Improving Attention and Mood in Heart Failure: Natural Restorative Environment Intervention.

Impaired attention has been found in approximately 1 out of 4 patients with heart failure (HF). Mechanisms of attention impairment are lowered cerebral oxygen supply due to cardiac dysfunction and increased mental effort from dealing with the fatal disease, HF. Although there is evidence that attention impairment is common in these patients and can affect their HF self-care activities, no interventions to date have directly targeted attention in HF patients. To improve attention, natural restorative environment (NRE) interventions have been conducted and found to be efficacious in diverse populations. NRE interventions are based on Attention Restoration Theory, which asserts that when directed attention is rested, it can be restored. Whether NRE intervention is efficacious for HF patients is not known. Thus, the primary aim of this study was to examine the efficacy of a NRE intervention for patients with HF on attention. The secondary aim was to examine its efficacy on mood. A randomized crossover design was used in 20 HF patients and 20 age- and education-matched healthy adults. The NRE intervention involved viewing 50 photographs of nature on a computer and the control condition involved viewing 50 photographs of urban environments. Pre and post intervention, attention was measured by four neuropsychological tests: the Multi-source Interference Task, Trail Making Test, Stroop Test, and Digit Span Test. Mood was measured by the Positive and Negative Affect Schedule. Intervention order was randomly assigned and delivered one week apart. At baseline, poorer attention was found correlated with lower oxygen saturation and greater mental effort in HF patients compared to healthy adults. Linear mixed models in a pooled sample (n = 40) showed that NRE intervention was efficacious in improving attention, specifically sustained attention compared to the control condition. Attention switching, however, was preserved only in healthy participants after the control condition, but decreased in HF patients. Mood did not differ after interventions. The NRE intervention is safe and has the potential to be widely disseminated. Future studies are needed on a larger sample with different intervention doses and a longer period of observations, providing knowledge about optimal quality of the intervention.PhDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/116681/1/miyeon_1.pd

From Opaque to Accountable Governance: Investor Activism for Transparency in Social Media Amid Disruption in Cryptocurrency

Cryptocurrencies have experienced rapid growth, but the absence of regulatory supervision has given rise to concerns regarding transparency. Unlike traditional financial systems, cryptocurrencies lack a central authority, resulting in unclear governance and potential issues. This is exemplified by the problems associated with Initial Coin Offerings (ICOs). The recent crisis at FTX underscores the importance of transparency. While some exchanges are beginning to list assets governed by ethical principles, the path towards establishing accountable governance remains uncertain. Our research delves into how the lack of transparency in cryptocurrency exchanges prompts investors to advocate for accountable governance. We employ an event study approach to examine the impact of the FTX bankruptcy, with a particular focus on activism on Twitter. Our findings indicate that investor demands for transparency encourage exchanges to adopt measures aimed at ensuring accountability, such as conducting Proof of Reserves audits. This shift has the potential to foster a more stable and reliable cryptocurrency ecosystem, ultimately benefiting both investors and the industry as a whole

Characterizing pain leading to emergency medical services activation in heart failure

Background Pain is a common but understudied symptom among patients with heart failure (HF) transported by emergency medical services (EMS). The aims were to determine explanatory factors of a primary complaint of pain and pain severity, and characterize pain among patients with HF transported by EMS. Methods Data from electronic health records of patients with HF transported by EMS within a midwestern United States county from 2009 to 2017 were analyzed. Descriptive statistics, χ2, analysis of variance, and logistic and multiple linear regression analyses were used. Results The sample (N = 4663) was predominantly women (58.1%) with self-reported race as Black (57.7%). The mean age was 64.2 ± 14.3 years. Pain was the primary complaint in 22.2% of the sample, with an average pain score of 6.8 ± 3.1 out of 10. The most common pain complaint was chest pain (68.1%). Factors associated with a primary pain complaint were younger age (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.96–0.97), history of myocardial infarction (OR, 1.96; 95% CI, 1.55–2.49), and absence of shortness of breath (OR, 0.67; 95% CI, 0.58–0.77). Factors associated with higher pain severity were younger age (b = −0.05, SE = 0.013), being a woman (b = 1.17, SE = 0.357), and White race (b = −1.11, SE = 0.349). Conclusions Clinical and demographic factors need consideration in understanding pain in HF during EMS transport. Additional research is needed to examine these factors to improve pain management and reduce transports due to pain

Design and Rationale of the Cognitive Intervention to Improve Memory in Heart Failure Patients Study

BACKGROUND: Memory loss is an independent predictor of mortality among heart failure patients. Twenty-three percent to 50% of heart failure patients have comorbid memory loss, but few interventions are available to treat the memory loss. The aims of this 3-arm randomized controlled trial were to (1) evaluate efficacy of computerized cognitive training intervention using BrainHQ to improve primary outcomes of memory and serum brain-derived neurotrophic factor levels and secondary outcomes of working memory, instrumental activities of daily living, and health-related quality of life among heart failure patients; (2) evaluate incremental cost-effectiveness of BrainHQ; and (3) examine depressive symptoms and genomic moderators of BrainHQ effect. METHODS: A sample of 264 heart failure patients within 4 equal-sized blocks (normal/low baseline cognitive function and gender) will be randomly assigned to (1) BrainHQ, (2) active control computer-based crossword puzzles, and (3) usual care control groups. BrainHQ is an 8-week, 40-hour program individualized to each patient's performance. Data collection will be completed at baseline and at 10 weeks and 4 and 8 months. Descriptive statistics, mixed model analyses, and cost-utility analysis using intent-to-treat approach will be computed. CONCLUSIONS: This research will provide new knowledge about the efficacy of BrainHQ to improve memory and increase serum brain-derived neurotrophic factor levels in heart failure. If efficacious, the intervention will provide a new therapeutic approach that is easy to disseminate to treat a serious comorbid condition of heart failure

Reduction of urate crystal-induced inflammation by root extracts from traditional oriental medicinal plants: elevation of prostaglandin D2 levels

Dried roots of the plants Acanthopanax senticosus, Angelica sinensis and Scutellaria baicalensis are used in traditional oriental medicine and reportedly possess anti-inflammatory properties. Using the murine air pouch model of inflammation, we investigated the efficacy and mode of action of an extract from these three plants in crystal-induced inflammation. Air pouches were raised on the backs of 8-week-old BALB/c mice. Mice were fed 100 mg/kg body weight of root extracts (A. senticosus:A. sinensis:S. baicalensis mixed in a ratio of 5:4:1 by weight) or vehicle only on days 3–6. Inflammation was elicited on day 6 by injecting 2 mg of monosodium urate (MSU) crystals into the pouch. Neutrophil density and IL-6 and TNF-α mRNA levels were determined in the pouch membrane, and the leukocyte count and IL-6, prostaglandin E2 (PGE2) and prostaglandin D2 (PGD2) levels were determined in the pouch exudate. Treatment with the root extracts led to a reduction in all inflammatory parameters: the leukocyte count in the pouch exudate decreased by 82%; the neutrophil density in the pouch membrane decreased by 68%; IL-6 and TNF-α mRNA levels in the pouch membrane decreased by 100%; the IL-6 concentration in the pouch fluid decreased by 50%; and the PGE2 concentration in the pouch fluid decreased by 69%. Remarkably, the concentration of the potentially anti-inflammatory PGD2 rose 5.2-fold in the pouch exudate (p < 0.005), which led to a normalization of the PGD2:PGE2 ratio. A 3.7-fold rise in hematopoietic PGD synthase (h-PGDS) mRNA paralleled this rise in PGD2 (p = 0.01)

Prediction of Daytime Hypoglycemic Events Using Continuous Glucose Monitoring Data and Classification Technique

Daytime hypoglycemia should be accurately predicted to achieve normoglycemia and to avoid disastrous situations. Hypoglycemia, an abnormally low blood glucose level, is divided into daytime hypoglycemia and nocturnal hypoglycemia. Many studies of hypoglycemia prevention deal with nocturnal hypoglycemia. In this paper, we propose new predictor variables to predict daytime hypoglycemia using continuous glucose monitoring (CGM) data. We apply classification and regression tree (CART) as a prediction method. The independent variables of our prediction model are the rate of decrease from a peak and absolute level of the BG at the decision point. The evaluation results showed that our model was able to detect almost 80% of hypoglycemic events 15 min in advance, which was higher than the existing methods with similar conditions. The proposed method might achieve a real-time prediction as well as can be embedded into BG monitoring device.1

Development of theranostic dual-layered Au-liposome for effective tumor targeting and photothermal therapy

Abstract Background Photothermal therapy (PTT) is an emerging anti-cancer therapeutic strategy that generates hyperthermia to ablate cancer cells under laser irradiation. Gold (Au) coated liposome (AL) was reported as an effective PTT agent with good biocompatibility and excretory property. However, exposed Au components on liposomes can cause instability in vivo and difficulty in further functionalization. Results Herein, we developed a theranostic dual-layered nanomaterial by adding liposomal layer to AL (LAL), followed by attaching polyethylene glycol (PEG) and radiolabeling. Functionalization with PEG improves the in vivo stability of LAL, and radioisotope labeling enables in vivo imaging of LAL. Functionalized LAL is stable in physiological conditions, and 64Cu labeled LAL (64Cu-LAL) shows a sufficient blood circulation property and an effective tumor targeting ability of 16.4%ID g−1 from in vivo positron emission tomography (PET) imaging. Also, intravenously injected LAL shows higher tumor targeting, temperature elevation in vivo, and better PTT effect in orthotopic breast cancer mouse model compared to AL. The tumor growth inhibition rate of LAL was 3.9-fold higher than AL. Conclusion Based on these high stability, in vivo imaging ability, and tumor targeting efficiency, LAL could be a promising theranostic PTT agent. Graphic Abstrac

Diagnosis in a Preclinical Model of Bladder Pain Syndrome Using a Au/ZnO Nanorod-based SERS Substrate

To evaluate the feasibility of ZnO nanorod-based surface enhanced Raman scattering (SERS) diagnostics for disease models, particularly for interstitial cystitis/bladder pain syndrome (IC/BPS), ZnO-based SERS sensing chips were developed and applied to an animal disease model. ZnO nanorods were grown to form nano-sized porous structures and coated with gold to facilitate size-selective biomarker detection. Raman spectra were acquired on a surface enhanced Raman substrate from the urine in a rat model of IC/BPS and analyzed using a statistical analysis method called principal component analysis (PCA). The nanorods grown after the ZnO seed deposition were 30 to 50 nm in diameter and 500 to 600 nm in length. A volume of gold corresponding to a thin film thickness of 100 nm was deposited on the grown nanorod structure. Raman spectroscopic signals were measured in the scattered region for nanometer biomarker detection to indicate IC/BPS. The Raman peaks for the control group and IC/BPS group are observed at 641, 683, 723, 873, 1002, 1030, and 1355 cm(-1),which corresponded to various bonding types and compounds. The PCA results are plotted in 2D and 3D. The Raman signals and statistical analyses obtained from the nano-sized biomarkers of intractable inflammatory diseases demonstrate the possibility of an early diagnosis

Testing Influences of APOE and BDNF Genes and Heart Failure on Cognitive Function

Background Apolipoprotein E ( APOE) ε2, ε4 and brain-derived neurotrophic factor ( BDNF) Val66Met alleles have been associated with cognition. Associations of these alleles with cognition in heart failure (HF) and influences of HF across the cognitive spectrum (i.e., cognitively normal to Alzheimer's dementia [AD]) remain unexplored. Objectives To investigate influences of APOE ε2, ε4, BDNF Met and HF on cognition among participants across the cognitive spectrum. Methods Genetic association study using national databases ( N = 7,166). Results APOE ε2 frequencies were similar across the cognitive spectrum among participants with HF. APOE ε4 frequency was lower among participants with HF and AD than non-HF participants with AD. BDNF Met frequencies did not differ across the spectrum. HF was associated with worse attention and language. In the HF subsample, ε4 was associated with worse memory. Conclusion Associations between APOE and cognition may differ in HF but need to be tested in a larger sample