Factors Associated With Depression and Anxiety for Community-Dwelling Patients With Heart Failure: A Retrospective Cohort Study.

BACKGROUND: Depression and anxiety are common comorbidities in heart failure (HF) and are associated with adverse outcomes including unplanned hospitalization. However, there is insufficient evidence on the factors associated with depression and anxiety for community patients with HF to inform optimal assessment and treatment in this population. AIM: The aim of this study was to examine the prevalence of and factors associated with depression and anxiety in community-dwelling patients with HF. METHODS: A retrospective cohort study of 302 adult patients given a diagnosis of HF referred to United Kingdom's largest specialist cardiac rehabilitation center, from June 2013 to November 2020. Main study outcomes were symptoms of depression using Patient Health Questionnaire-9 and anxiety using the General Anxiety Disorder 7-item scale. Explanatory variables included demographic and clinical characteristics and functional status from the Dartmouth COOP questionnaire: quality of life, pain, level of social activity and daily activities, and being bothered by emotional problems (feelings). Logistic regressions were performed to evaluate the association between demographic and clinical characteristics and depression and anxiety. RESULTS: Of the sample, 26.2% reported depression and 20.2% had anxiety. Higher depression and anxiety were associated with difficulty in performing daily activities (95% confidence interval, 1.11-6.46 and 1.13-8.09, respectively) and being bothered by feelings (95% confidence interval, 4.06-21.77 and 4.25-22.46, respectively). Depression was associated with limitations in social activity (95% confidence interval, 1.06-6.34) and anxiety with distressing pain (95% confidence interval, 1.38-7.23). CONCLUSION: Findings indicate the importance of psychosocial interventions for patients with HF to minimize and manage depression and anxiety. Patients with HF may benefit from interventions targeted to maintain independence, promote participation in social activities, and optimally manage pain.

The Efficacy of Psychological Interventions on Health-Related Quality of Life for Patients With Heart Failure and Depression: A Systematic Review.

BACKGROUND: Depression is prevalent among adults with chronic heart failure (CHF) and is associated with higher rates of morbidity and mortality and higher healthcare costs. OBJECTIVES: The aim of this study was to explore the efficacy of psychological interventions in reducing depression and improving quality of life and clinical outcomes (mortality, hospitalization) among adults with CHF. METHODS: This study performed a systematic review involving searches of 6 databases (MEDLINE, CINAHL, EMBASE, PsycINFO, ASSIA, and SSCI), the Cochrane library, and gray literature, completed in January 2020. Experimental and nonexperimental quantitative studies of psychological interventions for adults with CHF were included. Each study was quality appraised, and key data were extracted and tabled. Overall findings are presented as a narrative synthesis. RESULTS: Nine studies met eligibility. Study authors sampled 757 participants and evaluated 4 psychological interventions: cognitive behavioral therapy alone or combined with exercise, mindfulness-based psychoeducation, coping skills training, and innovative holistic meditation. Cognitive behavioral therapy was significantly associated with improved depression and quality of life, and reduced hospitalization risk. Mindfulness-based psychoeducation, holistic meditation, and coping skills training positively impacted depression and quality of life. Coping skills training also reduced hospitalization and mortality risks. CONCLUSION: Although this review indicates that psychological interventions can be beneficial to adults with CHF who have depression, the overall weight of evidence contains a number of biases. Larger, higher-powered studies are needed to confirm or refute these findings and to better understand how specific intervention and sample characteristics relate to outcomes.

Synergistic effect of sequential solvent treatment on the structural and low temperature charge transport of PEDOT:PSS films.

A detailed study on the low temperature charge transport and magnetoresistance (MR) measurements of spin-coated and solvent treated poly(3,4-ethylene dioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) films has been presented. The samples were prepared by sequential treatment of PEDOT:PSS film using dimethyl sulfoxide and sulphuric acid. X-ray diffraction and Raman spectroscopy elucidate the effect of solvent treatment on the structural modifications of the film, which correlates to the enhanced conductivity values. The nature of solvent and the sequence of successive treatments using different solvents has been effectively utilized to tune the conductivity of the film over a wide range. Further, the low temperature (300-2 K) charge transport study indicates that the resistance of the film rises sharply below 50 K, which implies the samples lie in the category of disordered materials. A linear fit of lnRvs.T-1/4for all the samples indicates that the temperature dependent resistance of solvent treated PEDOT:PSS films follow 3D variable range hopping model. The observed large positive MR behavior of the films has been discussed in terms of the wave function shrinkage of the charge carriers. The MR follows ∼B2and ∼B1/3dependence at low and high magnetic field regimes, respectively. The sequential treatment of PEDOT:PSS films shown in the present study is an effective method to enhance the electrical conductivity significantly.

Bifunctional Application of Viologen-MoS2-CNT/Polythiophene Device as Electrochromic Diode and Half-Wave Rectifier.

A dual purpose solid state electrochromic diode has been fabricated using polythiophene (P3HT) and ethyl Viologen (EV), predoped with multiwalled carbon nanotubes (MWCNTs) and MoS2. The device has been designed by considering two important aspects, first, the complementary redox activity of P3HT and EV and second, the electron holding properties of MoS2 and MWCNTs. The latter is found to enhance the electrochromic performance of the solid state device. On the other hand, the complementary redox nature gives the asymmetric diodic I-V characteristic to the device which has been exploited to use the electrochromic device for rectification application. The MoS2 nanoflower and MWCNTs are synthesized by one-step hydrothermal and pyrolysis techniques and well characterized by scanning electron microscopy (SEM), X-ray analysis (XRD), and Raman spectroscopy. Electrochromic properties of the device have been studied in detail to reveal an improvement in device performance in terms of faster speed and high coloration efficiency and color contrast. In situ bias-dependent Raman spectroscopy has been performed to understand the operation mechanism of the electrochromic diode which reveals (bi-)polaron formation as a result of dynamic doping eventually leading to color change. A half-wave rectifier has been realized from the electrochromic diode which rectifies an AC voltage of frequency 1 Hz or less making it suitable for low frequency operation. The study opens a new possibility to design and fabricate multipurpose frequency selective electrochromic rectifiers.

Fano-Type Wavelength-Dependent Asymmetric Raman Line Shapes from MoS2 Nanoflakes.

Excitation wavelength-dependent Raman spectroscopy has been carried out to study electron-phonon interaction (Fano resonance) in multi-layered bulk 2H-MoS2 nano-flakes. The electron-phonon coupling is proposed to be caused due to interaction between energy of an excitonic quasi-electronic continuum and the discrete one phonon, first-order Raman modes of MoS2. It is proposed that an asymmetrically broadened Raman line shape obtained by 633 nm laser excitation is due to electron-phonon interaction whose electronic continuum is provided by the well-known A and B excitons. Typical wavelength-dependent Raman line shape has been observed, which validates and quantifies the Fano interaction present in the samples. The experimentally obtained Raman scattering data show very good agreement with the theoretical Fano-Raman line-shape functions and help in estimating the coupling strength. Values of the electron-phonon interaction parameter obtained, through line-shape fitting, for the two excitation wavelengths have been compared and shown to have generic Fano-type dependence on the excitation wavelength.

Factors affecting survival to intestinal transplantation in the very young pediatric patient.

BACKGROUND: Very young pediatric patients awaiting intestinal transplantation have a high mortality rate due to long waiting times, scarcity of appropriate size donor organs, and mortality due to sepsis and liver failure. To investigate specific risk factors impacting survival to intestinal transplantation, we performed a 4-year institutional retrospective study comparing children who received grafts by age 18 months with children 18 months or younger who died while on the waiting list. PATIENTS AND METHODS: Twelve children comprised the transplanted group and had the underlying diagnoses: necrotizing enterocolitis, gastroschisis, Hirschsprung's disease, and omphalocele. Ten children comprised the deceased group and had the underlying diagnoses: intestinal atresia, necrotizing enterocolitis, gastroschisis, and midgut volvulus. Multiple risk factors were assessed in these groups. RESULTS: No differences in residual small bowel length, presence of the colon, number of line infections, or number of central lines were found. The average body weight of the transplanted group trended higher, whereas the deceased group had more impairment of hepatic function. Intestinal atresia was the most common diagnosis in the deceased group while none of the transplanted group carried this diagnosis. Ileocecal valve was retained in 80% of the deceased group and in none of the transplanted group. CONCLUSIONS: In children younger than 18 months, risk factors affecting survival to intestinal transplantation include small body size and advanced liver disease. A primary diagnosis of intestinal atresia and the presence of the ileocecal valve may confer additional risk to these very young children.