Objective To systematically evaluate the factors that promote and hinder exercise in frail older adults,and to provide references for the formulation of exercise intervention programs.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang,VIP database,and China Biomedical Literature Database for qualitative studies on exercise facilitators and hindrances in frail older adults,and the search time period was from the establishment of the databases to September 1,2024.The quality of the literature was evaluated using the Joanna Brigg Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated by integrating methods.Results A total of 18 studies were included,and 72 research results were extracted,and 10 categories were summarized.The final synthesis included 2 integrated results:the facilitators included personal exercise motivation,physical and psychological benefits,positive interpersonal interactions,multiple social support systems and person-centred exercise programme;the impediments included underlying diseases and somatic functional limitations,negative psychological status,low health literacy,family role conflicts and limits of the environment.Conclusion Exercise for frail older adults is affected by a variety of factors.Healthcare professionals should improve the positive perception of exercise for frail older people and help them overcome psychological barriers;establish an all-round support system to enhance the sense of social contact of the frail elderly;formulate a personalised exercise programme with a human-centred approach to enhance the motivation of the frail elderly.

Objective:To evaluate and integrate the evidence related to the prevention of unplanned readmission in elderly patients with ischemic stroke.Methods:A computerized search was conducted on various guideline websites and databases for clinical decisions, best practices, guidelines, evidence summaries, systematic reviews, and expert consensuses regarding the prevention of unplanned readmission in elderly patients with ischemic stroke. The search period was from the establishment of the databases to August 31, 2024. The literature quality evaluation criteria of the Joanna Briggs Institute Evidence-Based Health Care Centre and so on were used to evaluate the quality of different types of studies.Results:A total of 25 articles were included, consisting of one clinical decision, nine guidelines, six evidence summaries, eight systematic reviews, and one expert consensus. Evidence was integrated from two themes: discharge planning services (including five dimensions: principles, preliminary assessment, comprehensive assessment, plan formulation and implementation, tracking and evaluation) and early functional rehabilitation (including four dimensions: rehabilitation time, rehabilitation plan, rehabilitation intensity, and functional rehabilitation) , forming 39 pieces of best evidence.Conclusions:This study provides an evidence-based basis for the clinical nursing practice of preventing unplanned readmission in elderly patients with ischemic stroke. Evidence users need to select the best evidence according to the clinical reality to promote the smooth transition of patients and reduce the readmission rate.

Objective:To evaluate and integrate the evidence related to the prevention of unplanned readmission in elderly patients with ischemic stroke.Methods:A computerized search was conducted on various guideline websites and databases for clinical decisions, best practices, guidelines, evidence summaries, systematic reviews, and expert consensuses regarding the prevention of unplanned readmission in elderly patients with ischemic stroke. The search period was from the establishment of the databases to August 31, 2024. The literature quality evaluation criteria of the Joanna Briggs Institute Evidence-Based Health Care Centre and so on were used to evaluate the quality of different types of studies.Results:A total of 25 articles were included, consisting of one clinical decision, nine guidelines, six evidence summaries, eight systematic reviews, and one expert consensus. Evidence was integrated from two themes: discharge planning services (including five dimensions: principles, preliminary assessment, comprehensive assessment, plan formulation and implementation, tracking and evaluation) and early functional rehabilitation (including four dimensions: rehabilitation time, rehabilitation plan, rehabilitation intensity, and functional rehabilitation) , forming 39 pieces of best evidence.Conclusions:This study provides an evidence-based basis for the clinical nursing practice of preventing unplanned readmission in elderly patients with ischemic stroke. Evidence users need to select the best evidence according to the clinical reality to promote the smooth transition of patients and reduce the readmission rate.

Objective To systematically evaluate the factors that promote and hinder exercise in frail older adults,and to provide references for the formulation of exercise intervention programs.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang,VIP database,and China Biomedical Literature Database for qualitative studies on exercise facilitators and hindrances in frail older adults,and the search time period was from the establishment of the databases to September 1,2024.The quality of the literature was evaluated using the Joanna Brigg Institute Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated by integrating methods.Results A total of 18 studies were included,and 72 research results were extracted,and 10 categories were summarized.The final synthesis included 2 integrated results:the facilitators included personal exercise motivation,physical and psychological benefits,positive interpersonal interactions,multiple social support systems and person-centred exercise programme;the impediments included underlying diseases and somatic functional limitations,negative psychological status,low health literacy,family role conflicts and limits of the environment.Conclusion Exercise for frail older adults is affected by a variety of factors.Healthcare professionals should improve the positive perception of exercise for frail older people and help them overcome psychological barriers;establish an all-round support system to enhance the sense of social contact of the frail elderly;formulate a personalised exercise programme with a human-centred approach to enhance the motivation of the frail elderly.

Objective To systematically evaluate the real-life experience of stroke patients in the hospital-home transition period,and to provide a reference for better clinical development of transitional nursing practice.Methods We searched PubMed,Web of Science,Embase,CINAHL,Cochrane library,CNKI,Wanfang Data,VIP database,and China Biomedical Literature Database for qualitative studies on the real experience of stroke patients in the hospital-to-home transition period from the establishment of the database to October 2023.The quality of the literature was evaluated using the Joanna Brigg Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 14 studies were included,and 48 research results were extracted and 9 categories were summarized.The final synthesis included 3 integrated results:the discharge preparation period was in contradiction;after being discharged from the hospital,life changed dramatically and there was a variety of transition barriers;active response to illness and the experience of self-growth.Conclusion The hospital-home transition period for stroke patients is a critical period for patients'rehabilitation,and medical staff should strengthen the implementation of the transitional discharge plan,strengthen the connection between hospitals and families and communities,pay attention to the psychological experience of patients,so as to help stroke patients achieve a smooth transition from hospital to home.

Objective:To systematically synthesize and evaluate qualitative studies on the rehabilitation experience of stroke patients using virtual reality.Methods:A comprehensive search of databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and SinoMed was conducted for qualitative studies on the rehabilitation experience of stroke patients using virtual reality, with studies included up to October 24, 2023. Two researchers independently assessed study quality using the Joanna Briggs Institute qualitative assessment tool, and a Meta-synthesis approach was used to integrate findings.Results:Fourteen studies were included, yielding 72 distinct results that were categorized into 13 themes, and further integrated into four main themes: stroke patients' experience with virtual reality-assisted rehabilitation, facilitators for virtual reality-assisted rehabilitation, barriers to virtual reality-assisted rehabilitation, and stroke patients' needs and expectations for virtual reality-assisted rehabilitation.Conclusions:Virtual reality is widely appreciated by stroke patients for its rehabilitation benefits. Future efforts should focus on patient training, system enhancement, and the development of diverse and personalized virtual reality content to improve the user experience.

Objective:To systematically synthesize and evaluate qualitative studies on the rehabilitation experience of stroke patients using virtual reality.Methods:A comprehensive search of databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and SinoMed was conducted for qualitative studies on the rehabilitation experience of stroke patients using virtual reality, with studies included up to October 24, 2023. Two researchers independently assessed study quality using the Joanna Briggs Institute qualitative assessment tool, and a Meta-synthesis approach was used to integrate findings.Results:Fourteen studies were included, yielding 72 distinct results that were categorized into 13 themes, and further integrated into four main themes: stroke patients' experience with virtual reality-assisted rehabilitation, facilitators for virtual reality-assisted rehabilitation, barriers to virtual reality-assisted rehabilitation, and stroke patients' needs and expectations for virtual reality-assisted rehabilitation.Conclusions:Virtual reality is widely appreciated by stroke patients for its rehabilitation benefits. Future efforts should focus on patient training, system enhancement, and the development of diverse and personalized virtual reality content to improve the user experience.

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans ; Brain Neoplasms/pathology* ; Neoplasm Recurrence, Local/metabolism* ; Glioma/pathology* ; Neural Stem Cells/pathology* ; Oligodendrocyte Precursor Cells/pathology* ; Tumor Microenvironment

Epilepsy is a common chronic neurological disease, and its comorbidity has attracted more attention.The proportion of epileptic children with mental disorders is also increasing year by year.Among them, children with epilepsy have more depression and anxiety disorders.Repeated seizures can easily cause depression and anxiety, and depression and anxiety can also induce epilepsy, thus the two affect each other.The assessment, screening, diagnosis and intervention of comorbid depression and anxiety in children with epilepsy have become an important part of clinical practice.This review summarized the relationship between epilepsy and depression and anxiety disorders in children, and its research progress on pathogenesis, clinical diagnosis, evaluation and treatment.

This study compared the effects on bone metabolism and morphology of pathological obesity induced by excessive fat intake in a non-hibernator (mice) versus healthy obesity due to pre-hibernation fattening in a hibernator (ground squirrels). Kunming mice were fed a high-fat diet to provide a model of pathological obesity (OB group). Daurian ground squirrels fattened naturally in their pre-hibernation season (PRE group) were used as a healthy obesity model. Micro-computed tomography (micro-CT) and three-point bending tests were used to determine the microstructure and mechanical properties of bone. Western blots were used to analyze protein expression levels related to bone metabolism (Runt-related transcription factor 2 (RunX2), osteocalcin (OCN), alkaline phosphatase (ALP), osteoprotegerin (OPG), receptor activator of nuclear factor-‍κB ligand (RANKL), cathepsin K, matrix metallopeptidase 9 (MMP9), patched protein homolog 1 (Ptch1), phosphorylated β‍-‍catenin (P‍-‍β‍-‍catenin), and glycogen synthase kinase-3β (GSK-3β)). Compared with controls, there was no obvious bone loss in the OB mice, and the stiffness of the femur was increased significantly. Compared with summer active squirrels, bone formation was enhanced but the mechanical properties did not change in the PRE group squirrels. In OB mice, western blots showed significantly increased expression levels of all proteins except RunX2, OPG, and Ptch1. PRE ground squirrels showed significantly increased expression of most proteins except OCN and Ptch1, which decreased significantly, and P‍-‍β‍-‍catenin and OPG, which did not change. In conclusion, for non-hibernating mice, moderate obesity had a certain protective effect on bones, demonstrating two-way regulation, increasing both bone loss and bone formation. For pre-hibernating ground squirrels, the healthy obesity acquired before hibernation had a positive effect on the microstructure of bones, and also enhanced the expression levels of proteins related to bone formation, bone resorption, and Wnt signaling.
Mice ; Animals ; Hibernation ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Glycogen Synthase Kinase 3 beta/metabolism* ; Diet, High-Fat ; X-Ray Microtomography ; Sciuridae/metabolism* ; Obesity