Regular Treatment Research Articles

Beyond dialysis: Assessing therapeutic regimen compliance and sleep quality in chronic renal failure patients undergoing maintenance hemodialysis in Saudi Arabia.

Given its potential to impact physical and mental health, sleep quality is one of the most significant clinical outcomes among hemodialysis patients. Patients undergoing hemodialysis are required to adhere to an intricate treatment plan that consists of regular hemodialysis treatments, dietary and fluid restrictions, and a multi-drug regimen. Investigate the relationship between adherence to a therapeutic regimen and sleep quality among chronic renal failure patients undergoing maintenance hemodialysis. A descriptive correlational research design was followed. The study was conducted at the hemodialysis units in Hafr Albatin City, specifically at Hafr Albatin Central Hospital and King Khaled Hospital, Saudi Arabia. A convenience sample of 100 adult patients was selected for the study. The Hemodialysis Patients Adherence Questionnaire and Pittsburgh Sleep Quality Index were utilized to collect the data in 5 months from September 20, 2023 to February 15, 2024. The study revealed that more than half of the studied patients adhered to the therapeutic regimen, while (46%) did not adhere to it. More than half of the patients had poor sleep quality and were nonadherent to diet and fluid restrictions. Overall adherence score is negatively correlated with the global sleep quality score (r = -0.368, p < 0.001), indicating that poorer sleep quality is associated with lower overall adherence to the therapeutic regimen. While a significant proportion of the patients demonstrated adherence to overall therapeutic regimens, including dialysis sessions and medication intake, there was notable nonadherence to fluid and diet restrictions. Poor sleep quality, prevalent among two-thirds of the participants, correlates negatively with adherence to therapeutic regimens.

The research of influence factors that possibly lead to cardiovascular disease

Abstract. The emergence of cardiac disease is influenced by numerous variables. Every year a large percentage of people around the world die from heart attacks. This study was to look at how important clinical variables are connected to the chance of having CVD. The analysis used a Kaggle dataset with details from 70,000 patients and 10 different variables. The study examined how factors such as age, gender and changes in cardiac activity during exercise affect overall heart health. Multiple linear regression models were used to analyze these effects. The results show a significant correlation between these factors and an increased risk of heart disease. This emphasizes the importance of these predictors in clinical assessments. It can be concluded from this study that regular medical check-ups, early prevention and treatment should be carried out for these vulnerable groups. The general prevalence of heart disease in the nation can be decreased by implementing these strategies. According to the study, personalized health strategies have the potential to improve CVD outcomes and strengthen preventive measures. All of the experimental results suggest that continued documentation and study of these pathogenic factors in medical diagnostics and experiments could aid in drug development as well as improve medical technology and help more patients with cardiovascular disease recover.

Thematic and intertextual analysis from a feasibility study of the Bonny Method of Guided Imagery and Music with clients in eating disorder treatment

IntroductionEating disorders (ED) are characterized by serious and persistent disturbances with eating, weightcontrol, and body image. Symptoms impact physical health, psychosocial functioning, and can be life-threatening. Individuals diagnosed with an ED experience numerous medical and psychiatric comorbidities due to issues caused by or underlying the ED. Therefore, it is vital to address the complex nature of an ED, as well as the comorbid and underlying issues. This necessitates a psychotherapeutic approach that can help to uncover, explore, and support working through unresolved emotions and experiences. Guided Imagery and Music (GIM) is an in-depth music psychotherapy approach utilizing therapist-programmed music to support the client in uncovering and examining underlying and unresolved issues. The literature surrounding the use of GIM with clients in ED treatment is anecdotal and comprised primarily of clinical case studies.MethodThis secondary analysis, based on a descriptive feasibility study that integrated GIM sessions into the client’s regular ED treatment and examined 116 transcripts from a series of sessions of eight clients.ResultsThematic analysis of the transcripts identified nine subthemes and three themes that emerged. These themes include emotional landscape (feeling stuck, acknowledging emotions, and working through unresolved emotions), relationships (self, others, and eating disorders), and transformation and growth (finding strength, change, and empowerment). A short series of GIM sessions helped ED clients identify and address issues underlying the ED and to gain or reclaim a sense of self that enabled them to make choices for their life that support their recovery and sense of empowerment. Intertextual analysis revealed imagery indicative of the Hero’s Journey.DiscussionFurther, how engagement in this embodied aesthetic experience stimulates perceptual, cognitive, and affective brain functions which are key in fostering behavioural and psychological change is explicated as it relates to ED treatment and recovery.

Health-related quality of life and associated factors among children with Transfusion-dependent β-thalassaemia: a cross-sectional study in Guangxi Province

BackgroundTransfusion-dependent β-thalassemia (TDT) is a severe inherited disorder. Without regular treatment, patients with TDT experience complications that can significantly shorten life expectancy and severely impact both their quality of life and that of their families. The condition has attracted significant attention in global health discussions. Due to the challenges of blood supply shortages, the high costs of iron chelation therapy, and hematopoietic stem cell transplantation (HSCT), TDT presents a serious health risk to patients and imposes a substantial burden on families and society. However, research on the health-related quality of life (HRQoL) of thalassemia patients in China remains limited. This study evaluated the factors affecting the HRQoL of these patients, with the goal of developing strategies to improve their quality of life.MethodsIn this cross-sectional study, children with TDT were recruited from five treatment centers in Guangxi, a province with a high prevalence of thalassemia in China. Structured questionnaires were employed to gather relevant data on sociodemographic variables, disease characteristics, treatments, and associated costs. The HRQoL was assessed using the Transfusion-Dependent Quality of Life (TranQoL) questionnaire, with a proxy version for patients aged 0–11 years and a child version for those aged 12–18 years.ResultsThe study included 418 participants, yielding an overall TranQoL score of 60.6 ± 16.3 among thalassemia patients. Multiple linear regression analysis revealed a negative correlation (P < 0.05) between overall TranQoL scores and several factors: increasing patient age, the presence of multiple thalassemia patients within a family, and undergoing HSCT. Conversely, adherence to regular treatment was positively correlated with higher TranQoL scores (P < 0.05).ConclusionThe study demonstrates that HRQoL among Chinese patients with TDT is at a low level. Age, treatment adherence, family support, and socioeconomic status were identified as key determinants influencing HRQoL. It is essential to further enhance and optimize health insurance policies and medical services to support comprehensive treatment strategies for these patients.

History of Hypertension is The Most Influential Factor in Increasing The Occurrence of Preeclampsia in Lumajang Regency

Hypertensive disorders of pregnancy, including preeclampsia, are significant contributors to maternal mortality and morbidity globally. The study's objective was to investigate the most important factors that contribute to preeclampsia. in Lumajang Regency. The research design is a case-control study. The research location is at Rogorunan Health Center and Kunir Health Center. The sample in this study was determined using saturated sample techniques or total sampling. samples at the Rogotrunan Health Center totaled 80 respondents and the Kunir Health Center which amounted to 75 respondents, totaling 155 respondents. Data collection using questionnaires. Analysis using logistic regression. The results of the study of variables that have a significant influence are on the variables of age (p-value = 0.070), history of hypertension (p-value = 0.000), pregnancy pause (p-value = 0.002), body mass index (p-value = 0.045), and hereditary hypertension (p-value = 0.000). A history of preeclampsia (p-value = 0.255) on the variable was excluded. Multivariate results between preeclampsia occurrence and history of hypertension obtained a value of p = 0.000, OR = 6.004 (1.549-5.065) meaning that The incidence of preeclampsia is influenced by a history of hypertension and history of hypertension affects 6.004 times the incidence of preeclampsia. Conclusion A history of hypertension is the most significant risk factor for preeclampsia, so the recommended advice is the importance of a healthy lifestyle, a balanced diet, exercise regularly, avoiding stress, avoiding smoking, not consuming harmful substances, monitoring blood pressure regularly, and regular treatment. All of these actions are a preventive effort so that during pregnancy preeclampsia does not occur.

The Role of Greek Olive Leaf Extract in Patients with Mild Alzheimer’s Disease (the GOLDEN Study): A Randomized Controlled Clinical Trial

Background: Olive leaves are a significant source of biophenols, which have a beneficial impact on cognitive performance. Objective: To examine, for the first time, in humans the effect of the daily consumption of a beverage containing olive leaf extract (OLE) versus a Mediterranean diet (MeDi) on patients diagnosed with mild Alzheimer’s Disease (AD), in addition to their regular treatment. Methods: A randomized clinical trial compared OLE’s effects on cognitive and functional performance in 55 mild AD patients. Each participant was randomly assigned to two groups: (1) Group 1 was given olive leaves for making a daily beverage and MeDi instructions through monthly diet programs; (2) Group 2 received only the MeDi instructions. After six months, all participants underwent a second neuropsychological evaluation. Results: Group 1 participants had statistically significantly higher MMSE scores compared to Group 2 with a p-value of 0.0135. Specifically, the mean MMSE difference in patients receiving OLE was close to 0, indicating no memory deterioration, whereas in controls it was −4.1, indicative of cognitive decline. The remaining neuropsychological assessments (FRSSD, FUCAS, ADAS-Cog, CDR, GDS, and NPI) revealed better results in the OLE group, except for GDS, which showed no change, but without statistically significant differences between the two groups.

IEHT vs. Regular Treatment - Are there Differences between the Two forms of Treatment in the Retrospective Course with regard to Individual Objective and Subjective Outcome Variables?

This retrospective follow-up study over one year (after discharge from the index treatment), compares the effects of inpatient-equivalent home treatment (IEHT) and regular psychiatric treatment using subjective and objective quality indicators. Using a 1:1 matching of cohorts (diagnosis, age, gender, number of previous treatments and severity of illness), 732 IEHT patients were assigned to a comparison group. Outcome data was taken from the routine data of the clinic database and the in-house basic documentation. In the subjective quality measure, patients and practitioners in regular psychiatric treatment reported a significantly higher improvement in condition. In terms of the objective quality measure, the number of further inpatient treatment days in the observation period, the two groups did not differ significantly, which can be interpreted as encouragement for the use of this new, increasingly established form of treatment.

How different soil surface treatments in urban areas affect soil pore structure and associated soil properties and processes

Soil water and temperature regimes in urban environments are greatly affected by different surface treatments, and these may lead even to changes in soil properties. The goal of this study was to find out how soil properties had changed after 8 years of soil surface modification. Five surface treatment scenarios were considered: bare soil (BS), bark chips (BC), concrete paving (CP), mown grass (MG), and unmown grass (UG). X-ray computed tomography and micromorphological analyses showed that character of pores in soils with grass (MG, UG), which were mainly influenced by organisms living in soils and roots, differed from pore character in soil covers BC or CP, which mostly were impacted by organisms living in soils. Both groups differed from BS, which was predominantly affected by the regular treatment consisting in weed removal and soil loosening. Soil under BC was more compact than for other treatments due to decomposition of the bark chips mulch and migration of mulch components. Organic matter content was greatest but its quality lowest in the BC soil, followed by UG, MG, CP, and BS. The highest aggregate stability assessed using the water-stable aggregates (WSA) index was found for UG, followed by MG, BC, CP, and BS. The greatest water retention ability was observed for BC followed by UG, MG, CP, and BS. The unsaturated hydraulic conductivities for pressure head of –2 cm measured for UG, MG, and BS were much higher than were those for CP and BC. Finally, the greatest net CO2 efflux was measured for BC and MG, followed by UG, CP, and BS. CO2 emission correlated negatively with soil physical quality expressed as slope of the soil water retention curve at its inflection point. In general, the best soil conditions were observed for UG. No treatment considerably aggravated soil condition.

Sub-Optimal Compliance to Long-Term Inhalation Strategies and Poorer Health Care Outcomes Associated with Extended Tattoos in Adolescents with Mild-to-Moderate Bronchial Asthma.

Patients' compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated. To assess if "extended" tattoos can predict long-term compliance to regular therapy of adolescents with mild-to-moderate asthma. A 12-month retrospective observational investigation was conducted on non-smoker asthmatic adolescents of both genders. Patients assuming <70% of prescribed vilanterol/fluticasone furoate o.d. were defined as "non-compliant". Tattoo surfaces were defined as "mild" or "extended" if they were < or ≥400 cm2, respectively. The relationship between tattoos and compliance on the evolution of resources consumption at 6 and 12 months was assessed by generalized estimating equation (GEE) models at the first and second semester of the treatment period. It was found that 13.2% of compliant adolescents had mild tattoos, while 47.2% of non-compliant adolescents had mild-to-extended tattoos (odds ratio (OR) 6.91, 95% CI 2.49 to 19.17, p < 0.001). The mean annual adherence to treatment was 57.8% ± 10.1 SD expected doses in non-compliant subjects with "mild tattoos" (54.8 cm2 ± 36.9 SD), but 38.6% ± 11.4 SD expected doses in those with "extended tattoos" (568.4 cm2 ± 111.6 SD, p < 0.001). Total cost proved to be a linear trend from the lowest values of compliant patients with no/mild tattoos (EUR 65.22 at 6 months and EUR 33.63 at 12 months) to the highest values of non-compliant adolescents with extended tattoos (EUR 330.75 at 6 months and EUR 297.34 at 12 months). Tattoo extension might be used as a reliable predictor of poor compliance and higher health care costs in adolescents with mild-to-moderate asthma. Patients characterized by poor compliance to a long-term therapeutic strategy and tattooing attitude likely share some aspects of their personality profile.

Quantitative Assessment of New Frontiers in Dermatochalasis and Periorbital Hyperpigmentation Treatment: The Role of Cross-Linked Porcine Collagen.

Collagen dermal fillers have shown efficacy in addressing age-related changes in facial appearance. However, their potential in rejuvenating the periorbital region remains unexplored. The aim of this study was to evaluate the effectiveness, clinical safety, and patient satisfaction associated with the utilization of collagen dermal fillers in individuals with dermatochalasis and periorbital hyperpigmentation. This study was reviewed and approved by the institutional review board of China Medical University Hospital (IRB No. CMUH107-REC2-157). Adults diagnosed with dermatochalasis or periorbital hyperpigmentation received periorbital injections of a sterile cross-linked highly-purified specific antigen free porcine dermal collagen (FACIALGAIN® Collagen Implant with Lidocaine, Sunmax Biotechnology Co. Ltd., Taipei, Taiwan) and were assessed for hydration, elasticity, pigmentation index, redness index, lightness value, and density with the DermaLab® Combo Multiparameter Skin Analysis System (Cortex Technology, Hadsund, Denmark) and Cutometer® Dual MPA 580 (Courage+Khazaka electronic GmbH, Köln, Germany). Data was collected prior to injection and at 1 week, 4 weeks, and 12 weeks after injection. Patient satisfaction on volume augmentation, decrease in hyperpigmentation, persistence, and overall satisfaction were also recorded. A total of 12 samples each were recruited for dermatochalasis and periorbital hyperpigmentation. For dermatochalasis subjects, hydration of the periorbital tissue significantly increased at week 1 and 4 (p = 0.011 and p = 0.015). Elasticity decreased by week 4 and persisted until week 12 (p = 0.001 and 0.014). For periorbital hyperpigmentation patients, lightness value increased significantly starting week 1 (p = 0.016), tapering off at week 12. Elasticity decreased by week 4 and persisted until week 12 (p = 0.002 and p = 0.002). Median overall patient satisfaction was 4 out of 5 for the dermatochalasis group and 4.5 out of 5 for the periorbital hyperpigmentation group, with a mild but insignificant decrease by week 12. DermaLab® Combo and Cutometer® Dual MPA 580 are considered effective methods for evaluating patients undergoing dermal filler injections. The utilization of cross-linked porcine collagen dermal filler injections can serve as a minimally invasive approach to enhance skin laxity in dermatochalasis and address discoloration in periorbital hyperpigmentation. However, it is important to note that regular treatments may be necessary to sustain the desired outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/0026 .

Multiple relocation cases in disaster-related deaths after the Fukushima nuclear accident

IntroductionRelocation after a disaster often has negative health effects on vulnerable people, particularly older adults. However, little is known about the number of repeated evacuations and relocations after disasters among those experienced disaster-related deaths. This case series aimed to summarize the secondary problems and mortality risks in patients involved in relocation after disasters.MethodsWe analyzed and summarized the data on 520 disaster-related deaths in Minamisoma City, a municipality near the Fukushima Daiichi Nuclear Power Plant, focusing on the number of relocations. Herein, we describe the cases of three individuals over 80 years old, who died after eight or more relocations, which were certified as disaster-related deaths.ResultsWe discuss following three cases, which are (1) a female patient in her 90s who had a stroke and was completely disabled, (2) a female patient in her 80s whose cancer was detected later due to her failing to see her family doctor, and (3) a male patient in his 80s whose regular postoperative treatment was disrupted following cancer recurrence.DiscussionOur findings indicate that evacuation led to the worsening of chronic diseases and eventually to post-disaster death. Prolonged wide-area evacuation and repeated relocation likely interrupted the continuum of care and led to the failure of adequate care provision. To reduce the loss of human life, it is necessary to review the number of wide-area evacuations and relocations over the medium to long term after large-scale disasters, including nuclear disasters, which may occur in the future. Simultaneously, it is important to establish a medical system at the evacuation site so that disaster victims can continue to receive medical care even after evacuation or relocation.

"Y appearance" infarction: caused by essential thrombocythemia.

Essential thrombocythemia (ET) is a myeloproliferative malignancy caused by the excessive proliferation of megakaryocytes in the bone marrow, resulting in the overproduction of peripheral platelets. ET can lead to thrombotic events, such as ischemic stroke (IS), though it is a rare cause of IS. Bilateral medial medullary infarction (BMMI), also known as "Y appearance" infarction due to its distinctive imaging morphology, is a rare clinical subtype of IS which typically has a poor prognosis and a high mortality rate. Herein, we report the case of a 43-year-old male with a history of ET. The patient's platelet count was poorly controlled, and he did not receive regular treatment. After developing symptoms such as dizziness, dysphagia, choking on water, slurred speech, blurred vision, and bilateral limb numbness. Head magnetic resonance imaging revealed a "Y appearance" infarction in the bilateral medial medulla. After admission, the patient was administered intravenous antiplatelet therapy with tirofiban. However, when he was switched to oral aspirin after three days, he experienced decreased muscle strength and worsening symptoms. Therefore, tirofiban was continued for 14 days. Upon discharge, the patient experienced residual limb numbness. His National Institutes of Health Stroke Scale score was 1, Modified Rankin Scale score was 0, and platelet count had decreased to the normal range. During the 9-month follow-up period after discharge, the patient still had only mild limb numbness. Our report presents a special case of "Y appearance" infarction due to ET. Owing to fluctuations in the patient's condition, he received long-term high-dose tirofiban, which ultimately led to a significant improvement in his symptoms.

Missed Appointments and the Potential Correlation between Personal Characteristics, Personality, and Familial Characteristics and Missed Appointments for Adults with Diabetes Mellitus at the Primary Care Unit of Khon Kaen Province.

Regular follow-up treatment is important for the management of diabetes and to reduce the risk of complications. In this study, we aimed to evaluate the proportion of adult diabetic patients who miss appointments, in addition to the potential correlation between personal characteristics, personality, and the context of family structure and characteristics and missed appointments by adult patients with type 2 diabetes. This study was a cross-sectional descriptive study. The data were gathered through self-administered questionnaires and the patient medical records of 106 individuals who received healthcare services at the Khon Kaen Province primary care unit. Data were gathered from 1 November 2023 to 28 December 2023. Adjusted odds ratios (aORs) and Chi-Square statistics were used to evaluate the relationships with multivariate analyses via multinomial logistic regression and the Kruskal-Wallis test. The majority of patients in the sample, 39.62%, regularly missed appointments. There was a significant association between occasionally missed appointments and middle adulthood (p-value 0.013) and regular exercise (p-value 0.025). A moderate level of the agreeableness personality trait showed a significant association with missed appointments (p-value 0.042). It is important to have a comprehensive understanding of the patient's personality and family characteristics to effectively plan their healthcare and provide optimal support for diabetes treatment.

Personalized delayed anticoagulation therapy alleviates postoperative bleeding in total knee arthroplasty (TKA) patients.

Ecchymosis is one of the most common complications following total knee arthroplasty (TKA), which is closely related to postoperative bleeding. However, it is still controversial whether anticoagulation treatment should be continued for postoperative ecchymosis patients. We suppose that personalized delayed anticoagulation therapy could be beneficial for decreasing postoperative bleeding. A total of 201 TKA patients were retrospectively included in this study, among whom ecchymosis patients received drug anticoagulation treatment 1-2 days later than usual, while nonecchymosis patients received regular drug anticoagulation treatment. The perioperative blood loss, coagulation state, fibrinolytic state and complications were collected and analyzed. Eighty-nine patients (44.3%) developed ecchymosis within 3 days after TKA. There were no differences in baseline characteristics between the two groups. In the ecchymosis group, higher K values and lower calculated coagulation index values were observed in thromboelastography, along with greater total blood loss and a more significant decrease in haemoglobin levels on postoperative Day 1 (POD1) compared to the nonecchymosis group. Additionally, the ecchymosis patients exhibited higher levels of fibrinogen degradation products and D-dimer (D-D) on POD1, with no differences noted on POD3, indicating that patients with ecchymosis are in a relatively hypocoagulable and hyperfibrinolytic state compared to those without ecchymosis. Therefore, the delayed anticoagulation treatment proved beneficial for correcting these postoperative conditions. No statistically significant differences were found between the two groups in postoperative complications, demonstrating that delayed anticoagulation treatment is safe. Patients with ecchymosis exhibited a relatively hypocoagulable and hyperfibrinolytic state with a stronger tendency for postoperative bleeding. Delayed anticoagulation in ecchymosis patients could effectively prevent further exacerbation of postoperative bleeding by avoiding sustained hypocoagulable and hyperfibrinolysis states. Personalized delayed anticoagulation therapy could be beneficial for managing postoperative ecchymosis for TKA patients. Level IV.

Effect of diet on the management of hypertension and type 2 diabetes mellitus in adults from low-income and middle-income countries: protocol for a systematic review of randomised controlled trials.

Hypertension and type 2 diabetes mellitus (T2DM) are two highly prevalent non-communicable diseases worldwide, both leading to disability and premature mortality in low-and-middle-income countries (LMICs). Nutritional interventions towards a healthier dietary pattern or food and nutrients intake have an important role on the management of this disease. This systematic review aims to evaluate the effect of nutritional interventions on the management of blood pressure and glycaemia in adults with hypertension and T2DM from LMICs. We will conduct a systematic review of randomised controlled trials (RCTs) on the effect of nutritional interventions on blood pressure and glycaemia in adult patients with hypertension and T2DM. Literature search will be conducted in MEDLINE, EMBASE, Scopus, Cochrane and Web of Science databases from anytime until April 2024. Nutritional interventions would have been applied in addition to regular or standard treatment, which is prescribed and/or provided by the healthcare system. Studies in English and Spanish will be selected and reviewed by two independent reviewers. Risk of bias will be assessed using the Cochrane tool for RCTs. Heterogeneity and publication bias will be estimated using the I2 and Egger's test, respectively. Ethics approval was not required for this systematic review, considering there was no direct data collection or participation of patients. The investigators will write a manuscript of the final detailed report with the study development and main findings to be published in a peer- reviewed journal. The main findings may be shared with academia partners and groups working on similar topics in LMICs, in addition to policymakers and authorities in these countries. CRD42023483847.

Knowledge, attitudes, and practices of sickle cell hemoglobinopathies: A case-control study from the sickle cell belt of Odisha, India

Despite the high prevalence of sickle cell haemoglobin (HbS) in Odisha, awareness and understanding of sickle cell trait (SCT) and sickle cell disease (SCD) remain low in affected communities. This cross-sectional study assesses the knowledge, attitude, and practice (KAP) regarding sickle cell hemoglobinopathies among 182 sickle cell carriers and 200 age-sex-community matched controls. The overall knowledge of sickle cell hemoglobinopathies was very low among both case and control groups (score 2.8/10). Although most respondents had heard about SCD (85.71% vs. 82%), few were aware of SCT (34.07% vs. 27%). Notably, none of the participants knew their haemoglobin genotype or carrier status. Only a very small proportion were aware of symptoms, causes, and preventive measures. The overall attitude score was marginally higher in the control group (4.75/11) than in the case group (4.55/11), with an average score of 42.25%. While most recognized the need for regular treatment and screening of children (82.4% carriers, 90.5% controls), many were undecided about the necessity of premarital screening. The overall practice score was very low in both groups (0.4/5), but the mean practice score was significantly higher in cases than controls (11.01% vs. 7.55%). Most participants did not undergo regular health check-ups or engage in preventive measures (97.25%). Traditional health practices were commonly relied upon for treatment. Participants reported a lack of awareness about SCT and fear of discrimination, social isolation, and marriage refusal as major barriers to screening participation.

Clinical Features and Prognosis of Patients with Diffuse Large B-Cell Lymphoma of the Breast

To explore the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) of the breast. The clinical data of 28 DLBCL patients admitted to Shanxi Provincial Cancer Hospital from January 2013 to January 2023 were retrospectively analysed, including 13 cases of primary breast DLBCL (PB-DLBCL) and 15 cases of secondary breast DLBCL (SB-DLBCL), and the data of their clinical manifestations, laboratory tests, pathological examinations, treatment protocols, and follow-up were statistically analyzed. There were significant differences in IPI score, LDH level and β2- microglobulin between PB-DLBCL and SB-DLBCL patients (P < 0.05). Among the 23 patients with breast DLBCL who received regular treatment, 13 patients achieved complete remission (9 patients with PB-DLBCL and 4 patients with SB-DLBCL) after initial treatment. By the end of follow-up, 11 patients relapsed or progressed (5 patients with PB-DLBCL and 6 patients with SB-DLBCL) and 9 patients died (3 patients with PB-DLBCL and 6 patients with SB-DLBCL). The 5-year OS rate was (75.0±15.3)% in PB-DLBCL group and (32.3±17.1)% in SB-DLBCL group. The 5-year PFS rate was （59.1±19.8）% in PB-DLBCL and 0% in SB-DLBCL group. The 5-year OS rate and PFS rate of PB-DLBCL patients were higher than those of SB-DLBCL patients (P < 0.05); the 5-year OS rate of the combined central preventive treatment group was higher than that of the chemotherapy group (P < 0.05). Breast DLBCL is divided into two categories: PB-DLBCL and SB-DLBCL. Compared with SB-DLBCL, PB-DLBCL has the characteristics of lower IPI score, LDH, and β2-microglobulin levels. PB-DLBCL patients have a longer survival period. In addition, the prognosis of patients receiving central preventive treatment is more optimistic.

Bacteriological Evaluation of Drinking Water Quality from Kabul University Taps

Human health is significantly affected by poor-quality drinking water, and water-borne diseases are of the most significant concern. A wide variety of microorganisms contaminate drinking water. Water consumers face substantial challenges due to these pollutants and harmful bacteria. To evaluate the microbiological quality of drinking water samples from different places to identify and count Escherichia coli and Coliform bacteria, multiple tube fermentation technique tests (most likely 100 ml) were used. Bacteria were identified using their morphological, biochemical, and cultural characteristics. Sixty tap water samples were collected from different locations at Kabul University. Of these, 36 samples (60 %) were positive for E. coli and Coliform bacteria, and 24 (40 %) were negative. Girls’ and boys’ dormitories showed the highest bacterial contamination level among the multiple positive water samples collected from different locations. Thirty-one samples (86.1 %) of the water were contaminated with Coliform, and five (13.8 %) samples revealed contamination with E. coli. Therefore, it is suggested that all drinking water sources should plan and carry out regular bacteriological evaluations, water supply monitoring, regular treatment, and adequate sanitation.

Effect of Pre-Harvest Intermittent UV-B Exposure on Growth and Secondary Metabolites in Achyranthes japonica Nakai Microgreens in a Vertical Farm

Achyranthes japonica Nakai (AJN) is a medicinal plant known to be beneficial for the joints. Since it takes at least two years from sowing to harvesting in an open field, new AJN cultivation strategies are needed to shorten the production period and improve quality. In this study, high-quality AJN is produced as microgreens in a vertical farm using a commercial ginseng soil mix (Myeongpum-Insamsangto, Shinsung Mineral Co., Ltd., Goesan, Republic of Korea) and controlled environmental conditions. The cultivation conditions included a temperature of 23 ± 2 °C, relative humidity of 50 ± 10%, and a photosynthetic photon flux density of 170 ± 15 µmol·m−2·s−1. Pre-harvest intermittent UV-B exposure, with an intensity of 1.0 ± 0.3 W/m−2, was applied for one day before harvest to evaluate its effects, using controlled environmental conditions in the vertical farm. Ultraviolet-B (UV-B) irradiation increases secondary metabolite levels in plants; however, the effect of UV-B on 20-hydroxyecdysone (20E), an indicator of AJN, is unclear. Therefore, we aimed to investigate whether UV-B treatment of AJN microgreens affected growth and secondary metabolites. The treatment group was set to 12 h of continuous UV-B treatment during the day, two 6 h UV-B treatments, and four 3 h UV-B treatments to confirm the effectiveness of regular and intermittent treatment and recovery. Short-term UV-B treatment before harvesting increased phenols, flavonoids, antioxidant capacity, and 20E levels without affecting AJN biomass. The intermittent 6 h UV-B irradiation with a 6 h recovery time stimulated 20E content by approximately 1.4 times compared to the control. These study findings indicate that short-term UV-B treatment before harvesting, an appropriate recovery time, and intermittent UV-B exposure are more effective at increasing 20E content than continuous treatment. This approach provides a promising strategy for improving the nutritional and health benefits of AJN microgreens in vertical farming systems.

Combining low-technology augmentative and alternative communication with regular aphasia treatment: interim findings of a hospital-based RCT in post-stroke patients

ABSTRACT Background Previous research indicates that low-technology (low-tech) augmentative and alternative communication interventions (AACT) can enhance communication skills in individuals with post-stroke aphasia in China. However, there is limited evidence for low-tech AACT in inpatient settings. Aim This study aims to evaluate the impact of low-tech AACT combined with speech-language therapy (SLT) on communication skills related to basic needs, quality of life, and spoken language function among individuals with post-stroke aphasia in an inpatient setting. Methods & Procedures Twelve participants with aphasia having difficulty in daily communication were randomly assigned to an experimental group, receiving 30 minutes of SLT and 30 minutes of low-tech AACT per session (AACT + SLT), or a control group, receiving 60 minutes of SLT per session (SLT), over ten sessions in two weeks. Primary outcomes were measured using the basic needs (CBN) domain of the functional assessment of communication skills for adults (FACS). Secondary outcomes included scores from the Chinese version of the stroke-specific quality of life scale (SS-QOL) and subtests of spoken language production and comprehension from the aphasia battery of Chinese (ABC). The study was registered in the Chinese clinical trial registry (ChiCTR2000028870). Results The results indicated a significant improvement in the CBN domain of FACS in the AACT + SLT group, with larger clinically significant changes compared to the SLT group. The AACT+ SLT group also showed significantly higher overall scores on the SS-QOL and more significant improvements in the content of spontaneous speech than the SLT group after intervention. Comparable improvements were observed in other subtests of the ABC between the two groups. Conclusions Incorporating low-tech AACT into regular SLT in inpatient settings can improve communication for basic needs in an in-patient setting, facilitate language recovery, and potentially support the overall quality of life, compared to SLT alone, for people with post-stroke aphasia. This combined approach demonstrates preliminary feasibility in hospital settings, suggesting the value of low-tech AACT in aphasia rehabilitation.