Amaphuzu avelele
Ukukhathala noma i-cachexia ehlobene nomdlavuza yisimo esiphikelelayo, esicindezelayo esibonwa ezigulini eziningi zomdlavuza nakwabasindile ngisho nangemva kweminyaka yokwelashwa. Izifundo ezahlukahlukene zikhombisa ukuthi ukungenelela kokudla okunempilo okufanelekile kubandakanya ukusetshenziswa kwama-zinc supplements, i-Vitamin C, i-omega-3 fatty acids, ukukhishwa kwe-guarana, uju lwe-tualang noma uju osetshenzisiwe kanye ne-royal jelly kungasiza kakhulu ekwehliseni izimpawu ezihlobene nokukhathala noma i-cachexia ezinhlotsheni ezithile zomdlavuza kanye nasekwelapheni. Ukushoda kukaVitamin D ezigulini ezinomdlavuza ezibika ukukhathala kuphakamisa nokuthi ukwesekwa kukaVitamin D kungasiza ekwehliseni izimpawu ze-cachexia.
Ukukhathala okuqhubekayo noma ubuthakathaka obedlulele obuvame ukubonwa ezigulini zomdlavuza kubizwa ngokuthi 'Ukukhathala Okuhlobene Nomdlavuza' noma 'iCachexia'. Kuhlukile ebuthakathakeni obujwayelekile obuvame ukucima ngemuva kokuthatha ukudla okufanele nokuphumula. I-Cachexia noma ukukhathala kungabangelwa yisifo somdlavuza noma imiphumela emibi yezindlela zokwelapha ezisetshenziselwa ukwelashwa komdlavuza. Ubuthakathaka obungokomzimba, obungokomzwelo nobokuqonda obubonwa ezigulini ngenxa yomdlavuza noma ukwelashwa komdlavuza noma kokubili kuyacindezela futhi kuvame ukuphazamisa ukusebenza kweziguli ngokujwayelekile.
Izimpawu ze-cachexia ehlobene nomdlavuza:
- ukuncipha okukhulu kwesisindo
- ukulahlekelwa ukudla
- i-anemia
- ubuthakathaka / ukukhathala.
Ukukhathala noma i-cachexia ehlobene nomdlavuza bekulokhu kuyinkinga ebonakala ezigulini eziningi zomdlavuza ngesikhathi nangemva kokwelapha umdlavuza okugcina ngokulahlekelwa okukhulu kwesisindo. Ubukhulu bokukhathala nezimpawu ezihambisana nokukhathala okuhlobene nomdlavuza zingahluka ngokuya ngezici ezahlukahlukene kufaka phakathi:
- uhlobo lomdlavuza
- ukwelashwa komdlavuza
- umsoco nokudla
- impilo yangaphambi kokwelashwa kwesiguli
Ukuthatha ukudla okulungile kanye nezithasiselo njengengxenye yokudla okunomdlavuza yingakho kubalulekile ukubhekana nezimpawu ze-cachexia. Kule bhulogi, sizohlinzeka ngezibonelo zezifundo ezahlukahlukene ezenziwa ngabaphenyi emhlabeni wonke ukuhlola umthelela wokungenelela kokudla okunomsoco kufaka phakathi izithako zokudla ezahlukahlukene / ukudla okwehlisa ukukhathala noma i-cachexia ezigulini zomdlavuza.
Ucwaningo lomtholampilo olwenziwe ngabaphenyi eBrazil luhlolisise imininingwane evela ezigulini ezingama-24 ekhemotherapy ye-colorectal adenocarcinoma esibhedlela somphakathi sokunakekelwa kwezemfundo ephakeme, ukuhlola imiphumela yokwengezwa ngomlomo kwe-zinc ekukhatheni noma i-cachexia ehlobene nomdlavuza. Iziguli zathola ama-zinc zinc omlomo ama-35mg kabili ngosuku nsuku zonke amasonto ayi-16 ngokushesha kuthunyelwa ukuhlinzwa kuze kube ngumjikelezo wesine wamakhemikhali. (USofia Miranda de Figueiredo Ribeiro et al, Einstein (Sao Paulo)., Jan-Mar 2017)
Ucwaningo luthole ukuthi iziguli ezingawatholanga ama-zinc capsules zibike ukonakala kwekhwalithi yempilo nokukhathala okwandayo phakathi komjikelezo wokuqala nowesine we-chemotherapy. Kodwa-ke, lezo ziguli ezinomdlavuza ezazinikezwa amaphilisi eZinc azange zibike noma yiliphi ikhwalithi lempilo noma ukukhathala. Ngokuya ngocwaningo, abacwaningi baphethe ngokuthi i-zinc supplementation ingaba lusizo ekuvikeleni ukukhathala noma i-cachexia kanye nokugcina ikhwalithi yempilo yeziguli ezinomdlavuza obala ku-chemotherapy.
Ukudla Okufanele Ukudla Ngemuva Kokuxilongwa Komdlavuza!
Akukho mdlavuza owodwa ofanayo. Dlulela ngale kwemihlahlandlela ejwayelekile yokudla kuwo wonke umuntu futhi wenze izinqumo ezenziwe ngezifiso ngokudla nezithasiselo ngokuzethemba.
Ukusetshenziswa kukaVitamin C weBrain Cancer Treatment Associated Fatigue
Ocwaningweni lwasemtholampilo olwanyatheliswa ngo-2019, abacwaningi bahlola ukuphepha nomthelela wokusebenzisa ukumnika kwe-ascorbate (Vitamin C) kanye nokwelashwa okujwayelekile kweziguli ezinomdlavuza wobuchopho/glioblastoma. Ucwaningo luhlaziye idatha evela ebuchosheni be-11 umdlavuza iziguli futhi yahlola imiphumela engemihle yokwelashwa yokukhathala, isicanucanu kanye nezigameko ezimbi ze-hematological ezihlobene nezinga lokwelashwa kokunakekelwa. (U-Allen BG et al, iCancer Cancer Res., 2019)
Abaphenyi bathola ukuthi umthamo ophakeme we-Vitamin C / ascorbate infusions wenze ngcono ukusinda okuphelele kweziguli ze-glioblastoma kusuka ezinyangeni eziyi-12.7 kuya ezinyangeni ezingama-23 futhi kunciphise nemiphumela emibi kakhulu yokukhathala, isicanucanu kanye nezehlakalo ezimbi ze-hematological ezihambisana nokwelashwa komdlavuza wobuchopho. Imiphumela emibi kuphela ehlotshaniswa nokufakwa kwe-Vitamin C lapho iziguli zathola khona kwakungumlomo owomile nokubandayo.
Umthelela weVitamin C kuKhwalithi Yempilo Yeziguli Ezinomdlavuza
Ocwaningweni lokucwaninga oluphakathi nendawo olubanzi, abacwaningi bahlole imiphumela yokufakwa kwe-Vitamin C emithanjeni ephezulu ngekhwalithi yempilo yeziguli ezinomdlavuza. Kulolu cwaningo, abacwaningi bahlole imininingwane yeziguli zomdlavuza ezisanda kutholakala ezathola umthamo ophakeme we-Vitamin C njengomuthi wokwelapha osizayo. Imininingwane evela ezigulini ezinomdlavuza ezingama-60 itholakale ezikhungweni ezibambe iqhaza eJapan phakathi kukaJuni noDisemba 2010. Ukuhlolwa kwekhwalithi yempilo kwenziwa kusetshenziswa imininingwane esuselwa kuhla lwemibuzo etholwe ngaphambili, futhi emavikini ama-2 kanye nama-4 athumela umthamo omkhulu we-Vitamin C wokwelapha ngomthamo.
Ucwaningo lukhombisile ukuthi ukuphatha okuphezulu okufakwa emithanjeni kaVitamin C kungathuthukisa kakhulu impilo yomhlaba kanye nekhwalithi yempilo yeziguli ezinomdlavuza. Ucwaningo luphinde lwathola ukuthuthuka ekusebenzeni ngokomzimba, ngokomzwelo, kwengqondo, kanye nasekusebenzeni nomphakathi emavikini amane okuphathwa kukaVitamin C. Imiphumela ikhombise ukwehla okukhulu kwezimpawu kubandakanya ukukhathala, ubuhlungu, ukuqwasha nokuqunjelwa. (UHidenori Takahashi et al, I-Personalised Medicine Universe, 2012).
Ukuphathwa kukaVitamin C ezigulini zomdlavuza webele
Ocwaningweni lwe-multicentre cohort eJalimane, idatha evela ku-125 Stage IIa kanye ne-IIIb yeziguli ezinomdlavuza webele yahlolwa ukuze kucwaningwe umthelela wokuphathwa kwe-Vitamin C kukhwalithi yempilo yeziguli ezinomdlavuza webele. Kulokhu, iziguli ezingama-53 zanikezwa uvithamini C ngokufakwa emthanjeni kanye nokwelashwa kwazo okujwayelekile komdlavuza okungenani amasonto ama-4 kanti iziguli ezingama-72 azizange zinikezwe u-Vitamin C umdlavuza ukwelashwa. (Claudia Vollbracht et al, In Vivo., Nov-Dec 2011)
Ucwaningo luthole ukuthi uma kuqhathaniswa neziguli ezingazange zithole i-Vitamin C, kube nokuncipha okukhulu kwezikhalazo okubangelwe yilesi sifo kanye ne-chemotherapy / i-radiotherapy kufaka phakathi ukukhathala / i-cachexia, isicanucanu, ukulahlekelwa isifiso sokudla, ukudangala, ukuphazamiseka kokulala, isiyezi kanye ne-diemhesis eyophayo kulezo ziguli ezathola uVithamini C.
Okutholakele ezigulini zomdlavuza ngokususelwa ku-European Palliative Care Research Center Cachexia Project
Ukubuyekezwa okuhlelekile kwenziwe ngabaphenyi beSibhedlela i-University of Bonn eJalimane, University of Diponegoro / Kariadi Hospital e-Indonesia naseNorway University of Science and Technology eNorway, ukuhlola umthelela wamavithamini, amaminerali, amaprotheni, kanye nezinye izithasiselo kwi-cachexia kumdlavuza. Ucwaningo lwezincwadi oluhlelekile lweCENTRAL, MEDLINE, PsycINFO, ClinicalTrials.gov kanye nokukhethwa kwamajenali omdlavuza kuze kube ngumhla ziyi-15 Ephreli 2016 kuveze izincwadi ezingama-4214, lapho ezingama-21 zifakiwe ocwaningweni. (UMochamat et al, J Cachexia Sarcopenia Muscle., 2017)
Ucwaningo luthole ukuthi ukwengezwa kukavithamini C kuholele ekuthuthukisweni kwezici ezahlukahlukene zempilo kusampula enezinhlobonhlobo zokuxilongwa komdlavuza.
Umthelela we-β-hydroxy-β-methylbutyrate (HMB), i-Arginine ne-Glutamine inhlanganisela kwi-Lean Body Mass ku-Advanced Solid Tumor Patients
Esifundweni esifanayo esishiwo ngenhla ebesingaphansi kwe-European Palliative Care Research Center Cachexia Project, abacwaningi baphinde bathola ukuthi inhlanganisela yokwelashwa kwe-β-hydroxy-β-methylbutyrate (HMB), i-arginine, ne-glutamine ikhombise ukwanda kwesisindo somzimba esinciphile ngemuva Amaviki ama-4 esifundweni seziguli eziqinile ezithuthukile. Kodwa-ke, bathole nokuthi le nhlanganisela efanayo ayinayo inzuzo ebunzimeni bomzimba omncane kwisampula enkulu yamaphaphu athuthukile nezinye iziguli ezinomdlavuza ngemuva kwamasonto ayisishiyagalombili. (UMochamat et al, J Cachexia Sarcopenia Muscle., 8)
I-European Palliative Care Research Center Isikhungo seCachexia
I-European Palliative Care Research Centre Cachexia Project nayo ithole ukuthi i-vitamin D ukwesekwa kunamandla okuthuthukisa ubuthakathaka bemisipha ezigulini ezinomdlavuza we-prostate. (Mochamat et al, J Cachexia Sarcopenia Muscle., 2017)
Ngokwengeziwe, ucwaningo olufanayo luye lwathola nokuthi i-L-carnitine ingaholela ekwandeni kwesisindo somzimba kanye nokwanda kokusinda okuphelele kweziguli ezinomdlavuza we-pancreatic eziphambili.
Kwenziwe izifundo ezahlukahlukene ukuqonda ubudlelwano phakathi kokushoda kukaVitamin D nokukhathala noma i-cachexia ezigulini ezinomdlavuza.
Ocwaningweni olushicilelwe ngo-2015, abacwaningi baseSpain bahlole ukuhlangana kokushoda kukaVitamin D nekhwalithi yezinkinga zokuphila, ukukhathala / i-cachexia kanye nokusebenza komzimba ezigulini zomdlavuza eziqinile ezithuthukisiwe endaweni noma ezi-metastatic noma ezingasebenzi ngaphansi kokunakekelwa okunciphisayo. Phakathi kweziguli ezingama-30 ezinomdlavuza oqinile osezingeni eliphakeme ezazingaphansi kokunakekelwa okunciphisayo, ama-90% ayenenkinga kaVitamin D. Ukuhlaziywa kwemiphumela yalolu cwaningo kutholakale ukuthi ukushoda kukaVitamin D kungahle kuhlotshaniswe nokukhathala / i-cachexia ehlobene nomdlavuza, okusikisela ukuthi ukwesekwa kukavithamini D kunganciphisa izehlakalo zokukhathala futhi kuthuthukise inhlalakahle yomzimba kanye nokusebenza kweziguli ezinomdlavuza oqinile. (UMontserrat Martínez-Alonso et al, uPalliat Med., 2016)
Kodwa-ke, njengoba lokhu kuphakanyiswa kuphela ngokuya ngesixhumanisi phakathi kokushoda kukaVitamin D nokukhathala / i-cachexia ehlobene nomdlavuza, ukuqinisekiswa kwale ncazelo ocwaningweni olulawulwayo kuyadingeka.
I-Omega-3 Fatty Acid Supplementation ezigulini ezineBile Duct noma iPancreatic Cancer Underotherapy Chemotherapy
Ocwaningweni olwenziwe ngabaphenyi beJikei University School of Medicine, eTokyo eJapan, i-enteral (ukudla ukudla ngomgudu wamathumbu (GI)) izakhamzimba ezenziwe ngama-omega-3 fatty acids, yanikezwa ama-27 epancreatic and bile duct iziguli ezinomdlavuza. Imininingwane yemisipha yamathambo nokuhlolwa kwegazi itholakele ngaphambi kokunikeza i-omega-3-fatty acid supplement kwiziguli futhi emasontweni ama-4 nama-8 ngemuva kokuba beqale ukuthatha izithasiselo. (UKyohei Abe et al, Anticancer Res., 2018)
Ucwaningo luthole ukuthi kuzo zonke iziguli ezingama-27, ubukhulu bemisipha obunamathambo bukhuphuke kakhulu kuwo womabili amasonto ama-4 kanye nama-8 ngemuva kokuqala kwe-omega-3-fatty acids uma kuqhathaniswa nesisindo semisipha ngaphambi kokuphathwa kwama-omega-3-fatty acids. Okutholakele ocwaningweni kuphakamise ukuthi i-omega-3 fatty acid supplementation ezigulini ezinomdlavuza ongalawuleki wepancreatic kanye ne-bile duct ingasiza ekuthuthukiseni izimpawu zomdlavuza we-cachexia.
I-n-3-fatty acid isetshenziswa ezigulini zomdlavuza wePancreatic zeCachexia
Olunye uvivinyo lomtholampilo lwenziwe ngabaphenyi baseJalimane ukuqhathanisa umthamo ophansi we-phospholipids yasolwandle kanye nokwakhiwa kwamafutha enhlanzi, ayenezinga elifanayo nokwakheka kwe-n-3 fatty acid, enesisindo nasekuqineni kwesifiso, ikhwalithi yempilo kanye namaphrofayili e-plasma fatty acid ezigulini eziphethwe umdlavuza wepancreatic. Ucwaningo lubandakanya iziguli ezingama-60 zomdlavuza wepancreatic ezazinikezwa uwoyela wezinhlanzi noma i-phospholipids yasolwandle. (UKristin Werner et al, iLipids Health Dis. 2017)
Ucwaningo luthole ukuthi ukungenelela ngedosi ephansi n-3-fatty acids, kungaba uwoyela wezinhlanzi noma i-MPL supplementation, kuholele ekuthembekeni kwesisindo nasekuqineni kwesifiso ezigulini zomdlavuza wepancreatic. Ucwaningo luthole nokuthi amaphilisi asolwandle ama-phospholipids abekezeleleke kangcono ngemiphumela engemihle, uma kuqhathaniswa nokwengezwa kwamafutha ezinhlanzi.
I-Omega-3-Fatty Acid Supplementation kwiziguli zomdlavuza wamathumbu kanye nomgudu wamaphaphu
Ekuhlaziyweni kwe-meta okwenziwe ngabaphenyi basePortugal, bahlole umphumela we-n-3 polyunsaturated fatty acids kuzici zokudla okunempilo kanye nekhwalithi yempilo yomdlavuza we-cachexia. Bathole izifundo zesilingo somtholampilo ezishicilelwe phakathi kuka-2000 no-2015 ngosesho lwezincwadi kumininingwane yolwazi ye-PubMed ne-B. Izifundo ze-7 zisetshenziselwe ukuhlaziywa. (UDaryna Sergiyivna Lavriv et al, Umtholampilo Wezempilo ESPEN., 2018)
Ucwaningo luthole ukuthi isisindo seziguli ezinomdlavuza wamathumbu sikhule kakhulu ngokusetshenziswa kwe-n-3 polyunsaturated fatty acids, kepha iziguli ezinomdlavuza wamaphaphu azibonisanga mpendulo ebalulekile.
IGuarana (Paullinia cupana) Sebenzisa Iziguli Ezinomdlavuza Othuthukile
Abaphenyi abavela e-ABC Foundation Medical School eBrazil bahlole umthelela wokukhishwa kwe-guarana ekwehleni kwesifiso nokwehla kwesisindo ezigulini ezinomdlavuza eziphambili. Iziguli zanikezwa ama-50 mg we-guarana owomile ongahluziwe kabili ngosuku amasonto ama-4. (UCláudia G Latorre Palma et al, J Diet Suppl., 2016)
Ezigulini eziyi-18 eziphothule lo mthetho olandelwayo, iziguli ezimbili zithole isisindo esingaphezu kuka-5% kusuka kwesisekelo sazo kanti iziguli eziyisithupha zibe nokuthuthuka okungenani kwamaphoyinti ama-3 esikalini sesifiso sokubuka lapho zilawulwa ngokukhishwa kwe-guarana. Bathola ukuthi kube nokwehla okuphawulekayo ekushodweni kwesifiso nasekulaleni isikhathi eside ngokungavamile.
Ucwaningo luthi ukuqina kwesisindo nokwanda kwesifiso lapho kufakwa nezicucu ze-guarana eziphakamisa izinzuzo zokukhathala / i-cachexia ehlobene nomdlavuza. Abaphenyi bancoma ukuqhubeka kwezifundo ze-guarana kulesi siguli somdlavuza.
Ocwaningweni lomtholampilo olufaka ababambiqhaza abangama-40, abaneminyaka ephakathi kwengu-18 nengama-65 ubudala, abanomdlavuza wekhanda nowentamo abaphothule ukwelashwa ngamakhemikhali kanye / noma i-radiotherapy e-Hospital USM, eKelantan Malaysia noma esibhedlela iTaiping, abacwaningi bahlole umthelela wokwengeza uju lukaTualang noma uVitamin C ku ukukhathala nekhwalithi yempilo. (UViji Ramasamy, iGulf J Oncolog., 2019)
Ucwaningo luthole ukuthi ngemuva kwamasonto amane nesishiyagalombili ekwelashwa ngoju lukaTualang noma uVitamin C, izinga lokukhathala kweziguli eziphathwe uju lweTualang belingcono kakhulu kunalabo abaphathwa ngeVitamin C. Abaphenyi bathola nentuthuko enkulu kwikhwalithi yempilo ezigulini ezelashwa ngoju lukaTualang ngesonto 8. Kodwa-ke, lapho abatholanga mehluko / ukuthuthuka okuphawulekayo kokubalwa kwamaseli amhlophe kanye nezinga lamaprotheni asebenzayo phakathi kwamaqembu amabili eziguli.
Ocwaningweni olushicilelwe ngo-2016, abacwaningi abavela emanyuvesi ahlukene weSayensi yezokwelapha e-Iran bahlole ukusebenza koju olucutshungulwayo kanye ne-jelly yasebukhosini ngezimpawu zokukhathala noma i-cachexia ezigulini zomdlavuza ezelashwa i-hormone, i-chemotherapy, i-chemo-radiation noma i-radiotherapy. Ucwaningo lubandakanya ababambiqhaza abangama-52 abavela ezigulini ezivakashele emtholampilo we-oncology wesibhedlela iShohada-e-Tajrish eTehran (Iran) phakathi kukaMeyi 2013 no-Agasti 2014. Iminyaka yobudala yalezi ziguli cishe yayiyiminyaka engama-54. Kulezi, iziguli ezingama-26 zathola uju olucutshungulwayo kanye ne-royal jelly, kanti abanye bathola uju olumsulwa, kabili ngosuku amasonto ama-4. (Mohammad Esmaeil Taghavi et al, Electron Physician., 2016)
Ucwaningo luthole ukuthi ukusetshenziswa koju olusetshenzisiwe kanye ne-royal jelly kunciphise ukukhathala noma izimpawu ze-cachexia ezigulini zomdlavuza uma kuqhathaniswa nokusetshenziswa koju olumsulwa.
Isiphetho
Iningi lezifundo okukhulunywe ngazo ngenhla likhombisa ukubaluleka kokuthatha ukudla okulungile kanye nezithasiselo zezinhlobo ezithile zomdlavuza ukunciphisa ukukhathala kanye ne-cachexia ezigulini zomdlavuza. Ukuthatha izithasiselo ze-zinc, i-Vitamin C, i-omega-3 fatty acids, ukukhishwa kwe-guarana, uju lwe-tualang, uju olucutshungulwayo kanye ne-royal jelly kungasiza kakhulu ekwehliseni ukukhathala noma i-cachexia ezinhlotsheni ezithile zomdlavuza kanye nasekwelapheni. Ukushoda kukaVitamin D ezigulini ezinomdlavuza ezibika ukukhathala kungakhombisa nokuthi ukwesekwa kukaVitamin D kungasiza ekwehliseni i-cachexia.
Ukungenelela kokudla okunempilo kudlala indima enkulu ekwehliseni ukukhathala noma izimpawu ze-cachexia ezigulini zomdlavuza nakwabasindile. Iziguli ezinomdlavuza kufanele zithinte i-oncologist yazo kanye nochwepheshe wezokudla ukuze bakhe uhlelo lokudla okufanele olwenziwe ngomdlavuza nasekwelashweni kwabo ukwenza ngcono impilo yabo.
Ukudla okudlayo nokuthi yikuphi okunezelayo okwenzayo yisinqumo osithathayo. Isinqumo sakho kufanele sifake ukucutshungulwa kwezakhi zofuzo zomdlavuza, okuwumdlavuza, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imininingwane yokuphila, isisindo, ubude nemikhuba.
Ukuhlelela okunomsoco komdlavuza kusuka ku-addon akususelwa ekusesheni kwe-inthanethi. Kwenzela wena ukuthathela izinqumo ngokuya ngesayensi yamangqamuzana eyenziwe ososayensi bethu nonjiniyela be-software. Kungakhathalekile ukuthi ngabe uyakukhathalela ukuqonda okuyisisekelo kwamakhemikhali amakhemikhali noma cha - wokuhlelela umsoco ukuhlela lokho kudinga ukuqonda.
Qalisa MANJE ngokuhlela kwakho okunomsoco ngokuphendula imibuzo egameni lomdlavuza, ukuguquka kwezakhi zofuzo, ukwelashwa okuqhubekayo kanye nezithasiselo, noma yikuphi ukungezwani komzimba, imikhuba, indlela yokuphila, iqembu lobudala nobulili.
Ukudla Okungokwakho Komdlavuza!
Umdlavuza uyashintsha ngokuhamba kwesikhathi. Enza ngendlela oyifisayo futhi uguqule umsoco wakho ngokusekelwe kunkomba yomdlavuza, ukwelashwa, indlela yokuphila, okuncamelayo kokudla, izinto ezingakuphathi kahle nezinye izici.
Iziguli ezinomdlavuza ngokuvamile kufanele zibhekane nokuhlukile imiphumela emibi ye-chemotherapy okuthinta ikhwalithi yempilo yabo futhi babheke ezinye izindlela zokwelapha umdlavuza. Ukuthatha ukudla okunomsoco nezithasiselo ezisuselwa ekucabangeni kwesayensi (ukugwema ukuqagela nokukhetha okungahleliwe) yikhambi elingcono kakhulu lemvelo lomdlavuza nemiphumela emibi ehlobene nokwelashwa.