Life Assessment Research Articles

Quality of life and late therapy effects in pediatric non-Hodgkin lymphoma survivors: Insights from a single-institution study.

The survival outcomes of pediatric patients with mature B-non-Hodgkin lymphoma (NHL) have improved due to advances in treatment. We aimed to assess the frequency and severity of late effects and their impact on quality of life among pediatric NHL survivors. This retrospective study included patients diagnosed with mature B-NHL at Children's Cancer Hospital of Egypt (CCHE) 57357 from January 2012 through December 2015. Patients received treatment according to the modified LMB 96 protocol. The minimum follow-up period was 5years. Assessments for toxicity and quality of life were conducted at regular intervals during and after treatment. Patients were assessed for toxicity including pulmonary dysfunction, cardiac dysfunction, lipid profile abnormalities, endocrine dysfunction (thyroid function, vitamin D levels, growth curves), and cognitive function (intelligence quotient [IQ] level using Stanford-Binet Intelligence Scales-5th Edition, and quality of life (QoL) assessment (PedsQoL). A total of 273 patients were eligible, and 206 were evaluable. Median age was 5.45 (range: 2.4-18), with a male-to-female ratio 4:1. Pulmonary function abnormalities were detected in 119/203 (58.6%); most had mild dysfunction (72/119, 60.5%), while 17% had severe dysfunction. Cardiac toxicity occurred in 10% of the patients (n=20). IQ testing showed that 52 patients had a low average IQ score, while 151 patients had either average or above average scores. The total mean QoL score was 99±0.058 classified as "satisfactory." However, significant impairment of the physical domain of quality of life was observed among group C patients compared to A/B (p=.033), older age at diagnosis (p=.042), and those with pulmonary dysfunction (p<.001). Total score of quality of life was significantly impaired among patients with pulmonary dysfunction (p=.009), likewise older age at diagnosis (p=.017) and those with low average IQ scores (p=.033). Childhood mature B-NHL survivors are at significant risk for late effects; pulmonary dysfunction and low average IQ that can subsequently impact QoL.

A cGAN-based fatigue life prediction of 316 austenitic stainless steel in high-temperature and high-pressure water environments

The thermo-mechanical-chemical coupling effect presents significant challenges in accurately predicting the fatigue life of 316 austenitic stainless steel in high-temperature and high-pressure water environments (referred to hereafter as environmental fatigue). The complexity of environmental fatigue experiments results in limited and dispersed data, further making the life prediction difficult. Traditional fatigue life prediction models are often constrained by specific loading conditions and do not adequately account for the complex environmental influences. To address these issues, this paper proposes a novel environmental fatigue life prediction model of 316 stainless steel utilizing conditional Generative Adversarial Networks. The proposed model incorporates critical environmental factors, loading conditions and stacking fault energy, allowing direct prediction of environmental fatigue life. A comparative analysis on the predicted and experimental results reveals that the cGAN-based model significantly improves the prediction accuracy, reducing the fatigue life prediction error from a factor of 5 to within 3. To quantify the uncertainty in fatigue life prediction, the Monte Carlo Dropout method is employed to enable a probabilistic assessment of fatigue life. Furthermore, four environmental and loading conditions are established to evaluate the model’s extrapolation capability. The results demonstrate that the probabilistic fatigue assessment effectively captures data distribution and achieves high prediction accuracy.

6811 RESTORE: a Real-World Study of Setmelanotide in Patients With MC4R Pathway Diseases

Abstract Disclosure: C. Huber: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. B. Sweeney: Consulting Fee; Self; Rhythm Pharmaceuticals, Inc., Novo Nordisk. Research Investigator; Self; Rhythm Pharmaceuticals, Inc.. Speaker; Self; Rhythm Pharmaceuticals, Inc. J. Pomeroy: Research Investigator; Self; Rhythm Pharmaceuticals, Inc. U. Mallya: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. S. Zhang: Other; Self; Employer received funding from Rhythm Pharmaceuticals, Inc. to support this research. M. Yang: Other; Self; Employer received funding from Rhythm Pharmaceuticals, Inc. to support this research. S. Malhotra: Employee; Self; Rhythm Pharmaceuticals, Inc.. Stock Owner; Self; Rhythm Pharmaceuticals, Inc. A.M. Haqq: Advisory Board Member; Self; Rhythm Pharmaceuticals, Inc., Novo Nordisk, Foundation for Prader-Willi Research USA. Grant Recipient; Self; Weston Family Microbiome Initiative and Canadian Institutes of Health Research. Background: Setmelanotide has demonstrated efficacy in clinical trials of patients with obesity due to rare melanocortin-4 receptor pathway diseases. Real-world evidence can provide a greater understanding of patient outcomes, such as hyperphagia and quality of life, in a clinical practice setting. Real-world Evidence of SeTmelanotide fOr Hyperphagia and ChRonic Weight ManagEment (RESTORE) is a prospective, observational, longitudinal study aimed at assessing patient- and caregiver-reported real-world effectiveness of setmelanotide among patients with Bardet-Biedl syndrome and proopiomelanocortin, proprotein convertase subtilisin/kexin type 1, or leptin receptor deficiency and their caregivers. Methods: Patients aged ≥6 years and caregivers aged ≥18 years who are able to respond to a survey in English and consented to the Rhythm Intune Program are eligible for the study. Patients must have been prescribed, but not yet initiated, setmelanotide, not have been previously treated with setmelanotide, and not have previously participated in or be currently enrolled in any clinical trial, including setmelanotide trials. Caregivers must be confirmed legal guardians of patients without prior exposure to setmelanotide, have cared for their patient for ≥6 months, and not be paid professional caregivers. Participants will complete secure online surveys at baseline (ie, before treatment) and at 6 posttreatment time points over a 1-year study period. Patient surveys collect information on hyperphagia-related signs and symptoms, medical history, treatment adherence, weight management programs and treatment, comorbidities/complications, comedications, disease impact on psychological well-being and health-related quality of life, treatment satisfaction, work/school/activity status, and patient global assessment. Caregiver surveys include assessments on psychological well-being, treatment satisfaction, and impact on activities of daily living, work status, and family dynamics. A subset of study patients will be invited to receive a wearable device (CentrePoint® Insight Watch) to assess activity and sleep patterns. Treatments and outcomes among patients will be described and compared with baseline for all post-treatment initiation assessment time points. Current status: RESTORE is the first study to assess the real-world effectiveness of setmelanotide, has been IRB approved, and is actively enrolling. Presentation: 6/3/2024

Prediction of multiaxial fatigue life with a data-driven knowledge transfer model

A data-driven model is presented for accurate prediction of multiaxial fatigue life based upon the principle of transfer learning (TL). The Tradaboost framework is explored to adjust the weights of training data from different sources, actuating information transfer from domain knowledge to the data-driven modeling of multiaxial fatigue life. Subsequently, extensive experimental results tested under the proportional and non-proportional circle loadings are collected for model evaluation. The results demonstrate that the proposed model is more accurate than domain knowledge-based, conventional data-driven, and comparable TL-based models, with a low data requirement, showcasing good applicability for multiaxial fatigue life assessment.

A comparative effectiveness study of usual care, simple Chuna manual therapy, and complex Chuna manual therapy for the treatment of pelvic biomechanical lesions in patients with non-acute low back pain: a protocol for multicenter, randomized controlled trial

BackgroundChuna manual therapy (CMT), a Korean manual therapy technique predominantly used for treating low back pain (LBP) and related disorders, lacks well-conceived research focusing on its comparative effectiveness, safety, and economic evaluation, particularly with respect to complex CMT with established CMT diagnostic algorithms. This study aims to illustrate a protocol for a randomized clinical study for comparative effectiveness and cost-effectiveness of complex CMT with simple CMT and usual care.MethodsThis is a protocol for a three-armed, multicenter, assessor-blinded, pragmatic, randomized controlled trial study. A total of 81 patients suffering from non-acute LBP with pelvic biomechanical lesions (PBL), characterized by a pain duration of at least two weeks and a Numeric Rating Scale (NRS) score of 5 or higher, will be recruited from two Korean medicine hospitals. These participants will be randomly assigned to one of three groups: complex CMT plus usual care (UC; n = 27), simple CMT plus UC (n = 27), or UC groups (n = 27). They will undergo treatment for 4 weeks, and follow-up assessments will be performed 8 weeks after treatment completion. The primary outcome will be the NRS score of LBP, and secondary outcomes will include the Oswestry Disability Index, Patient Global Impression of Change, credibility and expectancy questionnaire, three-dimensional posture analysis indicators, quality of life assessment, economic evaluation, and safety assessments.DiscussionThis will be the first study to assess the comparative effectiveness, safety, and cost-effectiveness of complex CMT compared to UC and simple/complex CMT in patients with LBP and PBL. We will also analyze useful diagnostic methods to help in clinical practice for CMT diagnosis.Trial registrationClinical Research Information Service (CRIS), KCT0009210. Registered on February 28, 2024.

Single-component artificial urinary sphincter: Outcomes from one centre in Portugal.

Radical prostate cancer treatment is the predominant cause of iatrogenic stress urinary incontinence (SUI) in men, significantly impacting their quality of life (QoL). This prospective single-center study in Portugal aimed to evaluate the outcomes of men with moderate-to-severe SUI treated with a single-component artificial urinary sphincter (AUS). Male patients with iatrogenic moderate-to-severe SUI, determined by a 24-hour pad weight test, were included. The single-component device comprises a cuff linked to a pump unit through a kink-resistant tube. The implantation involved perineal incision for cuff placement and an inguinal incision for pump and tank positioning within the scrotum. Complications, pad usage, perioperative complications (Clavien-Dindo classification), and quality of life assessment using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire were documented. Between May 2021 and March 2023, 20 consecutive single-component AUS insertions were conducted at a Portuguese urology department. Follow-up concluded in July 2023, with a mean follow-up duration of 15 months (range: 5-27). Four patients experienced complications necessitating device revision or removal (erosion = 2, infection = 1, mechanical failure = 1). Social continence (0/1 pad/day) was achieved in 70% (14/20 patients), while 30% (6/20 patients) experienced incontinence. Perioperatively, one patient was classified as grade 2, while the remaining were grade 0/1 in the Clavien-Dindo classification. The mean ICIQ-SF score reduction was 10.5 points. The single-component AUS shows promising efficacy in managing moderate-to-severe male SUI, offering a good success rate, acceptable complications, improved QoL, and a straightforward surgical procedure.

A novel physics-based computational framework to model spacecraft solar array power under degradation: application to European Space Agency (ESA) Cluster mission

Accurate modeling and simulation (M&S) of spacecraft solar array power under degradation is essential for mission planning, remaining useful life assessment, and lifetime extension. A relevant example is ESA’s Cluster spacecraft fleet, launched in 2000 and operated at the European Space Operation Centre (ESOC), whose solar arrays have suffered severe degradation due to space radiation that has caused challenges to routine operations and mission planning. However, currently available physics-based and machine learning models have been proven ineffective in modeling the drastic reduction in power generation over the long operational life of the spacecraft.In response to these limitations, this work introduces a framework to model solar array degradation and predict power generation. It embeds a novel simplified physics-based model and a meta-heuristic optimization algorithm which exploits domain-specific knowledge and monitoring data for robust model parameter calibration and accurate power generation predictions. The results show the effectiveness of the proposed approach in avoiding overfitting and providing an accurate estimate of Cluster solar array power evolution.

Quality Of Life (QOL) assessment in dietary intervention for patients with systemic metal allergy syndrome

Quality Of Life (QOL) assessment in dietary intervention for patients with systemic metal allergy syndrome

The Correlation Between Odontogenic Infection and Total Spectrum of Dental Caries with Oral Health Related Quality of Life in Children with Intellectual Disabilities.

: Children with Intellectual Disabilities (ID) have a higher rate of untreated caries and often progress to caries with pulpal involvement or odontogenic infections. This can be assessed using the Caries Assessment Spectrum and Treatment (CAST) index and the Pulp Ulcer Fistula Abscess (PUFA) index. Dental problems often have an impact on quality of life, so Oral Health-Related Quality of Life (OHRQoL) assessment is needed for ID children. To identify and analyze the correlation between odontogenic infection, the total spectrum of caries, and OHRQoL in ID children. : The subjects of the research were 70 ID children who attended Special Needs Schools (SNS) Type D of the Foundation for the Development of Disabled Children (FDDC). This research uses an analytical survey using questionnaires and interviews to assess OHRQoL. The sampling technique, namely Total Sampling, obtained 43 ID child subjects who met the inclusion criteria. The data were tested statistically using the Spearman Correlation non-parametric test and the t-test. : The average value of odontogenic infection in the population was 1.79, including in the poor category, and the total spectrum of dental caries was 51.16%, including severe morbidity. Multivariate analysis showed a significant correlation between odontogenic infection, total spectrum of caries, and OHRQoL; odontogenic infection with total dental caries spectrum was significantly associated with each p-value = 0.0000, while the correlation between OHRQoL and both odontogenic infection and total caries spectrum had p-values > 0.05, respectively, so it is considered not significant. : Odontogenic infection in ID children is a poor category. The total spectrum of dental caries in ID children mostly includes severe morbidity. There is a correlation between odontogenic infections, the total spectrum of dental caries, and OHRQoL, as well as between odontogenic infections and the total spectrum of dental caries.

Profiling Voice Characteristics of Female Speech-Language Pathologists

PurposeThe present study examines the effects of service delivery on voice quality and Voice related quality of life among young female speech-language pathologists in India. MethodForty-four female speech-language pathologists (aged 19-40) working in Karnataka and Kerala clinics participated. A multi-faceted comprehensive voice evaluation was conducted pre- and post-service delivery. ResultsAuditory-perceptual analysis (CAPE-V) identified a significant shift towards mild dysphonia after service delivery. Aerodynamic evaluation showed a decrease in Maximum Phonatory Duration (MPD), suggesting reduced vocal efficiency. Acoustic analysis revealed significant post-service delivery changes in AVQI, CPPS, HNR, F0, and jitter, reflecting negative impacts on voice quality. Quality of life assessments using the V-RQOL questionnaire revealed limited heterogeneity in scores. ConclusionThese findings highlight the vulnerability of young female speech-language pathologists to voice problems due to service demands. The study underscores the importance of voice care practices and advocates for mandatory training programs across healthcare institutions to mitigate voice disorder risks. This research contributes to understanding the challenges faced by young female speech-language pathologists and emphasizes the need for strategies to promote vocal health and professional satisfaction.

Health-related quality of life assessment in health economic analyses involving type 2 diabetes.

Incorporating health-related quality of life (HRQoL) measures into health economic analyses can help to provide evidence to inform decisions about how to improve patient outcomes in the most cost-effective manner. The aim of this narrative review was to assess which HRQoL instruments have been used in economic evaluations of type 2 diabetes management including in Indigenous communities. MEDLINE (Ovid), Embase (Ovid) and Cochrane were searched from inception to June 2022. Studies included patients with type 2 diabetes; economic evaluations, derived scores from direct questioning of individuals; and were in English. Records were assessed for bias using the JBI critical appraisal tools. A total of 3737 records were identified, with 22 publications meeting the criteria for inclusion. Across those 22 articles, nine HRQoL instruments had been utilised. Generic tools were most frequently used to measure HRQoL, including EQ-5D (-3 L and -5 L) (n = 10, 38%); SF-12 (n = 5, 19%); and SF-36 (n = 4, 15%). Two tools addressing the specific stressors faced by people with type 2 diabetes were utilised: Problem Areas In Diabetes tool (n = 1, 4%) and Diabetes Distress Scale (n = 1, 4%). Two publications reported whether the study population included Indigenous peoples. A wide range of HRQoL instruments are used in economic evaluations of type 2 diabetes management, with the most frequent being varying forms of the EQ-5D. Few economic evaluations noted whether Indigenous peoples were featured in the study population. More research into HRQoL in people living with type 2 diabetes is urgently needed to improve evidence on effectiveness and cost-effectiveness of interventions.

The left atrial appendage exclusion for prophylactic stroke reduction (leaaps) trial: rationale and design

IntroductionLeft atrial appendage exclusion (LAAE) has been shown in randomized trials to reduce ischemic stroke risk in patients undergoing cardiac surgery with known atrial fibrillation (AF). Many patients undergoing cardiac surgery without pre-existing AF are at risk of stroke and may benefit from LAAE. MethodsLeft Atrial Appendage Exclusion for Prophylactic Stroke Reduction (LeAAPS) is an international, prospective, randomized, multicenter, blinded trial evaluating the effectiveness of LAAE in preventing ischemic stroke or systemic embolism in patients undergoing cardiac surgery at increased risk of AF and ischemic stroke. The trial will enroll 6500 patients at increased risk of stroke in whom a cardiac surgery is planned at 250 sites worldwide. Eligible patients are ≥18 years old, have no pre-existing AF but are at increased risk for AF and stroke (based on age, CHA2DS2-VASc score, left atrium size or brain natriuretic peptide). Patients are randomized 1:1 to receive either LAAE with AtriClip or no LAAE during cardiac surgery. Healthcare providers outside of the operating room and the patient will be blinded to allocation. The primary effectiveness endpoint is the first occurrence of ischemic stroke, systemic arterial embolism, or surgical or endovascular LAA closure. The powered secondary effectiveness endpoint is ischemic stroke or systemic arterial embolism. The primary safety endpoint is the occurrence of one of the following events (through 30 days): pericardial effusion requiring percutaneous or surgical treatment, peri-operative major bleeding, deep sternal wound infection, or myocardial infarction. Other endpoints include mortality, rehospitalizations, clinically diagnosed AF, transient ischemic attack, and cognitive and quality of life assessments. Follow-up is every 6 months for a minimum of 5 years; primary analysis occurs when 469 patients have had an ischemic stroke or systemic embolism. ConclusionThe results of the LeAAPS trial will demonstrate whether LAAE with AtriClip at the time of other routine cardiac surgery reduces stroke or systemic arterial embolism during long-term follow-up in patients at high risk of stroke without pre-existing AF. Trial RegistrationClinicalTrials.gov, Identifier: NCT05478304, https://clinicaltrials.gov/study/NCT05478304?term=%20NCT05478304&rank=1

Clinical Efficacy of Microwave Ablation Combined with Percutaneous Osteoplasty in the Treatment of Flat Bone Metastases.

Evaluating the clinical efficacy and safety of microwave ablation combined with percutaneous osteoplasty (MWA + PO group) versus percutaneous osteoplasty (PO group) for the treatment of flat bone metastases. Patients with flat bone metastases and intractable pain who underwent PO and/or MWA from January 2016 to January 2023 in our hospital were included, with 36 cases in the MWA+PO group and 21 cases in the PO group. Changes in the visual analog scale (VAS), Oswestry Disability Index (ODI), and quality of life assessment scale(QOL) were evaluated regularly. Postoperative complications and target lesion tumor treatment responses were also observed. The VAS and ODI in both the MWA+PO group and the PO group significantly decreased at 1week, 1 month, and 3 months postoperatively, The VAS and ODI in the MWA+PO group were lower than those in the PO group postoperatively. The QOL in both the MWA+PO group and the PO group significantly increased at 1week, 1 month, and 3 months postoperatively, with the QOL in the MWA+PO group being higher than that in the PO group postoperatively. According to the mRECIST criteria (target lesion tumor treatment response), the ORR in the MWA+PO group and PO group was 52.8% and 9.5%, respectively, while the DCR was 94.4% and 57.1%, respectively (P <0.001 and<0.001). Different degrees of bone cement extravasation were observed in both the PO group (38.1%) and MWA+PO group(19.4%)(χ²=2.38, P=0.12), but none of the patients developed clinical symptoms related to bone cement extravasation. The average cost of surgery was ¥10,480.43higher in the MWA+PO group than in the PO group. The MWA+PO treatment is more effective in relieving patients' local pain, improving local dysfunction, and enhancing quality of life, and can effectively improve target lesion tumor ORR and DCR, but it is also more costly.

Material volume reduction for creep testing using composite cantilevers and its application for residual life assessment

Digital image correlation (DIC) and finite element analysis (FEA) demonstrate that creep deformation in bending occurs primarily in ≈30 % of the cantilever volume near the fixed end, especially when the creep stress exponent ranges from 5 to 7. As an alternative approach to minimize the material volume required for testing, the concept of fabricating composite cantilevers is proposed and validated in this study. A composite cantilever sample consists of an “active” creeping portion (e.g., T22 boiler steel) and an additively extended “passive” non-creeping portion (e.g., IN718). The volume reduction process involved varying the length of the “active” section, a, while keeping the total length of the cantilever, L, constant. The DIC measurements conducted at 600 °C to assess the creep behavior of T22 steel revealed that analytical expressions for monolithic cantilevers could aptly predict the constitutive steady-state creep laws from the composite cantilevers if measurements are made in a region at a critical distance away from the interface. FEA indicates that accurate stress estimation enables predicting monolithic creep behavior using composite samples with “a/L” ratios of as small as 5 %. Using the developed approach, the loss of creep resistance of T11 boiler steel that was in service for ∼ 240,000 h was ascertained in high throughput fashion using a composite cantilever having only 30 vol % of the “active” material. Guidelines to minimize the volume fraction of the “active” portion in the composite cantilever and the implications of the observations for estimating the residual life of in-service high-temperature components are discussed.

1인 가구 가정생활 실태 및 요구 조사: 2023년 가족센터 이용자를 중심으로

This study examined the family life, program engagement, and policy support demands of single-person households associated with family centers across South Korea. Participants were recruited from 48 family centers, and the current study included 105 adults who met the criteria for single-person households. The assessment of family life focused on satisfaction, community participation, availability of support, and daily living challenges. The investigation of program engagement and demands for policy support included awareness of, and satisfaction with, diverse programs tailored for single-person households, and their expressed demands for support. Data were analyzed using descriptive statistics, t-tests, and F-tests. Results indicated that the family life satisfaction of single-person households scored an average of 7.7 out of 10. Community engagement and perceived availability of help were slightly above the median value. The greatest challenge for single-person households was maintaining a balanced diet. Overall, no significant differences in these features of family life across gender or age groups. Regarding program engagement, awareness of support programs for single-person households was higher among women than men, and satisfaction with these programs was higher among those in their 20s and 50s compared to those in their 40s. In terms of demands for policy support, housing stability support was the top priority for those in 20s to 40s, while family leisure/cultural activity support was most demanded by those in their 50s. This study highlights the importance of understanding the characteristics of single-person households using family centers nationwide and offers direction for the management and enhancement of support programs.

Health-related quality of life measured with K-BILD is associated with survival in patients with idiopathic pulmonary fibrosis

BackgroundHealth-related quality of life (HRQoL) assessments and estimates of prognosis are needed for comprehensive care and planning of subsequent treatment in patients with idiopathic pulmonary fibrosis (IPF). We investigated HRQoL and its association with survival using a disease-specific tool in patients with IPF.MethodsThe patients were recruited from the real-life FinnishIPF study in 2015. HRQoL was assessed with the King’s Brief Interstitial Lung Disease (K-BILD) questionnaire every six months for 2.5 years. Dyspnoea was assessed with the modified Medical Research Council (mMRC) dyspnoea scale. Survival was registered until 31 December 2022. Patient survival according to the K-BILD total score was evaluated using the Kaplan‒Meier method. The Friedman test was used to compare the K-BILD total scores longitudinally, and the Mann‒Whitney U test was used to compare the mMRC groups. P values < 0.05 were considered statistically significant.ResultsThe median K-BILD total score (n = 245) was 51.6. At baseline, patients in the highest HRQoL quartile (K-BILD scores 58.9–100) had a longer median survival time (5.3 years) than did those with scores of 51.7–58.8 (3.1 years), 45.7–51.6 (2.3 years), and 0.0–45.6 (1.8 years). A decrease in the K-BILD total score of ≥ 5 units in the preceding 12 or 24 months showed a trend towards poorer survival, although statistical significance was not reached. Ninety-four patients survived more than 2.5 years and had available K-BILD data at all time points. The K-BILD total score remained higher in patients with a baseline mMRC of 0–1 than in those with a mMRC of 2–4, and the total score decreased only modestly in both groups (median of 3.3 and 4.8 units in patients with mMRC scores of 0–1 and 2–4, respectively).ConclusionsIn IPF, a reduced HRQoL is associated with impaired survival. A K-BILD total score less than approximately 50 units is associated with a median survival of approximately two years. In addition to assessing the treatment needs of patients with IPF using K-BILD, a decreased score may be useful for facilitating advance care planning and transplantation assessment.

Degree of acceptance of the disease and quality of life in women after mastectomy: a preliminary study

Background: The sudden change of life situation caused by a cancer diagnosis and mastectomy disturbs the psychosomatic balance and the functioning of a woman's previous life and leads to a reduced quality of life. Many women adapt to their new situation, but a very large group cannot adapt and cope with their illness.Aim of the study: Evaluation of disease acceptance and quality of life (QoL) in women after mastectomy.Material and methods: A total of 171 post-mastectomy women were studied. The study was conducted by means of a diagnostic survey using a questionnaire technique. The Acceptance of Illness Scale (AIS) and the Quality of Life Assessment Questionnaire (WHOQOL-BREF) were used.Results: The mean disease acceptability was 25.68 7.978. A group of 42.69% (72/171) had moderate disease acceptability, 32.75% (56/171) had high disease acceptability and 20.47% (35/171) had low disease acceptability. 4.09% (8/171) of the women had no acceptance of the disease. The mean value for the perception of QoL was 3.65 0.71. The best values were obtained for QoL in the psychological domain (14.1 3.1) and the worst in the physical domain (13.0; 2.7). Place of residence (p = 0.081) and education level (p = 0.196) did not significantly influence the acceptance of illness. Women living in village areas had a lower quality of life in the environmental domain (p = 0.036) than those living in the city. The absence of complications after mastectomy determined a higher level of QoL in the physical (p &lt; 0.001), psychological (p = 0.029) and environmental (p = 0.010) domains, as well as greater acceptance of the disease (p = 0.001). Disease acceptance was associated with an improvement in the quality of life of women who had undergone a mastectomy, across all domains. Conclusions: It is important to increase interventions to support the adjustment process of women after mastectomy, as acceptance of the disease improves the QoL of these women.

Association of Self-Esteem with Academic Performance of Physiotherapy Students in Rawalpindi/Islamabad

Background: Self-esteem is a critical psychological factor influencing academic performance, especially in demanding educational programs like physiotherapy. Understanding this relationship is essential for enhancing student outcomes.Objective: To examine the correlation between self-esteem levels and academic performance of physiotherapy students in Rawalpindi/Islamabad and to investigate whether the relationship varies based on gender.Methods: A descriptive correlational study was conducted on 313 physiotherapy students selected through non-probability convenience sampling. Data were collected using a self-structured demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Academic Life Assessment Scale (ALAS). The study adhered to the Declaration of Helsinki, and analysis was performed using SPSS version 25. Pearson’s correlation, independent t-tests, and one-way ANOVA were used to evaluate relationships.Results: A weak but significant positive correlation was found between self-esteem and academic performance (r = 0.249, p &lt; 0.01). Female students performed better academically (Mean = 72.46 ± 7.77) compared to males (Mean = 72.53 ± 7.52), but gender differences were not statistically significant (p &gt; 0.05).Conclusion: The study concluded that higher self-esteem is associated with better academic performance, with no significant gender differences.

The Influence of Adherence to a Mediterranean Diet on Decompensation in Patients with Chronic Heart Failure.

Chronic heart failure (CHF) is a major health problem, representing the main cause of hospitalization in people over 65 years of age. Several studies have associated the Mediterranean diet with a cardioprotective function, improving prognoses in patients with high cardiovascular risk. Our main objective is to determine whether higher adherence to the Mediterranean diet is associated with a lower severity of CHF, based on the number of decompensations and disease complications. This study was a single-center retrospective cohort study conducted at the Virgen del Rocío Hospital (Seville). Adherence to a Mediterranean diet was determined by the Mediterranean Diet Adherence Screener (MEDAS) in patients with chronic heart failure in a state of clinical stability, the number of decompensations in the 12 months before inclusion, cardiac biomarkers (NT-proBNP and CA125), evaluation of dyspnea, and quality of life assessment according to NYHA and KCCQ scales and analytical profiles. Seventy-two patients were included (35 with high adherence to the Mediterranean diet and 37 with low adherence). The mean age was 81.29 ± 0.86 years. A trend towards fewer decompensations (1.49 ± 0.14 vs. 1.92 ± 0.17, p = 0.054) and lower NT-proBNP values (2897.02 ± 617.16 vs. 5227.96 ± 1047.12; p = 0.088) was observed in patients with high adherence compared to those with low adherence to the Mediterranean diet. Our results suggest that patients with CHF and high adherence to the Mediterranean diet have a tendency towards an improved cardiac profile, indicated by fewer decompensations and lower NT-proBNP levels. Future clinical trials are needed to substantiate these hypotheses.

Effectiveness of Mulligan Mobilization Technique and Core Stabilization Exercises in Female Patients With Knee Osteoarthritis: A Randomized Controlled Single-Blind Study

ObjectivesThe aim of this study was to compare the effectiveness of the Mulligan mobilization (MM) technique and Core stabilization (CS) exercises added to the conventional physiotherapy (CP) program in female patients with knee osteoarthritis (KOA). MethodsThe study included 42 female patients diagnosed with bilateral KOA. Participants were randomly divided into 3 groups as CP group (mean age: 57.79 ± 7.43 years), MM group (mean age: 56.14 ± 6.95 years), and CS group (mean age: 54.36 ± 6.56 years). They were divided into 3 groups and treated 3 sessions per week for 4 weeks. Pain intensity, range of motion (ROM), and muscle strength were evaluated with visual analog scale, universal goniometer, and handheld dynamometer, respectively. Balance, aerobic capacity, and functional level were assessed with 30-second sit-to-stand test, 6-minute walk test, and Western Ontario and McMaster Universities Osteoarthritis Index. The quality of life of the participants was evaluated with the Nottingham Health Profile. ResultsAfter treatment, significant improvement was achieved in the all parameters evaluated in the groups (P < .05). CS was found to be more effective in reducing resting pain intensity than the other two treatment approaches (P = .001). It was observed that MM technique increased knee flexion ROM more (P = .001). There was no superiority of MM group and CS group over each other in balance, functional level, aerobic capacity, and quality of life assessments (P > .05). ConclusionOur study showed that CP, MM technique, and CS exercises were effective treatment approaches in the management of KOA in female patients. Results revealed that the MM technique was more effective in increasing knee flexion ROM, and the CS exercise was more effective in reducing resting pain intensity in female patients with KOA.