Bioscience trends最新文献

As populations age at an unprecedented pace globally, frailty has emerged as a critical challenge in perioperative care. While clinicians broadly acknowledge the value of frailty assessment, embedding it systematically in care pathways remains difficult to implement systematically. We compared perioperative frailty guidelines from the United Kingdom, United States, Europe, and the Asia-Pacific, finding significant inconsistencies in tool selection, risk stratification criteria, and pathway design. Strikingly, approximately 99.6% of frailty research remains confined to risk characterization, whereas only 0.4% is directed toward improving care, highlighting a substantial gap between evidence and practice. Digital technologies promise a wider uptake of frailty screening, and yet algorithmic bias threatens to under-detect frailty in underserved groups if left unchecked. We outline five policy priorities: first, an internationally coordinated consensus on core assessment standards needs to be reached; second, end-to-end pathways that span screening, graded assessment, targeted intervention, and outcome tracking need to be devised; third, digital technology needs to be accelerated along with the devising of explicit safeguards for equity; fourth, high-quality evidence needs to be generated through function-centered outcomes and cost-effectiveness analyses to demonstrate the real-world value of frailty-focused care pathways; and fifth, frailty management needs to be integrated into national chronic-disease frameworks. Closing the gap between detection and action will require global collaboration and a reframing of frailty, not as a passive label but as a call to intervene.

Frailty significantly influences perioperative outcomes and healthcare resource utilization among older adults. Although the importance of intervention has been recognized, guidelines vary significantly across regions. This review synthesizes geriatric, perioperative, and specialty guidelines from the UK, the US, Europe, and the Asia-Pacific region. We found that, although they widely share core principles such as the use of validated tools and comprehensive geriatric assessment (CGA), guidance specific to the perioperative setting remains limited. Existing recommendations are often restricted to the preoperative phase and lack standardization of risk thresholds. However, high-quality evidence on the clinical and economic impact of frailty-based pathway redesigns is limited. Future research should focus on multicenter pragmatic trials that evaluate integrated care pathways extending from preoperative optimization through postoperative care. In parallel, further development of automated screening using electronic health records and electronic frailty indices is warranted. Such initiatives will require careful evaluation of feasibility and equity to support successful implementation in routine clinical practice. We recommend that clinicians routinely incorporate validated frailty screening into preoperative evaluation for all patients age 65 and older and that healthcare systems prioritize the development of an interoperable data infrastructure to enable the seamless transfer of community-derived frailty information into surgical decision-making workflows.

Frailty has become a pressing health concern in Japan as it has entered a super-aged society. Early identification of frailty is essential to preventing disability, hospitalization, and dependency on long-term care, and yet the implementation of standardized screening across clinical settings remains inconsistent. This review synthesizes current evidence on frailty assessment practices in Japan, highlights key challenges in routine implementation, and examines the potential of emerging digital tools. The feasibility of recent digital innovations - including artificial intelligence analysis of home electricity data, wearable-based mobility monitoring, and EMR-integrated frailty indices - has been demonstrated in pilot settings, though evidence of their large-scale clinical effectiveness remains limited. International comparisons have revealed that countries and regions such as the United Kingdom, Canada, Australia, and Singapore are increasingly implementing electronic frailty indices with policy-level support, offering valuable insights for Japan. Overall, although Japan has made significant progress in recognizing the importance of frailty assessment, substantial gaps remain in standardization, system integration, and clinical implementation. Strengthening national policy frameworks, enhancing workforce training, and accelerating a digital transformation may enable the development of a more comprehensive and scalable frailty-screening system to support healthy aging.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with limited treatment options. Transient receptor potential ankyrin 1 (TRPA1) has been implicated in inflammation and pain, but its role in UC remains a subject of debate. The current study investigated the effects of TRPA1 inhibition in both acute and subacute murine models of dextran sulfate sodium (DSS)-induced colitis. Genetic knockout of Trpa1 or pharmacological inhibition with A967079 significantly ameliorated inflammation in the acute model, reducing the disease activity index (DAI), colon shortening, histopathological damage, and TNF-α secretion from macrophages. In contrast, TRPA1 suppression exacerbated subacute colitis and worsened weight loss, DAI, colon shortening, and histopathology. Mechanistically, Trpa1 deletion promoted CD4+ T cell polarization toward the Th1 subtype in subacute colitis, increasing IFN-γ levels. These findings reveal a dual role for TRPA1 in colonic inflammation: it mediates pro-inflammatory effects primarily via innate immune cells in the acute phase but has anti-inflammatory effects by modulating adaptive immunity in the subacute phase. These findings provide new insights into the context-dependent roles of TRPA1 and suggest that TRPA1 may represent a context-specific and stage-dependent therapeutic target in UC.

Implantable artificial retinas have been a considerable technology to help blind people recover their sight. This topic has attracted increasing attention from both patients and clinicians because of the refractory nature of degenerative retinal diseases. A point worth noting is that artificial retinas are conventionally considered to be a tool to help blind patients recover their sight. With the development of materials and sensors, however, such devices might have characteristics of augmented reality that are beyond the capabilities of the natural eye. This study briefly summarizes the current clinical status of implantable artificial retinas, it explores emerging technologies that aim to augment vision, and it discusses the challenges that must be overcome before these devices can be further used clinically. Indeed, the implantation of such advanced retinal prostheses with augmented reality characteristics may bring about new ethical and legal risks that warrant further consideration.

Hearing impairments, as a prevalent and debilitating non-motor symptom of Parkinson's disease (PD), remain unclear in mechanisms. In this work, we established PD mouse and rat models by using 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and 6-hydroxydopamine (6-OHDA), respectively, and investigated their hearing functions and potential mechanisms through auditory brainstem response (ABR), distortion product otoacoustic Emissions (DPOAE), noise exposure, immunofluorescence labeling, volumetric measurement, and colocalization analysis. In MPTP-induced PD mice, we observed significant cholinergic fibers decompensation, heterogeneous dopaminergic fibers damage of cochlear efferent fibers, and adrenergic sympathetic fibers marked loss in the osseous spiral lamina (OSL), corresponding to insignificant cochlear hair cells, ribbon synapse alteration, and auditory sensitivity injury. While in 6-OHDA-induced PD rats, asymmetric alterations in cochlear cholinergic, dopaminergic fibers were found, accompanied by inconsistent adrenergic changes in the OSL, which matched unilateral hair cells, ribbon synapse damage, and hearing loss. Overall, findings from this work indicate that pathological alterations in the cochlea of PD mice and rats, particularly in efferent fibers, may be closely relevant to peripheral hearing alterations.

Faced with the global challenges of population aging and a surge in dementia cases, healthcare models worldwide are undergoing profound transformation. The Netherlands' "dementia villages" concept simulates living environments, with their antipsychotic drug usage rate (11%) being significantly lower than in traditional facilities (52%). Japan has established over 12,000 "small-scale multi-functional" care facilities, striving to achieve "life in the community." Meanwhile, China is promoting community-embedded elderly care models, exemplified by Shanghai's plan to increase the number of daycare centers from 720 in 2019 to 919 by 2024, establishing a "15-minute elderly care circle." This commentary compares the Netherlands, Japan, and China across four dimensions: aging trends, innovative care models, the development of multifunctional healthcare systems, and end-of-life care philosophies. It assesses current policy developments and practical challenges, proposing that future sustainable care systems should integrate healthcare with community resources, institutional frameworks with ethical considerations, technological advancements with humanistic values, and education on death with the preservation of life with dignity.

Endometrial receptivity plays a critical role in pregnancy, while controlled ovarian hyperstimulation (COH) - widely used for infertile patients - could impair endometrial receptivity and subsequent pregnancy outcomes. This study aims to explore the effect of Yiqi Bushen Shugan Huoxue Decoction (YBSHD) on impaired endometrial receptivity in patients with unexplained infertility (UI) undergoing COH and to determine the mechanism for it through modular pharmacology, molecular docking, and a murine model. First, we retrospectively studied 422 patients with UI who underwent COH to get pregnant. Results indicated that the live birth rate significantly increased in the YBSHD group. Second, a systematic network pharmacology analysis was performed to screen the ingredients and possible targets of YBSHD. The main targets concerning YBSHD and endometrial receptivity involved pathways including hormone regulation, inflammatory responses, and apoptosis. The active components of quercetin and kaempferol from YBSHD exhibited a strong binding affinity to key molecules, including BCL2, ESR1, IL6, IL1B, and TNF. Third, YBSHD improved endometrial receptivity in a murine COH model. Compared to the COH group, the number of embryo implantations and endometrial pinopodes significantly increased in the YBSHD group, indicating improved endometrial receptivity. YBSHD improved the local immune microenvironment in COH mice by regulating excessive hormone secretion, gene expression of inflammatory factors, and proportions of neutrophils and macrophages. Moreover, YBSHD inhibited apoptosis in the ovaries and uteruses of COH mice. In summary, YBSHD could increase the live birth rate in patients with UI, mainly because it can inhibit inflammation and cell apoptosis, thereby improving endometrial receptivity.

Against the backdrop of accelerating global population aging, China is undergoing significant demographic shifts. Its population aged 60 and above has reached 264 million, projected to account for 40% of the total population by the mid-21st century, becoming a "super-aging society" and triggering a surge in long-term care demand. On the demand side, the overall ADL disability rate among middle-aged and older adults is 23.8% (35.4% organic), rising to 30.5% among those aged 80 and above; 17.8% have IADL impairments, and 36.44% of households with older adults are empty-nest. Combined with population aging, rising disability rates, the growth of empty-nest families, and heavy disease burdens, care demand continues to grow annually. On the supply side, 13 million caregivers are needed for disabled/semi-disabled older adults, with only ~1 million practitioners; traditional models focusing solely on basic daily assistance fail to meet diverse needs like mental health support and rehabilitation. To this end, this study aims to synthesize evidence on the structural challenges faced by China's geriatric care workforce. By analyzing demographic data, care demand indicators, and geriatric care models, it identifies core issues and proposes evidence-based strategies, with the purpose of improving the quality of life of older adults and strengthening development of professional geriatric care talent.

Aging of the population has become a critical challenge globally. The proportion of individuals age 60 years and older is projected to increase from 12% in 2015 to 22% by 2050, representing more than 2.1 billion older adults globally. This demographic transition is advancing particularly rapidly in Japan, which has become the first nation to become a "super-aged society". Projections indicate that by 2060, the number of older adults living with dementia will reach approximately 6.45 million (more than 17% of the elderly population), making it one of the country's most urgent health and social care challenges. Japan has developed a comprehensive response system that integrates medical, community, and family-based care. Key initiatives include a national dementia strategy, mechanisms for early screening and diagnosis, the establishment of memory clinics, and the implementation of the community-based integrated care system, which emphasizes coordination between healthcare and long-term care services. These measures have alleviated part of the burden on patients and families while enhancing social awareness of dementia and inclusion of those with that condition. Nevertheless, Japan continues to face significant structural challenges, such as severe shortages of healthcare personnel and professional caregivers, increasing fiscal pressure on long-term care financing, insufficient dissemination of innovative therapies and digital diagnostic tools, and disparities in social support between urban and rural areas. Cross-national comparisons indicate that Japan's experience offers valuable lessons for other rapidly aging societies, particularly in policy design, the integration of community-based care, and the promotion of a dementia-inclusive society. Summarizing and adapting Japan's approaches may therefore provide globally applicable strategies to build sustainable and equitable systems for dementia prevention, management, and care.