Global population exposure to landscape fire air pollution from 2000 to 2019.

Wildfires are thought to be increasing in severity and frequency as a result of climate change1-5. Air pollution from landscape fires can negatively affect human health4-6, but human exposure to landscape fire-sourced (LFS) air pollution has not been well characterized at the global scale7-23. Here, we estimate global daily LFS outdoor fine particulate matter (PM2.5) and surface ozone concentrations at 0.25° × 0.25° resolution during the period 2000-2019 with the help of machine learning and chemical transport models. We found that overall population-weighted average LFS PM2.5 and ozone concentrations were 2.5 µg m-3 (6.1% of all-source PM2.5) and 3.2 µg m-3 (3.6% of all-source ozone), respectively, in 2010-2019, with a slight increase for PM2.5, but not for ozone, compared with 2000-2009. Central Africa, Southeast Asia, South America and Siberia experienced the highest LFS PM2.5 and ozone concentrations. The concentrations of LFS PM2.5 and ozone were about four times higher in low-income countries than in high-income countries. During the period 2010-2019, 2.18 billion people were exposed to at least 1 day of substantial LFS air pollution per year, with each person in the world having, on average, 9.9 days of exposure per year. These two metrics increased by 6.8% and 2.1%, respectively, compared with 2000-2009. Overall, we find that the global population is increasingly exposed to LFS air pollution, with socioeconomic disparities.

Altered brain function in classical trigeminal neuralgia patients: ALFF, ReHo, and DC static- and dynamic-frequency study.

The present study aimed to clarify the brain function of classical trigeminal neuralgia (CTN) by analyzing 77 CTN patients and age- and gender-matched 73 healthy controls (HCs) based on three frequency bands of the static and dynamic amplitude of low-frequency fluctuation, regional homogeneity, and degree centrality (sALFF, sReHo, sDC, dALFF, dReHo, and dDC). Compared to HCs, the number of altered brain regions was different in three frequency bands, and the classical frequency band was most followed by slow-4 in CTN patients. Cerrelellum_8_L (sReHo), Cerrelellum_8_R (sDC), Calcarine_R (sDC), and Caudate_R (sDC) were found only in classical frequency band, while Precuneus_L (sALFF) and Frontal_Inf_Tri_L (sReHo) were found only in slow-4 frequency band. Except for the above six brain regions, the others overlapped in the classical and slow-4 frequency bands. CTN seriously affects the mental health of patients, and some different brain regions are correlated with clinical parameters. The static and dynamic indicators of brain function were complementary in CTN patients, and the changing brain regions showed frequency specificity. Compared to slow-5 frequency band, slow-4 is more consistent with the classical frequency band, which could be valuable in exploring the pathophysiology of CTN.

Tropical cyclone-specific mortality risks and the periods of concern: A multicountry time-series study.

BACKGROUND: More intense tropical cyclones (TCs) are expected in the future under a warming climate scenario, but little is known about their mortality effect pattern across countries and over decades. We aim to evaluate the TC-specific mortality risks, periods of concern (POC) and characterize the spatiotemporal pattern and exposure-response (ER) relationships on a multicountry scale. METHODS AND FINDINGS: Daily all-cause, cardiovascular, and respiratory mortality among the general population were collected from 494 locations in 18 countries or territories during 1980 to 2019. Daily TC exposures were defined when the maximum sustained windspeed associated with a TC was ≥34 knots using a parametric wind field model at a 0.5° × 0.5° resolution. We first estimated the TC-specific mortality risks and POC using an advanced flexible statistical framework of mixed Poisson model, accounting for the population changes, natural variation, seasonal and day of the week effects. Then, a mixed meta-regression model was used to pool the TC-specific mortality risks to estimate the overall and country-specific ER relationships of TC characteristics (windspeed, rainfall, and year) with mortality. Overall, 47.7 million all-cause, 15.5 million cardiovascular, and 4.9 million respiratory deaths and 382 TCs were included in our analyses. An overall average POC of around 20 days was observed for TC-related all-cause and cardiopulmonary mortality, with relatively longer POC for the United States of America, Brazil, and Taiwan (>30 days). The TC-specific relative risks (RR) varied substantially, ranging from 1.04 to 1.42, 1.07 to 1.77, and 1.12 to 1.92 among the top 100 TCs with highest RRs for all-cause, cardiovascular, and respiratory mortality, respectively. At country level, relatively higher TC-related mortality risks were observed in Guatemala, Brazil, and New Zealand for all-cause, cardiovascular, and respiratory mortality, respectively. We found an overall monotonically increasing and approximately linear ER curve of TC-related maximum sustained windspeed and cumulative rainfall with mortality, with heterogeneous patterns across countries and regions. The TC-related mortality risks were generally decreasing from 1980 to 2019, especially for the Philippines, Taiwan, and the USA, whereas potentially increasing trends in TC-related all-cause and cardiovascular mortality risks were observed for Japan. CONCLUSIONS: The TC mortality risks and POC varied greatly across TC events, locations, and countries. To minimize the TC-related health burdens, targeted strategies are particularly needed for different countries and regions, integrating epidemiological evidence on region-specific POC and ER curves that consider across-TC variability.

Fine-grained image classification on bats using VGG16-CBAM: a practical example with 7 horseshoe bats taxa (CHIROPTERA: Rhinolophidae: Rhinolophus) from Southern China.

BACKGROUND: Rapid identification and classification of bats are critical for practical applications. However, species identification of bats is a typically detrimental and time-consuming manual task that depends on taxonomists and well-trained experts. Deep Convolutional Neural Networks (DCNNs) provide a practical approach for the extraction of the visual features and classification of objects, with potential application for bat classification. RESULTS: In this study, we investigated the capability of deep learning models to classify 7 horseshoe bat taxa (CHIROPTERA: Rhinolophus) from Southern China. We constructed an image dataset of 879 front, oblique, and lateral targeted facial images of live individuals collected during surveys between 2012 and 2021. All images were taken using a standard photograph protocol and setting aimed at enhancing the effectiveness of the DCNNs classification. The results demonstrated that our customized VGG16-CBAM model achieved up to 92.15% classification accuracy with better performance than other mainstream models. Furthermore, the Grad-CAM visualization reveals that the model pays more attention to the taxonomic key regions in the decision-making process, and these regions are often preferred by bat taxonomists for the classification of horseshoe bats, corroborating the validity of our methods. CONCLUSION: Our finding will inspire further research on image-based automatic classification of chiropteran species for early detection and potential application in taxonomy.

LSD1 is a subunit of the NuRD complex and targets the metastasis programs in breast cancer.

Lysine-specific demethylase 1 (LSD1) exerts pathway-specific activity in animal development and has been linked to several high-risk cancers. Here, we report that LSD1 is an integral component of the Mi-2/nucleosome remodeling and deacetylase (NuRD) complex. Transcriptional target analysis revealed that the LSD1/NuRD complexes regulate several cellular signaling pathways including TGFbeta1 signaling pathway that are critically involved in cell proliferation, survival, and epithelial-to-mesenchymal transition. We demonstrated that LSD1 inhibits the invasion of breast cancer cells in vitro and suppresses breast cancer metastatic potential in vivo. We found that LSD1 is downregulated in breast carcinomas and that its level of expression is negatively correlated with that of TGFbeta1. Our data provide a molecular basis for the interplay of histone demethylation and deacetylation in chromatin remodeling. By enlisting LSD1, the NuRD complex expands its chromatin remodeling capacity to include ATPase, histone deacetylase, and histone demethylase.

Huperzine A ameliorates neurological deficits after spontaneous subarachnoid hemorrhage through endothelial cell pyroptosis inhibition.

Spontaneous subarachnoid hemorrhage (SAH) is a kind of hemorrhagic stroke which causes neurological deficits in survivors. Huperzine A has a neuroprotective effect, but its role in SAH is unclear. Therefore, we explore the effect of Huperzine A on neurological deficits induced by SAH and the related mechanism. In this study, Evans blue assay, TUNEL staining, immunofluorescence, western blot analysis, and ELISA are conducted. We find that Huperzine A can improve neurological deficits and inhibit the apoptosis of nerve cells in SAH rats. Huperzine A treatment can improve the upregulation of brain water content, damage of blood-brain barrier, fibrinogen and matrix metalloprotein 9 expressions and the downregulation of ZO-1 and occludin expressions induced by SAH. Huperzine A inhibit the expressions of proteins involved in pyroptosis in endothelial cells in SAH rats. The increase in MDA content and decrease in SOD activity in SAH rats can be partly reversed by Huperzine A. The ROS inducer H 2O 2 can induce pyroptosis and inhibit the expressions of ZO-1 and occludin in endothelial cells, which can be blocked by Huperzine A. In addition, the increase in the entry of p65 into the nucleus in endothelial cells can be partly reversed by Huperzine A. Huperzine A may delay the damage of blood-brain barrier in SAH rats by inhibiting oxidative stress-mediated pyroptosis and tight junction protein expression downregulation through the NF-κB pathway. Overall, Huperzine A may have clinical value for treating SAH.

Pain Intensity and Satisfaction of Pain Relief in Discharged Cancer Patients: A Large Sample Study in China.

BACKGROUND: Many studies have focused on the quality of pain management in hospitalized patients with cancer pain, while what happens after discharge remains unclear. AIM: The purpose of this study was to investigate the pain intensity and satisfaction of pain relief among a large sample of Chinese patients with cancer pain after discharge. DESIGN: Cross-sectional, descriptive, correlational research. SETTINGS AND SAMPLE: ABOUT: 1,013 patients were recruited in a tertiary cancer hospital, and their residence addresses were distributed in 6 geographical regions, including 26 provinces, municipalities, and autonomous regions. METHODS: The 1,013 patients with cancer pain were discharged from the wards of a national cancer hospital in China from July 2020 to October 2021. A nurse in the pain clinic followed the patients based on a whole-process information system and collected the data after the cancer pain patients were discharged. The study methods followed the STROBE guidelines. RESULTS: The average age of 1,013 discharged patients was 61.30 (±12.56) years. Moderate and severe background pain (BGP) was reported in 749 patients (73.94%), and more than 3 instances of breakthrough pain (BTP) in the past 24 hours were reported in 541 patients (53.41%). More severe BGP was associated with more frequent BTP (p < .01). In addition, there were 572 patients (56.47%) whose satisfaction with pain relief was lower than 70%. More severe BGP was associated with a lower satisfaction degree (r = -0.796, p < .01). CONCLUSIONS: Pain among discharged Chinese patients with cancer is poorly managed, and there is a low degree of satisfaction with pain relief. Nurses can do more work to assist cancer patients in managing pain more effectively by ensuring they have a plan to report and manage pain after discharge.

Cu-Co Dual-Atom Catalysts Supported on Hierarchical USY Zeolites for an Efficient Cross-Dehydrogenative C(sp2)-N Coupling Reaction.

A cross-coupling reaction via the dehydrogenative route over heterogeneous solid atomic catalysts offers practical solutions toward an economical and sustainable elaboration of simple organic substrates. The current utilization of this technology is, however, hampered by limited molecular definition of many solid catalysts. Here, we report the development of Cu-M dual-atom catalysts (where M = Co, Ni, Cu, and Zn) supported on a hierarchical USY zeolite to mediate efficient dehydrogenative cross-coupling of unprotected phenols with amine partners. Over 80% isolated yields have been attained over Cu-Co-USY, which shows much superior reactivity when compared with our Cu1 and other Cu-M analogues. This amination reaction has hence involved simple and non-forceful reaction condition requirements. The superior reactivity can be attributed to (1) the specifically designed bimetallic Cu-Co active sites within the micropore for "co-adsorption-co-activation" of the reaction substrates and (2) the facile intracrystalline (meso/micropore) diffusion of the heterocyclic organic substrates. This study offers critical insights into the engineering of next-generation solid atomic catalysts with complex reaction steps.

Temporal change of serum xanthine oxidase levels and its relation to clinical outcome of severe traumatic brain injury: a prospective cohort study.

Xanthine oxidase (XO) may be involved in the induction of oxidative stress and inflammation. We measured serum XO levels at multiple days to determine whether it is associated with the severity and prognosis of severe traumatic brain injury (sTBI). In this prospective cohort study, we quantified serum XO levels in 112 sTBI patients and 112 controls. Serum XO levels of patients were measured at admission and at days 1, 3, 5, 7, and 10 after sTBI. Extended Glasgow outcome scale scores of 1-4 at post-trauma 180 days were defined as a poor prognosis. Multivariate analysis was employed to determine the relationship between poor prognosis and serum XO levels at multiple days. Serum XO levels were significantly increased at admission among patients, afterwards elevated gradually, peaked at day 3, and then diminished gradually until day 10, and were substantially higher during 10 days in patients than in controls. Serum XO levels at 6 different days were all correlated with admission Rotterdam computed tomography (CT) scores and Glasgow coma scale (GCS) scores. Serum XO levels at 6 different days were all substantially higher in patients with poor prognosis than in those with good prognosis. Serum XO levels at days 7 and 10, but not at days 1, 3, and 5, had significantly lower area under receiver operating characteristic (AUC) than those at admission. Serum XO levels at admission and at days 1 and 3, but not at day 5, were independently associated with 180-day poor prognosis. Prognostic prediction model containing GCS scores, Rotterdam CT scores, and serum XO levels at admission (or at days 1 and 3) showed substantially higher AUC than GCS scores and Rotterdam CT scores alone. The models were visually described using nomograms, which were comparatively stable under calibration curve and were relatively of clinical benefit under decision curve. Elevated serum XO levels during early period of sTBI are more closely associated with trauma severity and clinical adverse outcomes, assuming that serum XO may serve as a potential prognostic biomarker in sTBI.

Alteration of the cortical morphology in classical trigeminal neuralgia: voxel-, deformation-, and surface-based analysis.

OBJECTIVE: This study aimed to combine voxel-based morphometry, deformation-based morphometry, and surface-based morphometry to analyze gray matter volume and cortex shape in classical trigeminal neuralgia patients. METHODS: This study included 79 classical trigeminal neuralgia patients and age- and sex-matched 81 healthy controls. The aforementioned three methods were used to analyze brain structure in classical trigeminal neuralgia patients. Spearman correlation analysis was used to analyze the correlation of brain structure with the trigeminal nerve and clinical parameters. RESULTS: The bilateral trigeminal nerve was atrophied, and the ipsilateral trigeminal nerve volume was smaller than the contralateral volume in the classical trigeminal neuralgia. The gray matter volume of Temporal_Pole_Sup_R and Precentral_R was found to be decreased using voxel-based morphometry. The gray matter volume of Temporal_Pole_Sup_R had a positive correlation with disease duration and a negative correlation with the cross-section area of the compression point and the quality-of-life score in trigeminal neuralgia. The gray matter volume of Precentral_R was negatively correlated with the ipsilateral volume of the trigeminal nerve cisternal segment, cross-section area of compression point, and visual analogue scale. The gray matter volume of Temporal_Pole_Sup_L was found to be increased using deformation-based morphometry and had a negative correlation with the self-rating anxiety scale. The gyrification of the middle temporal gyrus_L increased and the Postcentral_L thickness decreased, as detected using surface-based morphometry. CONCLUSIONS: The gray matter volume and cortical morphology of pain-related brain regions were correlated with clinical and trigeminal nerve parameters. voxel-based morphometry, deformation-based morphometry, and surface-based morphometry complemented each other in analyzing the brain structures of patients with classical trigeminal neuralgia and provided a basis for studying the pathophysiology of classical trigeminal neuralgia.

Ambient air pollution and epileptic seizures: A panel study in Australia.

OBJECTIVE: Emerging evidence has shown that ambient air pollution affects brain health, but little is known about its effect on epileptic seizures. This work aimed to assess the association between daily exposure to ambient air pollution and the risk of epileptic seizures. METHODS: This study used epileptic seizure data from two independent data sources (NeuroVista and Seer App seizure diary). In the NeuroVista data set, 3273 seizures were recorded using intracranial electroencephalography (iEEG) from 15 participants with refractory focal epilepsy in Australia in 2010-2012. In the seizure diary data set, 3419 self-reported seizures were collected through a mobile application from 34 participants with epilepsy in Australia in 2018-2021. Daily average concentrations of carbon monoxide (CO), nitrogen dioxide (NO2 ), ozone (O3 ), particulate matter ≤10 µm in diameter (PM10 ), and sulfur dioxide (SO2 ) were retrieved from the Environment Protection Authority (EPA) based on participants' postcodes. A patient-time-stratified case-crossover design with the conditional Poisson regression model was used to determine the associations between air pollutants and epileptic seizures. RESULTS: A significant association between CO concentrations and epileptic seizure risks was observed, with an increased seizure risk of 4% (relative risk [RR]: 1.04, 95% confidence interval [CI]: 1.01-1.07) for an interquartile range (IQR) increase of CO concentrations (0.13 parts per million), whereas no significant associations were found for the other four air pollutants in the whole study population. Female participants had a significantly increased risk of seizures when exposed to elevated CO and NO2 , with RRs of 1.05 (95% CI: 1.01-1.08) and 1.09 (95% CI: 1.01-1.16), respectively. In addition, a significant association was observed between CO and the risk of subclinical seizures (RR: 1.20, 95% CI: 1.12-1.28). SIGNIFICANCE: Daily exposure to elevated CO concentrations may be associated with an increased risk of epileptic seizures, especially for subclinical seizures.

Intermolecular C-H Aminocyanation of Indoles via Copper-iodine Cocatalyzed Tandem C-N/C-C Bond Formation.

An efficient copper-iodine cocatalyzed intermolecular C-H aminocyanation of indoles with a broad substrate scope has been developed for the first time. This method enables highly step-economic access to 2-amino-3-cyanoindoles in moderate to good yields and provides a complementary strategy for the regioselective difunctionalization of carbon═carbon double bonds of interest in organic synthesis and related areas. Mechanistic studies suggest that these transformations are initiated by iodine-mediated C2-H amination with azoles, followed by copper-catalyzed C3-H cyanation with ethyl cyanoformate.

Pain knowledge of patients and family caregivers as predictors of pain management outcomes in cancer patients: a multicenter study in China.

PURPOSE: The purposes of this study were to evaluate the current situation of pain management outcomes, patients' pain knowledge, and family caregivers' pain knowledge in China and explore the impact of pain knowledge of patients and family caregivers on pain management outcomes. METHODS: A total of 410 patient-family caregiver dyads were assessed by Brief Pain Inventory (BPI), the Pain Knowledge subscales of Patient Pain Questionnaire (PPQ), and Family Pain Questionnaire (FPQ). The difference in pain management outcomes was analyzed using bivariate analysis first, and then variables with statistical significance in bivariate analysis were included in multivariable linear regression analysis. RESULTS: The average patient pain score in the last 24 h was 3.23 (SD = 2.16). The total average scores on pain knowledge of 410 patients and family caregivers were 3.60 ± 1.90 and 3.57 ± 1.76. Multivariable linear regression analysis showed taking strong opioids, patients' perceived moderate health status, patients' pain knowledge, and family caregivers' pain knowledge were the main factors influencing the pain management outcomes. CONCLUSION: Pain knowledge of patients and family caregivers were important indicators of pain management outcomes, indicating tailored cancer pain education program should be developed.

Economic burden of premature deaths attributable to non-optimum temperatures in Italy: A nationwide time-series analysis from 2015 to 2019.

BACKGROUND: Human beings and society are experiencing substantial consequences caused by non-optimum temperatures. However, limited studies have assessed the economic burden of premature deaths attributable to non-optimum temperatures. OBJECTIVES: To characterize the association between daily mean temperature and the economic burden of premature deaths. METHODS: A total of 3 228 098 deaths were identified from a national mortality dataset in Italy during 2015 and 2019. We used the value of statistical life to quantify the economic losses of premature death. A two-stage time-series analysis was performed to evaluate the economic losses of premature deaths associated with non-optimum temperatures. Attributable burden for non-optimum temperatures compared with minimum risk temperature were estimated. Potential effect modifiers were further explored. RESULTS: From 2015 to 2019, the economic loss of premature deaths due to non-optimum temperatures was $525.52 billion (95% CI: $461.84-$580.80 billion), with the attributable fraction of 5.74% (95% CI: 5.04%-6.34%). Attributable economic burden was largely due to moderate cold temperatures ($309.54 billion, 95% CI: $249.49-$357.34 billion). A higher economic burden was observed for people above the age of 65, accounting for 75.97% ($452.42, 95%CI: $406.97-$488.76 billion) of the total economic burden. In particular, higher fractions attributable to heat temperatures were observed for provinces with the lowest level of GDP per capita but the highest level of urbanization. DISCUSSION: This study shows a considerable economic burden of premature deaths attributed to non-optimum temperatures. These figures can help inform tailored prevention to tackle the large economic burden imposed by non-optimum temperatures.

Destabilizing LSD1 by Jade-2 promotes neurogenesis: an antibraking system in neural development.

Histone H3K4 demethylase LSD1 plays an important role in stem cell biology, especially in the maintenance of the silencing of differentiation genes. However, how the function of LSD1 is regulated and the differentiation genes are derepressed are not understood. Here, we report that elimination of LSD1 promotes embryonic stem cell (ESC) differentiation toward neural lineage. We showed that the destabilization of LSD1 occurs posttranscriptionally via the ubiquitin-proteasome pathway by an E3 ubiquitin ligase, Jade-2. We demonstrated that Jade-2 is a major LSD1 negative regulator during neurogenesis in vitro and in vivo in both mouse developing cerebral cortices and zebra fish embryos. Apparently, Jade-2-mediated degradation of LSD1 acts as an antibraking system and serves as a quick adaptive mechanism for re-establishing epigenetic landscape without more laborious transcriptional regulations. As a potential anticancer strategy, Jade-2-mediated LSD1 degradation could potentially be used in neuroblastoma cells to induce differentiation toward postmitotic neurons.

Short-term exposure to ozone and economic burden of premature mortality in Italy: A nationwide observation study.

Italy is among the countries with the highest ozone concentration in Europe. However, the mortality burden of ozone and related economic loss has not been fully characterized. This study aimed to estimate the ozone-mortality association in Italy and evaluate attributable mortality burden and related economic loss in 2015-2019. We collected daily all-cause mortality data stratified by age and sex from 2015 to 2019 in 107 provinces of Italy. A two-stage time-series framework was applied to estimate the association between daily maximum eight-hour average ozone and mortality as well as economic loss. An overall increase in the risk of mortality (RR=1.0043, 95% CI: 1.0029, 1.0057) was associated with every 10 µg/m3 increase in ozone. Generally, a total of 70,060 deaths and $65 billion economic loss were attributed to ozone exposure, corresponding to 3.11% of mortality and about 0.5% of the national GDP during the study period, respectively. The highest ozone-related mortality burden (30,910 deaths) and economic loss ($29.24 billion) were observed in the hot season. This nationwide study suggested considerable mortality burden and economic loss were associated with exposure to ozone. More actions and policies should be proposed to reduce ozone levels and help the public protect their health.

The Consistency Factor and the Viscosity Exponent of Soybean-Protein-Isolate/Wheat-Gluten/Corn-Starch Blends by Using a Capillary Rheometry.

Blends with different proportions of protein or starch show different rheological behaviors, which may be related to the fibrous structure formation of extruded textured plant proteins. The consistency factor K and the viscosity exponent n of soybean-protein-isolate (SPI)/wheat-gluten (WG)/corn-starch (CS) blends were investigated through capillary rheometry. All blends exhibited shear-thinning behavior at 80 °C and 50% moisture. The CS content in SPI/CS blends or WG content in SPI/WG blends showed a positive relation to the viscosity exponent n and a negative relation to the consistency factor K. However, there was no correlation between the CS content in WG/CS blends and n or K. The coefficient of determination of the linear relationship between K and mass fraction in SPI/CS, SPI/WG/CS, SPI/WG and WG/CS decreased from 0.872 to 0.073. SPI was more likely to form a non-interactive structure, while wheat-gluten was more likely to form a highly interactive structure. It turned out that the materials with globular morphology, such as soybean-protein-isolate and corn-starch, are likely to form a non-interactive structure.

Amplitude of low-frequency fluctuation after a single-trigger pain in patients with classical trigeminal neuralgia.

OBJECTIVE: This study aimed to explore the central mechanism of classical trigeminal neuralgia (CTN) by analyzing the static amplitude of low-frequency fluctuation (sALFF) and dynamic amplitude of low-frequency fluctuation (dALFF) in patients with CTN before and after a single-trigger pain. METHODS: This study included 48 patients (37 women and 11 men, age 55.65 ± 11.41 years) with CTN. All participants underwent 3D-T1WI and three times resting-state functional magnetic resonance imaging. The images were taken before stimulating the trigger zone (baseline), within 5 s after stimulating the trigger zone (triggering-5 s), and in the 30th minute after stimulating the trigger zone (triggering-30 min). The differences between the three measurements were analyzed using a repeated-measures analysis of variance. RESULTS: The sALFF values of the bilateral middle occipital gyrus and right cuneus gradually increased, and the values of the left posterior cingulum gyrus and bilateral superior frontal gyrus gradually decreased in triggering-5 s and triggering-30 min. The values of the right middle temporal gyrus and right thalamus decreased in triggering-5 s and subsequently increased in triggering-30 min. The sALFF values of the left superior temporal gyrus increased in triggering-5 s and then decreased in triggering-30 min. The dALFF values of the right fusiform gyrus, bilateral lingual gyrus, left middle temporal gyrus, and right cuneus gyrus gradually increased in both triggering-5 s and triggering-30 min. CONCLUSIONS: The sALFF and dALFF values changed differently in multiple brain regions in triggering-5 s and triggering-30 min of CTN patients after a single trigger of pain, and dALFF is complementary to sALFF. The results might help explore the therapeutic targets for relieving pain and improving the quality of life of patients with CTN.

Structural Equation Model of Factors Related to Death Anxiety for Chinese Patients with Cancer.

This study aimed to develop a model that specifies the predictive effects of factors on death anxiety among Chinese patients with cancer using structural equation modeling. Using convenience sampling, data were collected from 353 cancer patients. Self-administered questionnaires included Social Support Rating Scale, Rosenberg Self-Esteem Scale, Connor Davidson Resilience Scale, Templer's Death Anxiety Scale, and socio-demographic factors. The results showed that social support, self-esteem, and resilience significantly impacted death anxiety. The final model fitted the data acceptably (χ2 = 37.319, df =31, p = 0.201). Social support mediated death anxiety through self-esteem and resilience. Resilience mediated the buffer effect of self-esteem on death anxiety as an intermediary factor. Findings suggest the need for further studies to explore effective interventions to provide social support and improve self-esteem and resilience among patients with cancer to alleviate death anxiety.

Congruence of cancer pain experience between patients and family caregivers and associated factors: a multicenter cross-sectional study in China.

PURPOSE: The purposes of this study were to determine whether there were differences in the cancer pain experience between patients and family caregivers (FCGs) and to explore the associated factors that influence cancer pain experience congruence. METHODS: A multicenter cross-sectional study was conducted. A total of 410 patient-family caregiver dyads completed face-to-face surveys, including information about basic characteristics, the Patient Pain Questionnaire (PPQ), and the Family Pain Questionnaire (FPQ). The difference in cancer pain experience between patients and family caregivers was analyzed using a paired t test. Indicators for the congruence of cancer pain experience were analyzed using the chi-square test and two independent-sample t tests for bivariate analysis and multivariate binary logistic regression analysis. RESULTS: Of the patients, 57.1% were men, and 60.7% perceived moderate performance status. The majority of the family caregivers was female (54.9%). The mean (SD) score on the pain experience subscale was 4.82 (1.66) for 410 patients and 5.02 (1.66) for 410 family caregivers. The difference was significant (P < 0.01). Additionally, 87 (21.2%) dyads were in the congruent group, and 323 (78.8%) dyads were in the incongruent group. Patients' self-perceived moderate performance status (OR = 2.983, P < 0.01) and family caregivers' pain knowledge (OR = 1.171, P < 0.05) were the main factors influencing the congruence of cancer pain experience. CONCLUSION: The findings of this study indicate that family caregivers reported significantly worse cancer pain experiences than patients. Family caregivers' pain knowledge was a primary influencing factor. It is suggested that educational interventions aimed at teaching family caregivers and patients how to communicate their pain experience and improving the knowledge of family members regarding pain and its management may help in aligning their perceptions and thereby contribute to better quality of life and pain management outcomes.