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Sleep, Stress, and Symptoms Among People With Heart Failure During the COVID-19 Pandemic.
O'Connell, M, Jeon, S, Conley, S, Linsky, S, Redeker, NS
The Journal of cardiovascular nursing. 202301;38(2):E55-E60
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Plain language summary
COVID-19 pandemic raised concerns about the effects of stress on mental health and sleep deficiency. Cognitive behavioural therapy for insomnia (CBT-I) has been shown to improve sleep quality and insomnia severity, as well as anxiety and depression, and may be protective during times of stress, including the COVID-19 pandemic. The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with heart failure (HF). This study was a randomised controlled trial of the effects of CBT-I compared with HF self-management education (attention-control condition), the “HeartSleep Study.” Results showed that improvements in insomnia severity, sleep quality, latency, and efficiency, sleep-related cognitions and stress, anxiety, and depression after participation in CBT-I or an HF self-management class were sustained during the pandemic. Authors conclude that their findings confirm the clinical benefits of CBT-I for people with HF and comorbidities and also suggest the potential benefits of HF self-management education.
Abstract
BACKGROUND The COVID-19 pandemic raised concerns about the effects of stress on sleep and mental health, particularly among people with chronic conditions, including people with heart failure (HF). OBJECTIVE The aim of this study was to examine changes in sleep, sleep-related cognitions, stress, anxiety, and depression among people with HF who participated in a randomized controlled trial of cognitive behavioral therapy for insomnia before the COVID-19 pandemic. METHODS Participants self-reported sleep characteristics, symptoms, mood, and stress at baseline, 6 months after cognitive behavioral therapy for insomnia or HF self-management education (attention control), and during the pandemic. RESULTS The sample included 112 participants (mean age, 63 ± 12.9 years; 47% women; 13% Black; 68% New York Heart Association class II or III). Statistically significant improvements in sleep, stress, mood, and symptoms that occurred 6 months post treatment were sustained during the pandemic. CONCLUSIONS Improving sleep and symptoms among people with HF may improve coping during stressful events, and cognitive behavioral therapy for insomnia may be protective.
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The impact of the physical activity intervention on sleep in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis.
Liang, X, Haegele, JA, Tse, AC, Li, M, Zhang, H, Zhao, S, Li, SX
Sleep medicine reviews. 2024;:101913
Abstract
Pharmacological treatments (i.e., melatonin) and non-pharmacological therapies (e.g., parent-based sleep education programs and behavioural interventions) have been found to result in improved sleep in children and adolescents with autism spectrum disorder (ASD). However, there are several limitations to these treatment approaches, including concerns about the possible side-effects and safety, high-cost and uncertainties of long-term effects. Physical activity (PA) intervention is a promising behavioural intervention that has received increasing attention. However, the effects of PA intervention on sleep are still unclear in this clinical group. This study aimed to synthesize available empirical studies concerning the effects of PA interventions on sleep in children and adolescents with ASD. Following PRISMA guidelines, seven electronic databases: APA PsychInfo, CINAHL Ultimate, ERIC, MEDLINE, PubMed, SPORTDiscus, and Web of Science, were searched from inception to March 2023. Randomized controlled trials/quasi-experimental designs with comparison groups were included. Initially, 444 articles were identified, 13 articles underwent systematic review, and 8 studies with control groups and sufficient statistical data were selected for meta-analysis. Compared to no-treatment control groups, PA interventions had a large positive effect on parent-reported general sleep problems, night awakenings, sleep resistance, sleep duration and actigraphy-assessed sleep efficiency in children and adolescents with ASD.
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Prenatal iron supplementation adjusted to maternal iron stores reduces behavioural problems in 4-year-old children.
Iglesias-Vázquez, L, Canals, J, Hernández-Martínez, C, Voltas, N, Arija, V
Maternal & child nutrition. 2024;(1):e13595
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Abstract
Prenatal iron supplementation improves children's health and cognitive performance, but few studies explore behavioural development. This study assessed the effects of adjusting prenatal iron supplementation to maternal iron stores during early pregnancy on children's behavioural problems. Randomized controlled trial conducted in Tarragona (Spain) involving 230 nonanaemic pregnant women and their children after a 4-year follow-up. Based on haemoglobin (Hb) levels before gestational week (GW) 12, women receive different iron doses: those with Hb = 110-130 g/L were randomized to receive 80 or 40 mg/day and those with Hb > 130 g/L were randomized to receive 20 or 40 mg/day. Maternal iron stores at GW12 were classified using serum ferritin (SF) as low (SF < 15 µg/L), normal (SF = 15-65 µg/L), and normal-high (SF > 65 µg/L). Children's behaviour was assessed by parents using the Child Behaviour Checklist for ages 1.5-5 years and the Behaviour Rating Inventory of Executive Function-Preschool Version, and by teachers using the Teacher's Report Form for ages 1.5-5 years. Multivariable regression models were performed. Taking 80 mg/day of iron improved child behaviour when women had low iron stores but worsened it when mothers had normal-high iron stores, except for depressive and attention/hyperactivity problems. Taking 20 mg/day of iron improved behaviour only in those children whose mothers had SF > 65 µg/L in early pregnancy. Additionally, executive functioning improved at high doses of prenatal iron when maternal baseline SF < 15 µg/L. Adjusting prenatal iron supplementation to both maternal baseline Hb levels and iron stores reduces behavioural problems in 4-year-old children.
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Effect of Repeated Structured Diabetes Education on Lifestyle Knowledge and Self-Care Diabetes Management in Kidney Transplant Patients With Posttransplant Diabetes.
Othman, N, Al-Otaibi, T, Halim, MA, Said, T, Elserwy, N, Mahmoud, F, Abduo, H, Jahromi, M, Nampoory, N, Gheith, OA
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation. 2024;(Suppl 1):128-140
Abstract
OBJECTIVES Diabetes knowledge among kidney transplant recipients with posttransplant diabetes has not been clearly assessed. We evaluated whether diabetes education in kidney transplant recipients with posttransplant diabetes affected self-care, metabolic control variables, and reversibility of early diabetic microangiopathies. MATERIALS AND METHODS In this prospective randomized controlled study, we enrolled 210 renal transplant recipients with posttransplant diabetes. Group 1 patients (n = 140) received structured diabetes education, and group 2 patients (n = 70) received conventional education. Patient data were collected through patient identification and metabolic control parameter forms and a diabetes self-care scale questionnaire (scores between 0 and 7). RESULTS Diet knowledge improved and waist circumference was reduced with mild to moderate exercise in group 1 (P < .001), despite no differences between the 2 groups in mean body weight or body mass index. Patients in group 1 (structured diabetes education with repeated reinforcement) showed significant improvement in healthy lifestyle parameter scores versus group 2 (P < .05) and versus values before education (P < .05). At end of study, these achievements were translated into proper blood sugar monitoring, management of both hypoand hyperglycemia, improvements in logbook use and healthy sharp disposal, Ramadan fasting, sick day management, and knowledge on the importance of HbA1c (P < .05), which translated to decrease of HbA1c in group 1 by 1.35%. In group 1, proteinuria decreased significantly compared with before education and compared with group 2 values (P = .016). Diabetic retinopathy and neuropathy remained comparable between groups (P > .05). CONCLUSIONS Structured diabetes education improved lifestyle knowledge, self-care diabetes management, and metabolic control variables among kidney transplant recipients with posttransplant diabetes. Structured diabetes education also resulted in partial reversibility of the present early diabetic nephropathy. We recommended such education to be delivered to all kidney transplant recipients with diabetes.
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Mindfullness based intervention reduce anxiety in labor.
Kundarti, FI, Kiswati, , Komalyna, INT
Gaceta sanitaria. 2024;:102359
Abstract
OBJECTIVE To determine the effectiveness of mindfulness interventions on anxiety through a systematic review. METHOD Systematic review by searching articles through the PubMed, ProQuest, Science Direct, Wiley Library, Sage Journal, and Cochrane Library databases with publication years January 2012 to January 2022 RESULTS Eleven articles met the inclusion criteria covering several countries, including Canada 1 article, Egypt 1 article, Taiwan 1 article, Amsterdam 2 articles, Iran 1 article, Austria 1 article, San Francisco 1 article, Germany 1 article, Sweden 1 article, China 1 article, and Spain 1 article. CONCLUSIONS Management of anxiety about childbirth is important for pregnant women. Mindfulness interventions are effective for reducing anxiety about labor and increasing comfort during labor. Mindfulness intervention mechanisms have the potential to reduce anxiety by increasing skills to regulate emotions.
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Effects of astaxanthin on expression of apoptosis and oxidative stress related genes in H2O2 induced oxidative stress BE(2)-C human neuroblastoma cell line.
Hormozi, M, Beigi Boroujeni, N, Beigi Boroujeni, M
Preparative biochemistry & biotechnology. 2024;(3):374-381
Abstract
Antioxidants may affect the apoptosis induced by oxidative stress experimental models. The present study was conducted to investigate the effects of astaxanthin on expression of apoptosis and oxidative stress-related genes in H2O2 induced oxidative stress BE(2)-C human neuroblastoma cell line. This experimental study consisted of six groups including control, H2O2 induced oxidative stress control, 100 mM vitamin C intervention, 25 μM astaxanthin intervention (Ax1), 50 μM astaxanthin intervention (Ax2) and 100 μM astaxanthin intervention (Ax3). Real-time PCR was used to study the expression of BAX, BCL2, Caspase3 (CAS3), P53, peroxisome proliferator-activated receptor γ (PPARγ), superoxide dismutase (SOD), glutathione peroxidase 1 (GPX), catalase (CAT) and nuclear factor erythroid 2-related factor 2 (NRF2). According to the results, among the apoptosis-related genes, CAS3 was down-regulated in groups vitamin C, Ax1 and Ax2 compared with H2O2 group, while P53 was down-regulated only in group vitamin C (P < 0.05). Among the oxidative stress-related genes, GPX was up-regulated in groups Ax1, Ax2 and Ax3 compared with H2O2 group, while all the experimental groups showed up-regulation for CAT and NRF2 (P < 0.05). In conclusion, astaxanthin as a powerful antioxidant could inhibit apoptosis via amelioration of CAS3 gene which might be through amelioration of some antioxidant-related genes.
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IGFBP5 is released by senescent cells and is internalized by healthy cells, promoting their senescence through interaction with retinoic receptors.
Alessio, N, Aprile, D, Peluso, G, Mazzone, V, Patrone, D, Di Bernardo, G, Galderisi, U
Cell communication and signaling : CCS. 2024;(1):122
Abstract
Cells that are exposed to harmful genetic damage, either from internal or external sources, may undergo senescence if they are unable to repair their DNA. Senescence, characterized by a state of irreversible growth arrest, can spread to neighboring cells through a process known as the senescence-associated secretory phenotype (SASP). This phenomenon contributes to both aging and the development of cancer. The SASP comprises a variety of factors that regulate numerous functions, including the induction of secondary senescence, modulation of immune system activity, remodeling of the extracellular matrix, alteration of tissue structure, and promotion of cancer progression. Identifying key factors within the SASP is crucial for understanding the underlying mechanisms of senescence and developing effective strategies to counteract cellular senescence. Our research has specifically focused on investigating the role of IGFBP5, a component of the SASP observed in various experimental models and conditions.Through our studies, we have demonstrated that IGFBP5 actively contributes to promoting senescence and can induce senescence in neighboring cells. We have gained valuable insights into the mechanisms through which IGFBP5 exerts its pro-senescence effects. These mechanisms include its release following genotoxic stress, involvement in signaling pathways mediated by reactive oxygen species and prostaglandins, internalization via specialized structures called caveolae, and interaction with a specific protein known as RARα. By uncovering these mechanisms, we have advanced our understanding of the intricate role of IGFBP5 in the senescence process. The significance of IGFBP5 as a pro-aging factor stems from an in vivo study we conducted on patients undergoing Computer Tomography analysis. In these patients, we observed an elevation in circulating IGFBP5 levels in response to radiation-induced organismal stress.Globally, our findings highlight the potential of IGFBP5 as a promising therapeutic target for age-related diseases and cancer.
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Continuous microalgae cultivation for wastewater treatment - Development of a process strategy during day and night.
Ortiz Tena, F, Bickel, V, Steinweg, C, Posten, C
The Science of the total environment. 2024;:169082
Abstract
Conventional wastewater treatment (WWT) is not able to recycle nutrients from the wastewater (WW) directly. Microalgae integrate the valuable nutrients nitrogen and phosphorus within their biomass very efficiently, making them predestined for an application in WWT. Nevertheless, microalgae-based processes are driven by natural sunlight as energy source, making a continuous process mode during day and night difficult. The aim of this study was therefore to investigate metabolic activities of the continuously cultivated microalgae Chlorella vulgaris at light and dark periods (16 h,8 h) with focus on nutrient uptake during night from a synthetic WW. Varying the dilution rate D (D = 0.0-1.0 d-1 in 0.1 d-1-steps) causes different limitations for algae growth. Nutrient limitations at low D's cause maximum accumulation of intracellular storage components (sum of carbohydrates and lipids) of ~70 % of dry biomass, starch is converted to lipids at the absence of light. From middle to high D's, the growth rate is determined by light limitation, reducing the intracellular storage components to ~20 % of dry biomass. Complete nutrient uptake is measurable up to D = 0.5 d-1, marking the maximum operating point for wastewater purification. At that point, cells are characterised by high protein (up to 57%DBM) and pigment (up to 6.9%DBM) quotas. During the night, the build-up of proteins at the degradation of intracellular storage components is furthermore visible. Applying the concept of active biomass (cells without storage components), a constant cellular protein (~68%ABM) and nitrogen quota (11.94%ABM) was revealed. A nitrogen spiking experiment clearly showed nitrogen uptake and proliferation during the night period. Based on the experimental data, a window of operation for a continuous WWT process was designed, allowing the hypothesis that continuous WWT using microalgae during day and night operation is possible without the supplementation of artificial light. This revealed the system's capacity to treat WW throughout 24 h applying cell recycling and storage of carbohydrate-rich biomass. At the end of the night, protein-rich biomass is available for further valorisation.
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[Determination of organic acids and anions in exhaled breath by condensation collection-ion chromatography].
Gan, L, Zhou, YY, Fang, QQ, Xu, JJ, Chen, SQ, Zhu, Y, Ni, CZ
Se pu = Chinese journal of chromatography. 2024;(3):275-281
Abstract
A non-invasive condensation collection-ion chromatography method was established for the determination of organic acids and anions including lactic acid, formic acid, acetic acid, pyruvic acid, chloride, nitrate, nitrite, and sulfate in the exhaled breath of humans. The breath exhaled was condensed and collected using a home-made exhaled breath condensation equipment. This equipment included a disposable mouthpiece as a blow-off port, one-way valve and flow meter, cold trap, disposable condensate collection tube placed in the cold trap, and gas outlet. A standard sampling procedure was used. Before collection, the collection temperature and sampling volume were set on the instrument control panel, and sampling was started when the cold-trap temperature dropped to the set value, while maintaining the balance. Subjects were required to gargle with pure water before sampling. During the sampling process, the subjects were required to inhale deeply until the lungs were full of gas and then exhale evenly through the air outlet. When the set volume was collected, the instrument made a prompt sound; then, the collection was immediately ended, the expiration time was recorded, and the average collection flow was calculated according to the expiration time and sampling volume. After collection, the disposable condensation collection tube was immediately taken out, sealed, and stored in the refrigerator at -20 ℃ away from light, and immediately used for further testing. The organic acids and anions in exhaled breath condensation (EBC) were filtered through a 0.22 μm membrane filter before injection and detected by ion chromatography with conductivity detection. Factors such as collection temperature and collection flow rate during condensation collection were optimized. The optimal cooling temperature was set at -15 ℃, and the optimal exhaled breath flow rate was set at 15 L/min. The mobile phase consisted of a mixture of sodium carbonate (1.5 mmol/L) and sodium bicarbonate (3 mmol/L). The flow rate was 0.8 mL/min, and the injection volume was 100 μL. An IC-SA3 column (250 mm×4.0 mm) was used, and the temperature was set at 45 ℃. An ICDS-40A electrodialysis suppressor was used, and the current was set at 150 mA. The linear ranges of the eight organic acids and anions were 0.1-10.0 mg/L; their correlation coefficients (r) were ≥0.9993. The limits of detection (LODs) for the eight organic acids and anions were 0.0017-0.0150 mg/L based on a signal-to-noise ratio of 3, and the limits of quantification (LOQs) were 0.0057-0.0500 mg/L based on a signal-to-noise ratio of 10. The intra-day precisions were 5.06%-6.33% (n=5), and the inter-day precisions were 5.37%-7.50% (n=5). This method was used to detect organic acids and anions in the exhaled breath of five healthy subjects. The contents of organic acids and anions in the exhaled breath were calculated. The content of lactic acid was relatively high, at 1.13-42.3 ng/L, and the contents of other seven organic acids and anions were 0.18-11.0 ng/L. During a 10 km-long run, the majority of organic acids and anions in the exhaled breath of five subjects first increased and then decreased. However, due to abnormal metabolism, the content changes of lactic acid, acetic acid, pyruvic acid and chloride in one subject were obviously different from others during exercise, showing a continuous rise. This method has the advantages of involving a simple sampling process and exhibiting good precision, few side effects, and no obvious discomfort or risk to the subjects. This study provides experimental ideas and a theoretical basis for future research on human metabolites.
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Comparative efficacy of different growth hormone supplementation protocols in improving clinical outcomes in women with poor ovarian response undergoing assisted reproductive therapy: a network meta-analysis.
Xu, Z, Tong, W, Yang, Z, Zhang, H, Chen, X
Scientific reports. 2024;(1):3377
Abstract
Growth hormone (GH) has a long-standing history of use as an adjunctive therapy in the treatment of poor ovarian response (POR), but the optimal dosage and timing remains unclear. The aim of this study was to evaluate and compare the efficacy of different GH supplementation protocols through a network meta-analysis (NMA) and determine the optimal treatment protocol. This study was reported based on the Preferred Reporting Items for Systematic Reviews for Network Meta-Analysis (PRISMA-NMA) statement. Databases including PubMed, Web of Science, Cochrane Library and Embase were searched until June 2023. A total of 524 records were retrieved in our search, and 23 clinical studies comprising 4889 cycles were involved. Seven different GH protocols were identified. Results showed that compared to the control group, daily administration of 4-8 IU of GH during the follicular phase of the stimulation cycle had the best comprehensive therapeutic effects on improving the number of retrieved oocytes, mature oocytes, endometrial thickness, and reducing gonadotropin requirements in POR patients undergoing assisted reproductive therapy, with a relatively brief treatment duration and a moderate total GH dose. Subgroup analysis demonstrated that this protocol could significantly improve the clinical pregnancy rate of POR patients in the randomized controlled trials (RCT) subgroup and the African subgroup. Therefore, its clinical application is suggested. Besides, the potential advantages of long-term GH supplementation protocol (using GH for at least 2 weeks before oocyte retrieval) has merit for further research. Rigorous and well-designed multi-arm RCTs are needed in the future to confirm the conclusions drawn from this study.