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BACKGROUND: Social assistant robots (SARs) are an important part of providing high quality health and social care for older people, and are an effective measure to promote the development of smart aging. Therefore, it is important to understand the factors that influence the acceptance of assistive robots by older adults. PURPOSE: To investigate the acceptance of SARs for older adults living in the community and explore its influencing factors. METHODS: 207 elderly was invited to answer a questionnaire after watching a SAR video and discussing it. Participants' characteristics, physical health status, general self-efficacy, personality trait and acceptance toward SARs were recorded and analyzed using multiple linear regression analysis. RESULTS: showed that the degree of acceptance among older adults living in the community was moderate(2.55±0.86), and the acceptance rate was 51.0%. Whether to use mobile devices(smartphones, computers, robots), the experience of using mobile service devices, perceived usefulness, perceived enjoyment, perceived ease of use and attitude were the main affecting factors (P<0.05). CONCLUSIONS: The elderly Chinese in the community have a low acceptance of SARs. The higher the perceived usefulness, perceived enjoyment and perceived ease of use, the more positive attitude to using. The elderly who has the experience of using mobile service devices have a higher acceptance of SARs.

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OBJECTIVE: This study aims to provide an overview of meta-analyses and systematic reviews on the effectiveness and safety of immunosuppressive drug therapy for neuromyelitis optica spectrum disorders (NMOSD) by evaluating the methodological quality and reporting quality of reviews. METHODS: The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database, Web of Science, the Cochrane Library, PubMed, and Embase databases were searched to collect systematic reviews or meta-analyses on the effectiveness and safety of immunosuppressive therapy for NMOSD from inception to December 2, 2021. Two researchers independently screened reviews and extracted data. Any differences in the procession of review assessment between the two researchers were re-evaluated, and the disagreement was resolved by discussion with other researchers. The following data were extracted: author, year of publication, the country where the study was conducted, study type, the number of included studies, sample size, risk bias tools, medication of immunosuppressive therapy, and main outcomes. Then, the AMSTAR-2, which is a critical appraisal tool for systematic reviews (2nd edition), and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) were used to evaluate the methodological quality and reporting quality of evidence. A comprehensive analysis was conducted on the outcomes for all included reviews. RESULTS: A total of 15 reviews were included. Of the included reviews, 3 were systematic reviews, 7 were meta-analyses, and 5 were systematic reviews and meta-analyses. According to the AMSTAR-2 criteria, 6 studies had high quality, 1 study had moderate quality, 4 studies had low quality, and 4 studies had critically low quality. Based on the GRADE, neither evidence quality for effectiveness nor safety was high. CONCLUSION: Immunosuppressive drug therapy is effective for patients with NMOSD, but its safety is controversial. Due to the poor quality of evidence, reliability needs to be considered. Thus, large sample, multi-center, double-blind, randomized controlled studies are still needed in the future.

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OBJECTIVES: Hip arthroplasty is the most important surgical method for the treatment of hip fractures and necrosis in the femoral head. Limb function recovery is an important criterion to reflect the efficacy of surgery and the quality for life of patients. Postoperative rehabilitation exercises are crucial for limb function recovery. Otago exercise programme (OEP) is a safe, effective, practical, and economical rehabilitation exercise, which has been proven to prevent falls, improve limb function and walking ability, and lower limb strength. This study aims to explore the effect of OEP on limb function rehabilitation in elderly patients with hip arthroplasty for femoral neck fractures. METHODS: A total of 77 elderly patients with hip arthroplasty for femoral neck fractures who met the criteria for inclusion and exclusion were enrolled for this study. They were randomly divided into a control group ( n =39) and an intervention group ( n =38). The control group was given routine rehabilitation training, and the intervention group performed OEP on the basis of the control group. Time get up and go test (TGUT), five times sit to stand test (FTSST), 10-meter walking test (10MWT), Harris Hip Score (HHS), Daily Activity Scale (Barthel index), and the Mos 36-Item Short Form Health Survey (SF-36) were used before the intervention, at discharge, and the 12th week after discharge. RESULTS: Before the intervention, there were no differences in TGUT, FTSST, 10MWT, HHS score, Barthel index, and SF-36 score between the 2 groups (all P >0.05). At the discharge after the intervention, there was no difference in TGUT between the 2 groups ( P >0.05), but the FTSST and 10MWT in the control group were longer than those in the intervention group (both P <0.05), and the HHS score, Barthel index, and SF-36 score in the control group were lower than those in the intervention group ( P <0.05). At the 12th week after discharge, TGUT, FTSST, 10MWT, HHS score, Barthel index, and SF-36 score in the intervention group were better than those in the control group ( P <0.05). CONCLUSIONS: OEP can effectively promote limb stability and hip function recovery in elderly patients with hip arthroplasty for femoral neck fractures, improve daily mobility and quality of life, and it is suitable for clinical application.

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AIMS AND OBJECTIVES: Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19. BACKGROUND: Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people. DESIGN: A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines. METHODS: This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks. RESULTS: Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, -2.78; TUGT, -3.73; BBS, 2.17; GDS-15, -0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, -0.10; GDS-15, 1.07; SF-12 MCS, -5.95; all p < .001). CONCLUSION: Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.

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Vitamin D binding protein (DBP) may alter the biologic activity of 25-hydroxyvitamin D [25(OH)D]. The objective of our present study was to determine the joint effect of serum 25(OH)D and DBP on the risk of frailty. Five hundred sixteen male participants aged 70 years or older were recruited in Changsha city and its surrounding area in Hunan province of China. Frailty was defined as the presence of at least three of the five following criteria: weakness, low physical activity, slow walking speed, exhaustion, and weight loss. Multivariate linear regression analysis was performed to assess the relationship between 25(OH)D and DBP levels. Odds ratios (ORs) for frailty were evaluated across quartiles of 25(OH)D and DBP levels, adjusted age, education, and body mass index. The results showed that participants in the lowest quartile of 25(OH)D and the highest quartile of DBP levels, the lowest quartile of 25(OH)D and the lowest quartile of DBP levels, and those in the the lower quartile of 25(OH)D and lowest quartile of DBP levels had significantly higher OR of being frail compared with those in the highest quartile of 25(OH)D and lowest quartile of DBP, with OR of 3.18 (95% CI: 1.46-4.56, P < 0.05), 2.63 (95% CI: 1.31-3.68, P < 0.01), and 2.52 (95% CI: 1.22-3.52, P < 0.05), respectively. The results indicate that the joint effect of serum 25(OH)D and DBP levels is associated with the risk of frailty, and serum DBP levels affects 25(OH)D-frailty relationship in the older men.

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Vascularization is a crucial challenge in tissue engineering. One solution for this problem is to implant scaffolds that contain functional genes that promote vascularization by providing angiogenic growth factors via a gene delivery carrier. Poly(ethylenimine) (PEI) is a gene delivery carrier with high transfection efficiency but with cytotoxicity. To solve this problem, we utilized Antheraea pernyi silk fibroin (ASF), which has favorable cytocompatibility and biodegradability, RGD sequences and a negative charge, in conjunction with PEI, as the delivery vector for vascular endothelial growth factor (VEGF) 165-angiopoietin-1 (Ang-1) dual gene simultaneous expression plasmid, creating an ASF/PEI/pDNA complex. The results suggested that the zeta potential of the ASF/PEI/pDNA complex was significantly lower than that of the PEI/pDNA complex. Decreased nitrogen and increased oxygen on the surface of the complex demonstrated that the ASF had successfully combined with the surface of the PEI/pDNA. Furthermore, the complexes resisted digestion by nucleic acid enzymes and degradation by serum. L929 cells were cultured and transfected in vitro and improved cytotoxicity was found when the cells were transfected with ASF/PEI/pDNA compared with PEI/pDNA. In addition, the transfection efficiency and VEGF secretion increased. In general, this study provides a novel method for decreasing the cytotoxicity of PEI gene delivery vectors and increasing transfection efficiency of angiogenesis-related genes.

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