Assessment of the prevalence and related factors of financial toxicity in cancer patients based on the COST scale: A systematic review and meta-analysis.

PURPOSE: The high cost of cancer treatment exposes patients to financial toxicity during treatment; however, no study has comprehensively analyzed the incidence of financial toxicity using a validated assessment tool. In this study, the objective was to ascertain the incidence of financial toxicity in cancer patients and the factors influencing it. METHODS: Nine electronic databases were retrieved to collect cross-sectional studies reporting financial toxicity in cancer patients. A random effects meta-analysis was applied to yield the overall prevalence of financial toxicity. Subgroup analyses were conducted depending on the factors affecting financial toxicity. RESULTS: In total, 30 studies met our inclusion criteria. The pooled prevalence of financial toxicity in cancer patients was 48% (95%CI:38%-58%, I2 = 99.4%, p < 0.001). In the subgroup analysis, a higher prevalence of financial toxicity in patients aged <67 years (47%, 95%CI: 28%-66%, I2 = 97.5%, p < 0.001), female (46%, 95%CI:39%-53%, I2 = 94.9%,p < 0.001), lung cancer(57%, 95%CI:38%-75%, I2 = 96.9%, p < 0.001), developing countries (64%, 95%CI:55%-72%, I2 = 98.1%, p < 0.001), time of investigation following COVID-19 (53%, 95%CI:37%-69%, I2 = 99.4%, p < 0.001). CONCLUSION: Financial toxicity is prevalent in cancer patients and is increasingly evident after COVID-19. Furthermore, the odds of financial toxicity are higher in patients who are female, younger, whose cancer type is lung cancer, and from developing countries. These findings emphasize the significance of evaluating financial toxicity in cancer patients after COVID-19, especially in developing countries. This may play a pivotal role in helping patients cope with financial toxicity.

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study.

AIMS: This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses. BACKGROUND: Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear. METHODS: A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research. RESULTS: Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth. CONCLUSIONS: Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

Prevalence and factors of posttraumatic growth among Hubei residents during the COVID-19 pandemic: A cross-sectional study.

The adverse impact of the COVID-19 pandemic on mental health has been widely concerned, but the research on positive psychological factors is insufficient, this study aims to investigate the prevalence and factors of posttraumatic growth (PTG) among residents in the worst-hit areas of China (Hubei Province). We were conducted in three disaster areas with different severity in Hubei Province three months after the outbreak, and the data were from 575 respondents. Instruments included the simplified Chinese version of the Posttraumatic Growth Inventory (C-PTGI) and the public health emergency psychological questionnaire. Nonparametric tests, Spearman correlation analyses, and multiple linear regression equations were used to analyze the data. The results showed that three months after the outbreak of COVID-19, the PTG of Hubei residents was at a low level, and their sense of fear was the most prominent, with a positive detection rate of 82.09%. According to the results of this study, high PTG levels were associated with high levels of fear, married and healthcare providers, while low levels of PTG were associated with serious chronic diseases, males, good economic status, and poor prevention and control measures. Government departments should strengthen social support for residents, carry out necessary stress management training to help them correctly deal with negative emotions and promote their personal growth.

Prevalence and influencing factors of posttraumatic growth among nurses suffering from workplace violence: A cross-sectional study.

The purpose of this study was to (i) identify the level of posttraumatic growth among nurses suffering from workplace violence, (ii) clarify the relationship between nurses' posttraumatic growth and compassion satisfaction, burnout, secondary traumatic stress, and (iii) determine the influencing factors for posttraumatic growth among nurses suffering from workplace violence. A cross-sectional study was conducted to investigate 726 nurses suffering from workplace violence in 10 tertiary hospitals by using demographic, work-related information, lifestyle questionnaire, simplified Chinese version of the Posttraumatic Growth Inventory, and professional quality of life scale. In the findings, (i) the participants' posttraumatic growth scores were 57.29 ± 21.56, while the compassion satisfaction, burnout, and secondary traumatic stress scores were 32.82 ± 6.80, 27.17 ± 5.53, and 26.67 ± 5.29, respectively, (ii) posttraumatic growth was positively correlated with compassion satisfaction and secondary traumatic stress, and negatively correlated with burnout, and (iii) compassion satisfaction, sleep hours per day, department, scheduling, alcohol, secondary traumatic stress, children, and work hours per day were influencing factors of posttraumatic growth, which explained 36.3% of the total variance. Our study indicates that Chinese nurses may experience moderate levels of compassionate satisfaction, burnout, secondary traumatic stress, and low levels of posttraumatic growth after suffering from workplace violence, while the posttraumatic growth of nurses suffering from workplace violence is more affected by work-related variables and lifestyle-related variables, but less affected by other sociodemographic variables. Therefore, it is necessary to strengthen the psychological evaluation of nurses and adopt targeted strategies to promote nurses' posttraumatic growth.

Novel core-shell CHX/ACP nanoparticles effectively improve the mechanical, antibacterial and remineralized properties of the dental resin composite.

OBJECTIVE: The core-shell chlorhexidine/amorphous calcium phosphate (CHX/ACP) nanoparticles were synthesized and used to modify the dental resin composite, aiming to improve its remineralized and antibacterial properties. METHODS: The core-shell CHX/ACP nanoparticles were synthesized by vesicle-templating technology and characterized, and their sustained release and antibacterial properties were also evaluated. Subsequently, the synthesized nanoparticles were incorporated into the dental resin composite at 1 wt.%, 5 wt.% or 10 wt.% to obtain different experimental groups. The physical properties, including curing depth, double bond conversion rate, water absorption and solubility, the sustained-release effects, and mechanical properties of the modified resin composite were evaluated. The remineralization ability was also measured by SEM. The antibacterial experiment of the modified resin composite with fresh preparation or aging in water for 28 days was carried out by a plate count method. RESULTS: The physical and chemical characterizations showed that the synthesized nanoparticles presented a core-shell structure, and their diameter was about 98.5 nm. The shell was composed of ACP with the core full of CHX. These nanoparticles had a release effect on calcium, phosphate ions, and CHX. The nanoparticles could effectively inhibit the growth of S. mutan at a lower concentration (≥50 µg/mL). The curing depth, the double bond conversion, the water absorption, the solubility, the flexural strength, the flexural modulus, and the compressive strength of the modified resin composite were 3.86-4.88 mm, 62.32-73.61%, 1.47-2.84%, 0.21-0.48%, 45.83-109.46 MPa, 2.57-4.91 GPa, and 66.43-160.38 MPa, respectively. The modified resin composite containing 5 wt.% and above CHX/ACP nanoparticles could effectively inhibit the growth of S. mutans regardless of aging in water, with immediate and aging antibacterial rate of more than 92%. In addition, the modified resin composite had a certain remineralization property in the SBF solution verified by SEM. SIGNIFICANCE: The core-shell CHX/ACP nanoparticles were successfully prepared and used to modify the resin composite. The modified dental resin composite with 5 wt.% CHX/ACP nanoparticles had excellent mechanical, antibacterial, and remineralization properties. It is expected to be an ideal restorative filling material for clinical application.

Improvements on biological and antimicrobial properties of titanium modified by AgNPs-loaded chitosan-heparin polyelectrolyte multilayers.

Microbial infection around dental implants is a major cause for the loss of devices, including soft tissue infection in early period, post-operation peri-implantitis, and osseointegration failure. Silver nanoparticles (AgNPs) with wide antimicrobial spectrum, strong antimicrobial effect and hypotoxicity, as well as low incidence of antibiotic resistance, are widely involved in biomedical applications. Herein, firmly anchoring AgNPs onto the surface of implants through physical-chemical reaction is likely to relieve the above issues. In this study, AgNPs were biosynthesized by a simple and "green" method with chitosan (CS) as stabilizing and reducing agents. Then, AgNPs-loaded CS-heparin polyelectrolyte multilayers (PEMs) were constructed on alkali-heat treated titanium (Ti) substrates via layer-by-layer (LbL) self-assembly technique. The successful surface modification could be confirmed by scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS), and the constructed system could provide the continuous release of Ag+ over 28 days till mucosa healing. In short, this work revealed that the construction of multilayer coatings containing AgNPs on Ti substrates promoted adhesion and proliferation of human gingival fibroblasts (HGFs) and also enhanced the antimicrobial properties. This manifests the LbL technique is a viable and promising method for forming continuous antimicrobial coatings, to reduce microbial infection and improve the quality of peri-implant soft tissue seal. The preparation process of AgNPs-loaded CS-heparin PEMs on Ti substrate.

Low-level laser irradiation modulates the proliferation and the osteogenic differentiation of bone marrow mesenchymal stem cells under healthy and inflammatory condition.

The aim of this in vitro study was to evaluate the effects of low-level laser therapy (LLLT) at different energy intensities on proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) under healthy and inflammatory microenvironments. Human BMSCs and BMSCs from inflammatory conditions (i-BMSCs, BMSCs treated with tumor necrosis factor α; TNF-α) were subject to LLLT (Nd:YAG;1064 nm) at different intensities. We designed one control group (without irradiation) and four testing groups (irradiation at 2, 4, 8, and 16 J/cm2) for both BMSCs and i-BMSCs. Cell proliferation was measured using colony-forming unit fibroblast assay and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide assay. Osteogenic capacity of cells was determined by alkaline phosphatase (ALP) staining, ALP activity assay, Alizarin Red S staining and the mRNA transcript levels of genes runt-related transcription factor 2 (Runx2), ALP, and osteocalcin. Moreover, the effects of LLLT on secretion of TNF-α in BMSCs and i-BMSCs were measured by enzyme-linked immunosorbent assay. Our results demonstrated LLLT could significantly promote BMSC proliferation and osteogenesis at densities of 2 and 4 J/cm2. LLLT at density of 8 J/cm2 could promote the proliferation and osteogenesis of i-BMSCs. However, LLLT at 16 J/cm2 significantly suppressed the proliferation and osteogenesis of BMSCs both in healthy and in inflammatory microenvironment. Moreover, we also found that the expression of TNF-α was obviously inhibited by LLLT at 4, 8, and 16 J/cm2, in an inflammatory microenvironment. Considering these findings, LLLT could improve current in vitro methods of differentiating BMSCs under healthy and inflammatory microenvironments prior to transplantation.

Effect of contact stress on the cycle-dependent wear behavior of ceramic restoration.

AIM: Ceramic restoration experiences the non-linear wear process during the chewing simulation, which contains running-in, steady and severe wear stages. However since various levels of contact stress may be applied on the occlusal surface during chewing, the cycle-dependent wear behaviors of ceramic crowns may differ. The aim of this study was to investigate the effect of contact stress on the development of wear behavior, as tested in a chewing simulator. MATERIALS AND METHODS: Thirty-six anatomical metal-ceramic crowns using Ceramco III as the veneering porcelain were randomly assigned to two groups based on the contact stress applied in the wear testing. Stainless steel balls served as antagonists. The specimens were dynamically loaded in a chewing simulator up to 2.4×106 loading cycles, with additional thermal cycling between 5 and 55℃. For each group, several checkpoints were employed to measure the substance loss of the crowns' occlusal surfaces and to evaluate the microstructure of the worn areas. RESULTS: After 2.4×106 cycles, the ceramic restorations with lower contact stress demonstrated a long steady wear stage following the running-in, but without the severe wear stage. And a slowly microstructural degradation was observed that the subsurface defect could not be seen until final. With higher contact stress, however, the ceramic restorations experienced a faster transition from running-in to severe wear stage that the steady wear stage nearly disappeared. And an early formation of subsurface defects and the deterioration of microstructure were observed. CONCLUSIONS: Contact stress is a key factor affecting the wear development of ceramic restoration. The higher contact stress promotes the veneering porcelain to evolve into severe wear stage. In contrast, lower contact stress is prone to keep the veneering porcelain operating in steady wear stage, which delays the arrival of severe wear region.

[The effect of the structure of epithelial root sheath on the development of tooth root].

PURPOSE: To investigate the effect of the structure of epithelial root sheath (ERS) on the development of tooth root. METHODS: The first molars of postnatal (PN) 8 d SD rats were chosen to harvest the apical tissue. The tissues were digested by the mixture of type I collagenase and dispase. One part of the cell suspension was pelleted by centrifugalization. The other part of the cell suspension was digested by trypsin and then pelleted. The cell pellets were cultured in vitro for 4 hours and then implanted into renal capsule of the mother rats. RESULTS: It was found that ERS was dissociated into fragments by the mixture of type I collagenase and dispase or single cells by trypsin. The pellets containing fragments of ERS generated tooth root-like structure and periodontal tissues. The pellets containing single cells of ERS formed tubular and bone-like dentin. CONCLUSIONS: The bilayered epithelial structure of ERS has important role in the development of tooth root.

[Comparative study of friction and wear behavior of different human enamel in vitro].

OBJECTIVE: To investigate the friction and wear behavior of different human enamels. METHODS: 24 enamel samples selected from aged, young permanent and faded deciduous teeth were classified into 3 groups and slid against artificial porcelain teeth in the presence of artificial saliva on an oscillating friction and wear test rig. The wear volume loss, microhardness and toughness of each group of the enamel specimens were measured, the wear scars were observed with a scanning electron microscope, and the elemental compositions of Ca, P, and Si of the wear scar and wear debris were determined with an energy dispersion spectrometer. RESULTS: The wear volume losses of aged, young permanent and deciduous tooth enamels are (2.40 +/- 1.10) x 10(-12) m(3), (3.50 +/- 1.83) x 10(-12) m(3) and (4.86 +/- 2.49) x 10(-12) m(3). The data of aged tooth enamels are statistically greater than that of deciduous tooth enamels (P < 0.05). There is no significant difference between the wear volume loss of aged and young permanent tooth enamels or between the young permanent and deciduous tooth enamels (P > 0.05). However, the friction and wear behavior of each group of enamel specimens is different from each other. CONCLUSIONS: In the present testing condition, the wear scars of each kind of enamel specimens is characterized by ploughing and cracking. The different wear resistance of the three kinds of enamels is attributed to the different microstructure of the enamel, while the hardness and toughness of the enamels are not correlated with the wear resistance.