Association of depressive symptoms and sleep disturbances with survival among US adult cancer survivors.

BACKGROUND: Depression and sleep disturbances are associated with increased risks of various diseases and mortality, but their impacts on mortality in cancer survivors remain unclear. The objective of this study was to characterize the independent and joint associations of depressive symptoms and sleep disturbances with mortality outcomes in cancer survivors. METHODS: This population-based prospective cohort study included cancer survivors aged ≥ 20 years (n = 2947; weighted population, 21,003,811) from the National Health and Nutrition Examination Survey (NHANES) 2007-2018 cycles. Depressive symptoms and sleep disturbances were self-reported. Depressive symptoms were assessed using the Patient Health Questionnaire 9 (PHQ-9). Death outcomes were determined by correlation with National Death Index records through December 31, 2019. Primary outcomes included all-cause, cancer-specific, and noncancer mortality. RESULTS: During the median follow-up of 69 months (interquartile range, 37-109 months), 686 deaths occurred: 240 participants died from cancer, 146 from heart disease, and 300 from other causes. Separate analyses revealed that compared with a PHQ-9 score (0-4), a PHQ-9 score (5-9) was associated with a greater risk of all-cause mortality (hazard ratio [HR], 1.28; 95% CI, 1.03-1.59), and a PHQ-9 score (≥ 10) was associated with greater risk of all-cause mortality (HR, 1.37; 95% CI, 1.04-1.80) and noncancer mortality (HR, 1.45; 95% CI, 1.01-2.10). Single sleep disturbances were not associated with mortality risk. In joint analyses, the combination of a PHQ-9 score ≥ 5 and no sleep disturbances, but not sleep disturbances, was associated with increased risks of all-cause mortality, cancer-specific mortality, and noncancer mortality. Specifically, compared with individuals with a PHQ-9 score of 0-4 and no sleep disturbances, HRs for all-cause mortality and noncancer mortality in individuals with a PHQ-9 score of 5-9 and no sleep disturbances were 1.72 (1.21-2.44) and 1.69 (1.10-2.61), respectively, and 2.61 (1.43-4.78) and 2.77 (1.27-6.07), respectively, in individuals with a PHQ-9 score ≥ 10 and no sleep disturbances; HRs for cancer-specific mortality in individuals with a PHQ-9 score ≥ 5 and no sleep disturbances were 1.95 (1.16-3.27). CONCLUSIONS: Depressive symptoms were linked to a high risk of mortality in cancer survivors. The combination of a PHQ-9 score (≥ 5) and an absence of self-perceived sleep disturbances was associated with greater all-cause mortality, cancer-specific mortality, and noncancer mortality risks, particularly in individuals with a PHQ-9 score (≥ 10).

Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study.

Background: The role of age in metastatic disease, including breast cancer, remains obscure. This study was conducted to determine the role of age in patients with de novo metastatic breast cancer. Methods: Breast cancer patients diagnosed with distant metastases between 2010 and 2019 were retrieved from the Surveillance, Epidemiology, and End Results database. Comparisons were performed between young (aged ≤ 40 years), middle-aged (41-60 years), older (61-80 years), and the oldest old (> 80 years) patients. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariate Cox proportional hazard models. Survival analysis was performed by the Kaplan-Meier method. Results: This study included 24155 (4.4% of all patients) de novo metastatic breast cancer patients. The number of young, middle-aged, older, and the oldest old patients were 195 (8.3%), 9397 (38.9%), 10224 (42.3%), and 2539 (10.5%), respectively. The 5-year OS rate was highest in the young (42.1%), followed by middle-aged (34.8%), older (28.3%), and the oldest old patients (11.8%). Multivariable Cox regression analysis showed that middle-aged (aHR, 1.18; 95% CI, 1.10-1.27), older (aHR, 1.42; 95% CI, 1.32-1.52), and the oldest old patients (aHR, 2.15; 95% CI, 1.98-2.33) had worse OS than young patients. Consistently, middle-aged (aHR, 1.16; 95% CI, 1.08-1.25), older (aHR, 1.32; 95% CI, 1.23-1.43), and the oldest old patients (aHR, 1.86; 95% CI, 1.71-2.03) had worse BCSS than young patients. Conclusion: This study provided clear evidence that de novo metastatic breast cancer had an age-specific pattern. Age was an independent risk factor for mortality in patients with de novo metastatic breast cancer.

Risk factors and prognosis of acute lactation mastitis developing into a breast abscess: A retrospective longitudinal study in China.

BACKGROUND: Breast abscess is developed on the basis of acute mastitis, which will cause damage to the physical and mental health of lactating women and is an important factor affecting the rate of breastfeeding. This study examined the risk factors for mastitis to develop into breast abscess, and analyzed the distribution of pathogenic bacteria, bacterial resistance, and treatment outcome. METHODS: The medical records of 316 cases of mastitis and 219 cases of breast abscess were retrospectively collected. We analyzed the bacterial distribution of mastitis and breast abscess, and compared the differences of bacterial drug resistance. Univariate analysis and binary logistic regression were used to analyze the following aspects: age, primiparity or not, history of breast surgery, body temperature, puerperium or not, onset time, located in the nipple/areolar complexe area or not, history of massage by non-professionals, staphylococcus aureus/methicillin-resistant staphylococcus aureus (MRSA) infection or not, diabetes and white blood cell count. RESULTS: Of the 535 patients, 203 (37.9%) were positive for staphylococcus aureus. There were 133 (65.5%) cases of methicillin-sensitive staphylococcus aureus (MSSA) and 70 (34.5%) cases of MRSA. Concerning bacterial drug resistance, a statistical analysis showed that MSSA had high resistance rate to penicillin (96.2%), ampicillin (91%), clindamycin (42.9%) and erythromycin (45.9%). MRSA had a high resistance rate to penicillin (100%), ampicillin (98.6%), oxacillin (95.7%), erythromycin (81.4%), clindamycin (80%), and amoxicillin (31.7%). Risk factors for progression of mastitis to breast abscess include a body temperature<38.5°C, a postpartum time ≥ 42 days, an onset time ≥ 2 days, lesions in the nipple/areolar complex area, a history of massage by non-medical staff and bacterial cultures for milk or pus that test positive for staphylococcus aureus or MRSA (P < 0.001). CONCLUSIONS: The most common pathogenic bacteria of mastitis and breast abscess is staphylococcus aureus. There are many risk factors for mastitis to develop into breast abscess. We should take effective measures for its risk factors and select sensitive antibiotics according to the results of bacterial culture to reduce the formation of breast abscess.

Relationship between subgroups of central and lateral lymph node metastasis in clinically node-negative papillary thyroid carcinoma.

BACKGROUND: Lymph node metastasis (LNM) of papillary thyroid carcinoma (PTC) has a certain regularity and occurs first to the central lymph node and then to the lateral lymph node. The pathway of PTC LNM can guide surgical prophylactic lymph node dissection (LND) for clinical surgeons. AIM: To investigate the relationship between subgroups of central LNM and lateral LNM in unilateral clinically node-negative PTC (cN0-PTC). METHODS: Data were collected for 1089 PTC patients who underwent surgical treatment at the Department of Endocrine and Breast Surgery of the First Hospital of Chongqing Medical University from January 2016 to December 2017. A total of 388 unilateral cN0-PTC patients met the inclusion criteria and were enrolled in this study. The clinical and pathological data for these 388 patients who underwent total thyroidectomy + central LND + lateral LND were retrospectively analyzed. The relationship between the central LNM and lateral LNM subgroups was investigated. RESULTS: The coincidence rate of cN0-PTC was only 30.0%.Optimal scaling regression analysis showed that sex (57.1% vs 42.9%, P = 0.026), primary tumor size (68.8% vs 31.2%, P = 0.008), tumor location (59.7% vs 40.3%, P = 0.007), extrathyroid extension (ETE) (50.6% vs 49.9%, P = 0.046), and prelaryngeal LNM (57.1% vs 42.9%, P = 0.004) were significantly associated with ipsilateral level-II LNM. Their importance levels were 0.122, 0.213, 0.172, 0.110, and 0.227, respectively. Primary tumor size (74.6% vs 30.2%, P = 0.016), pretracheal LNM (67.5% vs 32.5%, P < 0.001), and paratracheal LNM (71.4% vs 28.6%, P < 0.001) were significantly associated with ipsilateral level-III LNM. Their importance levels were 0.120, 0.408, and 0.351, respectively. Primary tumor size (72.1% vs 27.9%, P = 0.003), ETE (70.4% vs 29.6%, P = 0.016), pretracheal LNM (68.3% vs 31.7%, P=0.001), and paratracheal LNM (80.8% vs 19.2%, P < 0.001) were significantly associated with ipsilateral level-IV LNM. Their importance levels were 0.164, 0.146, 0.216, and 0.472, respectively. CONCLUSION: The LNM pathway of thyroid cancer has a certain regularity. For unilateral cN0-PTC patients with a tumor diameter > 2 cm and pretracheal or ipsilateral paratracheal LNM, LND at ipsilateral level III and level IV must be considered. When there is a tumor in the upper third of the thyroid with prelaryngeal LNM, LND at level II, level III and level IV must be considered.

Metastatic papillary thyroid carcinoma with no primary tumor in the thyroid gland: a case report and review of literature.

Metastatic papillary thyroid carcinoma in the lymph nodes with no primary tumor in the thyroid gland is rarely reported and is easily missed. We report the case of a 27-year-old female who presented with a tiny nodule in her left thyroid gland, which was detected during a routine ultrasonographic examination. She did not present with fever, weight loss, or night sweats, and no palpable mass was found in the physical examination. The preoperative blood routine, thyroid function, and thyroglobulin test results were normal. Needle aspiration cytology of the thyroid and lymph nodes was recommended. However, the patient was anxious and refused to have a fine-needle aspiration biopsy (FNAB), requesting surgical excision instead. The patient underwent a left thyroid lobectomy and ipsilateral central lymph node dissection under general anesthesia. Metastasis of papillary thyroid carcinoma was found in the central lymph nodes although there was no primary tumor in the left thyroid gland. We reviewed the literature and found the possible hypotheses to explain this phenomenon included the lack of a pathologic biopsy, tumor regression, and ectopic thyroid carcinoma. After 2 years of follow-up, no recurrence or metastasis of the tumor was found in this patient. In conclusion, we believe attention should be paid to occult thyroid cancer with papillary carcinoma in the lymph nodes so as to avoid missed diagnoses and delayed treatment.

Arsenic in soils contaminated by arsenic-containing chemical weapons in a site of Jilin, China: fraction and bioaccessibility.

At the end of World War II, the Japanese abandoned arsenic (As)-containing chemical weapons (CWs) in China. During the long-term burial process, the As-containing agents leaked into the environment due to the corrosion of weapon shells. This study explored the surface distribution, fraction composition, and bioaccessibility of As in the soil contaminated by chemical weapons in a site of Jilin Province, China. Results showed that As was enriched in the soil of CWs buried and the maximum concentration of As in this area was 110 mg/kg (dry weight). In terms of fraction, As primarily accumulated in amorphous Fe/Al-oxides bound and residual fractions. Moreover, from the perspective of fractions with potential environmental risks, As accounted for 45.6-82.0% and 61.0-80.7% of the fractions extracted by Wenzel and Shiowatana sequential extraction procedure (SEP), respectively. Bioaccessibility can also be used to assess environmental risks. The mean values of As bioaccessibility were as follows: gastric phase (15.0%) > colon phase (14.8%) > small intestinal phase (13.3%), and the As bioaccessibility was closely related to the Fe/Al oxide bound fraction. Compared with the surrounding farmland, the potential environmental risk of soil pollution was more significant in the CW burial areas. This study provided support for remediation of As-containing agent-contaminated soil in China.

Metal organic framework UiO-66 incorporated ultrafiltration membranes for simultaneous natural organic matter and heavy metal ions removal.

In this work, a new type of UiO-66 incorporated polysulfone (PSf) ultrafiltration (UF) membranes was fabricated to enhance antifouling properties and heavy metal ions removal efficiency. The UF membranes incorporating different loadings of the UiO-66 filler were prepared via the classical phase inversion process. These membranes unveiled enhanced hydrophilicity, porosity, water uptake, zeta potential, mechanical strength, permeability, and HA removal ratios due to the incorporation of hydrophilic UiO-66 fillers. Particularly, HA rejection ratios were observed to be approximately 93% for all the modified membranes, which was attributed to electrostatic repulsion interactions between the hydrophilic groups of HA and UiO-66. Moreover, the antifouling abilities of the modified membranes were evaluated and found to be much better with a high flux recovery ratio (FRR) of about 88% when compared to the blank PSf membrane (only around 34%). Moreover, the UiO-66 incorporated membranes were highly-effective in the removal of contaminants like heavy metal ions (Sr2+, Pb2+, Cd2+, and Cr6+) and HA at the same time. Overall, the PSf UF membranes incorporating UiO-66 opened up a new avenue to enhance the membrane hydrophilicity, permeability, antifouling properties as well as heavy metal ions removal abilities.

Migration behavior and leaching ability of radioactive uranium during incineration of uranium-containing strippable coating wastes.

It is currently thought that the incineration approach is an effective method to minimize the volume of radioactive wastes. In this paper, we used an incinerator to burn uranium-containing strippable coating waste. The migration behavior of radioactive uranium during the incineration process were investigated based on hierarchical sampling and mass spectrometry. Results shows that the radioactive uranium is more easily to adhere to the particles with smaller size. The leaching abilities of radioactive uranium in the bottom ash and the fly ash were analyzed. The leaching rate of the uranium from the fly ash and bottom ash were 1% and 6%, respectively, indicating that most of the radioactive uranium was fixed in the ash and the same storage/disposal methods can be used for both the fly ash and bottom ash. According to x-ray spectrometry and SEM-EDS, mineral compositions of the original uranium ore and the bottom ash were mostly the same. Calcium plays an important role in uranium fixation during incineration. The potential mechanism of the uranium special transformation during uranium-containing strippable coating waste combustion was revealed. Our research results can provide technical support for nuclear emergency waste treatment and disposal.

Adsorption behavior of Cs(I) on natural soils: Batch experiments and model-based quantification of different adsorption sites.

Understanding the adsorption behavior of radiocesium (RCs) in natural soils is crucial for remediation and evaluation of radioactive contaminated sites. In this study, we investigated the adsorption behavior of Cs(I) onto natural soils collected in Beijing by batch adsorption experiments and sequential extraction. A multi-site adsorption model was built to quantitatively analyze the adsorption capacities of soil clay minerals and predict of Cs(I) adsorption ratio of different adsorption sites. Linear programming calculations show that illite/smectite (I/S) mixture and illite(I) are the mainly clay mineral composition. Batch adsorption experiment results show that soils adsorption of Cesium ions is an exothermic process, and the order of influence of competitive cations on the competitive adsorption strength of Cs(I) is:K+>Mg2+≈Ca2+>Na+. HA (Humic Acid)has little effect on soil adsorption. SEM-EDS analysis shows that Cs+ is mainly distributed on the surface (PS) of soil particles. Based on the above results, the adsorption of Cs(I) onto clay minerals in soils is well predicts in both linear programming calculations and a multi-site adsorption model. The multi-site adsorption model can quantitatively describe and predict the adsorption behavior of Cs(I) on different clay sites in the soils. Frayed edge sites (FES) in the soil can effectively fix trace RCs. The higher concentration of cesium ions is mainly adsorbed on the PS and TIIS. Sequential extraction experiment further proved the adsorption form of cesium in soil under trace and high concentration conditions.

A turn-on fluorescent probe based on N-(rhodamine-B)-thiolactam-2-n-butane with ionic liquids for selective and sensitive detection of mustard gas stimulant.

Sulfur mustard (SM) is recognized as one of the most lethal warfare agents. It has the potential to seriously affect public health and safety. To employ appropriate medical countermeasures and treat victims as quickly as possible, the development of a rapid and simple SM detection technique is crucial. The aim of the present study was to explore novel detection systems exhibiting excellent selectivity and high sensitivity. An SM probe, namely N-(rhodamine-B)-thiolactam-2-n-butane (SRB-NB), which was based on a thiolactam structure, was effectively designed and synthesized. The rhodamine and thiourea moieties played the roles of the chromogenic and reacting groups, respectively. Subsequently, using ionic liquids (ILs) as the solvents, a turn-on fluorescence detection system was constructed. Notably, it was found that imidazole-based ILs displayed good solubility for an SM simulant, specifically 2-chloroethyl ethyl sulfide (2-CEES). Moreover, 1-butyl-3-methylimidazolium dicyandiamide ([BMIm]DCA) IL held the maximum amount of 2-CEES (132.5 g/100 g). The SRB-NB probe exhibited better ultraviolet (UV) absorption and fluorescence properties in ILs than in other organic solvents. SRB-NB/IL was able to detect 2-CEES in liquid form with remarkable selectivity and sensitivity. The limit of detection (LOD) was established at 3.0 × 10-6 M. Importantly, SRB-NB/ILs also showed good optical response to gaseous 2-CEES and SM.

Long-term anti-inflammatory diet in relation to improved breast cancer prognosis: a prospective cohort study.

Inflammation-modulating nutrients and inflammatory markers are established cancer risk factors, however, evidence regarding the association between post-diagnosis diet-associated inflammation and breast cancer survival is relatively sparse. We aimed to examine the association between post-diagnosis dietary inflammatory index (DII®) and risks of all-cause and breast cancer-specific mortality. A total of 1064 female breast cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial prospective cohort, were included in this analysis if they had completed the diet history questionnaire (DHQ). Energy-adjusted DII (E-DIITM) scores were calculated based on food and supplement intake. Cox regression and competing risk models were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by E-DII tertile (T) for all-cause and breast cancer-specific mortality. With median follow-up of 14.6 years, there were 296 (27.8%) deaths from all causes and 100 (9.4%) breast cancer-specific death. The E-DII was associated with all-cause mortality (HR T3 vs T1, 1.34; 95% CI, 1.01-1.81; P trend, 0.049, Table 2) and breast cancer mortality (HR T3 vs T1, 1.47; 95% CI, 0.89-2.43; P trend, 0.13; multivariable-adjusted HR for 1-unit increment: 1.10; 95% CI: 1.00-1.22). Non-linear positive dose-response associations with mortality from all causes were identified for E-DII scores (P non-linearity < 0.05). The post-diagnosis E-DII was statistically significantly associated with mortality risk among breast cancer survivors. Long-term anti-inflammatory diet might be a means of improving survival of breast cancer survivors.

Layered Extraction and Adsorption Performance of Extracellular Polymeric Substances from Activated Sludge in the Enhanced Biological Phosphorus Removal Process.

A large amount of phosphorus was found in the extracellular polymeric substances (EPS) of activated sludge used in enhanced biological phosphorus removal (EBPR), so the role of EPS and extracellular phosphorus in EBPR should not be neglected. The composition and properties of tightly bound EPS (TB-EPS) and loosely bound EPS (LB-EPS) were significantly different, and it was necessary to study the adsorption performance of EPS through the fractionating of activated sludge into LB-EPS, TB-EPS and microbial cells. In this study, the adsorption performance of LB-EPS and TB-EPS for phosphate was explored by extracting LB-EPS and TB-EPS via sonication and cation exchange resin (CER), respectively. The results indicated that the sonication-CER method was an efficient and reliable extraction method for EPS with a synergistic effect. The performance of EPS in the adsorption/complexing of phosphate was excellent because of its abundant functional groups. Specifically, the type and content of metal elements and functional groups in TB-EPS were much greater than those in LB-EPS, which led to the key role of TB-EPS in the adsorption/complexing of phosphate. Finally, a metabolic model for EBPR with consideration of the adsorption performance of LB-EPS and TB-EPS was proposed.

Effect of grape pomace on fermentation quality and aerobic stability of sweet sorghum silage.

The objective of this study was to evaluate the effect of grape pomace (GP) with different adding levels (0%, 5%, 10% and 15%, fresh matter basis), alone (GP-LAB) or in combine with an inoculant LAB (GP+LAB), on the fermentation quality and aerobic stability of sweet sorghum silage. After 90 days of ensiling in vacuumized mini-silos, silages were subject to a 7-day aerobic stability test, in which chemical, microbial and polyphenol composition were measured. In the GP-LAB group, adding GP decreased (P < 0.05) concentrations of water-soluble carbohydrate (WSC) and butyric acid in silage. In the GP+LAB group, adding GP increased (P < 0.05) concentrations of lactic acid, WSC and crude protein, decreased (P < 0.05) final pH value, NH3 -N ratio and butyric acid concentration in silage. Polyphenol level was reduced (P < 0.05) after silage fermentation. During aerobic exposure, the fungi count, pH value and silage temperature increased (P < 0.05), the levels of lactic acid, acetic acid and polyphenols (quercetin 3-O-glucoside and quercetin 3-O-glucuronid) decreased (P < 0.05) in silage. GP+LAB treated silage had a lag phase for aerobic spoilage. When the fermentation products, microbial counts, chemical and polyphenol composition were considered, the use of 10% GP+LAB at ensiling could provide a valuable source for improved fermentation quality and aerobic stability of sweet sorghum silage.