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Background: Patients diagnosed with advanced stage cancer face an elevated risk of suicide. We aimed to develop a suicidal ideation (SI) risk prediction model in patients with advanced cancer for early warning of their SI and facilitate suicide prevention in this population. Patients and Methods: We consecutively enrolled patients with multiple types of advanced cancers from 10 cancer institutes in China from August 2019 to December 2020. Demographic characteristics, clinicopathological data, and clinical treatment history were extracted from medical records. Symptom burden, psychological status, and SI were assessed using the MD Anderson Symptom Inventory (MDASI), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire‐9 (PHQ‐9), respectively. A multivariable logistic regression model was employed to establish the model structure. Results: In total, 2814 participants were included in the final analysis. Nine predictors including age, sex, number of household members, history of previous chemotherapy, history of previous surgery, MDASI score, HADS‐A score, HADS‐D score, and life satisfaction were retained in the final SI prediction model. The model achieved an area under the curve (AUC) of 0.85 (95% confidential interval: 0.82–0.87), with AUCs ranging from 0.75 to 0.95 across 10 hospitals and higher than 0.83 for all cancer types. Conclusion: This study built an easy‐to‐use, good‐performance predictive model for SI. Implementation of this model could facilitate the incorporation of psychosocial support for suicide prevention into the standard care of patients with advanced cancer. [ABSTRACT FROM AUTHOR]

Objectives: Patients with advanced colorectal cancer (CRC) have multiple concurrent physical and psychological symptoms. This study aimed to explore the relationship between anxiety, depression, and symptom burden in advanced CRC. Methods: A multicenter cross‐sectional study was conducted in 10 cancer centers from geographically and economically diverse sites in China. A total of 454 patients with advanced CRC completed the Hospital Anxiety and Depression Scale and the MD Anderson Symptom Inventory. Multiple regression analysis was applied to explore the relationship between anxiety, depression and symptom burden. Results: About one‐third of the patients showed symptoms of anxiety or depression. Patients with anxiety or depression reported significantly higher symptom burden than those without (p < 0.001). Patients with anxiety or depression reported a higher proportion of moderate‐to‐severe (MS) symptom number than those without (p < 0.001). About 52% of the patients with anxiety or depression reported at least three MS symptoms. The prevalence of MS symptoms was ranging from 7.3% (shortness of breath) to 22% (disturbed sleep), and in patients with anxiety or depression was 2–10 times higher than in those without (p < 0.001). Disease stage (β = −2.55, p = 0.003), anxiety (β = 15.33, p < 0.001), and depression (β = 13.63, p < 0.001) were associated with higher symptom burden. Conclusions: Anxiety and depression in patients with advanced cancer correlated with higher symptom burden. Findings may lead oncology professionals to pay more attention to unrecognized and untreated psychological symptoms in symptom management for advanced cancer patients. [ABSTRACT FROM AUTHOR]

Purpose: The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. Methods: Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. Results: SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p < 0.05). The ORs indicate that depression and distress have the strongest associations with SI. Health status has a significant indirect effect (OR=-0.044, p = 0.005) and a strong total effect (OR=-0.485, p < 0.001) on SI, mediated by insomnia severity and emotional distress. Conclusions: There is a high SI prevalence among Chinese patients with advanced breast cancer. Our analysis revealed predictive pathways from poor health to heightened SI, mediated by emotional distress and insomnia. Regular management of distress and insomnia can decrease suicide risk in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Little is understood about the association between psychosomatic symptoms and advanced cancer among older Chinese patients. Methods: This secondary analysis was part of a multicenter cross-sectional study based on an electronic patient-reported outcome platform. Patients with advanced cancer were included between August 2019 and December 2020 in China. Participants (over 60 years) completed the MD Anderson Symptom Inventory (MDASI) and Hospital Anxiety and Depression Scale (HADS) to measure symptom burden. Network analysis was also conducted to investigate the network structure, centrality indices (strength, closeness, and betweenness) and network stability. Results: A total of 1022 patients with a mean age of 66 (60–88) years were included; 727 (71.1%) were males, and 295 (28.9%) were females. A total of 64.9% of older patients with advanced cancer had one or more symptoms, and up to 80% had anxiety and depression. The generated network indicated that the physical symptoms, anxiety and depression symptom communities were well connected with each other. Based on an evaluation of the centrality indices, 'distress/feeling upset' (MDASI 5) appears to be a structurally important node in all three networks, and 'I lost interest in my own appearance' (HADS-D4) had the lowest centrality indices. The network stability was relatively high (> 0.7). Conclusion: The symptom burden remains high in older patients with advanced cancer in China. Psychosomatic symptoms are highly interactive and often present as comorbidities. This network can be used to provide targeted interventions to optimize symptom management in older patients with advanced cancer in China. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900024957), registered on 06/12/2020. [ABSTRACT FROM AUTHOR]

With global warming, previous studies have found nonuniformity responses of precipitation because of regional differences. However, climate change affects the mean, extreme, and data structure of precipitation. Quantile regression, which can reflect every part of the trends of data, was used to detect responses of each part of precipitation in China. The V2.0 dataset of daily precipitation grid data (0.5° × 0.5°) from 1961 to 2020 in China was used as practical observation data. Daily precipitation in 2015–2100 from the China Model BCC-CSM2-MR of scenarios SSP2-4.5 and SSP5-8.5 were chosen as future climate changes with moderate and high radiative forcing, respectively. On the basis of the sign consistency of the slope coefficients with quantile regression, the results of quantiles q = 0.3, 0.5, 0.7 and 0.9 were selected to represent low, median, high and flood precipitation, respectively. Precipitation in four seasons was separately analyzed to observe seasonal characteristics in China. For the observation data, precipitation had obviously different responses in the low and high percentiles and was present in mainly spring and summer. In spring, in the middle and lower Yangtze Plains, the low and median precipitation increased, whereas the high and flood precipitation significantly decreased. In summer, Heilongjiang Province and northern Inner Mongolia showed decreasing trends in the low quantile and increasing trends in the high quantile, indicating a completely opposite trend adjustment. These regions deserve more attention. However, obviously different responses in low and high percentiles were not so evident in future climate changes. Self-consistency in model data may weaken the heteroscedastic characteristics of precipitation. [ABSTRACT FROM AUTHOR]

Long-term exposure to low polycyclic aromatic hydrocarbon (PAH) concentration may ave detrimental effects, including changing platelet indices. Effects of chronic exposure to low PAH concentrations have been evaluated in cross-sectional, but not in longitudinal studies, to date. We aimed to assess the effects of long-term exposure to the low-concentration PAHs on alterations in platelet indices in the Chinese population. During 2014–2017, we enrolled 222 participants who had lived in a village in northern China, 1–2 km downwind from a coal plant, for more than 25 years, but who were not employed by the plant or related businesses. During three follow-ups, annually in June, demographic information and urine and blood samples were collected. Eight PAHs were tested: namely 2-hydroxynaphthalene, 1-hydroxynaphthalene, 2-hydroxyfluorene, 9-hydroxyfluorene (9-OHFlu), 2-hydroxyphenanthrene (2-OHPh), 1-hydroxyphenanthrene (1-OHPh), 1-hydroxypyrene (1-OHP), and 3-hydroxybenzo [a] pyrene. Five platelet indices were measured: platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet crit, and the platelet-large cell ratio. Generalized mixed and generalized linear mixed models were used to estimate correlations between eight urinary PAH metabolites and platelet indices. Model 1 assessed whether these correlations varied over time. Models 2 and 3 adjusted for additional personal information and personal habits. We found the following significant correlations: 2-OHPh (Model1 β1 = 18.06, Model2 β2 = 18.54, Model β3 = 18.54), 1-OHPh (β1 = 16.43, β2 = 17.42, β3 = 17.42), 1-OHP(β1 = 13.93, β2 = 14.03, β3 = 14.03) with PLT, as well as 9-OHFlu with PDW and MPV (odds ratio or Model3 ORPDW[95%CI] = 1.64[1.3–2.06], ORMPV[95%CI] = 1.33[1.19–1.48]). Long-term exposure to low concentrations of PAHs, indicated by2-OHPh, 1-OHPh, 1-OHP, and 9-OHFlu, as urinary biomarkers, affects PLT, PDW, and MPV. 9-OHFlu increased both PDW and MPV after elimination of the effects of other PAH exposure modes. [ABSTRACT FROM AUTHOR]

Introduction: Major depressive disorder (MDD) is associated with an increased risk of suicide and suicide attempt among cancer patients. However, we do not know how many cancer patients without MDD have suicidal ideation (SI). Objectives: This study aimed to investigate the prevalence, characteristics and correlated factors of SI among advanced cancer patients without MDD. Methods: This is a multi‐center, cross‐sectional study based on an electronic patient‐reported outcome systems in patients who were diagnosed with advanced lung, liver, gastric, esophageal, colorectal or breast cancer, the top six prevalent cancers in China. A total of 2930 advanced cancer patients were recruited from 10 regional representative cancer centers across China from August 2019 to December 2020. Patients completed the Patient Health Questionnaire‐9 regarding if they had thoughts of being better off dead or of hurting themselves in some way in the previous 2 weeks. Patients also completed the symptom inventory and quality of life assessment. Generalized estimating equation model was performed to explore the correlated factors associated with SI among the patients without MDD. Results: The overall prevalence of SI among advanced cancer patients without MDD was 13.1%. The prevalence was higher in older patients. After adjusted for existing conditions, patients with vomiting symptom (p < 0.001), poorer life quality (p < 0.001), and middle education level (p = 0.031) were correlated factors of SI. Conclusions: The suicidal ideation is common in advanced cancer patients without MDD. Patients with vomiting, poor quality of life, and middle education level should be screened and monitored for suicidal ideation even without MDD. Clinical Trial Information: ChiCTR1900024957. [ABSTRACT FROM AUTHOR]

Objectives. The integration of patient-reported health status has been increasingly emphasised for delivering high-quality care to advanced cancer patients. This research is designed to track health status changes over time in Chinese advanced cancer patients to explore the risk factors affecting their health status. Methods. Advanced cancer patients were recruited from Peking University Cancer Hospital. An electronic patient-reported outcome (ePRO) system with validated measurements was used to collect the data. ANOVA, the chi-square test, the nonparametric Kruskal–Wallis H test, and generalized estimating equation (GEE) analysis were used for the data analysis. Results. One hundred and three patients completed a baseline survey (T = 0) and two follow-up surveys (T1 = 14 days, T2 = 28 days). Chi-square test results indicate a significant decrease in the percentage of patients reporting moderate or severe difficulty experienced by patients in terms of mobility, pain/discomfort, and anxiety/depression. However, there is a significant increase in the percentage of patients reporting moderate or severe difficulty in self-care and usual activities. Scores on the visual analogue scale in the EQ-5D-5L instrument (EQ-VAS) are associated with patients' income, and the degree of moderate or severe anxiety/depression is found to be associated with employment status. The GEE results show that pain, loss of appetite, poor walking status effected by symptoms, depression, and anxiety has worsened the health status. Conclusions. The health status of Chinese advanced cancer patients under ePRO follow-up in China significantly improves in the physical and psychological dimensions, accompanied by a decrease in usual activities and self-care. Routine screening and rational supportive care are recommended in oncology for cancer care. Based on the rational application of ePRO, longitudinal studies exploring the potential mechanisms of health status changing would provide more beneficial guidance for improving the quality of life in patients with advanced cancer. [ABSTRACT FROM AUTHOR]

The present study sought to determine if the positive association between positive emotions and life satisfaction can be understood as a function of hope in Chinese. Consistent with the broaden-and-build model of positive emotions, we tested the hypothesis that positive affectivity, the disposition to experience positive emotions, would be associated with broadening hope agency, building hope pathways, or both, in a sample of 212 Chinese college students. Results examining for bootstrapped mediation testing with multiple mediators indicated that positive affectivity was indirectly associated with life satisfaction through hope agency, but not through hope pathways. In support for partial mediation, however, the association between positive affectivity and life satisfaction remained significant even after including hope components in the model. Some implications of the present findings are discussed. [ABSTRACT FROM AUTHOR]

Patients were interviewed by psychiatrists; if a psychiatrist find a patient needs psychiatric referral, he/she will directly refer the patient to the department of psycho-oncology and record as one time of psychiatrist-patient consultation. In 2017, psychiatric consultation referral number increased in both CLPS Model wards and TAU wards ( I i SB CLPS sb SP 2 sp = 507.54, I P i <.001; I i SB TAU sb SP 2 sp =9.78, I P i <.01), and the change in CLPS wards was statistically significant than TAU wards ( I i SB CLPS-TAU sb SP 2 sp = 877.22, I P i <.001). In 2018, psychiatric consultation referral number increased in CLPS wards ( I i SB CLPS sb SP 2 sp = 160.15, I P i <.001), while TAU wards did not show this tend ( I i SB TAU sb SP 2 sp = 19.2, I P i >.05), and the difference between CLPS wards and TAU wards was still significant ( I i SB CLPS-TAU sb SP 2 sp = 791.78, I P i <.001). Psychiatrists worked in CLPS wards often use anti-depressants to help patients to manage neuropathic pain and use antipsychotics to release chemo-related NV. [Extracted from the article]

Sulfate is traditionally considered to have retrograde solubility in aqueous solutions. However, our recent hydrothermal diamond-anvil cell (HDAC) experiments have shown that the solubility of Na2SO4 changes from retrograde to prograde in the presence of silica, leading to the formation of sulfate-rich solutions at high temperatures, in line with observations on natural geofluids. In this study, we use synthetic inclusions of fused silica capillary capsules containing saturated Na2SO4 solutions and Na2SO4 crystals to quantitatively investigate the solubility of Na2SO4 at different temperatures in the Na2SO4-SiO2-H2O system. Sulfate concentrations were measured using Raman spectroscopy and calibrated using Cs2SO4 solutions with known concentrations. The solubility of crystalline Na2SO4 dropped slightly when heated from 50 to 225 °C and dramatically from 225 to 313 °C. At 313 °C, the Na2SO4 crystals began to melt, forming immiscible sulfate melt coexisting with the aqueous solution, with or without solid Na2SO4. With the formation of sulfate melt, the solubility of Na2SO4 was reversed to prograde (i.e., solubility increased considerably with increasing temperatures). The solubility of Na2SO4 in the measured solution was significantly higher than that predicted in the absence of SiO2 over the entire temperature range (except for temperatures around 313 °C). This indicates that the presence of SiO2 greatly changes the dissolution behavior of Na2SO4, which may be caused by the formation of a sulfate-silicate intermediates such as Si(OH)4SO4 2-. Considering that most crustal fluids are silicasaturated, the solubility curve of Na2SO4 obtained in this study can better reflect the characteristics of geofluids when compared to that of Na2SO4-H2O binary system. At temperatures of 313-425 °C, the solubility of Na2SO4 increases with temperature following the function Csulfate = -3173.7/T + 5.9301, where Csulfate and T represent the solubility of Na2SO4 in mol/kg H2O and temperature in Kelvin, respectively. As an application, this temperature-solubility relationship can be used to evaluate the sulfate contents in fluid inclusions that contain sulfate daughter minerals, based on the temperature of sulfate disappearance obtained from microthermometric analysis. The sulfate concentrations of the ore-forming fluids of the giant Maoniuping carbonatite-related rare earth element (REE) deposit (southwest China) were calculated to be 4.67-4.81 m (mol/kg H2O). These sulfate concentrations were then used as internal standards to calibrate the previously reported semi-quantitative results of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) analysis of REE-forming stage fluid inclusions at this deposit. The calculated Ce concentrations in the REE-mineralizing fluid range from 0.42 to 0.49 wt%. The high fluid REE contents suggest that the sulfate-rich fluids are ideal solvents for REE transport. A mass-balance calculation was carried out to evaluate the minimal volume of carbonatite melt that was required for the formation of the giant Maoniuping REE deposit. The result indicates that the carbonatite dikes in the mining area are enough to provide the required fluids and metals, and thus a deep-seated magma chamber is not necessary for ore formation. [ABSTRACT FROM AUTHOR]

• The PAE content in used face towels was significantly higher than that of new face towels. • The concentrations of PAEs in coral velvet were significantly higher than those in cotton. • Water washing removed some PAEs from the face towels, while detergent washing increased the PAE content. • The health risks from PAEs exposure were far below the limit. The production of face towels is growing at an annual rate of about 4% in China, reaching 1.13 million tons by 2021. Phthalates (PAEs) are widely used in textiles, and face towels, as an important household textile, may expose people to PAEs via the skin, further leading to health risks. We collected new face towels and analyzed the distribution characterization of PAEs in them. The changes of PAEs were explored in a face towel use experiment and a simulated laundry experiment. Based on the use of face towels by 24 volunteers, we calculated the estimated daily intake (EDI) and comprehensively assessed the hazard quotient (HQ), hazard index (HI), and dermal cancer risk (DCR) of PAEs exposure in the population. PAEs were present in new face towels at total concentrations of

Contaminants present in dust adhering to the skin can pose a significant risk to human health through dermal absorption and hand-to-mouth contact. The adhesion capacity of dust differs significantly from that of soil due to its physicochemical properties. Therefore, applying the raw soil exposure parameters to estimate the health risks associated with dermal exposure to dust may lead to erroneous conclusions. In this study, we quantified the maximum amount of dust that adhered to the skin (MAD max) and the upper limit of dust-skin adherence factor (DSAF max) in 26 adults using element markers as a proxy for dust. The volunteers were exposed to dust and rinse water samples were collected from their hands, forearms, lower legs, and feet. We analyzed both the raw dust samples and the rinse water samples for 11 element markers, including Be, V, Cr, Mn, Co, Ni, Cu, Zn, Se, Ba, and Pb. The results showed that the MAD max of indoor dust and outdoor dust increased by 0.08–0.62 mg and 0.33–0.56 mg following a 1 cm2 increase in skin surface area, respectively. Based on best dust element markers, the body part-weighted dust-skin adherences (WDSAF max s) of indoor dust and outdoor dust were 0.35 and 0.64 mg/cm2, respectively. A smaller particle size and higher moisture content resulted in a larger DSAF max. Only when indoor dust concentrations exceed 24.2 mg/m3 or outdoor dust concentrations exceed 44.3 mg/m3, can the WDSAF max be applied directly in the health risk assessment of dermal exposure to dust. The method from this study can be re-applied in different regions, and the adherence data can help to improve future studies on the health effects of dermal exposure to dust. [Display omitted] • Dust type is the most important factor, followed by body part. • Outdoor dust result in higher dust-skin adherence factor than indoor dust. • Smaller particle size and higher moisture content cause higher adherence factor. [ABSTRACT FROM AUTHOR]

Sargassum fusiforme is widely cultivated in the temperate coastal areas, and is particularly abundant in China, Korea, and Japan. However, information about if large-scale seaweed cultivation can affect the bacterial community in the coastal sea area is limited. This study explores the effects of large-scale cultivation of Sargassum fusiforme on the biodiversity and network structure of marine bacteria in the coastal water of Dongtou Island, China. The diversity of marine bacteria in the surface waters was significantly higher than that in the bottom waters in the cultivation area and adjacent area. The α-diversity metrics showed no significant difference between surface waters and bottom waters in the open sea area. Additionally, permutational multivariate analysis of variances suggested a significant difference in the microbial community structure between location, which were sampled relative to the cultivation area. At the phylum level, the dominant phyla in all groups were Proteobacteria, Cyanobacteria, Actinobacteria and Bacteroidetes. Proteobacteria was the most abundant phylum, accounting for more than 65% in all groups. The redundancy analysis showed that environmental factors affected the bacterial communities, and the results of an aggregated boosted tree analysis indicated that dissolved oxygen was a critical factor in controlling the bacterial communities in the surface waters, NO 3 −-N and NH 4 +-N were identified as primary factors associated with the change in bacterial community composition in the bottom waters. Network analysis revealed that the negative interactions between species pairs were the major relationship in the microbial ecosystem. Bacterial communities at S. fusiforme location were associated with larger sub-modules and a larger number of keystone species. Alphaproteobacteria and Gammaproteobacteria were identified as the keystone species in all locations. The results of the present study suggested that the differences in biodiversity and network structure of marine bacteria might be associated with the S. fusiforme cultivation. • Microbial community structure differed between locations relative to the cultivation area. • Proteobacteria, Cyanobacteria, Actinobacteria and Bacteroidetes were the dominant phyla in the areas with and without S. fusiforme cultivation. • Negative interactions among species were the major relationship in the microbial ecosystem. • Alphaproteobacteria and Gammaproteobacteria served as the keystone species in the microbial ecosystem. [ABSTRACT FROM AUTHOR]

Sulfate-bearing geofluids are widespread in many geological environments and play important roles in ore-forming processes. Recent experiments provide evidences that in silica-rich fluids, Na 2 SO 4 solubility exhibits a complex temperature dependence, first decreasing from 25 to 313 °C and then increasing from 313 to 425 °C. The fluid-borne silica have critical implications for sulfate-bearing hydrothermal systems and formations of rare earth element deposits. However, whether other sulfate salts share the same characteristics remains unknown. In this study, fused silica capillary capsules (FSCCs) containing K 2 SO 4 -saturated solutions and K 2 SO 4 crystals are used to quantitatively investigate the solubility of K 2 SO 4 at different temperatures in the K 2 SO 4 -SiO 2 -H 2 O system. In the K 2 SO 4 -SiO 2 -H 2 O system, K 2 SO 4 shows prograde solubility from 50 to 400 °C, and does not melt through the whole investigated temperature range. The relationship between temperature and the solubility of K 2 SO 4 can be described by a simple linear function with R 2 = 0.991: C sulfate = 4.1307 × 10−3 × T + 0.5532, where C sulfate and T represent the solubility of K 2 SO 4 in m (mol/kg H 2 O) and temperature in °C, respectively. These results show that the solubility of K 2 SO 4 can be enhanced by 3 to 5 times at 300–400 °C by the presence of silica, compared with that in silica-absent system, even without the formation of sulfate melt. Considering that quartz is ubiquitous in the Earth's crust, the solubility of sulfate in natural geofluids may reach a much higher level than previously expected. The temperature dependences of the solubilities of K 2 SO 4 and Na 2 SO 4 in silica-saturated fluids were used to constrain the compositions of the mineralizing fluids of the synmetamorphic hematite-quartz veins at Ouro Fino (SE Brazil) and the Maoniuping REE deposit (SW China), based on the previously reported microthermometric results of fluid inclusions that contain sulfate daughter minerals. For the hematite-quartz vein at Ouro Fino, the sulfate concentration was calculated to be 8.9–19.2 wt%, which is in line with previous laser ablation measurements (~15.3 wt%). For the Maoniuping REE deposit, the total sulfate concentration was determined to be 16.3–27.4 wt%, and the REE concentration of the ore-fluid was further estimated to be 0.30–0.44 wt%. • Potassium sulfate exhibits prograde solubility in the presence of silica. • Presenting solubility of K2SO4 in silica-saturated fluids at 50–400 °C • Evaluating REE contents in ore-fluids of the Maoniuping deposit [ABSTRACT FROM AUTHOR]

Long-term satellite missions could help to provide insights into spatial and temporal variations in algal blooms. However, the traditional reflectance-based method has limitations in regards to determining the available threshold for algal bloom detection among the time-varying observation conditions. In terms of extracting useful information from long-term data series precisely and efficiently, the deep learning method has shown its superiority over traditional algorithms in batch data processing. In this study, a U-net model for algal bloom extraction along the coast of the East China Sea was developed using GOCI images. The U-net model was trained with two different datasets that were constructed with six-band channels (all visible bands from GOCI imagery) and RGB-band channels (bands of 443, 555, and 680 nm from GOCI imagery). The quantitative assessment from the U-net models suggests that the U-net model trained with the six-band channel datasets outperformed the RGB-band channel datasets, with increases of 23.6%, 18.1%, and 12.5% in terms of accuracy, precision, and F-score, respectively. The validation map derived from the U-net model trained with six-band channel datasets also showed considerable matching with the ground-truth maps. By using the U-net model, the occurrence of algal blooms was automatically extracted from GOCI images. A 10-year time series of GOCI data collected between 2011 and 2020 was derived using an output-trained U-net model to explore spatial variation along the coast of the ECS. It was found that the most affected areas of the algal blooms varied by year, but were mainly located in the Zhoushan and Zhejiang coasts. Additionally, by performing principal component analysis on the daily meteorological data during April and August 2011-2020, factors related to algal bloom occurrence were discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The aims of this study were to explore the frequency of somatic symptom disorder (SSD) and the relationship between SSD and somatic, psychological, and social factors in Chinese patients with breast cancer., Methods: This multicenter cross-sectional study enrolled 264 patients with breast cancer from three different departments in Beijing. The structured clinical interview for fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (SCID-5) for SSD. Standardized questionnaires and clinical data were used to compare patients with and without SSD., Results: Somatic symptom disorder was diagnosed in 21.6% (57/264) of all enrolled patients. No differences were found between SSD patients and non-SSD patients in terms of sociodemographic characteristics and tumor-specific variables, except radiotherapy. However, patients with SSD reported higher levels of depression, anxiety and cancer-related worry. They also showed a longer duration of symptoms, greater impairment in daily life, more concern over their physical complaints and more doctor visits. In a stepwise binary logistic regression analysis, among others, higher health anxiety (WI-8, Exp(B) = 0.107, p = 0.009) and more doctor visits (OR = -1.841, p < 0.001) showed a significant association with SSD; the model explained 53.7% of the variance., Conclusions: Similar to other physical diseases, there is a high prevalence of SSD in patients with breast cancer. Somatic symptom disorder patients differ from non-SSD patients by exhibiting higher cancer-related emotional distress and dysfunctional illness perception and behavior. There remain substantial challenges in the diagnosis of SSD in patients with cancer and other medical conditions., Clinical Trial Registration: ChiCTR2100051525., (© 2022 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Background: Evidence of the efficacy of Shenfu injection (SFI) in the treatment of heart failure (HF) is inconsistent. This study aimed to strictly evaluate the methodological quality, reporting quality, and evidence quality of systematic reviews (SRs) and meta-analyses (MAs) on the efficacy of SFI., Methods: From inception to December 2020, using standardized search strategies, we searched for relevant SRs and MAs in the following seven databases: Cochrane library, Embase, PubMed, SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database. The Appraisal Tool for Systematic Reviews of Randomized and Observational Studies 2 (AMSTAR-2) and Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) tools were used to evaluate the methodological and reporting quality of SRs, respectively. The quality of results was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. If necessary, we conducted quantitative synthesis or descriptive analysis of the original data., Results: There were 12 SRs/MAs involving 302 original randomized controlled trials (RCTs) and more than 22,445 participants (the total number was not mentioned in 1 study). The treatment group was classified as SFI combined with western medicine (WM), while the control group was WM alone. The methodological quality of all the literatures was very low, and the quality of reports was relatively good, with an average PRISMA score of 18.25 points. We evaluated 52 outcomes, of which 3 were moderate quality, 13 were low quality, and the rest were very low quality. Low quality evidences indicated that the clinical efficacy of SFI combined with WM for HF was better than that of WM, which can improve the quality of life and cardiac function of patients., Conclusions: It appeared that SFI was effective in the treatment of HF. Due to the low quality of methodology and reports in the literature, we cannot be sure of the results. We strongly recommend that more high-level RCTs be carried out in the future. Besides, researchers should strictly comply with the AMSTAR-2, PRISMA, and GRADE guidelines for SRs.

Background: Both demoralization and depression are common forms of psychological distress in cancer patients. This study aimed to investigate the severity of demoralization in Chinese cancer patients and to explore the factors influencing depression and demoralization and their effects on quality of life to better understand the differences and the relationship between demoralization and depression., Methods: Cross-sectional study design, in-patients sequentially recruited from a tertiary-level cancer hospital in Beijing between January 2016 and April 2016 completed Mandarin version of Demoralization Scale (DS-MV), Patient Health Questionnaire-9 (PHQ-9), Revised Life Orientation Test (CLOT-R), Beck Hopelessness Scale (BHS), and the 12-items Short Form Health Survey, version 2 (SF-12 V2) and provided socio-demographic and clinical information., Results: 296/424 (70.0%) of patients completed questionnaires. The mean score of DS is 30.4 (SD = 13.0). There are 28% (83/296) patients who experienced a low level of depression but a high level of demoralization. Resignation medical coping method (b = 0.279, P < .001), hopelessness (b = 0.492, P < .001), positive life orientation (b = -0.170, P < .001), and education level (b = -0.132, P < .001) were found to be predictors of demoralization, while only resignation medical coping method (b = 0.373, P < .001) and hopelessness (b = 0.350, P < .001) were found to be predictors of depression. Depression is a mediator between demoralization and physical aspects of quality of life (γ = -0.1604, LLCI = -0.244, ULCI = -0.080)., Conclusion: Demoralization is a prevalent psychiatric problem in Chinese cancer patients, and a large proportion of patients had low depression but high demoralization. Therefore, screening for demoralization in Chinese oncology practice is essential. A positive life orientation was found to be protective against demoralization., (© 2019 John Wiley & Sons, Ltd.)

Introduction: The purpose of this study is to evaluate the efficacy and safety of acupuncture on relieving abdominal pain and distension in acute pancreatitis., Methods and Analysis: We will electronically search PubMed, MEDLINE, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database from their inception. Furthermore, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to acupuncture treating acute pancreatitis will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data will be synthesized using a fixed effects model or random effects model depending on the heterogeneity test. The overall response rate and the visual analog scale score will be the primary outcomes. The time of first bowel sound, the time of first defecation, the length of hospitalization, acute physiology and chronic health evaluation II score, and the adverse events will also be assessed as secondary outcomes. RevMan 5 (version 5.3) statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation. Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals, whereas dichotomous data will be expressed in the form of risk ratios with 95% confidence intervals., Ethics and Dissemination: The protocol of this systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and present at relevant conferences., Prospero Registration Number: CRD42019147503.

Objectives: The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures., Design: Mixed-method research study to collect and analyse both quantitative and qualitative data., Setting: Class A tertiary hospitals in China., Participants: The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital., Methods: Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners., Results: A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on 'lack of access', 'less convenient', 'lack of applicability' and 'lack of evidence from Chinese sample'. Higher frequency and higher ranking of enablers converged on 'Short formats presentation', 'Utilisation of various media', 'Information visualisation' and 'Linking to patient electronic medical records'. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous., Conclusion: Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)