Summary of evidence on comprehensive healthcare for chemotherapy-induced peripheral neuropathy in cancer patients.

OBJECTIVE: This paper aims to provide an evidence-based summary of the most effective strategies for comprehensive healthcare of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. METHOD: Following the "6S" model, relevant evidence on CIPN management was collected from reputable evidence-based resource websites and databases nationally and internationally. The included articles were evaluated for methodological quality, and evidence was extracted using the Australian JBI Evidence-based Health Care Center's literature evaluation standard (2016 edition). RESULTS: A total of 60 articles were included in this study, comprising 2 guidelines, 5 expert consensus statements, and 53 systematic reviews. The findings of these articles were summarized across 7 dimensions, including risk factor screening, assessment, diagnosis, prevention, treatment, management, and health education, resulting in the identification of 42 relevant pieces of evidence. CONCLUSIONS: This study provides a comprehensive synthesis of evidence-based recommendations for managing CIPN in cancer patients, offering guidance for healthcare professionals engaged in clinical practice. However, when implementing these recommendations, it is crucial to consider the individual patient's clinical circumstances, preferences, and expert judgment, ensuring feasibility and applicability in real-world clinical settings.

Case report: Metastatic choriocarcinoma in the second trimester of a viable pregnancy with successful delivery and outcome after chemotherapy.

Metastatic choriocarcinoma during viable pregnancy is rare worldwide, and neonate survival following pregnancy termination in the second trimester is uncommon. Here, we report the successful delivery of a pregnancy by a patient with metastatic choriocarcinoma, who received three courses of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMA-CO) chemotherapy in the second trimester. After multidisciplinary discussions, she was administered paclitaxel and carboplatin (TC) chemotherapy. Regular contractions occurred during her first paclitaxel infusion, and a healthy infant was delivered by cesarean section at 26+4 gestational weeks. Choriocarcinoma was not detected in the placenta. Following delivery of the pregnancy, the patient underwent total treatment comprising one cycle of TC, seven cycles of EMA-CO, and five courses of etoposide, cisplatin, methotrexate, and dactinomycin chemotherapy; her serum level of beta-human chorionic gonadotropin gradually fell after chemotherapy. Uterine and pulmonary metastases shrank, and no distant metastasis or recurrence were found until the eighth course of maintenance treatment with immunotherapy. The patient received periodic chemotherapy for recurrence at the time of publishing this case report. The child was disease-free 15+ months after delivery. Despite serious metastases and complications, metastatic choriocarcinoma diagnosed in the second trimester of pregnancy can be successfully treated with minimal delay by multidisciplinary medical and nursing management.

Construction and evaluation of a cloud follow-up platform for gynecological patients receiving chemotherapy.

BACKGROUND: Patient follow-up is an essential component of hospital management. In the current information era, the patient follow-up scheme is expected to be replaced by Internet technology. This study constructed a cloud follow-up platform for gynecological chemotherapy patients and assessed its cost-effectiveness and patients' feedback. METHODS: A total of 2,538 patients were followed up using a cloud follow-up system between January and October 2021. Prior to this, 690 patients were followed manually via telephone calls. Patients' characteristics, follow-up rate, satisfaction, and session duration were compared between the cloud follow-up and manual follow-up groups. In addition, the read rate of health education materials in the cloud follow-up group was analyzed. RESULTS: General information, including age, education attainment, cancer stage, and disease category, and follow-up rate (cloud: 6,957/7,614, 91.4%; manual: 1,869/2,070, 90.3%; P = 0.13) did not significantly differ between the two groups. The follow-up satisfaction of the cloud follow-up patients was significantly better than that of the manual follow-up group (cloud: 7,192/7,614, 94.5%; manual: 1,532/2,070, 74.0%; P<0.001). The time spent on the follow-up was approximately 1.2 h for 100 patients in the cloud follow-up group and 10.5 h in the manual follow-up group. Multivariate analysis indicated that the cloud follow-up group had significantly greater follow-up satisfaction (odds ratio: 2.239, 95% CI: 1.237 ~ 5.219). Additionally, the average follow-up duration of the cloud follow-up group decreased by 9.287 h (coefficient: -9.287, 95% CI: -1.439~-0.165). The read rate of health education materials was 72.9% in the cloud follow-up group. CONCLUSIONS: The follow-up effect of the cloud follow-up group was not inferior to that of the manual follow-up group. The cloud follow-up was more effective for prevention and control requirements in the post-epidemic era. Cloud follow-up can save medical resources, improve cost-effectiveness, provide sufficient health education resources for patients, and improve their satisfaction.

Mesoporous TiO2 Single-Crystal Particles from Controlled Crystallization-Driven Mono-Micelle Assembly as an Efficient Photocatalyst.

Mesoporous materials with crystalline frameworks have been widely explored in many fields due to their unique structure and crystalline feature, but accurate manipulations over crystalline scaffolds, mainly composed of uncontrolled polymorphs, are still lacking. Herein, we explored a controlled crystallization-driven monomicelle assembly approach to construct a type of uniform mesoporous TiO2 particles with atomically aligned single-crystal frameworks. The resultant mesoporous TiO2 single-crystal particles possess an angular shape ∼80 nm in diameter, good mesoporosity (a high surface area of 112 m2 g-1 and a mean pore size at 8.3 nm), and highly oriented anatase frameworks. By adjusting the evaporation rate during assembly, such a facile solution-processed strategy further enables the regulation of the particle size and mesopore size without the destruction of the oriented crystallites. Such a combination of ordered mesoporosity and crystalline orientation provides both effective mass and charge transportation, leading to a significant increase in the hydrogen generation rate. A maximum hydrogen evolution rate of 12.5 mmol g-1 h-1 can be realized, along with great stability under solar light. Our study is envisaged to extend the possibility of mesoporous single crystal growth to a range of functional ceramics and semiconductors toward advanced applications.

Explore the use of complementary and alternative medicine among Chinese gynaecological patients with cancer undergoing chemotherapy: a qualitative phenomenological study.

OBJECTIVES: To explore the use of complementary and alternative medicine (CAM) by Chinese gynaecological oncology patients undergoing chemotherapy and discuss measures to address the existing gaps. DESIGN: Qualitative phenomenology. Semistructured in-depth interview. Colaizzi's method data analysis. SETTING: A tertiary general hospital. PARTICIPANTS: 16 gynaecological oncology patients (mean age 51.7) having undergone ≥1 chemotherapy cycle were recruited by purposive sampling. RESULTS: Six themes were generated. The participants were under-informed about CAM concept and options. They were open to explore various modalities after chemotherapy as long as it could alleviate symptoms. The gynaecological patients with cancer sought information about CAM from diverse sources, with professional expertise being the most desirable way to seek information. They used CAM as a strategy to support continued chemotherapy and for symptom alleviation. Financial burden was not stressed but they had concerns about sustainability of some therapies. Their attitudes toward different CAM types varied. Some were sceptical about the efficacy. CONCLUSIONS: The Chinese gynaecological oncology patients may be under-informed about CAM. They are open to use various CAM therapies for symptom relief and as a support strategy. However, their attitudes toward specific therapies may vary. Some may host scepticism about certain CAM modalities. The patients actively seek information on CAM and treatment resources but prefer professional expertise to other sources. Financial burden due to continued CAM use is inconclusive due to possible sampling bias. Sustainability of CAM therapies is a common concern because of limited resources and access. Education on CAM should be incorporated into the curriculum of healthcare professionals. Oncologists and nurses should educate gynaecological patients with cancer on the concept and options of CAM, preferably with information tailored to patient's individual needs. Health authorities should advocate provisions of diverse CAM services and develop the necessary technologies such as network of local care resources.

Construction of Type-II Heterojunctions in Crystalline Carbon Nitride for Efficient Photocatalytic H2 Evolution.

As an encouraging photocatalyst, crystalline carbon nitride (CCN) exhibits unsatisfactory photocatalytic activity and stability due to its rapid recombination of photo-generative carriers. Herein, high-crystalline g-C3N4 was prepared, including CCN obtained in KCl (K-CCN), LiCl-KCl mixture (Li/K-CCN), and LiCl-NaCl-KCl mixture (Li/Na/K-CCN), via the molten salt strategy using pre-prepared bulk carbon nitride (BCN) as a precursor. The obtained BCN sample was formed by heptazine-based units, which convert into triazine-based units for K-CCN. Heptazine and triazine are two isotypes that co-exist in the Li/K-CCN and Li/Na/K-CCN samples. Compared with BCN and other CCN samples, the as-prepared Li/Na/K-CCN sample exhibited the optimal photocatalytic hydrogen evolution rates (3.38 mmol·g-1·h-1 under simulated sunlight and 2.25 mmol·g-1·h-1 under visible light) and the highest apparent quantum yield (10.97%). The improved photocatalytic performance of the Li/Na/K-CCN sample is mainly attributed to the construction of type-II heterojunction and the institution of the built-in electric field between triazine-based CCN and heptazine-based BCN. This work provides a new strategy for the structural optimization and heterostructure construction of crystalline carbon nitride photocatalysts.

A two-sample mendelian randomization analysis investigates associations between gut microbiota and infertility.

Observational studies have provided evidence of a correlation between alterations in gut microbiota composition and infertility. However, concrete proof supporting the causal relationship is still lacking. We performed a Mendelian randomization study to assess whether genetically gut microbiota composition influences the risk of infertility. The genetic data pertaining to gut microbiota were obtained from a genome-wide association study meta-analysis, which was conducted among 24 cohorts (18,340 participants) from the international MiBioGen consortium. By the primary method of assessing causality, we have identified 2 family taxa, 2 genus taxa, and 1 order taxa that were linked to a low risk of male infertility, while 1 genus taxa were associated with a high risk of male infertility. Furthermore, we have discovered 6 genus taxa, 1 phylum taxa, 1 class taxa, 1 order taxa, and 1 family taxa that were associated with a low risk of female infertility, while 1 genus taxa were linked to a high risk of female infertility. This study successfully confirmed that there was a causal link between gut microbiota and infertility. The identification of these specific strains through genetic prediction offers a valuable insight for early diagnosis, prevention, and treatment of infertility.

Professional Nursing Practice Environment and Work Engagement: The Mediating Roles of Self-Efficacy and Achievement Motivation.

BACKGROUND: The shortage of nurses is a global problem. Increasing the level of work engagement is known to effectively reduce turnover rate among nursing staff. Strategies to improve work engagement based on the job demands-resources model may effectively improve nurses' job satisfaction and reduce staff turnover. PURPOSE: A job demands-resources model was used in this study to test the hypothesis that work engagement is affected by both external resources (professional nursing practice environment) and internal resources (self-efficacy and achievement motivation). In addition, the mediating role of self-efficacy and achievement motivation in the relationship between professional nursing practice environment and work engagement was also verified. METHODS: A cross-sectional survey employing a convenience sampling design was implemented. Five hundred fifteen registered nurses were recruited from four tertiary hospitals in Chengdu, China, from January to June 2020. The Practice Environment Scale of the Nursing Work Index, General Self-Efficacy Scale, Achievement Motive Scale, and Utrecht Work Engagement Scale were used to measure the four variables. RESULTS: The results of the structural equation model showed that the degree of fit for each index model was good, indicating that all of the three variables, including professional nursing practice environment, self-efficacy, and achievement motivation, directly affected work engagement. In addition, the variable professional nursing practice environment was found to indirectly influence work engagement through the partial mediation of self-efficacy and achievement motivation. CONCLUSIONS: The results may be used to guide health policymakers and nurse managers attempting to enhance the work engagement of nurses by providing a supportive working environment, improving the welfare mechanism, formulating a talent training plan, and fostering appropriate empowerment to improve the working environment, self-efficacy, and motivation in nurses.

Longitudinal Change in Symptom Clusters in Patients With Ovarian Cancer.

BACKGROUND: The symptoms of patients with ovarian cancer at a specific time point during the treatment process have been investigated in previous studies. However, only a few longitudinal studies have been conducted in China to determine the symptom cluster of patients with ovarian cancer before surgery, after surgery, and during the initial stage of chemotherapy. PURPOSE: This study was carried out to identify the symptom clusters in patients with ovarian cancer at different stages of treatment. METHODS: A longitudinal survey was designed, and 430 patients with ovarian cancer who had undergone surgical operation combined with chemotherapy were recruited as participants. Exploratory factor analysis was conducted to identify the components of symptom cluster at three different time points: 3 days before surgery (T1), 2 days after surgery (T2), and the first day after the completion of chemotherapy cycle 1 (T3). RESULTS: The symptom clusters varied across the three time points. Notably, the pain-related, emotional, cognitive, and disease-related symptom clusters occurred at T1 and persisted through T2 and T3; the treatment-related symptom cluster occurred at T2 and persisted through T3; and the numbness symptom and gastrointestinal symptom clusters were observed at T3. CONCLUSIONS: Priority symptom management interventions should be provided according to the most severe symptom clusters such as the emotional symptom cluster at T1, the treatment-related symptom cluster at T2, and the gastrointestinal symptom cluster at T3.

Parents' and Guardians' Willingness to Vaccinate Their Children against COVID-19: A Systematic Review and Meta-Analysis.

COVID-19 vaccination for children is crucial to achieve herd immunity. This is the first systematic review and meta-analysis to estimate parents' and guardians' willingness to vaccinate their children against COVID-19 and identify the determinants of vaccination intention. Systematic research was performed on the two databases (PubMed and EMBASE) from inception to 6 November 2021. Acceptance rates were pooled by use of a random-effects model and all predictors of vaccine acceptance were identified according to the health belief model (HBM) framework. This analysis was registered with PROSPERO (CRD42021292326) and reported in compliance with the PRISMA guidelines. Of 452 identified records, 29 eligible studies were included (N = 68,327 participants). The estimated worldwide vaccination acceptance rate was 61.40% (95% CI: 53.56-68.69%, I2 = 99.3%), ranging from 21.6% to 91.4% across countries and regions. In the determinant assessment, the age of parents and guardians, access to scientific information and recommendations, routine and influenza vaccination behavior, and the willingness of parents and guardians to vaccinate themselves were potentially significant predictors of the vaccination willingness. Given the limited quality and quantity of included articles, future studies with a rigorous design will be necessary for the confirmation of our findings.

Effects of 16-Form Wheelchair Tai Chi on the Autonomic Nervous System among Patients with Spinal Cord Injury.

OBJECTIVE: This study aims to investigate the effects of 16-form Wheelchair Tai Chi (WCTC16) on the autonomic nervous system among patients with spinal cord injury (SCI). METHODS: Twenty patients with chronic complete thoracic SCI were recruited. Equivital life monitoring system was used to record and analyze heart rate variability (HRV) of patients for five minutes before and after five consecutive sets of WCTC16, respectively. The analysis of HRV in the time domain included RR intervals, the standard deviation of all normal RR intervals (SDNN), and the root mean square of the differences between adjacent NN intervals (RMSSD). The analysis of HRV in the frequency domain included total power (TP), which could be divided into very-low-frequency area (VLFP), low-frequency area (LFP), and high-frequency area (HFP). The LF/HF ratio as well as the normalized units of LFP (LFPnu) and HFP (HFPnu) reflected the sympathovagal balance. RESULTS: There was no significant difference in RR interval, SDNN, RMSSD, TP, HEP, VLFP, and LFP of SCI patients before and after WCTC16 exercise (P > 0.05). LFPnu and HF peak decreased, while HFPnu and LF/HF increased in SCI patients after WCTC16 exercise. The differences were statistically significant (P < 0.001). CONCLUSION: WCTC16 can enhance vagal activity and decrease sympathetic activity so that patients with chronic complete thoracic SCI can achieve the balanced sympathovagal tone.

Informal caregiver burden and influencing factors in gynaecological oncology patients hospitalized for chemotherapy: a cross-sectional study.

OBJECTIVE: To determine the level and influencing factors of informal caregiver burden in gynaecological oncology inpatients receiving chemotherapy. METHODS: This cross-sectional study enrolled gynaecological oncology patients and their informal caregivers between May 2018 and November 2018 and measured the caregivers' burden using the Caregiver Burden Inventory. The influencing factors were evaluated with univariate regression analysis and multivariate linear stepwise regression analysis. RESULTS: A total of 138 patients and their informal caregivers completed the questionnaire. The mean ± SD total informal caregiver burden score was 53.18 ± 10.97. The highest mean ± SD score was recorded in the dimension of time-dependent burden (14.28 ± 2.74), followed by developmental burden (13.65 ± 2.15), physical burden (10.52 ± 2.07), social burden (7.61 ± 2.58) and emotional burden (7.12 ± 1.43). Multivariate analysis showed that the informal caregiver's sex, relationship to the patient, daily duration of care, presence of chronic health problems and the duration of the patient's disease were factors influencing the level of caregiver burden. CONCLUSIONS: The informal caregivers of gynaecological cancer patients hospitalized for chemotherapy experience a moderate level of burden. Nursing measures should be considered to reduce informal caregiver burden and improve the quality of lives of both patients and their caregivers.

Effects of oligopeptide simulating DMP-1/mineral trioxide aggregate/agarose hydrogel biomimetic mineralisation model for the treatment of dentine hypersensitivity.

Dentine hypersensitivity (DH) occurs when dentine is exposed to stimuli from the oral environment due to a lack of enamel or cementum. The use of biomimetic mineralisation in occluding exposed dentinal tubules and regenerating enamel-like tissues on dentine surfaces is preferred for a long-lasting treatment. In this study, we established a biomimetic mineralisation model composed of oligopeptide stimulating dentine matrix protein 1 (DMP-1), mineral trioxide aggregate (MTA) and an agarose hydrogel biomimetic mineralisation model (AHBMM); the proposed model is thus referred to as DMP-1@MTA@AHBMM. The effectiveness of DMP-1@MTA@AHBMM for the management of DH was analysed with scanning electron microscopy, energy dispersive X-ray spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy and a microhardness test. The use of DMP-1@MTA@AHBMM on a demineralised dentine surface occluded the dentinal tubules and regenerated an enamel-like tissue containing well-defined fluoridated hydroxyapatite crystals on the dentine surface. The microhardness of the regenerated enamel-like tissue was greater than that of the demineralised dentine. Therefore, DMP-1@MTA@AHBMM can be a promising method for the management of DH.