The mediating role of meaning in life between experiential avoidance and death anxiety among cancer patients: a cross-sectional study.

BACKGROUND: Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. METHODS: A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer's Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. RESULTS: A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p < 0.01) was moderately positively correlated with death anxiety. Presence of meaning (r = - 0.400, p < 0.01) was moderately negatively correlated with death anxiety, while search for meaning (r = - 0.151, p < 0.01) was weakly negatively correlated with death anxiety. Regression analysis showed that experiential avoidance (ß = 0.464) and presence of meaning (ß = -0.228) were predictors of death anxiety. Mediating effect analysis revealed that presence of meaning either completely or partially mediated the effect of experiential avoidance and death anxiety, and the indirect effect accounted for 14.52% of the total effect. CONCLUSION: Overall, experiential avoidance predicts death anxiety in cancer patients, and meaning in life can mediate this effect. The results of this study provide a new path for studying the mechanism of death anxiety and suggest a more positive and promising strategy for its management.

Trajectories of fear of cancer recurrence and its influence factors: A longitudinal study on Chinese newly diagnosed cancer patients.

OBJECTIVE: The fear of cancer recurrence (FCR) is an ongoing and common psychological problem faced by cancer patients. The objective of this study was to explore the variation trend of FCR and its influencing factors in Chinese newly diagnosed cancer patients from admission to 2 months after discharge. Demographic and tumor characteristics, as well as experiential avoidance (EA), were used as predictors. METHOD: A longitudinal design and a consecutive sampling method were used to select 266 newly diagnosed cancer patients admitted to a tertiary cancer hospital in China from July to December 2022. Measurements of FCR and EA were obtained at admission (T1), 1 month after discharge (T2), and 2 months post-discharge (T3). Generalized estimating equations were used to identify factors associated with FCR for longitudinal data analysis. RESULTS: A total of 266 participants completed the follow-up. Both FCR and EA scores of patients with newly diagnosed cancer showed a significant trend of first increasing and then decreasing at baseline and follow-up (p < 0.001). The junior secondary and less education level, rural residence, advanced tumor and high EA level were risk factors for higher FCR. CONCLUSIONS: Our findings suggest that the FCR levels of most newly diagnosed cancer patients in China are different at the three time points and affected by different factors, with the highest level at 1 month after discharge. These results have significant implications for future identifying populations in need of targeted intervention based on their FCR trajectories.

Thermal transport properties of graphene aerogel as an advanced carrier for enhanced energy storage.

Leveraging graphene aerogels as carriers offers innovative avenues for achieving enhanced energy density, thermal conductivity, and stability in energy storage materials due to their unique attributes. This study investigates the thermal transport properties of composite sulfur cathode materials and phase change materials based on graphene aerogels using molecular dynamics simulation. A graphene aerogel model is established, and the effects of sulfur and octadecane content on the thermal transport properties of graphene aerogels and graphene aerogel-based composites are examined. A theoretical model of heat transport is developed to analyze the contribution of fillers and graphene aerogels to the thermal conductivity of the composites. The results show that the theoretical analytical model shows strong agreement with the molecular dynamics results, especially at high filler content. This research provides valuable theoretical guidance for understanding the thermal transport properties of graphene aerogel-based composite sulfur cathode materials and phase change materials.

The relationship between fear of cancer recurrence and death anxiety among Chinese cancer patients: the serial mediation model.

AIMS: This study aims to investigate the association between fear of cancer recurrence (FCR) and death anxiety (DA) among Chinese cancer patients, while considering the mediating effects of experiential avoidance (EA) and meaning in life (MIL). METHODS: From February to June 2023, convenience sampling was used to select newly diagnosed cancer patients in a tertiary Cancer Hospital in Chinese Hunan Province as the survey objects. A total of 436 cancer patients completed the Fear of Cancer Recurrence Inventory, the Meaning in Life Questionnaire, the Acceptance and Action Questionnaire-II, and the Templer's death anxiety scale. Descriptive analysis and Pearson correlation analysis were conducted using SPSS 28.0 software. Serial mediation analysis was performed by Hayes' PROCESS macro. RESULTS: Gender, age, educational level, marital status, residence, occupation, per capita monthly household income, tumor type, and cancer stage were controlled in the model. The results revealed that fear of cancer recurrence had a significant direct effect on death anxiety (Effect = 0.075, 95% CI: 0.064 to 0.087). Additionally, three indirect pathways were identified: (1) through experiential avoidance (Effect = 0.037, 95% CI: 0.026 to 0.049), (2) through meaning in life (Effect = 0.022, 95% CI: 0.014 to 0.031), and (3) through the serial mediators involving meaning in life and experiential avoidance (Effect = 0.016, 95% CI: 0.010 to 0.023). The total indirect effect of the three mediation paths was 63.56%. CONCLUSION: Fear of cancer recurrence is a significant psychological distress experienced by cancer patients, which not only directly contributes to death anxiety but also may triggers changes, such as experiential avoidance and meaning in life. Ultimately, this comprehensive psychological distress leads to death anxiety.

Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis.

OBJECTIVES: To gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management. METHODS: From July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis. RESULTS: The experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action). CONCLUSION: Most patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients' pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

Perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer: a qualitative study in mainland China.

BACKGROUND: Despite being driven by a strong sense of duty and familial obligation, providing care for patients nearing the end of life poses challenges for family caregivers. Telemedicine has rapidly gained traction as a transformative approach to healthcare delivery, offering an array of benefits that could be particularly valuable in end-of-life care. However, research on the perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer is limited. Therefore, this study aims to explore the perspectives and preferences of telemedicine-based services among family caregivers of patients with end-of-life cancer and provide a framework for developing and executing a tailored telemedicine-based end-of-life care program that addresses the unique needs of family caregivers in mainland China. METHOD: A descriptive phenomenological approach was used. Family caregivers were selected using purposive sampling at a tertiary cancer hospital. One-on-one semi-structured interviews were conducted with the participants from November to December 2022. Colaizz's method was used to analyze the interviews. RESULTS: Fourteen participants participated in interviews. Three themes and ten subthemes were identified: motivation to receive telemedicine services (relief from the burden of home care; access to professional health care services), supportive care needs for telemedicine services (support for symptom management; negative emotional adjustment; death education; daily life care guidance), and functional expectations of telemedicine service platforms (ease of use; real-time online guidance and response; personalized automatic reminder; targeted matching push of health knowledge). CONCLUSION: Family caregivers expressed interest in telemedicine-based services and identified various care needs before receiving telemedicine services. The findings of this study can help policymakers and healthcare providers develop more effective and culturally appropriate telemedicine-based service programs that can better support family caregivers of end-of-life cancer patients.

Core competencies among nurses engaged in pallative care: A scoping review.

AIM: To synthesize available evidence about core competencies for nurses engaged in palliative care. DESIGN: A scoping review conducted according to the framework from Joanna Briggs Institute. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist was adopted to report this scoping review. The PubMed, Web of Science, Embase, ScienceDriect, CNKI, WangFang, VIP and Sinomed databases were used to systematically search for published studies from their inception to December 2023. Two researchers independently screened and selected relevant studies and performed the data charting. RESULTS: Twenty-six studies were included in this scoping review. Among these, 14 studies identified core competency assessment instruments among nurses engaged in palliative care, with the Palliative Care Core Competence Questionnaire was used most frequently; 13 studies investigated the status of core competencies of nurses engaged in palliative care, the majority of included studies indicated that nurse's core competencies were at moderate levels; 11 studies explored the factors influencing the core competencies of the nurses engaged in palliative care, which were classified as sociodemographic-related factors, palliative care education-related factors, death attitude, palliative care practice-related experience and others. CONCLUSION: This scoping review offers a comprehensive overview of the current landscape of core competencies among nurses in palliative care. Findings suggested that the clinical nursing leaders need to develop tailored strategies and interventions to address specific factors and promote the continuous development of nurses' competencies in palliative care. RELEVANCE TO CLINICAL PRACTICE: Core competency assessment instruments equip nurses and healthcare organizations with a range of validated tools for evaluating their proficiency in palliative care. Targeted core competency enhancement programmes need to be developed to foster a nursing workforce better equipped to improve the quality of life of end-of-life patients and their families. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development of a supportive care framework for breast cancer survivor's unmet needs: A modified Delphi study.

AIM: To establish a supportive care framework for addressing unmet needs among breast cancer survivors, providing practical guidance for healthcare providers to assess and manage these needs, ultimately enhancing the health outcomes and quality of life of breast cancer survivors. DESIGN: We conducted a two-round Delphi survey to gather expert opinions regarding the unmet needs supportive care framework for breast cancer survivors. METHODS: Initial framework identification and inquiry questionnaire creation was achieved via literature search and expert group discussions, which included 15 experts from nursing practice, clinical medicine, nursing management and nursing education was conducted using a Delphi survey. To establish consensus, a two-round Delphi poll was done, using criteria based on the mean (≥4.0), coefficient of variation (CV < 0.25) and percentage for entire score (≥20%). RESULTS: Experts reached a consensus, leading to six care modules, and 28 care entries: Tumour Detection Support (three care entries), Management of Complications of Antitumor Therapy (seven care entries), Healthy Lifestyle Management (five care entries), Sexual and Fertility Support (four care entries), Psychosocial Support (four care entries) and Resource and Linkage Support (five care entries). CONCLUSION: To address breast cancer survivors' unmet needs, a supportive framework was developed to actively enhance their health outcomes. However, further refinement and feasibility testing using mobile devices or artificial intelligence are required. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: This pioneering framework prioritises addressing unmet needs and equips healthcare providers to assess and manage these needs effectively, facilitating the implementation of programs aimed at improving the well-being of breast cancer survivors. REPORTING METHOD: This study was guided by a modified guideline for the Conducting and Reporting of Delphi Studies (CREDES) (Palliative Medicine, 31(8), 684, 2017). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution. TRIAL AND PROTOCOL REGISTRATION: The Delphi study methodology does not require registration.

Nursing informatics competency and its associated factors among palliative care nurses: an online survey in mainland China.

BACKGROUND: Nursing informatics (NI) competency is a required core competency for high-quality care in digitally enabled healthcare environments. Given the increasing reliance on digital health in palliative care settings, it becomes crucial to evaluate the NI competency of nurses to ensure the seamless integration and effective utilization of digital health in their clinical practice. This study aimed to investigate the level of NI competency and explore its associated factors among palliative care nurses in mainland China. METHODS: A cross-sectional design was conducted for this study, involving a total of 409 palliative care nurses from 302 hospitals in mainland China. Anonymous data were collected through a self-designed sociodemographic questionnaire, the Nursing Informatics Competency Scale (NICS) and the Innovative Self-Efficacy Scale. RESULTS: The total score of the NICS was 129.19 ± 22.02, which indicated that Chinese palliative care nurses had a moderate level of NI competency. There was a positive correlation between innovative self-efficacy and NI competency (r = 0.602, P < 0.01). The hospital level and innovative self-efficacy were identified as statistically significant factors influencing nurses' NI competency based on multiple linear regression analysis results. These associated factors could explain 35.1% of the difference in NI competency. CONCLUSIONS: This study found that palliative care nurses in mainland China exhibited moderate levels of NI competency and identified the hospital level and innovative self-efficacy as associated factors of nurses' NI competency. Measures such as developing supported strategies, including targeted NI training programs by nursing education managers of primary-level hospitals and creating a positive culture of innovation by healthcare institutions can be considered to improve the level of NI competency among Chinese palliative care nurses.

Status quo of advanced cancer patients participating in shared decision-making in China: a mixed study.

PURPOSE: Patients with advanced cancer are usually willing to participate in shared decision-making (SDM), but in clinical practice, patient participation is easily ignored. This study aimed to analyze the current SDM status of advanced cancer patients and related factors. METHODS: In quantitative research, we administered a cross-sectional survey to 513 advanced cancer patients in 16 tertiary hospitals in China. A sociodemographic information questionnaire, the Control Preference Scale (CPS), and Perceived-Involvement in Care Scale (PICS) were used to analyze current SDM status and influencing factors. Our qualitative research was based on the Ottawa Decision Support Framework (ODSF), and 17 advanced cancer patients were interviewed to explore their perceptions of SDM. RESULTS: Our quantitative results show that patients' actual and expected decision-making participation differed; statistically significant influencing factors were age, insurance, and whether patients were worried about the therapeutic effects. We also found that dynamic decision-making mode changes, disease information acquisition, decision-making participation obstacles, and family members' roles affected patients' SDM through qualitative interviews. CONCLUSION: Advanced cancer patients' SDM in China is dominated by sharing and continuously fluctuates. Influenced by Chinese traditional culture, family members play an important role in SDM. In clinical work, we should pay attention to the dynamic changes in patients' participation in decision-making and the role of family members.

Exploring the telehealth readiness and its related factors among palliative care specialist nurses: a cross-sectional study in China.

BACKGROUNDS: The majority of Chinese people who are nearing the end of their lives prefer to receive home-based palliative care. Telehealth, as a new service model, has the potential to meet the increasing demand for this service, especially in remote areas with limited resources. However, nurse-led telehealth-based palliative care services are still in the pilot implementation phase. Assessing the telehealth readiness among palliative care specialist nurses and identifying associated factors is crucial to facilitate the successful implementation of telehealth services. Therefore, this study aimed to examine TH readiness and its related factors among Chinese palliative care specialist nurses. METHODS: Four hundred nine Chinese palliative care specialist nurses from 28 provinces or municipalities participated in this study between July and August 2022. The Chinese version of Telehealth Readiness Assessment Tools (TRAT-C), and Innovative Self-Efficacy Scale (ISES-C) were used to assess the degree of TH readiness and the levels of innovative self-efficacy. RESULTS: The total score of the TRAT-C was 65.31 ± 9.09, and the total score of ISES was 29.27 ± 5.78. The statistically significant factors that influenced telehealth readiness were the experience of using telehealth platforms or services, the willingness to provide telehealth to patients, and the level of nurses' innovative self-efficacy. The innovative self-efficacy is positively correlated to telehealth readiness (r = 0.482, P < 0.01). These related factors could explain 27.3% of the difference in telehealth readiness. CONCLUSION: The telehealth readiness of Chinese palliative care specialist nurses are at a moderate level. Measures such as providing incentives to promote nurses' innovation self-efficacy by nurse managers, and establishing a comprehensive telehealth training system for palliative care specialist nurses should be taken to facilitate the implementation of telehealth services in the field of palliative care.

Factors Related to Nurses' Knowledge and Attitudes Toward Pain in Hospitals in Low-Income Areas.

BACKGROUND: Effective pain management is closely related to nurses' knowledge and attitudes toward pain. Limited studies have been performed related to nurses' knowledge and attitudes toward pain in hospitals in low-income areas. AIMS: This study surveyed the knowledge and attitudes of nurses toward pain management in county hospitals from low-income areas in Hunan Province, China. SETTING AND PARTICIPANTS: The study included 4,668 registered nurses working in 48 county hospitals in low-income areas in China. METHODS: A cross-sectional study examined the knowledge and attitudes of nurses with regard to pain using the Chinese version of the Knowledge and Attitude Survey Regarding Pain (KASRP) via the WeChat application. RESULTS: The 4,668 registered nurses completed the survey; of these, 43.6% indicated they had never received continuing education for pain. The mean percentage score for KASRP was (40.3 ± 7.95), and none of the respondents achieved a percentage score of >80%. Further, of the 40 items, only two had a correct rate of >80%. Continuing pain education did not significantly affect KASRP. Multiple stepwise linear regression showed that education level, ethnicity, professional title, position, and department were independent influencing factors for KASRP scores. CONCLUSION: Almost all nurses in county hospitals of low-income areas had deficiencies in various aspects of pain management knowledge. Better educated nurses with higher professional title or management position, those from the Han ethnicity, and those from the oncology department had higher mean KASRP scores. Current continuing education programs for pain did not improve the pain management capability of the nurse. High-quality and standardized pain educational programs should be implemented to improve pain management.

The Quality of Life of Patients with Colorectal Cancer and a Stoma in China: A Quantitative Cross-sectional Study.

OBJECTIVE: To explore quality of life (QOL) in patients with colorectal cancer and a stoma and factors associated with their QOL. METHODS: A quantitative cross-sectional study was carried out in the stoma and wound care clinic of a cancer hospital in China. Participants were recruited from clinic patients. Investigators collected demographic data and clinical information; QOL was measured using a Chinese version of the stoma-QOL scale. RESULTS: In total, 359 participants took part; 161 (44.8%) had an ileostomy, whereas the others had a colostomy, and about half of the participants (46.5%) had a permanent stoma. The mean age was 57.86 ± 11.92 years. The QOL scores of most participants were poor, with a median value of 49.44. Participants whose stoma was cared for by others had a significantly lower QOL score than those who cared for their own stomas (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.05-2.38; P = .029). Participants with a temporary stoma had a lower QOL score than those with a permanent stoma (OR, 2.08; 95% CI, 1.275-3.40; P = .004). Further, participants with a complication had a lower QOL score than those without (OR, 1.62; 95% CI, 1.07-2.43; P = .022). CONCLUSIONS: These findings suggest a need for well-developed interventions to improve the QOL of these patients. This study provides valuable insights to inform the development of future clinical practice and research in this area in China and beyond.

Spatial Distribution and Source Apportionment of Agricultural Soil Heavy Metals in a Rapidly Developing Area in East China.

We collected 682 topsoil samples (0-20cm) from agricultural lands of Luhe County in East China, and analyzed the spatial distribution patterns and potential sources of four major heavy metals. High Pb and Cr were mainly in the southeast adjacent to the Yangtze River, and Cd were characterized by an increasing trend from northwest to southeast, while high Hg mainly occurred in the areas near downtown. Spatially-continuous sources dominated the soil heavy metal concentrations. Contributions of spatially-continuous natural source (soil parent material) to Cr and Cd were 97.0% and 77.7%, respectively, whereas contributions of spatially-continuous anthropogenic source such as diffuse pollution to Pb and Hg were 75.7% and 86.7%, respectively. The distance to factories was the most influential anthropogenic factor for localized anomaly patterns of Pb, Cd, and Cr, while the intensive agricultural land uses associated with the rapid urban expansion were particularly relevant to the anomaly patterns of Hg.

Optimizing Charging Efficiency and Maintaining Sensor Network Perpetually in Mobile Directional Charging.

Wireless Power Transfer (WPT) is a promising technology to replenish energy of sensors in Rechargeable Wireless Sensor Networks (RWSN). In this paper, we investigate the mobile directional charging optimization problem in RWSN. Our problem is how to plan the moving path and charging direction of the Directional Charging Vehicle (DCV) in the 2D plane to replenish energy for RWSN. The objective is to optimize energy charging efficiency of the DCV while maintaining the sensor network working continuously. To the best of our knowledge, this is the first work to study the mobile directional charging problem in RWSN. We prove that the problem is NP-hard. Firstly, the coverage utility of the DCV's directional charging is proposed. Then we design an approximation algorithm to determine the docking spots and their charging orientations while minimizing the number of the DCV's docking spots and maximizing the charging coverage utility. Finally, we propose a moving path planning algorithm for the DCV's mobile charging to optimize the DCV's energy charging efficiency while ensuring the networks working continuously. We theoretically analyze the DCV's charging service capability, and perform the comprehensive simulation experiments. The experiment results show the energy efficiency of the DCV is higher than the omnidirectional charging model in the sparse networks.

Minimum Cost Deployment of Bistatic Radar Sensor for Perimeter Barrier Coverage.

Perimeter barriers can provide intrusion detection for a closed area. It is efficient for practical applications, such as coastal shoreline monitoring and international boundary surveillance. Perimeter barrier coverage construction in some regions of interest with irregular boundaries can be represented by its minimum circumcircle and every point on the perimeter can be covered. This paper studies circle barrier coverage in Bistatic Radar Sensor Network (BRSN) which encircles a region of interest. To improve the coverage quality, it is required to construct a circle barrier with a predefined width. Firstly, we consider a BR deployment problem to constructing a single BR circular barrier with minimum threshold of detectability. We study the optimized BR placement patterns on the single circular ring. Then the unit costs of the BR sensor are taken into account to derive the minimum cost placement sequence. Secondly, we further consider a circular BR barrier with a predefined width, which is wider than the breadth of Cassini oval sensing area with minimum threshold of detectability. We propose two segment strategies to efficiently divide a circular barrier to several adjacent sub-ring with some appropriate width: Circular equipartition strategy and an adaptive segmentation strategy. Finally, we propose approximate optimization placement algorithms for minimum cost placement of BR sensor for circular barrier coverage with required width and detection threshold. We validate the effectiveness of the proposed algorithms through theory analysis and extensive simulation experiments.

Approximate Optimal Deployment of Barrier Coverage on Heterogeneous Bistatic Radar Sensors.

Heterogeneous Bistatic Radars (BR) have different sensing ranges and couplings of sensing regions, which provide more flexible coverage for the boundary at complex terrain such as across rivers and valleys. Due to the Cassini oval sensing region of a BR and the coupling of sensing regions among different BRs, the coverage problem of BR sensor networks is very challenging. Existing works in BR barrier coverage focus mainly on homogeneous BR sensor networks. This paper studies the heterogeneous BR placement problem on a line barrier to achieve optimal coverage. 1) We investigate coverage differences of the basic placement sequences of heterogeneous BRs on the line barrier, and prove the optimal basic placement spacing patterns of heterogeneous BRs. 2) We study the coverage coupling effect among adjacent BRs on the line barrier, and determine that different placement sequences of heterogeneous BR transmitters will affect the barrier's coverage performance and length. The optimal placement sequence of heterogeneous BR barrier cannot be solved through the greedy algorithm. 3) We propose an optimal BRs placement algorithm on a line barrier when the heterogeneous BR transmitters' placement sequence is predetermined on the barrier, and prove it to be optimal. Through simulation experiments, we determine that the different placement sequences of heterogeneous BR transmitters have little influence on the barrier's maximum length. Then, we propose an approximate algorithm to optimize the BR placement spacing sequence on the heterogeneous line barrier. 4) As a heterogeneous barrier case study, a minimum cost coverage algorithm of heterogeneous BR barrier is presented. We validate the effectiveness of the proposed algorithms through theory analysis and extensive simulation experiments.

Effects of Silicon Application on Uptake of Arsenic and Phosphorus and Formation of Iron Plaque in Rice Seedlings Grown in an Arsenic-Contaminated Soil.

Silicon (Si) plays important roles in improving rice growth and mitigating rice arsenic (As) uptake. In the present study, a pot experiment was carried out to investigate effects of Si application on uptake of As and phosphorus (P) and formation of iron (Fe) plaque on root surface of two rice cultivars (Zhendao 10 and Nanjing 44) grown in a high As-contaminated soil. The results showed that dry weights of shoots and roots for both rice cultivars didn't significantly varied under low Si level, but significantly increased for Zhendao 10, while decreased for Nanjing 44 under high Si level (p < 0.05). As concentrations in shoots and roots of Nanjing 44 significantly decreased for low Si level, while significantly increased for high Si level (p < 0.05). Different from Nanjing 44, effect of Si application on As concentrations in the plants of Zhendao 10 wasn't significant (p > 0.05). Si significantly increased concentrations of P in shoots and roots of both rice cultivars (p < 0.05). However, Si didn't significantly affect formation of Fe plaque on root surface. These results suggest that the effects of Si application on rice growth and As uptake in As-contaminated soils may depend on type of rice cultivar and Si application level. Rice cultivar and Si application rate should be considered when Si application is used to mitigate As accumulation in rice.

Spiritual needs and their associated factors among cancer patients in China: a cross-sectional study.

PURPOSE: Spiritual needs are important for many patients with life-limiting illnesses. Knowledge of spiritual needs is a first step to their fulfillment; however, such knowledge is lacking for patients with cancer in mainland China. This study evaluated spiritual needs among patients with cancer in China and analyzed their associations with demographic and clinical characteristics. METHODS: A descriptive, cross-sectional study was performed. A general information questionnaire and a Chinese version of the Spiritual Needs Scale were used to collect information about patients with cancer. A total of 200 participants were recruited, and 182 completed the survey. RESULTS: The overall average spiritual needs score was 3.15. Of five dimensions investigated, the highest and lowest scores were for "hope and peace" (mean = 3.31) and "relationship with transcendence" (mean = 2.96). Of specific needs, "to be accepted," "to take responsibility for my life," and "to alleviate my suffering" (means = 3.36-3.38) were valued as most important by participants. "To talk to someone," "to pray and participate in religious rituals and services," and "to feel God with me during my struggle against disease" (means = 2.71-2.91) were considered least important. Participants' spiritual needs differed significantly according to disease stage (p < 0.001), time since diagnosis (p = 0.002), and hospitalization frequency (p = 0.004). CONCLUSIONS: The spiritual needs of patients with cancer should receive more attention in China. Effective assessment tools and procedures should be established to evaluate the spiritual needs of patients and formulate appropriate interventions at an early stage.

Novel laparoscopic training system with continuously perfused ex-vivo porcine liver for hepatobiliary surgery.

OBJECTIVE: To introduce a novel laparoscopic training system with a continuously perfused ex-vivo porcine liver for hepatobiliary surgery. BACKGROUND: Existing models for laparoscopic training, such as box trainers and virtual reality simulators, often fail to provide holistic training and real haptic feedback. We have formulated a new training system that addresses these problems. METHODS: Real-Liver Laptrainer consists of a porcine liver, customized mannequin, ex-vivo machine perfusion system, and monitoring software. We made a detailed comparison of Real-Liver Laptrainer with the LapSim virtual reality simulator and the FLS Trainer Box systems. Five laparoscopic surgeons assessed the new system on multiple features. We assessed the performances of 43 trainees who used the new system to perform laparoscopic cholecystectomy (LC) three times. RESULTS: Real-Liver Laptrainer offered more functions and better tactile feedback than the FLS or LapSim system. All five surgeons graded the quality of the new system as realistic. The utility of the system for training was scored as 3.6 ± 1.1 on a scale of 1-5. Between the first and third attempts, the number of successfully performed LCs increased (9 vs 14 vs 23; P = .011), while the numbers of liver damage incidents (25 vs. 21 vs. 18, P = .303) and gallbladder perforations decreased (17 vs. 12 vs. 9, P = .163). The mean LC operation time significantly decreased (63 vs. 50 vs. 44, P < .0001). CONCLUSION: Real-Liver Laptrainer is a feasible, stable, and practical training model that has potential for improving the laparoscopic skills of surgeons.