Mechanisms of a mindfulness psyCho-behAvioRal intErvention (MCARE) on depression and anxiety symptoms in patients with acute coronary syndrome: A longitudinal mediation analysis.

OBJECTIVE: This study aimed to explore the mediating roles of mindfulness and illness perception in the effects of a social media-based Mindfulness psyCho-behAvioRal intErvention (MCARE) on depressive and anxiety symptoms among patients with ACS. METHODS: This study conducted a secondary longitudinal mediation analysis using data from a randomized controlled trial of the MCARE grogram in patients with ACS. Participants were recruited at two tertiary hospitals in Jinan, China. The MCARE program consisted of six weekly sessions addressing mindfulness training and disease management to facilitate understanding and management of emotions and illness. The analytical sample included participants who completed measures of the primary outcomes, i.e., depression (PHQ-9) and anxiety (GAD-7) and potential mediators, i.e., mindfulness (CAMS-R) and illness perception (Brief-IPQ) at baseline (T0), immediate post-intervention (T1), and 12-week after the commencement of the intervention (T2). RESULTS: This study included 146 participants (mean age 58.9 years (SD = 8.9), 69.2 % male), including both intervention and control groups. The mediation analysis revealed a significant mediating effect of T1 mindfulness in the relationship between the group and T2 depression symptoms (indirect effect: -0.109, 95 % CI: -0.191, -0.041; P = 0.004), accounting for 26 % of the effect. For T2 anxiety symptoms, T1 illness perception exhibited a significant mediating effect (indirect effect: -0.055, 95 % CI: -0.110, -0.005; P = 0.035), accounting for 22 % of the effect. CONCLUSIONS: This study found that mindfulness and illness perception played a mediating role in the effects of the MCARE program on depressive and anxiety symptoms among patients with ACS.

The association between food environments and cardiovascular disease outcomes: A systematic review.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide, particularly affecting low- and middle-income countries. Food environments may be linked with the risk of CVD; however, current study findings regarding their relationship are inconsistent. A systematic review of their associations is needed to guide interventions to improve cardiovascular health. OBJECTIVE: This systematic review aimed to comprehensively assess the relationship between food environments and CVD outcomes, including incidence, hospitalization, mortality, and recurrence rates. METHOD: According to PRISMA guidelines, a systematic search was conducted until 28th March 2024, using eight databases, including PubMed, Embase, Ovid, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The review quality was assessed according to the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS). The included studies were categorized based on their exposure factors into unhealthy, healthy, and comprehensive food environments, encompassing facilities that offer healthy and unhealthy foods. The findings were narratively synthesized according to this classification. RESULT: A total of 23 studies, encompassing 13 cross-sectional studies and 10 cohort-longitudinal studies, were included in this review. Among the 20 studies on unhealthy food environments, 13 found a positive association with CVD outcomes. Of the seven studies on healthy food environments, 3 found a negative association with CVD outcomes. Additionally, 4 out of 8 studies on comprehensive food environments found a significant but inconsistent association with CVD outcomes. CONCLUSION: This study suggested that unhealthy food environments are probably associated with CVD outcomes. At the same time, there is currently no conclusive evidence to indicate a relationship between healthy food environments or comprehensive food environments and CVD outcomes.

Conformational Landscape of NADH and Ion Binding in Water/DMSO Mixtures via 31P NMR Spectroscopy.

This study reports on the conformational states of nicotinamide adenine dinucleotide (NADH) in water/DMSO mixtures and examines the influence of ion binding. We observe evidence of conformational changes through a series of NMR techniques, including 31P NMR relaxation (R1 and R2), chemical exchange saturation transfer (CEST), and diffusion-ordered spectroscopy (DOSY) experiments. The observed variation of the conformational states is indicative of the solvent's influence on NADH's structural flexibility. The experimental findings, in combination with viscosity data, are shown to be in line with findings from earlier molecular dynamics studies. The reported observations emphasize the critical role of the solvent environment in determining the conformational states of NADH and similar molecules with relevance for the biophysiological context. The results found herein can help in studying the biophysical behavior of NADH and similar biomolecules and their associated metabolic pathways under various solvent conditions.

Relationships between disease severity, psychological stress, and health-related quality of life among patients with acute coronary syndrome: mediation of illness perception.

AIMS: Patients with acute coronary syndrome (ACS) often experience reduced health-related quality of life (HRQOL), which may be attributable to the disease severity and psychological stress. While illness perception is speculated to be a potential pathway underlying these relationships, evidence supporting this mechanism remains limited. This study aimed to investigate the relationships between disease severity, psychological stress, and HRQOL and whether these relationships are mediated by illness perception in patients with ACS. METHODS AND RESULTS: Data were collected from June to July 2019 and June to September 2020 in the cardiology departments of four public hospitals in China. Eligible patients completed measures of disease severity, psychological stress, illness perception, HRQOL, and socio-demographic and clinical characteristics. Data were analysed employing hierarchical multiple regression and structural equation modelling. This study included 405 participants (mean age 60.63 years, 67.4% male). After controlling for socio-demographic and clinical covariates, higher levels of disease severity (ß = 0.115, P = 0.024) and psychological stress (ß = -0.209, P＜0.001) were associated with poorer HRQOL; however, the relationships became non-significant after adding illness perception into the regression model. Structural equation modelling analysis suggested that illness perception played a mediating role between disease severity, psychological stress, and HRQOL, accounting for 45.95% and 65.79% of the total effects, respectively. CONCLUSION: This study found that illness perception mediated the relationships between disease severity, psychological stress, and HRQOL among patients with ACS. Improving patients' HRQOL should consider its important influencing factors with a focus on promoting positive illness perception.

A Social Media-Based Mindfulness Psycho-Behavioral Intervention (MCARE) for Patients With Acute Coronary Syndrome: Randomized Controlled Trial.

BACKGROUND: Psychological distress is common among patients with acute coronary syndrome (ACS) and has considerable adverse impacts on disease progression and health outcomes. Mindfulness-based intervention is a promising complementary approach to address patients' psychological needs and promote holistic well-being. OBJECTIVE: This study aims to examine the effects of a social media-based mindfulness psycho-behavioral intervention (MCARE) on psychological distress, psychological stress, health-related quality of life (HRQoL), and cardiovascular risk factors among patients with ACS. METHODS: This study was a 2-arm, parallel-group randomized controlled trial. We recruited 178 patients (mean age 58.7, SD 8.9 years; 122/178, 68.5% male) with ACS at 2 tertiary hospitals in Jinan, China. Participants were randomly assigned to the MCARE group (n=89) or control group (n=89). The 6-week intervention consisted of 1 face-to-face session (phase I) and 5 weekly WeChat (Tencent Holdings Ltd)-delivered sessions (phase II) on mindfulness training and health education and lifestyle modification. The primary outcomes were depression and anxiety. Secondary outcomes included psychological stress, HRQoL, and cardiovascular risk factors (ie, smoking status, physical activity, dietary behavior, BMI, blood pressure, blood lipids, and blood glucose). Outcomes were measured at baseline (T0), immediately after the intervention (T1), and 12 weeks after the commencement of the intervention (T2). RESULTS: The MCARE group showed significantly greater reductions in depression (T1: ß=-2.016, 95% CI -2.584 to -1.449, Cohen d=-1.28, P<.001; T2: ß=-2.089, 95% CI -2.777 to -1.402, Cohen d=-1.12, P<.001) and anxiety (T1: ß=-1.024, 95% CI -1.551 to -0.497, Cohen d=-0.83, P<.001; T2: ß=-0.932, 95% CI -1.519 to -0.346, Cohen d=-0.70, P=.002). Significantly greater improvements were also observed in psychological stress (ß=-1.186, 95% CI -1.678 to -0.694, Cohen d=-1.41, P<.001), physical HRQoL (ß=0.088, 95% CI 0.008-0.167, Cohen d=0.72, P=.03), emotional HRQoL (ß=0.294, 95% CI 0.169-0.419, Cohen d=0.81, P<.001), and general HRQoL (ß=0.147, 95% CI 0.070-0.224, Cohen d=1.07) at T1, as well as dietary behavior (ß=0.069, 95% CI 0.003-0.136, Cohen d=0.75, P=.04), physical activity level (ß=177.542, 95% CI -39.073 to 316.011, Cohen d=0.51, P=.01), and systolic blood pressure (ß=-3.326, 95% CI -5.928 to -0.725, Cohen d=-1.32, P=.01) at T2. The overall completion rate of the intervention (completing ≥5 sessions) was 76% (68/89). Positive responses to the questions of the acceptability questionnaire ranged from 93% (76/82) to 100% (82/82). CONCLUSIONS: The MCARE program generated favorable effects on psychological distress, psychological stress, HRQoL, and several aspects of cardiovascular risk factors in patients with ACS. This study provides clues for guiding clinical practice in the recognition and management of psychological distress and integrating the intervention into routine rehabilitation practice. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000033526; https://www.chictr.org.cn/showprojEN.html?proj=54693.

Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning.

BACKGROUND: Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. METHODS: Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LIMITATIONS: The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. CONCLUSIONS: These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.

A mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome: A pilot study.

BACKGROUND: People frequently experience physical and psychological challenges (e.g., depression and anxiety) and high risk of poor prognosis after an acute coronary event. Mindfulness-based intervention holds promise as an effective approach to promoting health and well-being. OBJECTIVES: To explore the feasibility, acceptability, and potential effects on psychological distress, cardiovascular risk factors and health-related quality of life of a mindfulness-oriented psycho-behavioral intervention for patients with acute coronary syndrome. METHODS: We conducted a pilot randomized controlled trial to test the feasibility, acceptability and potential effects of the intervention in 50 patients with acute coronary syndrome. The intervention included six weekly sessions, including one face-to-face session and five WeChat-delivered sessions that incorporated mindfulness training with health education and lifestyle modification. Eligible patients were recruited in two public hospitals in China and randomly allocated into the intervention group (n = 25) or control group (n = 25). RESULTS: Intervention feasibility was supported by a relatively high recruitment rate (66.7%) and retention rate (84%) and a smooth and brief data collection procedure (15 to 25 min) of the pilot study. Positive responses of the acceptability dichotomous scale ranged from 81% to 100%, suggesting the intervention was generally acceptable. The intervention had a significant group × time effect on dietary behavior (B = 0.31,95% CI: 0.08, 0.54, P = 0.008) with an effect size (Cohen's d) of -0.72. CONCLUSIONS: The mindfulness-oriented psycho-behavioral intervention appears to be feasible and acceptable and have a promising effect on dietary behavior in patients with acute coronary syndrome. A fully powered randomized controlled trial is warranted to further assess the efficacy of the intervention. TRIAL REGISTRATION: Chinese Clinical Trial Registry, No., ChiCTR2000033526.

Depressive and anxiety symptoms and illness perception among patients with acute coronary syndrome.

AIMS: To evaluate the features of depressive and anxiety symptoms and illness perception and their associations in patients with acute coronary syndrome (ACS). DESIGN: Secondary analysis of data from a cross-sectional study and baseline data from a randomized controlled trial. METHODS: From June to July 2019 and June to September 2020, patients with ACS in four public hospitals in China completed measurements of depressive and anxiety symptoms, illness perception, and sociodemographic and clinical characteristics. Data were analysed using univariate and multiple logistic regression analyses. RESULTS: This study included 510 participants (mean age, 61.0 ± 9.9 years; 67.8% male). The prevalence of depressive and anxiety symptoms was 66.3% and 56.5%, respectively. Total score of illness perception was 43.5 ± 9.1 and mean scores of each dimension ranged from 5.5 to 7.6, suggesting relatively negative illness perceptions. The top two perceived causes of illness were negative emotions or stress (27.3%) and dietary habits (25.5%) and 24.7% of participants were unaware of causes regarding their illness. After adjusting for potential confounders, a one-point increase in scores on illness perception regarding consequences and emotional response (range, 0-10) was related to a 22% increased probability of depressive symptoms. Every one-point increase in scores on illness perception related to emotional response, personal control and illness comprehensibility was associated with a 38% increased, 13% decreased and 9% decreased probability of anxiety symptoms, respectively. CONCLUSION: Depressive and anxiety symptoms are prevalent at high rates in patients with ACS. They have a relatively negative illness perception that is associated with the prevalence of depressive and anxiety symptoms. IMPACT: This study highlights the importance of screening for depressive and anxiety symptoms in patients with ACS, especially for those with negative illness perceptions. Targeted strategies are imperative to improve patients' health outcomes. NO PATIENT OR PUBLIC CONTRIBUTION: These details do not apply to this work.

Vasomotor symptoms, cardiovascular risk factors, and cardiovascular disease risk among Chinese postmenopausal women in Hong Kong.

Vasomotor symptoms are frequently reported by postmenopausal women and linked with unfavorable changes in cardiovascular risk factors, suggesting a likely association with cardiovascular disease (CVD) risk. This study aimed to investigate the characteristics of and associations between vasomotor symptoms, cardiovascular risk factors, and CVD risk among Chinese postmenopausal women. From March 2018 to August 2019, a convenience sample of 288 postmenopausal women who experienced natural menopause for ≥12 months were recruited from district centers of women associations in Hong Kong. We assessed vasomotor symptoms, cardiovascular risk factors, and CVD risk using questionnaires, anthropometric measures, and laboratory testing of fasting blood samples. Data were analyzed using bivariate correlation analyses and linear regression analyses. Over half of the participants experienced vasomotor symptoms (50.3 percent), and 23.3 percent had a high 10-year CVD risk. After adjusting for sociodemographic and clinical variables, flashing (ß = 0.270, P = .002) and sweating (ß = > -0.206, P = .018) were significantly associated with low-density lipoprotein cholesterol and flashing (ß = 0.229, P = .007) were significantly associated with total cholesterol. No statistically significant association was observed between vasomotor symptoms and CVD risk. Vasomotor symptoms were common and associated with several cardiovascular risk factors in Chinese postmenopausal women.

Reversible Diels-Alder Addition to Fullerenes: A Study of Dimethylanthracene with H2@C60.

The study of isolated atoms or molecules inside a fullerene cavity provides a unique environment. It is likely to control the outer carbon cage and study the isolated species when molecules or atoms are trapped inside a fullerene. We report the Diels-Alder addition reaction of 9,10-dimethyl anthracene (DMA) to H2@C60 while 1H NMR spectroscopy is utilized to characterize the Diels-Alder reaction of the DMA with the fullerene. Through 1H NMR spectroscopy, a series of isomeric adducts are identified. The obtained peaks are sharp, precise, and straightforward. Moreover, in this paper, H2@C60 and its isomers are described for the first time.

Aged landfill leachate enhances anaerobic digestion of waste activated sludge.

Anaerobic digestion (AD) is considered as a sustainable pathway to recover energy from organic wastes, but the digestive efficiency for waste activated sludge (WAS) is not as expected due to the limitations in WAS hydrolysis. This study proposes an effective strategy to simultaneously treat WAS and landfill leachate, aiming to promote WAS hydrolysis and enhance organics converting to methane. The effects of landfill leachate on the four stages (i.e., solubilization, hydrolysis, acidogenesis, and methanogenesis) of AD of WAS, as well as the effect mechanisms were investigated. Results showed that adding appropriate amounts of landfill leachate could promote the steps of solubilization, hydrolysis and acidogenesis of WAS, but had no-effect on methanogenesis. The hydrolysis and acidogenesis efficiency in the leachate added digesters were 2.0%-8.4% and 35.2%-72.7% higher than the control digester. Mechanism studies indicated that humic acid (HA) contained in the leachate was conducive to the processes of both hydrolysis and acidogenesis, but detrimental to the methanogenesis. Effects of heavy metals (HMs) on AD of WAS was also dose-dependent. Digestive performance was inhibited by excessive HMs but promoted by moderate dosages. Humic acid and metal ions tend to interact to form complexes, and thus relieve their each inhibition effects. It is also found that the stability of sludge flocs was reduced by the leachate through reducing both apparent activation energy (AAE) and median particle size (MPS) of the sludge. Microbial community and diversity results revealed that the relative abundance of microbes responsible for hydrolysis and acidogenesis increased when landfill leachate was present. This research provides a more technically and economically feasible approach to co-treating and co-utilizing WAS and landfill leachate.

Co-digestive performance of food waste and hydrothermal pretreated corn cob.

Anaerobic co-digestion of lignocellulosic biomass and food waste (FW) has been extensively applied. However, whether hydrothermal pretreatment (HTP) of lignocellulosic biomass can enhance the performance in co-digestion deserves further investigation. In this study, corn cob (CC) was adopted as a typical lignocellulosic biomass for co-digestion with FW at different VS ratios of 1:3 (S1-S4) and 1:6 (S5-S8), attempting to evaluate the effect of HTP of CC at different temperature gradients (125, 150 and 175 °C) on the co-digestion performance. The emphasis was placed on hydrolysis, acidification and methanogenesis for different feedstock conditions. Results illustrated that the HTP had a certain destroying effect on the lignocellulose structure in CC and the crystallinity of cellulose decreased, significantly facilitating its co-digestion with FW. For FW/CC co-digestion at the VS ratio of 1:3, the S3 group (CC was pretreated at 150 °C) reached the maximum cumulative biogas yield (CBY) of 4660 mL and the maximum specific methane yield (SMY) of 316.9 mL/g·VS. Moreover, at 1:6, S7 group (pretreated at 150 °C) exhibited the optimal CBY of 4100 mL while achieving the SMY of 277.6 mL/g·VS among the digesters, indicating that the co-digestion of pretreated CC and FW could achieve higher methane production, and 150 °C refers to the optimal pretreatment temperature. Moreover, the peak values of the accumulated VFAs in digesters S1-S4 (2000-3000 mg/L) is higher than that in digesters S5-S8 (800-1500 mg/L). As suggested from microbial community and diversity date, the HTP expedited the enrichment of system hydrolyzing and acidogenic bacteria. These results are significant and provide certain guidance for optimizing the co-digestion of FW and CC in actual engineering.

A systematic review and meta-analysis of mindfulness-based interventions for patients with coronary heart disease.

AIMS: To assess the effects of mindfulness-based interventions for patients with coronary heart disease. DESIGN: A systematic review with meta-analysis. DATA SOURCES: Eight mainstream databases, including Ovid MEDLINE, Embase, Ovid Emcare, PsycInfo, CINAHL complete, Web of Science, CENTRAL and PubMed, were searched from January 1979-March 2020. REVIEW METHODS: Randomized controlled trials that evaluated mindfulness-based interventions on psychological outcomes, cardiovascular risk factors and quality of life in adults with coronary heart disease were considered. We conducted meta-analyses using the random-effects model. RESULTS: Nine studies involving 644 participants were included. Compared with inactive controls (e.g. usual care), mindfulness-based interventions significantly reduced depression (SMD -0.72, 95% CI -1.23 to -0.21, p < .01) and stress (SMD -0.67, 95% CI -1.00 to -0.34, p < .01), but not anxiety and blood pressure. There were no significant psychological effects compared with active controls (e.g. other psychological interventions). In one of three studies that assessed generic quality of life, mindfulness-based interventions significantly improved psychological and social domains compared with active control. The intervention effects on other cardiovascular risk factors were inconclusive given that only one study assessed each outcome with non-significant findings. Subgroup analyses suggest that intervention type and participants' depression and anxiety status may influence intervention effects. CONCLUSIONS: Mindfulness-based interventions may benefit patients with coronary heart disease in reducing depression and stress, but the effects on cardiovascular risk factors and quality of life are inconclusive. IMPACT: This review offers preliminary evidence for the potential of mindfulness-based interventions as an effective complementary approach to addressing psychological distress among people with coronary heart disease. Given the limitations in current studies, further rigorously designed and well-reported research is necessary to give robust evidence. Studies exploring the intervention effects on cardiovascular risk factors and quality of life are warranted to remedy the research and knowledge gap.

A systematic review of effects of recorded music listening during exercise on physical activity adherence and health outcomes in patients with coronary heart disease.

BACKGROUND: Exercise training is a key facet of cardiac rehabilitation and is associated with irrefutable benefits for individuals with coronary heart disease. However, compliance with and adherence to such interventions are challenging among this population. The incorporation of music into exercise training may be a potential approach to address this issue. OBJECTIVES: This study aimed to evaluate the effects of recorded music listening during exercise on adherence to physical activity and health outcomes in individuals with coronary heart disease. METHODS: A systematic review was conducted by searching 7 English databases for reports of randomized controlled trials and quasi-experimental studies evaluating the effects of recorded music listening during exercise on adherence to physical activity and physical, psychological, and cognitive outcomes in adults with coronary heart disease. Two reviewers independently screened records for eligibility, extracted data, and assessed the quality of reports by using the Effective Public Health Practice Project Quality Assessment Tool tool. RESULTS: We identified 7 studies involving 293 participants (mean age 62.6 to 72 years, men: 57% to 80%). All but one study included relatively small samples (17 to 56). The overall quality was weak for 3 studies, moderate for 2, and strong for 2. Several reviewed studies showed significant effects of music on attendance at exercise-based cardiac rehabilitation (1 of 2 studies), maintenance of physical activity after intervention (1 study), perceived exertion (2 of 3 studies), exercise capacity (1 of 3 studies), heart rate during exercise (1 of 2 studies), male waist circumference (1 of 2 studies), mood (2 of 3 studies), and cognitive function (1 study) as compared with controls. CONCLUSIONS: This review provides relatively limited evidence for the potential benefits of recorded music listening during exercise in individuals with coronary heart disease. The findings should be carefully interpreted and generalised. Further rigorous-designed research addressing the limitations of current literature is needed.

Effects of Exercise Therapy for Adults With Coronary Heart Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: Exercise therapy has been recommended as a core element for the prevention of coronary heart disease (CHD). However, the independent impact of exercise therapy remains unclear. OBJECTIVE: The aim of this study was to assess the effects of exercise therapy compared with no exercise control in patients with CHD. METHODS: We searched 8 electronic databases from January 2000 to March 2020. Randomized controlled trials with at least 6 months of follow-up that evaluated the effects of exercise therapy on hospital admissions, health-related quality of life (HRQoL), mortality, and morbidity in adults with CHD were included. Two reviewers independently screened records for eligibility, extracted data, and assessed risks of bias using the Cochrane tool. Meta-analyses were conducted using the random-effects model. RESULTS: We included 22 randomized controlled trials involving 4465 participants. Compared with no exercise control, exercise therapy reduced all-cause hospital admissions (10 studies; risk ratio, 0.46; 95% confidence interval, 0.25-0.83; I = 64%) and cardiovascular mortality (9 studies; risk ratio, 0.44; 95% confidence interval, 0.22-0.89; I= 0%) across all studies reporting these outcomes at their longest follow-up. Eight of 14 studies that assessed HRQoL observed a significant improvement in at least 1 domain or overall HRQoL with exercise therapy compared with control. There were no significant reductions in cardiovascular hospital admissions, all-cause mortality, incidence of myocardial infarction, or revascularization. CONCLUSIONS: This review shows the independent benefits of exercise therapy in reducing all-cause hospital admissions and cardiovascular mortality for adults with CHD.

Functional status mediates the association of nutritional status with depressive symptoms in patients with heart failure.

AIMS: The decline of nutritional status and depressive symptoms are pandemic in heart failure patients and functional status may play a pivotal role between these. This study aimed to determine whether nutritional status is associated with depressive symptoms and whether functional status mediates this relationship in heart failure patients. DESIGN: This was a secondary analysis of a cross-sectional study. METHODS: The data were collected from November 2015-April 2016. Heart failure patients (N = 254) being hospitalized were included in this secondary analysis. The Depression Sub-Scale of the Hospital Anxiety and Depression Scale and the Duke Activity Status Index were used to assess patients' depressive symptoms and functional status. The nutritional status of patients was calculated using the Geriatric Nutritional Risk Index. RESULTS: In this study, the average scores of depressive symptoms, nutritional status and functional status were 4.91 (SD 3.12), 102.38 (SD 6.57) and 20.58 (SD 8.96) respectively. Out of the 254 patients, 46 patients (18.1%) had significant depressive symptoms (the score of Depression Sub-Scale of the Hospital Anxiety and Depression Scale ≥ 8) and 55 (21.7%) suffered from malnutrition (the score of Geriatric Nutritional Risk Index ≤ 98). In the multiple regression analyses, nutritional status was negatively associated with depressive symptoms (ß = -0.142, p = .02) and functional status mediated the relationship between nutritional status and depressive symptoms. CONCLUSIONS: Many patients with heart failure have malnutrition and depressive symptoms. Functional status plays a mediating role in the relationship between nutritional status and depressive symptoms. IMPACT: To relieve depressive symptoms in patients with heart failure, it is of importance to improve the functional status, especially for those with poor nutritional status.

Effects of mindfulness-based interventions on health-related outcomes for patients with heart failure: a systematic review.

BACKGROUND: Mindfulness-based interventions may offer a promising approach for promoting psychological and physical health and wellbeing for patients with heart failure. However, the effects of mindfulness-based interventions for this population have not been systematically reviewed. AIMS: This review aimed to synthesise available evidence to assess the effects of mindfulness-based interventions on psychological and physical outcomes and health-related quality of life in patients with heart failure. METHODS: Seven English and two Chinese electronic databases were searched with keywords from inception to May 2019. Experimental studies that examined mindfulness-based interventions in adults with heart failure were eligible for inclusion. Two reviewers independently performed study selection, data extraction and study quality assessment. The results were then narratively synthesised. RESULTS: This review identified five studies involving 467 patients with heart failure. The reviewed studies had weak to moderate quality. There were consistent findings that mindfulness-based interventions could significantly reduce depression (three studies) and anxiety (two studies) and improve health-related quality of life (two studies) after intervention. However, the effects on physical symptoms were inconsistent in three studies. The effects on physical function were only measured in one study, with non-significant changes being reported. CONCLUSIONS: This review provides preliminary evidence that mindfulness-based interventions are beneficial for patients with heart failure in reducing depression and anxiety and enhancing health-related quality of life in the short term. These findings should be carefully generalised considering the methodological limitations across studies. More rigorous studies are required to examine further the effects of mindfulness-based interventions in patients with heart failure.

Enhanced hydrolysis of lignocellulose in corn cob by using food waste pretreatment to improve anaerobic digestion performance.

This study aims to enhance hydrolysis and anaerobic digestion of corn cob (CC) by using food waste (FW) pretreatment. FW, which tends to be acidification in fermentation, was applied in this process as an acid-like agent to accelerate lignocellulose hydrolysis, aiming to promote methane yield in further digestion process. The effect of FW pretreatment on pH, soluble chemical oxygen demand (SCOD), volatile fatty acids (VFAs), cellulose/hemicellulose contents and cellulose crystallinity are specially focused. FW:CC = 1:3 based on volatile solid (VS) was found to be the optimal mixing ratio in pretreatment and its hydrolysis efficiency was 28% higher than the control group. An increase of 13.2% in cellulose reduction and a decrease of 6.7% in cellulose crystallinity was achieved at this ratio. Supplementation of FW increased VFA concentrations in slurry mixture that directly change the activities of enzymes and microorganisms. In the stage of methane production, the digester A3 (FW:CC = 1:6 based on VS) with higher hydrolysis efficiency presented the best performance in methane production with a specific methane yield of 401.6 mL/g·VS, due to the recovery of the pH in this digester to the optimal pH range for methanogens' metabolism (pH 6.3-7.2). Kinetics studies of cellulose/hemicellulose degradation indicated that the pretreatment of FW could improve the degradation of cellulose. Three-dimensional excitation emission matrix (3DEEM) results further confirmed that FW play an important role in lignocellulose hydrolysis. In addition, variations of lignocellulosic textures during the pretreatment were also cleared by using field emission-scanning electron microscopy (FE-SEM) analysis.

Comprehensively evaluating the digestive performance of sludge with different lignocellulosic components in mesophilic anaerobic digester.

In excess sludge digestion, organic matters cannot be digested adequately due to its high lignocellulose content. This study attempted to comprehensively evaluate the digestive performances of sludge with different lignocellulosic components (hemicellulose, cellulose and lignin). Results show that hemicellulose/dealkaline lignin addition (S6) presents the highest methane yield of 203.6 mL/gVS. Compared to hemicellulose, dealkaline lignin is hardly degraded (lower than 10%), while its participation can promote the degradation of other organics in the system. Additionally, solo cellulose feedstock is difficult to be hydrolyzed (only 40.1%) without hemicellulose and dealkaline lignin addition. VFAs composition analysis indicates that VFA inhibition occurs in the digester with hemicellulose, cellulose and dealkaline lignin addition (S8). Microbial diversities of different digestive systems show that the relative abundance of Euryarchaeota in the digester S6 (7.2%) is much higher than others, and some specific microbes (Bacteroidetas and Firmicutes) are enriched in the S5 (74.1%) and S8 (54.7%) digesters.