Falls and potential therapeutic interventions among elderly and older adult patients with cancer: a systematic review

Objectives: The aim of this study was to perform a systematic review for previous publications that have assessed the incidence, risk factors, and favorable procedures to prevent and manage falls among cancer survivors of elderly and older adults. Materials: This systematic review was undertook using PubMed, SCOPUS, Web of Science, Medline, and Cochrane Database of clinical studies and systematic reviews to determine the incidence, risk factors, favorable inpatient and outpatient management, and non-pharmacological interventions for falls among elderly and older adult patients with cancer from 2010 to October, 2020. Results: After the comprehensive screening, clinical studies, meta-analysis, systematic reviews, and established guidelines were included in this review. Only 5 clinical studies (3 randomized and 2 single-arm studies), 5 systematic reviews, and 6 established guidelines were considered eligible. The five systematic reviews provide risk factors of falls and the 6 guidelines provide assessment & prevention modalities of falls, however, the 6 clinical studies provide the non-pharmacological intervention for falling among cancer survivors. Many factors associated are demonstrated among wide range of elderly individuals.Earlier falls were reliably listed as an important risk factor of falls in the two inpatient and outpatient environments including both general older people and geriatric cancer populations. Conclusions: This review concludes that the assessment of falls among older individuals with cancer is the most important way for determining who could need additional observation and treatment program. Health professions involving physical therapy and occupational therapy have an important function for promoting health well-being in elderly and older adults with cancer. Keywords: Cancer; falls; elderly; older adults, risk factors, intervention

Efficacy of fetal echocardiography in prenatal diagnosis of congenital heart diseases

Background: Congenital heart diseases are the commonest fetal congenital defects and until nowadays most of them are bypassed without prenatal diagnosis to be still considered as unexplained stillbirths or perinatal deaths. In this study, we tried to prove the importance of routine fetal cardiac screening in the ANC visits and also confirming its high accuracy.Methods: This study was prospective longitudinal one, including doing ISUOG extended fetal cardiac screening for one hundred foetuses  scheduled at certain gestational age visits, whom their half were at risks for CHDs and the other were not, with comparing the results to antenatal and postnatal detailed fetal echocardiography.Results: The best gestational age for the fetal cardiac screening was at 18-22 weeks gestation. The accuracy of the screening to the antenatal echocardiogram was 96%-100% and to the postnatal one was 96%-98%.Conclusions: CHDs are still the commonest congenital fetal defects and the antenatal fetal cardiac screening by extended basic views has high accuracy. Making this screening a routine in ANC visits will be of great help in improving the fetal outcome

Effect of physical therapy rehabilitation program (exercise-therapy) on Irritable Bowel Syndrome

To evaluate the effect of physical therapy rehabilitation program consisted of moderate intensity aerobic exercise training (60% MHR) (Maximum Heart Rate) treadmill training on irritable bowel syndrome (IBS) symptom and quality of Life in post cholecystectomy patients. Thirty post cholecystectomy patients complaining from irritable bowel syndrome were recruited for this study; age ranged from 25 to 40 years, Patients were divided randomly into two equal groups, Group (A): received 4 weeks moderate intensity aerobic training program (60% MHR treadmill training (3 sessions per week) plus routine medical treatment protocol, Group (B): received routine medical care only. Patients assessed by Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) and Irritable Bowel Syndrome Quality of Life (IBS-QOL), Assessment was carried out before treatment and 4 weeks after treatment in both groups. Results showed that there was a significant decrease in post treatment values of IBS-SSS and IBS-QOL in comparison to pre-treatment values at both groups with (p-value < .001). Comparison between both groups post treatment showed significant difference in IBS-SSS and IBS-QOL variables, in group (A) more than group (B). Moderate intensity aerobic exercise training (60% MHR) for 4 weeks is effective in treatment of IBS post cholecystectomy through reducing IBS symptoms and improving Quality of Life

Advanced Protocol of Shock Wave Therapy for Diabetic Foot Ulcer

Abstract: Foot ulceration is one of the most common and severe complications of diabetes mellitus causing hospitalization and amputation of lower limb. Delivery of shock wave therapy stimulates the early expression of angiogenesis-related growth factors so it results in new vessel in-growth that improves blood supply, increases cell proliferation and accelerates tissue regeneration and healing. Purpose of this study was to evaluate the effectiveness of shock wave therapy in enhancing diabetic wound healing. Material &amp; methods Forty diabetic patients with stage (II or III) lower limb ulcers were randomly divided into two groups (shock wave group and control group). Shock wave group received 3 sessions of unfocused shock wave (500 pulses/cm 2 at 0.1 mJ/mm 2 ) one session every week beside traditional wound care, the control group received traditional wound care. The methods of assessment were wound surface area and epithelialization rate. Results showed significant decrease in wound surface area and increase in the rate of epithelialization in shock wave group compared to the control group. Conclusions From the finding of the current study we concluded that shock wave with these parameters (500 pulses/cm 2 at 0.1 mJ/mm 2 ) is an effective, safe, relatively inexpensive, simple and available modality in enhancing and accelerating diabetic wound healing

Effect of Female Sex Hormones on Cardiorespiratory System: Theoretical Review

This study aimed at analyzing the effect of the female sex hormones upon  the cardiorespiratory system. And the results showed that the cardiac output measurement showed no significant increase during both phases of menstrual cycle before exercise but there was an insignificant increase soon after exercise owing to sympathetic over activity. The observed increase in the peripheral blood flow during mid-follicular phase before and after exercise revealed that influence of estrogen increases the arterial distensibility. The observed increase in the respiratory efficiency test during early luteal phase before and soon after exercise revealed the influence of progesterone, which is considered to be a potent stimulator of respiration, and added up effect of hormones and exercise-induced changes

Lipid nanocarriers overlaid with chitosan for brain delivery of berberine via the nasal route

This research aimed to design, optimize, and evaluate berberine-laden nanostructured lipid carriers overlaid with chitosan (BER-CTS-NLCs) for efficient brain delivery via the intranasal route. The nanostructured lipid carriers containing berberine (BER-NLCs) were formulated via hot homogenization and ultrasonication strategy and optimized for the influence of a variety of causal variables, including the amount of glycerol monostearate (solid lipid), poloxamer 407 (surfactant) concentration, and oleic acid (liquid lipid) amount, on size of the particles, entrapment, and the total drug release after 24 h. The optimal BER-NLCs formulation was then coated with chitosan. Their diameter, in vitro release, surface charge, morphology, ex vivo permeability, pH, histological, and in vivo (pharmacokinetics and brain uptake) parameters were estimated. BER-CTS-NLCs had a size of 180.9 ± 4.3 nm, sustained-release properties, positive surface charge of 36.8 mV, and augmented ex-vivo permeation via nasal mucosa. The histopathological assessment revealed that the BER-CTS-NLCs system is safe for nasal delivery. Pharmacokinetic and brain accumulation experiments showed that animals treated intranasally with BER-CTS-NLCs had substantially greater drug levels in the brain. The ratios of BER brain/blood levels at 30 min, AUCbrain/AUCblood, drug transport percentage, and drug targeting efficiency for BER-CTS-NLCs (IN) were higher compared to BER solution (IN), suggesting enhanced brain targeting. The optimized nanoparticulate system is speculated to be a successful approach for boosting the effect of BER in treating CNS diseases, such as Alzheimer’s disease, through intranasal therapy

A novel voting classifier for electric vehicles population at different locations using Al-Biruni earth radius optimization algorithm

The rising popularity of electric vehicles (EVs) can be attributed to their positive impact on the environment and their ability to lower operational expenses. Nevertheless, the task of determining the most suitable EV types for a specific site continues to pose difficulties, mostly due to the wide range of consumer preferences and the inherent limits of EVs. This study introduces a new voting classifier model that incorporates the Al-Biruni earth radius optimization algorithm, which is derived from the stochastic fractal search. The model aims to predict the optimal EV type for a given location by considering factors such as user preferences, availability of charging infrastructure, and distance to the destination. The proposed classification methodology entails the utilization of ensemble learning, which can be subdivided into two distinct stages: pre-classification and classification. During the initial stage of classification, the process of data preprocessing involves converting unprocessed data into a refined, systematic, and well-arranged format that is appropriate for subsequent analysis or modeling. During the classification phase, a majority vote ensemble learning method is utilized to categorize unlabeled data properly and efficiently. This method consists of three independent classifiers. The efficacy and efficiency of the suggested method are showcased through simulation experiments. The results indicate that the collaborative classification method performs very well and consistently in classifying EV populations. In comparison to similar classification approaches, the suggested method demonstrates improved performance in terms of assessment metrics such as accuracy, sensitivity, specificity, and F-score. The improvements observed in these metrics are 91.22%, 94.34%, 89.5%, and 88.5%, respectively. These results highlight the overall effectiveness of the proposed method. Hence, the suggested approach is seen more favorable for implementing the voting classifier in the context of the EV population across different geographical areas

Electrical power output prediction of combined cycle power plants using a recurrent neural network optimized by waterwheel plant algorithm

It is difficult to analyze and anticipate the power output of Combined Cycle Power Plants (CCPPs) when considering operational thermal variables such as ambient pressure, vacuum, relative humidity, and temperature. Our data visualization study shows strong non-linearity in the experimental data. We observe that CCPP energy production increases linearly with temperature but not pressure. We offer the Waterwheel Plant Algorithm (WWPA), a unique metaheuristic optimization method, to fine-tune Recurrent Neural Network hyperparameters to improve prediction accuracy. A robust mathematical model for energy production prediction is built and validated using anticipated and experimental data residuals. The residuals’ uniformity above and below the regression line suggests acceptable prediction errors. Our mathematical model has an R-squared value of 0.935 and 0.999 during training and testing, demonstrating its outstanding predictive accuracy. This research provides an accurate way to forecast CCPP energy output, which could improve operational efficiency and resource utilization in these power plants

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London