The effects of cognitive behavioural therapy on depression and quality of life in patients with maintenance haemodialysis: a systematic review

Depression is highly prevalent among Haemodialysis (HD) patients and is known to results in a series of adverse outcomes and poor quality of life (QoL). Although cognitive behavioural therapy (CBT) has been shown to improve depressive symptoms and QoL in other chronic illness, there is uncertainty in terms of the effectiveness of CBT in HD patients with depression or depressive symptoms. All randomised controlled trials relevant to the topic were retrieved from the following databases: CINHAL, MEDLINE, PubMed, PsycINFO and CENTRAL. The grey literature, specific journals, reference lists of included studies and trials registers website were also searched. Data was extracted or calculated from included studies that had measured depression and quality of life using valid and reliable tools -this included mean differences or standardised mean differences and 95% confidence intervals. The Cochrane risk of bias tool was used to identify the methodological quality of the included studies. Six RCTs were included with varying methodological quality. Meta-analysis was undertaken for 3 studies that employed the CBT versus usual care. All studies showed that the depressive symptoms significantly improved after the CBT. Furthermore, CBT was more effective than usual care (MD = - 5.28, 95%CI - 7.9 to - 2.65, P = 0.37) and counselling (MD = - 2.39, 95%CI - 3.49 to - 1.29), while less effective than sertraline (MD = 2.2, 95%CI 0.43 to 3.97) in alleviating depressive symptoms. Additionally, the CBT seems to have a beneficial effect in improving QoL when compared with usual care, while no significant difference was found in QoL score when compared CBT with sertraline. CBT may improve depressive symptoms and QoL in HD patients with comorbid depressive symptoms. However, more rigorous studies are needed in this field due to the small quantity and varied methodological quality in the identified studies

Function of Lactate Dehydrogenase in Cardiac and Skeletal Muscle of Phrynocephalus Lizard in Relation to High-Altitude Adaptation

Poikilothermic animals living in high-altitude environments can be greatly affected by the anaerobic metabolism and lactate recycling, which are catalyzed by an enzyme called lactate dehydrogenase (LDH). However, the function and possible regulatory mechanisms of their anaerobic glycolysis remained elusive. We compared the difference in LDH between a native high-altitude (4 353 m) lizard, Phrynocephalus erythrurus, and a closely related species, Phrynocephalus przewalskii that lives in intermediate altitude environment (1 400 m). The activity of LDH, the concentration of lactate, the distribution of isoenzyme, and the mRNA amounts of Ldh-A and Ldh-B were determined. In cardiac muscle, the lactate-forming activity of P. erythrurus in LDH was higher than of P. przewalskii LDH at all three temperatures tested (10 °C, 25 °C and 35 °C), while lactate-oxidation activity of LDH was significantly different between the two species only at 25 °C and 35 °C. In skeletal muscle, both lactate-forming and lactate-oxidation rates of P. erythrurus were lower than that of P. przewalskii. There was a higher proportion of H subunit and a significantly higher expression of Ldh-B, with a concomitant decrease of lactate concentration in P. erythrurus. These results indicate that P. erythrurus may have a strong potential for anaerobic metabolism, which is likely adapted to the hypoxic environment at high altitudes. Furthermore, P. erythrurus is capable of oxidizing more lactate than P. przewalskii. The Ldh-A cDNA of the two species consists of a 999 bp open reading frame (ORF), which encodes 332 amino acids, while Ldh-B cDNA consists of a 1 002 bp ORF encoding 333 amino acids. LDHA has the same amino acid sequence between the two species, but three amino acid substitutions (V12I, N21S and N318K) were observed in LDHB. Structure analysis of LDH indicated that the substitutions of residues Val12 and Asp21 in P. erythrurus could be responsible for the high-altitude adaptation. The LDH characteristics of LDH in P. erythrurus suggest unique adaptation strategies of anaerobic metabolism in hypoxia and cold environments at high altitudes for poikilothermic animals

Effects of sedentary behaviour and long-term regular Tai Chi exercise on dynamic stability control during gait initiation in older women

Background: Sedentary behaviour has been associated with an increased risk of falls among older adults. Although gait initiation (GI) is a promising tool used to assess fall risk, it has yet to be quantitatively evaluated for dynamic stability in sedentary populations. Tai Chi exercise is believed to be effective in preventing falls in older adults, but its effect on GI stability has not been quantified. This study aims to compare the stability of GI in sedentary older individuals versus those who are long-term Tai Chi exercisers by using a quantitative approach.Methods: This study included 17 sedentary older women without exercise habits (age: 65.59 ± 3.66 years, average daily sitting time: 8.735 ± 1.847 h/day) and 19 older women who regularly engage in Tai Chi exercise (age: 65.58 ± 3.63 years, years of exercise: 9.84 ± 3.48 years). Every participant underwent five trials of self-paced GI walking tests. Eight cameras and four force plates were used to obtain kinematic and kinetic parameters. The trajectory of the centre of mass (CoM) and the position of the foot placement were recorded. The anterior–posterior (A-P) and medio–lateral (M-L) dynamic stability at the onset and end moments of the single-legged support was calculated using CoM and gait spatiotemporal parameters. The stepping dynamic stability and foot placement positions of both groups were compared.Results: The Tai Chi group had greater stability in the M-L directions at the swing leg’s toe-off moment and in the M-L and A-P directions at the heel-strike moment, as well as significantly larger step length, step width and step speed during locomotion than sedentary older women. However, the stability in the A-P directions at the swing leg’s toe-off moment and the foot inclination angle was not statistically different between the two groups.Conclusion: Long-term regular Tai Chi exercise can enhance the dynamic stability of GI in older women, and effectively improve their foot placement strategy during GI. The findings further confirm the negative effect of sedentary on the stability control of older women and the positive role of Tai Chi in enhancing their gait stability and reducing the risk of falls

A High‐Resolution Prediction Network for Predicting Intratumoral Distribution of Nanoprobes by Tumor Vascular and Nuclear Feature

In this study, the critical need for precise and accurate prediction of intra‐tumor heterogeneity related to the enhanced permeability and retention effect and spatial distribution of nanoprobes is addressed for the development of effective nanodrug delivery strategies. Current predictive models are limited in terms of resolution and accuracy, prompting the construction of a high‐resolution prediction network (HRPN) that estimates the microdistribution of quantum dots, factoring in tumor vascular and nuclear features. The HRPN algorithm is trained using 27 780 patches and validated on 4920 patches derived from 4T1 breast cancer whole‐slide images, demonstrating its reliability. The HRPN model exhibits minimal error (mean square error = 1.434, root mean square error = 1.198), satisfactory goodness of fit (R2 = 0.891), and superior image quality (peak signal‐to‐noise ratio = 44.548) when compared to a generative‐adversarial‐network‐structured model. Furthermore, the HRPN model offers improved prediction accuracy, broader prediction intervals, and reduced computational resource requirements. Consequently, the proposed model yields high‐resolution predictions that more closely resemble actual tumor microdistributions, potentially serving as a powerful analytical tool for investigating the spatial relationship between the tumor microenvironment and nanoprobes

The value of DCE- MRI of the breast as a diagnostic tool in assessing amorphous calcifications in screening mammography

PurposeTo evaluate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging in differentiating benign and malignant amorphous calcifications.MethodsThis study included 193 female patients with 197 suspicious amorphous calcifications detected on screening mammography. The patients’ demographics, clinical follow-up, imaging, and pathology outcomes were reviewed, and sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DCE-MRI were calculated.ResultsOf 197 lesions (193 patients) included in the study, 50 (25.4%) were histologically proved to be malignant. DCE-MRI based on breast imaging report and diagnosis system (BI-RADS) had a sensitivity of 94.4%, specificity of 85.7%, PPV of 69.1%, and NPV of 97.7% for the detection of malignant amorphous calcifications. Notably, diagnosis solely based on the presence or absence of DCE-MRI enhancement showed the same sensitivity but significantly decreased specificity (44.8%, p < 0.001) and PPV (44.8%, p < 0.001). In patients with a minimal or mild degree of background parenchymal enhancement (BPE), the sensitivity, specificity, PPV, and NPV increased to 100%, 90.6%, 78.6%, and 100%, respectively. However, in patients with a moderate degree of BPE, MRI resulted in three false negatives of ductal carcinoma in situ (DCIS). Overall, the addition of DCE-MRI detected all invasive lesions and could decrease unnecessary biopsy by 65.5%.ConclusionDCE-MRI based on BI-RADS has the potential to improve the diagnosis of suspicious amorphous calcifications and avoid unnecessary biopsy, especially for those with low-degree BPE