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Background The comprehensive management of heart failure in conjunction with frailty necessitates a multidimensional approach to frailty assessment. However, the social frailty, despite being an incremental predictor of negative health outcomes in heart failure patients, has not been adequately addressed. Objective To understand the current status of social frailty in patients with chronic heart failure and analyze its influencing factors. Methods From September 2022 to July 2023, convenience sampling was used to select patients with chronic heart failure from the First Affiliated Hospital with Nanjing Medical University as the research objects, the general information questionnaire, the HALFT Scale, the Loneliness Scale, the Brief 2-Way Social Support Scale, Personal Mastery Scale, and the Patient Health Questionnaire were used to investigate. Univariate analysis and support vector machine-feature recursive elimination were used to filter the feature, SVM classification model was constructed, and SHAP value was introduced to analyze the influencing factors. Results A total of 228 patients were screened in this study, of which 8 patients refused to fill in. A total of 220 questionnaires were distributed and 213 valid questionnaires were returned, with an effective recovery rate of 96.81%. The proportion of pre-social frailty and social frailty in patients with chronic heart failure was 46.0% (98/213) and 17.8% (38/213), respectively. Statistically significant differences were observed among chronic heart failure patients with different degrees of social frailty in terms of education level, place of residence, working status, economic burden of disease, personal monthly income, course of disease, exercise habits, medical satisfaction, traffic, the UCLA Loneliness Scale score, the Brief 2-Way Social Support Scale score, the PMS score, and the PHQ-9 score. When the SVM-RFE model play the best performance, the optimal feature subset was used to construct the SVM classification prediction model and perform SHAP interpretability analysis. The accuracy of the model was 0.73 in the training set and 0.63 in the test set, respectively. At this time, the ranking of feature importance from high to low was no exercise habit (+), personal mastery (-), heavy economic burden of disease (+), 2-way social support (-), depression (+), loneliness (+), unemployment (+) . Conclusion Patients with chronic heart failure experiencing severe social frailty. Healthcare providers should prioritize identifying and addressing the resource deficits of patients and the underlying factors contributing to social frailty. Targeted interventions should be implemented to mitigate social frailty in patients with heart failure by enhancing external support systems, fostering positive beliefs, addressing negative emotional experiences, developing comprehensive management plans, coordinating medical resources, and implementing strategies to delay or reverse social frailty progression. These interventions aim to enhance the prognosis and quality of life for patients with heart failure.

Background Nowadays, cardiac rehabilitation is mostly transferred from the hospital to a home environment. Mobile health applications assist patients in bridging the support gap from hospital to home environment, which encourages home-based recovery processes. Unfortunately, numerous quality difficulties accompany its promise, and the service quality of cardiac rehabilitation applications must be ＂confirmed＂ as soon as possible. Objective To develop a quality assessment indicator system for home-based rehabilitation APP services for heart failure patients, and to provide a model for standardizing and increasing the quality of mobile health APP. Methods This study was conducted from July 2022 to January 2023, using semi-structured interviews, literature review, the expert consultation method and analytic hierarchy process (AHP) to determine the content of indicator system and the weight for each index. Results 2 rounds of expert consultations resulted in the effective response rates of 100%, with the authority coefficients of 0.867, and the coordination coefficients of 0.128-0.154 and 0.151-0.197 respectively (P

Background The maintenance of exercise rehabilitation effect in patients with chronic heart failure depends on good adherence to exercise rehabilitation. It is of great practical significance to evaluate the adherence to exercise rehabilitation effectively and scientifically, however, there is still a lack of accepted tools to evaluate the adherence to exercise rehabilitation in patients with chronic heart failure at home and abroad. Objective To develop an exercise rehabilitation adherence scale for patients with chronic heart failure, and provide a scientific and appropriate tool for the rapid and convenient evaluation of adherence to exercise rehabilitation in patients with chronic heart failure. Methods Based on the previous summary of the best evidence and qualitative research on exercise rehabilitation of patients with chronic heart failure, the initial pool of entries was formed through literature review, combining the opinions of the research group; the clinical test version of the scale was formed based on a small sample pre-survey and Delphi expert correspondence. Patients with stable chronic heart failure who were treated in the cardiovascular department from three tertiary-level hospitals in Jiangsu Province from November 2020 to January 2021 were selected as the study subjects using a convenience sampling method. In the first phase, 274 valid scales were recovered, aiming to screen the items of the scale and conduct exploratory factor analysis by combining item response theory and classical test theory to form the official version of the scale; in the second phase, 282 valid scales were recovered, aiming to perform confirmatory factor analysis and test on reliability and validity of the official version of the scale to form the final version of the scale. Results The formal scale consisted of 11 items in 2 dimensions. The difficulty of each item was reasonable without no inverse threshold, and the item differentiation, item information content, and item characteristic curve were all superior. The total Cronbach's α coefficient of the exercise rehabilitation adherence scale for patients with chronic heart failure was 0.905, of which the dimension of "prescription adherence" was 0.895, the dimension of "monitoring adherence" was 0.910. The total Spearman-Brown split reliability coefficient of the scale was 0.724, and the retest reliability was 0.902. The results of exploratory factor analysis showed that the two factors could explain 70.231% of the total variation. The results of further confirmatory factor analysis showed that the model was better fitted with each parameter. Conclusion The exercise rehabilitation adherence scale for patients with chronic heart failure developed in the study is reasonable in terms of item difficulty, differentiation, the information content of the items is good with high reliability and validity, which can be used as an evaluation tool for adherence to exercise rehabilitation in patients with chronic heart failure.

Background Telerehabilitation based on digital medical care can efficiently improve the health status of patients after radiofrequency ablation of atrial fibrillation. However, the current participation rate in telerehabilitation is low. Objective To analyse the reasons for refusal of exercise rehabilitation in patients after radiofrequency ablation of atrial fibrillation in the context digital medical care based on the theory of leisure constraints. Methods Patients after radiofrequency ablation of atrial fibrillation in the inpatient department or outpatient clinic of Department of Cardiology, at the First Affiliated Hospital of Nanjing Medical University from July to September 2022 were selected as the study subjects by using the purposive sampling method. The phenomenological approach was adopted to collect data from patients who refused exercise telerehabilitation after radiofrequency ablation through semi-structured interviews, and Colaizzi analysis was used to summarize the reasons. Results A total of 14 patients were finally included in this study. Three themes including self-limiting factors, interpersonal limiting factors, and structural limiting factors, and twelve sub-themes were extracted, namely, low level of digital literacy, negative illness perception, psychological distress caused by disease, digital medical trust crisis, deep-rooted personal exercise habits, alienation sense from rehabilitation team, insufficient social network establishment, economic burden related to equipment acquisition, harsh climate, low rehabilitation service capacity in primary care, constraints of available time by role pressure, and poor applicability of wearable devices. Conclusion The reasons for refusal to exercise telerehabilitation include lack of literacy and trust in digital medical care, high level of illness perception and psychological distress, poor exercise habits, rehabilitation team and peer alienation, economic burden, harsh climate, lack of capacity and personal time for rehabilitation service capacity in primary care, and inadequate applicability of existing wearable devices.

Background The prevalence of atrial fibrillation (AF) in China is increasing year by year, and the prognosis and quality of life of patients urgently need attention. Current studies have confirmed that exercise rehabilitation is a beneficial way to improve the prognosis and poor quality of life in patients with AF after radiofrequency catheter ablation (RFCA). Adherence is a key measure of whether the benefits of exercise rehabilitation persist, but its trajectory remains unknown. Objective To examine the development trajectory and predictors of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA using five-period follow-up data based on prospective longitudinal observation. Methods Convenience sampling method was used to select 246 patients with AF who attended the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University for RFCA from May to November 2020 for follow-up. The baseline survey was conducted 1 week after enrollment, and the follow-up survey was conducted at 3, 6, 9 and 12 months after enrollment. The general and clinical data of patients were collected. The strength-duration adherence was monitored and recorded using smart devices or fitness log to assess exercise adherence in terms of strength-duration adherence; Self-efficacy for Exercise Scale (SEE), Fear of Activity in Patients with Chronic Heart Failure (Fact-CHF), Perceived Social Support Scale (PSSS), Patient Activation Measure 13 (PAM13) were used for assessing self-efficacy of exercise, fear of activity, social support and motivation level. Mplus tool was used to construct latent class growth model (LCGM), and the optimal fitting model was selected to determine the development trajectory of strength-duration adherence to home-based exercise rehabilitation among patients with AF after RFCA. Logistic regression analysis was used to identify the predictors of trajectory categories. Results A total of 202 patients were included in the final analysis with 44 patients lost to follow-up. The number of patients at baseline, 3 months, 6 months, 9 months, and 12 months after exercise were 202, 201, 185, 174 and 159, respectively, and the strength-duration adherence were (0.83±0.55), (1.07±0.54), (0.99±0.57), (0.91±0.55) and (0.89±0.60). The LCGM results showed group heterogeneity in the process of change in strength-duration adherence to exercise rehabilitation in patients, which was divided into 3 latent classes based on their development trajectories, including 69 in slow decline-low level group (34.2%), 14 in rapid increase-high level group (6.9%), and 119 in sustained adherence group (58.9%). Multinomial unordered Logistic regression showed higher levels of intensity-time adherence in the rapid increase-high level group and sustained adherence group using the slow decline-low level group as the reference group (P

Background The glycemic fluctuation in peri-percutaneous coronary intervention (PCI) period is closely related to the short-term and long-term prognosis in patients with coronary heart disease (CHD). At present, there are few studies on glycemic fluctuation and its influencing factors in peri- PCI period in these patients. Objective To explore the characteristics and influencing factors of glycemic fluctuation during peri-PCI period in patients with CHD and type 2 diabetes (T2DM) . Methods One hundred and fifty-six patients undergoing PCI in the cardiology ward of Jiangsu Provincial People's Hospital from April 2021 to November 2021 were selected. General demographics were collected by general demographics questionnaire. Perioperative glycemic fluctuation was collected by glycemic data questionnaire. The patients were stratified according to the normal reference value range of blood glucose fluctuation evaluation indicators: normal standard deviation of blood glucose level (SDBG) group (

Atrial fibrillation (AF) is one of common clinical arrhythmias, among which asymptomatic AF is insidious, poorly understood, and prone to adverse outcomes, bringing a serious burden to patients. As disease screening is a measure that should be implemented prior to the prevention of disease-related complications, it is crucial to carry out asymptomatic AF screening and scientific management. Current hot issues in screening for AF include the selection of the most appropriate screening population, the selection of screening devices and modalities, the improvement of screening participation, standard indications of anticoagulation therapy for those diagnosd, and the evaluation of the best economic screening option. We included twenty-five articles related to screening for atrial fibrillation, and systematically reviewed the AF screening section in AF management guidelines published in recent five years and opinions of relevant experts, then gave a summary of the latest advances in AF screening, involving screening strategies, screening devices, screening participation, anticoagulation treatment participation and monitoring duration and monitoring modalities in post-stroke screening, and the association of screening strategies on cost-effectiveness of the screening analyzed using a perspective in health economics, as well as economic impact of patient participation in screening and anticoagulation treatment. All these are beneficial to the guidance for clinical practice. The more internationally recognised guidelines for the screening and management of atrial fibrillation are the European Heart Rhythm Society guidelines and the North American Heart Rhythm Society guidelines. Most studies on the cost-effectiveness of AF screening have used Markov models for lifetime simulation. Health economics analyses include stroke events, bleeding events, quality-adjusted life year (QALY) , and incremental cost-effectiveness ratio (ICER) . Most guidelines recommend routine screening with newer devices, such as portable single-lead ECGs in high-risk groups aged 65-75 years, to facilitate continuous monitoring and improve AF detection rates; for post-stroke screening, national and international guidelines emphasize screening for AF in patients with cryptogenic transient ischemic attacks (TIA) /stroke, with the main focus on Long-range ECG and implantation of an insertable cardiac monitor (ICM) . In summary, although some progress has been made in understanding the cost-effectiveness of AF screening, many differences still need to be fitted, and the health economics of AF screening are poorly understood in China. This will provide an evidence-based basis for improving life expectancy and quality of life and reducing the economic burden of healthcare.

Objective: To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity. Methods: 28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion. Results: In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences (p <.01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement (p >.05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow. Conclusion: The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated. [ABSTRACT FROM AUTHOR]

The precise measurements of the magnetic field are essential for particle accelerators, and the harmonic coil measurement system is especially suitable for the multipole field because of its unique advantages. The accurate placement of magnets is essential for accurate magnetic field measurements. The current positioning technique employed for harmonic coil measurement is inefficient due to its labor-intensive and time-consuming nature. The aim of this study is to automate the positioning of the quadrupole magnet. Therefore, a close-range photogrammetry system is utilized to monitor the position of the magnet due to its non-contact feature, and an electrically driven Stewart platform is utilized to manipulate the magnet. Meanwhile, a control system has been developed to regulate the automatic positioning. The system is capable of receiving measurements from the close-range photogrammetry system in order to ascertain the displacements of the magnet from its current position to the target. Subsequently, it can transmit commands to Stewart platform to regulate its movement. The experiments indicate that the efficiency of the quadrupole magnet positioning has increased significantly by at least 5 times, and the final positioning accuracy was verified by the laser tracker. The study also addresses the potential application of this technology in high radiation environments that are otherwise inaccessible. [ABSTRACT FROM AUTHOR]

BACKGROUND: The main treatment method for end-stage renal disease (ESRD) is maintenance hemodialysis (MHD). With the continuous improvement of dialysis technology, the survival period of MHD patients has been effectively prolonged, but dialysis technology still cannot completely replace renal function. OBJECTIVE: To study the dietary compliance and its correlation with thirst in MHD patients and to provide guidance for clinical development of corresponding intervention countermeasures. METHODS: A total of 90 patients who received MHD treatment from March 2021 to March 2022 were selected as objects. The Renal Adherence Attitudes Questionnaire (RAAQ) and the Renal Adherence Behaviour Questionnaire (RABQ) were used to analyze the dietary compliance and thirst status of patients. Pearson correlation analysis was used to analyze the correlation between diet compliance and thirst. RESULTS: Positive correlations were found between VAS and DTI, SXI and TDS (P < 0.05). Social restrictive attitude was positively correlated with VAS, DTI, SXI, TDS, acceptance attitude and compliance in facing difficulties (P < 0.05), and negatively correlated with self-care compliance (r = - 0.35, P < 0.05). Health attitude was positively correlated with VAS, DTI and SXI (P < 0.05). Acceptance attitude was positively correlated with DTI, SXI and TDS (P < 0.05). High RAAQ was associated with high VAS (b = 0.11, 95% CI: 0.05, 0.18), DTI (b = 0.28, 95% CI: 0.17, 0.38), SXI (b = 0.24, 95% CI: 0.14, 0.34) and TDS (b = 0.26, 95% CI: 0.13, 0.4). CONCLUSION: The overall performance of dietary compliance in patients with MHD is at a moderate level, and dietary compliance is negatively correlated with disease perception. [ABSTRACT FROM AUTHOR]

Burning hydrogen-rich syngas fuels derived from various sources in combustion equipment is an effective pathway to enhance energy security and of significant practical implications. Emissions from the combustion of hydrogen-rich fuels have been a main concern in both academia and industry. In this study, the NO and CO emission characteristics of both laminar and turbulent counterflow premixed hydrogen-rich syngas/air flames were experimentally and numerically studied. The results showed that for both laminar and turbulent counterflow premixed flames, the peak NO mole fraction increased as the equivalence ratio increased from 0.6 to 1.0 and decreased as the strain rate increased. Compared with the laminar flames at the same bulk flow velocity, turbulent flames demonstrated a lower peak NO mole fraction but broader NO formation region. Using the analogy theorem, a one-dimensional turbulent counterflow flame model was established, and the numerical results indicated that the small-scale turbulence-induced heat and mass transport enhancements significantly affected NO emission. Considering NO formation at the same level of fuel consumption, the NO formation of the turbulent flame was significantly lower than that of the laminar flame at the same level of fuel consumption, implying that the turbulence-induced heat and mass transfer enhancement favored NOx suppression. [ABSTRACT FROM AUTHOR]

Background: In the fight against heart failure (HF), informal caregivers are an indispensable part of the team. As a protective factor against stress, resilience can help to enhance caregivers' psychological adaptation and ultimately increase the quality of care during the HF caregiving period. Recognizing its predictors and exploring how these variables interact could promote tailored strategies to enhancing caregivers' resilience of HF patients. Thus, this study aimed to identify promoting and risk factors of resilience in informal caregivers of HF patients from the Chinese context and to understand the interactions between these factors and resilience. Methods: This cross-sectional study was conducted from December, 2020 to March, 2022 among 210 caregivers in Nanjing, China. The General Information Questionnaire, the Connor-Davidson Resilience Scale, the General Self-Efficacy Scale, the Perceived Social Support Scale, the Positive and Negative Affect Scale, the Simplified Coping Style Questionnaire and the Family Hardiness Index were used in this survey. Data were analysed with Pearson's correlation analysis, the multiple linear regression model and the structural equation modeling (SEM). Results: The resilience of 210 Chinese HF caregivers was at the moderate and higher level (66.40± 15.08). The SEM had a good fit (root mean square error of approximation=0.047, comparative fit index=0.994, Tucker-Lewis index=0.987). Perceived social support (β=0.390, P< 0.001), positive coping style (β=0.159, P=0.019) and self-efficacy (β=0.332, P< 0.001) had positive direct effects on resilience among HF caregivers, separately. Both perceived social support (β=0.04, P< 0.001) and self-efficacy (β=0.07, P< 0.001) indirectly influenced resilience through positive coping style. Conclusion: We recommended that multi-dimensional and greater social support, higher self-efficacy and especially, positive coping strategies should be offered or encouraged during the caregiving period, which may contribute to enhancing HF caregivers' resilience. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to synthesize qualitative evidence on experiences of patients with atrial fibrillation (AF) during the course of diagnosis and treatment. We addressed three main questions: (a) What were the experiences of patients with AF during the course of diagnosis and treatment? (b) How did they respond to and cope with the disease? (c) What were the requirements during disease management? Design: In this study, qualitative evidence synthesis was performed using the Thomas and Harden method. Data Sources: Electronic databases, including PubMed, the Cochrane Library, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, the China Biomedical Database, the WanFang Database, Chinese National Knowledge Infrastructure and VIP, were searched. The databases were searched from inception to August 2021. Review Methods: Two researchers independently selected studies using qualitative assessment and review instruments for quality evaluation and thematic synthesis for the data analysis. Results: A total of 2627 studies were identified in the initial search and 15 studies were included. Five analytical themes were generated: 'Diagnosing AF'; 'The impact of AF on the patients'; 'Self‐reorientation in the therapeutic process'; 'Living with AF and QoL'; and 'External support to facilitate coping strategies.' Conclusions: Our findings point out unique experiences of patients across the trajectory of AF related to delayed diagnosis, feelings of nonsupport, disappointment of repeated treatment failure and multiple distress associated with unpredictable symptoms. Future research and clinical practice are expected to improve the quality of medical diagnosis and treatment, optimize administrative strategy and provide diverse health support for patients with AF. Impact: Understanding the experiences and needs of patients with AF in the entire disease process will inform future clinical practice in AF integrated management, which would be helpful in improving the professionalism and confidence of healthcare providers. In addition, our findings have implications for improving the effectiveness of AF diagnostic and treatment services. Patient or Public Contribution: This paper presents a review of previous studies and did not involve patients or the public. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group (n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group (n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to examine the effectiveness of high-intensity interval training (HIIT) on pulmonary function and exercise capacity in individuals with chronic obstructive pulmonary disease (COPD). Methods: Ten databases (PubMed, the Cochrane Library, Web of Science, EMBASE, MEDLINE, CINAHL, CNKI, Wanfang, Weipu, and CBM) were searched for relevant articles published from inception to 30 June 2020. Studies were included if they were randomized controlled trials (RCTs) comparing a HIIT group with usual care or other training groups. Quality was assessed using the Physiotherapy Evidence Database (PEDro) scale, and the overall quality of evidence was assessed using the GRADE approach. The primary outcomes were peak VO2 and FEV1% predicted, and the secondary outcomes were FEV1/FVC, peak VE, peak WR, 6MWD, dyspnea, health-related quality of life, and adverse event. Results: Twelve articles (689 patients) were included. HIIT was shown to have a positive effect on exercise capacity (peak WR, 6MWD), pulmonary function (FEV1% pred, peak VE), dyspnea, and quality of life. However, sensitivity analyses for dyspnea were unstable, and the result changed from positive to negative after removing one study (SMD = − 0.13, 95% CI [− 0.44, 0.17], P = 0.40). Conclusions: HIIT could improve pulmonary function, exercise capacity, and quality of life but may not decrease dyspnea in patients with COPD. It can be recommended as a safe and effective exercise modality in rehabilitation programs. Given that the overall results were based on a limited number of studies with significant heterogeneity and some of the results were based on low GRADE rating evidence, more high-quality, larger sample size, multicenter, and long-term follow-up RCTs are needed to confirm the clinical efficacy of HIIT in patients with COPD. PROSPERO Registration: CRD42020165897. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the influence of patient activation (PA) and relational aspects on the quality of life (QoL) in patients with Atrial Fibrillation (AF) for developing measures to improve PA and QoL. Methods: A cross-sectional study was undertaken in 2021 among 190 AF patients in Nanjing, China. Research instruments included a self-designed social-demographic characteristics scale, the Patient Activation Measure (PAM), the Atrial Fibrillation Effect on Quality of Life (AFEQT). The data analysis was performed using IBM SPSS 25.0. Spearman correlation analysis, multiple linear regression analysis, and Wilcoxon rank-sum tests were used to assess the association accordingly. Results: The average AFEQT score for the 190 AF patients was 69.32 ± 14.52. The distribution of activation Levels 1, 2, 3, and 4, were where 4.7, 34.2, 47.4, and 13.7%, respectively. The multiple linear regression analysis revealed that patient activation, work status, and cardiac rehabilitation of AF patients predicted AF-related QoL (β = 0.270, −0.205, and 0.183, respectively; all P < 0.05). The influences of PA level on subdimensions of AF-related QoL were as follows: symptoms, daily activities and treatment concern. Conclusion: The level of QoL of patients with AF was moderate. Higher levels of patient activation in those with AF were associated with milder symptoms, more positive daily activities and fewer treatment concern. Based on our findings, we suggest that healthcare personnel should encourage AF patients to take active participation in cardiac rehabilitation, disease self-management and foster progression of PA level. Future research is warranted to develop tailor-made interventions aimed at the activation level. [ABSTRACT FROM AUTHOR]

Uncontrolled bleeding is thought to be the most deadly cause of pre‐hospital, traffic, and military accidents death. However, the popular commercial hemostats can only realize the hemostasis of mild bleeding. Therefore, we developed polydopamine (PDA) composite materials (PMs), which applied hydroxyapatite as the parent body. The PMs were produced via lyophilization and functionalized with amino, phenol hydroxyls groups, which endowed hydrophobicity to materials. This ensured a high aggregation ability of blood cells to the PMs and they were tested to be as high as 300% compared with the negative control group. The clotting time was shortened to 79.7% compared with the usually used commercial hemostat (Celox) in the test of in vitro hemostasis. Through the results of PT and APTT tests, blood coagulation index test, and the analysis of intracellular Ca2+ activation, we further understood the mechanism of the hemostasis of the materials, which explained the low blood loss and quick coagulation time of the PM hemostats in detail. Besides, the low hemolysis and cytotoxicity of the PMs suggested the good biocompatibility of the hemostats, which was further proved by the regular morphology maintained by erythrocytes in the hemolysis tests. The study of nanoscale composites led the research for the methods of hemostasis. [ABSTRACT FROM AUTHOR]

Aim: To evaluate whether high‐intensity interval training (HIIT) was superior to low‐intensity training or usual care among patients after percutaneous coronary intervention. The hypothesis was that HIIT would help patients after percutaneous coronary intervention (PCI) improve cardiopulmonary function, lipid profiles and in‐stent restenosis. Design: A systematic review and meta‐analysis were conducted according to the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA)2009 Checklist. Methods: Randomized controlled trials (RCTs) focusing on HIIT programme in patients after PCI were searched in Cochrane Library, Web of Science Core Collection, EMbase, PubMed, China National Knowledge Infrastructure (CNKI) and SinoMed from the inception to 24 March 2020. Standard Mean difference (SMD) and 95% confidence intervals (CI) were performed to summarize the effect sizes. Results: Six RCTs (247 patients) met the criteria. HIIT programme had a statistically significant effect on raising left ventricular ejection function (LVEF) (SMD = 0.38, 95%CI [0.03, 0.73], I2 = 3%), VO2peak (SMD = 0.94, 95%CI [0.61, 1.28], I2 = 0%), as well as improving the serum level of high‐density lipoprotein (SMD = 0.55, 95%CI [0.06, 1.03], I2 = 0%) and late luminal loss (SMD = −0.65, 95%CI [−1.07, −0.23], I2 = 0%). But HIIT had no prominent effect on improving heart rate (SMD = −0.04, 95%CI [−0.29, 0.21], I2 = 0%). Summarily, HIIT programme appears to be favourable for CAD patients after PCI by improving cardiopulmonary function, such as LVEF and VO2peak, as well as reducing late luminal loss in per stented arteries. Nevertheless, HIIT has no advantage for adjusting heart rate. More researches with rigorous methods are warranted to explore the controversy about lipid profiles. [ABSTRACT FROM AUTHOR]

Background: Struggling with heart failure (HF) may be a distressful experience for the entire family. As a key variable contributing to positive family functioning, family hardiness can protect against HF-related harm. Thus, recognizing factors associated with family hardiness could promote strategies that enable successful adaptation to HF. This study aimed to explore protective factors linked to family hardiness among HF patients. Patients and Methods: A cross-sectional study was undertaken in 2020 among 167 HF patients in Nanjing, China. The study measures comprised a self-designed general information questionnaire, the Family Hardiness Index, the Mutuality Scale, the Positive and Negative Affect Scale, and the Simplified Coping Style Questionnaire. The data analysis was performed using IBM SPSS, version 25 and comprised Pearson's correlation analysis, a multiple linear regression model, and an analysis of mediating effects. Results: The average Family Hardiness Index score for the 167 HF patients was 57.95 ± 11.41. The multiple linear regression analysis revealed that mutuality, active coping style, and positive emotions of HF patients positively predicted family hardiness (β = 0.359, 0.308, and 0.215, respectively; all P ˂ 0.05). Mutuality between patients and family members had partial mediating effects between active coping style, positive emotions, and family hardiness. Conclusion: Our results revealed that patients' active coping styles, positive emotions, and mutuality were protective factors associated with family hardiness. In light of our findings, we suggest that active coping strategies, positive emotions, and, especially, closer relationships within families should be encouraged during the rehabilitation and follow-up care of HF patients. [ABSTRACT FROM AUTHOR]