wells in different time intervals in the month of March 2021, which is a dry season. As per standards the water quality parameters have been evaluated and observed to be within the range. All the physico-chemical parameters for the samples have been studied for boreholes and hand-dug wells as all the values are observed to be within the range and are highlighted in the results.

Every society organizes itself to reduce the complexity of living together in order to ensure relative peace of mind for its members. Major technological accidents such as the Chernobyl or Fukushima nuclear accidents are violent disruptions that affect the quality of life of tens of thousands of people and generate increased distrust and anxiety among them as well as the questioning of the state system’s ability to restore some peace of mind. Past experience has shown that the measurement of radiation and the development of local projects with the support of professionals and experts prove to be effective levers for those affected to regain the ability to make decisions for their protection and to assess the protective actions implemented collectively. It also showed that restoring confidence and restoring the dignity of these people, seriously impaired by the accident, takes time.

Parkinson’s disease is a progressive and debilitating neurodegenerative disorder affecting millions of people worldwide. The disease is characterized by motor symptoms such as tremors, rigidity and postural instability, as well as non-motor symptoms such as depression and cognitive impairment. While there is no cure for Parkinson’s disease, there are various treatments available to manage symptoms and improve quality of life for patients.This case study examines a 65-year-old retired accountant, Mr. John Smith, who was diagnosed with Parkinson’s disease five years ago. Mr. Smith has been treated with a combination of medications, including levodopa and carbidopa and physical therapy to manage his symptoms. However, his symptoms have not significantly improved.This literature review explores the current research on Parkinson’s disease, including its pathophysiology, diagnosis and treatment. Parkinson’s disease is caused by the degeneration of dopamine-producing neurons in the brain, leading to a depletion of dopamine and the accumulation of alpha-synuclein protein, oxidative stress and inflammation. Diagnosis is based on clinical symptoms, neurological examination and response to dopaminergic therapy. Treatment focuses on managing symptoms, with medications and non-pharmacological interventions such as exercise and physical therapy. Deep brain stimulation is a surgical treatment option that has been shown to be effective in managing motor symptoms.While there is currently no cure for Parkinson’s disease, ongoing research into its pathophysiology and treatment holds promise for improving outcomes for patients. This case study highlights the importance of early diagnosis and personalized treatment plans for patients with Parkinson’s disease.

Quick and cost-effective recovery is foundational to high-quality training and good competition results in today’s sports. The aim of the research was to elucidate the effects of hand and massage chair massage on the biomechanical parameters of muscles of lower limbs and back, indicators of Pain Pressure Thresholds (PPT) and subjectively perceived fatigue. A total of 32 female recreational athletes (18 – 50 years old) were assigned to a hand massage, massage chair, or lying down the group. They were measured for muscle biomechanical properties (MyotonPro), PPT (Wagner Instruments) and subjectively perceived fatigue (VAS scale) before and after fatigue tests and treatment. The recovery procedure and subjective satisfaction with treatment were rated on a Likert scale. Changes in the median value of m. rectus femoris and m. gastrocnemius stiffness with treatment showed that hand massage could be more effective in reducing stiffness, as compared to chair massage. Hand massage may have benefits for recovery from physical exertion, but due to the individuality of subjects, detailed methodological studies are needed to evaluate the effects of massage chair vs. hand massage.

Background: Measurement of health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes mellitus (T1DM) is as important as metabolic control in the management and prevention of diabetes-related complications. Aim: To describe the self-reported HRQOL outcomes in Ghanaian children and adolescents with T1DM compared with healthy controls and perceived HRQOL by caregivers.Setting: Out-patient clinics of the Departments of Child Health, Medicine and Therapeutics, Family Medicine, and Ophthalmology, the National Diabetes Management and Research Centre (all at the Korle Bu Teaching Hospital), and the Cape Coast Teaching Hospital (CCTH).Methods: Socio-demographic and clinical characteristics of study participants were documented. Participants completed the PedsQL™ 4.0 Generic Core Scales. Data analysis was done with SPSS Version 25.0. An unpaired t-test was used in comparing the HRQOL scores between children and adolescents with T1DM and controls, and parental proxy reports. Results: Fifty children and adolescents with T1DM, 50 parents/caregivers, and 80 healthy non-diabetic controls took part in this study. There was no significant difference in mean score between the patients and the caregivers for overall HRQOL (p = 0.270). Patients reported significantly worse overall HRQOL than their controls (p = 0.001). Males with diabetes reported better HRQOL than females (p = 0.007). Conclusion: Children and adolescents with T1DM and their parents/caregivers reported lower HRQOL scores compared to healthy controls. Males reported better HRQOL than females. Potential implications: HRQOL should be routinely assessed together with proxy reports from parents to identify those who might benefit from further attention including referral to a psychologist.

There is an urgent need for predictive preclinical models to enhance the success rate of clinical trial outcomes. One of the main reasons for drug attrition is the lack of translational models, methods using human cells are particularly in the spotlight of regulatory bodies as they offer an alternative to in vivo studies and have the potential to improve the translational of preclinical trials. Organs-on-Chips (OoCs) are sensible candidates to reduce the cost and the ethical burden of animal models while accelerating and de-risking drug development. The innovation of such systems is based on both the increased relevance of the cells used and the ability to build precise, yet physiologically relevant, complex architectures. The use of microfluidic technologies with human induced pluripotent stem cells (hiPSCs) opens new routes to create relevant in vitro approaches as they will soon be able to reproduce clinical characteristics of donors or specific populations. The adoption of OoC models by pharmaceutical industries, and in fine by regulatory agencies, still requires: (i) establishing standardized, reproducible, robust, and replicable cell culture protocols with specific validation and characterization criteria, (ii) evidence that the technology predicts human responses, thus allowing to contribute efficiently and reliably to clinical trials success of novel therapeutics, and (iii) evidence that the models refine and reduce animal testing without compromising with the quality and the pertinence of the data generated.