Conectar
To explore the relationship between sleep and cognitive frailty in older adults.
A systematic review and meta-analysis.
The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.
Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.
This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.
This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.
The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.
No patient or public contribution.
Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.
A cross-sectional study was conducted from December 2023 to March 2024 in China.
A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.
Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.
A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.
This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.
This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.
This study was reported in accordance with the STROBE guidelines.
No patient or public contribution was involved in this study.
This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.
A systematic review and meta-analysis following the PRISMA 2020 guidelines.
Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.
Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.
Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.
E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.
Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.
This study adhered to the PRISMA checklist.
No patient or public involvement.
The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)
Investigate the epidemiological characteristics of outpatients initially diagnosed with skin ulcers who were ultimately confirmed to have cutaneous malignant tumours, and provide a diagnostic and therapeutic basis for the occurrence of secondary diseases in chronic wounds. We conducted a retrospective study analysing clinical data from patients initially diagnosed with skin ulcers at our hospital between July 2021 and February 2025, and analysed the epidemiological characteristics of malignant transformation in these ulcer cases. Among 128 patients initially diagnosed with skin ulcers, 16 cases (12.5%) were confirmed with cutaneous malignancies. The malignant group had a significantly higher mean age (69.44 ± 11.30 years) compared to the non-malignant group (58.39 ± 17.88 years; t = 5.752, p = 0.01). The distribution of lesion sites differed significantly between the malignant and non-malignant groups (χ2 = 30.498, p < 0.01). In the malignant group, the head and neck (41.2%) and trunk & extremities (41.2%) were the predominant sites. The most common malignancy was squamous cell carcinoma (SCC). The trunk & extremities was the most frequent site (62.5%). The second was basal cell carcinoma, which mainly occurs in the head and neck (80.0%). The mean duration of ulceration was 4.5 years. The primary treatment modality was surgical excision (11 cases, 68.8%). Approximately one-seventh of skin ulcer cases were confirmed as cutaneous malignancies. This finding underscores the significance of skin ulcers as potential malignant lesions, highlighting the need for clinicians to maintain a high index of suspicion and promptly perform histopathological examinations to improve early detection rates of skin cancers.
by Lei Guo, Jun Ge, Li Cheng, Xinyi Zhang, Zhengzheng Wu, Meili Liu, Hanmei Jiang, Wei Gong, Yi Liu
BackgroundThe incidence of ulcerative colitis (UC) remains high, with an increasing prevalence among elderly patients. Cellular senescence has been widely recognized as a contributor to UC susceptibility; however, the underlying molecular mechanisms remain incompletely understood. This study aimed to identify senescence-associated biomarkers in UC to provide new insight for diagnosis and treatment.
MethodsBy integrating transcriptomic data from UC patients with established aging-related databases, we identified aging-associated differentially expressed genes (DEGs). Using weighted gene co-expression network analysis (WGCNA) and Cytoscape, we pinpointed the core genes involved. A diagnostic model for UC was then developed based on these core genes, and their expression patterns were characterized at single-cell resolution. The roles of these genes were ultimately validated through in vitro and animal experiments.
ResultsWe identified 24 aging-related DEGs in UC, which were primarily implicated in inflammatory responses and cytokine-receptor interactions. Further analyses pinpointed three core genes (CXCL1, MMP9, and STAT1) that were predominantly expressed in macrophages. A diagnostic model constructed using these genes exhibited robust predictive performance. Experimental validation confirmed that the expression levels of all three core genes were significantly upregulated in both a UC mouse model and in macrophages compared to controls. Additionally, pathway analyses revealed elevated levels of CXCL12 and VEGFA in the enriched pathways.
DiscussionOur findings underscore the pivotal roles of CXCL1, MMP9, and STAT1 in UC-associated cellular senescence. The analysis positions these molecules as promising macrophage-mediated diagnostic biomarkers and therapeutic targets. Collectively, this work provides novel insights into UC pathogenesis and lays a foundation for developing precision medicine strategies that target senescence pathways.
The incidence of psychological distress in patients with malignant tumors is high, which seriously affects the treatment compliance and quality of life of patients and even reduces the survival time. Non-pharmacological interventions are acceptable to patients because of their minor side effects. However, among the numerous interventions, which non-pharmacological intervention has demonstrated the most significant effect is still unclear.
This study aimed to compare the efficacy of different non-pharmacological interventions on psychological distress in patients with malignant tumors.
The databases, including Wanfang databases, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, SinoMed, PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO, were searched systematically for randomized controlled trials on non-pharmacological interventions for psychological distress in patients with malignant tumors that were published up to July 5, 2025. Revman 5.3 and Stata 18.0 were used for paired and network meta-analysis, respectively.
A total of 43 randomized controlled trials were included. The area under the cumulative sorting curve was ranked as Naikan Morita therapy (99.6%) > acceptance and commitment therapy (79.0%) > music therapy (78.3%) > logotherapy (77.8%) > behavioral activation (67.5%) > solution-focused nursing (66.1%) > dignity therapy (51.2%) > mindfulness-based stress reduction (50.6%) > mindfulness-based cognitive therapy (46.7%) > Mika app (39.8%) > psychological education (38.5%) > multi-dimensional collaborative nursing (29.0%) > life review therapy (26.0%) > exercise therapy (14.7%) > usual care (5.0%).
Non-pharmacological interventions had overall benefits in reducing the psychological distress of patients with malignant tumors, especially Naikan Morita therapy, acceptance and commitment therapy, music therapy and logotherapy. However, more high-quality randomized controlled trials are still needed to obtain more reliable conclusions.
Although cancer is a worldwide public health problem, it can be detected early and prevented through cancer screening. However, not all individuals are motivated to undergo cancer screening. Current studies have revealed that decision aids can impact decision-related outcomes among individuals at risk of cancer. However, their efficacy on decision knowledge and decision conflict remains unclear.
The purpose of this meta-analysis was to appraise the efficacy of decision aids on decision knowledge and conflict among people at risk of cancer.
Nine electronic databases were utilized to search the literature until October 31, 2024. The Cochrane Risk of Bias Tool 2.0 and the Grading of Recommendations Assessment, Development, and Evaluation approach were used to evaluate the certainty of evidence. The data were analyzed using Stata 16.0.
Thirteen relevant studies with 2971 participants published between 2002 and 2023. The pooled results showed that decision aids significantly improved decision knowledge (SMD = 0.45, 95% CI [0.19–0.72], p = 0.00) and decreased decision conflict (SMD = −0.47, 95% CI [−0.73 to −0.21], p = 0.00). Subgroup analyses revealed that the framework, format, population, and duration of decision aids can influence their effects on decision knowledge and decision conflict among people at risk of cancer.
This meta-analysis illuminates that decision aids are effective for improving decision knowledge and diminishing decision conflict among people at risk of cancer. The framework, format, population, and duration should be considered when developing decision aids. Our findings may suggest future directions for assisting people at risk of cancer in making informed decisions about cancer screening. Additional trustworthy research is required to verify these findings.
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