Effect of Otago exercise on fear of falling in older adults: a systematic review and meta-analysis.

BACKGROUND: Approximately 40-70% of older adults who have experienced falls develop fear of falling (FOF), with the incidence rate in nursing home residents reaching as high as 79.4%. An increasing number of studies have focused on the effect of the Otago Exercise Programme (OEP) on reducing FOF among older adults, yet comprehensive analysis is lacking due to regional and demographic variations. Therefore, this study integrates the relevant literature to provide evidence supporting interventions aimed at alleviating FOF among older adults. OBJECTIVE: To evaluate the impact of OEP on FOF in older adults through meta-analysis. METHODS: We searched ten databases using computer systems, covering all records up to May 1, 2024. Two researchers independently conducted the literature screening, bias risk assessment, and data extraction. We performed data analysis using RevMan 5.3 and Stata 15.0 software, assessed result stability through sensitivity analysis, and examined publication bias with funnel plots and Egger's test. RESULTS: Sixteen RCTs were included. Meta-analysis revealed that the OEP significantly reduced FOF among older adults [SMD = 0.96, 95%CI (0.68, 1.23), P < 0.00001]. Subgroup analysis revealed that interventions lasting more than 16 weeks [SMD = 1.12, 95%CI (0.75, 1.49), P < 0.00001], with a frequency of more than twice a week [SMD = 0.99, 95%CI (0.64, 1.35), P < 0.00001], and for older adults in community and nursing institutions [SMD = 1.03, 95%CI (0.50, 1.57), P = 0.0002] were more effective. A comparison of the 16-week and 24-week interventions revealed that the latter had better outcomes [SMD = 0.87, 95%CI (0.66, 1.08), P = 0.0004]. CONCLUSION: Current evidence indicates that OEP effectively reduces FOF among older adults. It is recommended that interventions last for more than 24 weeks, occur more than twice a week, and suitable for application among older adults in community settings or elder care institutions.

Recent Advances and Perspectives in Relation to the Metabolomics-Based Study of Diabetic Retinopathy.

Diabetic retinopathy (DR), a prevalent microvascular complication of diabetes, is a major cause of acquired blindness in adults. Currently, a clinical diagnosis of DR primarily relies on fundus fluorescein angiography, with a limited availability of effective biomarkers. Metabolomics, a discipline dedicated to scrutinizing the response of various metabolites within living organisms, has shown noteworthy advancements in uncovering metabolic disorders and identifying key metabolites associated with DR in recent years. Consequently, this review aims to present the latest advancements in metabolomics techniques and comprehensively discuss the principal metabolic outcomes derived from analyzing blood, vitreous humor, aqueous humor, urine, and fecal samples.

Epileptic prediction using spatiotemporal information combined with optimal features strategy on EEG.

Objective: Epilepsy is the second most common brain neurological disease after stroke, which has the characteristics of sudden and recurrence. Seizure prediction is seriously important for improving the quality of patients' lives. Methods: From the perspective of multiple dimensions including time-frequency, entropy and brain network, this paper proposed a novel approach by constructing the optimal spatiotemporal feature set to predict seizures. Based on strong independence and large information capabilities, the two-dimensional feature screening algorithm is performed to eliminate unnecessary redundant features. In order to verify the effectiveness of the optimal feature set, support vector machine (SVM) was used to classify the preictal and interictal states on both the Kaggle intracranial EEG and CHB-MIT scalp EEG dataset. Results: This model achieved an average accuracy of 98.01%, AUC of 0.96, F-Score of 98.3% and FPR of 0.0383/h on the Kaggle dataset; On the CHB-MIT dataset, the average accuracy, AUC, F-score and FPR were 95.93%, 0.92, 94.97% and 0.0473/h, respectively. Further ablation experiments have confirmed that the temporal and spatial features fusion has better performance than the individual temporal or spatial features. Conclusion: Compared to the state-of-the-art methods, our approach outperforms most of these existing techniques. The results show that our approach can effectively extract the spatiotemporal information of epileptic EEG signals to predict epileptic seizures with high performance.

Epileptic seizure prediction in intracranial EEG using critical nucleus based on phase transition.

BACKGROUND AND OBJECTIVE: Epilepsy is the second most prevalent neurological disorder of brain activity, affecting about seventy million people, or nearly 1% of the world population. Epileptic seizures prediction is extremely important for improving the epileptic patients' life. This paper proposed a novel method to predict seizures by detecting the critical transition of brain activities with intracranial EEG (iEEG) signals. METHODS: This article used three key measures of fluctuation, correlation and percolation to quantify pre-ictal states of epilepsy. Based on these measures, a ritical nucleus of iEEG signals was constructed and a composite index was introduced to detect the likelihood of impending seizures. In addition, we analyzed the dynamical mechanism of seizures at the tipping point from the perspective of spatial diffusion and temporal fluctuation. RESULTS: The empirical results supported that the seizures are self-initiated via a critical transition in pre-ictal state and showed that the proposed model can achieve a good prediction performance. The average accuracy, sensitivity, specificity and false-positive rate (FPR) attain 87.96%, 82.93%, 89.33% and 0.11/h respectively. The results also suggest that the temporal and spatial factors have strong synergistic effect on triggering seizures. For those seizures consistent with critical transition, the predictive performance was greatly improved with sensitivity up to 96.88%. CONCLUSIONS: This article proposed a critical nucleus model combined with spatial and temporal features of iEEG signals capable of seizure prediction. The proposed model brings insight from phase transition into epileptic iEEG signals analysis and quantifies the transition of the state to predict epileptic seizures with high accuracy.

The efficacy and safety of gemcitabine-based combination therapy vs. gemcitabine alone for the treatment of advanced pancreatic cancer: a systematic review and meta-analysis.

Background: Gemcitabine (GEM) is used as a standard first-line drug to effectively alleviate symptoms and prolong survival time for advanced pancreatic cancer. Most randomized controlled trials (RCTs) show that GEM-based combination therapy is better than GEM alone, while some RCTs have the opposite conclusion. This study aimed to investigate whether GEM-based combination therapy would be superior to GEM alone by a systematic review and meta-analysis. Methods: According to the PICOS principles, RCTs (S) focused on comparing GEM-based combination therapy (I) vs. GEM alone (C) for advanced pancreatic cancer (P) were collected from eight electronic databases, outcome variables mainly include survival status and adverse events (AEs) (O). Review Manager 5.4 was used to evaluate the pooled effects of the results among selected articles. Pooled estimate of hazard ratio (HR) and odds ratio (OR) with 95% confidence interval (CI) were used as measures of effect sizes. Quality assessment for individual study was performed using the Cochrane tool for risk of bias. Results: A total of 17 studies including 5,197 patients were selected in this analysis. The pooled results revealed that GEM-based combination therapy significantly improved the overall survival (OS; HR =0.84; 95% CI: 0.79 to 0.90; P<0.00001), progression-free survival (PFS; HR =0.78; 95% CI: 0.72 to 0.84; P<0.00001), overall response rate (ORR; OR =1.92; 95% CI: 1.61 to 2.30; P<0.00001), 1-year survival rate (OR =1.44; 95% CI: 1.02 to 2.03; P=0.04), respectively. Subgroup analysis showed that the efficacy of GEM plus capecitabine (CAP) and GEM plus S-1 was better than that of GEM alone, while GEM plus cisplatin (CIS) did not achieve an improved effect. GEM-based combination therapy can significantly increase the incidence of AEs, such as leukopenia (P<0.001), neutropenia (P<0.001), anemia (P<0.05), nausea (P<0.001), diarrhea (P<0.05), and stomatitis (P<0.001). No publication bias existed in our meta-analysis (P>0.10). Discussion: Our study supported that GEM-based combination therapy was more beneficial to improve patient's survival than GEM alone, while there was no additional benefits in GEM plus CIS. We also found that GEM-based combination therapy increased the incidence of AEs. Clinicians need to choose the appropriate combination therapy according to the specific situation.

Technological Requirements and Challenges in Wireless Body Area Networks for Health Monitoring: A Comprehensive Survey.

With the rapid growth in healthcare demand, an emergent, novel technology called wireless body area networks (WBANs) have become promising and have been widely used in the field of human health monitoring. A WBAN can collect human physical parameters through the medical sensors in or around the patient's body to realize real-time continuous remote monitoring. Compared to other wireless transmission technologies, a WBAN has more stringent technical requirements and challenges in terms of power efficiency, security and privacy, quality of service and other specifications. In this paper, we review the recent WBAN medical applications, existing requirements and challenges and their solutions. We conducted a comprehensive investigation of WBANs, from the sensor technology for the collection to the wireless transmission technology for the transmission process, such as frequency bands, channel models, medium access control (MAC) and networking protocols. Then we reviewed its unique safety and energy consumption issues. In particular, an application-specific integrated circuit (ASIC)-based WBAN scheme is presented to improve its security and privacy and achieve ultra-low energy consumption.

Effect of remained stem height on yield, quality of Inula helenium I. and on soil water content.

To explore the reason causing low yield, poor quality of Inula helenium I., this paper investigated the influence of different remained stem heights on the yield, quality and water consumption of Inula helenium I. in Gannan plateau area using field single factor randomized block method. Research results showed that Inula helenium I. which was cut before blooming period in the last ten-day of July with remained stem height of 25 cm had the lowest water consumption, the best underground root traits (including main root length, root diameter, and root dry weight per plant), and the highest yield which was higher that control group by 18.73% (P < .01) Moreover, Inula helenium I. with remained stem height of 25 cm had the lowest ash content while the highest alantolactone content, therefore its quality was the best. The water use efficiency (WUE) of Inula helenium I. with remained stem height of 35 cm at September was the highest (1.12 kg⋅h⋅m-2⋅mm-1). However, in terms of biological yield WUE and economic yield WUE, Inula helenium I. with remained stem height of 15 cm was the highest. Therefore, it can be concluded that remained stem height from 15 to 25 cm is an ideal solution, which can not only save water, but also improve yield and quality of Inula helenium I.

Effects of different cultivation material formulas on the growth and quality of Morchella spp.

To study the effects of different cultivation material formulas on the growth and quality of Morchella spp. With the cultivated species strains extracted from wild Morchella spp. in Diebu County, Gannan Prefecture as experimental materials, an experiment was designed and the data then obtained was anyalyzed using the single factor variable method. By measuring the pileus length, pileus perimeter, stipe length, stipe perimeter and yield as well as the ash content, total sugar content, crude protein content and crude fiber content of wild Morchella spp., the effects of four different cultivation material formulas on the growth and quality of Morchella spp. were studied. The result showed that the Morchella spp. cultivated using Formula 1, i.e., the formula to which Morchella spp. footing soil was added, grew best, and had the highest yield and the best quality; and the qualities of Morchella spps cultivated using other formulas decreased in a row. Formula 1 to which Morchella spp. footing soil was added had the optimal effect on promoting the growth and quality of Morchella spp.

Distribution and Determinants of Unmet Need for Supportive Care Among Women with Breast Cancer in China.

BACKGROUND The aim of this study was to determine the need for supportive care among women suffering from breast cancer in China and to identify its potential determinants to inform the development of effective and efficient healthcare services across different settings. MATERIAL AND METHODS In a tertiary-care hospital in Weifang, China, between July 2015 and January 2016, all women attending the Breast Cancer Clinic for regular physical examinations after treatment for breast cancer were consecutively recruited. The 34-item Supportive Care Needs Survey tool (Chinese version) (SCNS-SF34-C) was used to assess the unmet needs among participants. RESULTS Among 264 recruited patients, based on at least single-item endorsement, 60.2% had moderate to high level of need for supportive care, while only 13.3% expressed no need. Lack of information regarding health systems was the most common domain with moderate to high unmet needs, more so among rural patients (8 vs. 5 out of 10). In each information-related domain, huge unmet need was observed among all patients irrespective of urban or rural residence. Both overall and individual information-related domain-specific unmet needs were significantly higher among rural patients as opposed to their urban counterparts. Multiple regression analyses revealed a significant rural-urban variation of unmet needs. Moreover, education and post-diagnosis time duration were negatively associated with unmet needs while stage of cancer was positively associated with these unmet needs. CONCLUSIONS There is a huge burden of unmet needs for information on the healthcare system among breast cancer survivors in China. Rural residence, less education, advanced stage of cancer, and shorter duration since diagnosis were the identified determinants requiring targeted intervention.

Comparison of cold resistance physiological and biochemical features of four Herba Rhodiola seedlings under low temperature.

To discuss the cold resistance performance of different Herba Rhodiolae and successfully transplant Herba Rhodiolae to the Gansu plateau area for nursing, domestication and planting, this paper systematically studies six physiological and biochemical features of Rhodiola kirilowii, Rhodiola algida, Rhodiola crenulata and Herba Rhodiolae that are closely associated with cold resistance features and concludes with the cold resistance capability of Rhodiola kirilowii. In the selected six main indexes of the Herba Rhodiolae, the POD, SOD and CAT activity and MDA and Pro content in the leaf are the main physiological and biochemical indexes to indicate the cold resistance performance of four Herba Rhodiolae seedlings and can be regarded as the preliminary indexes to assess the winter performance of Herba Rhodiolae. The research work will provide the theoretical basis for the wild variants of Herba Rhodiolae and GAPJ base construction.

[Correlation of single small vessels infarction in carotid territory with large arterial lesion].

OBJECTIVE: Whether small vessel infarction (SVI) correlates with large arterial lesion is under debate. The aim of the present study was to analyze the relationship between the single SVI in carotid territory by diffusion weight imaging (DWI) and arterial lesion by contrast enhanced magnetic resonance angiography (CEMRA). METHODS: Sixty patients with acute cerebral infarction underwent DWI within 7 days and CEMRA within 2 weeks after onset. They were divided into 2 groups of patients with and without single SVI. The clinical and magnetic resonance image features were compared between two groups. RESULTS: Lesions of ipsilateral extracranial carotid artery were detected in 10 patients of SVI groups (36%) versus 8 patients (25%) of non-SVI group (P = 0.54). Incidence of intracranial vascular lesion in single SVI group (32%) was slightly lower than that of non-SVI group (47%) (P = 0.52). And 46 patients (77%) were assessed on plaque of carotid artery. Incidence of ipsilateral carotid artery plaque (44%) was higher in single SVI group than that of non-SVI group (35%) (P = 0.76). And the incidence of vulnerable plaque in single SVI group (26%) was similar to that of non-SVI group (22%) (P = 0.73). CONCLUSION: SVI has not a single underlying mechanism of stroke. However, further studies with a large number of patients are warranted.