Thermal-Induced Microstructure Deterioration of Egyptian Granodiorite and Associated Physico-Mechanical Responses.

Mineral transformations often induce microstructural deteriorations during temperature variations. Hence, it is crucial to understand why and how this microstructure weakens due to mineral alteration with temperature and the correlated physical and mechanical responses. Therefore, in this study, physical, chemical, thermal, petrographic, and mechanical analyses were carried out to comprehend better the thermal behaviors of Egyptian granodiorite exposed to temperatures as high as 800 °C. The experimental results indicate that the examined attributes change in three distinct temperature phases. Strength zone (up to 200 °C): During this phase, the temperature only slightly impacts the granodiorite mass loss and porosity, and the P-wave velocity and E slightly decrease. However, the rock structure was densified, which resulted in a minor increase in strength. After that, the transition zone (200-400 °C) was distinguished by the stability of most studied parameters. For instance, mass and porosity did not significantly alter, and the uniaxial compressive strength steadily increased with an axial failure mode. When the temperature rises, transgranular cracks cause the P-wave velocity and elastic modulus to decrease moderately. The decay zone started after 400 °C and continued to 800 °C. This zone is characterized by complicated factors that worsen the granodiorite properties, lead to color shift, and produce a shear failure mode. The properties of granodiorite became worse because of chemical reactions, structural and crystal water evaporation, rising thermal expansion coefficient variation, and quartz inversion at 575 °C (α to ß, according to the differential thermal analysis). Thermal damage greatly affected granodiorite's physical and mechanical properties and microstructure at 800 °C. As a result, UCS measurements were extremely small with a complex failure pattern, making Vp and E unattainable.

Prevalence of multidimensional frailty among community-dwelling older adults: A systematic review and meta-analysis.

OBJECTIVE: The aims of this systematic review were to explore the pooled prevalence of multidimensional frailty assessed by the Tilburg Frailty Indicator among community-dwelling older adults. DESIGN: A systematic review and meta-analysis. METHODS: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Embase, the Cochrane Library, CINAHL and three Chinese databases. Two independent researchers selected the literatures, extracted the data and evaluated the quality. All statistical analyses were performed using STATA version 16.0. RESULTS: There were 66 studies with a total of 40,597 individuals that were eligible for the meta-analysis. Data from the meta-analysis revealed the pooled prevalence of 42 % for multidimensional frailty (95 % CI: 38 %-45 %, I2 = 98.9 %, T2 = 0.024, p < 0.001). Among the six studies that provided data for different age groups, the results demonstrated an increasing trend in the prevalence of multidimensional frailty with advancing age. The results of gender-stratified analysis proved that the pooled prevalence of multidimensional frailty in women (45 %, 95 % CI: 39 %-51 %, p < 0.001) was higher than that in men (33 %, 95 % CI: 28 %-39 %, p < 0.001). Based on different education levels, the prevalence of multidimensional frailty is highest in the primary elementary or illiterate group (41 %, 95 % CI: 30 %-52 %, p < 0.001). According to different marital status types, the pooled prevalence of multidimensional frailty in the married group was significantly lower (36 %, 95 % CI: 28 %-43 %) than that in the unmarried, divorced or widowed group (51 %, 95 % CI: 37 %-65 %). CONCLUSIONS: Through a comprehensive review, we identified that 42 % of elderly individuals living in communities exhibit multidimensional frailty, indicating that multidimensional frailty is relatively common in this population. Stratified analysis revealed that advanced age, female gender, lower education level and unmarried status were associated with higher rates of multidimensional frailty.

Synthesis of three cisplatin-conjugated asymmetric porphyrin photosensitizers for photodynamic therapy.

Photodynamic therapy provides a promising solution for treating various cancer types. In this study, three distinct asymmetric porphyrin-cisplatin complex photosensitizers (ZnPt-P1, ZnPt-P2, and ZnPt-P3) were synthesized, each having unique side chains. Through a set of experiments involving singlet oxygen detection and density functional theory, ZnPt-P1 was demonstrated to have excellent efficacy, exceeding that of ZnPt-P2 and ZnPt-P3. Notably, ZnPt-1 showed significant phototoxicity while maintaining low dark toxicity when tested on HepG2 cells. Additionally, further examination revealed that ZnPt-P1 had the capability to generate reactive oxygen species within cancer cells when exposed to light irradiation. Taken together, these results highlight the potential of ZnPt-P1 as a photosensitizer for use in photodynamic therapy. This study contributes to enhancing cancer treatment methodologies and provides insights for the future development of innovative drugs for photosensitization.

Comparative Analysis of Volatile Compounds from Four Radish Microgreen Cultivars Based on Ultrasonic Cell Disruption and HS-SPME/GC-MS.

The ultrasonic cell disruption method was used to efficiently extract isothiocyanates and other volatile compounds from radish microgreens. A total of 51 volatiles were identified and quantified by headspace solid-phase micro-extraction and gas chromatography-mass spectrometry (HS-SPME/GC-MS) in four radish microgreen cultivars, mainly including alcohols, aldehydes, isothiocyanates, sulfides, ketones, esters, terpenes, and hydrocarbons. The correlation between cultivars and volatile compounds was determined by chemometrics analysis, including principal component analysis (PCA) and hierarchical clustering heat maps. The aroma profiles were distinguished based on the odor activity value (OAV), odor contribution rate (OCR), and radar fingerprint chart (RFC) of volatile compounds. This study not only revealed the different flavor characteristics in four cultivars but also established a theoretical basis for the genetic improvement of radish microgreen flavors.

Relationship Between Cognitive Frailty and Mortality in Older Adults: A Systematic Review and Meta-Analysis.

OBJECTIVE: To synthesize the pooled mortality risk estimate and determine whether cognitive frailty is a predictor of mortality. DESIGN: A systematic review and meta-analysis. SETTING AND PARTICIPANTS: The participants were community-dwelling older adults aged ≥60 years. METHODS: PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library databases were systematically searched. Two researchers independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. We used STATA, version 15.0 to perform the all data. RESULTS: Nineteen studies were included. The association between cognitive frailty and a higher risk of death was statistically significant [hazard ratio (HR), 2.01; 95% CI, 1.84-2.19; P < .001]. The outcomes indicated that cognitive frailty was a critical risk factor for predicting mortality (OR, 4.82; 95% CI, 1.59-14.57; P < .01). Based on different models of cognitive frailty, the results of subgroup analyses revealed that the risk of mortality was the highest in the Frail + mild cognitive impairment group (HR, 2.35; 95% CI, 2.05-2.70; P < .001). The subgroup analyses by region demonstrated that mortality risk was lowest in the European group (HR, 1.63; 95% CI, 1.4-1.87; P < .001). CONCLUSIONS AND IMPLICATIONS: This study quantitatively portrays the pooled mortality risk estimate of cognitive frailty. The results suggest that in older adults, cognitive frailty can be a predictor of mortality. The findings could alert health care providers to pay more attention to cognitive frailty.

Liquid biopsy analysis of lipometabolic exosomes in pancreatic cancer.

Pancreatic cancer is characterized by its high malignancy, insidious onset and poor prognosis. Most patients with pancreatic cancer are usually diagnosed at advanced stage or with the distant metastasis due to the lack of an effective early screening method. Liquid biopsy technology is promising in studying the occurrence, progression, and early metastasis of pancreatic cancer. In particular, exosomes are pivotal biomarkers in lipid metabolism and liquid biopsy of blood exosomes is valuable for the evaluation of pancreatic cancer. Lipid metabolism is crucial for the formation and activity of exosomes in the extracellular environment. Exosomes and lipids have a complex relationship of mutual influence. Furthermore, spatial metabolomics can quantify the levels and spatial locations of individual metabolites in cancer tissue, cancer stroma, and para-cancerous tissue in pancreatic cancer. However, the relationship among exosomes, lipid metabolism, and pancreatic cancer is also worth considering. This study mainly updates the research progress of metabolomics in pancreatic cancer, their relationship with exosomes, an important part of liquid biopsy, and their lipometabolic roles in pancreatic cancer. We also discuss the mechanisms by which possible metabolites, especially lipid metabolites through exosome transport and other processes, contribute to the recurrence and metastasis of pancreatic cancer.

Multicomponent All-Carbon Cascade and Sequential Annulation: Construction of Functionalized Decalins.

The decalin skeleton is found in numerous bioactive molecules. The present study describes a multicomponent all-carbon cascade and sequential annulation involving benzoylacetonitrile derivatives and 2-arylidene-1,3-indanediones that yields highly functionalized decalin derivatives. The reaction strategy consisted of a consecutive Michael/Michael/tautomerization/Michael/Aldol annulation sequence and involved organic amine catalysts, mild conditions, and high stereoselectivity. This strategy, using a one-pot approach, resulted in the construction of four C-C bonds and the formation of fused carbocyclic decalin derivatives.

Social frailty as a predictor of adverse outcomes among older adults: a systematic review and meta-analysis.

BACKGROUND: With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function. AIMS: To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty. METHODS: Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale. RESULTS: A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)]. CONCLUSION: In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes.

Effectiveness of interventions in older adults with cognitive frailty: a systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: interventions targeting older adults with cognitive frailty have grown rapidly in recent years with inconsistent findings. However, there is no meta-analysis that has synthesised pooled estimates. OBJECTIVE: to synthesise the pooled effect of current targeted interventions in older people with cognitive frailty. METHODS: we conducted a systematic search in PubMed, Embase, Web of Science, the Cochrane Library, the JBI database and three Chinese databases (CNKI, Wan-Fang and VIP) for literature from the inception of the database until 8 March 2022. The mean difference or standardised mean difference with 95% CIs was calculated. The methodological quality was assessed by the Cochrane RoB 2.0. The certainty of evidence was assessed using the GRADE criteria. RESULTS: thirteen randomised controlled trials with a total of 1,089 participants were included. The results of the meta-analysis showed that older adults with cognitive frailty in the intervention groups had significant improvement in frailty score [MD = -1.67, 95% CI (-2.39, -0.95), P < 0.00001, I2 = 97%], global cognitive function [MD = 3.38, 95% CI (1.90, 4.85), P < 0.00001, I2 = 93%], mobility [MD = -0.96, 95% CI (-1.27, -1.66), P < 0.00001, I2 = 0%], muscle strength [SMD = 0.75, 95% CI (0.09, 1.41), P = 0.03, I2 = 85%] and nutritional status [MNA:MD = 5.64, 95% CI (3.99, 7.29), P < 0.00001, I2 = 89%; ALB: MD = 3.23, 95% CI (0.76, 5.71), P = 0.01, I2 = 93%; PALB: MD = 54.52, 95% CI (25.26, 83.77), P = 0.0003, I2 = 96%; TRF: MD = 0.64, 95% CI (0.22, 1.06), P = 0.003, I2 = 97%]. The overall certainty of the evidence ranged from low to moderate. CONCLUSIONS: interventions targeting older adults with cognitive frailty are effective in improving physical frailty, global cognitive function, physical function and nutritional status with low to moderate certainty. More research is still needed in the future to further enrich the evidence in these fields. PROSPERO NUMBER: CRD42022318758.

Lactate attenuates astrocytic inflammation by inhibiting ubiquitination and degradation of NDRG2 under oxygen-glucose deprivation conditions.

BACKGROUND: Brain lactate concentrations are enhanced in response to cerebral ischemia and promote the formation of reactive astrocytes, which are major components of the neuroinflammatory response and functional recovery, following cerebral ischemia. NDRG2 is upregulated during reactive astrocyte formation. However, its regulation and function are unclear. We studied the relationship between lactate and NDRG2 in astrocytes under conditions of ischemia or oxygen-glucose deprivation (OGD). METHODS: We examined astrocytic NDRG2 expression after middle cerebral artery occlusion (MCAO) using western blot and immunofluorescence staining. Under hypoxia conditions, we added exogenous L-lactate sodium (lactate) to cultured primary astrocytes to explore the effects of lactate on the ubiquitination modification of NDRG2. We profiled the transcriptomic features of NDRG2 silencing in astrocytes after 8 h of OGD conditions as well as exogenous lactate treatment by performing RNA-seq. Finally, we evaluated the molecular mechanisms of NDRG2 in regulating TNFα under OGD conditions using western blot and immunohistochemistry. RESULTS: Reactive astrocytes strongly expressed NDRG2 in a rat model of MCAO. We also showed that lactate stabilizes astrocytic NDRG2 by inhibiting its ubiquitination. NDRG2 inhibition in astrocytes increased inflammation and upregulated immune-associated genes and signaling pathways. NDRG2 knockdown induced TNFα expression and secretion via c-Jun phosphorylation. CONCLUSIONS: We revealed that under OGD conditions, lactate plays an important anti-inflammatory role and inhibits TNFα expression by stabilizing NDRG2, which is beneficial for neurological functional recovery. NDRG2 may be a new therapeutic target for cerebral ischemia.

Effects of virtual reality-based interventions on the physical and mental health of older residents in long-term care facilities: A systematic review.

BACKGROUND: Older residents in long-term care facilities often experience physical and mental health problems along with vulnerability to psychological and social stressors. Due to the shortage of human resources, the application of virtual reality technology may be a new way to promote healthy aging for older residents in long-term care facilities. OBJECTIVES: To identify the effects of virtual reality-based interventions for improving physical and mental health outcomes among older residents in long-term care facilities. DESIGN: Systematic review. METHODS: A systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. Four databases (the Cochrane Library, PubMed, EMBASE, and Web of Science) were searched from their inception until May 2022 for original articles. Randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of virtual reality-based interventions on physical and mental health outcomes were included. Two independent reviewers extracted trial data and assessed the risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group and the Methodological Index for Non-Randomized Studies. RESULTS: Of the 8511 articles that were screened, 30 articles including 1057 participants met the inclusion criteria. Many studies have investigated multiple outcomes. Eighteen of the twenty-five studies that assessed physical health-related outcomes (n = 18/25, 72%) reported positive intervention effects, and fourteen (n = 14/25, 56%) reported negative postintervention effects. Eight of the sixteen studies that assessed mental health-related outcomes (n = 8/16, 50%) reported positive intervention effects, while twelve (n = 12/16, 75%) reported negative intervention effects. Meta-analysis was not conducted due to the heterogeneity of the study designs and outcome measures. CONCLUSIONS: This study demonstrated that virtual reality-based interventions could be a safe and effective approach to improve the physical outcomes of older residents in long-term care facilities, but this evidence lacks certainty. The effectiveness of virtual reality-based interventions for mental health outcomes is uncertain. Virtual reality-based interventions have the potential to provide individualized, error-free self-training for older residents in long-term care facilities, but the usability for these residents requires further study. Future studies should use RCT designs and aim to include larger sample sizes and have longer intervention durations. REGISTRATION NUMBER: PROSPERO registration ID: CRD42022331917. TWEETABLE ABSTRACT: Virtual reality-based interventions are possibly effective for improving physical health of older residents in long-term care facilities.

Concrete Strength Prediction Using Different Machine Learning Processes: Effect of Slag, Fly Ash and Superplasticizer.

Blast furnace slag (BFS) and fly ash (FA), as mining-associated solid wastes with good pozzolanic effects, can be combined with superplasticizer to prepare concrete with less cement utilization. Considering the important influence of strength on concrete design, random forest (RF) and particle swarm optimization (PSO) methods were combined to construct a prediction model and carry out hyper-parameter tuning in this study. Principal component analysis (PCA) was used to reduce the dimension of input features. The correlation coefficient (R), the explanatory variance score (EVS), the mean absolute error (MAE) and the mean square error (MSE) were used to evaluate the performance of the model. R = 0.954, EVS = 0.901, MAE = 3.746, and MSE = 27.535 of the optimal RF-PSO model on the testing set indicated the high generalization ability. After PCA dimensionality reduction, the R value decreased from 0.954 to 0.88, which was not necessary for the current dataset. Sensitivity analysis showed that cement was the most important feature, followed by water, superplasticizer, fine aggregate, BFS, coarse aggregate and FA, which was beneficial to the design of concrete schemes in practical projects. The method proposed in this study for estimation of the compressive strength of BFS-FA-superplasticizer concrete fills the research gap and has potential engineering application value.

Personally tailored exercises for improving physical outcomes for older adults in the community: A systematic review.

PURPOSE: To identify the effects of personally tailored exercise programmes for improving physical outcomes amongst older people living in the community. METHODS: Four databases (the Cochrane Library, PubMed, EMBASE, and Web of Science) were searched (from inception until Jan 25th, 2022) for original articles. All studies were randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of personally tailored exercise programmes on physical outcomes. Two independent reviewers extracted trial data and assessed the risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group and the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: Of the 7310 articles that were screened, 10 articles including 959 participants met the inclusion criteria. Nine of the included studies reported significant improvements in physical outcomes including balance, strength, mobility and physical activity, and disease symptoms. Meta-analysis was not conducted due to the heterogeneity of study designs and outcome measures. CONCLUSIONS: This study demonstrated that personally tailored exercises based on assessments of physical function may be a safe and effective approach to improve physical outcomes in older adults living in the community. However, personally tailored exercise has no advantage in improving exercise adherence or economic benefits, and thus, further high-quality RCTs with larger sample sizes and qualitative studies are needed to better understand the effectiveness of personally tailored exercise and the attitude of elderly individuals towards such exercise. Future research should consider not only physical functions but also psychological factors when developing personalized exercise programs.

Development and Comprehensive SPE-UHPLC-MS/MS Analysis Optimization, Comparison, and Evaluation of 2,4-Epibrassinolide in Different Plant Tissues.

A determination method for trace 24-epibrassinolide (EBL) in plant tissues was developed using ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The plant tissue samples were extracted using a methanol-formic acid solution, and the corresponding supernatant was purified with ODS C18 solid-phase extraction column. The extracts were separated using a Zorbax Eclipse Plus C18 (2.1 mm × 50 mm, 1.8 µm) column with methanol and 0.1% formic acid as the mobile phase. The ion source for the mass spectrometry was an electrospray ionization source with positive ion mode detection. The linear range of the target compound was 0.7~104 µg/kg, the limit of detection (LOD) was 0.11~0.37 µg/kg, the limit of quantification (LOQ) was 0.36~1.22 µg/kg, the recovery rate was 84.0~116.3%, and the relative standard deviation (RSD%) was 0.8~10.5. The samples of maize plumule, brassica rapeseed flower, and marigold leaf were detected using the external standard method. The optimization of the extraction method and detection method of EBL improved the detection sensitivity, laid a foundation for the artificial synthesis of EBL, improved the extraction rate of EBL, and provided a theoretical basis for the study of EBL in many plants.

Long non-coding RNAs as epigenetic mediator and predictor of glioma progression, invasiveness, and prognosis.

Gliomas are aggressive brain tumors with high mortality rate. Over the past several years, non-coding RNAs, specifically the long non-coding RNAs (lncRNAs), have emerged as biomarkers of considerable interest. Emerging data reveals distinct patterns of expressions of several lncRNAs in the glioma tissues, relative to their expression in normal brains. This has led to the speculation for putative exploitation of lncRNAs as diagnostic biomarkers as well as biomarkers for targeted therapy. With a focus on lncRNAs that have shown promise as epigenetic biomarkers in the proliferation, migration, invasion, angiogenesis and metastasis in various glioma models, we discuss several such lncRNAs. The data from cell line / animal model-based studies as well as analysis from human patient samples is presented for the most up-to-date information on the topic. Overall, the information provided herein makes a compelling case for further evaluation of lncRNAs in clinical settings.

The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials.

BACKGROUND: The state of mild cognitive impairment (MCI) provides an optimal window for preventing progression to dementia. Combined cognitive intervention and physical exercise may yield additive and synergistic effects on cognition in older adults with MCI. OBJECTIVES: The purpose of this study was to assess the efficacy of a combined intervention to improve cognition in older adults with MCI by comparing a control group that underwent only cognitive intervention, a control group that underwent only physical exercise, and a control group that did not undergo cognitive intervention or physical exercise. DESIGN: Meta-analysis of randomized controlled trials (RCTs). DATA SOURCES: The online databases of PubMed, Web of Science, Embase, the Cochrane Library, PsycINFO, and CINAHL were systematically searched. REVIEW METHODS: The outcomes were global cognition, memory, and executive function/attention. A sensitivity analysis was conducted when the I2 statistic was > 50%. RESULTS: A total of 16 studies were included. The results showed that the combined intervention had positive effects on global cognition compared to the effects of the other control group [SMD = 0.27, 95% CI (0.09, 0.44), p = 0.003]. Regarding memory, the combined intervention had positive effects compared to the effects observed in the single physical exercise group [SMD = 0.25, 95% CI (0.07, 0.44), p = 0.006] and the other control group [SMD = 0.29, 95% CI (0.12, 0.47), p = 0.001]. For executive function/attention, the combined intervention had also positive effects compared to the effects of the single cognitive intervention group [SMD = 0.28, 95% CI (0.09, 0.47), p = 0.004], the single physical exercise group [SMD = 0.32, 95% CI (0.16, 0.49), p = 0.0002], and the other control group [SMD = 0.23, 95% CI (0.05, 0.41), p = 0.01]. CONCLUSIONS: The combined intervention resulted in cognitive benefits in older adults with MCI and exhibited limited superiority over the single cognitive intervention and the single physical exercise on cognitive subdomains.

Clinical practice guidelines for the prevention and management of frailty: A systematic review.

AIMS: To systematically search for clinical practice guidelines focusing on the prevention and management of frailty, to evaluate their methodological quality and to synthesize the consensus recommendations. DESIGN: A systematic review. DATA SOURCES: Guideline websites, related professional association websites and electronic databases were systematically searched through 4 November 2020. REVIEW METHODS: We evaluated the methodological quality of the eligible guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II). Two reviewers synthesized the consensus recommendations proposed by at least two guidelines. RESULTS: Eight guidelines met the eligibility criteria and were included in the review. The mean scores of the six domains were as follows: the 'scope and purpose' domain scored 88.0%, the 'clarity of presentation' domain scored 81.9%, the 'stakeholder involvement' domain scored 63.4%, the 'editorial independence' domain scored 62.2%, the 'rigour of development' domain scored 61.1% and the 'applicability' domain scored 57.8%. In total, we synthesized 23 recommendations for the prevention and management of frailty that are consistent among the included guidelines. CONCLUSIONS: The number of clinical practice guidelines for the prevention and management of frailty is limited. The methodological quality of existing guidelines needs to be improved. Our synthesized findings provide an intuitive, convenient and summative reference resource for frailty prevention and management. It' is worth noting that recommendations described in the included guidelines require additional detail. IMPACT: Although the prevention and management of frailty is urgent, there is currently a lack of evidences guiding these processes, especially in the prevention. The methodological quality of existing guidelines is insufficient, and the recommendations described in the guidelines require additional detail. Therefore, users of these guidelines, especially nurses, should make a careful decision according to the specific situation when using. Nurses also have a key role in providing more clinical evidences for the improvement of the quality of the guidelines.

Prevalence of cognitive frailty among community-dwelling older adults: A systematic review and meta-analysis.

OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate the pooled prevalence of cognitive frailty among community-dwelling older adults and provide evidence-based support for policy-makers planning health and social care policies. DESIGN: A systematic review and meta-analysis. METHODS: PubMed, Web of Science, Embase and the Cochrane Library were systematically searched from their inception to December 10, 2020. Descriptive studies (cross-sectional studies or population-based longitudinal studies) and cohort studies were available. Participants were community-dwelling older adults aged 60 years and above. Two researchers independently screened the literature, extracted the data and evaluated the quality of the included studies. All statistical analyses were conducted using Stata 15.0. RESULTS: We screened 2815 records, among which 24 studies met the inclusion criteria and were included in the review. The pooled prevalence of cognitive frailty was 9% (95% CI: 8%-11%, I2 = 99.3%). The results of the subgroup analysis showed that the pooled prevalence of cognitive frailty was 11% (95% CI: 9%-14%) in men and 15% (95% CI: 11%-19%) in women. The pooled prevalence of cognitive frailty based on the descriptive studies and cohort studies was 7% (95% CI: 5%-9%) and 17% (95% CI: 11%-22%), respectively. The pooled estimates of cognitive frailty prevalence were 6% (95% CI: 4%-8%) from 2012 to 2017 and 11% (95% CI: 9%-14%) from 2018 to 2020. CONCLUSIONS: This systematic review analyzed the available literature and revealed that the pooled prevalence of cognitive frailty among community-dwelling older adults was 9%. The stratified analysis showed that the prevalence of cognitive frailty was higher in older women. In addition, the prevalence has increased in recent years, which has important implications for adapting health and social care systems.

A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study.

BACKGROUND: Mild cognitive impairment (MCI) is often a precursor of dementia, and patients with MCI develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence regarding the use of virtual supermarkets to screen for MCI. OBJECTIVE: The objectives of this study are to validate a VR game-based test, namely, the Virtual Supermarket Program (VSP), for differentiating patients with MCI and healthy controls and to identify cutoff scores for different age levels. METHODS: Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into a healthy control group (n=64) and an MCI group (n=62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity, and retest reliability of the VSP. We used the area under the receiver operating characteristic curve (AUC) to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively. RESULTS: A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and specificity of 79.0% for differentiating individuals with MCI and healthy controls, and the AUC was 0.870 (95% CI 0.799-0.924). The median index of VSP score was 51.1 (range 42.6-60.0). There was a moderate positive correlation between the VSP total score and Mini-Mental State Examination score (r=0.429, P<.001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r=0.645, P<.001). The retest reliability of the VSP was feasible (r=0.588, P=.048). CONCLUSIONS: The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000040074; https://www.chictr.org.cn/showprojen.aspx?proj=64639.