Exploring shared decision-making needs in lung cancer screening among high-risk groups and health care providers in China: a qualitative study.

BACKGROUND: The intricate balance between the advantages and risks of low-dose computed tomography (LDCT) impedes the utilization of lung cancer screening (LCS). Guiding shared decision-making (SDM) for well-informed choices regarding LCS is pivotal. There has been a notable increase in research related to SDM. However, these studies possess limitations. For example, they may ignore the identification of decision support and needs from the perspective of health care providers and high-risk groups. Additionally, these studies have not adequately addressed the complete SDM process, including pre-decisional needs, the decision-making process, and post-decision experiences. Furthermore, the East-West divide of SDM has been largely ignored. This study aimed to explore the decisional needs and support for shared decision-making for LCS among health care providers and high-risk groups in China. METHODS: Informed by the Ottawa Decision-Support Framework, we conducted qualitative, face-to-face in-depth interviews to explore shared decision-making among 30 lung cancer high-risk individuals and 9 health care providers. Content analysis was used for data analysis. RESULTS: We identified 4 decisional needs that impair shared decision-making: (1) LCS knowledge deficit; (2) inadequate supportive resources; (3) shared decision-making conceptual bias; and (4) delicate doctor-patient bonds. We identified 3 decision supports: (1) providing information throughout the LCS process; (2) providing shared decision-making decision coaching; and (3) providing decision tools. CONCLUSIONS: This study offers valuable insights into the decisional needs and support required to undergo LCS among high-risk individuals and perspectives from health care providers. Future studies should aim to design interventions that enhance the quality of shared decision-making by offering LCS information, decision tools for LCS, and decision coaching for shared decision-making (e.g., through community nurses). Simultaneously, it is crucial to assess individuals' needs for effective deliberation to prevent conflicts and regrets after arriving at a decision.

The effects of art-making intervention on mind-body and quality of life in adults with cancer: a systematic review and meta-analysis.

PURPOSE: To investigate the effectiveness of art-making interventions on physical and psychological outcomes, as well as quality of life (QOL), in adult patients with cancer. METHODS: Seven English-language databases (PubMed, Academic Search Premier, EMBASE, CINAHL, PsycINFO, The Cochrane Library, and Web of Science) and three Chinese-language databases (CNKI, WanFang, and VIP) were searched up to and including May 1, 2023. We used the Cochrane Risk of Bias tool 2.0 and the Risk of Bias in Non-Randomized Studies-of Interventions to evaluate the certainty of evidence. The data were analyzed using Review Manager software 5.4. The study protocol was registered with PROSPERO (CRD42022321471). RESULTS: The studies predominantly focused on visual art (n = 21), two specifically used performing art (n = 2), and five integrated both forms of art-making (n = 5). The pooled results showed that art-making significantly improved anxiety (SMD = - 1.12, 95% CI [- 1.43, - 0.81], p < 0.01), depression (SMD = - 0.91, 95% CI [- 1.16, - 0.65], p < 0.01), distress (SMD = - 1.19, 95% CI [- 1.43, - 0.95], p < 0.01), psychological well-being (SMD = 0.41, 95% CI [0.02, 0.80], p = 0.04), societal well-being (SMD = 0.29, 95% CI [0.04, 0.54], p = 0.03), nausea (SMD = - 1.81, 95% CI [- 2.84, - 0.78], p < 0.01), physical well-being (SMD = 0.11, 95% CI [0.02, 0.20], p = 0.02), and QOL (SMD = 0.81, 95% CI [0.29, 1.33], p < 0.01). However, it did not significantly improve fatigue (SMD = - 0.28, 95% CI [- 0.75, 0.19], p = 0.24) and pain (SMD = - 0.18, 95% CI [- 1.97, 1.60], p = 0.84) in patients with cancer. CONCLUSIONS: Art-making interventions may boost psychological well-being, physical symptoms, and QOL among patients with cancer. More robust studies are necessary to overcome methodological limitations and promote wider adoption of these interventions. TRIAL REGISTRATION: Prospero registration number: CRD42022321471.

Demoralization profiles and their association with depression and quality of life in Chinese patients with cancer: a latent class analysis.

PURPOSE: The study aimed to identify latent classes of demoralization and examine their associations with depression and quality of life (QOL) among patients with cancer. METHODS: Cross-sectional data from 874 patients with cancer from three tertiary hospitals in Fujian province were collected using a convenience sampling method. Demoralization, depression, and QOL were assessed using the Chinese version of the Demoralization Scale-II, Patient Health Questionnaire-9, and McGill Quality of Life Questionnaire. Latent class analysis was performed on demoralization profiles. Binary logistic regression and multiple stepwise linear regression were used to examine the identified classes' associations with depression and QOL. RESULTS: Three latent classes of demoralization were identified: the "low demoralization and emotional disturbance" class (Class 1; 49.6%); "moderate demoralization and meaninglessness" class (Class 2; 29.1%); and "high demoralization and existential despair" class (Class 3; 21.3%). The severity of depression increased and the levels of QOL decreased with the three classes of demoralization. Patients with cancer being depressed in Classes 1 and 2 were 0.128 and 0.018 times that of Class 3, respectively, whereas the magnitudes of decrease in QOL scores for Classes 2 and 3 were 0.378 and 0.629, respectively. CONCLUSION: This study revealed three heterogeneous classes of demoralization in Chinese patients with cancer and indicated that increased classes were associated with more severe depression and decreased QOL. Targeted, step-by-step psychological interventions should be developed and implemented according to the characteristics of each class of demoralization to effectively promote psychological well-being among patients with cancer.

TiO2 and Co Nanoparticle-Decorated Carbon Polyhedra as Efficient Sulfur Host for High-Performance Lithium-Sulfur Batteries.

Metal organic frameworks (MOFs)-derived porous carbon is proposed as a promising candidate to develop novel, tailorable structures as polysulfides immobilizers for lithium-sulfur batteries because of their high-efficiency electron conductive networks, open ion channels, and abundant central ions that can store a large amount of sulfur and trap the easily soluble polysulfides. However, most central ions in MOFs-derived carbon framework are encapsulated in the carbon matrix so that their exposures as active sites to adsorb polysulfides are limited. To resolve this issue, highly dispersed TiO2 nanoparticles are anchored into the cobalt-containing carbon polyhedras that are converted from ZIF-67. Such a type of TiO2 and Co nanoparticles-decorated carbon polyhedras (CCo/TiO2 ) provide more exposed active sites and much stronger chemical trapping for polysulfides, hence improving the sulfur utilization and enhancing reaction kinetics of sulfur-containing cathode simultaneously. The sulfur-containing carbon polyhedras decorated with TiO2 nanoparticles (S@CCo/TiO2 ) show a significantly improved cycling stability and rate capability, and deliver a discharge capacity of 32.9% higher than that of TiO2 -free S@CCo cathode at 837.5 mA g-1 after 200 cycles.

[Study on Sleep Staging Based on Support Vector Machines and Feature Selection in Single Channel Electroencephalogram].

Sleep electroencephalogram (EEG) is an important index in diagnosing sleep disorders and related diseases. Manual sleep staging is time-consuming and often influenced by subjective factors. Existing automatic sleep staging methods have high complexity and a low accuracy rate. A sleep staging method based on support vector machines (SVM) and feature selection using single channel EEG single is proposed in this paper. Thirty-eight features were extracted from the single channel EEG signal. Then based on the feature selection method F-Score's definition, it was extended to multiclass with an added eliminate factor in order to find proper features, which were used as SVM classifier inputs. The eliminate factor was adopted to reduce the negative interaction of features to the result. Research on the F-Score with an added eliminate factor was further accomplished with the data from a standard open source database and the results were compared with none feature selection and standard F-Score feature selection. The results showed that the present method could effectively improve the sleep staging accuracy and reduce the computation time.

Development and psychometric testing of the narrative nursing teaching effectiveness scale: A methodological study.

BACKGROUND: Narrative teaching is widely used in nursing education. However, there is currently a lack of valid and reliable tool to assess the effectiveness of narrative nursing teaching from the perspective of nursing students. OBJECTIVES: This study developed a Narrative Nursing Teaching Effectiveness (NNTE) scale and evaluated its psychometric properties. DESIGN: A methodological design was used to develop and validate the instrument. SETTINGS: The study took place at a university in southern China. PARTICIPANTS: The study involved 283 nursing students enrolled at a medical university in Fujian Province, China. METHODS: The researchers conducted literature reviews, held focus groups and individual interviews, and utilized the Delphi method to create a pool of indicators for a narrative nursing teaching evaluation system. A pretest was administered to 150 nursing students. Next, the primary study involved 283 nursing students, chosen through cluster sampling, completed a general information questionnaire along with the NNTE scale. Data analysis was performed using SPSS 26.0, Mplus 6.1, and STATA 16.0, and included general statistical analysis, critical test theory, and item response theory analyses. RESULTS: The researchers created a 42-item scale with four subdomains, explaining 60.32 % of the total variance. Confirmatory factor analysis proved the four-factor model's validity. Cronbach's alpha values for the four subscales ranged from 0.869 to 0.949. The average content validity index of the scale was 0.923 and the item content validity index ranged from 0.872 to 1. In addition, all item characteristic curves displayed desirable shapes, and the test information functions provided precise information. CONCLUSIONS: The NNTE scale exhibits good psychometric properties, providing a scientifically sound and effective instrument to evaluate the effectiveness of the narrative nursing teaching approach to nursing education.

Screening behaviors of high-risk individuals for lung cancer: A cross-sectional study.

Objective: To investigate current screening behaviors among high-risk individuals and analyse the factors that influence them. Methods: A cross-sectional of 1652 high-risk individuals were recruited in Fujian Province, China from February to October 2022. Socio-demographic characteristics of participants were collected and other survey measures included a lung cancer and lung cancer screening knowledge questionnaire and a stage of adoption algorithm. Standardized measures on surveys were comprised of the: Lung Cancer Screening Health Belief Scales, Cataldo Lung Cancer Stigma Scale, Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-9, and the Patient Trust in the Medical Profession Scale. Factors associated with screening behavior were identified using binary logistic regression analysis. Results: Lung cancer screening behavior stages were largely reported as Stage 1 and Stage 2 (64.4%). The facilitators of lung cancer screening included urban residence (OR = 1.717, 95% CI: 1.224-2.408), holding administrative positions (OR = 16.601, 95% CI: 2.118-130.126), previous lung cancer screening behavior (OR = 10.331, 95% CI: 7.463-14.302), media exposure focused on lung cancer screening (OR = 1.868, 95% CI: 1.344-2.596), a high level of knowledge about lung cancer and lung cancer screening (OR = 1.256, 95% CI: 1.185-1.332), perceived risk of lung cancer (OR = 1.123, 95% CI: 1.029-1.225) and lung cancer screening health beliefs (OR = 1.090, 95% CI: 1.067-1.113). A barrier to lung cancer screening was found to be social influence (influence of friends or family) (OR = 0.669, 95% CI: 0.465-0.964). Conclusions: This study found a low participation rate in lung cancer screening and identified eight factors that affected lung cancer screening behaviors among high-risk individuals. Findings suggest targeted lung cancer screening programs should be developed based on identified influencing factors in order to effectively promote awareness and uptake of lung cancer screening.

Promoting Lung Cancer Screen Decision-Making and Early Detection Behaviors: A Systematic Review and Meta-analysis.

BACKGROUND: Promoting lung cancer screening (LCS) is complex. Previous studies have overlooked that LCS behaviors are stage based and thus did not identify the characteristics of LCS interventions at different screening stages. OBJECTIVE: The aims of this study were to explore the characteristics and efficacy of interventions in promoting LCS decision making and behaviors and to evaluate these interventions. METHODS: We conducted a study search from the inception of each bibliographic database to April 8, 2023. The precaution adoption process model was used to synthesize and classify the evidence. The RE-AIM framework was used to evaluate the effectiveness of LCS programs. Heterogeneity tests and meta-analysis were performed using RevMan 5.4 software. RESULTS: We included 31 studies that covered 4 LCS topics: knowledge of lung cancer, knowledge of LCS, value clarification exercises, and LCS supportive resources. Patient decision aids outperformed educational materials in improving knowledge and decision outcomes with a significant reduction in decision conflict (standardized mean difference, 0.81; 95% confidence interval, -1.15 to -0.47; P < .001). Completion rates of LCS ranged from 3.6% to 98.8%. Interventions that included screening resources outperformed interventions that used patient decision aids alone in improving LCS completion. The proportions of reported RE-AIM indicators were highest for reach (69.59%), followed by adoption (43.87%), effectiveness (36.13%), implementation (33.33%), and maintenance (9.68%). CONCLUSION: Evidence from 31 studies identified intervention characteristics and effectiveness of LCS interventions based on different stages of decision making. IMPLICATIONS FOR PRACTICE: It is crucial to develop targeted and systematic interventions based on the characteristics of each stage of LCS to maximize intervention effectiveness and reduce the burden of lung cancer.

Dyadic effects of family resilience on quality of life in patients with lung cancer and spousal caregivers: The mediating role of dyadic coping.

PURPOSE: This study explored the effects of family resilience on quality of life (QOL) and examined whether dyadic coping mediates these effects in patients with lung cancer and their spousal caregivers. METHODS: In total, 313 dyads were recruited from three tertiary hospitals in Fujian Province, China, between March and July 2022. Study participants independently completed sociodemographic and clinical characteristics questionnaires, the Shortened Chinese version of the Family Resilience Assessment Scale, the Dyadic Coping Inventory, and the 8-Item Short-Form Health Survey. Data analysis utilized the actor-partner interdependence mediation model (APIMeM). RESULTS: Family resilience of both patients with lung cancer and their spouses were positively and directly associated with their own QOL, which was mediated by dyadic coping. Family resilience did not significantly influence the partners' QOL. The APIMeM model produced acceptable fit (χ2/df = 2.857, RMSEA = 0.077, CFI = 0.992, TLI = 0.941, and NFI = 0.998). CONCLUSION: Dyadic coping mediated both actor and partner effects between family resilience and QOL, and there was no significant direct partner effect between individual family resilience and their partner's QOL. The development of efficient family- or dyad-based interventions is essential to improve family resilience and encourage dyadic coping strategies among patients with lung cancer and their spousal caregivers who experience poor family resilience and low dyadic coping. Such interventions have the potential to enhance QOL for both parties.

Trajectories of cognitive reactivity and its predictive value on postpartum depression in Chinese women: a latent class growth modeling analysis.

Many women are experiencing postpartum depression (PPD) after giving birth. How to recognize and intervene in high-risk PPD women early and effectively remains unknown. Our objective is to describe the latent trajectory groups of cognitive reactivity (CR) in perinatal women, and their relationship to demographic and disease-related factors, as well as investigate the associations with PPD. Data from 321 perinatal women who were evaluated in urban tertiary hospitals in China at three-time points: 32-35 weeks of pregnancy, 1 week postpartum, and 6 weeks postpartum. Latent class growth modeling was used to identify the trajectory patterns of CR and logistic regression was used to explore the association between demographic and disease-related factors, CR trajectories, and depression. Three trajectory groups were identified: the continuing deterioration group (17.2%), the postpartum deterioration group (22.1%), and the consistent resilient group (60.7%). Participants with a bachelor's degree or higher and with gestational diabetes diagnosis were more likely to be in the continuing deterioration group. Those who were from only-child families were more likely to be in the postpartum deterioration group. Women in the continuing deterioration group and postpartum deterioration group were more likely to experience PPD. Targeted interventions should be developed based on trajectory group of CR.

A self-healing polymerized-ionic-liquid-based polymer electrolyte enables a long lifespan and dendrite-free solid-state Li metal batteries at room temperature.

The implementation of high-safety Li metal batteries (LMBs) needs more stable and safer electrolytes. The solid-state electrolytes (SSEs) with their advantageous properties stand out for this purpose. However, low Li/electrolyte interfacial instability and uncontrolled Li dendrites growth trigger unceasing breakage of the solid electrolyte interphase (SEI), leading to fast capacity degradation. In response to these shortcomings, a new type of polymer electrolyte with self-healing capacity is introduced by grafting ionic liquid chain units into the backbones of polymers, which inherits the chemical inertness against the Li anode, allowing high Li+ transport, wide electrochemical window, and self-healing traits. Benefiting from the strong external H-bonding interactions, the obtained polymer electrolyte can spontaneously reconstruct dendrite-induced defects and fatigue crack growth at the Li/electrolyte interface, and, in turn, help tailor Li deposition. Owing to the resilient Li/electrolyte interface and dendrite-free Li plating, the equipped Li|LFP batteries display a high initial specific capacity of 134.7 mA h g-1, rendering a capacity retention of 91.2% after 206 cycles at room temperature. The new polymer electrolyte will undoubtedly bring inspiration for developing practical LMBs with highly improved safety and interfacial stability.

Conductive Porous Laminated Vanadium Nitride as Carbon-Free Hosts for High-Loading Sulfur Cathodes in Lithium-Sulfur Batteries.

Improving the sulfur loading in cathodes is a significant challenge for practical lithium-sulfur batteries. Although carbonaceous sulfur hosts can achieve higher sulfur content and loading, the low tap densities of carbonaceous materials lead to low volumetric energy densities, restricting practical application. Here, conductive porous laminated vanadium nitride (VN) as a carbon-free sulfur host has been successfully developed to construct high tap density, high sulfur loading, and high energy density sulfur electrodes. The laminated stacking multiscale VN featuring interconnected holes possesses high storage space for sulfur loading, achieving high sulfur loading and utilization. VN@S materials' sulfur content and tap density can achieve 80 wt % and 1.17 g cm-3, respectively. At the sulfur loading of 1.0 mg cm-2, the VN@S cathode reaches the reversible capacity of 790 mAh g-1 at 1 C after 200 cycles and 145.2 mAh g-1 at 15 C after 500 cycles. Precisely, at a high sulfur loading of 12.6 mg cm-2, the VN@S cathode delivers a reversible capacity of 518.8 mAh g-1 (485.6 mAh cm-3) at 0.1 C after 100 cycles.

Daily intakes of naturally occurring radioisotopes in typical Korean foods.

The concentrations of naturally occurring radioisotopes ((232)Th, (228)Th, (230)Th, (228)Ra, (226)Ra, and (40)K) in typical Korean foods were evaluated. The daily intakes of these radioisotopes were calculated by comparing concentrations in typical Korean foods and the daily consumption rates of these foods. Daily intakes were as follows: (232)Th, 0.00-0.23; (228)Th, 0.00-2.04; (230)Th, 0.00-0.26; (228)Ra, 0.02-2.73; (226)Ra, 0.01-4.37 mBq/day; and (40)K, 0.01-5.71 Bq/day. The total daily intake of the naturally occurring radioisotopes measured in this study from food was 39.46 Bq/day. The total annual internal dose resulting from ingestion of radioisotopes in food was 109.83 muSv/y, and the radioisotope with the highest daily intake was (40)K. These values were same level compiled in other countries.

Copper Mesh Templated by Breath-Figure Polymer Films as Flexible Transparent Electrodes for Organic Photovoltaic Devices.

UNLABELLED: Metal mesh is a significant candidate of flexible transparent electrodes to substitute the current state-of-the-art material indium tin oxide (ITO) for future flexible electronics. However, there remains a challenge to fabricate metal mesh with order patterns by a bottom-up approach. In this work, high-quality Cu mesh transparent electrodes with ordered pore arrays are prepared by using breath-figure polymer films as template. The optimal Cu mesh films present a sheet resistance of 28.7 Ω·sq(-1) at a transparency of 83.5%. The work function of Cu mesh electrode is tuned from 4.6 to 5.1 eV by Ag deposition and the following short-time UV-ozone treatment, matching well with the PEDOT: PSS (5.2 eV) hole extraction layer. The modified Cu mesh electrodes show remarkable potential as a substitute of ITO/PET in the flexible OPV and OLED devices. The OPV cells constructed on our Cu mesh electrodes present a similar power conversion efficiency of 2.04% as those on ITO/PET electrodes. The flexible OLED prototype devices can achieve a brightness of 10 000 cd at an operation voltage of 8 V.

Carbon-free (Co, Mn)3O4 nanowires@Ni electrodes for lithium-oxygen batteries.

A carbon-free, three-dimensional network structured material composed of (Co, Mn)3O4 nanowires and Ni foam was synthesized. Without the addition of any binder or conductive additives, it could be employed as the air electrode for lithium-oxygen batteries and delivers a specific capacity of 3605 mA h g(electrode)(-1) at a current density of 0.05 mA cm(-2). Fifty cycles of continuous discharge and charge have been obtained with a cut-off capacity of 500 mA h g(electrode)(-1). The high reversibility and large capacity of the batteries is largely attributed to the unique features of the as-prepared (Co, Mn)3O4@Ni electrode, which enables the surface of nanowires to become highly accessible to the reactants and provides more void volume for the deposition of discharge products. This work suggests that there is great potential in employing the carbon-free (Co, Mn)3O4@Ni as air electrodes for lithium-oxygen batteries.