Background: The full life cycle perspective emphasizes the profound impact of early-life events on later health. Age at first sexual intercourse (AFS) marks the onset of an individual’s sexual development and behavior, which may influence the aging trajectory.
Objective: This study aims to investigate the causal effects of AFS on multidimensional aging phenotypes and identify potential mediating mechanisms from a full life cycle perspective.
Study design: Mendelian Randomization (MR) analysis.
Methods: This study employed two-sample MR analysis, using genetic instruments for AFS to estimate its causal effects on various aging phenotypes, including aging-genetically independent phenotypes (aging-GIP), longevity, frailty index, parental lifespan, healthspan, and self-rated health. Subsequently, a two-step MR mediation analysis was conducted to determine the mediating effects between AFS and aging-GIP.
Results: Earlier AFS was causally associated with lower aging-GIP (β, 0.42; 95%CI, 0.36-0.48). Similar association patterns were observed for longevity (OR, 1.41; 95%CI, 1.11-1.78) and parental lifespan (β, 0.33; 95%CI, 0.28-0.39), while negative causal relationships were found with frailty index (β, −0.30; 95%CI, −0.36 to −0.25), healthspan (β, −0.26; 95%CI, −0.33 to −0.18), and self-rated health (β, −0.32; 95%CI, −0.37 to −0.26). Mediation analysis identified 34 exploratory mediators among 145 candidate mediators between AFS and aging-GIP.
Conclusion: The findings underscore the importance of early sexual health education and suggest implementing targeted interventions to mitigate the adverse effects of early sexual behavior on aging. This approach can promote healthy aging and reduce aging disparities caused by early sexual initiation.

Background: Risky sexual behaviors (RSBs) among college students pose a substantial threat to both physical and mental health and are associated with sexually transmitted infections and unintended pregnancies. However, many existing interventions demonstrate limited sustainability in achieving lasting behavioral change. Objective: This study aimed to develop a theory-driven, evidence-based intervention program to reduce RSBs among college students in China.
Study design: A sequential mixed-methods study design was employed.
Methods: Program development was guided by the Behavior Change Wheel (BCW) and conducted in two phases. Phase 1 involved developing a preliminary intervention draft informed by a systematic literature review and semi-structured interviews with college students who reported RSBs, with the aim of identifying barriers and facilitators mapped to the Capability, Opportunity, Motivation-Behavior (COM-B) model. Phase 2 consisted of a two-round Delphi consultation with multidisciplinary experts to evaluate and refine the program. Data were analyzed using thematic analysis and descriptive statistics, including the authority coefficient and Kendall’s coefficient of concordance (W).
Results: The literature review identified 1893 records, of which 21 studies were included in the synthesis. Fifteen students participated in qualitative interviews, generating three themes and eight subthemes that mapped directly onto COM-B components. Thirteen experts completed both rounds of the Delphi consultation, yielding a 100% response rate and a high authority coefficient (Cr = 0.819). Kendall’s W increased from 0.313 (Round 1) to 0.437 (Round 2; P < 0.05), indicating improved consensus. The finalized intervention program comprises six primary indicators (COM-B domains), 12 secondary indicators (intervention functions), and 39 tertiary indicators (specific activities). The program is delivered as a six-week, group-based peer intervention (90 min per week), integrating education, skills training, and environmental restructuring.
Conclusions: A theory- and evidence-informed intervention program targeting RSBs among Chinese college students was developed and refined through expert consensus. The program provides a structured blueprint for potential implementation in university settings; however, its feasibility, acceptability, and effectiveness should be examined in future pilot and evaluation studies.

This perspective proposes a restrained rehabilitation design that reframes an electroencephalography (EEG)-based brain-computer interface (BCI) from continuous motor control to an intention-gating signal that determines when and how strongly haptic cues should be delivered. A McKibben artificial-muscle haptic navigation module encodes task deviation into a small, semantically consistent directional codebook, enabling intuitive “coach-like” guidance while minimizing visual/verbal dependence. This concept emphasizes safety-biased thresholds, low-intrusion feedback, protocol-level reporting of gating reliability, and cue-dose tapering to promote autonomy and skill transfer under real-world variability and drift.

Background: Regular submaximal strengthening exercises are recommended for patients with Duchenne muscular dystrophy (DMD); however, evidence regarding the optimal intensity is limited.
Objective: To evaluate the effects of a 12-month home-based strength training program at different intensities on muscle strength and physical function in boys with DMD and inform the design of a future definitive randomized controlled trial (RCT).
Study design: Single-site, parallel-group, exploratory pilot RCT.
Methods: Sixty boys aged 5-10 years with DMD will be randomized in a 1:1:1 ratio to non-resistance, low-resistance, or moderate-resistance strength training groups. All groups will perform a standardized exercise regimen thrice weekly for 12 months at home, including warm-up, static stretching, and strengthening exercises. Training will be initiated through a face-to-face instructional session. Adherence and safety will be monitored using exercise logs and biweekly telephonic assessments. Primary and secondary outcomes will be assessed at baseline, 6 months, and 12 months by blinded outcome assessors.
Outcome measures: Primary outcome measures are muscle strength and the North Star Ambulatory Assessment. Secondary outcomes include the Motor Function Measure, timed function tests, range of motion, and Vignos and Brooke scales. The exploratory outcomes comprise feasibility (eligibility, recruitment rate, intervention adherence, and study completion rate), tolerability (nonadherence and withdrawal), and safety (adverse events, serum creatine kinase levels, and muscle pain).
Conclusions: This Chinese exploratory RCT will provide critical data on the preliminary effects and feasibility of home-based strength training at different intensities in DMD. These findings will guide sample size calculation and outcome selection for larger multicenter trials.

Background: Phantom Limb Pain (PLP) is a common and intractable neuropathic pain condition that occurs following limb amputation, significantly impacting patients’ quality of life. The prevalence of PLP ranges from 45% to 85%. Traditional pharmacological treatments have limited efficacy and are frequently accompanied by significant side effects.
Objective: This review aims to provide a comprehensive overview of the multi-level pathophysiological mechanisms underlying PLP, synthesize clinical evidence on both invasive and non-invasive neuromodulation techniques, analyze differences in therapeutic outcomes and targets, and offer insights for clinical practice and future research.
Methods: This is a narrative review that integrates the existing evidence and current clinical applications of various treatment approaches for PLP.
Results: The mechanisms of PLP involve peripheral nerve ectopic discharges, cortical reorganization, and the interaction of various psychological factors. The short-term efficacy of invasive treatments, such as spinal cord stimulation (SCS) and dorsal root ganglion (DRG) stimulation, ranges from 14% to 80%. DRG stimulation shows more promise in terms of long-term stability. Non-invasive techniques, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), when combined with mirror therapy, can enhance therapeutic outcomes. Emerging technologies, such as brain-computer interfaces (BCI) and temporally interfering stimulation (TIS), remain in the preclinical phase of investigation.
Conclusion: Neuromodulation techniques offer a multi-dimensional treatment strategy for PLP, with potential improvements through parameter standardization, individualized treatment optimization, validation in multi-center randomized controlled trials, and an overall enhancement of clinical efficacy.

Background: Falls are the leading cause of injury and mortality in older adults; however, the relative contributions of different fall risk factor domains remain unclear. A past fall history strongly predicts future falls, making fall history classification critical for prospective risk assessment.
Objective: This study compared three domains for classifying fall history status in older adults as the basis for fall risk assessment.
Study design: Cross-sectional observational study.
Methods: We analyzed the G-STRIDE dataset (163 older adults; mean age [standard deviation] = 82.6 [6.2] years; 72.4% female; 52.8% fallers). Three domains were examined: demographic information (DGI), clinical scales and questionnaires (CSQ), and mobility tests and contexts (MTC). Four classifiers (logistic regression, support vector machine, random forest, and artificial neural network) were evaluated using 10-fold cross-validation, leave-one-out, and hold-out validation. Bootstrap 95% confidence intervals (CIs) and paired t-tests were used for area under the receiver operating characteristic curve (AUC) comparisons.
Results: MTC alone achieved AUC = 0.89 (95% CI: 0.83-0.94), significantly outperforming DGI (AUC = 0.76, P < 0.001). DGI plus MTC showed a marginal advantage over DGI plus CSQ (P = 0.064). The evolutionary optimization identified a seven-variable subset dominated by mobility measures that matched the full-model performance (AUC = 0.90). A multi-method feature importance analysis identified the examination location, frailty index, and short Falls Efficacy Scale-International as the top predictors. The external validation of GAIT2CARE (N = 127) achieved an AUC of 0.802 for DGI plus MTC.
Conclusions: Objective mobility tests combined with demographic data provided efficient fall risk assessment without extensive questionnaire-based assessments, supporting streamlined clinical screening.