The adult subventricular zone of the lateral ventricles and the subgranular zone in the hippocampal dentate gyrus(DG)are the two brain regions where neurogenesis occurs throughout life in the adult mammalian brain(Min...The adult subventricular zone of the lateral ventricles and the subgranular zone in the hippocampal dentate gyrus(DG)are the two brain regions where neurogenesis occurs throughout life in the adult mammalian brain(Ming and Song,2011).Adult quiescent hippocampal neural stem cells(NSCs)are bona fide stem cells and,when activated,give rise to newborn granule neurons in the adult brain,which play vital roles in learning,memory,mood,and affective cognition(Bonaguidi et al.,2011;Ming and Song,2011).展开更多
Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered...Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents aged 40-64 years from 5 cities in Osaka Prefecture,Japan.Of these,12,446(36.7%)agreed to participate in the survey.After exclusion of those with regular visits to medical institutions and those with missing data,the analysis included 3742 participants.Health literacy was measured by the communicative and critical health literacy(CCHL)scale,and participants were classified into 3 groups(low,medium,and high health literacy groups)by the tertiles of the CCHL scale score.Physical inactivity was defined as not completing at least 150 min of moderate-intensity physical activity throughout the week.Results:After adjustment for age,gender,education level,occupation,economic status,living alone,and stages of health behavior change,the multivariable-adjusted odds ratios(ORs)for physical inactivity were 1.36(95% confidence interval[CI]:1.16-1.59,P<0.001)in the medium health literacy group and 1.70(95%CI:1.36-2.11,P<0.001)in the low health literacy group compared with the high health literacy group.Conclusions:This large-scale study provides compelling evidence that those with inadequate health literacy are at higher risk for physical inactivity among middle-aged adults.展开更多
Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients...Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.展开更多
Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear ...Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear and contentious.This study offered a comprehensive review and meta-analysis of research published until June 2024,analyzing the effects of multivitamins on various cognitive functions in individuals aged 65 and older.We included ten randomized controlled trials encompassing 13,600 participants from multiple databases.These studies evaluated the impact of multivitamins on reasoning,memory,learning,visual perception,idea production,cognitive speed,psychomotor abilities,and higher cognitive functions.Our meta-analysis revealed that multivitamins significantly enhanced delayed free recall (standardized mean difference(SMD)=0.09,95%confidence interval(CI)=[0.05,0.13],P<0.0001).However,they had no substantial effects on immediate free recall(SMD=0.85,95%CI=[-0.18,1.90],P=0.11),idea production(SMD=0.00,95%CI=[-0.04,0.03],P=0.86),or cognitive speed(SMD=0.34,95%CI=[-0.07,0.74],P=0.11).Thus,while multivitamins facilitated delayed free recall,they did not significantly improve other cognitive functions in older adults.展开更多
Objective:Intergenerational ambivalence is the conflicts or differences in opinion occurring between 2 or more generations.Advanced technology,busy lifestyles,working parents,etc.,have widened the area of ambivalence ...Objective:Intergenerational ambivalence is the conflicts or differences in opinion occurring between 2 or more generations.Advanced technology,busy lifestyles,working parents,etc.,have widened the area of ambivalence between the mother and young adult.Therefore,the present study aimed to assess the intergenerational ambivalence and psychological well-being of mothers and young adults.Methods:A descriptive correlational survey was done among 150 participants(75 mothers and 75 young adults)of the Shirva panchayat area of Udupi taluk,Karnataka,India.Participants were selected based on the study inclusion criteria.Data were obtained using the demographic pro forma,followed by the Intergenerational Ambivalence Scale and Ryff Psychological Wellbeing Scale.Results:Based on the objectives and hypotheses of the study,the data analysis was done with SPSS version 20(IBM Corporation,Armonk,New York,United States).The mean age of mothers was 46.20 years,and that of young adults was 21.49 years.Both mothers and young adults have moderate levels of intergenerational ambivalence with scores of 70.7% and 73.3%,respectively.The psychological well-being of 57.3% of mothers was at a moderate level.A significant relationship was found between intergenerational ambivalence and psychological well-being(ρ=-0.035,P=0.0767).Conclusions:The present study concluded that as the intergenerational ambivalence of mothers increases,their psychological wellbeing decreases.展开更多
Objective:To investigate subjective and objective listening abilities in noise in young adults,older adults with normal hearing,and adults with listening difficulties(LiD).Methods:This study examined 20 young adults,2...Objective:To investigate subjective and objective listening abilities in noise in young adults,older adults with normal hearing,and adults with listening difficulties(LiD).Methods:This study examined 20 young adults,20 older adults with normal hearing,and 20 adults with LiD.All participants underwent pure-tone audiometry and the Hearing in Noise Test-Japanese version(HINT-J)and completed the Speech,Spatial and Qualities of Hearing Scale(SSQ).Results:All groups had normal hearing thresholds(125-8,000 Hz).Older adults with normal hearing performed worse on the HINT-J than young adults,while adults with LiD reported greater subjective LiD on the SSQ.No significant correlations were found between HINTJ and SSQ scores with any group.Significant differences were found between groups in terms of both the HINT-J(χ^(2)(2)=17.9,p<0.01)and SSQ(χ^(2)(2)=38.7,p<0.01).Conclusion:Despite normal audiometric thresholds,older adults with normal hearing and adults with LiD experience distinct LiD in noisy environments,highlighting the need for comprehensive assessment beyond traditional audiometry.Future research should focus on developing more sensitive diagnostic tools.展开更多
Background:Intrinsic capacity reflects the overall health status of older adults and decline in intrinsic abilities can lead to adverse health outcomes.However,empirical studies examining the association between digit...Background:Intrinsic capacity reflects the overall health status of older adults and decline in intrinsic abilities can lead to adverse health outcomes.However,empirical studies examining the association between digital health literacy,health-promoting lifestyles and intrinsic capacity are scarce.Methods:A cross-sectional study was conducted.Using convenience sampling method,371 older adults were recruited from communities.Multidimensional intrinsic capacity,digital health literacy,health promoting lifestyle and sociodemographic information were measured.Results:The intrinsic capacity of older adults scored 3.75±1.10.The prevalences of declined cognitive capacity,psychological capacity,sensory capacity,vitality,and locomotor capacity were 13.7%,24.3%,19.1%,14.8%,53.1%,respectively.The multiple regression analysis revealed that age(β=−0.253),only living with children and/or grandchildren(β=0.249),current working status(β=−0.132),number of chronic diseases(β=−0.149),frequency of Internet usage(β=0.193),the domain of ability to acquire and evaluate digital health information(β=0.197)in digital health literacy,and the domain of nutrition(β=0.171)in health-promoting lifestyle were the significant factors influencing intrinsic capacity,explaining 27.1%of the variance.Conclusion:Digital health literacy and health-promoting lifestyle have a significant impact on intrinsic capacity.Enhancing digital health literacy and advocating a health-promoting lifestyle are critical to promoting intrinsic capacity for community-dwelling older adults.展开更多
Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Metho...Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.展开更多
Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.C...Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.展开更多
Background:In the Chinese context,the impact of short video applications on the psychological well-being of older adults is contested.While often examined through a pathological lens of addiction,this perspective may ...Background:In the Chinese context,the impact of short video applications on the psychological well-being of older adults is contested.While often examined through a pathological lens of addiction,this perspective may overlook paradoxical,context-dependent positive outcomes.Therefore,the main objective of this study is to challenge the traditional Compensatory Internet Use Theory by proposing and testing a chained mediation model that explores a paradoxical pathway from social support to life satisfaction via problematic social media use.Methods:Data were collected between July and August 2025 via the Credamo online survey platform,yielding 384 valid responses from Chinese older adults aged 60 and above.Key constructs were assessed using the Social Support Rating Scale(SSRS),Bergen Social Media Addiction Scale(BSMAS),Simplified UCLA Loneliness Scale,and Satisfaction with Life Scale(SWLS).A chained mediation model was tested using stepwise regression and non-parametric bootstrapping(5000 resamples),controlling for age,gender,household income,and health status.Results:The analysis revealed a paradoxical pathway,which was clarified by a key statistical suppression effect.Social support significantly and positively predicted problematic usage(β=0.157,p=0.002).After controlling for the suppressor effect of social support,problematic usage in turn negatively predicted social connectedness(β=−0.177,p<0.001).Finally,reduced social connectedness—reflecting a state of solitude—positively predicted life satisfaction(β=−0.227,p<0.001).Conclusion:The findings suggest that for older adults with sufficient offline social support,these resources may serve a“social empowerment”function.This empowerment allows behaviors measured as“problematic usage”to be theoretically reframed as a form of“deep immersive entertainment”.This immersion appears to occur alongside a state of“high-quality solitude”,which ultimately is associated with higher life satisfaction.This study provides a novel,non-pathological theoretical perspective on the consequences of high engagement with emerging social media,offering empirical grounds for non-abstinence-based intervention strategies.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
BACKGROUND Adolescent/adult pancreatoblastoma(PB)is an uncommon malignant pancreatic tumor.The paucity of data stemming from the rarity of this disease leads to minimal generalized guidelines regarding its diagnosis a...BACKGROUND Adolescent/adult pancreatoblastoma(PB)is an uncommon malignant pancreatic tumor.The paucity of data stemming from the rarity of this disease leads to minimal generalized guidelines regarding its diagnosis and treatment.There is a limited number of case reports in the literature and there has been no recent analysis of the literature to consolidate their common features.The purpose of the featured study is to review the available cases of adolescent/adult PB and analyze the common genetic features,histologic features,treatment regimens,tumor sizes,tumor locations,and areas of metastasis to advance ongoing research and better understand and treat this rare condition.AIM To present a patient case and systematically review all available cases in the literature to consolidate the common physical,genetic,and histologic features of PB.METHODS This is a systematic review of the literature with a case study.A total of 89 patient cases were discovered in the literature database for adolescent/adult PB,all of which were reviewed and are included in our research.Patients aged 16-18 were considered adolescent and patients aged greater than 18 were considered adult.Adolescents and adults were grouped together for the purpose of this study.The patient from the case report was seen in a community hospital setting.RESULTS The 89 cases analyzed from the literature were found in 51 references(our case report included),which were consolidated into the six categories mentioned above.A plurality of references reports PB in the head of the pancreas,4.0-10.0 cm in size,and with the most common site of metastasis to the liver.Histology studies most commonly included acinar groups,squamous corpuscles/nests,cytokeratin,chromogranin,trypsin,chymotrypsin,and synaptophysin.Genetic studies most commonly included adenomatous polyposis coli,B-cell lymphoma/leukemia 10,catenin beta 1,and Wnt/beta-catenin mutations.The mainstay of treatment was surgery with chemotherapy typically including cisplatin,carboplatin,doxorubicin,5 fluorouracil,mitomycin,bleomycin,gemcitabine,and vindesine.Radiation was also often used.CONCLUSION Common pancreatoblastoma features include acinar groups,chromogranin,chymotrypsin,squamous corpuscles,synaptophysin and trypsin on histology and adenomatous polyposis coli,B-cell lymphoma/leukemia 10,catenin beta 1,and Wnt/beta-catenin genetic mutations.展开更多
This study aims to systematically explore the differences in health status between empty-nest and non-empty-nest older adults and further analyze the potential impact of empty-nest and non-empty-nest status on their p...This study aims to systematically explore the differences in health status between empty-nest and non-empty-nest older adults and further analyze the potential impact of empty-nest and non-empty-nest status on their physical and mental health.The study surveyed older adult populations in Anhui Province(N=379,average age=69.51 years)to assess their mental and physical health.Correlation analysis,multiple linear regression analysis,and propensity score matching were used to quantify the health differences between empty-nest and non-empty-nest older adults.Multiple linear regression analysis showed that empty-nest status has a significant positive impact on mental health but a negative impact on physical health.Propensity score matching analysis further validated the main findings of the multiple regression analysis.These findings should be interpreted within specific contexts and conditions,considering individual characteristics and historical perspectives,and fully considering the actual circumstances of the respondents.展开更多
The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate ne...The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.展开更多
This letter evaluates Shahid et al’s study in 2025 on the rising hepatitis A virus(HAV)among adults in Pakistan,highlighting a shift in the virus’s epidemiology.Once primarily a childhood disease in low-income regio...This letter evaluates Shahid et al’s study in 2025 on the rising hepatitis A virus(HAV)among adults in Pakistan,highlighting a shift in the virus’s epidemiology.Once primarily a childhood disease in low-income regions,HAV is now increasingly affecting adults,also seen globally due to improved sanitation.The study highlights public health challenges from adult HAV infections,which can lead to complications like coagulopathy and acute liver failure.It also has limitations,including being a single-center study and lacking seroprevalence and socioeconomic data,indicating the need for further research.This letter calls for urgent public health measures to extend adult vaccination programs and improve sanitation to address the increasing HAV infection in adult populations.展开更多
Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous atrophy.It has also been observed in adults p...Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous atrophy.It has also been observed in adults presenting diagnostic and treatment challenges due to its overlap with other gastrointestinal disorders such as celiac disease.Initial diagnostic criteria for AIE include small bowel villous atrophy,lack of response to dietary restrictions,presence of anti-enterocyte antibodies,and predisposition to autoimmunity without severe immu-nodeficiency.Refined criteria emphasize characteristic histological findings and exclusion of other causes of villous atrophy.AIE is associated with various autoimmune disorders and can present with overlapping features with Celiac disease,including villous atrophy but without significant intraepithelial lympho-cytosis.Treatment primarily involves immunosuppression using corticosteroids,calcineurin inhibitors,and anti-tumor necrosis factor therapy,alongside nutri-tional support.Despite the challenges,understanding AIE’s diverse manifest-ations and improving diagnostic criteria are essential for effective management and improved patient outcome.Further research is needed to elucidate the pathogenesis,disease progression and long-term outcomes of AIE.展开更多
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ...Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.展开更多
Background:Adult medulloblastoma(MB)represents less than 1%of central nervous system malignancies,lacking standardized therapeutic approaches due to its rarity.This retrospective single-center analysis aimed to assess...Background:Adult medulloblastoma(MB)represents less than 1%of central nervous system malignancies,lacking standardized therapeutic approaches due to its rarity.This retrospective single-center analysis aimed to assess survival outcomes and treatment-associated toxicities in adult MB patients managed with pediatric-derived protocols.Methods:Eighteen patients(≥18 years)with MB treated at Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)(January 1997–January 2024)were analyzed.All received craniospinal radiotherapy with posterior fossa boost,followed by adjuvant chemotherapy utilizing pediatric regimens(PNET3,PNET4,PNET5,or high-risk protocols incorporating high-dose chemotherapy with autologous stem cell rescue).Primary outcomes included overall survival(OS)and progression-free survival(PFS).Secondary analyses focused on comprehensive toxicity assessment.Results:The cohort included 11 males and 7 females(median age:23 years).Metastatic disease was present in 6 patients(33%)at diagnosis.Histopathological distribution showed classic MB(55.5%),desmoplastic/nodular(39%),and large cell/anaplastic variants(5.5%).Molecular subgrouping(available in 6 patients)identified SHH subgroup in four cases and WNT subgroup in two.Three-year and fiveyear overall survival rates reached 94.5%and 88.8%,respectively.Treatment-related adverse events included grade 3–4 hematologic toxicities,clinically significant weight loss,and grade≥3 neurological and ototoxic complications.These toxicities necessitated treatment modifications including dose adjustments,cycle delays,and occasional early discontinuation.Conclusions:Adult MB patients treated with pediatric-adapted protocols demonstrated excellent long-termsurvival outcomes,comparable to or surpassing historical data.Despite frequent toxicity requiring treatment modifications,these regimens proved feasible with acceptable risk-benefit profiles.These results support implementing modified pediatric protocols for adult MB management.Future multicenter investigations with larger cohorts are essential for refining risk stratification,optimizing treatment intensity,and evaluating long-term outcomes in this rare malignancy.展开更多
In this editorial,I comment on the article conducted by Yang and Woo.Mental health in older adults remains underserved and underexamined,with final decades shaped by cumulative life stressors,chronic conditions,and so...In this editorial,I comment on the article conducted by Yang and Woo.Mental health in older adults remains underserved and underexamined,with final decades shaped by cumulative life stressors,chronic conditions,and social determinants that disproportionately affect marginalized communities.In this study,I would like to synthesize current evidence on the prevalence,presentation,and trajectories of mental health concerns among older adults,highlighting common challenges such as late-life depression,anxiety,cognitive concerns,and underutilization of care.I am going to examine barriers to outreach and treatment,including stigma,cultural and linguistic mismatches,access limitations,and gaps in geriatric mental health services.The analysis in the paper identifies promising pathways to improve outcomes:Community-engaged interventions,culturally tailored care models,integration of mental health with primary and geriatric care,and policy reforms to expand coverage and reduce disparities.As a conclusion,with actionable recommendations for clinicians,researchers,policymakers,and community organizations to break the silence,enhance early detection,and foster resilient aging through equitable,person-centered approaches.展开更多
BACKGROUND Human beings,by nature,have many expectations that create a feeling of anxiety about the future,but they are endured and long-ranged.They expect to have relationships with others and need to perceive an emo...BACKGROUND Human beings,by nature,have many expectations that create a feeling of anxiety about the future,but they are endured and long-ranged.They expect to have relationships with others and need to perceive an emotional interest,an interpersonal bond,and sustainment to continue living.Perceiving this link is required for feelings of belongingness,which decreases future anxiety.AIM To investigate the future anxiety and belongingness of young and older adults and determine their relationships.METHODS The study was conducted with 404 volunteer participants.Data were collected using the demographic characteristics from the“Dark Future Scale”and“General Belongingness Scale”.RESULTS The mean age of older adults was 66.76±3.74,while that of younger adults was 36.72±10.12.The average score for“future anxiety”was 18.81±7.59,and for“general belongingness",it was 63.31±1.40.Findings indicated a reverse correlation between future anxiety and belongingness.A significant difference in belonging scores was observed between young and older adults(P=0.016,which is<0.05),whereas no significant difference was found regarding future anxiety scores(P>0.05).CONCLUSION Participants had a moderate level of“future anxiety”and higher“belongingness”.Lower belongingness scores correlated with increased future anxiety.Older adults reported a lower sense of belonging than younger individuals.展开更多
基金supported by National Institutes of Health(R35NS137480,R35NS116843,and RF1AG079557)by Dr.Miriam and Sheldon G.Adelson Medical Research Foundation.
文摘The adult subventricular zone of the lateral ventricles and the subgranular zone in the hippocampal dentate gyrus(DG)are the two brain regions where neurogenesis occurs throughout life in the adult mammalian brain(Ming and Song,2011).Adult quiescent hippocampal neural stem cells(NSCs)are bona fide stem cells and,when activated,give rise to newborn granule neurons in the adult brain,which play vital roles in learning,memory,mood,and affective cognition(Bonaguidi et al.,2011;Ming and Song,2011).
基金supported by the Fund for Health Promotion from Osaka Prefecture。
文摘Objective:We assessed the risk for physical inactivity due to inadequate health literacy using multivariable analysis in a large middleaged population.Methods:This cross-sectional mail survey using a self-administered questionnaire was conducted in 2020 and included 33,902 community residents aged 40-64 years from 5 cities in Osaka Prefecture,Japan.Of these,12,446(36.7%)agreed to participate in the survey.After exclusion of those with regular visits to medical institutions and those with missing data,the analysis included 3742 participants.Health literacy was measured by the communicative and critical health literacy(CCHL)scale,and participants were classified into 3 groups(low,medium,and high health literacy groups)by the tertiles of the CCHL scale score.Physical inactivity was defined as not completing at least 150 min of moderate-intensity physical activity throughout the week.Results:After adjustment for age,gender,education level,occupation,economic status,living alone,and stages of health behavior change,the multivariable-adjusted odds ratios(ORs)for physical inactivity were 1.36(95% confidence interval[CI]:1.16-1.59,P<0.001)in the medium health literacy group and 1.70(95%CI:1.36-2.11,P<0.001)in the low health literacy group compared with the high health literacy group.Conclusions:This large-scale study provides compelling evidence that those with inadequate health literacy are at higher risk for physical inactivity among middle-aged adults.
基金funded by the National Key Research and Development Program of China(grant number 2022YFC2305204).
文摘Objective To determine the proportions of drug-resistant tuberculosis(TB),its trends,and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.Methods The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis.Joinpoint regression software was used to analyze time trends.We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.Results Among 4,235 patients with pulmonary TB,the proportion of new cases of multidrug-resistant tuberculosis(MDR-TB)was 3.18%(95%confidence interval[CI]:2.37-4.15)for adolescents and 3.76%(95%CI:3.03-4.60)for young adults;for previously treated patients,MDR-TB accounted for 11.25%(95%CI:5.28-20.28)of adolescents and 11.05%(95%CI:6.88-16.55)of young adults.The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period.Through whole genome sequencing,we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene(71.74%)and Ser450Leu in the rpoB gene(50.00%).Conclusion This study revealed a high proportion of MDR-TB among adolescents and young adults,indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.
基金supported by the Fundamental Research Funds for the Central Universities(2042023gf0003)Hubei Provincial Natural Science Foundation of China(2024AFD126)National Key Research and Development Program of China(2023YFF1104404).
文摘Multivitamins were widely used health supplements that replenished essential nutrients in the human body.Despite their popularity,the impact of multivitamins on the cognitive function of older adults remained unclear and contentious.This study offered a comprehensive review and meta-analysis of research published until June 2024,analyzing the effects of multivitamins on various cognitive functions in individuals aged 65 and older.We included ten randomized controlled trials encompassing 13,600 participants from multiple databases.These studies evaluated the impact of multivitamins on reasoning,memory,learning,visual perception,idea production,cognitive speed,psychomotor abilities,and higher cognitive functions.Our meta-analysis revealed that multivitamins significantly enhanced delayed free recall (standardized mean difference(SMD)=0.09,95%confidence interval(CI)=[0.05,0.13],P<0.0001).However,they had no substantial effects on immediate free recall(SMD=0.85,95%CI=[-0.18,1.90],P=0.11),idea production(SMD=0.00,95%CI=[-0.04,0.03],P=0.86),or cognitive speed(SMD=0.34,95%CI=[-0.07,0.74],P=0.11).Thus,while multivitamins facilitated delayed free recall,they did not significantly improve other cognitive functions in older adults.
文摘Objective:Intergenerational ambivalence is the conflicts or differences in opinion occurring between 2 or more generations.Advanced technology,busy lifestyles,working parents,etc.,have widened the area of ambivalence between the mother and young adult.Therefore,the present study aimed to assess the intergenerational ambivalence and psychological well-being of mothers and young adults.Methods:A descriptive correlational survey was done among 150 participants(75 mothers and 75 young adults)of the Shirva panchayat area of Udupi taluk,Karnataka,India.Participants were selected based on the study inclusion criteria.Data were obtained using the demographic pro forma,followed by the Intergenerational Ambivalence Scale and Ryff Psychological Wellbeing Scale.Results:Based on the objectives and hypotheses of the study,the data analysis was done with SPSS version 20(IBM Corporation,Armonk,New York,United States).The mean age of mothers was 46.20 years,and that of young adults was 21.49 years.Both mothers and young adults have moderate levels of intergenerational ambivalence with scores of 70.7% and 73.3%,respectively.The psychological well-being of 57.3% of mothers was at a moderate level.A significant relationship was found between intergenerational ambivalence and psychological well-being(ρ=-0.035,P=0.0767).Conclusions:The present study concluded that as the intergenerational ambivalence of mothers increases,their psychological wellbeing decreases.
基金supported by the Japan Society for the Promotion of Science(JSPS)Grants in Aids for Scientific Research(KAKENHI)[grant number 21K20238].
文摘Objective:To investigate subjective and objective listening abilities in noise in young adults,older adults with normal hearing,and adults with listening difficulties(LiD).Methods:This study examined 20 young adults,20 older adults with normal hearing,and 20 adults with LiD.All participants underwent pure-tone audiometry and the Hearing in Noise Test-Japanese version(HINT-J)and completed the Speech,Spatial and Qualities of Hearing Scale(SSQ).Results:All groups had normal hearing thresholds(125-8,000 Hz).Older adults with normal hearing performed worse on the HINT-J than young adults,while adults with LiD reported greater subjective LiD on the SSQ.No significant correlations were found between HINTJ and SSQ scores with any group.Significant differences were found between groups in terms of both the HINT-J(χ^(2)(2)=17.9,p<0.01)and SSQ(χ^(2)(2)=38.7,p<0.01).Conclusion:Despite normal audiometric thresholds,older adults with normal hearing and adults with LiD experience distinct LiD in noisy environments,highlighting the need for comprehensive assessment beyond traditional audiometry.Future research should focus on developing more sensitive diagnostic tools.
基金funded by the College Students’Innovation and Entrepreneurship Program(X2024110650385).
文摘Background:Intrinsic capacity reflects the overall health status of older adults and decline in intrinsic abilities can lead to adverse health outcomes.However,empirical studies examining the association between digital health literacy,health-promoting lifestyles and intrinsic capacity are scarce.Methods:A cross-sectional study was conducted.Using convenience sampling method,371 older adults were recruited from communities.Multidimensional intrinsic capacity,digital health literacy,health promoting lifestyle and sociodemographic information were measured.Results:The intrinsic capacity of older adults scored 3.75±1.10.The prevalences of declined cognitive capacity,psychological capacity,sensory capacity,vitality,and locomotor capacity were 13.7%,24.3%,19.1%,14.8%,53.1%,respectively.The multiple regression analysis revealed that age(β=−0.253),only living with children and/or grandchildren(β=0.249),current working status(β=−0.132),number of chronic diseases(β=−0.149),frequency of Internet usage(β=0.193),the domain of ability to acquire and evaluate digital health information(β=0.197)in digital health literacy,and the domain of nutrition(β=0.171)in health-promoting lifestyle were the significant factors influencing intrinsic capacity,explaining 27.1%of the variance.Conclusion:Digital health literacy and health-promoting lifestyle have a significant impact on intrinsic capacity.Enhancing digital health literacy and advocating a health-promoting lifestyle are critical to promoting intrinsic capacity for community-dwelling older adults.
文摘Objective To determine whether frailty is a risk factor for hospitalization and mortality in older adults enrolled in the "Chronic Heart Failure Program" at a hospital in Lima, Peru, between 2018–2021.Methods This was an ambispective cohort study. A total of 85 older adults participating in the Chronic Heart Failure Program at Guillermo Almenara National Hospital were included. Each had an initial frailty assessment, forming two cohorts: frail and non-frail older adults. Medical records were reviewed, and patients were followed for one year to track events of interest(hospitalization and mortality). Overall survival and risk factors for hospitalization and death were determined.Results During follow-up, 15.3% of the older adults died, and frailty was identified in 58.8% of the patients. Overall survival using the Kaplan-Meier method was 96.5% at 3 months after entering the Chronic Heart Failure Program;92.9% at 6 months;and85.9% at one year. Multivariate analysis using Poisson regression found that frailty was not a risk factor for hospitalization(a RR =0.92;95% CI: 0.42–2.03). Survival analysis using the Cox proportional hazards model showed that frailty was also not a risk factor for mortality after one year of follow-up(a HR = 1.32;95% CI: 0.27–6.53).Conclusions Our research does not confirm frailty as a risk factor for hospitalization or mortality in older adults enrolled in the“Chronic Heart Failure Program” after one year of follow-up.
基金supported by the 2025 Jiangsu Province Graduate Student Practice Innovation Program(No.SJCX25_1696)the 2024 Changzhou University Educational Research Project(No.GJY2024009).
文摘Background:The phenomenon of multimorbidity in chronic diseases among the elderly is prevalent,and its significant association with depression poses a serious threat to the physical and mental health of older adults.Current research on the associations between 24-hour movement behaviors(including physical activity,sedentary behavior,and sleep)and depression has largely been confined to examining the effects of single behaviors,overlooking the intrinsic compositional nature and interrelationships among these behaviors.Therefore,it is necessary to investigate the integrated effects of 24-hour movement behaviors on depression in older adults with multimorbidity from a holistic,compositional perspective.Methods:From November 2024 to April 2025,a total of 226 older adult patients with multimorbidity were recruited from a tertiary hospital in Changzhou City.Data were collected using a general information questionnaire,the International Physical Activity Questionnaire–Short Form(IPAQ-SF),the Pittsburgh Sleep Quality Index(PSQI),and the Patient Health Questionnaire-9(PHQ-9).Compositional data analysis and isotemporal substitution models were employed for statistical analysis.Results:The mean daily durations of Light-Intensity Physical Activity(LPA),Moderate-to-Vigorous Physical Activity(MVPA),Sedentary Behavior(SB),and Sleep(SLP)in older adults with multimorbidity were 402.48 min,12.04 min,511.52 min,and 458.68 min,respectively.The prevalence of depressive symptoms was 37.6%.Compositional data analysis revealed that SB was positively associated with depression(βSB=1.005,P=0.006),while SLP was negatively associated with depression(βSLP=−1.736,P<0.001).No statistically significant associations were found between MVPA or LPA and depression(P>0.05).In the 10-minute isotemporal substitution model,replacing SB with any other behavioral component was associated with a decrease in depression scores.Conversely,substituting SLP with either LPA or SB resulted in an increase in depression scores,while substituting SLP with MVPA led to a decrease in depression scores.The dose-response analysis revealed that,among the isotemporal substitution effects,replacing SB with SLP and replacing SLP with MVPA were the substitution pathways associated with the most rapid decline in depression scores,representing the greatest beneficial health effects.Conclusion:The prevalence of depression is notably high among older adults with multimorbidity.Reducing daily sedentary behavior(SB),maintaining adequate sleep(SLP),and increasing moderate-to-vigorous physical activity(MVPA)can improve depressive symptoms and enhance overall health in this population.
基金funded by the Guangxi Philosophy and Social Science Research Project,grant number 24XWC002.
文摘Background:In the Chinese context,the impact of short video applications on the psychological well-being of older adults is contested.While often examined through a pathological lens of addiction,this perspective may overlook paradoxical,context-dependent positive outcomes.Therefore,the main objective of this study is to challenge the traditional Compensatory Internet Use Theory by proposing and testing a chained mediation model that explores a paradoxical pathway from social support to life satisfaction via problematic social media use.Methods:Data were collected between July and August 2025 via the Credamo online survey platform,yielding 384 valid responses from Chinese older adults aged 60 and above.Key constructs were assessed using the Social Support Rating Scale(SSRS),Bergen Social Media Addiction Scale(BSMAS),Simplified UCLA Loneliness Scale,and Satisfaction with Life Scale(SWLS).A chained mediation model was tested using stepwise regression and non-parametric bootstrapping(5000 resamples),controlling for age,gender,household income,and health status.Results:The analysis revealed a paradoxical pathway,which was clarified by a key statistical suppression effect.Social support significantly and positively predicted problematic usage(β=0.157,p=0.002).After controlling for the suppressor effect of social support,problematic usage in turn negatively predicted social connectedness(β=−0.177,p<0.001).Finally,reduced social connectedness—reflecting a state of solitude—positively predicted life satisfaction(β=−0.227,p<0.001).Conclusion:The findings suggest that for older adults with sufficient offline social support,these resources may serve a“social empowerment”function.This empowerment allows behaviors measured as“problematic usage”to be theoretically reframed as a form of“deep immersive entertainment”.This immersion appears to occur alongside a state of“high-quality solitude”,which ultimately is associated with higher life satisfaction.This study provides a novel,non-pathological theoretical perspective on the consequences of high engagement with emerging social media,offering empirical grounds for non-abstinence-based intervention strategies.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
基金Supported by the Honor Health Foundation,Michael and Mary Ellen Francisthe Seena Magowitz Foundation.
文摘BACKGROUND Adolescent/adult pancreatoblastoma(PB)is an uncommon malignant pancreatic tumor.The paucity of data stemming from the rarity of this disease leads to minimal generalized guidelines regarding its diagnosis and treatment.There is a limited number of case reports in the literature and there has been no recent analysis of the literature to consolidate their common features.The purpose of the featured study is to review the available cases of adolescent/adult PB and analyze the common genetic features,histologic features,treatment regimens,tumor sizes,tumor locations,and areas of metastasis to advance ongoing research and better understand and treat this rare condition.AIM To present a patient case and systematically review all available cases in the literature to consolidate the common physical,genetic,and histologic features of PB.METHODS This is a systematic review of the literature with a case study.A total of 89 patient cases were discovered in the literature database for adolescent/adult PB,all of which were reviewed and are included in our research.Patients aged 16-18 were considered adolescent and patients aged greater than 18 were considered adult.Adolescents and adults were grouped together for the purpose of this study.The patient from the case report was seen in a community hospital setting.RESULTS The 89 cases analyzed from the literature were found in 51 references(our case report included),which were consolidated into the six categories mentioned above.A plurality of references reports PB in the head of the pancreas,4.0-10.0 cm in size,and with the most common site of metastasis to the liver.Histology studies most commonly included acinar groups,squamous corpuscles/nests,cytokeratin,chromogranin,trypsin,chymotrypsin,and synaptophysin.Genetic studies most commonly included adenomatous polyposis coli,B-cell lymphoma/leukemia 10,catenin beta 1,and Wnt/beta-catenin mutations.The mainstay of treatment was surgery with chemotherapy typically including cisplatin,carboplatin,doxorubicin,5 fluorouracil,mitomycin,bleomycin,gemcitabine,and vindesine.Radiation was also often used.CONCLUSION Common pancreatoblastoma features include acinar groups,chromogranin,chymotrypsin,squamous corpuscles,synaptophysin and trypsin on histology and adenomatous polyposis coli,B-cell lymphoma/leukemia 10,catenin beta 1,and Wnt/beta-catenin genetic mutations.
基金Shanghai Philosophy and Social Science Planning General Project“Research on the Mechanism of Population Aging in the Yangtze River Delta Urban Agglomeration on Economic Growth”(2023ZSH002).
文摘This study aims to systematically explore the differences in health status between empty-nest and non-empty-nest older adults and further analyze the potential impact of empty-nest and non-empty-nest status on their physical and mental health.The study surveyed older adult populations in Anhui Province(N=379,average age=69.51 years)to assess their mental and physical health.Correlation analysis,multiple linear regression analysis,and propensity score matching were used to quantify the health differences between empty-nest and non-empty-nest older adults.Multiple linear regression analysis showed that empty-nest status has a significant positive impact on mental health but a negative impact on physical health.Propensity score matching analysis further validated the main findings of the multiple regression analysis.These findings should be interpreted within specific contexts and conditions,considering individual characteristics and historical perspectives,and fully considering the actual circumstances of the respondents.
基金supported by the National Natural Science Foundation of China,Nos.82272171(to ZY),82271403(to XL),81941011(to XL),31971279(to ZY),31730030(to XL)the Natural Science Foundation of Beijing,No.7222004(to HD).
文摘The presence of endogenous neural stem/progenitor cells in the adult mammalian brain suggests that the central nervous system can be repaired and regenerated after injury.However,whether it is possible to stimulate neurogenesis and reconstruct cortical layers II to VI in non-neurogenic regions,such as the cortex,remains unknown.In this study,we implanted a hyaluronic acid collagen gel loaded with basic fibroblast growth factor into the motor cortex immediately following traumatic injury.Our findings reveal that this gel effectively stimulated the proliferation and migration of endogenous neural stem/progenitor cells,as well as their differentiation into mature and functionally integrated neurons.Importantly,these new neurons reconstructed the architecture of cortical layers II to VI,integrated into the existing neural circuitry,and ultimately led to improved brain function.These findings offer novel insight into potential clinical treatments for traumatic cerebral cortex injuries.
文摘This letter evaluates Shahid et al’s study in 2025 on the rising hepatitis A virus(HAV)among adults in Pakistan,highlighting a shift in the virus’s epidemiology.Once primarily a childhood disease in low-income regions,HAV is now increasingly affecting adults,also seen globally due to improved sanitation.The study highlights public health challenges from adult HAV infections,which can lead to complications like coagulopathy and acute liver failure.It also has limitations,including being a single-center study and lacking seroprevalence and socioeconomic data,indicating the need for further research.This letter calls for urgent public health measures to extend adult vaccination programs and improve sanitation to address the increasing HAV infection in adult populations.
文摘Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous atrophy.It has also been observed in adults presenting diagnostic and treatment challenges due to its overlap with other gastrointestinal disorders such as celiac disease.Initial diagnostic criteria for AIE include small bowel villous atrophy,lack of response to dietary restrictions,presence of anti-enterocyte antibodies,and predisposition to autoimmunity without severe immu-nodeficiency.Refined criteria emphasize characteristic histological findings and exclusion of other causes of villous atrophy.AIE is associated with various autoimmune disorders and can present with overlapping features with Celiac disease,including villous atrophy but without significant intraepithelial lympho-cytosis.Treatment primarily involves immunosuppression using corticosteroids,calcineurin inhibitors,and anti-tumor necrosis factor therapy,alongside nutri-tional support.Despite the challenges,understanding AIE’s diverse manifest-ations and improving diagnostic criteria are essential for effective management and improved patient outcome.Further research is needed to elucidate the pathogenesis,disease progression and long-term outcomes of AIE.
文摘Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.
基金approved by the Institutional Review Board of Università Cattolica del Sacro Cuore-Policlinico Gemelli IRCCS(number DIPUSVSP-21-03-252).
文摘Background:Adult medulloblastoma(MB)represents less than 1%of central nervous system malignancies,lacking standardized therapeutic approaches due to its rarity.This retrospective single-center analysis aimed to assess survival outcomes and treatment-associated toxicities in adult MB patients managed with pediatric-derived protocols.Methods:Eighteen patients(≥18 years)with MB treated at Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)(January 1997–January 2024)were analyzed.All received craniospinal radiotherapy with posterior fossa boost,followed by adjuvant chemotherapy utilizing pediatric regimens(PNET3,PNET4,PNET5,or high-risk protocols incorporating high-dose chemotherapy with autologous stem cell rescue).Primary outcomes included overall survival(OS)and progression-free survival(PFS).Secondary analyses focused on comprehensive toxicity assessment.Results:The cohort included 11 males and 7 females(median age:23 years).Metastatic disease was present in 6 patients(33%)at diagnosis.Histopathological distribution showed classic MB(55.5%),desmoplastic/nodular(39%),and large cell/anaplastic variants(5.5%).Molecular subgrouping(available in 6 patients)identified SHH subgroup in four cases and WNT subgroup in two.Three-year and fiveyear overall survival rates reached 94.5%and 88.8%,respectively.Treatment-related adverse events included grade 3–4 hematologic toxicities,clinically significant weight loss,and grade≥3 neurological and ototoxic complications.These toxicities necessitated treatment modifications including dose adjustments,cycle delays,and occasional early discontinuation.Conclusions:Adult MB patients treated with pediatric-adapted protocols demonstrated excellent long-termsurvival outcomes,comparable to or surpassing historical data.Despite frequent toxicity requiring treatment modifications,these regimens proved feasible with acceptable risk-benefit profiles.These results support implementing modified pediatric protocols for adult MB management.Future multicenter investigations with larger cohorts are essential for refining risk stratification,optimizing treatment intensity,and evaluating long-term outcomes in this rare malignancy.
文摘In this editorial,I comment on the article conducted by Yang and Woo.Mental health in older adults remains underserved and underexamined,with final decades shaped by cumulative life stressors,chronic conditions,and social determinants that disproportionately affect marginalized communities.In this study,I would like to synthesize current evidence on the prevalence,presentation,and trajectories of mental health concerns among older adults,highlighting common challenges such as late-life depression,anxiety,cognitive concerns,and underutilization of care.I am going to examine barriers to outreach and treatment,including stigma,cultural and linguistic mismatches,access limitations,and gaps in geriatric mental health services.The analysis in the paper identifies promising pathways to improve outcomes:Community-engaged interventions,culturally tailored care models,integration of mental health with primary and geriatric care,and policy reforms to expand coverage and reduce disparities.As a conclusion,with actionable recommendations for clinicians,researchers,policymakers,and community organizations to break the silence,enhance early detection,and foster resilient aging through equitable,person-centered approaches.
文摘BACKGROUND Human beings,by nature,have many expectations that create a feeling of anxiety about the future,but they are endured and long-ranged.They expect to have relationships with others and need to perceive an emotional interest,an interpersonal bond,and sustainment to continue living.Perceiving this link is required for feelings of belongingness,which decreases future anxiety.AIM To investigate the future anxiety and belongingness of young and older adults and determine their relationships.METHODS The study was conducted with 404 volunteer participants.Data were collected using the demographic characteristics from the“Dark Future Scale”and“General Belongingness Scale”.RESULTS The mean age of older adults was 66.76±3.74,while that of younger adults was 36.72±10.12.The average score for“future anxiety”was 18.81±7.59,and for“general belongingness",it was 63.31±1.40.Findings indicated a reverse correlation between future anxiety and belongingness.A significant difference in belonging scores was observed between young and older adults(P=0.016,which is<0.05),whereas no significant difference was found regarding future anxiety scores(P>0.05).CONCLUSION Participants had a moderate level of“future anxiety”and higher“belongingness”.Lower belongingness scores correlated with increased future anxiety.Older adults reported a lower sense of belonging than younger individuals.
