Depression as a Risk Factor for Developing Heart Failure: A Meta-Analysis of Prospective Cohort Studies.

BACKGROUND: The associations of depression with incident heart failure (HF) risk based on epidemiological studies have been inconsistent. OBJECTIVE: We aimed to quantitatively estimate the relative effect of depression on the development of HF. METHODS: We performed a systematic review and meta-analysis of cohort studies published between January 1, 1950, and August 31, 2019, from PubMed, Embase, and the Science Citation Index databases. We selected prospective cohort studies reporting the relationship between depression and incident HF. Maximally adjusted hazard ratios and their 95% confidence intervals were combined using a random-effects model. The heterogeneity across studies was calculated by the I2 statistic. This meta-analysis was registered in PROSPERO (number CRD42020149274). RESULTS: Six population-based, prospective cohort studies with 4727 HF events among 131 282 participants were eligible for meta-analysis. Compared with participants reporting no depression, those with depression had a 23% increased risk of developing HF (pooled hazard ratio, 1.23; 95% confidence interval, 1.08-1.41). There was no significant heterogeneity across studies (χ2 = 7.75, df = 5, P = .17, I2 = 35.5%). CONCLUSION: Published literature supports a significant association of depression with an increased incidence of HF in the general population.

Reliability and validity of the multidimensional dyspnea profile in hospitalized Chinese patients with respiratory diseases.

BACKGROUND: Dyspnea is a multidimensional experience similar to pain and is one of the most common clinical presentations in patients with respiratory diseases. Accurately evaluating the experience of dyspnea allows nurses and physicians to deliver better medical services to patients. The multidimensional dyspnea profile emphasizes the psychosocial factors of dyspnea and assesses immediate discomfort, sensory qualities, and the emotional responses of patients with dyspnea. At present, the validity, reliability, and test-retest reliability of the multidimensional dyspnea profile in patients with respiratory diseases in China are unclear. OBJECTIVES: The aim of this study was to investigate the validity, reliability, and test-retest reliability of the Chinese version of the multidimensional dyspnea profile and to assess the convergent validity between the Chinese version of the multidimensional dyspnea profile and the modified Medical Research Council Dyspnea Scale. METHODS: The factorial construct, intraclass correlations, internal consistency, and convergent validity of the Chinese version of the multidimensional dyspnea profile was evaluated using data from 231 inpatients with dyspnea from the respiratory department of a hospital. In the principal component analysis stage, 131 inpatients were evaluated. In the test-retest reliability analysis stage, 50 out of the 131 patients responded to the questionnaire again. In the confirmatory factor analysis, 100 inpatients from an independent sample were assessed. RESULTS: The principal component analysis showed that the Chinese version of the multidimensional dyspnea profile had a two-factor structure: the immediate perceptual-related problem factor (6 items) and the emotional response-related problem factor (5 items). The convergent validity between the Chinese version of the multidimensional dyspnea profile and the modified Medical Research Council Dyspnea Scale was significant and acceptable based on the average variance extracted (r = .56, p < .001). The confirmatory factor analysis revealed a good model fit and provided support for the construct validity of the Chinese version of the multidimensional dyspnea profile. Overall, the internal consistency and intraclass correlation coefficient of the Chinese version of the multidimensional dyspnea profile were good. CONCLUSION: The 11-item Chinese version of the multidimensional dyspnea profile has acceptable validity and reliability in patients with respiratory diseases in China. In the future, more studies should be performed to further explore its clinical application.

Otago exercise programme for physical function and mental health among older adults with cognitive frailty during COVID-19: A randomised controlled trial.

AIMS AND OBJECTIVES: Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19. BACKGROUND: Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people. DESIGN: A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines. METHODS: This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks. RESULTS: Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, -2.78; TUGT, -3.73; BBS, 2.17; GDS-15, -0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, -0.10; GDS-15, 1.07; SF-12 MCS, -5.95; all p < .001). CONCLUSION: Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic. RELEVANCE TO CLINICAL PRACTICE: Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.

Somatization disorder mediates the association of depression and anxiety with functional impairment in patients with heart failure.

Previous studies have suggested that depression, anxiety, and somatization disorder are strongly associated with diminished functional status. However, research has not tested the mediational models of how depression and anxiety lead to functional impairment. The aim of this study was to examine whether somatization disorder mediates the association of depression and anxiety with functional impairment in heart failure (HF) patients. The self-reported questionnaires were applied to measure depression, anxiety, and somatization disorder. Functional status was evaluated by the NYHA Class. Ordinal logistic regression analysis was performed to examine the association of depression, anxiety, and somatization disorder with functional status. Mediation analysis was conducted to determine indirect effects. Functional impairment was both related to depression (OR = 2.257, 95% CI = 1.534-3.322, P < 0.001) and elevated somatization severity (OR = 1.042, 95% CI = 1.003-1.082, P = 0.032) in HF patients, whereas anxiety was not associated with functional impairment (OR = 0.659, 95% CI = 0.429-1.012, P > 0.05). Mediation analysis indicated that both depression and anxiety have indirect effects on functional impairment as mediated by somatization disorder in HF patients. Additionally, depression has direct effect on functional impairment of the patients.

The Autism-Related lncRNA MSNP1AS Regulates Moesin Protein to Influence the RhoA, Rac1, and PI3K/Akt Pathways and Regulate the Structure and Survival of Neurons.

Autism spectrum disorder (ASD) is a complex disease involving multiple genes and multiple sites, and it is closely related to environmental factors. It has been gradually revealed that long noncoding RNAs (lncRNAs) may regulate the pathogenesis of ASD at the epigenetic level. In neuronal cells, the lncRNA moesin pseudogene 1 antisense (MSNP1AS) forms a double-stranded RNA with moesin (MSN) to suppress moesin protein expression. MSNP1AS overexpression can activate the RhoA pathway and inhibit the Rac1 and PI3K/Akt pathways; however, the regulation of Rac1 by MSNP1AS is not associated with MSN, and the effect on the RhoA pathway may also be associated with other factors. MSNP1AS can decrease the number and length of neurites, inhibit neuronal cell viability and migration, and promote apoptosis. Downregulation of MSN expression functions similarly to MSNP1AS, and its overexpression can block the above functions of MSNP1AS. In addition, in vivo experiments show that MSN improves social interactions and reduces repetitive behaviors in BTBR mice, decreases the activity of RhoA and restores the activity of PI3K/Akt pathway. Therefore, the abnormal expression of MSNP1AS in ASD patients might influence the structure and survival of neuronal cells through the regulation of moesin protein expression to facilitate the development and progression of ASD. These findings provide new evidence for studying the mechanisms of lncRNAs in ASD. LAY SUMMARY: Autism spectrum disorder (ASD) is a common neurodevelopmental disease and its neurodevelopmental mechanisms have not been elucidated. More and more studies have found that long noncoding RNAs (lncRNAs) can regulate the development of central nervous system in many ways and affect the pathogenic process of ASD. Moesin pseudogene 1 antisense (MSNP1AS) is an up-regulated lncRNA in ASD patients. In-depth functional experiments showed that MSNP1AS inhibited moesin protein expression and regulated the activation of multiple signaling pathways, thus decreasing the number and length of neurites, inhibiting neuronal cell viability and migration, and promoting apoptosis. Therefore, MSNP1AS is an important lncRNA related to ASD and can regulate the biological function of neurons.

The role of non-invasive ventilation used immediately after planned extubation for adults with chronic respiratory disorders.

OBJECTIVE:  To estimate the benefits of non-invasive ventilation (NIV) used immediately after planned postextubation in patients with chronic respiratory disorders. METHODS:  Cochrane Library, PubMed, the Chinese BioMedical Literature Database of clinical trials (CBD) and Embase were searched for pertinent studies by 2 trained investigators. Pooled odds ratios and 95% confidence intervals (CIs) were calculated by employing both fixed-effects and random-effects models. RESULTS:  Eight studies enrolling 736 patients were included in the meta-analysis. Compared with general oxygen therapy, NIV used immediately after planned extubation in patients with chronic respiratory disease reduced the reintubation rate (p=0.02), ventilator-associated pneumonia (VAP) incidence rate (p=0.000), and ICU mortality (p=0.002) and increased the level of PO2 (p=0.03). CONCLUSION:  Non-invasive ventilation used immediately after planned extubation seems to be advantageous for decreasing the reintubation rate, VAP incidence, and ICU death rate in patients with chronic respiratory disease.