Nomogram prediction of vessels encapsulating tumor clusters in small hepatocellular carcinoma ≤ 3 cm based on enhanced magnetic resonance imaging.

BACKGROUND: Vessels encapsulating tumor clusters (VETC) represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma (HCC). However, it seems that no one have focused on predicting VETC status in small HCC (sHCC). This study aimed to develop a new nomogram for predicting VETC positivity using preoperative clinical data and image features in sHCC (≤ 3 cm) patients. AIM: To construct a nomogram that combines preoperative clinical parameters and image features to predict patterns of VETC and evaluate the prognosis of sHCC patients. METHODS: A total of 309 patients with sHCC, who underwent segmental resection and had their VETC status confirmed, were included in the study. These patients were recruited from three different hospitals: Hospital 1 contributed 177 patients for the training set, Hospital 2 provided 78 patients for the test set, and Hospital 3 provided 54 patients for the validation set. Independent predictors of VETC were identified through univariate and multivariate logistic analyses. These independent predictors were then used to construct a VETC prediction model for sHCC. The model's performance was evaluated using the area under the curve (AUC), calibration curve, and clinical decision curve. Additionally, Kaplan-Meier survival analysis was performed to confirm whether the predicted VETC status by the model is associated with early recurrence, just as it is with the actual VETC status and early recurrence. RESULTS: Alpha-fetoprotein_lg10, carbohydrate antigen 199, irregular shape, non-smooth margin, and arterial peritumoral enhancement were identified as independent predictors of VETC. The model incorporating these predictors demonstrated strong predictive performance. The AUC was 0.811 for the training set, 0.800 for the test set, and 0.791 for the validation set. The calibration curve indicated that the predicted probability was consistent with the actual VETC status in all three sets. Furthermore, the decision curve analysis demonstrated the clinical benefits of our model for patients with sHCC. Finally, early recurrence was more likely to occur in the VETC-positive group compared to the VETC-negative group, regardless of whether considering the actual or predicted VETC status. CONCLUSION: Our novel prediction model demonstrates strong performance in predicting VETC positivity in sHCC (≤ 3 cm) patients, and it holds potential for predicting early recurrence. This model equips clinicians with valuable information to make informed clinical treatment decisions.

Optimizing predictions: improved performance of preoperative gadobenate-enhanced MRI hepatobiliary phase features in predicting vessels encapsulating tumor clusters in hepatocellular carcinoma-a multicenter study.

BACKGROUND: Vessels Encapsulating Tumor Clusters (VETC) are now recognized as independent indicators of recurrence and overall survival in hepatocellular carcinoma (HCC) patients. However, there has been limited investigation into predicting the VETC pattern using hepatobiliary phase (HBP) features from preoperative gadobenate-enhanced MRI. METHODS: This study involved 252 HCC patients with confirmed VETC status from three different hospitals (Hospital 1: training set with 142 patients; Hospital 2: test set with 64 patients; Hospital 3: validation set with 46 patients). Independent predictive factors for VETC status were determined through univariate and multivariate logistic analyses. Subsequently, these factors were used to construct two distinct VETC prediction models. Model 1 included all independent predictive factors, while Model 2 excluded HBP features. The performance of both models was assessed using the Area Under the Curve (AUC), Decision Curve Analysis, and Calibration Curve. Prediction accuracy between the two models was compared using Net Reclassification Improvement (NRI) and Integrated Discriminant Improvement (IDI). RESULTS: CA199, IBIL, shape, peritumoral hyperintensity on HBP, and arterial peritumoral enhancement were independent predictors of VETC. Model 1 showed robust predictive performance, with AUCs of 0.836 (training), 0.811 (test), and 0.802 (validation). Model 2 exhibited moderate performance, with AUCs of 0.813, 0.773, and 0.783 in the respective sets. Calibration and decision curves for both models indicated consistent predictions between predicted and actual VETC, benefiting HCC patients. NRI showed Model 1 increased by 0.326, 0.389, and 0.478 in the training, test, and validation sets compared to Model 2. IDI indicated Model 1 increased by 0.036, 0.028, and 0.025 in the training, test, and validation sets compared to Model 2. CONCLUSION: HBP features from preoperative gadobenate-enhanced MRI can enhance the predictive performance of VETC in HCC.

Sorption enhancement of Cr(VI) from aqueous solution by polyaniline confined in three-dimensional network of composite porous hydrogel.

Hexavalent chromium Cr(VI) is a typical harmful pollutant, which is carcinogenic or mutagenic to aquatic animals and humans. In this study, sepiolite/humic acid/polyvinyl alcohol@ polyaniline (SC/HA/PVA@PANI) composite porous hydrogel adsorbent was synthesized by Pickering emulsion template in situ chemical oxidative polymerization for adsorption of Cr(VI) from aqueous solution. The in situ polymerization of aniline at the Pickering emulsion interface and the unique three-dimensional network structure of the hydrogel act as an effective "confinement" for the growth of the polymer. The porous structure of the material acts as a water channel, which effectively accelerates the binding of the adsorbate to the adsorption sites, and significantly improves the adsorption rate and adsorption capacity. The adsorption capacity of PANI for Cr(VI) confined in three-dimensional network of composite porous SC/HA/PVA@PANI hydrogel reached 1180.97 mg/g-PANI, which increased about 27-fold compared the adsorption capacity of pure PANI (43.48 mg/g). It is shown that the experimental design effectively avoids the agglomeration of PANI and improves its potential adsorption performance. In addition, the analysis of FESEM-EDX, FT-IR, and XPS spectra before and after adsorption confirmed that the main adsorption mechanisms of Cr(VI) on SC/HA/PVA@PANI included ion exchange, electrostatic attraction, and redox reaction. In conclusion, SC/HA/PVA@PANI has good stability and excellent adsorption performance, which is a new type of Cr(VI) ion adsorbent with great potential.

Why breast cancer patients avoid communicating disease-related information to their dependent children: A qualitative study.

AIM AND OBJECTIVES: This qualitative study explores why breast cancer patients do not share disease-related information with their dependent children. BACKGROUND: 'Open' communication between breast cancer patients and their children is beneficial to both. However, some still try to avoid discussing their diagnosis and related information with their children. Some worries lie in communicating with dependent children, but the underlying cause remains unclear. DESIGN: Qualitative descriptive study. METHODS: Semi-structured interview was used in this study. Twenty breast cancer patients with children (aged 8-18 years) were recruited at two urban tertiary hospitals in mainland China. Qualitative content analysis was conducted to analyse and identify themes and subthemes. This study followed the COREQ checklist for qualitative studies. RESULTS: Three main themes were identified: (1) Uncertainty about the future: Their struggles with cancer remain a sensitive subject with their children. They described the uncertainty surrounding their disease prognosis and their children's response. They were also unsure whether, when and how to inform their children of their conditions; (2) Useless and risky for their children to know the truth: They considered it useless because their children can neither understand nor change the existing facts. They were concerned that it could affect their children's emotional state, character and academic performance; and (3) All for their children's sake: They were willing to take care of their affairs without troubling their dependent children as much as possible. CONCLUSION: Most mothers delayed communicating disease-related information to their dependent children. However, they often underestimated children's abilities and ignored their thoughts and wishes. Motherhood leads to avoidance and concealment in discussing health issues with their children. RELEVANCE TO CLINICAL PRACTICE: Mothers should try to understand their children's views towards cancer earlier. Healthcare professionals, especially nurses, should provide further consultation and intervention services to assist mothers and their children.

Effect of hospital-based case management on psychosocial wellbeing and treatment outcomes in colorectal cancer patients: A quasi-experimental study.

BACKGROUND: Case management has been regarded as the front line of necessary change for fragmented healthcare system. AIM: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12-month follow-up. METHODS: A quasi-experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. RESULTS: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. CONCLUSION: Nurse-led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital-dominated healthcare systems where primary care is underutilized.

Factors associated with psychosocial adjustment in working-age colorectal cancer survivors: A cross-sectional study.

Objective: This study aimed to describe the level of psychosocial adjustment and identify factors associated with psychosocial adjustment in working-age colorectal cancer survivors. Methods: This cross-sectional study involved 212 colorectal cancer survivors visiting a cancer clinic at a specialized oncology hospital in China. Socio-demographic characteristics, disease-related characteristics, status of returning to work, Work Ability Index scores, M. D. Anderson Symptom Inventory for Gastrointestinal Cancer scores, and self-reported Psychological Adjustment to Illness Scale scores were collected from all participants. Data analyses included descriptive statistics, independent t-test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis, which were performed using the Statistical Package for the Social Sciences version 25.0 (IBM Corporation, Armonk, NY, USA). Results: Participants reported a medium level of psychosocial maladjustment (35.73 â€‹± â€‹19.68), with 19.3% of participants experiencing severe maladjustment, 29.7% experiencing moderate maladjustment, and 50.9% experiencing mild maladjustment, respectively. Age, gender, marital status, having a child, education level, having a stoma, comorbidities, return to work, work ability, and symptom distress were entered into a multiple linear regression analysis. The strongest factor influencing the level of psychosocial adjustment was work ability (ߠ​= â€‹-0.393, P â€‹< â€‹0.001), followed by symptom distress (ߠ​= â€‹0.380, P â€‹< â€‹0.001) and an education level of college or above (ߠ​= â€‹0.150, P â€‹= â€‹0.027). These variables accounted for 46.1% of the variance in psychosocial adjustment. Conclusions: Colorectal cancer survivors with low work ability, high symptom distress, and an education level of college or above are at a high risk for psychosocial maladjustment. Nursing interventions for psychosocial adjustment should attach increased importance to the work status and symptom distress of colorectal cancer survivors.

Psychometric properties of a simplified Chinese version of the cancer predisposition perception scale.

Objective: Cancer predisposition perception refers to the subjective estimation of the likelihood of being diagnosed with cancer in the future. It affects people's behavior concerning cancer screening and prevention. At present, there is no available tool to evaluate cancer predisposition perception. The aim of this study was to translate the cancer predisposition perception scale into simplified Chinese (C-CPPS), and then test its psychometric properties among Chinese patients. Methods: In phase I, the CPPS was translated into Chinese, and validated by an expert panel. In phase II, data on reliability and validity was evaluated in terms of construct validity, criterion validity, internal consistency, test-retest reliability, and item-total correlations, with a convenience sample of 208 patients recruited from the colorectal cancer surgical ward. Results: The C-CPPS had desirable validity and reliability. The scale-level content validity index was 0.96. Exploratory factor analysis indicated that the six-factor structure of the C-CPPS was good fit to the data. Correlation between the C-CPPS and the Brief Illness Perception Questionnaire was statistically significant. Cronbach's α for the entire scale was 0.90 and 0.71-0.95 for five of the six subscales. Item-total correlations ranged from 0.309 to 0.775, and the intraclass correlation coefficient was 0.97. Conclusions: The C-CPPS appears to be culturally appropriate, reliable, and valid for assessing cancer predisposition perception among patients with colorectal cancer in China.

The role of space in obstructing clinical sexual health education: A qualitative study on breast cancer patients' perspectives on barriers to expressing sexual concerns.

OBJECTIVE: Breast cancer patients report hoping to receive professional medical advice on sexual health and sexuality, but only few of them actively seek help from medical professionals. This study aims to gain clear understanding about barriers to patients' sexual health education seeking from the patient perspective. METHODS: A qualitative study using in-depth interviews was conducted in an urban hospital in Guangdong Province. China. 20 female breast cancer patients were selected and interviewed. The interview was recorded and transcribed verbatim. Content analysis was used for the data analysis. RESULTS: Four main barriers participants experienced to expressing sexual health education need to medical personnel included: (1) Avoiding discussion of sexuality due to the inappropriate space. (2) Avoiding sexual activity due to the disease treatment. (3) Avoiding sexual activity due to the body related distress. (4) Sexuality as a metaphor. CONCLUSIONS: It is found that breast cancer patients' expression about sexuality was constrained by the hospital, disease, body space and the cultural logic behind the three spaces. Clinical staff should provide an appropriate space for discussing sexual concerns, increase sexual health knowledge, comprehensively evaluate patients' condition and develop a culturally adaptable sexual health education.