Sexual experience in patients with coronary heart disease: a descriptive phenomenological study.

Sex is an essential part of life and is a basic demand for human beings. Coronary heart disease can have an impact on patients' sexual lives; however, not much attention has been paid to it in China, and few studies have been conducted on this topic. Therefore, this study used a qualitative approach to understand the sexual experience of patients after the illness, thus laying the foundation for the development of relevant measures. Semi-structured interviews were conducted with 14 patients. Descriptive phenomenological methods were employed to collect data and explore the sexual experience of patients with coronary heart disease. A total of 4 thematic groups, 9 themes, and 23 subthemes were extracted. The four thematic groups were independent and cross-influenced. In these groups, alterations in the sexual experience, including the change in sexual physiology and psychological state, were affected by the lack of knowledge, age, disease, and other factors. Furthermore, the patient's perception of sexuality affected the quality of sexual life after the illness. The sexual experience of patients with coronary heart disease and its influencing factors, such as age, disease factors, and lack of related knowledge, were described. The findings are expected to aid in formulating targeted and personalized intervention measures.

A Practical Tool for Measuring Home-Based Cardiac Rehabilitation Self-Management Behavior: A Multiphase Cross-Sectional Study.

BACKGROUND: Optimal self-management is the key to home-based cardiac rehabilitation for patients with heart disease. At present, there is a lack of a specific assessment tool to evaluate the home-based cardiac rehabilitation self-management behavior in patients with heart disease. Therefore, the aim of this study was to develop the Home-Based Cardiac Rehabilitation Self-Management Scale and validate its psychometric properties among patients with coronary heart disease. METHODS AND RESULTS: A multiphase cross-sectional study was conducted that study covered 3 phases: (1) item generation and revision, (2) item evaluation and preliminary exploration, and (3) assessment of the psychometric properties of the scale. A scale with 21 items was developed to measure the home-based cardiac rehabilitation self-management behavior. The content validity index of the scale was 0.980. In exploratory factor analysis, the 5-factor structure supported by eigenvalues and screen plot explained 74.326% of the total variation. In confirmatory factor analysis, all fitting indicators were acceptable, further supporting the construct validity of the scale. The criterion validity of the scale was 0.783. In the reliability analysis, the Cronbach's α coefficient of the scale was 0.882, with a dimensionality range of 0.780 to 0.936. The split-half reliability coefficient and test-retest reliability coefficient were 0.774 and 0.770, respectively. CONCLUSIONS: This study is the first to develop and validate a practical tool. This scale can comprehensively and accurately assess the self-management behavior of patients with heart disease in a home-based cardiac rehabilitation environment.

A behavioural driving model of adherence to home-based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed-methods study.

AIMS AND OBJECTIVES: To develop and validate a behavioural driving model for adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence. BACKGROUND: Despite the benefits of home-based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored. DESIGN: An exploratory sequential mixed-methods study was conducted in this study. METHODS: A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self-report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1). RESULTS: Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self-efficacy and exercise fear played a chain-mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence. CONCLUSIONS: This study reveals a potential pathway mechanism for social support to improve adherence to home-based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence. RELEVANCE TO CLINICAL PRACTICE: To enhance exercise adherence in home-based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self-efficacy and alleviate exercise fear. PATIENT OR PUBLIC CONTRIBUTION: None.

"Challenges to Normalcy"- Perceived Barriers to Adherence to Home-Based Cardiac Rehabilitation Exercise in Patients with Chronic Heart Failure.

Purpose: The aim of this study was to explore perceived barriers to adherence to home-based cardiac rehabilitation exercise in patients with chronic heart failure. Patients and Methods: A qualitative descriptive study was conducted in this study from May to July 2023. A purposive sampling approach was adopted to select patients with chronic heart failure. Semi-structured interviews were completed to collect qualitative data for exploring the perceived barriers. In addition, information saturation and validation strategies were adopted to prove the adequacy of qualitative data. Transcripts were analysed using thematic analysis. Results: A total of 16 patients with chronic heart failure were included in this study. Analysis of the data revealed five main barriers to adherence to home-based cardiac rehabilitation in patients with chronic heart failure. These include (1) lack of knowledge, (2) activity intolerance, (3) exercise fear, (4) role conflict, and (5) lower exercise self-efficacy. Conclusion: This study delved deeper into understanding the challenges faced by chronic heart failure patients in adhering to home-based cardiac rehabilitation exercise. The development of precise and effective management and intervention strategies based on these barriers is necessary to improve patient compliance with home-based cardiac rehabilitation exercise.

Hepatoenteric Protective Effect of Melanin from Inonotus hispidus on Acute Alcoholic Liver Injury in Mice.

SCOPE: Alcoholic liver disease (ALD) is a common disease with a high incidence. Because traditional drugs have obvious side effects, it is desired to find more effective drugs. METHODS AND RESULTS: This study investigates the effects of melanin from Inonotus hispidus fruiting bodies (IHFM) on acute alcoholic injury mice and detects the protective mechanisms via the gut-microbiota-liver axis. The results show that IHFM alleviates mouse liver injury by enhancing alcohol metabolism capacity, reducing inflammation response level and strengthening antioxidant activities. IHFM also improves mouse liver injury by activating Nrf2 signaling pathway and inhibiting toll-like receptor4 (TLR4)/nuclear factor-κß (NF-κß) signaling pathway. Furthermore, 16S amplification sequencing shows that IHFM can significantly increase the relative abundance of Lactobacillus reuteri and Lactobacillus johnsonii. The relative abundance of L. reuteri positively correlates with an antioxidant index, while negatively correlates with inflammatory factors. CONCLUSION: IHFM can protect mice from acute alcoholic liver injury by upregulating the Nrf2 signaling pathway, downregulating the TLR4/NF-κß signaling pathway, and upregulating the relative abundance of L. reuteri and L. johnsonii, representing a step forward in the development of IHFM.

Factors influencing the quality of sexual life in the older adults: A scoping review.

Objective: Older people are often considered asexual, but sex is still important for older adults. So, this review aimed to analyze relevant studies on the sexual life of older adults to clarify factors, and provide a basis for their quality of sexual life. Method: A scoping review was performed according to Arksey and O'Malley's framwork, aiming to identify eligible research studies in PubMed, Web of Science, CINAHL, and PsycINFO, Cochrane Library, and Scopus databases. Peer-reviewed articles published in Chinese or English language from January 2012 to April 2022 were retrieved. All of identified studies were screened, extracted, and analyzed independently by two researchers. Result: A total of 7,374 studies were retrieved, and 13 eligible studies were finally included. The factors affect the sexual quality of life in older adults that included physiological, sociocultural, and health factors and being affected by marital relationships and a lack of relevant knowledge. Conclusion: The factors that affect the quality of old people's sex life interact and influence each other. Medical and health professionals can assist with the improvement of sexual health.

Differences between water-soluble and water-insoluble melanin derived from Inonotus hispidus mushroom.

Melanin is a natural pigment with a high content and a complex polymer structure. In this study, both water-soluble and water-insoluble melanin were obtained from the fruiting bodies of the mushroom Inonotus hispidus, and scanning electron microscopy (SEM), ultraviolet (UV) absorption, Fourier transform infrared (FTIR) spectroscopy, elemental analysis, nuclear magnetic resonance (NMR) spectroscopy, pyrolysis gas chromatography mass spectroscopy (Py-GCMS), and matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS/MS) were used to analyze the water-soluble and water-insoluble I. hispidus fungal melanin (IHFM). Differences in the chemical composition and structure of I. hispidus fungal melanin (IHFM) were found. Studies showed that both have a maximum absorbance at 226 nm, and the maximum mass-to-charge ratios are [M + H] + m/z = 272.2434 and 272.0308, respectively. Elemental analysis revealed that they both contain C, H, N, O, and do not contain sulfur, which is only found in eumelanin. The differences between water-soluble and water-insoluble IHFM may relate to the following factors: (i) the microscopic particles of water-soluble IHFM are relatively small, the arrangement is relatively neat, and they contain a large quantity of benzene, phenol, and indole compounds; and (ii) the microscopic particles of water-insoluble IHFM are larger and the arrangement is irregular. The types and quantities of benzene, phenol, and indole compounds are relatively small, rich in a variety of sugar monomers, and may be insoluble in water due to the presence of a greater number of aliphatic groups. Studies have found that water-soluble IHFM has good cellular antioxidant activity, can reduce oxidative damage by hydrogen peroxide (H2O2) on LO2 cells effectively and can significantly reduce the level of intracellular reactive oxygen species (ROS) to protect the liver. These results are beneficial in order to develop applications of melanin in the food industry and in other fields.

Lyophyllum decastes fruiting body polysaccharide alleviates acute liver injury by activating the Nrf2 signaling pathway.

Polysaccharides have high antioxidant, hypoglycemic, hypolipidemic, hepatoprotective, anti-tumor, and anticancer activities. In this study, the ability of the Lyophyllum decastes fruiting body polysaccharide (LDFP) to protect against CCl4-induced acute liver injury in mice by activating the Nrf2 pathway was studied. LDFP can inhibit the activity of ALT, AST, TC, TG, tumor necrosis factor (TNF-α), and interleukin-6 (IL-6) in serum; significantly improve the inflammatory state of the liver; increase the activity of superoxide dismutase (SOD) and the glutathione (GSH) content; decrease the malondialdehyde (MDA) content; alleviate the toxicity caused by reactive oxygen species; and alleviate liver injury. Immunohistochemistry and western blot showed that LDFP can activate the Nrf2 pathway, up-regulate the expression of Nrf2, down-regulate the expression of Keap1, and increase the expression of the anti-oxidation factors HO-1 and CuZn-SOD. At the same time, it was found that the expression of the transcription factors TLR-4 and NF-κB were decreased in the NF-κB signaling pathway, the synthesis and secretion of the pro-inflammatory factors IL-6 and TNF-α were decreased consequently. These results suggest that LDFP protects the liver by activating the Nrf2 pathway and reducing the inflammatory response. Generally, the results of this study could be used to aid the development of hepatoprotective products and their application.

Optimization of Solid-State Fermentation Extraction of Inonotus hispidus Fruiting Body Melanin.

Melanin has good nutritional and medicinal value; however, its extraction rate is extremely low. This study explored the edible and medicinal fungus Inonotus hispidus fruiting body melanin (IHFM) extraction process and solid-state fermentation conditions. The results showed that the best way to extract IHFM is the compound enzymatic method, with complex enzyme 26.63 mg/g, liquid material ratio 5:1, enzymatic hydrolysis 80 min, pH 4.61, and enzymolysis temperature at 36.07 °C. The yield of IHFM was 23.73 ± 0.57%, which was equivalent to 1.27 times before optimization. The best solid medium formula was normal pH, rice 20 g per cultivation bottle, maltose 22 g/L, beef extract 4.4 g/L, carbon-nitrogen ratio 5:1, and liquid-to-material ratio 1.1:1, where the IHFM yield was 31.80 ± 1.34%, which was equivalent to 1.7 times that before optimization. In summary, solid-state fermentation and extraction optimization greatly improved the yield of melanin, provided a reference to produce melanin, and laid a foundation for the development and utilization of melanin.