[Simultaneous determination of five indole/indazole amide-based synthetic cannabinoids in electronic cigarette oil by ultra performance liquid chromatography].

Synthetic cannabinoids (SCs), which are considered some of the most widely abused new psychoactive substances available today, are much more potent than natural cannabis and display greater efficacy. New SCs can be developed by adding substituents such as halogen, alkyl, or alkoxy groups to one of the aromatic ring systems, or by changing the length of the alkyl chain. Following the emergence of the so-called first-generation SCs, further developments have led to eighth-generation indole/indazole amide-based SCs. Given that all SCs were listed as controlled substances on July 1, 2021, the technologies used to detect these substances must be quickly improved. Due to the sheer number of SCs, the chemical diversity and the fast update speed, it is challenging to determine and identify the new SCs. In recent years, several types of indole/indazole amide-based SCs have been seized, but systematic research on these compounds remains limited. Therefore, developing rapid, sensitive, and accurate quantitative methods to determine new SCs are of great importance. Compared with high performance liquid chromatography (HPLC), ultra performance liquid chromatography (UPLC) shows higher resolution, better separation efficiency, and faster analysis speeds; thus, it can meet the demand for the quantitative analysis of indole/indazole amide-based SCs in seized materials. In this study, a UPLC method was developed for the simultaneous determination of five indole/indazole amide-based SCs, including N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-butyl-1H-indazole-3-carboxamide (ADB-BUTINACA), methyl 2-(1-(4-fluorobutyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate (4F-MDMB-BUTICA), N-(1-methoxy-3,3-dimethyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1H-indole-3-carboxamide (5F-MDMB-PICA), methyl 3,3-dimethyl-2-(1-(pent-4-en-1-yl)-1H-indazole-3-carboxamido)butanoate (MDMB-4en-PINACA), and N-(adamantan-1-yl)-1-(4-fluorobutyl)-1H-indazole-3-carboxamide (4F-ABUTINACA) in electronic cigarette oil; these SCs have been detected with increasing frequency in seized materials in recent years. The main factors influencing the separation and detection performance of the proposed method, including the mobile phase, elution gradient, column temperature, and detection wavelength, were optimized. The proposed method successfully quantified the five SCs in electronic cigarette oil via the external standard method. The samples were extracted using methanol, and the target analytes were separated on a Waters ACQUITY UPLC CSH C18 column (100 mm×2.1 mm, 1.7 µm) at column temperature of 35 ℃ and flow rate of 0.3 mL/min. The injection volume was 1 µL. The mobile phase consisted of acetonitrile and ultrapure water, and gradient elution was employed. The detection wavelengths were 290 and 302 nm. The five SCs were completely separated within 10 min under optimized conditions and showed good linear relationships between 1-100 mg/L, with correlation coefficients (r2) of up to 0.9999. The limits of detection (LOD) and quantification (LOQ) were 0.2 and 0.6 mg/L, respectively. Precision was determined using standard solutions of the five SCs at mass concentrations of 1, 10, and 100 mg/L. The intra-day precision (n=6) was <1.5%, and the inter-day precision (n=6) was <2.2%. Accuracy was determined by spiking electronic cigarette oil with low (2 mg/L), moderate (10 mg/L), and high (50 mg/L) levels of the five SCs, with six replicates per determination. The recoveries of the five SCs were 95.5%-101.9%, and their relative standard deviations (RSDs, n=6) were 0.2%-1.5%, with accuracies ranging from -4.5% to 1.9%. The proposed method showed good performance when applied to the analysis of real samples. It is accurate, rapid, sensitive, and effective for the determination of five indole/indazole amide-based SCs in electronic cigarette oil. Thus, it satisfies the requirements for practical determination and provides a reference for the determination of SCs with similar structures by UPLC.

Prevalence and risk factors of self-reported financial toxicity in cancer survivors: A systematic review and meta-analyses.

BACKGROUND: Similar to the side effects of cancer treatment, financial toxicity (FT) can affect the quality of life of patients, which has attracted increasing attention in the field of oncology. Despite the fact that the estimated prevalence and risk factors of FT are widely reported, these results have not been synthesized. OBJECTIVES: This review is aimed to systematically assess the prevalence and risk factors of self-reported FT. DESIGN: Systematic review and meta-analyses. DATA SOURCES: A computer search of English literature was conducted using databases of PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL, and reference lists of the qualified articles were also included between January 2010 and September 2021. Observational studies that reported the prevalence or risk factors of FT using subjective measures were included. METHODS: The systematic review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The risk of bias was assessed by the NIH observational cohort and cross-sectional study quality assessment tool. The data were extracted by two reviewers and listed in a descriptive table for meta-analyses. RESULTS: In the 22 studies available for meta-analyses of pooled prevalence of FT, the result was estimated to be 45% (95% CI: 38% to 53%, I2 = 97.3%, P < 0.001) based on a random-effects model. The pooled analysis identified 9 potential risk factors of FT (7 in ß and 8 in OR): low income (OR = 2.48, 95% CI: 1.72 to 3.24, I2 = 3.1%, P < 0.001), greater annual OOP (ß = -4.26, 95% CI: -6.95 to -1.57, I2 = 0%, P = 0.002), younger age (OR = 2.05, 95% CI: 1.56 to 2.54, I2 = 0%, P < 0.001), no private insurance (OR = 1.69, 95% CI: 1.02 to 2.37, I2 = 0%, P < 0.001), unmarried (OR = 1.10, 95% CI: 0.95 to 1.25, I2 = 53,3%, P < 0.001), nonwhite (OR = 1.59, 95% CI: 1.33 to 1.85, I2 = 0%, P < 0.001), advanced cancer (ß = -4.74, 95% CI: -6.90 to -2.57, I2 = 0%, P < 0.001), unemployed (ß = -2.90, 95% CI: -5.71 to -0.63, I2 = 75,7%, P < 0.001), more recent diagnosis (OR = 1.31, 95% CI: 1.04 to 1.57, I2 = 0%, P < 0.001). CONCLUSION: This systematic review reported a pooled prevalence of self-reported FT of 45%. Low income, greater annual OOP (Out of pocket), younger age, unmarried, unemployed, nonwhite, no private insurance, advanced cancer, and more recent diagnosis constituted risk factors for self-reported FT. The research on risk factors for FT can provide a theoretical basis for medical staff to evaluate and intervene in the FT among cancer survivors.

Association between financial toxicity and health-related quality of life in cancer survivors: A systematic review.

Over the past decade, the number of cancer cases has continued to rise, placing a heavy burden on patients' families and healthcare systems. Although innovative treatments and drugs have improved patient outcomes, the financial toxicity (FT) of treatment is a growing concern among oncologists. Previous research have examined the impacts of FT on the HRQOL of cancer patients. However, the extent of the association is unclear, given that previous studies vary in the enrolled population, adjustment of confounding factors, and usage of FT assessment tools. To address this gap, the main purpose of this systematic review is to examine the relationship between FT and HRQOL of cancer survivors, and explore any potential factors that may affect this relationship.

Assessment of self-reported financial toxicity among patients with nasopharyngeal carcinoma undergoing radiotherapy: A cross-sectional study in western China.

Objective : Using the Comprehensive Score for Financial Toxicity (COST) tool to measure financial toxicity (FT) among nasopharyngeal cancer (NPC) patients in western China and investigate the association between FT and psychological distress. Methods: We conducted a cross-sectional study of survivors with NPC in a tertiary oncology hospital in China. FT was assessed using the COST (Chinese version), a validated instrument widely used both at home and abroad. The NCCN Distress Thermometer (DT) was used to measure psychological distress. A multivariate logistic regression model was built to determine factors associated with FT, and the Pearson correlation was used to assess the correlation between COST and DT scores. Results: Of 210 patients included in this study, the mean FT score was 16.3 (median: 22.5, SD: 9.7), and the prevalence of FT was 66.2% (mild FT: 37.1%, moderate FT: 50.5%, severe FT: 2.4%). Suggested by the logistic regression model, 5 variables were associated with increased FT: unemployed, no commercial insurance, receiving lower annual income, advanced cancer, and receiving targeted therapy. The Pearson correlation showed a significantly moderate correlation between financial toxicity and psychological distress (r= -0.587, P < 0.001). Conclusion: Patients with nasopharyngeal carcinoma (NPC) in western China demonstrated higher self-reported financial toxicity (FT) associated with factors including unemployed, no commercial insurance, receiving lower annual income, advanced cancer, and receiving targeted therapy. These predictors will help clinicians identify potential patients with FT in advance and conduct effective psychological interventions.

Effects of nurse-led supportive-expressive group intervention for post-traumatic growth among breast cancer survivors: A randomized clinical trial.

BACKGROUND: Post-traumatic growth induced from cancer diagnosis and treatment could benefit the prognosis of cancer survivors, but intervention based on self-disclosure in group is limited. OBJECTIVE: Aimed to examine the effectiveness of a supportive-expressive group intervention on post-traumatic growth. The impact of the intervention on anxiety and depression were also explored. DESIGN: This randomized clinical trial enrolled patients from June 2017 to September 2018 with a one-month follow-up. Data collectors were blinded to patient grouping. SETTING: A single center study in Chengdu, China. PARTICIPANTS: One hundred sixty-eight participants who met the eligibility criteria were randomly assigned to the intervention group (n = 84) or control group (n = 84); 46 were excluded and 122 patients finished the one-month follow-up. METHODS: Participants in the intervention group received nurse-led support intervention focusing on topics such as "Being a Patient", "Interpersonal Relationships", "Journey for Recovery", and "Planning the Future" while participants in the control group received health education, rehabilitation training etc. according to the nursing routine of breast cancer patients. The intervention was designed in accordance with the diagnosis and treatment process as well as patient needs. Participants in both groups were evaluated three times (T1-baseline before the intervention, T2-end of the intervention, and T3-1 month follow up). Post-traumatic growth, anxiety and depression were evaluated. RESULTS: Participants in the intervention group reported higher level of post-traumatic growth (p < 0.01 or 0.05) and reduced anxiety and depression (p < 0.01 or 0.05 and p < 0.01 or 0.05). The multilevel model indicated that the intervention significantly promoted post-traumatic growth (ßT3  = 7.87, p < 0.05) and dimensions of relating to others (ßT3  = 4.26, p < 0.001), personal strength (ßT3  = 4.27, p < 0.01), appreciation of life (ßT3  = 8.69, p < 0.001), and new possibilities (ßT3  = 1.91, p < 0.05), anxiety (ßT3  = -3.63, p < 0.001), and depression (ßT3  = -2.27, p < 0.001), but had no effect on the dimension of spiritual change. In addition, the multi-level model showed that patients with younger ages (ß = -0.05~-0.52, p < 0.05-0.001), with high school and above education levels (ß = 1.53~9.29, p < 0.01) and accompanied by husbands(ß = -1.48~-8.51, p < 0.05) had more effective intervention and patients with religious belief had a better spiritual change level (ß = 1.86, p < 0.001). CONCLUSIONS: These findings provide evidence for the potential effectiveness of the nurse-led intervention on positive benefits of post-traumatic growth and relieved anxiety and depression for Chinese breast cancer survivors and will inform the design and development of a large randomized controlled trial. CLINICAL RELEVANCE: The supportive-expression group intervention can be applied independently by nurses. The four themes of self-disclosure can help patients grow after trauma, and this method can be used as a psychological support technique for breast cancer patients during hospitalization.

The Educational Program for Healthcare Providers Regarding Fertility Preservation for Cancer Patients: a Systematic Review.

The emerging discipline of oncofertility advocates for the timely provision of fertility preservation (FP) to all cancer patients of childbearing age by healthcare providers. A lack of practice due to limited FP-related knowledge was found among healthcare providers. A systematic review was undertaken on the educational programs on FP for healthcare providers. An initial search was performed in MEDLINE, PsycINFO, CINAHL, Web of Science, PubMed, and Scopus databases in October 2019. This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Among the 160 articles that were identified, five relevant articles published between 2009 and 2019 were reviewed. Of the five studies, three were quantitative nonrandomized studies, one was a randomized controlled trial, and one was a qualitative study. Three programs were relevant to oncology nurses, one was relevant to social workers as well as nurses, and one was relevant to oncology fellows and residents. The four programs significantly increased healthcare providers' knowledge about FP, but clinical practice was only improved in the Educating Nurses about Reproductive Issues in Cancer Healthcare program (P < 0.01). Nevertheless, most of the studies used a self-made questionnaire or tool to assess the effects of the training programs. The educational programs improved the FP-related knowledge of healthcare providers but lacked the high-quality randomized controlled trials needed to provide robust evidence on the effectiveness of training programs using standard tools. More training projects should be developed based on learning theories or models to improve oncofertility care in clinical practice.

Reliability and validity of the mandarin version of the supportive care needs survey short-form (SCNS-SF34) and the head and neck cancer-specific supportive care needs (SCNS-HNC) module.

BACKGROUND: This study aimed to translate the English version of the supportive care needs scale of head and neck cancer patients (SCNS-HNC) questionnaire into Mandarin and to test the reliability and validity of the SCNS-SF34 and SCNS-HNC module in head and neck cancer patients. METHODS: The Mandarin version of the Supportive Care Needs Survey Short-Form (SCNS-SF34) and SCNS-HNC scales were used to assess 206 patients with head and neck cancer in Chengdu, China. Among them, 51 patients were re-tested 2 or 3 days after the first survey. The internal consistency of the scale was evaluated by Cronbach's alpha coefficient, the retest reliability of the scale was evaluated by retest correlation coefficient r, the structural validity of the scale was evaluated by exploratory factor analysis, and the ceiling and floor effects of the scale were evaluated. RESULTS: The Mandarin version of the SCNS-HNC had Cronbach's alpha coefficients greater than 0.700 (0.737 ≤ 0.962) for all of the domains. Except for the psychological demand dimension (r = 0.674) of the SCNS-SF34 scale, the retest reliability of the other domains was greater than 0.8. Three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 64.39%. CONCLUSIONS: The Mandarin version of the SCNS-SF34 and SCNS-HNC demonstrated satisfactory reliability and validity and is able to measure the supportive care needs of Chinese patients with head and neck cancer. TRIAL REGISTRATION: ChiCTR, ChiCTR1900026635 . Registered 16 October 2019- Retrospectively registered.