טנזיהTanzia

טנזיה (Tanzia) הוא משחק תפקידים והרפתקאות לשחקן יחיד, המשלב בין סגנון ויזואלי ייחודי בהשראת ספרי קומיקס לבין עולם פתוח תלת-ממדי עשיר וקסום. המשחק שואב השראה ממשחקי תפקידים קלאסיים ומציע חוויה המשלבת חקירה חופשית, לחימה אסטרטגית ושימוש במערכות קסם ואלכימיה מורכבות. עלילת המשחק מתרחשת באי טרופי רחב ידיים, שבו השחקנים יוצאים למסע בעקבות היעלמותו המסתורית של סבם, בעודם מנסים למנוע מכוח אפל להחריב את ביתם. העולם של טנזיה מלא בפרטים ונופים מגוונים, החל מחופים פסטורליים ומפלים ועד למעמקי הריסות של תרבויות עתיקות. במהלך ההרפתקה, השחקנים יתמודדו מול מגוון רחב של אויבים פנטסטיים, מיצורים קטנים ועד למלכים אל-מתים, תוך שימוש במערכת קרב דינמית המעודדת ניצול של נקודות תורפה ושילובי יכולות. המשחק מציע חופש פעולה רב, המאפשר לשחקנים לחקור את האי בקצב שלהם, לגלות סודות חבויים ולשפר את דמותם באמצעות לימוד כשפים חדשים וייצור שיקויים עוצמתיים. השילוב בין המכניקות הקלאסיות לממשק משתמש מודרני הופך את טנזיה ליצירה המנגישה את ז'אנר ה-RPG בצורה מרעננת, צבעונית ומזמינה עבור שחקנים המעריכים עולמות פנטזיה עשירים ומשחקיות עמוקה אך נגישה. הקפדה על סגנון הרטרו בשילוב עם טכנולוגיה מודרנית יוצרת חוויה ייחודית בנוף משחקי האינדי.

_1. In this context, the primary care provider (PCP) is crucial in identifying high-risk families, early detection of the problem, diagnosis and treatment and coordination of and communication with secondary specialists.This scoping review aims at examining current knowledge about PCPs in the long-term followup of children and adolescents with cancer, and exploring the current status, needs, and barriers of General Practice (GP) regarding the medical follow-up of childhood cancer survivors.An electronic search on PubMed, CINAHL, EMBASE, and PsycINFO was performed to identify papers on childhood cancer survivor (CCS) follow-up care in primary care.The initial search resulted in 1642 articles, out of which 110 full texts were reviewed, and 33 met the inclusion criteria. Six themes emerged: 1) current role of the PCP, 2) educational needs, 3) informational needs, 4) communication and care coordination, 5) preferences for models of follow-up care, and 6) barriers to care.Current follow-up care is mostly hospital based, but PCPs and survivors prefer shared care. Main barriers include a lack of knowledge, inadequate information from specialists, and low numbers of CCS in each practice.The successful involvement of PCPs in the follow-up of CCS is hampered by several factors. There is a need for better communication, a clear definition of the roles of all healthcare providers, and the use of tools such as Survivorship Care Plans. Future research should implement and evaluate specific interventions and models for long-term follow-up care in primary care.Copyright © 2017. Published by Elsevier Ltd. All rights reserved.Anterior and posterior visual pathways and optic radiations (OR) can be compromised in preterm infants by diverse etiologies, of which periventricular leukomalacia (PVL) is the most frequent. Our objective was to clarify the utility of fundoscopy, visual evoked potentials (VEP), and brain MRI as predictive factors for visual outcome in preterm infants with PVL. Children with the diagnosis of PVL, with gestational age ≤ 34 weeks, were included in a historical cohort study. Demographic, ophthalmological, and neurodevelopmental data and findings on brain MRI and VEP were evaluated. Of the 100 children, 85 had neuro-ophthalmological abnormalities, the most frequent being strabismus (52.0%) and refractive errors (46.0%). Cortical visual impairment (CVI) was found in 18% of the children. Optic nerve atrophy (ONA) was strongly associated with CVI (p = 0.001) and with the severity of PVL (p = 0.012). Abnormal VEP significantly increased the risk of developing CVI (p = 0.002, OR = 5.67, 94%CI = 1.83-17.51). In the multivariate analysis, Grade 3 PVL (p = 0.038) and abnormal VEP (p = 0.015) remained as independent risk factors for CVI. In conclusion, early VEP and brain MRI are useful tools to predict the neuro-ophthalmological outcome in preterm infants with PVL. Normal VEP and low-grade PVL are associated with better visual outcomes. High-risk infants require a regular ophthalmological follow-up to detect and treat visual problems. Lay Summary: Children born preterm with a certain type of brain injury (periventricular leukomalacia - PVL) are at high risk for visual problems. This study evaluates several factors and exams (brain imaging, ophthalmological exam, and neurophysiological testing) to see if we can identify children at the highest risk for severe visual impairment. We found that severe brain injury on MRI and abnormal results on neurophysiological testing (visual evoked potentials) were the best predictors of visual impairment. These children require close follow-up by ophthalmologists and other specialists to treat these problems and to help improve their visual development. Copyright © 2021 Elsevier Inc. All rights reserved. Show more 1. INTRODUCTION Over the last few decades, survival rates for children with cancer have improved considerably, with five-year survival rates now around 80%–85% in high-income countries. 1 There are more than 500,000 survivors of childhood cancer in Europe today, and this number is expected to rise. 2 This success in treatment has been followed by the recognition of significant long-term health problems. Many survivors develop therapy-related late effects, including secondary malignancies, organ dysfunction, and psychosocial issues. 3–5 Most of these conditions can lead to increased morbidity and premature mortality. 3,6,7 Therefore, long-term follow-up (LTFU) is crucial for this population. 8–10 Traditionally, the follow-up of childhood cancer survivors (CCS) has taken place in специализирован hospital-based clinics. 11,12 However, as the number of survivors increases, the demands on these specialized clinics grow. There is a need for sustainable models of care that provide appropriate and specialized follow-up, while ensuring the transition from pediatric to adult care. 13,14 General practitioners (GPs) or primary care physicians (PCPs) are often considered the ideal professionals to coordinate or provide long-term care for survivors, given their holistic approach to health and their longitudinal relationship with patients and their families. 15,16 Some studies have suggested that a shared care model, involving both specialists and PCPs, could be the most effective way to manage the complex needs of this population. 17,18 Despite the potential benefits, several studies have identified barriers to the involvement of PCPs in the follow-up of CCS. These include a lack of specialized knowledge about the late effects of cancer treatment, inadequate communication between specialists and PCPs, and the relatively small number of survivors in each practice, making it difficult for individual PCPs to gain extensive experience in this area. 19,20 To address these issues, it is essential to understand the current role of PCPs, their educational and informational needs, and the barriers they face. This scoping review was conducted to map the existing literature on the role of primary care in the long-term follow-up of childhood cancer survivors and to identify key areas for future research and practice improvements. 2. MATERIALS AND METHODS 2.1 Study Design A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. 21,22 2.2 Search Strategy A comprehensive search was conducted in four databases: PubMed, CINAHL, EMBASE, and PsycINFO, covering the period from their inception to December 2023. The search strategy used a combination of keywords and MeSH terms related to