Bioscience trends最新文献

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.

Colorectal liver metastasis (CRLM) remains lethal, and the convergence of cellular senescence with metabolic reprogramming via epigenomic rewiring is poorly understood. We integrated genome-wide DNA methylation and RNA-seq data from 10 paired primary tumors and liver metastases (GSE213402). After calling differentially methylated genes (3,399 hyper- and 9,519 hypomethylated) and differentially expressed genes (406 DEGs), we intersected them with curated senescence (n = 866) and metabolic reprogramming (n = 948) gene sets, yielding 28 differentially expressed cellular-senescence-related genes (DE-CSRGs) and 24 metabolic-reprogramming-related genes (DE-MRRGs). Machine-learning pipelines (LASSO + SVM-RFE) converged on a five-gene signature: CXCL1, SERPINE1, NDRG1, SRM and GATM, most of which are hypomethylated and over-expressed in metastases. Gene-set enrichment analysis revealed that these genes are involved in pathways such as oxidative phosphorylation, focal adhesion, complement-coagulation cascades, and PPAR signaling. Immune de-convolution revealed strong positive correlations between signature genes and immunosuppressive subsets (MDSCs, Tregs, type-1 T-helper cells; p < 0.05). Elevated IC₅₀ values for oxaliplatin and 5-fluorouracil in metastatic samples were positively associated with NDRG1 and negatively with SRM, indicating chemo-resistance modulation. This five-gene epigenetic-transcriptomic hub identifies a molecular signature that warrants prospective validation as a potential biomarker for patient stratification and combination therapy in CRLM.

The apolipoprotein E ε4 (APOE ε4) allele, the strongest genetic risk factor for late-onset Alzheimer's disease (AD), induces cell-type-specific disturbances in brain lipid metabolism. Although impacting astrocytes and neurons, its most pronounced effects occur in microglia, where it causes energy metabolism deficits and promotes the formation of lipid droplet-accumulating microglia, triggering a cascade of neurodegenerative responses. This review comprehensively examines how microglial APOE4-driven lipid metabolic dysregulation exacerbates neuroinflammation and compromises phagocytic capacity, particularly in the clearance of amyloid-β, phosphorylated-tau, and pathological synapses. Mechanistically, microglial APOE4 activates neuroinflammation via LilrB3-mediated type I interferon signaling and induces lipid metabolic imbalance through PU.1/NF-κB-driven transcriptional reprogramming and ER stress-SREBP2 activation. These disturbances exacerbate neuroinflammation, promote lipid droplet accumulation and cholesterol overload, impair lysosomal function, and ultimately compromise microglial phagocytosis. The resulting disruption of neuron-microglia interactions further amplifies neurotoxicity in AD. Furthermore, this review summarizes emerging therapeutic strategies targeting APOE4-related pathway in microglia. By synthesizing these insights, this review highlights the multifaceted role of microglial APOE4 in AD pathology, with particular emphasis on the central role of lipid metabolism dysregulation, and provides new intervention ideas for reducing its damage to brain function.

The high performance of core members of social organizations (SOs) caring for the elderly can enhance the quality of management and services, thereby improving the life satisfaction of older adults residing there. However, the factors influencing the performance of core members and their pathways remain unclear. This research seeks to uncover how social support mediates and self-efficacy moderates the association between a social network and individual performance of core members of SOs caring for the elderly. A cross-sectional survey was conducted from June to August 2023 in Shanghai, China, and data on participants' demographics, social network, social support, individual performance, and self-efficacy were collected. Hierarchical stepwise regression, bootstrap analysis, and simple slope method analysis were used to test potential mediating and moderating effects. After adjusting for confounders, the total effect of a social network on core members' individual performance (β = 0.078, 95% CI: 0.052-0.103) consisted of a direct effect (β = 0.059, 95% CI: 0.030-0.087) as well as an indirect effect mediated through social support (β = 0.019, 95% CI: 0.006-0.033). In addition, self-efficacy was identified as a moderating factor in the relationship between a social network and individual performance, with higher levels of self-efficacy diminishing the influence of a social network on performance outcomes. An extensive social network can enhance social support for core members of SOs caring for the elderly, thereby improving individual performance. Concurrently, targeted interventions should be developed to draw on self-efficacy to activate social network resources and to have a synergistic effect on individual performance.

With the accelerating trend of population aging, Japan has become the first country to enter a "super-aged society", where the proportion of people age 65 and over exceeds 21%, making it a global model in addressing aging-related challenges. In response to the various social and healthcare issues arising from this demographic shift, the Japanese Government has implemented a series of policy measures. Among them, "Small-scale Multifunctional In-home Care (Shotaki)" and "Nursing Small-scale Multifunctional In-home Care (Kantaki)" have emerged as key components of the community-based care system. This paper explores the common challenges faced in super-aged populations and provides a comparative analysis of the functions, current status, existing issues, and future prospects of "Shotaki" and "Kantaki". By examining these two service models, the study aims to offer policy recommendations and practical insights to build a sustainable elderly care system.

On May 5, 2023, the WHO declared that the COVID-19 pandemic no longer constitutes a public health emergency of international concern (PHEIC), but SARS-CoV-2 continues to spread and evolve on a global scale. The WHO reported that COVID-19 still poses a threat to humanity, and especially in some areas with large numbers of infected people. For some high-risk COVID-19 patients, such as those with underlying conditions, elderly patients, patients who need long-term immunosuppressive therapy after organ transplantation, patients with immunosuppressive diseases, patients who tend not to test negative for SARS-CoV-2 despite standard antiviral therapy, and cancer patients, special attention is still required after infection with SARS-CoV-2. How to clear SARS-CoV-2 in a timely manner is the key to treating such patients. Based on the demands of clinical practice and medical evidence, the National Center for Infectious Diseases of China assembled experts from relevant disciplines to reach the Chinese expert consensus on the combined use of antivirals to treat COVID-19, providing timely suggestions to resolve the medication issues that have been plaguing clinical practice. The consensus suggests that for special patients, combined medication can promptly eliminate the virus without increasing the risk to patient safety.

Treatments for solid tumors, the most common malignant neoplasms, are often confounded by tumor microenvironments that impede the achievement of uniform anti-tumor effects throughout the entire malignant mass, which contributes to recurrence and progression, negatively impacting clinical outcomes. Improved treatment methods for solid malignancies are therefore needed. Mesenchymal stromal cells (MSCs) have been investigated for treatments for various types of solid tumor cancers due to their ability to target tumor cells with similar cell surface protein profiles. MSC-derived exosomes (MSC-Exos) elicit many of the tumor cell responses produced by MSC with no potential for differentiation and reduced risks of adverse effects. We surveyed the literature and clinical trials registries to identify studies investigating MSC-Exo-based anti-cancer therapies for gastric cancer, colorectal cancer, breast cancer, lung cancer, brain cancer, pancreatic cancer, and urological malignancies, and summarize the results of relevant studies herein to provide a comprehensive description of the therapeutic effects and potential clinical applications of MSC-Exos for the treatment of solid tumor malignancies. We include a summary of relevant clinical trials performed to date in an attempt to assess the data available regarding MSC-Exo safety, and propose future efforts regarding the requirements for transitioning forward from phase-1, 2 trials.

Premature ovarian failure (POF), also referred to as premature ovarian insufficiency (POI), is a multifactorial reproductive endocrine disorder characterized by amenorrhea, infertility, hypoestrogenism, and elevated gonadotropin levels before the age of 40. Emerging evidence links its pathogenesis to oxidative stress and dysregulation of the autophagy-apoptosis balance in ovarian cells. Excessive accumulation of reactive oxygen species (ROS) impairs mitochondrial function in oocytes, while aberrant autophagy and granulosa cell apoptosis accelerate the depletion of primordial follicles. The AMP-activated protein kinase/mammalian target of rapamycin (AMPK/mTOR) pathway serves as a critical nexus between energy metabolism, oxidative stress, and cell survival. Traditional Chinese medicine (TCM), with its multi-component and multi-target characteristics, has demonstrated unique advantages in modulating the AMPK/mTOR pathway to restore ovarian function. This review synthesizes recent findings on single herbs, classical formulas, and non-pharmacological therapies (acupuncture and moxibustion). Mechanistic studies have revealed that these interventions can activate AMPK, inhibit mTOR overactivation, enhance Nrf2-mediated antioxidant defenses, reduce ROS production, and rebalance autophagy and apoptosis via pathways such as PI3K/Akt and SIRT1/p53. By aligning stage-specific regulation of AMPK/mTOR signaling with the TCM principle of syndrome differentiation, this integrative approach provides theoretical guidance for precise, personalized treatment to optimize multi-target strategies for POF management.

Effective antiretroviral therapy (ART) depends on adequate drug exposure. Plasma ART concentrations provide a short-term assessment of drug exposure, and hair promises to be an alternative matrix for measuring long-term exposure. We aimed to determine the association between plasma and hair ART concentrations and explore the therapeutic concentrations in hair. A cohort study in which HIV-infected adults receiving tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + efavirenz (EFV) regimen for at 6 months were recruited and paired hair and plasma samples collected at about 6±1 months of ART. Previously validated liquid chromatography and tandem mass spectrometry methods were used to measure ART concentrations in plasma and hair. Among 74 participants enrolled, 47 used a 400 mg dose of EFV daily and 27 used 600 mg EFV daily. Hair and plasma EFV concentrations were strongly correlated, with particularly strong association observed in the 600 mg EFV group. The hair EFV concentration of female participants was significantly higher than in male participants, which might be the inter-individual variations in the drug metabolism and dissolution and life habits. The concentrations of TDF and 3TC in hair are too low to determine effective threshold and relationship with plasma drugs concentrations. The accumulation and correlation of hair and plasma EFV concentrations promise to determine a therapeutic range in hair. The therapeutic range for EFV in hair needs to be calculated in order to give quantitative results more value within the field of drug exposure assessment.