Background As the global population ages, the issue of frailty in older people is gaining international attention. As one of the major subtypes of frailty, cognitive frailty is a heterogeneous clinical manifestation characterised by the co-existence of physical decline and cognitive impairment. The occurrence of cognitive frailty increases the risk of adverse health outcomes in older people, affecting their daily functioning and quality of life. However, cognitive frailty is a reversible state, and many interventions have been explored, with exercise interventions playing an important role in the non-pharmacological management of cognitive frailty. This study describes and summarises current exercise interventions for older people with cognitive frailty (including parameters such as mode, frequency and duration of exercise) and identifies the limitations of existing studies to inform future exercise interventions for older people with cognitive frailty. Methods Using a scoping review approach, Chinese and English literature published in PubMed, Web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Database, China Biomedical Literature Database (SinoMed) and Vipshop from April 2013, when the definition of cognitive frailty first appeared, to August 2021 was searched to select studies related to exercise interventions for this group, extract information from the included literature, and summarise and report the findings. Results Nine RCT trial studies and one quasi-experiment study were included, for a total of 10 articles. The exercise modalities involved walking, brisk walking, Otago exercise, resistance exercise, balance training, flexibility training and Baduanjin, etc.; the intensity of exercise was based on individualised guidance and graded exercise intensity; the frequency of exercise was mostly 3–4 times/week; the duration of exercise was mostly 30–60 min/time; compared to the control group, the included studies showed statistically significant improvements in cognitive function, frailty status, and depression with the exercise intervention. Conclusion There is a paucity of evidence on exercise interventions for older people with cognitive frailty. The evidence provided in this study suggests that exercise interventions may be beneficial for older people with cognitive frailty. However, the existing studies suffer from small sample sizes, short intervention periods, inadequate monitoring of the entire exercise process, and non-uniformity in the assessment of exercise effects. More randomized controlled trials should be conducted in the future to explore the most effective, low-cost and simple interventions to meet the needs of the older people with cognitive frailty.
The worldwide overall 5‐year survival rate of esophageal squamous cell carcinoma (ESCC) patients is less than 20%, and novel therapeutic strategies for these patients are urgently needed. Harmine is a natural β‐carboline alkaloid, which received great interest in cancer research because of its biological and anti‐tumor activities. The aim of this study is to examine the effects of harmine on ESCC and its mechanism. We investigated the effects of harmine on proliferation, cell cycle, apoptosis, and tumor growth in vivo. RNA sequencing (RNA‐seq), real‐time PCR, and western blotting were used to detect the mechanism. Harmine inhibited ESCC cell growth in vitro and tumor growth in vivo. Differentially expressed genes in harmine‐treated ESCC cells were mainly involved in protein processing in the endoplasmic reticulum (ER). Real‐time PCR and western blotting confirmed harmine‐induced cellular ER stress. CRISPR‐Cas9 knockout of C/EBP homologous protein (CHOP) abolished harmine‐induced expression of death receptor 5 and apoptosis. Harmine also induced the expression of CHOP‐mediated sestrin‐2, which in turn contributes to autophagosome formation via suppressing the AMP‐activated protein kinase‐protein kinase B‐mammalian target of rapamycin signaling pathway. In conclusion, our results demonstrate that harmine inhibits the growth of ESCC through its regulation of ER stress, suggesting that it is a promising candidate for ESCC treatment.
Background The global population is ageing in a serious way and the number of disabled elderly people is increasing. Disability is a combination of physical and functional impairments, activity limitations, and social participation restrictions that significantly affect the quality of life of older adults. This study used the Roy adaptation model to examine the adaptive strategies of rural disabled elderly. Methods An interview outline was prepared based on the Roy Adaptation Model, in-depth interviews were conducted with eligible rural elderly with disabilities using purposive sampling. Interview data were analyzed using the colaizzi method to obtain relevant themes and sub-themes of the adaptation experience. Results Fifteen eligible disabled elderly participated in the interview, with an average age of 73.7 years old, showing different adaptation experiences in different aspects, a total of 5 themes and 18 sub-themes were extracted: (a)physiological function adaptation: learning to monitor physiological indicators, active medical compliance behavior, active rehabilitation exercise, adjusting lifestyle and coping with failure, (b) self-concept adaptation: adjustment of gratitude mentality, self-consolation, transferring the attention, seeking emotional comfort, and negative emotional response, (c) role function adaptation: positive self-care role, negative family role and escape of social role, (d) interdependence adaptation: actively seeking support and complex social coping, and (e) adaptation influencing factors: personal factors, caregiver factors and the policy factors. Conclusions The disabled elderly show different adaptation strategies in four ways, and are affected by personal factors, caregiver factors and policy factors. A multi-faceted support system for the disabled elderly is recommended, and the caregivers should be trained in all-round care knowledge and skills.
Increasing the level of reactive oxygen species (ROS) in cancer cells has been suggested as a viable approach to cancer therapy. Our previous study has demonstrated that mitochondria-targeted flavone-naphthalimide-polyamine conjugate 6c elevates the level of ROS in cancer cells. However, the detailed role of ROS in 6c-treated cancer cells is not clearly stated. The biological effects and in-depth mechanisms of 6c in cancer cells need to be further investigated. In this study, we confirmed that mitochondria are the main source of 6c-induced ROS, as demonstrated by an increase in 2′,7′-dichlorodihydrofluorescein diacetate (DCFH-DA) and MitoSox fluorescence. Compound 6c-induced mitochondrial ROS caused mitochondrial dysfunction and lysosomal destabilization confirmed by absolute quantitation (iTRAQ)-based comparative proteomics. Compound 6c-induced metabolic pathway dysfunction and lysosomal destabilization was attenuated by N-acetyl-L-cysteine (NAC). iTRAQ-based comparative proteomics showed that ROS regulated the expression of 6c-mediated proteins, and treatment with 6c promoted the formation of autophagosomes depending on ROS. Compound 6c-induced DNA damage was characterized by comet assay, p53 phosphorylation, and γH2A.X, which was diminished by pretreatment with NAC. Compound 6c-induced cell death was partially reversed by 3-methyladenine (3-MA), bafilomycin (BAF) A1, and NAC, respectively. Taken together, the data obtained in our study highlighted the involvement of mitochondrial ROS in 6c-induced autophagic cell death, mitochondrial and lysosomal dysfunction, and DNA damage.
Background: Integrated care is an important initiative to respond positively to the ageing of society and information and communication technology(ICT) plays an important role in facilitating the integration of functional and normative health and social care. The scoping review aims to synthesize evidence on the experience and practice of ICT-based implementation of integrated care for older adults. Methods: This study followed the research framework developed by Arksey and O’malley for the scoping review and systematically searched for relevant studies published between 1 January 2000 and 30 March 2022 from nine electronic databases, three specialist journals, three key institutional websites, 11 integrated care project websites, google scholar and references of the studies to be included. Two reviewers independently screened and extracted data and used thematic analysis to sort out and summarize the core elements, hindrances and facilitators of ICT-based integrated care. Results: A total of 77 studies were included in this study, including 36 ICT-based practice models of integrated care with seven core elements of implementation including single entry point, comprehensive geriatric assessment, personalized care planning, multidisciplinary case conferences, coordinated care, case management and patient empowerment, which generally had a positive effect on improving quality of life, caregiver burden and primary care resource utilization for older adults, but effectiveness evaluations remained Heterogeneity exists. The barriers and facilitators to ICT-based implementation of integrated care were grouped into four themes: demand-side factors, provider factors, technology factors and system factors. Conclusion: The implementation of ICT-based integrated care for the elderly is expected to improve the health status of both the supply and demand of services, but there is still a need to strengthen the supply of human resources, team training and collaboration, ICT systems and financial support in order to promote the wider use of ICT in integrated care.
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