BACKGROUND:Frailty is associated with increased risks of disability, hospitalization, and mortality. Emerging evidence suggests that the oral microbiome may influence frailty development, but population-based evidence is limited and causal relationships remain unclear. This study explored the link between oral bacteria and frailty, using genetic analysis to investigate causality. METHODS:We analyzed data from 2,696 adults aged ≥50 years in NHANES 2009-2012. Oral microbiome diversity was assessed using 16S rRNA gene sequencing. Frailty was measured using a 36-item Frailty Index. Survey-weighted linear regression and restricted cubic spline models examined associations between four α-diversity indices and frailty. β-diversity was quantified using Bray-Curtis dissimilarities and compared by frailty status using PERMANOVA. Bidirectional two-sample Mendelian randomization (MR) using GWAS data assessed causal relationships between taxa and frailty. RESULTS:Lower α-diversity across all four indices were associated with higher frailty scores (P < 0.050). β-diversity differed by frailty (P = 0.001). MR analyses indicated that in saliva, Campylobacter_A, Saccharimonadaceae, and TM7x were protective, whereas Gemella was associated with increased frailty risk. In tongue samples, Saccharimonadaceae was a risk factor, while Fusobacterium, TM7x, and Solobacterium showed protective effects. CONCLUSIONS:Oral microbiome diversity is inversely associated with frailty in U.S. adults, and MR analyses identify specific oral taxa potentially involved in frailty development. These findings provide population-level evidence and genetic support for the oral microbiome as a potential modifiable target to promote healthy aging.

Abstract Background Frailty is associated with increased risks of disability, hospitalization, and mortality. Emerging evidence suggests that the oral microbiome may influence frailty development, but population-based evidence is limited and causal relationships remain unclear. This study explored the link between oral bacteria and frailty, using genetic analysis to investigate causality. Methods We analyzed data from 2696 adults aged ≥50 years in NHANES 2009-2012. Oral microbiome diversity was assessed using 16S rRNA gene sequencing. Frailty was measured using a 36-item Frailty Index. Survey-weighted linear regression and restricted cubic spline models examined associations between 4 α-diversity indices and frailty. β-diversity was quantified using Bray–Curtis dissimilarities and compared by frailty status using PERMANOVA. Bidirectional 2-sample Mendelian randomization (MR) using GWAS data assessed causal relationships between taxa and frailty. Results Lower α-diversity across all 4 indices were associated with higher frailty scores (p < .050). β-diversity differed by frailty (p = .001). MR analyses indicated that in saliva, Campylobacter_A, Saccharimonadaceae, and TM7x were protective, whereas Gemella was associated with increased frailty risk. In tongue samples, Saccharimonadaceae was a risk factor, while Fusobacterium, TM7x, and Solobacterium showed protective effects. Conclusions Oral microbiome diversity is inversely associated with frailty in U.S. adults, and MR analyses identify specific oral taxa potentially involved in frailty development. These findings provide population-level evidence and genetic support for the oral microbiome as a potential modifiable target to promote healthy aging.

PURPOSE:Acute postoperative pain after esophageal cancer surgery is highly prevalent and hinders rehabilitation. This study explores the trajectory and influencing factors of acute postoperative pain to guide targeted pain management. METHODS:A prospective design was adopted among 200 patients who had undergone esophageal cancer surgery in a tertiary hospital in Nanjing, China, from June to November 2025. Pain was assessed via the Numerical Rating Scale across 11 postoperative time-points (1 h after surgery, 8 a.m. and 8 p.m. from day 1 to 5 after surgery). Latent class growth analysis identified pain trajectories, while logistic regression and decision tree models evaluated influencing factors. RESULTS:Two distinct pain trajectories were identified, i.e., a mild-pain-stable group (81.0%) and a pain-exacerbated-then-relieved group (19.0%). Logistic regression identified smoking, drinking, preoperative sleep disorders, preoperative pain history, and chest tube indwelling time as significant predictors (P < 0.05). The decision tree model identified smoking, drinking, preoperative sleep disorders, and chest tube indwelling time as core variables, with chest tube duration showing the strongest correlation. Both models demonstrated promising preliminary predictive performance (Logistic regression AUC = 0.931; Decision tree AUC = 0.893), though these findings require external validation. CONCLUSION:Acute postoperative pain trajectories in esophageal cancer patients exhibit clear population heterogeneity. These preliminary findings suggest that the identified risk factors may inform targeted analgesic interventions in future study designs, but prospective validation in independent cohorts is warranted before clinical implementation.

Frailty in older adults has been linked to gut microbiota, but the underlying mechanisms remain unclear. This study investigates the relationship between gut microbiota and frailty, focusing on the potential mediating roles of serum metabolites, immune cells, and inflammatory proteins. We used a combination of mouse model experiments and Mendelian randomization (MR) analysis to examine how gut microbiota contributes to frailty development. In a mouse model of chronic inflammation-induced frailty, a standardized frailty index was used for assessment. High-throughput 16 S rRNA sequencing revealed significant gut microbiota dysbiosis in frail mice, with a notable elevation in Ruminococcus abundance. Spearman correlation analysis showed a strong positive association between Ruminococcus, frailty scores (⍴ = 0.716, P < 0.001), and inflammatory markers. Metabolomic profiling further identified key metabolites linked to frailty, including S-Methyl-5’-thioadenosine, L-anserine, and indolelactic acid (IAA), with IAA showing a significant correlation with Ruminococcus (P < 0.001). To validate these findings, MR analysis was performed using data from the European Bioinformatics Institute and the MiBioGen consortium. The analysis confirmed a causal relationship between Ruminococcus and frailty (OR = 1.035, 95

BACKGROUND:Postoperative lymphedema is a chronic complication that impairs quality of life (QoL) in breast cancer survivors. Preventive behaviors are key to mitigation, but their relationship with QoL in high-risk populations requires further investigation. PATIENTS AND METHODS:A cross-sectional study enrolled 276 high-risk post-surgical breast cancer patients. A self-developed preventive behavior questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) were used. Data were analyzed with correlation and multivariate regression. RESULTS:Overall preventive behavior scores were moderate-to-low, with poorest adherence in skin care and exercise. A significant positive correlation was found between the total preventive behavior score and total QoL score (r = 0.45 and P < .01). Regression analysis confirmed that better preventive behaviors significantly predicted higher QoL, particularly in functional and emotional domains (P < .05). CONCLUSION:Preventive behavior adherence is significantly associated with QoL in high-risk patients. Enhancing behaviors-especially skin care and exercise-can improve QoL. Targeted education and personalized intervention strategies are recommended.

Gastrointestinal cancer patients face significant dietary challenges, compounded in China by competing recommendations from Western clinical nutrition and Traditional Chinese Medicine (TCM). As family caregivers increasingly turn to social media for guidance, the quality and nature of dietary content remains largely unexplored. This study employed multimodal critical discourse analysis to examine 370 posts on Xiaohongshu, a Chinese social media platform with over 200 million monthly active users. Analysis revealed a complex information ecology characterized by four patterns. First, family caregivers dominated the discourse, constructing "experiential authority" through accumulated practice while health professionals remained peripheral. Second, a "nutritional double bind" emerged from tensions between clinical nutrition and TCM dietary principles, with caregivers navigating contradictory guidance through selective adherence or syncretic formulations. Third, "aestheticized care labor" transformed everyday cooking into performative visual displays, establishing aspirational standards that may exclude caregivers with fewer resources. Fourth, "Trojan Horse marketing" characterized commercial accounts that appropriated authentic caregiving conventions to embed promotional content within seemingly personal narratives. These findings highlight that dietary discourse on social media is deeply entangled with cultural values, emotional labor, and economic interests, with implications for health communication, digital health literacy, and platform governance.

Gastrointestinal (GI) cancers significantly affect nutritional intake, while clinical measures offer limited insight into how patients navigate dietary decisions in their daily lives. Social media platforms, particularly comment sections, create spaces for interactive exchange in which dietary norms are collectively tested and renegotiated. Despite growing interest in online health discourse, the interactive dynamics of comment sections within GI cancer online communities remain underexplored. This study aimed to characterise dietary-related online discussions among a Chinese GI cancer community on Xiaohongshu, identifying prominent topics, emotional expression patterns, and the discursive processes through which dietary norms are constructed and negotiated at the community level. A mixed-methods approach integrating latent Dirichlet allocation (LDA) topic modelling, sentiment analysis, and Fairclough's three-dimensional critical discourse analysis (CDA) framework. Comments were collected from posts on Xiaohongshu identified through keyword searches combining GI cancer types with diet-related terms from September to December 2025, yielding 1,865 valid comments from 370 posts for analysis. Nine topics were identified, grouped into four thematic categories: acute-phase nutritional support interventions, basic food choices and dietary principles, dietary management of common symptoms, and special conditions and metabolic diets. Sentiment analysis revealed predominantly neutral expressions (66.6%), followed by positive (21.4%) and negative (12.0%) sentiments. CDA revealed that dietary decisions were guided by risk minimization and bodily feedback rather than nutritional optimization. Interactive negotiations shifted epistemic authority from medical-centred to community-centred models. Traditional beliefs about fawu coexisted with biomedical perspectives, reflecting ongoing discursive renegotiation of cultural dietary prohibitions. Commercial discourse permeated discussions, linking disease management to consumption practices. Dietary discourse within this online community reflects complex negotiations among medical knowledge, experiential wisdom, and traditional cultural beliefs. Effective nutritional interventions require attention to patients' risk perceptions, emotional regulation through neutral language, cultural frameworks surrounding dietary prohibitions, and the commercial information environment shaping dietary decisions. Oncology nurses should integrate authoritative recommendations with patients' experiential knowledge and develop culturally sensitive approaches to nutritional counselling. This study is a retrospective observational content analysis of publicly available user-generated content on the Xiaohongshu platform, using latent Dirichlet allocation (LDA) topic modeling and sentiment analysis methods. The research does not involve any clinical intervention, human subject recruitment, experimental manipulation, or prospective clinical trial. As it is not a clinical trial or interventional study, trial registration is not required.

[This corrects the article DOI: 10.1016/j.jcte.2025.100427.].

BACKGROUND:Fear of cancer recurrence (FCR) is one of the most prevalent psychological burdens among cancer patients and exerts a substantial negative impact on their quality of life and overall well-being. Although various psychological interventions have demonstrated promise in alleviating FCR, their comparative effectiveness remains unclear. OBJECTIVE:To conduct an up-to-date systematic review and network meta-analysis to compare the relative efficacy of psychological interventions for alleviating FCR in cancer patients. METHODS:Six electronic databases were systematically searched from inception to October 2025 to identify randomized controlled trials comparing psychological interventions with each other or with control conditions. Two investigators independently conducted study selection, data extraction, and risk-of-bias assessment using the Cochrane RoB 2.0 tool. Pairwise meta-analyses and a frequentist random-effects network meta-analysis were performed using Review Manager 5.4, R 4.4.0, and STATA 14.0. Interventions were ranked using the Surface Under the Cumulative Ranking Curve (SUCRA). The protocol was registered with PROSPERO (CRD42023414987). RESULTS:Sixty-one randomized controlled trials involving 6932 patients and 10 psychological interventions were included in the network meta-analysis. Cancer and living meaningfully interventions (SMD ranged from -1.78 to -2.68), comprehensive therapy (SMD ranged from -0.97 to -1.67), mindful-ness-based interventions(SMD = -0.90; 95%CrI [-1.56, -0.24]), and cognitive behavioral therapy(SMD = -0.71; 95%CrI [-1.18, -0.23]) were superior to control comparisons for improving FCR. Subgroup analyses showed that face-to-face delivery formats and longer intervention durations were consistently associated with greater effectiveness. Global and local consistency diagnostics indicated good model fit. CONCLUSIONS:Cancer and living meaningfully, comprehensive therapy, acceptance and commitment therapy, mindfulness-based interventions and cognitive behav-ioural therapy are the most efficacious psychological interventions for reducing FCR and should be prioritized in clinical care. Clinicians should consider implementing interventions delivered face-to-face and of longer duration to maximize therapeutic benefits.

To systematically review the predictive performance of Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), and Edmonton Frailty Scale (EFS) for adverse outcomes including postoperative complications, unplanned readmission, 30-day mortality, prolonged length of stay among cancer patients. A comprehensive search was conducted across English and Chinese databases until October 2, 2025. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies 2 tool. Predictive performance was evaluated by pooling sensitivity, specificity, and summary receiver operating characteristic curves. There were 21 studies (4,435 individuals) that were included for the meta-analysis. TFI demonstrated pooled sensitivities of 0.64 (for postoperative complications), 0.77 (for unplanned readmission), and 0.50 (for prolonged hospital stay), with corresponding specificities of 0.67, 0.54, and 0.64 respectively. The areas under the curve (AUC) were 0.70, 0.71, and 0.60. GFI demonstrated sensitivities of 0.59, 0.65, and 0.55 for complications, 30-day mortality, and functional decline, with specificity of 0.73, 0.63, and 0.77, and the AUC of 0.71, 0.68, and 0.74. EFS had sensitivity 0.39, specificity 0.87, and AUC 0.57 for complications. Subgroup analysis revealed that TFI had reasonable predictive value for adverse outcomes with sensitivity 0.61–0.81 and specificity 0.60–0.68 among most gynecological and gastrointestinal cancer subgroups. In most subgroups, GFI showed higher specificity (0.64–0.84) relative to sensitivity (0.43–0.68). TFI and GFI demonstrated moderate predictive validity for adverse outcomes, whereas EFS exhibited poor predictive performance. These findings highlight the necessity for caution interpretation of frailty assessments in clinical practice and underscore the importance of further validating these tools within diverse oncological contexts.

Cancer patients experience changing supportive care needs throughout the disease journey. However, existing Patient Journey Map (PJM) mainly describe experiences at specific stages, with limited attention to supportive care needs across the cancer trajectory and opportunities for care improvement. This qualitative meta-synthesis aimed to synthesize evidence on supportive care needs across the cancer patient journey from a cross-cancer perspective and develop an integrated PJM framework to capture unmet needs and experiences across disease stages and identify opportunities for supportive care. This qualitative meta-synthesis aimed to synthesize evidence on supportive care needs across the cancer patient journey from a cross-cancer perspective and to develop an integrated Patient Journey Map (PJM) framework that illustrates changes in patients’ unmet needs and experiences across disease stages and identifies opportunities for supportive care. A systematic search was conducted across eight electronic databases from database inception to March 2026. Qualitative studies using a PJM approach to explore the supportive care needs and experiences of cancer patients were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research, and confidence in the synthesized findings was evaluated using the ConQual approach. Findings were synthesized using the JBI meta-aggregation methodology. Thirteen studies involving patients with diverse cancer types were included. Three synthesized findings were identified: (1) Challenges at the cognitive and psychosocial levels during the diagnostic phase; (2) Physical and psychological distress and unmet supportive needs under multiple treatment burdens; (3) Rehabilitation remodeling and ongoing challenges during long-term adaptation in the follow-up period. In addition, three cross-cutting trajectories: information needs and financial burden, identity reconstruction, and fear of recurrence, were identified as evolving needs that spanned the entire cancer journey. Based on these findings, an integrated cancer PJM framework was developed to characterize changes in supportive care needs, identify stage-specific intervention opportunities, and support the delivery of person-centered care across the cancer journey. This review provides a comprehensive understanding of stage-specific changes in supportive care needs across the cancer patient journey and extends existing PJM research by proposing an integrated cross-cancer PJM framework with potential transferability. The findings offer a theoretical foundation for designing stage-specific, patient-centered supportive care interventions, improving care coordination across the cancer journey, and informing future research on the development and implementation of an integrated cancer PJM framework. Not applicable

BACKGROUND:Frailty is a key intervention target for older adults with cardiovascular-kidney-metabolic (CKM) syndrome. Evidence suggests that the triglyceride glucose (TyG) index and body roundness index (BRI) are associated with frailty; however, the predictive value of their combination (TyG-BRI) remains unclear. METHODS:We analyzed data from 3687 middle-aged and older adults with CKM syndrome in the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020). The frailty index serving as the outcome variable was constructed based on 30 multidimensional health deficit items. The primary exposure, the TyG-BRI index, was calculated as the product of the TyG index and the BRI. Latent growth mixture modeling was employed to identify frailty trajectories. Multivariable adjusted logistic regression was conducted to explore the association between TyG-BRI and frailty trajectories. Subgroup analyses were performed to elucidate the interactions among these factors further. RESULTS:Three distinct frailty trajectories emerged: pre-frailty to frailty deterioration (18.8%), persistent frailty (53.7%), and pre-frailty transition to health (27.4%). The highest TyG-BRI quartile was associated with a higher risk of pre-frailty to frailty deterioration than the lowest quartile (OR = 2.229, 95% CI, 1.137-4.367). Subgroup analysis indicated a significant interaction between age and the association of TyG-BRI with frailty trajectories (p = .041), suggesting the need for age-specific intervention strategies. CONCLUSIONS:The TyG-BRI may be an early metabolic biomarker for pre-frailty to frailty deterioration in individuals with CKM syndrome, particularly in older adults. These findings suggest a critical intervention window targeting metabolic dysregulation during the pre-frailty stage.

Frailty is highly prevalent among older gastric cancer patients and strongly associated with adverse postoperative outcomes. While frailty interventions have been implemented, few have focused on family cohesion as a pivotal aspect. This study aims to evaluate the effectiveness of a family cohesion-centered frailty intervention grounded in the Satir Family Therapy Model among for high-risk frailty older patients with gastric cancer. A non-randomized, time-based controlled trial was conducted in a tertiary hospital in China, with 79 participants and their family caregivers allocated according to sequential admission periods into an experimental group (n = 40) or a control group (n = 39). The intervention focused on enhancing family communication and cohesion. Frailty, family cohesion, self-efficacy, anxiety, depression, and quality of life were assessed on the day of admission (T0), at the end of the intervention, specifically at 4 weeks after surgery (T1), and 1 month after the completion of the intervention (T2). Analyses used generalized estimating equations with multiple imputation under an intention-to-treat framework, adjusting for demographic and clinical covariates. Moderation analyses tested three-way interactions. Significant group by time interactions were observed for frailty, family cohesion, self-efficacy, anxiety, depression, and quality of life (all P < 0.05). Compared with usual care, the experimental group showed greater reductions in frailty, anxiety, and depression and was associated with improvement in family cohesion, self-efficacy, and quality of life, with effects strengthening at T2. Sensitivity analyses yielded consistent results. Limited moderating effects were identified for age, education, and TNM stage. The family-cohesion-centered intervention was associated with multidimensional and sustained improvements among older gastric cancer patients at high risk of frailty. By integrating the Satir Family Therapy Model into perioperative care, this program may represent a feasible family-based approach that could contribute to optimizing frailty management and postoperative recovery. However, the non-randomized, time-based controlled design may introduce potential biases, including from secular trends or contamination; such biases could affect the estimates in either direction. Further randomized controlled trials are needed to verify this. ChiCTR2400082744.

Frailty is prevalent in older gastric cancer patients, seriously affecting prognosis. This study aimed to estimate the effect of hypothetical interventions on frailty heterogeneous trajectories (FHT) to design targeted intervention programs. Data from a longitudinal follow-up study of 381 gastric cancer patients ≥60 years were collected at admission, discharge, and 1, 3, 6, and 12 months post-surgery. The parametric g-formula estimated the effects of single and joint hypothetical interventions on FHT risk across physical, psychological, familial, and social factors. The observed FHT risk was 43.57%. Single intervention on nutrition most effectively reduced FHT risk (RR = 0.790, 95% CI: 0.692-0.974), followed by family cohesion (RR = 0.810) and social objective support (RR = 0.822). The “all-factors” joint intervention reduced risk by 31.26% (RR = 0.323, 95% CI: 0.208-0.685). An evidence-based intervention program was designed with good precision and scientificity. Based on optimal intervention combinations determined from parametric g-formula, we designed a comprehensive FHT intervention program covering multiple time periods, scenarios and factors, providing theoretical and practical guidance for frailty prevention in older gastric cancer patients.

INTRODUCTION:Poor physical activity (PA) conditions post-bariatric surgery can negatively affect patient prognosis. The long-term PA intervention effects are suboptimal, and lacking exploration regarding the dose-response relationship between intervention configurations and outcome. This study aims to explore the association between post-bariatric surgery PA intervention design components and actual PA improvements. METHODS:Seven electronic databases were searched. Included were randomized or quasi-randomized controlled trials post-bariatric surgery that implemented PA interventions and reported PA levels. Meta-analyses were conducted for changes in PA and BMI. Subgroup analysis and meta-regression were performed based on score of consensus on exercise reporting template (CERT), subjective and objective PA reports, intervention type, and intervention-related timing. RESULTS:Out of 11,896 screened articles, 16 were included, totaling 1256 participants. Meta-analysis results showed significant improvements in PA status at the end of the intervention (SMD = 0.82, 95%CI 0.25-1.40, p = 0.005), with no significant differences in PA changes at follow-up times or BMI changes (p > 0.05). Subgroup analysis indicated that subjective reporting, combined exercise type, starting intervention 1.5 months post-surgery, and a CERT score ≤7, as well as clear reporting of certain CERT items, enhanced intervention effects. Meta-regression demonstrated significant associations between CERT score and changes in PA (β = 0.415, p = 0.038) and BMI (β = -0.253, p = 0.022) at follow-up times. CONCLUSIONS:PA interventions should adopt a training program combining resistance training with aerobic exercise, clearly define training equipment and locations, and provide supervision, motivational strategies, replicable exercise guidance, and training compliance evaluations to enhance the long-term improvement of PA levels in post-bariatric surgery patients.

With advancements in cancer treatment approaches, patients face increasingly complex decisions regarding their care and treatment. Although Shared Decision-Making (SDM) can help patients make more informed and optimal choices, its development remains limited, and it has not been widely integrated into clinical practice. Identifying the barriers and facilitators to SDM from the perspective of patients and health care providers (HCPs) is essential. The Capability, Opportunity, and Motivation Model of Behaviour (COM-B) provides a framework for understanding these factors. This review aimed to explore the barriers and facilitators of SDM between patients and HCPs on the basis of the COM-B and to identify key common and dual-effect factors. Seven databases were searched for qualitative, quantitative, and mixed-methods studies. Data on the study design and key findings were extracted and analyzed guided by the COM-B model. The findings were reported in accordance with the PRISMA guidelines. Study quality was appraised via the Mixed Methods Appraisal Tool. A total of 6,811 papers were identified, 32 of which met the inclusion criteria. From these studies, 64 key barriers and facilitators influencing the implementation of SDM from the perspective of patients and HCPs were extracted. These factors were systematically categorized according to the subcomponents of the COM-B model: physical capability (e.g, poor health status), psychological capability (e.g, inaccurate understanding of the disease), reflective motivation (e.g, conflicting goals), automatic motivation (e.g, fear of cancer), physical opportunity (e.g, supplemental resources), and social opportunity (e.g, good family support). Guided by the COM-B model, this study identified factors associated with SDM among patients with cancer and HCPs. Further analysis revealed that some factors are shared by both groups; interventions targeting these common factors may produce simultaneous effects on patients and HCPs, offering more implementation value. Other factors exhibit dual characteristics, acting as both facilitators and barriers depending on the context. Future efforts should focus on exploring mechanisms to address such barriers into facilitators in specific clinical settings, thereby promoting the widespread implementation of SDM. Our protocol was registered in PROSPERO (ID: CRD42024568101).

Frailty is prevalent in older patients with gastric cancer, seriously affecting their prognosis. The time-varying nature of frailty increases the difficulty of intervention. This study aimed to estimate the effect of hypothetical interventions on the risk of frailty heterogeneous trajectory (FHT) at physical, psychological, familial, and social levels to provide a basis for the subsequent design of intervention programs of FHT. The data of hypothetical interventions from a longitudinal follow-up study of older patients with gastric cancer were obtained for 381 patients ≥ 60 years complete at admission, discharge, 1, 3, 6, and 12 months after surgery. The parametric g-formula was used to estimate the risk of single hypothetical interventions on nutrition, anxiety, depression, family cohesion and adaptability, social objective and subjective support, and nursing satisfaction, and its joint interventions in different combinations, for FHT, which were compared with observations to calculate population risk ratios and to determine the optimal combination of interventions. The observed risk of FHT was 43.57 https://clinicaltrials.gov/ct2/show/NCT05982899 .

Background:Postoperative glioma patients experience diverse rehabilitation needs impacting their quality of life (QoL). Understanding the dynamic changes in these needs and their relationship with QoL is crucial for developing tailored care strategies. Methods:Using convenience sampling, 115 postoperative glioma patients from the neurosurgery department of The First Affiliated Hospital of Nanjing Medical University were enrolled. Rehabilitation needs and QoL were assessed using standardized questionnaires at 3 postoperative phases: T1 (early), T2 (3 months), and T3 (6 months). Results:Rehabilitation needs were significantly influenced by age, clinical stage, education, surgery type, disease knowledge, and monthly household income (P <.05). Total needs scores and specific dimensions varied significantly across T1, T2, and T3 (P <.05): Physiological, spiritual, and psychological needs decreased by 3 months (T2). Care and information needs declined by 6 months (T3).Self-esteem needs increased progressively, peaking at T3. A negative correlation existed between rehabilitation needs and QoL at all time points (P <.05), indicating higher needs corresponded to poorer QoL. Conclusion:Postoperative glioma patients exhibit dynamic, multifaceted rehabilitation needs influenced by clinical and socioeconomic factors. The 3-month postoperative phase (T2) represents a critical window for intervention, characterized by heightened needs and diminished QoL. The consistent inverse relationship between needs and QoL underscores the necessity for personalized, phase-specific rehabilitation programs to optimize patient outcomes.

We investigated how body fat distribution, specifically central adiposity measured by the A Body Shape Index (ABSI), modifies the association between obstructive sleep apnea (OSA) and frailty and explored racial /ethnic differences, particularly focus on non-Hispanic White individuals. We used data from 4,154 adults in the NHANES 2015–2018. Frailty was measured using the 36-item Frailty Index. We applied logistic regression models to investigate the association between OSA and frailty, grouping participants into three levels (tertiles) based on their ABSI scores, with particular focus on the role of non-Hispanic White individuals. Among the 4,154 participants, 2,376 (57.2%) had OSA, and 469 (19.7%) were classified as frail. Individuals with OSA had a 1.5 times higher likelihood of frailty (P < 0.001). However, this association varied based on central adiposity levels. In participants with the lowest ABSI, no significant relationship was found between OSA and frailty. In contrast, the association was significant among those with moderate (OR = 1.564, 95% CI: 1.062–2.303, P = 0.049) and high (OR = 1.681, 95% CI: 1.105–2.556, P = 0.038) ABSI levels, indicating that greater central adiposity amplifies the OSA-frailty link. Racial differences were also evident. Non-Hispanic White participants exhibited a stronger association between OSA and frailty (OR = 1.829, 95% CI: 1.148–2.914, P = 0.009) compared to other racial/ethnic groups in the intermediate ABSI group. These findings emphasize the role of central adiposity in frailty risk among individuals with obstructive sleep apnea and underscore the need for race/ethnicity-specific risk assessments.

This paper reviewed the concept and significance,evaluation methods,management characteristics and intervention measures of symptom burden in cancer survivors at home and abroad,so as to promote nursing staff's attention to symptom burden management and provide guidance for symptom burden management.