Discharge teaching quality positively predicts quality of life in colorectal cancer patients with temporary enterostomy: The mediating role of readiness for hospital discharge and stoma self-efficacy.

OBJECTIVES: This study aimed to examine the mediating role of readiness for hospital discharge (RHD) and stoma self-efficacy (SSE) in the relationship between quality of discharge teaching (QDT) and health-related quality of life (HRQOL) in colorectal cancer patients with temporary enterostomy, and the gender difference of mediating effect. BACKGROUND: It is not clear how RHD, QDT, SSE and HRQOL interact in colorectal cancer patients with temporary enterostomy. METHODS: This was a prospective follow-up survey. 221 colorectal cancer patients with temporary enterostomy were conveniently recruited from a general hospital in Southeast China. The Quality of Discharge Teaching Scale, Readiness for Hospital Discharge Scale, Stoma Self-Efficacy Scale, and Stoma Quality of Life Scale were used to collect data. Pearson's correlation and structural equation models were used to analyze the data. SPSS 26.0 and Amos 28.0 software were used for analysis the collected data. RESULTS: Regarding the relationship of QDT and HRQOL, only QDT-T had a direct effect among colorectal cancer patients with stomas (b = 0.233, P<0.001, percentile 95% CI = [0.145, 0.314]). However, both QDT-T and QDT-R can predict HRQOL indirectly through three paths: (1) the mediating role of SSE (b = 0.050, P = 0.009, percentile 95% CI = [0.013, 0.098]; b = 0.077, P = 0.008, percentile 95% CI = [0.021, 0.164]), (2) the mediating role of RHD (b = 0.044, P = 0.004, percentile 95% CI = [0.014, 0.085]; b = 0.044, P = 0.005, percentile 95% CI = [0.010, 0.102]), and (3) the chain mediating role of SSE and RHD (b = 0.030, P = 0.003, percentile 95% CI = [0.011, 0.059]; b = 0.047, P = 0.003, percentile 95% CI = [0.015, 0.103]). The similar chain mediating effect in male stoma patients was also found (b = 0.041, P = 0.002, percentile 95% CI = [0.016, 0.080]; b = 0.046, P = 0.004, percentile 95% CI = [0.011, 0.114]). CONCLUSIONS: Stoma self-efficacy and readiness for hospital discharge played important intermediary roles in the relationship between quality of discharge teaching and health-related quality of life in colorectal cancer patients with stomas. Health care providers can design SSE-enhancing and RHD-enhancing discharge planning for colorectal cancer patients with temporary enterostomies.

Electrospun Photodynamic Antibacterial Konjac Glucomannan/Polyvinylpyrrolidone Nanofibers Incorporated with Lignin-Zinc Oxide Nanoparticles and Curcumin for Food Packaging.

Due to the growing concerns surrounding microbial contamination and food safety, there has been a surge of interest in fabricating novel food packaging with highly efficient antibacterial activity. Herein, we describe novel photodynamic antibacterial konjac glucomannan (KGM)/polyvinylpyrrolidone (PVP) nanofibers incorporated with lignin-zinc oxide composite nanoparticles (L-ZnONPs) and curcumin (Cur) via electrospinning technology. The resulting KGM/PVP/Cur/L-ZnONPs nanofibers exhibited favorable hydrophobic properties (water contact angle: 118.1°), thermal stability, and flexibility (elongation at break: 241.9%). Notably, the inclusion of L-ZnONPs and Cur endowed the nanofibers with remarkable antioxidant (ABTS radical scavenging activity: 98.1%) and photodynamic antimicrobial properties, demonstrating enhanced inhibitory effect against both Staphylococcus aureus (inhibition: 12.4 mm) and Escherichia coli (12.1 mm). As a proof-of-concept study, we evaluated the feasibility of applying nanofibers to fresh strawberries, and the findings demonstrated that our nanofibers could delay strawberry spoilage and inhibit microbial growth. This photodynamic antimicrobial approach holds promise for design of highly efficient antibacterial food packaging, thereby contributing to enhanced food safety and quality assurance.

Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study.

BACKGROUND: The global aging population presents challenges that are particularly acute in China. Older Chinese adults' attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs. METHODS: This mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group. RESULTS: Forty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one's acceptance and others' avoidance, and evaluation of the life education program. CONCLUSIONS: The KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort. TRIAL REGISTRATION: This study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176 .

Development and evaluation of a narrative therapy program combined with a solution-focused approach for nursing home residents: A quasi-experimental study.

The transition from the family home to a nursing home can be an emotionally stressful experience for older adults. This study aimed to examine the feasibility and effects of a narrative therapy combined with a solution focus (NTCSF) program on the psychological adjustment, depression, and self-efficacy of nursing home residents. A non-random concurrent controlled trial was conducted in Fujian, China that involved 81 participants (intervention = 41, comparison = 40) from four separate nursing homes. The control group received routine institutional care, while the intervention group underwent a three-week NTCSF program in addition to receiving routine care. In the variance analyses, significant differences were found in "psychological adjustment" (T = 4.007, P < 0.001) and "self-efficacy" (T = 3.204, P = 0.002), compared to the control group. There was no significant difference in "depression" (t = -1.550, P = 0.125) between the groups at the baseline, but the experimental group showed a significant decrease in depression (t = -2.204, P = 0.033) after the intervention. The NTCSF program was found to be effective in improving the psychological adjustment of nursing home residents. Trial registration This study was registered on the Chinese Clinical Trial Registry (Registration No: ChiCTR-2100042767).

Development and psychometric evaluation of the death risk perception scale for advanced cancer patients.

BACKGROUND: An accurate perception of death risk is a prerequisite for advanced cancer patients to make informed end-of-life care decisions. However, there is to date no suitable scale to measure death risk perception. This study was to develop and psychometrically test the death risk perception scale (DRPS) for advanced cancer patients. METHODS: Process of instrument development and psychometric evaluation were used. First, qualitative research, a literature review, brainstorming, a Delphi study, and cognitive interviews were conducted to construct a pretest scale of death risk perception. Second, a scale-based survey was administered to 479 advanced cancer patients. Item, exploratory factor, and confirmatory factor analyses were employed to optimize the scale. The Cronbach's alpha was calculated as a reliability analysis. The validity analysis included construct, convergent, discriminant, and content validity values. RESULTS: A three-dimension, 12-item scale was developed, including deliberative, affective, and experiential risk perception. The confirmatory factor analysis supported the three-factor model with satisfactory convergent and discriminant validity levels. The Cronbach's alpha coefficient for internal consistency was 0.807 and scale-level content validity index was 0.98. CONCLUSIONS: The 12-item DRPS is a reliable and valid instrument for assessing the level of death risk perception in advanced cancer patients. More studies are needed to examine its structure and robustness prior to use.

Effect of gut hormones on bone metabolism and their possible mechanisms in the treatment of osteoporosis.

Bone is a highly dynamic organ that changes with the daily circadian rhythm. During the day, bone resorption is suppressed due to eating, while it increases at night. This circadian rhythm of the skeleton is regulated by gut hormones. Until now, gut hormones that have been found to affect skeletal homeostasis include glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2), glucose-dependent insulinotropic polypeptide (GIP), and peptide YY (PYY), which exerts its effects by binding to its cognate receptors (GLP-1R, GLP-2R, GIPR, and Y1R). Several studies have shown that GLP-1, GLP-2, and GIP all inhibit bone resorption, while GIP also promotes bone formation. Notably, PYY has a strong bone resorption-promoting effect. In addition, gut microbiota (GM) plays an important role in maintaining bone homeostasis. This review outlines the roles of GLP-1, GLP-2, GIP, and PYY in bone metabolism and discusses the roles of gut hormones and the GM in regulating bone homeostasis and their potential mechanisms.

The effects of a nurse-led discharge planning on the health outcomes of colorectal cancer patients with stomas: A randomized controlled trial.

BACKGROUND: Nursing care of colorectal cancer patients with stomas presents unique challenges, particularly during the transition from hospital to home. Early discharge programs can assist patients during this critical period. However, the effects of delivering a nurse-led discharge planning program remain under-studied. OBJECTIVE: Evaluate the effects of a nurse-led discharge planning on the quality of discharge education, stoma self-efficacy, readiness for hospital discharge, stoma quality of life, incidence of stoma complications, unplanned readmission rate, and length of stays. DESIGN: Assessor-blind parallel-arm randomized controlled trial with a repeated-measures design. SETTING(S): Participants were recruited from inpatients in the colorectal surgery unit of a university-affiliated hospital in Fujian, China. PARTICIPANTS: A total of 160 patients with colorectal cancer who received enterostomy surgery and were scheduled to be discharged to their homes. METHOD: Participants were randomly allocated to the experimental and control groups. The former received nurse-led discharge planning in addition to the usual discharge education, while the control group received only the usual discharge education. The program included an assessment, health education, stoma care, stoma support, discharge review, discharge medication and checklist integration, discharge referral, and post-hospital follow-up. Baseline data were collected prior to the intervention (T0). Data on the quality of discharge teaching, readiness for hospital discharge, stoma self-efficacy, and stoma quality of life were measured on the day of discharge from the hospital (T1). Patients' stoma self-efficacy and quality of life were repeat-measured 30 (T2) and 90 days post-discharge (T3). Data on stoma complications (T1, T2, T3), length of stays (T1), and unplanned readmission (T2, T3) were collected from medical records. RESULTS: Participants in the intervention group showed significant improvement in the quality of discharge teaching, readiness for hospital discharge, stoma self-efficacy, stoma quality of life, complications, and unplanned readmission, compared to the control group (p < 0.001). However, no statistically significant differences were observed in length of stays (p > 0.05). CONCLUSIONS: The program was effective for improving quality of discharge teaching, readiness for hospital discharge, stoma self-efficacy, and stoma quality of life, as well as for reducing complications and unplanned readmission among stoma patients. Integration of discharge planning into the usual process of care is recommended for clinical practice to facilitate a successful transition from hospital to home. REGISTRATION: This study was registered at the Chinese clinical trial registry (ChiCTR2200058756) on April 16, 2022, and participant recruitment was initiated in May 2022.

The effect of a resourcefulness-based instrumental reminiscence program for nursing home residents: A pilot study.

OBJECTIVES: To examine the effect of a resourcefulness-based instrumental reminiscence program (RIRP) for nursing home residents. METHODS: This study was a mixed-methods study with one-group pretest-posttest design. The RIRP incorporated Emotional Venting, Reconstruction Strategies, Planning for Future, and Strengthening Support. It was performed once a week for 6 weeks. A post-intervention interview was conducted to explore participants' perception of the RIRP and quantitative data about psychological adjustment, learned resourcefulness, social support, self-efficacy, and quality of life were collected. RESULTS: 40 participants completed the RIRP with an 88.9% intervention compliance rate. 92.5% participants satisfied with the RIRP. A significant improvement was identified in psychological adjustment, learned resourcefulness, self-efficacy, social support, and mental health in nursing home residents after the RIRP. Qualitative results identified three prominent categories: innovation, benefits, and challenges. CONCLUSION: The innovative RIRP is a feasible intervention in potentially improving psychological adjustment, learned resourcefulness, self-efficacy, social support, and mental health of nursing home residents. TRIAL REGISTRATION: The study was registered in the Chinese Clinical Trial Registry (https://www.chictr.org.cn/). Identifier: ChiCTR2100042767. Date of trial Registration: 28/01/2021.

Combination of concept maps and case-based learning in a flipped classroom: A mixed-methods study.

AIM: This study aimed to evaluate the impact of a hybrid learning method on the academic achievements, learning skills and experiences of undergraduate nursing students. BACKGROUND: Case-based learning is a student-centered approach that is commonly integrated into the flipped classroom model in nursing education. However, effectively combining the flipped classroom model and case-based learning into a hybrid learning format is challenging. To address this gap, this study integrated concept maps with case-based learning and the flipped classroom and evaluated the impact of this hybrid learning method on the academic achievements, learning skills and experiences of undergraduate nursing students. DESIGN: A mixed-methods approach, including a quasi-experimental study and semi-structured interviews, was employed. METHODS: A total of 277 undergraduate nursing students participated, with 136 students in the control group undergoing case-based learning and 141 students in the experimental group taught using the hybrid learning approach, which combined concept maps, case-based learning and a flipped classroom. The study assessed self-directed learning, critical thinking, learning strategy and curriculum grades in both groups before and after the intervention. Additionally, students in the experimental group participated in semi-structured interviews. RESULTS: The quantitative findings indicated that both case-based learning and the hybrid learning method (combined concept maps, case-based learning and a flipped classroom) had similar impacts on the curriculum grades, self-directed learning, cognitive maturity and learning strategy of nursing students. The qualitative results further demonstrated how the hybrid approach facilitated integrated learning, promoted self-evaluation, aided adaptation to the flipped classroom and enhanced teacher-student interaction. CONCLUSIONS: Combining case-based learning, a flipped classroom and concept maps is an effective learning approach for undergraduate nursing students. It may improve students' self-directed learning, cognitive maturity and learning strategy. Additionally, concept maps are a beneficial supplement to case-based learning and a flipped classroom in terms of guiding integrated learning, promoting self-evaluation, enhancing adaptation to a flipped classroom and increasing interaction between teachers and students and between classmates.

Existential distress and associated factors in advanced cancer patients: A cross-sectional study.

BACKGROUND: Advanced cancer patients often experience existential distress (ED). However, the factors associated with ED remain unclear. This study investigated the current state of ED and identified the associated factors in Chinese patients with advanced cancer. METHODS: A cross-sectional study was conducted among 352 advanced cancer patients from 3 tertiary hospitals in Fujian, China. Participants were invited to complete the Existential Distress Scale, Number Rating Scale, Self-Perceived Burden Scale, Quality of Life Concerns in the End-of-Life Questionnaire, and Hospital Anxiety and Depression Scale. OBJECTIVES: This study aimed to investigate the level of existential distress among advanced cancer patients in China and identify the associated factors. RESULTS: A total of 352 advanced cancer patients were recruited for this study. The average score for ED was 8.48 ± 7.12 among the advanced cancer patients. Multiple regression showed that the associated factors included depression (ß = 0.32, p = 0.000), self-perceived burden (SPB) (ß = 0.18, p = 0.001), the presence of a spouse (ß = -0.10, p = 0.050), and reception of government subsidies (ß = 0.17, p = 0.001). The factors accounted for 30.1% of the total variance in ED (F = 8.472, p < 0.001). SIGNIFICANCE OF RESULTS: Among the advanced cancer patients queried, ED was found to be positively influenced by depression, SPB, and reception of government subsidies and negatively influenced by the presence of a spouse. Depression was the most important risk factor, and thus future ED interventions should target depression.

The effects of resourcefulness-based instrumental reminiscence therapy on psychological adjustment in nursing home residents: a randomised controlled trial.

BACKGROUND: Older adults do not always adapt successfully to nursing homes. Learning resourcefulness and instrumental reminiscence may contribute to the psychological adjustment made by nursing home residents. How both attributes can be combined to enhance residents' adjustment remains unclear. OBJECTIVES: This study examined the effects of resourcefulness-based instrumental reminiscence therapy (RBIRT) on psychological adjustment, learned resourcefulness, self-efficacy, social support and quality of life (QoL) of nursing home residents. METHODS: A randomised, controlled, assessor-blinded, parallel-arm trial was conducted between January 2022 and February 2023 in Fujian, China, with 120 participants (intervention = 60, comparison = 60) from two separate nursing homes. The intervention group participants received a 6-week RBIRT, involving Reminiscence Interview, Emotional Venting, Reconstruction Strategies, Planning for the Future and Strengthening Support. The control group participants received routine institutional care. Participants were assessed using the Nursing Home Adjustment Scale, Resourcefulness Scale, General Self-efficacy Scale, Perceived Social Support Scale and the 12-item Short-Form Health Survey. Outcomes were evaluated at baseline (T0), immediately post intervention (T1) and at 1-month (T2) and 3-months (T3) post-intervention. RESULTS: Participants in the intervention group showed significant improvement in 'psychological adjustment,' 'learned resourcefulness,' 'self-efficacy,' 'social support' and 'QoL-mental health dimension' compared to the control group (P < 0.001). These effects were sustained at the 1- and 3-month follow-ups. CONCLUSIONS: Innovative RBIRT improved psychological adjustment, learned resourcefulness, self-efficacy, social support and mental health-related QoL among nursing home residents.

Effects of death education interventions on cancer patients in palliative care: A systematic review and meta-analysis.

This review summarizes the best available evidence on the effects of death education in palliative care for cancer patients. A systematic literature review was conducted across 9 databases, revealing 22 eligible studies (N = 2,374). After two reviewers independently engaged in study selection, quality assessment, and data extraction, the results were synthesized through qualitative and quantitative analysis. Overall, the focus on death education for cancer patients showed an upward trend and consistently demonstrated significant positive effects with regards to the control of anxiety and depression, attitudes toward death, and quality of life. However, high-quality evidence regarding the effects of death education on cancer patients is lacking, warranting additional well-designed rigorous studies and standardized programs with specific and feasible steps.

Fear of recurrence in postoperative lung cancer patients: Trajectories, influencing factors and impacts on quality of life.

AIMS: To investigate the trajectory, influencing factors and dynamic relationships between fear of cancer recurrence (FCR) and quality of life (QOL) in lung cancer patients. DESIGN: Prospective longitudinal study. METHODS: Longitudinal data from 310 lung cancer patients across three hospitals in China were assessed at 1, 3, 6 and 12 months postoperatively (T1 -T4 ). Descriptive statistics characterised patient demographics, clinical characteristics, levels of FCR and QOL. A linear mixed-effects model was employed to analyse FCR trajectories, identify influencing factors on these trajectories, and predict the impact of FCR on QOL. RESULTS: FCR changed significantly over time, with a slight decrease during T1 -T2 , an increase at T3 and gradual decline at T4 . Higher fear levels were associated with female sex, suburban or rural residency, being a family breadwinner, presence of comorbidities and negative coping behaviours, and low family resilience. QOL negatively correlated with FCR, and FCR predicted lower QOL. CONCLUSIONS: At 3 and 6 months postoperatively, lung cancer patients, especially women, suburban or rural residents, family breadwinners, those with comorbidities, negative coping behaviours and low family resilience, reported high levels of FCR. Healthcare providers should pay special attention to lung cancer patients especially during the period of 3-6 months post-surgery and offer tailored interventions to improve their QOL. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Understanding the FCR trajectories, its influencing factors and its negative impacts on QOL can guide the development of targeted interventions to reduce fear and enhance well-being in patients with cancer. IMPACT: Identifying the trajectories and influencing factors of fear of lung cancer recurrence in patients at different time points informs future research on targeted interventions to improve QOL. REPORTING METHOD: The study adhered to the guidelines outlined in the Statement on Reporting Observational Longitudinal Research.

Predicting the prognosis in patients with sepsis by an endoplasmic reticulum stress gene signature.

BACKGROUND: Prognostic stratification of patients with sepsis is important for the development of individualized treatment strategies. Endoplasmic reticulum stress (ERS) plays a key role in sepsis. This study aimed to identify a set of genes related to ER stress to construct a predictive model for the prognosis of sepsis. METHODS: The transcriptomic and clinical data of 479 sepsis patients were obtained from GSE65682 and divided into a training set (n=288) and a validation set (n=191) at a ratio of 3:2. The external test set was GSE95233 (n=51). LASSO and Cox regression analyses were performed to establish a signature to predict the prognosis of patients with sepsis. Moreover, we developed a nomogram that included the risk signature and clinical features to predict survival probability. RESULTS: A prognostic signature was constructed with ten endoplasmic reticulum related genes (ADRB2, DHCR7, GABARAPL2, MAOA, MPO, PDZD8, QDPR, SCAP, TFRC, and TLR4) in the training set, which significantly divided patients with sepsis into high- and low-risk groups in terms of survival. This signature was validated using validation and external test sets. A nomogram based on the risk signature was constructed to quantitatively predict the prognosis of patients with sepsis. CONCLUSIONS: We constructed an ERS signature as a novel prognostic marker for predicting survival in sepsis patients, which could be used to develop novel biomarkers for the diagnosis, treatment, and prognosis of sepsis and to provide new ideas and prospects for future clinical research.

Inhibition of SF3B1 improves the immune microenvironment through pyroptosis and synergizes with αPDL1 in ovarian cancer.

Ovarian cancer is resistant to immune checkpoint blockade (ICB) treatment. Combination of targeted therapy and immunotherapy is a promising strategy for ovarian cancer treatment benefit from an improved immune microenvironment. In this study, Clinical Proteomic Tumor Analysis Consortium (CPTAC) and The Cancer Genome Atlas (TCGA) cohorts were used to screen prognosis and cytotoxic lymphocyte infiltration-associated genes in upregulated genes of ovarian cancer, tissue microarrays were built for further verification. In vitro experiments and mouse (C57/BL6) ovarian tumor (ID8) models were built to evaluate the synergistic effect of the combination of SF3B1 inhibitor and PD-L1 antibody in the treatment of ovarian cancer. The results show that SF3B1 is shown to be overexpressed and related to low cytotoxic immune cell infiltration in ovarian cancer. Inhibition of SF3B1 induces pyroptosis in ovarian cancer cells and releases mitochondrial DNA (mtDNA), which is englobed by macrophages and subsequently activates them (polarization to M1). Moreover, pladienolide B increases cytotoxic immune cell infiltration in the ID8 mouse model as a SF3B1 inhibitor and increases the expression of PD-L1 which can enhance the antitumor effect of αPDL1 in ovarian cancer. The data suggests that inhibition of SF3B1 improves the immune microenvironment of ovarian cancer and synergizes ICB immunotherapy, which provides preclinical evidence for the combination of SF3B1 inhibitor and ICB to ovarian cancer treatment.

Highly Hydrophobic Gelatin Nanocomposite Film Assisted by Nano-ZnO/(3-Aminopropyl) Triethoxysilane/Stearic Acid Coating for Liquid Food Packaging.

Biodegradable gelatin (G) food packaging films are in increasing demand as the substitution of petroleum-based preservative materials. However, G packaging films universally suffer from weak hydrophobicity in practical applications. Constructing a hydrophobic micro/nanocoating with low surface energy is an effective countermeasure. However, the poor compatibility with the hydrophilic G substrate often leads to the weak interfacial adhesion and poor durability of the hydrophobic coating. To overcome this obstacle, we used (3-aminopropyl) triethoxysilane (APS) as an interfacial bridging agent to prepare a highly hydrophobic, versatile G nanocomposite film. Specifically, tannic acid (TA)-modified nanohydroxyapatite (n-HA) particles (THA) were introduced in G matrix (G-THA) to improve the mechanical properties. Micro/nanostructure with low surface energy composed of nanozinc oxide (Nano-ZnO)/APS/stearic acid (SA) (NAS) was constructed on the surface of G-THA film (G-THA/NAS) through one-step spray treatment. Consequently, as-prepared G-THA/NAS film presented excellent mechanics (tensile strength: 7.6 MPa, elongation at break: 292.7%), water resistance ability (water contact angle: 150.4°), high UV-shielding (0% transmittance at 200 nm), degradability (100% degradation rate after buried in the natural soil for 15 days), antioxidant (78.8% of 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity), and antimicrobial (inhibition zone against Escherichia coli: 15.0 mm and Staphylococcus aureus: 16.5 mm) properties. It should be emphasized that the bridging function of APS significantly improves the interfacial adhesion ability of the NAS coating with more than 95% remaining area after the cross-cut adhesion test. Meanwhile, the G-THA/NAS film could maintain stable and long-lasting hydrophobic surfaces against UV radiation, high temperature, and abrasion. Based on these multifunctional properties, the G-THA/NAS film was successfully applied as a liquid packaging material. To sum up, we provide a feasible and effective method to prepare high-performance green packaging films.

Cognitive appraisal and depression in cancer patients undergoing chemotherapy: mediation by perceived stress and self-efficacy.

PURPOSE: Cancer patients undergoing chemotherapy are prone to suffering a higher incidence rate of depression, leading to poor quality of life. However, how cancer affects depression is unclear. This study aimed to examine whether the relationship between cognitive appraisal and depression is mediated by perceived stress and self-efficacy in cancer patients undergoing chemotherapy. METHODS: A total of 421 cancer patients undergoing chemotherapy participated in this cross-sectional survey. Cognitive appraisal of cancer, perceived stress, self-efficacy, and depression were measured with the Perceived Life Threat Scale, Perceived Stress Scale, General Self-efficacy Scale and Hospital Anxiety, and Depression Scale-Depression Scale, respectively. Path analysis was performed to analyze the mediating effects of perceived stress and self-efficacy on the relationship between cognitive appraisal of cancer and depression. RESULTS: Cognitive appraisal of cancer exerted direct (b = 0.066, SE = 0.020, p < 0.001, bias-corrected 95% CI = [0.027, 0.106]) and indirect (mediated by depression and insomnia) (b = 0.136, SE = 0.015, p < 0.001, bias-corrected 95% CI = [0.107, 0.167]) effects on depression. Perceived stress and self-efficacy were significant in mediating the relationship between cognitive appraisal of cancer and depression (b = 0.101, SE = 0.014, p < 0.001, bias-corrected 95% CI = [0.074, 0.132]; b = 0.021, SE = 0.006, p < 0.001, bias-corrected 95% CI = [0.006, 0.028], respectively). Additionally, a sequential mediating effect of perceived stress via self-efficacy was found, and the mediating effect size was 0.014 (p < 0.01, bias-corrected 95% CI = [0.010,0.034]). CONCLUSIONS: This study suggests that medical staff could prevent or relieve depression through improving self-efficacy or reducing perceived stress in cancer patients undergoing chemotherapy.

Effects of Psycho-education Interventions on Colorectal Cancer Patients: A systematic review and meta-analysis.

Colorectal cancer (CRC) patients not only undergo physical symptoms but also psychological suffering. Psycho-education interventions have been implemented widely to improve their psychological well-being. However, the effectiveness of psycho-education is unclear. Therefore, this research evaluates the effectiveness of psycho-education interventions on CRC patient outcomes and identifies effective intervention characteristics. The researchers searched the following databases: PubMed, Embase, PsycINFO, Cochrane, Medline, Web of Science, CINAHL, ProQuest, Wan Fang Data, Chinese National Knowledge Infrastructure, Chinese Biomedicine Database, and China Academic Journals Full-Text Database. Additionally, gray literature and bibliographies of the included studies were also searched. Finally, this review included 11 randomized controlled trials and one controlled clinical trial. The results showed that psycho-education interventions exerted positive impacts on relieving anxiety and depression, improving self-efficacy and quality of life for CRC patients either immediately, post-intervention, or at least 2 months after intervention. Despite the variety of psycho-education interventions, health education, stress management, coping skills training, and social support are also essential components. Future research should include multi-center studies with sufficient sample sizes and rigorous designs.

Biomimetic hydrogel derived from decellularized dermal matrix facilitates skin wounds healing.

Cutaneous wound healing affecting millions of people worldwide represents an unsolvable clinical issue that is frequently challenged by scar formation with dramatical pain, impaired mobility and disfigurement. Herein, we prepared a kind of light-sensitive decellularized dermal extracellular matrix-derived hydrogel with fast gelling performance, biomimetic porous microstructure and abundant bioactive functions. On account of its excellent cell biocompatibility, this ECM-derived hydrogel could induce a marked cellular infiltration and enhance the tube formation of HUVECs. In vivo experiments based upon excisional wound splinting model showed that the hydrogel prominently imparted skin wound healing, as evidenced by notably increased skin appendages and well-organized collagen expression, coupled with significantly enhanced angiogenesis. Moreover, the skin regeneration mediated by this bioactive hydrogel was promoted by an accelerated M1-to-M2 macrophage phenotype transition. Consequently, the decellularized dermal matrix-derived bioactive hydrogel orchestrates the entire skin healing microenvironment to promote wound healing and will be of high value in treatment of cutaneous wound healing. As such, this biomimetic ddECMMA hydrogel provides a promising versatile opinion for the clinical translation.