Background: The World Health Organization published the 2019 Integrated Care for Older People (ICOPE) framework to guide, assess, and promote the intrinsic capacity (IC) of older adults, referring to their physical and mental health. This study aims to investigate the relationship between IC and frailty among older adults. Methods: This cross-sectional study was conducted in a medical center in Taiwan in 2021. Two hundred ten patients over 65 admitted to the geriatric ward were invited to participate. The questionnaire included an IC measure, Fried Frailty Scale, and demographic items. The IC measure was ascertained using the six domains of ICOPE (cognition, mobility, nutrition, visual, hearing, and depressive symptoms). The Fried Frailty Scale was used to categorize participants as robust (Fried Frailty Scale=0), prefrail (Fried Frailty Scale=1-2), or frail (Fried Frailty Scale ≥3). Multinomial logistic regression was used to analyze the association between individual ICOPE domains and frailty stages, while adjusting for confounders. Results: Among the participants, 39.0% were prefrail, and 28.6% were frail. Limited mobility and depressive symptoms were significantly associated with prefrail (adjusted odds ratio [aOR]=4.44, 95% confidence interval [CI] 1.82–10.82; aOR=8.41, 95% CI 1.75–40.37) and frail (aOR=11.57, 95% CI 3.63–36.93; aOR=13.77, 95% CI 2.62–72.49) individuals, respectively. Malnutrition (aOR=4.01, 95% CI 1.18–13.62) and hearing loss (aOR=4.37, 95% CI 1.09–19.66) were significantly associated with frail older adults. Conclusion Limited mobility and depressive symptoms occurring at the prefrail stage could be used as assessment items for early detection of prefrail.

Introduction: The 2021 IDF-DAR risk calculator had been previously evaluated in multiple studies and subsequently widely accepted and applied in clinical practice as a practical standardized tool for patient risk stratification. Recently updated, the 2026 IDF-DAR Risk calculator enables a more individualized, evidence-related evaluation of patientrelated and disease-related risk factors, incorporating modern diabetes technologies, including continuous glucose monitoring (CGM), automated insulin delivery (AID) systems, and advanced insulin formulations to enhance risk stratification. This tool allows medical professionals to tailor Ramadan practices based on overall factors toward promoting safe fasting. Methodology: This prospective multicentre observational study recruited adults with Type 1 and Type 2 diabetes attending public hospitals nationwide. People with diabetes (PwD) intending to perform Ramadan fasting were invited to participate and assessed using the 2026 IDF-DAR Risk Calculator in the 6-week pre-Ramadan period between 30th January and 19th March 2026. Results: A total of 458 PwD were evaluated and stratified into low (15.7%), moderate (41%), and high risk (43.3%) categories. Most participants had Type 2 diabetes (83.6%), with 60.3% having a disease duration exceeding 10 years and 43% exhibiting poor glycemic control (hemoglobin A1c >9%). Insulin therapy was used by 76.4% of participants, including two individuals with Type 1 diabetes using AID systems. Most participants reported no recent hypoglycemia (76.4%), 81.0% performed glucose monitoring, and 3.3% used CGM. Severe comorbidities were uncommon, with 1.1% having unstable macrovascular disease and 4.4% advanced chronic kidney disease (estimated glomerular filtration rate <30). Notably, 72.2% received structured Ramadan education. Conclusion Majority of PwD attending tertiary diabetes clinics were in the moderate- to high-risk category and intended to fast despite medical advice against fasting in some cases. Although most participants were on insulin therapy, hypoglycemia was low in the pre-Ramadan period. Integration of modern technologies, advanced insulin therapies, and structured education may support safer fasting practices.
Risk Assessment ; Diabetes Mellitus ; Hospitals ; Fasting

BACKGROUND:Metal-organic framework is an emerging porous material composed of metal nodes and organic ligands.Metal-organic frameworks can be both intrinsic photodynamic or photothermal and modified by photothermal agents or photosensitizers.Upon light irradiation,phototherapy effects are exerted through production of reactive oxygen species or rise in temperature,which is widely applied to antitumor and antibacterial treatments.When metal-organic frameworks possess both of above phototherapeutic effects,they can exert a synergistic therapeutic effect to compensate for the shortcomings of using a single phototherapy method.OBJECTIVE:To summarize recent proposed photodynamic-thermal synergistic strategies according to different structures of metal-organic frameworks,to provide new insights into the structural design,functionalization,and clinical scenarios of combined therapy metal-organic frameworks.METHODS:Using"metal-organic frameworks,photodynamic therapy,photothermal therapy"as Chinese search terms and"metal-organic frameworks,photodynamic therapy,photothermal therapy,phototherapy"as English search terms,articles were searched on PubMed,Web of Science,ScienceDirect,CNKI,and WanFang databases.Finally,76 articles were included for review.RESULTS AND CONCLUSION:(1)The combination of photothermal and photodynamic therapy has been shown to exert a synergistic effect.(2)Current strategies for combined photothermal and photodynamic therapy predominantly involve the modifying of metal-organic frameworks to impart photothermal and photodynamic properties,encapsulating phototherapeutic agents within metal-organic frameworks,forming core-shell structures with phototherapeutic agents and metal-organic frameworks,in-situ reduction of phototherapeutic agents within metal-organic frameworks,adhering phototherapeutic agents to metal-organic framework surfaces,and unique modification methods like pyrolyzing metal-organic frameworks to form metal-organic frameworks-derived carbon materials.(3)To construct metal-organic framework structures for specific phototherapy,it is essential to comprehensively consider the type,size,and binding of the phototherapeutic agents and metal-organic frameworks,and select different synthesis strategies accordingly.Encapsulation is a straightforward synthesis approach but is only suitable for small-sized phototherapeutic agents.Core-shell structures are stable,but their synthesis process is relatively complex.In situ reduction does not impose special restrictions on the size of phototherapeutic agents,but it is challenging to precisely control the growth of the phototherapeutic agents within the metal-organic frameworks.Surface attachment offers a simple synthesis step,but it cannot prevent the early aggregation and quenching of phototherapeutic agents.Surface attachment requires stringent conditions and can only be implemented with specific metal-organic frameworks.(4)The existing photothermal and photodynamic combined therapy approaches have been primarily applied in antimicrobial and antitumor treatments,demonstrating remarkable efficacy.The specific applications are related to the properties of the phototherapeutic agents and metal-organic frameworks.A minority of applications extend to rheumatoid arthritis and anticoagulation thrombolysis treatments,indicating a broad potential application scope.(5)The clinical translation of photothermal and photosensitizing agents is currently in its nascent stage,facing key challenges that include the evaluation of biocompatibility and biosafety,optimization of laser irradiation parameters,and the development of efficient methods for large-scale synthesis.

This study was aimed at understanding the prevalence and drug resistance status of Salmonella of waterfowl ori-gin in the Guangdong region in the past decade,to guide prevention and control efforts.The drug-sensitive paper slide method was used to conduct drug susceptibility testing on 314 waterfowl-originating Salmonella strains isolated from 238 waterfowl farms in the Guangdong region from 2013 to 2023.The isolated Salmonella strains were most resistant to penicillin,amoxicil-lin,cefradine,and cefazolin in the β-lactam group;sulphadoxine dimethylpyrimidine in the sulphonamide group;and tetracy-cline in the tetracycline group.The resistance rates ranged from 73.57％to 89.49％.The highest sensitivity was observed to amikacin,gentamicin,and kanamycin in the aminoglycoside group,and norfloxacin in the quinolone group,with susceptibility rates all exceeding 50％.The 280 strains of Salmonella showed multi-drug resistance to six classes of antimicrobial drugs and high resistance(as much as 60.83％)to five drug classes.Correlation analysis revealed the highest correlations for florfenicol with gentamicin,and for amoxicillin with penicillin(r=0.650 for both),followed by gentamicin with kanamycin(r=0.620).Salmonella resistance in waterfowl in Guangdong Province was generally severe and showed a complex pattern of drug resist-ance.Detection of waterfowl pathogens should be strengthened to prevent the spread of drug-resistant bacteria and support ra-tional use of antibiotics.This work provides a reference for Salmonella prevention and control in waterfowl farms.

This study was aimed at understanding the prevalence and drug resistance status of Salmonella of waterfowl ori-gin in the Guangdong region in the past decade,to guide prevention and control efforts.The drug-sensitive paper slide method was used to conduct drug susceptibility testing on 314 waterfowl-originating Salmonella strains isolated from 238 waterfowl farms in the Guangdong region from 2013 to 2023.The isolated Salmonella strains were most resistant to penicillin,amoxicil-lin,cefradine,and cefazolin in the β-lactam group;sulphadoxine dimethylpyrimidine in the sulphonamide group;and tetracy-cline in the tetracycline group.The resistance rates ranged from 73.57％to 89.49％.The highest sensitivity was observed to amikacin,gentamicin,and kanamycin in the aminoglycoside group,and norfloxacin in the quinolone group,with susceptibility rates all exceeding 50％.The 280 strains of Salmonella showed multi-drug resistance to six classes of antimicrobial drugs and high resistance(as much as 60.83％)to five drug classes.Correlation analysis revealed the highest correlations for florfenicol with gentamicin,and for amoxicillin with penicillin(r=0.650 for both),followed by gentamicin with kanamycin(r=0.620).Salmonella resistance in waterfowl in Guangdong Province was generally severe and showed a complex pattern of drug resist-ance.Detection of waterfowl pathogens should be strengthened to prevent the spread of drug-resistant bacteria and support ra-tional use of antibiotics.This work provides a reference for Salmonella prevention and control in waterfowl farms.

BACKGROUND:Metal-organic framework is an emerging porous material composed of metal nodes and organic ligands.Metal-organic frameworks can be both intrinsic photodynamic or photothermal and modified by photothermal agents or photosensitizers.Upon light irradiation,phototherapy effects are exerted through production of reactive oxygen species or rise in temperature,which is widely applied to antitumor and antibacterial treatments.When metal-organic frameworks possess both of above phototherapeutic effects,they can exert a synergistic therapeutic effect to compensate for the shortcomings of using a single phototherapy method.OBJECTIVE:To summarize recent proposed photodynamic-thermal synergistic strategies according to different structures of metal-organic frameworks,to provide new insights into the structural design,functionalization,and clinical scenarios of combined therapy metal-organic frameworks.METHODS:Using"metal-organic frameworks,photodynamic therapy,photothermal therapy"as Chinese search terms and"metal-organic frameworks,photodynamic therapy,photothermal therapy,phototherapy"as English search terms,articles were searched on PubMed,Web of Science,ScienceDirect,CNKI,and WanFang databases.Finally,76 articles were included for review.RESULTS AND CONCLUSION:(1)The combination of photothermal and photodynamic therapy has been shown to exert a synergistic effect.(2)Current strategies for combined photothermal and photodynamic therapy predominantly involve the modifying of metal-organic frameworks to impart photothermal and photodynamic properties,encapsulating phototherapeutic agents within metal-organic frameworks,forming core-shell structures with phototherapeutic agents and metal-organic frameworks,in-situ reduction of phototherapeutic agents within metal-organic frameworks,adhering phototherapeutic agents to metal-organic framework surfaces,and unique modification methods like pyrolyzing metal-organic frameworks to form metal-organic frameworks-derived carbon materials.(3)To construct metal-organic framework structures for specific phototherapy,it is essential to comprehensively consider the type,size,and binding of the phototherapeutic agents and metal-organic frameworks,and select different synthesis strategies accordingly.Encapsulation is a straightforward synthesis approach but is only suitable for small-sized phototherapeutic agents.Core-shell structures are stable,but their synthesis process is relatively complex.In situ reduction does not impose special restrictions on the size of phototherapeutic agents,but it is challenging to precisely control the growth of the phototherapeutic agents within the metal-organic frameworks.Surface attachment offers a simple synthesis step,but it cannot prevent the early aggregation and quenching of phototherapeutic agents.Surface attachment requires stringent conditions and can only be implemented with specific metal-organic frameworks.(4)The existing photothermal and photodynamic combined therapy approaches have been primarily applied in antimicrobial and antitumor treatments,demonstrating remarkable efficacy.The specific applications are related to the properties of the phototherapeutic agents and metal-organic frameworks.A minority of applications extend to rheumatoid arthritis and anticoagulation thrombolysis treatments,indicating a broad potential application scope.(5)The clinical translation of photothermal and photosensitizing agents is currently in its nascent stage,facing key challenges that include the evaluation of biocompatibility and biosafety,optimization of laser irradiation parameters,and the development of efficient methods for large-scale synthesis.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.