This study is a prospective observational study to systematically compare the effects of intermittent tube feeding and thickened feeding on dehydration status, thirst degree and quality of life in patients with dysphagia after stroke. A total of forty-eight patients with dysphagia after stroke were selected and divided into intermittent tube feeding group (twenty-four cases) and thickened feeding group (twenty-four cases). The grouping was based on the nutritional intake mode after clinical decision-making. Participants were selected from the Affiliated Brain Hospital of Nanjing Medical University and the First Affiliated Hospital of Nanjing Medical University. All enrolled patients received conventional treatment and nursing measures and were treated for 2 weeks. The dehydration status was evaluated by plasma osmotic pressure. The degree of thirst is evaluated by the Numerical Rate Scale. Total protein and Hb are used to assess nutritional status; The Functional Oral Intake Scale (FOIS) assesses swallowing function. The Swallowing Quality of Life Scale (SWAL-QOL) was used to assess the quality of life. After 2 weeks of treatment, the improvement in dehydration and thirst in intermittent tube feeding group was better than that in thickened feeding group (P < 0·05). The FOIS and SWAL-QOL scores of both groups of patients improved compared with those before treatment (P < 0·05). Intermittent tube feeding can improve the dehydration status of patients with dysphagia after stroke, relieve thirst and enhance swallowing function and quality of life. The study may provide a more comprehensive basis for the selection of clinical nutritional support plans.

Background:Systemic inflammation plays a key role in the development and progression of coronary artery disease (CAD). However, the clinical relevance of hematologic inflammatory indices in elderly patients has not been fully clarified. Objective:To investigate the association of five hematologic inflammatory indices-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI)-with the presence and severity of CAD in an elderly population. Methods:This retrospective single-center study included 582 consecutive patients aged ≥60 years who underwent coronary angiography between 2021 and 2023. Based on the extent of coronary artery involvement, patients were categorized into four groups: normal (n = 131), single-vessel disease (n = 133), two-vessel disease (n = 136), and three-vessel disease (n = 182). Inflammatory indices were calculated from routine blood counts. Group differences were assessed using the Kruskal-Wallis test. Multivariable logistic regression analysis was performed after adjustment for age, sex, body mass index, hypertension, and diabetes. Discriminatory performance was evaluated using receiver operating characteristic (ROC) curve analysis with comparisons conducted by the DeLong test. Results:All five inflammatory indices were significantly associated with increasing angiographic severity of CAD (all P < 0.05). Among them, SIRI demonstrated the strongest independent association (OR = 4.91, 95% CI: 2.11-11.44) and the highest area under the ROC curve (AUC = 0.766), followed by SII (AUC = 0.749). The addition of inflammatory indices to conventional risk factors modestly improved model discrimination. Conclusion:This study demonstrates that SIRI and SII are valuable inflammatory biomarkers for evaluating the severity of coronary artery disease in elderly patients, highlighting the role of systemic inflammation in the progression of age-related atherosclerosis. As the first systematic comparison of five hematologic composite indices in a geriatric cohort, our findings suggest that SII and SIRI-both cost-effective and readily available parameters-are closely associated with CAD severity, though prospective studies are needed to establish their clinical value.

BACKGROUND:The accurate prediction of Alzheimer's disease (AD) is crucial for the efficient management of its progression. The objective of this research was to construct a new risk predictive model utilizing novel plasma protein biomarkers for predicting AD incidence in the future and analyze their potential biological correlation with AD incidence. METHODS:A cohort of 440 participants aged 60 years and older from the Alzheimer's Disease Neuroimaging Initiative (ADNI) longitudinal cohort was utilized. The baseline plasma proteomics data was employed to conduct Cox regression, LASSO regression, and cross-validation to identify plasma protein signatures predictive of AD risk. Subsequently, a multivariable Cox proportional hazards model based on these signatures was constructed. The performance of the risk prediction model was evaluated using time-dependent receiver operating characteristic (t-ROC) curves and Kaplan-Meier curves. Additionally, we analyzed the correlations between protein signature expression in plasma and predicted AD risk, the time of AD onset, the expression of protein signatures in cerebrospinal fluid (CSF), the expression of CSF and plasma biomarkers, and APOE ε4 genotypes. Colocalization and Mendelian randomization analyses was conducted to investigate the association between protein features and AD risk. GEO database was utilized to analyze the differential expression of protein features in the blood and brain of AD patients. RESULTS:We identified seven protein signatures (APOE, CGA, CRP, CCL26, CCL20, NRCAM, and PYY) that independently predicted AD incidence in the future. The risk prediction model demonstrated area under the ROC curve (AUC) values of 0.77, 0.76, and 0.77 for predicting AD incidence at 4, 6, and 8 years, respectively. Furthermore, the model remained stable in the range of the 3rd to the 12th year (ROC ≥ 0.74). The low-risk group, as defined by the model, exhibited a significantly later AD onset compared to the high-risk group (P < 0.0001). Moreover, all protein signatures exhibited significant correlations with AD risk (P < 0.001) and the time of AD onset (P < 0.01). There was no strong correlation between the protein expression levels in plasma and CSF, as well as AD CSF biomarkers. APOE, CGA, and CRP exhibited significantly lower expression levels in APOE ε4 positive individuals (P < 0.05). Additionally, colocalization analysis reveals a significant association between AD and SNP loci in APOE. Mendelian randomization analysis shows a negative correlation between NRCAM and AD risk. Transcriptomic analysis indicates a significant downregulation of NRCAM and PYY in the peripheral blood of AD patients (P < 0.01), while APOE, CGA, and NRCAM are significantly downregulated in the brains of AD patients (P < 0.0001). CONCLUSION:Our research has successfully identified protein signatures in plasma as potential risk biomarkers that can independently predict AD onset in the future. Notably, this risk prediction model has demonstrated commendable predictive performance and stability over time. These findings underscore the promising utility of plasma protein signatures in dynamically predicting the risk of AD, thereby facilitating early screening and intervention strategies.

BACKGROUND:Silent aspiration poses significant clinical risks in dysphagia patients, contributing to recurrent respiratory infections and aspiration pneumonia that ultimately result in elevated hospitalization rates and increased mortality. While video fluoroscopic swallowing studies (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) remain the diagnostic gold standards, their high costs create substantial barriers to efficient large-scale screening. Conventional bedside swallowing assessments demonstrate limited sensitivity for silent aspiration detection due to inherent subjectivity in evaluation process. This diagnostic dilemma presents nursing professionals with critical challenges in achieving timely and accurate identification of aspiration events. OBJECTIVE:To develop and validate a diagnostic model for detecting silent aspiration in dysphagia patients through acoustic analysis of breath sound parameters. DESIGN:A prospective diagnostic accuracy study. SETTINGS:Four hospitals in Nanjing, China. PARTICIPANTS:A total of 212 patients with dysphagia were included in this study. METHODS:Breath sounds were recorded with an electronic stethoscope, and acoustic parameters were extracted via Fourier transform spectral analysis. The relative change in acoustic parameters was quantified by comparing post-swallow measurements against baseline values. Based on VFSS/FEES findings, breath sounds were categorized into no aspiration, silent aspiration, and overt aspiration. Through computer-generated randomization, samples were stratified into modeling (70 %) and validation (30 %) groups. A logistic regression diagnostic model was developed in the modeling cohort, with subsequent evaluation of its performance in the validation group using receiver operating characteristic (ROC) curve analysis. RESULTS:Silent aspiration breath sounds demonstrated comparable prevalence between cohorts, occurring in 41.6 % (226/543; modeling group) and 41.8 % (97/232; validation group). The derived logistic model comprised three acoustic parameters with the following equation: logit(P) = -0.621 - (0.672 × change of aggregated entropy) + (0.279 × change of average power) + (0.632 × change of delta time). ROC analysis revealed comparable diagnostic performance between cohorts, with the modeling cohort demonstrating an AUC of 0.785 (95 % CI: 0.744-0.821) and the validation cohort achieving 0.746 (95 % CI: 0.679-0.806). CONCLUSION:A novel acoustic-based diagnostic model for silent aspiration risk stratification in dysphagia patients demonstrated good discriminatory power across both modeling and validated cohorts. This decision-support tool enables nursing staff to proactively identify high-risk patients through continuous monitoring, facilitating early implementation of aspiration-prevention protocols.

Objective: To assess the efficacy and safety of thymosin alpha 1 (Tα1) combined with sivelestat sodium and ambroxol in elderly patients with sepsis-associated acute respiratory distress syndrome (ARDS). Methods: In this single-center randomized trial, 171 elderly patients with sepsis-associated ARDS were assigned to a control group (sivelestat sodium + ambroxol, n=86) or an experimental group (same regimen + Tα1, n=85) for 7 days, both receiving high-flow nasal cannula oxygen therapy. Primary outcomes included clinical response, mortality, survival, respiratory function, and safety. Results: The experimental group showed a higher overall response rate than the control group (85.9% vs. 72.1%, P<0.05), lower 28-day mortality (17.6% vs. 27.9%, P<0.05), and higher 90-day survival (77.6% vs. 62.8%, P<0.05). Respiratory function improved significantly, with no difference in adverse event rates between groups. Conclusions: Tα1 combined with sivelestat sodium and ambroxol enhances clinical outcomes and respiratory function, reduces mortality, and demonstrates a favorable safety profile in elderly sepsis-associated ARDS patients.

The vacuolar-type H+-ATPase (V-ATPase) is a proton pump responsible for controlling the intracellular and extracellular pH of cells. Its activity and assembly are tightly controlled by multiple pathways, of which phosphorylation-mediated regulation is poorly understood. In this report, we show that in response to starvation stimuli, the nonreceptor tyrosine kinase ABL1 directly interacts with ATP6V1B2, a subunit of the V1 domain of the V-ATPase, and phosphorylates ATP6V1B2 at Y68. Y68 phosphorylation in ATP6V1B2 facilitates the recruitment of the ATP6V1D subunit into the V1 subcomplex of V-ATPase, therefore potentiating the assembly of the V1 subcomplex with the membrane-embedded V0 subcomplex to form the integrated functional V-ATPase. ABL1 inhibition or depletion impairs V-ATPase assembly and lysosomal acidification, resulting in an increased lysosomal pH, a decreased lysosomal hydrolase activity, and consequently, the suppressed degradation of lumenal cargo during macroautophagy/autophagy. Consistently, the efficient removal of damaged mitochondrial residues during mitophagy is also impeded by ABL1 deficiency. Our findings suggest that ABL1 is a crucial autophagy regulator that maintains the adequate lysosomal acidification required for both physiological conditions and stress responses.Abbreviation: ANOVA: analysis of variance; Baf A1: bafilomycin A1; CCCP: carbonyl cyanide 3-chlorophenylhydrazone; CRK: CRK proto-oncogene, adaptor protein; CTSD: cathepsin D; DMSO: dimethylsulfoxide; EBSS: Earle's balanced salt solution; FITC: fluorescein isothiocyanate; GFP: green fluorescent protein; GST: glutathione S-transferase; LAMP2: lysosomal associated membrane protein 2; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; MTORC1: mechanistic target of rapamycin kinase complex 1; PD: Parkinson disease; PLA: proximity ligation assay; RFP: red fluorescent protein; WT: wild-type.

Physio-Cognitive Decline Syndrome (PCDs) is characterized by the coexistence of MIND (mobility impairment, no disability) and CIND (cognitive impairment, no dementia), which predicts dementia risk. Deteriorating oral health can contribute to malnutrition, cognitive decline, and physical frailty, all of which may exacerbate PCDs symptoms. This study investigates the association between oral health and PCDs, exploring sex differences in this relationship. A cross-sectional analysis of the baseline data from the Nanjing Brain Health Cohort included 252 participants aged 60 and older, assessing physical mobility (6-meter walk test, grip strength), cognitive function (MoCA), and oral health (natural teeth count, denture use, tongue and lip motor function, masticatory and swallowing ability, Oral Frailty Index). Logistic regression models were used to examine associations between oral health and PCDs. Among participants, 15.5

Abstract Background Oral frailty is reported to increase the risk of new onset of mild cognitive impairment. Whereas, the association of oral frailty with cognition among older adults in both physical frail and non-physical frail status has not been sufficiently explored, and whether there are sex differences in the association is unclear. This study investigated the association of oral frailty and physical frailty with global cognitive function and executive function among older adults, as well as the sex differences in such association. Methods This cross-sectional study included 307 participants aged ≥ 60 years old from communities between June 2023 and August 2023, in Nanjing, China. Global cognitive function and executive function were assessed by using the Montreal Cognitive Assessment (MoCA) and Trail Making Tests A (TMT-A), respectively. Oral frailty was identified by the combination of natural tooth, Oral Frailty Index-8 (OFI-8), and oral diadochokinesis. Physical frailty was measured by using Fried phenotype model which contained 5 criteria: unintentional weight loss, weakness, exhaustion, slowness, and low physical activity. Multiple linear regression analyses for overall participants and stratified by sex and presence or absence of physical frailty were performed, respectively, to examine the association between oral frailty and cognitive functions. Results The median age of participants was 70 years old. The study included 158 (51.5%) females, 53 (17.3%) individuals with physical frailty, and 65 (21.2%) participants with oral frailty. After adjustment, the association between oral frailty and global cognitive function was observed in the physical frailty group (B = -2.67, 95% Confidence Interval [CI]: -5.27 to -0.07, p = 0.045) and the females with physical frailty (B = -4, 95% CI: -7.41 to -0.58, p = 0.024). Oral frailty was associated with executive function in overall participants (B = 0.12, 95% CI: 0.01 to 0.22, p = 0.037), physical frailty group (B = 23.68, 95% CI: 1.37 to 45.99, p = 0.038). In the adjusted models, oral frailty was significantly associated with executive function in all females (B = 0.21, 95% CI: 0.05 to 0.36, p = 0.009), in females without physical frailty (B = 0.19, 95% CI: 0.02 to 0.36, p = 0.027), and in females with physical frailty (B = 48.69, 95% CI: 7.17 to 90.21, p = 0.024). Conclusions Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among older adults, particularly among females. It is ponderable to consider sex differences and facilitate the management of physical frailty when it comes to promoting cognitive health based on the perspective of oral health among older adults.

Glioma is a refractory malignant tumor with a powerful capacity for invasiveness and a poor prognosis. This study aims to investigate the role and mechanism of tubulin beta class IVA (TUBB4A) in glioma progression. The differential expression of TUBB4A in humans was obtained from databases and analyzed. Glioma cells U251-MG and U87-MG were intervened by pcDNA3.1(+) and TUBB4A overexpression plasmid. MTT, CCK8, LDH, wound healing, transwell, and western blotting were used to explore whether TUBB4A participates in the development of glioma. Reactive oxygen species (ROS) were detected by the DCFH-DA probe. Mitochondrial membrane potential (MMP) was examined by JC-1. It was found that TUBB4A expression level correlated with tumor grade, IDH1 status, 1p/19q status, and poor survival in glioma patients. In addition, TUBB4A overexpression inhibited the proliferation, migration, and invasion of U251-MG and U87-MG, while increasing the degree of apoptosis. Notably, TUBB4A overexpression promotes ROS generation and MMP depolarization, and induces mitophagy through the PINK1/Parkin pathway. Interestingly, mitochondria-targeted ROS scavenger reversed the effect of TUBB4A overexpression on PINK1/Parkin expression and mitophagy, whereas mitophagy inhibitor did not affect ROS production. And the effect of TUBB4A overexpression on mitophagy and glioma progression was consistent with that of PINK1/Parkin agonist. In conclusion, TUBB4A is a molecular marker for predicting the prognosis of glioma patients and an effective target for inhibiting glioma progression by regulating ROS-PINK1/Parkin-mitophagy pathway.

Aims/Background The prevalence of postpartum fatigue among primipara is high in China, which seriously affects women's subsequent physical and mental recovery. In order to deeply understand this phenomenon, domestic scholars began to conduct research on postpartum fatigue from the aspects of assessment tools and intervention measures. This study aims to investigate postpartum fatigue in primiparous women and its association with family functioning and social support, providing valuable insights for improving the condition in this population. Methods Primiparous women from February 2023 to March 2024 were selected as participants. Baseline demographic information was collected, and postpartum fatigue levels were assessed using Postpartum Fatigue Scale (PFS) at 7 days postpartum. Social support was evaluated with Postpartum Social Support Scale, and maternal role adaptation was assessed using Maternal Role Adaptation Questionnaire (MRAQ). Pearson correlation analysis was conducted to examine the relationship between postpartum fatigue levels, role adaptation, and social support. Results A total of 210 survey questionnaires were distributed; following which, 201 valid questionnaires were received. The total PFS score was 13.93 ± 4.53 points. Among the participants, 50 cases (24.87%) experienced no fatigue, 58 cases (28.86%) with mild fatigue, 78 cases (38.81%) with moderate fatigue, and 15 cases (7.46%) with severe fatigue. There were statistically significant differences in all dimensions and total scores of the Postpartum Social Support Level Scale for primiparas with different levels of postpartum fatigue (p < 0.001), with those facing severe fatigue reporting significantly lower level of social support. There were statistically significant differences in the comparison of each dimension and total score of the role adaptation scale for primiparas with different levels of postpartum fatigue (p < 0.001). The degree of role adaptation in patients with severe fatigue was significantly lower. The PFS score of primiparas was negatively correlated with the level of social support and role adaptation (r = -0.693, r = -0.735, p < 0.001). Conclusion The majority of primiparous women experience varying degrees of postpartum fatigue at 7 days postpartum. Poor newborn health, artificial feeding, and nighttime feeding frequency ≥4 times per night can exacerbate postpartum fatigue. Good social support and role adaptation are beneficial in alleviating postpartum fatigue. Strengthening social support and role adaptation can help reduce postpartum fatigue levels in primiparous women.

The care for people with dementia (PwD) in low- and middle-income countries (LMICs) is dominated by home care and supplemented sporadically by public care provided using public resources. In the context of community resources cannot meet the demand for high-quality services for PwD, dementia-friendly communities (DFCs) provide ideas for alleviating this situation by integrating resources from multiple stakeholders. However, there is still a considerable gap between the capacity of services and the demand of PwD. Based on the experience of elderly services and DFCs construction in Nanjing, China, this study developed a stakeholder collaboration model and clarified the collaborative relationship among stakeholders such as the government, communities, and medical institutions in meeting the needs of PwD. This work summarizes the partnerships and specific actions of stakeholders and highlights the importance of facilitating resource integration to provide comprehensive services.

AimThe chin-down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin-down manoeuvre application.MethodologyWe retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022. Raters independently screened literature according to inclusion and exclusion criteria. The quality of the included literature was evaluated, and data were extracted. The software Review Manager software 5.3 was used for statistical analysis.ResultsFourteen studies with a total of 571 patients were included in this meta-analysis. The meta-analysis indicated that chin-down manoeuvre could significantly reduce the risk of aspiration (MD = -1.35, 95% CI [-2.25, -0.44], Z = 2.92, p < .01), decrease the chin angle (MD = -12.20, 95% CI [-14.61, -9.79], Z = 9.91, p < .001), shorten oral transit time (MD = -0.81, 95% CI [-1.20, -0.43], Z = 4.17, p < .001), reduce the maximum swallowing pressure at upper oesophageal sphincter (MD = -82.07, 95% CI [-112.77, -51.37], Z = 5.24, p < .001) and decrease pharyngeal residue.ConclusionsExisting evidence indicated that chin-down manoeuvre could reduce the risk of aspiration and pharyngeal residue, decrease the maximum swallowing pressure at UES. More large-sample, high-quality clinical trials are still needed in the future to further ascertain the results of this research.

The chin-down posture is a widely used compensatory manoeuvre for patients with dysphagia. The aim of this study was designed to systematically measure the effectiveness of chin-down manoeuvre application. We retrieved the PubMed, Web of Science, Embase, Cochrane Library, EBSCO, Medline, CNKI, WANFANG, VIP and SinoMed databases from inception to 30 August 2022. Raters independently screened literature according to inclusion and exclusion criteria. The quality of the included literature was evaluated, and data were extracted. The software Review Manager software 5.3 was used for statistical analysis. Fourteen studies with a total of 571 patients were included in this meta-analysis. The meta-analysis indicated that chin-down manoeuvre could significantly reduce the risk of aspiration (MD = −1.35, 95% CI [−2.25, −0.44], Z  = 2.92, p  < .01), decrease the chin angle (MD = −12.20, 95% CI [−14.61, −9.79], Z  = 9.91, p  < .001), shorten oral transit time (MD = −0.81, 95% CI [−1.20, −0.43], Z  = 4.17, p  < .001), reduce the maximum swallowing pressure at upper oesophageal sphincter (MD = −82.07, 95% CI [−112.77, −51.37], Z  = 5.24, p  < .001) and decrease pharyngeal residue. Existing evidence indicated that chin-down manoeuvre could reduce the risk of aspiration and pharyngeal residue, decrease the maximum swallowing pressure at UES. More large-sample, high-quality clinical trials are still needed in the future to further ascertain the results of this research.

As populations live longer, there is a progressive increase in chronic degenerative diseases, particularly those related to the musculoskeletal system. Sarcopenia is characterized by loss of skeletal muscle mass, muscle strength, and loss of physical function. It is a common disease in older adults associated with various adverse health outcomes. There is a lack of bioindicators to screen for sarcopenia. Albumin and lymphocyte counts are commonly used to assess the degree of malnutrition, and blood routine, lipids, and thyroid function are relatively easy to obtain as part of a routine physical examination. Therefore, finding blood markers that can screen for sarcopenia is essential. Our primary aim was to explore whether the bioindicators of body composition, lymphocytes, albumin, lipids, and thyroid hormones are associated with sarcopenia, and a secondary aim was to investigate changes in these indicators after an intensive lifestyle intervention preliminarily. 60 subjects were selected from Runda and Bailian community health centers in Suzhou, China. They underwent body composition analysis and tested lymphocyte, albumin, lipid, and thyroid hormone levels. The 30 sarcopenia subjects underwent a 3-month intensive lifestyle intervention program. At the end of the intervention, we rechecked the bioindicators. Statistical analyses were performed in IBM SPSS v26.0. The blood indices of sarcopenia subjects were generally lower in albumin, non-high-density lipoprotein cholesterol (non-HDL-C), and free triiodothyronine (FT3). Body mass index (BMI)(r = 0.6266, p < 0.0001), fat-free mass (r = 0.8110, p < 0.0001), basal metabolism (r = 0.7782, p < 0.0001), and fat mass (r = 0.3916, p = 0.0020) were positively correlated with appendicular skeletal muscle index (ASMI). Higher BMI and FT3 were associated with lower odds of sarcopenia, while higher fat mass was associated with higher odds of sarcopenia. After a 3-month intensive intervention, sarcopenia subjects had a significant increase in BMI, ASMI, lymphocyte, and albumin levels, and an increase in FT3, but with a non-significant difference (p = 0.342). Low BMI, FT3, and high fat mass were associated with sarcopenia. Intensive lifestyle intervention can significantly improve ASMI, BMI, lymphocytes, albumin, and FT3 in sarcopenia subjects, which is favorable for delaying the progression of sarcopenia. This study was retrospectively registered on ClinicalTrials.gov, registration number NCT06128577, date of registration: 07/11/2023.

Abstract Disclosure: Y. Cui: None. X. Zhang: None. L. You: None. H. Zhong: None. X. Cui: None. C. Ji: None. Obesity and its associated chronic diseases, such as type 2 diabetes mellitus, hypertension, and coronary artery disease, afflicting adults and children globally. PSMB9, a proteolytic subunit of the immunoproteasome that shapes the repertoire of antigenic peptides, is hypothesized to be associated with obesity. To investigate this association, we examined PSMB9 expression in primary mature adipocytes from obese and normal individuals. LC-MS/MS-PRM was used to quantify PSMB9 content in primary mature adipocytes, revealing a negative correlation between PSMB9 content and obesity while positively correlated with high-density lipoprotein levels. Furthermore, we examined the effect of PSMB9 on human preadipocyte differentiation. During the early stages of differentiation, the expression of PSMB9 was at its highest level, decreasing as preadipocytes matured. Overexpression of PSMB9 significantly inhibited preadipocyte differentiation, resulting in reduced lipid droplets and decreased expression levels of classical differentiation markers such as FABP4, C/EBPα, and PPARγ. These findings suggest that PSMB9 could be a potential therapeutic target for preventing and treating obesity and metabolic disorders. In conclusion, our study provides insights into the role of the immunoproteasome in obesity and highlights the importance of further exploration of this pathway. Presentation: Saturday, June 17, 2023

体面劳动感知(decent work perception,DWP)是个体对劳动体面度的主观感知.由于个体因素、组织因素和家庭社会因素,护理人员DWP处于较低水平,影响护理人员的就业意向与离职意愿.本文综述了国内外关于护理人员DWP的概念、测量工具、研究现状及影响因素,旨在为护理人员职业心理健康与人力资源管理提供参考.

Objective To understand the symptom experience of patients with mild cognitive impairment（MCI） and to provide refe-rence for targeted symptom management.Methods A descriptive qualitative design was used. A purposive sample of 16 patients with MCI was recruited.Individual face-to-face interviews were conducted with a semi-structured interview guideline.Content analysis was adopted to analyze the data.Results Three themes and seven sub-themes were extracted: symptom perception included cognitive symptoms, neuropsychiatric symptoms, and physical symptoms; symptom evaluation included lack of correct cognition on symptom and impact on self; and symptom coping included negative coping and positive coping.Conclusion Symptoms in MCI patients are complex and mutually interact with each other.Patients seem to lack knowledge of MCI symptoms, and some of them adopt negative coping.Health literacy of middle-aged and older adults should be improved, symptom assessment tool and intervention program for MCI should be constructed, and multifaceted social support should be provided to alleviate the symptom burden of MCI patients.

Background High turnover intention of nursing assistants was detrimental to the sustainability of long-term care. Career adaptability is an important determinant in reducing turnover intention, but little research has explored the mechanism from the perspective of psychological capital. The aim of this study was to analyze the association between career adaptability and turnover intention and to examine the mediating role of psychological capital between career adaptability and turnover intention among nursing assistants in mainland China. Methods A cross-sectional online study was conducted among 276 nursing assistants from eight nursing homes in Nanjing, China. The participants’ career adaptability, psychological capital, and turnover intention were obtained. SPSS 26.0 and Amos 24.0 software were employed for statistical analysis. Results Career adaptability was positively related to psychological capital and negatively linked to turnover intention ( P < 0.01). Psychological capital played a fully mediating role ( β = -0.085, P < 0.05) in the relationship between career adaptability and turnover intention, and the largest indirect effect was generated through the curiosity dimension. Conclusions The management of long-term care facilities should focus on assessing the level of career adaptability of nursing assistants. The overall improvement of career adaptability and psychological capital is conducive in reducing turnover intention. Targeted interventions are recommended to improve career adaptability and reduce turnover intentions by increasing career curiosity. Online career adaptability programs can be developed for nursing assistant students to improve their psychological capital and facilitate career transitions.

Background Polypharmacy increases the risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI). This study conducts a retrospective analysis to detect PIMs, DDIs and adverse drug reactions (ADR) among older adults with psychiatric disorders. Methods A retrospective analysis was carried out based on medical records of aged inpatient people with psychiatric disorders. Demographic details, hobbies, medical history, medication and laboratory examination were extracted. Three criteria and one online DDIs database were used to detect PIMs and DDIs. The minimally clinical important difference (MCID) was defined as the score change of the Treatment Emergent Symptom Scale (TESS) between admission and discharged. Mean and standard deviation (SD) was used for continuous variables and frequency was calculated for dichotomous variables. Ordinal regression was carried out to detect the independent factors of PIM. Binary logistic regression analysis was implemented to determine the independent factors on the likelihood of ADR or the MCID. ANOVA was used to detect the relationship between the co-administration of drugs and the changes of ALT, AST, urea nitrogen, creatinine, total cholesterol, triglycerides. P<0.05 was considered as statistically significant. Results 96.8% inpatients had at least 1 PIM and lorazepam was the most frequently prescribed drug (75.0%). Co-administration of three or more central nervous system (CNS) active drugs was the principal DDI (70.45%) and the most frequent DDI which should be avoided was the co-administration of lorazepam and olanzapine (55.5%). The common ADR were constipation (25.6%), hepatotoxicity (14.0%) and extrapyramidal symptoms (13.0%). The co-administration of quetiapine and potassium chloride was an independent risk factor of constipation (P=0.011, OR=10.821, 95%CI [1.738 67.748]) and the score change of TESS scale (P=0.024, OR=0.024, 95%CI [1.274 32.288]). Conclusions The rate of PIM in the elderly with psychiatric disorders is high and brought serious adverse consequences. Further studies to prevent medication-related problems and costs such as raising awareness of PIM and DDI among healthcare professionals and patients, regulating deprescription, the pharmacokinetic and pharmacodynamic mechanism of drugs induced DDIs, and the influence of different drug administration routes on DDIs among aged people are needed.