A systematic review and meta-analysis of interventions to reduce perceived stress in breast cancer patients.

PURPOSE: Breast cancer (BC) patients commonly face stress that causes severe psychological and physiological problems. The main objective of the review was to confirm the effect of interventions on breast cancer patients' perceived stress, and the secondary objective was to explore the impact of interventions on anxiety, depression, and inflammatory markers. METHODS: A systematic and comprehensive search for randomized controlled trials (RCTs) that reported interventions' effects on perceived stress in breast cancer patients was performed in nine databases. RESULTS: Twenty-four RCTs, including 1887 participants, met the inclusion criteria, summarizing six categories for the intervention group: mindfulness and yoga, exercise, cognitive-behavioral stress management, self-regulation, relaxation training, and acupuncture. Compared with usual care or other types of care, mindfulness and yoga had excellent effects against perceived stress, anxiety, and depression; self-regulation could reduce perceived stress and anxiety; exercise could reduce perceived stress; acupuncture could reduce the level of depression; mindfulness could improve the TNF-α level, and yoga can reduce the level of salivary cortisol and DNA damage. CONCLUSION: This systematic review indicated that nondrug interventions, such as mindfulness and yoga, effectively reduce perceived stress, anxiety, and depression. Rigorous studies with large sample sizes are needed to address the limitations of small sample sizes and shortcomings in methodology in this area.

Measurement of neuropsychiatric symptoms in the older adults with mild cognitive impairment based on speech and facial expressions: a cross-sectional observational study.

OBJECTIVES: To examine the association between speech and facial features with depression, anxiety, and apathy in older adults with mild cognitive impairment (MCI). METHODS: Speech and facial expressions of 319 MCI patients were digitally recorded via audio and video recording software. Three of the most common neuropsychiatric symptoms (NPS) were evaluated by the Public Health Questionnaire, General Anxiety Disorder, and Apathy Evaluation Scale, respectively. Speech and facial features were extracted using the open-source data analysis toolkits. Machine learning techniques were used to validate the diagnostic power of extracted features. RESULTS: Different speech and facial features were associated with specific NPS. Depression was associated with spectral and temporal features, anxiety and apathy with frequency, energy, spectral, and temporal features. Additionally, depression was associated with facial features (action unit, AU) 10, 12, 15, 17, 25, anxiety with AU 10, 15, 17, 25, 26, 45, and apathy with AU 5, 26, 45. Significant differences in speech and facial features were observed between males and females. Based on machine learning models, the highest accuracy for detecting depression, anxiety, and apathy reached 95.8%, 96.1%, and 83.3% for males, and 87.8%, 88.2%, and 88.6% for females, respectively. CONCLUSION: Depression, anxiety, and apathy were characterized by distinct speech and facial features. The machine learning model developed in this study demonstrated good classification in detecting depression, anxiety, and apathy. A combination of audio and video may provide objective methods for the precise classification of these symptoms.

Association between self-perception of aging and cognitive function in Chinese older adults: The mediation effect of health behaviors.

OBJECTIVE: To investigate the association between self-perception of aging (SPA) and cognitive function in Chinese older adults, and to explore the mediating role of health behaviors. METHODS: This study included 5,445 Chinese older adults from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Correlation, linear regression and mediation effect analysis were employed to evaluate the association. RESULTS: SPA is significantly related to the health behaviors (r = 0.160, P < 0.01) and cognition (r = 0.086, P < 0.01), and health behaviors exhibited a positive correlation with cognition (r = 0.179, P < 0.01). SPA and health behaviors significantly impacted cognition (ß = 0.032, P = 010; ß = 0.103, P < 0.001). Health behaviors partially mediated the effect of SPA on cognitive function, accounting for 27.12 % of the total effect. CONCLUSION: Health behaviors mediate the association between SPA and cognitive function. Healthcare providers should prioritize addressing SPA of older adults and encourage them to engage in health behaviors for cognitive health.

Developing a machine learning model for detecting depression, anxiety, and apathy in older adults with mild cognitive impairment using speech and facial expressions: A cross-sectional observational study.

BACKGROUND: Depression, anxiety, and apathy are highly prevalent in older people with preclinical dementia and mild cognitive impairment. These symptoms have also proven valuable in predicting the progression from mild cognitive impairment to dementia, enabling a timely diagnosis and treatment. However, objective and reliable indicators to detect and distinguish depression, anxiety, and apathy are relatively scarce. OBJECTIVE: This study aimed to develop a machine learning model to detect and distinguish depression, anxiety, and apathy based on speech and facial expressions. DESIGN: An observational, cross-sectional study design. SETTING(S): The memory outpatient department of a tertiary hospital. PARTICIPANTS: 319 older adults diagnosed with mild cognitive impairment. METHODS: Depression, anxiety, and apathy were evaluated by the Public Health Questionnaire, General Anxiety Disorder, and Apathy Evaluation Scale, respectively. Speech and facial expressions of older adults with mild cognitive impairment were digitally captured using audio and video recording software. Open-source data analysis toolkits were utilized to extract speech, facial, and text features. The multiclass classification was used to develop classification models, and shapely additive explanations were used to explain the contribution of each feature within the model. RESULTS: The random forest method was used to develop a multiclass emotion classification model, which performed well in classifying emotions with a weighted-average F1 score of 96.6 %. The model also demonstrated high accuracy, precision, and recall, with 87.4 %, 86.6 %, and 87.6 %, respectively. CONCLUSIONS: The machine learning model developed in this study demonstrated strong classification performance in detecting and differentiating depression, anxiety, and apathy. This innovative approach combines text, audio, and video to provide objective methods for precise classification and remote monitoring of these symptoms in nursing practice. REGISTRATION: This study was registered at the Chinese Clinical Trial Registry (registration number: ChiCTR1900023892; registration date: June 19th, 2019).

[Start-up Characteristics of SNAD Process and Functional Abundance Succession of Volcanic Rock Biological Aerated Filter].

A SNAD(simultaneous partial nitrification,ANAMMOX,and denitrification) process initiated in a submerged biological aerated filter (SBAF) was started up by seeding nitrification sludge and an ANAMMOX filter to investigate the operating characteristics and the succession of functional bacteria. The results showed that when the autotrophic nitrogen removal and denitrification were operated stably for 67 days at an initial COD concentration of 60 mg·L-1, the maximum nitrogen removal efficiency, the COD removal rate, and the nitrogen removal rate were 92.0%, 82.9%, and 2.3 kg·(m3·d)-1, respectively. Moreover, the total nitrogen removal rate of the SNAD process in this study was 12.6% higher than that of CANON process. The results of quantitative PCR showed that the abundance of AOB slightly increased, while the abundance of ANAMMOX was one order higher than that before the start-up of SNAD. In comparison, the abundances of denitrifiers and NOB remained at a relatively low level (107 copies·g-1). Taken together, these results suggested that the SBAF process with volcanic filter was beneficial for the accumulation of ANAMMOX and AOB.

Adipose tissue-derived stem cells in combination with xanthan gum attenuate osteoarthritis progression in an experimental rat model.

The current study explored the efficacy of an intra-articular (IA) injection of allogeneic adipose tissue-derived stem cells (ADSCs) combined with xanthan gum (XG) in a rat osteoarthritis (OA) model. We confirmed that XG significantly inproved proliferation of ADSCs in a dose dependent manner in vitro. The rat OA model was induced by an anterior cruciate ligament transection (ACLT), and at 4 weeks after surgery, rats were divided into four groups: the XG-ADSCs group, the ADSCs group, the XG group and the phosphate-buffered saline (PBS) group. A single dose of 1 × 106 allogeneic ADSCs suspended in 1% XG, ADSCs suspended in PBS, 1% XG alone or PBS alone was injected into the OA joint of rats in the respective treatment groups. Rats were sacrificed at 8 weeks after surgery. Treatment outcomes were evaluated by weight-bearing control of the hind limbs, gross morphological analysis, histological analysis and specific staining of articular cartilage, and measurement of inflammatory factors in synovial fluid. For the rats in the XG-ADSC-s and ADSCs-treated groups, the weight-bearing percentage of the right hind limb was significantly increased compared to that in the PBS group and was sustained over 4 weeks. However, the positive effect in the XG-ADSCs group was significantly greater than that in the ADSCs group. For the rats in the XG group, the efficacy decreased during the third week after surgery. The articular cartilage was relatively normal in the XG-ADSCs group, and moderate degeneration was observed in the ADSCs and XG groups. ADSCs and XG-ADSC treatments significantly decreased the concentrations of IL-1ß, TNF-α, MMP-3 and MMP-13 in synovial fluid; however, the attenuating effect of the XG-ADSCs treatment was significantly enhanced compared with that of the ADSCs treatment alone. These results indicate that a single IA injection of allogeneic ADSCs combined with XG efficiently attenuated OA progression with a therapeutic effect that was significantly greater than that of either ADSCs or XG alone. IA injection of XG-ADSCs might be an effective treatment for OA in humans.

Culture-expanded allogenic adipose tissue-derived stem cells attenuate cartilage degeneration in an experimental rat osteoarthritis model.

Mesenchymal stem cell (MSC)-based cell therapy is a promising avenue for osteoarthritis (OA) treatment. In the present study, we evaluated the efficacy of intra-articular injections of culture-expanded allogenic adipose tissue-derived stem cells (ADSCs) for the treatment of anterior cruciate ligament transection (ACLT) induced rat OA model. The paracrine effects of major histocompatibility complex (MHC)-unmatched ADSCs on chondrocytes were investigated in vitro. Rats were divided into an OA group that underwent ACLT surgery and a sham-operated group that did not undergo ACLT surgery. Four weeks after surgery mild OA was induced in the OA group. Subsequently, the OA rats were randomly divided into ADSC and control groups. A single dose of 1 × 106 ADSCs suspended in 60 µL phosphate-buffered saline (PBS) was intra-articularly injected into the rats of the ADSC group. The control group received only 60 µL PBS. OA progression was evaluated macroscopically and histologically at 8 and 12 weeks after surgery. ADSC treatment did not cause any adverse local or systemic reactions. The degeneration of articular cartilage was significantly weaker in the ADSC group compared to that in the control group at both 8 and 12 weeks. Chondrocytes were co-cultured with MHC-unmatched ADSCs in trans-wells to assess the paracrine effects of ADSCs on chondrocytes. Co-culture with ADSCs counteracted the IL-1ß-induced mRNA upregulation of the extracellular matrix-degrading enzymes MMP-3 and MMP-13 and the pro-inflammatory cytokines TNF-α and IL-6 in chondrocytes. Importantly, ADSCs increased the expression of the anti-inflammatory cytokine IL-10 in chondrocytes. The results of this study indicated that the intra-articular injection of culture-expanded allogenic ADSCs attenuated cartilage degeneration in an experimental rat OA model without inducing any adverse reactions. MHC-unmatched ADSCs protected chondrocytes from inflammatory factor-induced damage. The paracrine effects of ADSCs on OA chondrocytes are at least part of the mechanism by which ADSCs exert their therapeutic activity.

Impact of donor binding on polymerization catalyzed by KfoC by regulating the affinity of enzyme for acceptor.

BACKGROUND: Currently marketed chondroitin sulfate isolated from animal sources and structurally quite heterogeneous. Synthesis of structurally defined chondroitin sulfate is highly desired. The capsular polysaccharide from Escherichia coli strain K4 is similar to chondroitin, and its biosynthesis requires a chondroitin polymerase (KfoC). The essential step toward de novo enzymatic synthesis of chondroitin sulfate, synthesis of chondroitin, could be achieved by employing this enzyme. METHODS: Structurally defined acceptors and donor-sugars were prepared by chemoenzymatic approaches. In addition, surface plasmon resonance was employed to determine the binding affinities of individual substrates and donor-acceptor pairs for KfoC. RESULTS: KfoC has broad donor substrate specificity and acceptor promiscuity, making it an attractive tool enzyme for use in structurally-defined chimeric glycosaminoglycan oligosaccharide synthesis in vitro. In addition, the binding of donor substrate molecules regulated the affinity of KfoC for acceptors, then influenced the glycosyl transferase reaction catalyzed by this chondroitin polymerase. CONCLUSION AND GENERAL SIGNIFICANCE: These results assist in the development of enzymatic synthesis approaches toward chimeric glycosaminoglycan oligosaccharides and designing future strategies for directed evolution of KfoC in order to create mutants toward user-defined goals.