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BackgroundCancer indeed represents a significant public health challenge, and unplanned extubation of peripherally inserted central catheter (PICC-UE) is a critical concern in patient safety. Identifying independent risk factors and implementing high-quality assessment tools for early detection in high-risk populations can play a crucial role in reducing the incidence of PICC-UE among patients with cancer. Precise prevention and treatment strategies are essential to improve patient outcomes and safety in clinical settings. ObjectiveThis study aims to identify the independent risk factors associated with PICC-UE in patients with cancer and to construct a predictive model tailored to this group, offering a theoretical framework for anticipating and preventing PICC-UE in these patients. MethodsProspective data were gathered from January to December 2022, encompassing patients with cancer with PICC at Xiangya Hospital, Central South University. Each patient underwent continuous monitoring until the catheter’s removal. The patients were categorized into 2 groups: the UE group (n=3107) and the non-UE group (n=284). Independent risk factors were identified through univariate analysis, the least absolute shrinkage and selection operator (LASSO) algorithm, and multivariate analysis. Subsequently, the 3391 patients were classified into a train set and a test set in a 7:3 ratio. Utilizing the identified predictors, 3 predictive models were constructed using the logistic regression, support vector machine, and random forest algorithms. The ultimate model was selected based on the receiver operating characteristic (ROC) curve and TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) synthesis analysis. To further validate the model, we gathered prospective data from 600 patients with cancer at the Affiliated Hospital of Qinghai University and Hainan Provincial People’s Hospital from June to December 2022. We assessed the model’s performance using the area under the curve of the ROC to evaluate differentiation, the calibration curve for calibration capability, and decision curve analysis (DCA) to gauge the model’s clinical applicability. ResultsIndependent risk factors for PICC-UE in patients with cancer were identified, including impaired physical mobility (odds ratio [OR] 2.775, 95% CI 1.951-3.946), diabetes (OR 1.754, 95% CI 1.134-2.712), surgical history (OR 1.734, 95% CI 1.313-2.290), elevated D-dimer concentration (OR 2.376, 95% CI 1.778-3.176), targeted therapy (OR 1.441, 95% CI 1.104-1.881), surgical treatment (OR 1.543, 95% CI 1.152-2.066), and more than 1 catheter puncture (OR 1.715, 95% CI 1.121-2.624). Protective factors were normal BMI (OR 0.449, 95% CI 0.342-0.590), polyurethane catheter material (OR 0.305, 95% CI 0.228-0.408), and valved catheter (OR 0.639, 95% CI 0.480-0.851). The TOPSIS synthesis analysis results showed that in the train set, the composite index (Ci) values were 0.00 for the logistic model, 0.82 for the support vector machine model, and 0.85 for the random forest model. In the test set, the Ci values were 0.00 for the logistic model, 1.00 for the support vector machine model, and 0.81 for the random forest model. The optimal model, constructed based on the support vector machine, was obtained and validated externally. The ROC curve, calibration curve, and DCA curve demonstrated that the model exhibited excellent accuracy, stability, generalizability, and clinical applicability. ConclusionsIn summary, this study identified 10 independent risk factors for PICC-UE in patients with cancer. The predictive model developed using the support vector machine algorithm demonstrated excellent clinical applicability and was validated externally, providing valuable support for the early prediction of PICC-UE in patients with cancer.

Abstract Background The reasons for hospice underuse in China need exploration from the perspective of patients with cancer and their families. Furthermore, existing literature about hospice decision-making among Chinese families with cancer patients is limited. This study aimed to investigate the awareness of hospice care among families with cancer patients, their preference for healthcare at the end-of-life stage of care, and the predictors of hospice preference. Methods This was an exploratory study conducted between July 2021 and January 2022. Overall, 300 decision-makers of cancer patients were recruited from the oncology ward of seven hospitals in Shanghai, China. Of these, 285 valid responses were included in the data analysis. A self-developed questionnaire about their preference for healthcare when the patient was at the end-of-life stage was completed. Descriptive analysis, t-test, chi-square test, and multivariable logistic regression were conducted to analyze the data. Results Only 46.0% of the participants have heard of hospice care. Most participants (78.2%) reported no introduction to hospice care from their doctors. More than half of the participants (58.2%) did not have a preference for healthcare at the end-of-life stage. Seventy-eight (65.5%) of the 119 participants who had a preference chose hospice care, and the other 41 participants (34.5%) refused hospice care. Having heard of hospice care had a significant impact on preferring healthcare at the end-of-life stage (adjusted OR = 14.346, 95%CI 7.219–28.509, p

Duck egg white jelly, a protein-rich, alkali-induced gel, mirrors preserved duck egg white in appearance and properties, offering easier storage and utility, especially when excess egg white is available. This research focuses on incorporating duck egg white jelly into emulsified meat snacks to enhance texture while reducing the phosphate content. This study suggests that adding phosphate and duck egg white jelly increases raw meat paste pH, affecting its viscosity. With half the usual phosphate and either 3.0% or 6.0% jelly, the pH significantly increases compared to the control paste, containing 0.2% phosphate (p < 0.05). Viscosity remains unaffected in the group with 6.0% jelly and no phosphate versus the control (p > 0.05). The least favorable viscosity is observed in pastes without phosphate or jelly, suggesting that the jelly plays a similar role to phosphate. After boiling and shaping the pastes into emulsified meat snacks, their texture profiles and water-holding capacities were analyzed. Formulas with phosphate and jelly produced emulsified meat snacks with improved springiness, chewiness, reduced cooking loss, and decreased purge loss during storage. Color analysis showed no significant differences between the control and treatment groups (p > 0.05). Duck egg white jelly, when added, effectively reduces the phosphate content while enhancing texture and consumer acceptance of emulsified meat snacks. It serves as a versatile ingredient for low-phosphate, emulsified meat products, with potential for various meat combinations.

Exploring the microscopic reaction mechanism of dicyandiamide (DCD) synthesis using calcium cyanamide (CaCN2) is highly desirable because of the low conversion of reactants and selectivity of DCD products. DCD synthesis consists of a two-step sequential hydrolysis of CaCN2, followed by dimerization of cyanamide to DCD in an alkaline environment. Density functional theory (DFT) results revealed that the rate-limiting step (RLS) was the formation of a C-N bond between the cyanamide and cyanamide anion in the dimerization of the DCD reaction. Secondary reactions of cyanamide with water, hydrogen sulfide, and DCD were also analyzed. The effects of solvation on the principal and secondary reactions were systematically explored. A single explicit water molecule can significantly lower the free energy barrier of the RLS. Water molecules facilitate the C-N bonding of the reactants in DCD reactions, resulting in a reduction in the free energy barrier of the RLS. The facilitation of double explicit water for the reaction is weaker than that of single explicit water and even yields negative catalysis. The effect of the [OH(H2O)3]− cluster lowering the reaction barrier with the hydrogen-bonding network is the most remarkable, which can alter the reaction path by the direct and indirect involvement of OH− ions. Furthermore, the reaction rate constants were computed by canonical variational theory with the Eckart tunneling correction (CVT/Eckart) and fitted to the Arrhenius expression. The reaction mechanism and kinetics revealed at the microscopic level provide efficient and clean production of DCD with certain theoretical guidance. [ABSTRACT FROM AUTHOR]

Duck egg white jelly, a protein-rich, alkali-induced gel, mirrors preserved duck egg white in appearance and properties, offering easier storage and utility, especially when excess egg white is available. This research focuses on incorporating duck egg white jelly into emulsified meat snacks to enhance texture while reducing the phosphate content. This study suggests that adding phosphate and duck egg white jelly increases raw meat paste pH, affecting its viscosity. With half the usual phosphate and either 3.0% or 6.0% jelly, the pH significantly increases compared to the control paste, containing 0.2% phosphate (p < 0.05). Viscosity remains unaffected in the group with 6.0% jelly and no phosphate versus the control (p > 0.05). The least favorable viscosity is observed in pastes without phosphate or jelly, suggesting that the jelly plays a similar role to phosphate. After boiling and shaping the pastes into emulsified meat snacks, their texture profiles and water-holding capacities were analyzed. Formulas with phosphate and jelly produced emulsified meat snacks with improved springiness, chewiness, reduced cooking loss, and decreased purge loss during storage. Color analysis showed no significant differences between the control and treatment groups (p > 0.05). Duck egg white jelly, when added, effectively reduces the phosphate content while enhancing texture and consumer acceptance of emulsified meat snacks. It serves as a versatile ingredient for low-phosphate, emulsified meat products, with potential for various meat combinations. [ABSTRACT FROM AUTHOR]

How to break the C═O bond and reduce the energy barrier of *COOH formation is the key to triggering the photocatalytic CO2 reduction (PCR) reaction and subsequent proton‐electron processes, which is as important as overcoming high recombination rate of photocarriers. In order to solve this issue, the symmetric structure of CuS/TiO2 is destroyed by S vacancy and Al doping (denoted as Al‐CuS/TiO2), which significantly expands the electron localization range and promotes the cis‐coordination splitting of Cu 3d orbits. The experimental results show that the CO yield selectivity of ≈90.68% and yield of ≈335.68 µmol·g−1·h−1 on Al‐CuS/TiO2. The redistribution of Cu electron states in specific d/s/p orbitals increases the adsorption of CO2 and reduces the reaction energy barrier of *COOH intermediates, while effectively breaking the C═O bond. Doped Al atoms also serve as adsorption sites for H2O molecules, effectively interleaving the competition with photocatalytic CO2 reduction at the Cu sites is effectively staggered. This study provides a new approach to reduce the energy barrier of *COOH formation and to accelerate the photocarrier migration by destroying local symmetry to adjust the crystal structure, which is important for further improving the activity and selectivity of PCR. [ABSTRACT FROM AUTHOR]