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BMJ Open Jul 2024The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary...
Fatigue and physical activity in post-CABG patients: the parallel mediation model of kinesiophobia and self-efficacy : a prospective multicentre and cross-sectional study in China.
OBJECTIVES
The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the age of 45.
DESIGN
A prospective multicentre and cross-sectional study.
SETTING
The study was conducted in four public tertiary hospitals in China.
PARTICIPANTS
A total of 1278 patients who underwent CABG surgery were selected from the case pool, with their surgeries occurring between 3 and 19 months prior to selection. Out of 1038 patients who met the inclusion criteria and were invited to participate in the study, 759 patients agreed to participate and complete the questionnaire. Ultimately, 376 questionnaires were deemed eligible and included in the analysis.
PRIMARY AND SECONDARY OUTCOME MEASURES
The questionnaire included the following scales: the Chinese version of the Multidimensional Fatigue Inventory (MFI-20), the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI) and the International Physical Activity Questionnaire-Long (IPAQ-L). A serial mediation model was used to test whether the association between fatigue and PA was mediated by kinesiophobia and self-efficacy, in the overall sample and subsamples defined by age.
RESULTS
The results confirmed that fatigue was directly (95% CI (-5.73 to -3.02)) associated with PA. Higher kinesiophobia (95% CI (-0.16 to -0.05)) or lower PA self-efficacy (95% CI (-0.11 to -0.02)) were parallel pathways through which higher fatigue impediment reduced PA levels. In both subgroups, the street pathways of kinesiophobia and self-efficacy were altered. In the age, 45-60 years group, kinesiophobia (Boot 95% CI (-0.19 to-0.05)) was a mediator of fatigue on PA levels, while in the 61-75 years age group, self-efficacy (Boot 95% CI (-0.17 to -0.04)) was a mediator of fatigue on PA levels.
CONCLUSIONS
A clear relationship between fatigue and PA was mediated by both kinesiophobia and self-efficacy. Furthermore, our findings highlight the importance of adapting the intervention according to the age of the patients, mainly by reducing patients' kinesiophobia in patients aged 45-60 years and increasing patients' self-efficacy in patients aged 61-75 years. It may be possible to improve PA levels in post-CABG patients over 45 years of age by eliminating kinesiophobia and increasing self-efficacy.
Topics: Humans; Self Efficacy; Cross-Sectional Studies; Male; Prospective Studies; Female; Middle Aged; China; Exercise; Fatigue; Aged; Coronary Artery Bypass; Phobic Disorders; Surveys and Questionnaires; Kinesiophobia
PubMed: 38951011
DOI: 10.1136/bmjopen-2023-082576 -
ACS Nano Jul 2024Raman spectroscopy has made significant progress in biosensing and clinical research. Here, we describe how surface-enhanced Raman spectroscopy (SERS) assisted with... (Review)
Review
Raman spectroscopy has made significant progress in biosensing and clinical research. Here, we describe how surface-enhanced Raman spectroscopy (SERS) assisted with machine learning (ML) can expand its capabilities to enable interpretable insights into the transcriptome, proteome, and metabolome at the single-cell level. We first review how advances in nanophotonics-including plasmonics, metamaterials, and metasurfaces-enhance Raman scattering for rapid, strong label-free spectroscopy. We then discuss ML approaches for precise and interpretable spectral analysis, including neural networks, perturbation and gradient algorithms, and transfer learning. We provide illustrative examples of single-cell Raman phenotyping using nanophotonics and ML, including bacterial antibiotic susceptibility predictions, stem cell expression profiles, cancer diagnostics, and immunotherapy efficacy and toxicity predictions. Lastly, we discuss exciting prospects for the future of single-cell Raman spectroscopy, including Raman instrumentation, self-driving laboratories, Raman data banks, and machine learning for uncovering biological insights.
PubMed: 38950145
DOI: 10.1021/acsnano.4c04282 -
PloS One 2024The objective of this study is to determine the components that contribute to psychological resilience in adolescents and to determine if physical exercise, emotion...
The objective of this study is to determine the components that contribute to psychological resilience in adolescents and to determine if physical exercise, emotion control, or self-efficacy are more effective predictors of resilience. Data from participants was collected through a personal information form, the International Physical Activity Questionnaire-Short Form, the Self-Efficacy Scale for Children, the Emotion Regulation Scale for Children and Adolescents, and the Psychological Resilience Scale for Children and Adolescents. The data were gathered online from 16 out of the 81 provinces in Turkey, representing 7 different regions, using convenience sampling. The study sample comprised 505 adolescents, with 309 females and 196 males. The average age of the participants was 15.66 years, with a standard deviation of 1.34. The data obtained from the students was analyzed using SPSS 27.0 statistical software. The Chi-Square test was employed to establish the correlation between the demographic features of adolescents and their levels of physical activity. The relationship between the independent variables and the dependent variable was determined using correlation analysis and hierarchical regression analysis. According to the analyzed results, there was a substantial positive correlation between physical activity and resilience, reappraisal and resilience, and self-efficacy and resilience. In addition, it was noted that physical activity alone explains 4.8% of the overall variation in resilience and is a significant predictor of resilience. The inclusion of reappraisal in the model resulted in a partial prediction of resilience by physical activity. However, the primary strength of the model was attributed to reappraisal. The inclusion of self-efficacy in the model resulted in a significant prediction of resilience, accounting for 36.8% of the total variance. The self-efficacy variable had a higher impact level compared to the other variables. Furthermore, the inclusion of self-efficacy in the model resulted in the elimination of the influence of physical activity on resilience. The research conclusions point out that self-efficacy has a greater impact on psychological resilience compared to physical activity and emotion regulation.
Topics: Humans; Adolescent; Female; Male; Resilience, Psychological; Turkey; Self Efficacy; Exercise; Surveys and Questionnaires; Emotions
PubMed: 38950024
DOI: 10.1371/journal.pone.0300165 -
Clinical Gerontologist Jul 2024Health-related factors, such as health status, health anxiety, and health literacy, are established contributors to self-efficacy. However, the relationship between...
OBJECTIVES
Health-related factors, such as health status, health anxiety, and health literacy, are established contributors to self-efficacy. However, the relationship between electronic health literacy and self-efficacy is less known. The present study examined the role of electronic health literacy in relation to self-efficacy among community-dwelling older adults.
METHODS
Cross-sectional survey data were collected in the United States between September 2022 and March 2023. The survey dataset consisted of 191 responses from individuals in the United States who were ages 65 or older. It provided information about survey respondents' sociodemographic status, perceived health status, health anxiety, electronic health literacy, and self-efficacy. Hierarchical linear regression was conducted to analyze the data.
RESULTS
Electronic health literacy was positively related to self-efficacy, and health anxiety was negatively related to self-efficacy, with sociodemographic status and perceived health status controlled.
CONCLUSIONS
The results indicate that electronic health literacy can be a source of self-efficacy among community-dwelling older adults.
CLINICAL IMPLICATIONS
Improving older adults' electronic health literacy may help them maintain self-efficacy, and the improvement should be made, especially in the domains of evaluating health information found on the internet and making decisions based on the information.
PubMed: 38949203
DOI: 10.1080/07317115.2024.2373894 -
Small (Weinheim An Der Bergstrasse,... Jul 2024Azobenzene, while relevant, has faced constraints in biological system applications due to its suboptimal quantum yield and short-wavelength emission. This study...
Azobenzene, while relevant, has faced constraints in biological system applications due to its suboptimal quantum yield and short-wavelength emission. This study presents a pioneering strategy for fabricating organic microdots by coupling foldamer-linked azobenzene, resulting in robust fluorescence intensity and stability, especially in aggregated states, thereby showing promise for bioimaging applications. Comprehensive experimental and computational examinations elucidate the mechanisms underpinning enhanced photostability and fluorescence efficacy. In vitro and in vivo evaluations disclose that the external layer of cis-azo-foldamer microdots performs a self-sacrificial function during photo-bleaching. Consequently, these red-fluorescent microdots demonstrate extraordinary structural and photochemical stabilities over extended periods. The conjugation of a β-peptide foldamer to the azobenzene chromophore through a glycine linker instigates a blue-shifted and amplified π-n transition. Molecular dynamics simulations reveal that the aggregated state of cis-azo-foldamers fortifies the stability of cis isomers, thereby augmenting fluorescence efficiency. This investigation furnishes crucial insights into conceptualizing novel, biologically inspired materials, promising stable and enduring imaging applications, and carries implications for diverse arenas such as medical diagnostics, drug delivery, and sensing technologies.
PubMed: 38949050
DOI: 10.1002/smll.202401480 -
BioRxiv : the Preprint Server For... Jun 2024Oxidative stress is implicated in the pathogenesis and progression of abdominal aortic aneurysm (AAA). Antioxidant delivery as a therapeutic for AAA is of substantial...
BACKGROUND
Oxidative stress is implicated in the pathogenesis and progression of abdominal aortic aneurysm (AAA). Antioxidant delivery as a therapeutic for AAA is of substantial interest although clinical translation of antioxidant therapy has met with significant challenges due to limitations in achieving sufficient antioxidant levels at the site of AAA. We posit that nanoparticle-based approaches hold promise to overcome challenges associated with systemic administration of antioxidants.
METHODS
We employed a peptide-based nanoplatform to overexpress a key modulator of oxidative stress, superoxide dismutase 2 (SOD2). The efficacy of systemic delivery of SOD2 mRNA as a nanotherapeutic agent was studied in two different murine AAA models. Unbiased mass spectrometry-enabled proteomics and high-dimensional bioinformatics were used to examine pathways modulated by SOD2 overexpression.
RESULTS
The murine SOD2 mRNA sequence was mixed with p5RHH, an amphipathic peptide capable of delivering nucleic acids to form self-assembled nanoparticles of ∼55 nm in diameter. We further demonstrated that the nanoparticle was stable and functional up to four weeks following self-assembly when coated with hyaluronic acid. Delivery of SOD2 mRNA mitigated the expansion of small AAA and largely prevented rupture. Mitigation of AAA was accompanied by enhanced SOD2 protein expression in aortic wall tissue. Concomitant suppression of nitric oxide, inducible nitric oxide synthase expression, and cell death was observed. Proteomic profiling of AAA tissues suggests that SOD2 overexpression augments levels of microRNAs that regulate vascular inflammation and cell apoptosis, inhibits platelet activation/aggregation, and downregulates mitogen-activated protein kinase signaling. Gene set enrichment analysis shows that SOD2 mRNA delivery is associated with activation of oxidative phosphorylation, lipid metabolism, respiratory electron transportation, and tricarboxylic acid cycle pathways.
CONCLUSIONS
These results confirm that SOD2 is key modulator of oxidative stress in AAA. This nanotherapeutic mRNA delivery approach may find translational application in the medical management of small AAA and the prevention of AAA rupture.
PubMed: 38948794
DOI: 10.1101/2024.06.17.599454 -
Sexuality Research & Social Policy :... Jun 2024Parents who do not feel responsible for parent-child sexual communication (PCSC) may be missing out on opportunities to engage in PCSC that has protective effects on...
INTRODUCTION
Parents who do not feel responsible for parent-child sexual communication (PCSC) may be missing out on opportunities to engage in PCSC that has protective effects on children's sexual well-being. Using the theory of planned behavior and feminist theory, we explore how parents' PCSC attitudes and demographics are associated with perceptions of who is responsible for PCSC.
METHODS
Using data collected in December 2019 through January 2020 from parents of 6-11-year-olds, we ran chi-square tests, ANOVAs, and logistic regressions to determine how parent PCSC attitudes and other parental factors are associated with parent perceptions of who is responsible for PCSC.
RESULTS
The majority of parents saw themselves and/or a co-parent as primarily responsible for PCSC about facts and values. Bivariately, parents with higher scores of perceived positive PCSC outcomes, subjective norms, and self-efficacy were more likely to believe that they were solely responsible or shared an equal responsibility for PCSC. Multivariately, mothers and genderqueer parents, parents with the same gender as their child, and parents whose co-parent was less involved in parenting were more likely to report being solely responsible for PCSC.
CONCLUSIONS
Most parents saw themselves or a partner as most responsible for PCSC; parent and child gender were the strongest determinants of parents' perceptions of PCSC responsibility.
POLICY IMPLICATIONS
These results suggest that it may be more effective for parent education to challenge and deconstruct traditional gender roles versus focusing on self-efficacy, norms, and perceived outcomes if we want to increase parents' perceived PCSC responsibility, especially within different-gender parent-child dyads.
PubMed: 38948363
DOI: 10.1007/s13178-023-00898-w -
Computational Psychiatry (Cambridge,... 2024Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update, including global, prospective beliefs about their...
Patients with anorexia nervosa (AN) typically hold altered beliefs about their body that they struggle to update, including global, prospective beliefs about their ability to know and regulate their body and particularly their interoceptive states. While clinical questionnaire studies have provided ample evidence on the role of such beliefs in the onset, maintenance, and treatment of AN, psychophysical studies have typically focused on perceptual and 'local' beliefs. Across two experiments, we examined how women at the acute AN (N = 86) and post-acute AN state (N = 87), compared to matched healthy controls (N = 180) formed and updated their self-efficacy beliefs retrospectively (Experiment 1) and prospectively (Experiment 2) about their heartbeat counting abilities in an adapted heartbeat counting task. As preregistered, while AN patients did not differ from controls in interoceptive accuracy , they hold and maintain 'pessimistic' interoceptive, metacognitive self-efficacy beliefs after performance. Modelling using a simplified computational Bayesian learning framework showed that neither local evidence from performance, nor retrospective beliefs following that performance (that themselves were suboptimally updated) seem to be sufficient to counter and update pessimistic, self-efficacy beliefs in AN. AN patients showed lower learning rates than controls, revealing a tendency to base their posterior beliefs more on prior beliefs rather than prediction errors in both retrospective and prospective belief updating. Further explorations showed that while these differences in both explicit beliefs, and the latent mechanisms of belief updating, were not explained by general cognitive flexibility differences, they were explained by negative mood comorbidity, even after the acute stage of illness.
PubMed: 38948255
DOI: 10.5334/cpsy.109 -
Theranostics 2024: Molecular imaging of microenvironment by hypoxia-activatable fluorescence probes has emerged as an attractive approach to tumor diagnosis and image-guided treatment....
: Molecular imaging of microenvironment by hypoxia-activatable fluorescence probes has emerged as an attractive approach to tumor diagnosis and image-guided treatment. Difficulties remain in its translational applications due to hypoxia heterogeneity in tumor microenvironments, making it challenging to image hypoxia as a reliable proxy of tumor distribution. : We report a modularized theranostics platform to fluorescently visualize hypoxia via light-modulated signal compensation to overcome tumor heterogeneity, thereby serving as a diagnostic tool for image-guided surgical resection and photodynamic therapy. Specifically, the platform integrating dual modules of fluorescence indicator and photodynamic moderator using supramolecular host-guest self-assembly, which operates cooperatively as a cascaded "AND" logic gate. First, tumor enrichment and specific fluorescence turn-on in hypoxic regions were accessible via tumor receptors and cascaded microenvironment signals as simultaneous inputs of the "AND" gate. Second, image guidance by a lighted fluorescence module and light-mediated endogenous oxygen consumption of a photodynamic module as dual inputs of "AND" gate collaboratively enabled light-modulated signal compensation , indicating homogeneity of enhanced hypoxia-related fluorescence signals throughout a tumor. In and analyses, the biocompatible platform demonstrated several strengths including a capacity for dual tumor targeting to progressively facilitate specific fluorescence turn-on, selective signal compensation, imaging-time window extension conducive to precise normalized image-guided treatment, and the functionality of tumor glutathione depletion to improve photodynamic efficacy. The hypoxia-activatable, image-guided theranostic platform demonstrated excellent potential for overcoming hypoxia heterogeneity in tumors.
Topics: Animals; Theranostic Nanomedicine; Humans; Optical Imaging; Mice; Tumor Microenvironment; Cell Line, Tumor; Fluorescent Dyes; Photochemotherapy; Neoplasms; Mice, Nude; Surgery, Computer-Assisted
PubMed: 38948059
DOI: 10.7150/thno.95590 -
World Journal of Transplantation Jun 2024Endoscopic management is the first-line therapy for post-liver-transplant anastomotic strictures. Although the optimal duration of treatment with plastic stents has been...
BACKGROUND
Endoscopic management is the first-line therapy for post-liver-transplant anastomotic strictures. Although the optimal duration of treatment with plastic stents has been reported to be 8-12 months, data on safety and duration for metal stents in this setting is scarce. Due to limited access to endoscopic retrograde cholangiopancreatography (ERCP) during the coronavirus disease 2019 pandemic in our centre, there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable anatomy. This was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic stents.
AIM
To compare the safety and efficacy profile of different stenting durations using Kaffes stents.
METHODS
Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database query. Unplanned admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical records. The main outcome was the incidence of complications when stents were left indwelling for 3 months 6 months. Stent efficacy was calculated rates of stricture recurrence between patients that had stenting courses for ≤ 120 d or > 120 d.
RESULTS
During the study period, a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting course. In 33 ERCPs, the stent was removed or exchanged on a 3-month interval. No pancreatitis, perforations or deaths occurred. Minor post-ERCP complications were similar between the 3-month (abdominal pain and intraductal migration) and 6-month (abdominal pain, septic shower and embedded stent) groups - 6.1% 9.1% respectively, = 0.40. All strictures resolved at the end of the stenting course, but the stenting course was variable from 3 to 22 months. The recurrence rate for stenting courses lasting for up to 120 d was 71.4% and 21.4% for stenting courses of 121 d or over ( = 0.03). There were 28 patients that were treated with a single ERCP with Kaffes, 21 with removal after 120 d and 7 within 120 d. There was a significant improvement in stricture recurrence when the Kaffes was removed after 120 d when a single ERCP was used for the entire stenting course (71.0% 10.0%, = 0.01).
CONCLUSION
Utilising a single Kaffes intraductal fully-covered metal stent for at least 4 months is safe and efficacious for the management of post-transplant anastomotic strictures.
PubMed: 38947975
DOI: 10.5500/wjt.v14.i2.91081