The effect of an exercise program on the health-quality of life in older adults

INTRODUCTION: An essential public health goal is to reduce age-related disabilities in the elderly. The present study aimed to investigate the effect of exercise program on health-quality of life (HQL) in older adults. METHODS: Subjects were sixty healthy adult volunteers over the age of �� years. None of the subjects had any experience in exercise programs but were physically active and able to perform activities of daily living independently. The subjects were randomly assigned into one of two groups each with �� people: test (exercise) group and control (no exercise) group. The test group was taken into a � - week aerobic exercise program. The exercises included a �- �� minute circulatory warm-up, a �� minute walking and a �-�� minute stretching/cool-down period. The exercises were performed three times per week under supervision of an experienced instructor. No exercise program was prescribed for the control group. Both groups were assessed before and after the exercise program. The LEIPAD questionnaire was used to measure HQL. RESULTS: The results showed significant improvements in all domains of the LEIPAD questionnaire whilst the level of HQL did not change and none of the scores obtained by the LEIPAD was significant. Measures of HQL improved with exercise so that there were no HQL changes in the control but significant changes were observed in the exercise group. CONCLUSION: This study suggests that an exercise program has resulted in a signific

A Comprehensive VSG-Based Onshore FRT Control Strategy for OWFs with VSC-MT-HVDC Transmission

This paper proposes a communication-free control strategy at the offshore wind farm (OWF) level to enhance onshore fault ride-through (FRT) grid code compliance of the voltage source converter (VSC)-based multi-terminal high voltage direct current (MT-HVDC) grid. In this proposal, the emerging virtual synchronous generator (VSG) concept is employed to equip the Type 4 wind turbine generator (WTG)s with inherent grid forming ability. Accordingly, it is proposed to switch the offshore HVDC converters control mode from grid forming to grid feeding during onshore FRT period to realize direct wind power in-feed reduction as a function of the severity of MT-HVDC grid's overvoltage. The related dynamics are mainly characterized by the high-speed current control loop, so improved OWF response is achieved during onshore FRT period as conventional voltage/frequency modulation strategies are not employed. New analysis/amendments are also proposed to study and improve the transient active power reduction sharing between the WTGs in first few power cycles under wind wake effect. Finally, with the objective of a smooth transfer of HVDC converters and WTGs in several proposed operation states, a set of state machines are proposed considering whole WTG's dynamics. Comprehensive time-domain simulations are performed with averaged electromagnetic transient models to demonstrate the improved onshore FRT behavior in terms of minimizing the electrical stress at both MT-HVDC grid and OWF levels

Relationship Between Depth of Anesthesia and Severity of Pain after Abdominal Surgeries

Background: Pain control during and after surgeries can reduce subsequent complications, improve the recovery period of the patient after the surgery and immediately after discharge from the hospital, and shorten the length of stay in the hospital. Objectives: The present research aimed to study the relationship between the depth of anesthesia and severity of pain after general anesthesia. Methods: This prospective study carried out on 57 patients undergoing hernia surgery during the summer of 2014. The subjects were selected based on convenience sampling method. The same technique of anesthesia was used for all patients. The depth of anesthesia was monitored using bispectral index (BIS) and recorded at five-minute intervals. In addition, the severity of pain in the recovery and during the first 6 hours after the surgery was measured by a numerical scale. The obtained data were statistically analyzed using ANOVA and correlation coefficient in SPSS-18 at a significant level of P<0.05. Results: According to the results, the mean age of subjects was 45.54±13.46. In terms of gender, 36 subjects were male and 21 of them were female. The normal depth of anesthesia (40-60) was experienced by 59.6% of patients. The results also showed that there is a significant correlation between depth of anesthesia and severity of pain in the recovery (P=0.001, r=0.694) and during the first 6 hours after the surgery (P=0.001, r=0.734). Conclusion: The present study showed that monitoring depth of anesthesia during surgery, in addition to helping nurses to monitor patients more accurately, can prevent some of the complications of anesthesia such as severe pain

Phenoloxidase activity acts as a mosquito innate immune response against infection with semliki forest virus

Several components of the mosquito immune system including the RNA interference (RNAi), JAK/STAT, Toll and IMD pathways have previously been implicated in controlling arbovirus infections. In contrast, the role of the phenoloxidase (PO) cascade in mosquito antiviral immunity is unknown. Here we show that conditioned medium from the Aedes albopictus-derived U4.4 cell line contains a functional PO cascade, which is activated by the bacterium Escherichia coli and the arbovirus Semliki Forest virus (SFV) (Togaviridae; Alphavirus). Production of recombinant SFV expressing the PO cascade inhibitor Egf1.0 blocked PO activity in U4.4 cell- conditioned medium, which resulted in enhanced spread of SFV. Infection of adult female Aedes aegypti by feeding mosquitoes a bloodmeal containing Egf1.0-expressing SFV increased virus replication and mosquito mortality. Collectively, these results suggest the PO cascade of mosquitoes plays an important role in immune defence against arboviruses

Five insights from the Global Burden of Disease Study 2019

The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a rules-based synthesis of the available evidence on levels and trends in health outcomes, a diverse set of risk factors, and health system responses. GBD 2019 covered 204 countries and territories, as well as first administrative level disaggregations for 22 countries, from 1990 to 2019. Because GBD is highly standardised and comprehensive, spanning both fatal and non-fatal outcomes, and uses a mutually exclusive and collectively exhaustive list of hierarchical disease and injury causes, the study provides a powerful basis for detailed and broad insights on global health trends and emerging challenges. GBD 2019 incorporates data from 281 586 sources and provides more than 3.5 billion estimates of health outcome and health system measures of interest for global, national, and subnational policy dialogue. All GBD estimates are publicly available and adhere to the Guidelines on Accurate and Transparent Health Estimate Reporting. From this vast amount of information, five key insights that are important for health, social, and economic development strategies have been distilled. These insights are subject to the many limitations outlined in each of the component GBD capstone papers.Peer reviewe

The global, regional, and national burden of oesophageal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background Oesophageal cancer is a common and often fatal cancer that has two main histological subtypes: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Updated statistics on the incidence and mortality of oesophageal cancer, and on the disability-adjusted life-years (DALYs) caused by the disease, can assist policy makers in allocating resources for prevention, treatment, and care of oesophageal cancer. We report the latest estimates of these statistics for 195 countries and territories between 1990 and 2017, by age, sex, and Socio-demographic Index (SDI), using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD). Methods We used data from vital registration systems, vital registration-samples, verbal autopsy records, and cancer registries, combined with relevant modelling, to estimate the mortality, incidence, and burden of oesophageal cancer from 1990 to 2017. Mortality-to-incidence ratios (MIRs) were estimated and fed into a Cause of Death Ensemble model (CODEm) including risk factors. MIRs were used for mortality and non-fatal modelling. Estimates of DALYs attributable to the main risk factors of oesophageal cancer available in GBD were also calculated. The proportion of oesophageal squamous cell carcinoma to all oesophageal cancers was extracted by use of publicly available data, and its variation was examined against SDI, the Healthcare Access and Quality (HAQ) Index, and available risk factors in GBD that are specific for oesophageal squamous cell carcinoma (eg, unimproved water source and indoor air pollution) and for oesophageal adenocarcinoma (gastro-oesophageal reflux disease). Findings There were 473 000 (95% uncertainty interval [95% UI] 459 000–485 000) new cases of oesophageal cancer and 436 000 (425 000–448 000) deaths due to oesophageal cancer in 2017. Age-standardised incidence was 5·9 (5·7–6·1) per 100 000 population and age-standardised mortality was 5·5 (5·3–5·6) per 100 000. Oesophageal cancer caused 9·78 million (9·53–10·03) DALYs, with an age-standardised rate of 120 (117–123) per 100 000 population. Between 1990 and 2017, age-standardised incidence decreased by 22·0% (18·6–25·2), mortality decreased by 29·0% (25·8–32·0), and DALYs decreased by 33·4% (30·4–36·1) globally. However, as a result of population growth and ageing, the total number of new cases increased by 52·3% (45·9–58·9), from 310 000 (300 000–322 000) to 473 000 (459 000–485 000); the number of deaths increased by 40·0% (34·1–46·3), from 311 000 (301 000–323 000) to 436 000 (425 000–448 000); and total DALYs increased by 27·4% (22·1–33·1), from 7·68 million (7·42–7·97) to 9·78 million (9·53–10·03). At the national level, China had the highest number of incident cases (235 000 [223 000–246 000]), deaths (213 000 [203 000–223 000]), and DALYs (4·46 million [4·25–4·69]) in 2017. The highest national-level age-standardised incidence rates in 2017 were observed in Malawi (23·0 [19·4–26·5] per 100 000 population) and Mongolia (18·5 [16·4–20·8] per 100 000). In 2017, age-standardised incidence was 2·7 times higher, mortality 2·9 times higher, and DALYs 3·0 times higher in males than in females. In 2017, a substantial proportion of oesophageal cancer DALYs were attributable to known risk factors: tobacco smoking (39·0% [35·5–42·2]), alcohol consumption (33·8% [27·3–39·9]), high BMI (19·5% [6·3–36·0]), a diet low in fruits (19·1% [4·2–34·6]), and use of chewing tobacco (7·5% [5·2–9·6]). Countries with a low SDI and HAQ Index and high levels of indoor air pollution had a higher proportion of oesophageal squamous cell carcinoma to all oesophageal cancer cases than did countries with a high SDI and HAQ Index and with low levels of indoor air pollution. Interpretation Despite reductions in age-standardised incidence and mortality rates, oesophageal cancer remains a major cause of cancer mortality and burden across the world. Oesophageal cancer is a highly fatal disease, requiring increased primary prevention efforts and, possibly, screening in some high-risk areas. Substantial variation exists in age-standardised incidence rates across regions and countries, for reasons that are unclear. Funding Bill & Melinda Gates Foundation