Selective Oxidative Methyl C-H Functionalization of Butylated Hydroxytoluene toward Arylimines/N-Heterocycles.

A metal-free and selective oxidative methyl C-H functionalization of BHT with aniline compounds has been developed. This innovative method enables the facile and efficient synthesis of a diverse array of BHT-functionalized N-containing skeletons, including arylamines, benzoxazoles, benzothiazoles, benzimidazoles, quinazolines, and quinazolinones, all of which are challenging to access. The control experiment involving TEMP18O suggests that the radical adduct of TEMPO with the benzyl radical of BHT may serve as an intermediate.

Impacts of artificial reef on community structure and functional traits of macrobenthos near Furong Island, Shandong, China.

To evaluate the ecological restoration effect of artificial reefs and explore the impacts of artificial reefs age on the structure and functional traits of the macrobenthos community, two artificial reef areas with different reef ages in the coastal waters of Furong Island, Laizhou Bay were investigated in May, August, and October 2019. A total of 120 macrobenthos species were identified in the three seasons, including 72 species in the control area, 74 species in the artificial reef with short age (1 year), and 80 species in the artificial reef with greater age (4-5 years). Nihonotrypaea harmandi was the dominant species in all areas. The biomass, abundance, Shannon diversity index, Margalef species richness index of macrobenthos communities were all in order of reef area with greater age > reef area with lower age > control area, and the biomass and abundance in the reef area with greater age were significantly higher than those in the other two areas. The composition and relative abundance of functional traits of macrobenthos communities in the reef area and the control area were different. However, the dominant categories of traits in different areas were consistent, including deposit-feeder, burrower, medium body size, medium life span, high body flexibility and infauna. The composition and relative abundance of functional traits of macrobenthos communities in the reef area and the control area were different mainly in feeding mode, habitat, and body size. The relative abundance of smaller individuals (1-3 cm) and suspension feeders in the reef area was higher than those in the control area, while predator abundance was lower, and such effect became more pronounced with increasing reef age. The reef area was significantly higher than the control area in functional diversity, but without significant difference in functional redundancy. The results of abundance/biomass comparison curve and marine biotic index showed that the benthic ecological quality in the study area was good. The macrobenthos community was slightly disturbed after 1 year of reef construction, while the conservation effect of macrobenthic resources and the benthic ecological quality were significantly improved after 4-5 years of reef placement.

Lower SLC7A2 expression is associated with enhanced multidrug resistance, less immune infiltrates and worse prognosis of NSCLC.

BACKGROUND: Solute carrier family 7 member 2 (SLC7A2), a cationic amino acid transporter, is lowly expressed in ovarian and hepatocellular cancers, which is associated with their worse prognosis. However, its roles in the prognosis, drug resistance and immune infiltration in non-small-cell lung cancer (NSCLC) are unclear. METHODS: We chose SLC7A2 from RNA-Seq of paclitaxel/cisplatin-resistant A549 cells, then bioinformatics, cell lines construction, RT-qPCR, and CCK8 were performed to investigate SLC7A2 role. RESULT: We analyzed the 223 differentially expressed genes (DEGs) from RNA-Seq of paclitaxel/cisplatin-resistant A549 cells and found that SLC7A2 expression was down-regulated in NSCLC. Lower SLC7A2 expression was associated with worse recurrence-free survival (RFS) in NSCLC. SLC7A2 silencing enhanced the proliferation of NSCLC cells and their insensitivity to paclitaxel, cisplatin, and gemcitabine in vitro. Activation of AMPK has up-regulated SLC7A2 expression and enhanced the sensitivity of NSCLC cells to anti-tumor drugs, which could be attributed to E2F1's regulation. In addition, the levels of SLC7A2 expression were correlated to the numbers of infiltrated neutrophils, macrophages, dendritic cells and their marker genes, like CD86, HLA-DPA1 and ITGAM. CONCLUSIONS: SLC7A2 may act as a tumor suppressor to modulate drug sensitivity, immune infiltration and survival in NSCLC. Video abstract.

Assessing shellfish farming-mediated benthic impacts based on organic carbon flux simulation and composition of macrofaunal community.

Marine benthic environments serve as the ultimate sink for sediment organic matter (SOM), but shellfish farming can potentially disturb the natural sink of seston, altering ecosystem functioning. Understanding the potential disturbance of a shellfish farm and its ecological effects is therefore important for a responsible management of shellfish-mediated marine ecosystem. In this study, the variations in benthic organic carbon flux of a bottom-based Manila clam (Ruditapes philippinarum) farm in Laizhou Bay, China were estimated by using a carbon flux model coupled with hydrodynamic and individual growth models. SOM and macrofaunal community were monitored for 3 years to investigate their changes to the carbon fluxes. Model simulations illustrated that the carbon flux in an area of 247 km2 was altered due to seston depletion and biodeposition, which caused decrease and increase in SOM in different areas, respectively. Cluster analysis based on taxonomic composition of macrofaunal community divided the sites into four groups, which corresponded with predicted changes of carbon flux. Increased carbon flux caused higher disturbance level (indicated by AMBI) to the macrofaunal community but increased species richness, abundance, and Shannon-Wiener index, suggesting the community was both disturbed and benefited from clam farming. This study confirmed that the benthic organic carbon flux is a key factor causing differences in SOM and macrofaunal community outside the farm, and thus can be used as an efficient method for estimating the benthic impacts of shellfish farming both in and outside the farming area.

Ensemble habitat suitability modeling for predicting optimal sites for eelgrass (Zostera marina) in the tidal lagoon ecosystem: Implications for restoration and conservation.

Seagrass systems are in decline, mainly due to anthropogenic pressures and ongoing climate change. Implementing seagrass protection and restoration measures requires accurate assessment of suitable habitats. Commonly, such assessments have been performed using single-algorithm habitat suitability models, nearly always based on low environmental resolution information and short-term species data series. Here we address eelgrass (Zoostera marina) meadows' large-scale decline (>80%) in Shandong province (Yellow Sea, China) by developing an ensemble habitat model (EHM) to inform eelgrass conservation and restoration strategies in the Swan Lake (SL). For this, we applied a weighted EHM derived from ten single-algorithm models including profile, regression, classification, and machine learning methods to generate a high-resolution habitat suitability map. The EHM was constructed based on the predictive performances of each model, by combining a series of present-absent eelgrass datasets from recent years coupled with oceanographic and sediment data. The model was cross-validated with independent historical datasets, and a final habitat suitability map for conservation and restoration was generated. Our EHM scheme outperformed all single models in terms of habitat suitability, scoring ∼0.95 for both true statistic skill (TSS) and area under the curve (AUC) performance criteria. Machine learning methods outperformed profile, regression and classification methods. Regarding model explanatory variables, overall, topographic characteristics such as depth (DEP) and seafloor slope (SSL) are the most significant factors determining the distribution of eelgrass. The EHM predicted that the overlapping area was almost 90% of the current eelgrass habitat. Using results from our EHM, a LOESS regression model for the relationship of the habitat suitability to both the biomass and density of Z. marina outperformed better than the classic Ordinary Least Squares regression model. The EHM is a promising tool for supporting eelgrass protection and restoration areas in temperate lagoons as data availability improves.

Copper-Catalyzed Nitrogen Atom Transfer to Isoquinolines via C-N Triple Bond Cleavage and Three-Component Cyclization.

A copper(I)-catalyzed tandem reaction of 2-bromoaryl ketones, terminal alkynes, and CH3CN is developed, which combines N atom transfer and three-component [3 + 2 + 1] cyclization, and efficiently produces densely functionalized isoquinolines in a facile, highly selective, and general manner. In the reaction, the formation of aromatic C-N bonds along with the complete C-N triple bond cleavage is first realized; Cu(III)-acetylide species might serve as the intermediates, which allow highly selective 6-endo-dig cyclization.

Metal-Free Oxidative Annulation of Phenols and Amines: A General Synthesis of Benzoxazoles.

The ubiquity of benzoxazoles in natural products, drugs, and functional materials has stimulated numerous efforts toward their synthesis; however, the developed methods rely on prefunctionalized substrates and lack generality. Under metal-free conditions, a highly general synthesis of benzoxazoles direct from abundant and easily available phenols and amines is developed via a modular phenol functionalization controlled by TEMPO. In the reaction, various phenols and primary amines with a broad range of functional groups are compatible, producing structurally and functionally diverse benzoxazoles (64 examples) without or with trace observation of the byproducts of phenol transformation with amines. The practical synthesis, especially for drug tafamidis, demonstrates decisive advantages in generality, selectivity, efficiency, and atom- and step-economies over traditional methods, even in the cases of low yields. Mechanistically, the radical adducts of TEMPO with ortho-cyclohexa-2,4-dien-1-one radicals rather than the well-recognized cyclohexa-3,5-diene-1,2-diones may serve as intermediates.

TEMPO mediated oxidative annulation of aryl methyl ketones with amines/ammonium acetate for imidazole synthesis.

A facile synthesis of 1H-imidazoles by direct oxidative annulation of aryl methyl ketones and primary amines has been developed in the presence of TEMPO under weakly acidic conditions. By replacing amines with ammonium acetate, 2H-imidazole skeletons were achieved for the first time from ketones. Substrates containing various functional groups, such as alkyl, aryl, naphthyl, halogen (F, Cl, Br, I), nitro, trifluoromethyl, sulfonyl ester, furyl, thienyl, and pyridyl groups, were readily transformed into the desired products. The application potential of this method was verified by the scale-up synthesis and Sonogashira coupling functionalization of imidazoles. Mechanistically, the α-TEMPO-enamine adduct may serve as the key reaction intermediate.

Prevalence of breast fibroadenoma in healthy physical examination population in Guangdong province of China: a cross-sectional study.

OBJECTIVE: To provide an accurate assessment of the prevalence of breast fibroadenoma in a large population and to confirm the diagnostic accuracy of ultrasound for fibroadenoma. DESIGN: This was a cross-sectional survey. SETTING: This research was conducted at Nanfang Hospital, Guangzhou, Guangdong, China. PARTICIPANTS: A total of 11 898 women aged 18-40 years who underwent breast screening between 1 January 2019 and 31 December 2019 were included in the fibroadenoma prevalence study. From 1 June 2019 to 31 December 2019, 342 breast lesions with pathology reports and preoperative ultrasound images were collected for diagnostic fibroadenoma testing (vs histological diagnostic testing). PRIMARY OUTCOME MEASURES: Pearson's χ2 test was performed to compare the prevalence of different lesions between age groups, and descriptive statistics were used to report the clinical characteristics of fibroadenoma. For ultrasound diagnosis, fibroadenoma was defined as a well-circumscribed lesion with round or oval shape, consisting of a homogeneously hypoechoic or isoechoic solid mass, located parallel to the chest wall with a smooth margin and no posterior shadowing. Diagnostic test results for breast fibroadenoma were stratified by diagnostic type (histological vs ultrasound). RESULTS: Of the women aged 18-40 years, 27.6% (3285/11 898) had an ultrasound diagnosis offibroadenoma. Of these, the prevalence of fibroadenoma was stable across age groups (p=0.14) and did not differ between the left and right sides of the breast. Almost two-thirds of women presented with a single fibroadenoma, and most fibroadenomas did not exceed 1 cm in size. The sensitivity and specificity for fibroadenoma were 97.0% (95% CI for sensitivity: 93.7% to 98.8%) and 91.4% (95% CI for specificity: 85.4% to 95.5%) for ultrasonography, respectively. CONCLUSIONS: The prevalence of fibroadenoma in South China is as high as 27.6%, and ultrasound could be used as a tool to diagnose fibroadenoma.

Copper-Catalyzed 6-endo-dig Cyclization-Coupling of 2-Bromoaryl Ketones and Terminal Alkynes toward Naphthyl Aryl Ethers in Water.

The cyclization-coupling reaction of 2-bromoaryl ketones and terminal alkynes is first realized by copper catalysis, which produces polyfunctional naphthyl aryl ethers in moderate to excellent yields with broad substrate scope and good functional group tolerance. This reaction proceeds via 6-endo-dig cyclization and C(sp2)-O coupling using green H2O as the unique solvent and 5-bromopyrimidin-2-amine as the critical additive. Mechanistically, a unique Cu(III)-acetylide probably is the key intermediate, which allows exclusive 6-endo-dig selectivity.

Cardiovascular risk factors and breast cancer incidence in a large middle-aged cohort study.

BACKGROUND: Several studies have demonstrated that cardiovascular risk factors play a role in the etiology of breast cancer. However, the combined effect of cardiovascular risk factors on the risk of breast cancer is still uncertain. METHODS: Data from the Atherosclerosis Risk in Communities (ARIC) study, a prospective cohort of middle-aged women, were used to investigate the association of individual and combined cardiovascular risk factors with breast cancer. Cox proportional hazards models were applied to calculate the hazard ratio (HR) and 95% confidence intervals (CI). RESULTS: A total of 7501 women were included. During a mean follow-up of 19.7 years, 576 women were diagnosed with breast cancer. White women and premenopausal status were independently associated with increased risk of breast cancer. Of the individual cardiovascular risk factors, only obesity was independently associated with an increased risk of breast cancer (HR 1.29, 95% CI 1.04-1.61). Compared with women without cardiovascular risk factors, women having three or greater, but not those with fewer than three cardiovascular risk factors, had a significantly higher risk of developing breast cancer (HR 1.27, 95% CI 1.06-1.53). Subgroup analyses indicated that women with three or greater cardiovascular risk factors had higher risk of breast cancer among postmenopausal Black women, but not among premenopausal Black and White women. CONCLUSIONS: Combinations of cardiovascular risk factors are associated with increased risk of breast cancer in middle-aged women, especially in postmenopausal Black women. Joint interventions to modify cardiovascular risk factors could be used to prevent breast cancer in these higher-risk individuals.

Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet Therapy After PCI.

Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.

Taxonomic and functional responses of macrofaunal assemblage provide insight into ecological impacts of bottom-based Manila clam aquaculture.

Understanding ecological impacts of bottom-based clam aquaculture can improve its management. In this study, taxonomic and functional macrofaunal assemblage were evaluated for two clam farms located in Laizhou Bay, China. Beta diversity and factors potentially regulating the dissimilarity of macrofauna were estimated. Both taxonomic and functional composition of macrofauna showed large differences between the clam farm and the control area. Functional dissimilarity within the clam farms was found to be nestedness and negatively correlated to local clam abundance. Additionally, the cultured clam enhanced the functional richness but made the macrofaunal assemblage more fragile against species or function loss. This effect would increase with clam abundance, which highlights the importance of identifying optimal clam culture intensity in developing a bottom-based clam aquaculture program.

Integrating Self-determination Theory and Upper Limb Factors to Predict Physical Activity in Patients With Breast Cancer During Chemotherapy.

BACKGROUND: Some empirical investigations try to describe the factors that affect the physical activity of breast cancer survivors, but these investigations rarely focus on the basic psychological needs or motivation regulation of breast cancer survivors in physical activity. OBJECTIVE: The aim of this study was to construct structural equation modeling of the self-determination theory and upper limb factors to predict the physical activity of breast cancer patients during chemotherapy. METHODS: A total of 236 breast cancer survivors completed measures of basic psychological needs, behavioral regulation in exercise, symptoms and dysfunction of upper limb factors, and physical activity. Path analyses structured the direct and indirect effects (via motivational orientations) of basic psychological needs and upper limb factors on physical activity. RESULTS: A total of 216 (91.5%) participants met the standard physical activity metabolic equivalent recommended. The final model has a good degree of fit (χ2 = 809.363, df = 391, χ2/df ≤ 2.07 [1-3]; root-mean-square error of approximation, 0.067 [<0.008]). The competence (0.309) of basic psychological needs and amotivation (-0.38) of motivation regulations have the greatest effect on physical activity. CONCLUSIONS: Competence is the most important basic psychological need of breast cancer patients during chemotherapy, and amotivation is the most important motivation regulation. IMPLICATIONS FOR PRACTICE: Nurses need to pay more attention to the basic psychological needs and the motivation regulation in breast cancer patients during chemotherapy. Randomized controlled trials of breast cancer survivor interventions based on the self-determination theory are needed.

Integrated analyses of long noncoding RNAs and mRNAs in the progression of breast cancer.

OBJECTIVE: The objective was to explore the expression and potential functions of long noncoding RNA (lncRNA) and mRNAs in human breast cancer (BC). METHODS: Differentially expressed lncRNAs and mRNAs were identified and annotated in BC tissues by using the Agilent human lncRNA assay (Agilent Technologies, Santa Clara, CA, USA) and RNA sequencing. After identification of lncRNAs and mRNAs through quantitative reverse transcription polymerase chain reaction, we conducted a series of functional experiments to confirm the effects of knockdown of one lncRNA, TCONS_00029809, on the progression of BC. RESULTS: We discovered 238 lncRNAs and 200 mRNAs that were differentially expressed in BC tissues and para-carcinoma tissue. We showed that differentially expressed mRNAs were related to biological adhesion and biological regulation and mainly enriched in cytokine-cytokine receptor interaction, metabolic pathways, and PI3K-Akt signaling pathway. We created a protein-protein interaction network to analyze the proteins enriched in these pathways. We demonstrated that silencing of TCONS_00029809 remarkably inhibited proliferation, invasion, and migration of BC cells, and accelerated their apoptosis. CONCLUSIONS: We identified a large number of differentially expressed lncRNAs and mRNAs, which provide data useful in understanding BC carcinogenesis. The lncRNA TCONS_00029809 may be involved in the development of BC.

MAPK4 silencing together with a PARP1 inhibitor as a combination therapy in triple­negative breast cancer cells.

Triple­negative breast cancer (TNBC) is the most common type of cancer among females worldwide and is associated with poor prognosis. Poly ADP­ribose polymerase­1 (PARP1) inhibitors are effective against TNBC with mutations in the breast cancer type 1 susceptibility protein (BRCA1) and/or BRCA2 genes; however, the development of resistance to PARP1 inhibitors limits their use. Thus, identifying strategies to overcome this resistance is urgently required. The aim of the present study was to investigate the potential function and mechanism of small interfering (si)RNA­MAPK4 (siMAPK4) in enhancing the efficacy of a PARP1 inhibitor and reducing the resistance. In the present study, data on the mRNA expression level of MAPK4 in normal breast tissues and TNBC tissues were obtained from The Cancer Genome Atlas database. The mRNA and protein expression levels of MAPK4 in normal breast cells and TNBC cells were analyzed using reverse transcription­quantitative PCR and western blotting, respectively. The phosphorylated (p) histone H2AX (γH2AX) protein expression was assessed via immunofluorescence. Cell Counting Kit­8, wound healing and TUNEL assays were used to determine the proliferative, migratory and apoptotic abilities of HCC1937 cells. MAPK4 was highly expressed in TNBC patient tissues and cell lines. Moreover, overexpression of MAPK4 could promote HCC1937 cell proliferation. Treatment of HCC1937 cells with the combination of siMAPK4 and a PARP1 inhibitor olaparib decreased their proliferation and migration and increased their apoptosis. The protein expression levels of the DNA repair­related proteins p­DNA­dependent protein kinase catalytic subunit (DNA­PK) and RAD51 recombinase (RAD51) were inhibited in the siMAPK4 and siMAPK4 + olaparib groups. However, the marker of a double­stranded break γH2AX showed increased protein expression in the siMAPK4 + olaparib group. As MAPK4 could phosphorylate AKT at threonine 308 (AKTT308), the current study restored p­AKTT308 using a constitutively active AKT plasmid (AKT­CA). p­DNA­PK and RAD51 showed high expression and γH2AX exhibited lower protein expression in the AKT­CA group. The present findings suggested that siMAPK4 can enhance the sensitivity of TNBC cells to PARP1 inhibitors.

Predicting breast cancer 5-year survival using machine learning: A systematic review.

BACKGROUND: Accurately predicting the survival rate of breast cancer patients is a major issue for cancer researchers. Machine learning (ML) has attracted much attention with the hope that it could provide accurate results, but its modeling methods and prediction performance remain controversial. The aim of this systematic review is to identify and critically appraise current studies regarding the application of ML in predicting the 5-year survival rate of breast cancer. METHODS: In accordance with the PRISMA guidelines, two researchers independently searched the PubMed (including MEDLINE), Embase, and Web of Science Core databases from inception to November 30, 2020. The search terms included breast neoplasms, survival, machine learning, and specific algorithm names. The included studies related to the use of ML to build a breast cancer survival prediction model and model performance that can be measured with the value of said verification results. The excluded studies in which the modeling process were not explained clearly and had incomplete information. The extracted information included literature information, database information, data preparation and modeling process information, model construction and performance evaluation information, and candidate predictor information. RESULTS: Thirty-one studies that met the inclusion criteria were included, most of which were published after 2013. The most frequently used ML methods were decision trees (19 studies, 61.3%), artificial neural networks (18 studies, 58.1%), support vector machines (16 studies, 51.6%), and ensemble learning (10 studies, 32.3%). The median sample size was 37256 (range 200 to 659820) patients, and the median predictor was 16 (range 3 to 625). The accuracy of 29 studies ranged from 0.510 to 0.971. The sensitivity of 25 studies ranged from 0.037 to 1. The specificity of 24 studies ranged from 0.008 to 0.993. The AUC of 20 studies ranged from 0.500 to 0.972. The precision of 6 studies ranged from 0.549 to 1. All of the models were internally validated, and only one was externally validated. CONCLUSIONS: Overall, compared with traditional statistical methods, the performance of ML models does not necessarily show any improvement, and this area of research still faces limitations related to a lack of data preprocessing steps, the excessive differences of sample feature selection, and issues related to validation. Further optimization of the performance of the proposed model is also needed in the future, which requires more standardization and subsequent validation.

Two-sided effects of prolonged hypoxia and sulfide exposure on juvenile ark shells (Anadara broughtonii).

Oxygen deficit and sulfide have been restrictive factors in mariculture zones. However, the adaptive mechanism in aquatic lives is still unclear. The commercial ark shells Anadara broughtonii were selected to test the tolerance and adaptive responses to prolonged and intermittent hypoxia with or without exogenous sulfide (mild, moderate, high) by evaluating their behavior, mortality, oxidative level, antioxidant responses, and the MAPK-mediated apoptosis in gills. The results indicated that the clams were tolerant to hypoxia and sulfide exposure but vulnerable during reoxygenation from the challenges. Even so, sulfide had remarkable effect on attenuating the accumulation of reactive oxygen species (ROS) and lipid peroxides caused by reoxygenation from prolonged hypoxia. The increase of glutathione level was probably as an early and primary protective response to prevent the expected reperfusion injury from reoxygenation. The challenges suppressed the oxidative level with a dose-dependent effect of sulfide, with an exception when exposed to mild sulfide. Synchronously, biphasic effects of exogenous sulfide on apoptotic cascade, which was induced by mild sulfide while it was inhibited by higher sulfide, were also detected in gills. The induced or inhibited apoptosis by hypoxia and sulfide kept to a typical ROS-MAPK-CASPASE cascade, desiderating further investigation.

Response of macrobenthic communities to heavy metal pollution in Laoshan Bay, China: A trait-based method.

The effects of multiple natural and anthropogenic stressors on the functional trait composition and diversity of marine macrobenthic communities in Laoshan Bay were investigated using biological trait analysis (BTA). Seven traits, including 27 trait modalities and four functional diversity indices (functional richness, functional evenness, functional divergence, and Rao's quadratic entropy), were considered. The results of RLQ (environmental variables (R), species taxa (L), and traits (Q)) and variance partitioning analysis (VPA) showed that the trait compositions and functional diversity of macrobenthic communities were influenced by a combination of stressors, among which heavy metals were the major factors. At the sites with high heavy metal pollution, the prevalent traits were infauna, burrower, and deposit feeder, whereas epifauna, carnivores and crawlers were dominant at the sites of low heavy metal contamination. The impact of natural environmental gradients on macrobenthic communities is also worthy of attention.

Hope and symptom burden of women with breast cancer undergoing chemotherapy: A cross-sectional study.

AIM: This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated. BACKGROUND: Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope. DESIGN/METHODS: A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross-sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines. RESULTS: Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24-35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope. CONCLUSIONS: The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope. RELEVANCE TO CLINICAL PRACTICE: If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope.