The Effect of Distance Education on Self-care in Patients With Heart Failure in the Chronic or Stable Phase: A Systematic Review and Meta-analysis.

BACKGROUND: Health education is important for self-care in patients with heart failure. However, the evidence for the effect of distance education as an intervention to deliver instruction for patients after discharge through digital devices on self-care is limited. OBJECTIVES: In this study, our aim was to explore the effect of distance education on self-care in patients with heart failure. METHODS: We searched 11 electronic databases and 3 trial registries for randomized controlled trials with low risk of bias and high-quality evidence to compare the effect of usual and distance education on self-care. Quality appraisal was performed using the Cochrane Risk of Bias Tool. Using the Review Manager 5.4 tool, a meta-analysis was conducted. Certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS: Fifteen articles were eligible for this study. Compared with usual education, distance education improved self-care maintenance (mean difference [MD], 6.62; 95% confidence interval [CI], 3.93-9.31; GRADE, moderate quality), self-care management (MD, 5.10; 95% CI, 3.25-6.95; GRADE, high quality), self-care confidence (MD, 6.66; 95% CI, 4.82-8.49; GRADE, high quality), heart failure knowledge (MD, 0.78; 95% CI, 0.01-1.56; GRADE, moderate quality), and quality of life (MD, -5.35; 95% CI, -8.73 to -1.97; GRADE, moderate quality). Subgroup analysis revealed distance education was more effective than usual education in self-care when the intervention was conducted for 1 to 6 months, more than 3 times per month, and a single intervention lasting more than 30 minutes. CONCLUSIONS: This review shows the benefits of distance education on self-care, heart failure knowledge, and quality of life of patients with heart failure. The intervention duration, frequency, and duration of a single intervention could have affected the intervention effect.

Enhanced pH-Responsive Chemo/Chemodynamic Synergistic Cancer Therapy Based on In Situ Cu2+ Di-Chelation.

Considering the chemodynamic therapy and chemotherapy independent of external stimulus witnessing great advantage in the clinical translation, developing a smart nanoplatform that can realize enhanced chemo/chemodynamic synergistic therapy in the tumor microenvironment (TME) is of great significance. Herein, we highlight the enhanced pH-responsive chemo/chemodynamic synergistic cancer therapy based on in situ Cu2+ di-chelation. The alcohol-withdrawal drug disulfiram (DSF) and chemotherapeutic drug mitoxantrone (MTO) were embedded into PEGylated mesoporous CuO (denoted as PEG-CuO@DSF@MTO NPs). The acidic TME triggered the collapse of CuO and the concurrent release of Cu2+, DSF, and MTO. Then, the in situ complexation between Cu2+ and DSF, as well as the coordination between Cu2+ and MTO not only prominently enhanced the chemotherapeutic performance but also triggered the chemodynamic therapy. In vivo mouse model experiments demonstrated that the synergistic therapy can remarkably eliminate tumors. This study provides an interesting strategy to design intelligent nanosystems, which could proceed to clinical translations.

Black graphitic carbon nitride nanosheets with mid-gap states realizing highly efficient near-infrared photo-thermal conversion for photoacoustic imaging.

Developing metal-free photo-thermal transduction nanoagents (PTNAs) with high conversion efficiency addresses the balance between superior photothermal performance and good biocompatibility in the field of bio-applications of PTNAs. Herein, we highlight the bandgap-engineered black graphitic carbon nitride nanosheets (denoted as B-g-C3N4) as a novel metal-free PTNA with high conversion efficiency (62% at 808 nm) for photoacoustic imaging. The B-g-C3N4 absorbed infrared light with a narrowed bandgap and electronic states within the band (known as mid-gap states) due to the synergistic effect of sulfur incorporation, nitrogen vacancies and the porous structure. Notably, the mid-gap states mediated the non-irradiative recombination of electrons and holes, bringing about energy dissipated as phonons. Owing to the high conversion efficiency as well as superior biocompatibility, HeLa cells incubated with B-g-C3N4 can be ablated under 808 nm light illumination. Furthermore, the B-g-C3N4 realized cross-sectional multispectral optoacoustic tomography (MSOT) imaging of the U14-tumor-bearing mouse. This work expands the catalogue of highly efficient metal-free PTNAs, showing great promise in biological applications.

Locally linear representation Fisher criterion based tumor gene expressive data classification.

Tumor gene expressive data are characterized by a large amount of genes with only a small amount of observations, which always appear with high dimensionality. So it is necessary to reduce the dimensionality before identifying their genre. In this paper, a discriminant manifold learning method, named locally linear representation Fisher criterion (LLRFC), is applied to extract features from tumor gene expressive data. In LLRFC, an inter-class graph and an intra-class graph are constructed based on their genre information, where any tumor gene expressive data in the inter-class graph should select k nearest neighbors with different class labels and in the intra-class graph the k nearest neighbors for any tumor gene expressive data must be sampled from those with the same class. And then the locally least linear reconstruction is introduced to optimize the corresponding weights in both graphs. Moreover, a Fisher criterion is modeled to explore a low dimensional subspace where the reconstruction errors in the inter-class graph can be maximized and the reconstruction errors in the intra-class graph can be minimized, simultaneously. Experiments on some benchmark tumor gene expressive data have been conducted with some related algorithms, by which the proposed LLRFC has been validated to be efficient.