Nutritional Management of Lung Cancer Patients Undergoing Chemotherapy: A Qualitative Exploration of Patients' and Healthcare Professionals' Perspectives.

OBJECTIVES: To describe the experiences of lung cancer patients undergoing chemotherapy in nutrition management and the problems in the process of implementing nutrition management for patients by healthcare professionals. METHODS: This is a qualitative descriptive study. Qualitative data were collected through semistructured interviews with lung cancer patients undergoing chemotherapy (N = 16) and healthcare professionals (N = 24) from the oncology department at three tertiary grade A hospitals. RESULTS: Three themes emerged from the patients' interviews: deficiency in nutritional management capabilities; barriers to implementing nutritional management; incentives to implementing nutritional management. Five themes emerged from the healthcare professionals' interviews: insufficient attention to nutritional management of lung cancer patients undergoing chemotherapy; lack of standardization in nutritional management; inadequate support for nutritional management; weak multidisciplinary awareness; poor compliance from patients and their families. CONCLUSIONS: The nutritional management of lung cancer patients undergoing chemotherapy is a complicated and vital process that requires the joint efforts of healthcare professionals and patients. Formulating corresponding strategies from multiple perspectives is suggested to provide targeted nutritional guidance for patients. IMPLICATION FOR NURSING PRACTICE: This study can help nurses better understand the nutritional management needs and challenges of patients to provide individualized nutritional guidance to patients. Meanwhile, the study also found the existing problems of nutrition management in clinical work, which can help nurses to reflect on and better participate in the nutrition management of patients.

Profiles of financial toxicity and influencing factors among cancer patients: A latent profile analysis.

BACKGROUND: While cancer treatment has improved patient prognosis, it has also become more costly. The high hospitalization expenses for cancer patients place a significant financial burden on individuals, families, and society. OBJECTIVES: To identify the potential categories and characteristics of Financial Toxicity (FT) among cancer patients and explore the associated influencing factors. METHODS: A cross-sectional study was conducted on 299 cancer patients in southwest China from February 2023 to May 2023(response rate 96.45 %). FT was measured by Financial Toxicity based on Patient-Reported Outcome Measures (COST-PROM), emotional inhibition was measured by the emotional inhibition scale (EIS), and treatment burden was measured by the Treatment Burden Questionnaire (TBQ). We used latent profile analysis (LPA) by Mplus.8.0 to identify latent classes of the FT. Multinomial logistic regression analysis was used to analyze the relevant factors on the different categories. RESULTS: The FT of cancer patients can be identified into 3 groups: high-level (43.1 %), medium-level (36.1 %), and low-level (20.7 %) groups. Literacy, annual household income, health problem dimension scores, verbal inhibition scores, and self-control scores can be the predictors of FT among different profiles. CONCLUSIONS: Our findings may provide a new viewpoint for managing FT among cancer patients. Healthcare providers should pay attention to the FT of cancer patients and develop targeted interventions to reduce their FT levels.

Association between self-disclosure and benefit finding of Chinese cancer patients caregivers: the mediation effect of coping styles.

PURPOSE: To examine the relationship between self-disclosure, coping styles, and benefit finding (BF) among caregivers of cancer patients. The study also aimed to identify the factors influencing BF and the impact of coping styles on the relationship between self-disclosure and BF. METHODS: Convenience sampling was used to select 300 caregivers of cancer patients aged greater than 18 years from October 2022 to April 2023 in Chengdu, China. The demographic and clinical characteristics questionnaire, the Benefit Finding Scale (BFS), the Distress Disclosure Index Scale (DDI), and the Simple Coping Style Scale (SCSQ) for caregivers were included in this study. Descriptive statistics, t-tests, one-way analysis of variance, Pearson's correlation analyses, and multiple linear regression models were used. The effect of mediation was tested by the PROCESS macro (Model 4) for SPSS 26.0 by Hayes using 5000 bootstrap samples. RESULTS: There were 292 valid questionnaires (effective response rate 97.33%). The total scores of BF, self-disclosure, negative coping style, and positive coping style of caregivers were 67.77 ± 14.78, 38.23 ± 8.59, 19.68 ± 5.98, and 9.88 ± 4.18, respectively; Pearson's correlation analysis showed that BF was positively correlated with self-disclosure, positive coping, and negatively correlated with negative coping; multiple linear regression analysis showed that self-disclosure, positive coping, and negative coping were influential factors of BF. The results revealed that the effect of self-disclosure on BF was partly mediated by coping styles. It also confirmed that the mediation effect accounted for 54.03% of the total effect. CONCLUSION: The BF of caregivers is at a moderate level. Self-disclosure may influence BF partly because of coping styles.

Interleukin-6 in retinal diseases: From pathogenesis to therapy.

Interleukin-6 (IL-6) is a pleiotropic cytokine that participates in immunomodulation, inflammation, increases vascular permeability, hematopoiesis, and stimulates cell proliferation, among other biological processes. It exerts effects primarily through the classic and trans-signaling pathways. Many studies have demonstrated that IL-6 plays a critical role in the development of retinal diseases including diabetic retinopathy, uveitis, age-related macular degeneration, glaucoma, retinal vein occlusion, central serous chorioretinopathy and proliferative vitreoretinopathy. Thus, the progressive development of drugs targeting IL-6 and IL-6 receptor may play a role in the treatment of multiple retinal diseases. In this article, we comprehensively review the IL-6's biological functions of and its mechanisms in the pathogenesis of various retinal diseases. Furthermore, we summarize the drugs targeting IL-6 and its receptor and prospect their potential application in retinal diseases, hoping to provide new ideas for the treatment of retinal diseases.

Case report: Traumatic ventricular aneurysm combining tricuspid valve avulsion in a child: Diagnostic findings and treatment protocols.

This case report is an extremely rare case of a traumatic left ventricular aneurysm in a 3-year-old child who also had tricuspid valve avulsion due to blunt trauma. The diagnostic findings and treatment protocols are discussed to provide a clinical reference.

Effectiveness of a combined problem-based learning and flipped classroom teaching method in ophthalmic clinical skill training.

BACKGROUND: Previous studies have primarily implemented problem-based learning (PBL) or flipped classroom (FC) teaching models in different majors; however, research on the combined PBL-FC teaching method in clinical medicine is scarce. Therefore, we investigated the combined PBL-FC teaching method in teaching ocular trauma on students' competencies. METHOD: About 75 ophthalmology postgraduates were randomly divided into PBL-FC and traditional teaching groups. Students completed pre-and post-class theoretical examinations, skills evaluation, learning ability scales, and feedback questionnaires. RESULTS: Both groups showed significantly higher theoretical scores and improved learning ability. Feedback questionnaire scores of the PBL-FC group's postgraduates without clinical experience were significantly higher than the traditional group's for some items; there was no difference between groups in postgraduates with clinical experience. PBL-FC group's pre-class preparation time was significantly longer than the traditional group's, but the post-class review time was significantly shorter. PBL-FC group's post-class theoretical performance was significantly higher than the traditional group's. There was no statistical difference between the groups regarding skill operation. Among postgraduates without clinical experience, the PBL-FC group's skill operation performance was significantly higher than the traditional group's; for postgraduates with clinical experience, the traditional group's skill operation performance was significantly higher than the PBL-FC group's. CONCLUSIONS: PBL-FC teaching is better for students without clinical experience or knowledge of ophthalmic diseases. Meanwhile, traditional teaching is a good choice for students with clinical experience who need more relevant knowledge.

Different variations in soil CO2, CH4, and N2O fluxes and their responses to edaphic factors along a boreal secondary forest successional trajectory.

Forest succession is an important process regulating the carbon and nitrogen budgets in forest ecosystems. However, little is known about how and extent by which vegetation succession predictably affects soil CO2, CH4, and N2O fluxes, especially in boreal forest. Here, a field study was conducted along a secondary forest succession trajectory from Betula platyphylla forest (early stage), then Betula platyphylla-Larix gmelinii forest (intermediate stage), to Larix gmelinii forest (late stage) to explore the effects of forest succession on soil greenhouse gas fluxes and related soil environmental factors in Northeast China. The results showed significant differences in soil greenhouse gas fluxes during the forest succession. During the study period, the average soil CO2 flux was greatest at mid-successional stage (444.72 mg m-2 h-1), followed by the late (341.81 mg m-2 h-1) and the early-successional (347.12 mg m-2 h-1) stages. The average soil CH4 flux increased significantly during succession, ranging from -0.062 to -0.036 mg m-2 h-1. The average soil N2O flux was measured as 17.95 µg m-2 h-1 at intermediate successional stage, significantly lower than that at late (20.71 µg m-2 h-1) and early-successional (20.85 µg m-2 h-1) stages. During forest succession, soil greenhouse gas fluxes showed significant correlations with soil and environmental factors at both seasonal and successional time scales. The seasonal variations of soil GHG fluxes were mainly influenced by soil temperature and water content. Meanwhile, soil MBN and soil NO3--N content were also important factors for soil N2O fluxes. Structural equation modelling showed that forest succession affected soil CO2 fluxes by changing soil temperature and microbial biomass carbon, affected soil CH4 fluxes mainly by changing soil water content and soil pH value, and affected soil N2O fluxes mainly by changing soil temperature, microbial biomass nitrogen, and soil NO3--N content. Our study suggests that forest succession mainly alters soil nutrient and soil environment/chemical properties affecting soil CO2 and N2O fluxes and soil CH4 fluxes, respectively, in the secondary forest succession process.

SILICONE OIL-FILLED FOLDABLE CAPSULAR VITREOUS BODY VERSUS SILICONE OIL ENDOTAMPONADE FOR TREATMENT OF NO LIGHT PERCEPTION AFTER SEVERE OCULAR TRAUMA.

PURPOSE: To compare the anatomical and functional outcomes of silicone oil (SO)-filled foldable capsular vitreous body (FCVB) and SO endotamponade in vitrectomy for patients with no light perception after ocular trauma. METHODS: A total of 64 patients (64 eyes) with no light perception caused by severe ocular trauma were divided into FCVB and SO groups based on the surgical treatment. The main outcome measurements were retinal reattachment rate, intraocular pressure, best-corrected visual acuity, and number of operations. RESULTS: Both the FCVB group (29 eyes) and the SO group (35 eyes) showed significant improvement in postoperative best-corrected visual acuity and intraocular pressure. The two groups showed no significant differences in final intraocular pressure and the retinal reattachment rate. The postoperative vision (≥LP) in the FCVB group was significantly worse than in the SO group (FCVB [4/29] vs. SO [18/35], P = 0.003). However, the number of surgeries in the FCVB group was significantly lower than in the SO group (FCVB [1.10] vs. SO [2.23], P < 0.001). CONCLUSION: Vitrectomy combined with SO endotamponade shows better short-term improvement in the treatment of no light perception caused by severe ocular trauma. However, SO-filled FCVB can effectively prevent many complications caused by direct SO endotamponade, such as secondary surgeries or SO dependence.

Understory species composition mediates soil greenhouse gas fluxes by affecting bacterial community diversity in boreal forests.

Introduction: Plant species composition in forest ecosystems can alter soil greenhouse gas (GHG) budgets by affecting soil properties and microbial communities. However, little attention has been paid to the forest types characterized by understory vegetation, especially in boreal forests where understory species contribute significantly to carbon and nitrogen cycling. Method: In the present study, soil GHG fluxes, soil properties and bacterial community, and soil environmental conditions were investigated among three types of larch forest [Rhododendron simsii-Larix gmelinii forest (RL), Ledum palustre-Larix gmelinii forest (LL), and Sphagnum-Bryum-Ledum palustre-Larix gmelinii forest (SLL)] in the typical boreal region of northeast China to explore whether the forest types characterized by different understory species can affect soil GHG fluxes. Results: The results showed that differences in understory species significantly affected soil GHG fluxes, properties, and bacterial composition among types of larch forest. Soil CO2 and N2O fluxes were significantly higher in LL (347.12 mg m-2 h-1 and 20.71 µg m-2 h-1) and RL (335.54 mg m-2 h-1 and 20.73 µg m-2 h-1) than that in SLL (295.58 mg m-2 h-1 and 17.65 µg m-2 h-1), while lower soil CH4 uptake (-21.07 µg m-2 h-1) were found in SLL than in RL (-35.21 µg m-2 h-1) and LL (-35.85 µg m-2 h-1). No significant differences between LL and RL were found in soil CO2, CH4, and N2O fluxes. Soil bacterial composition was mainly dominated by Proteobacteria, Actinobacteria, Acidobacteria, and Chloroflexi among the three types of larch forest, while their abundances differed significantly. Soil environmental variables, soil properties, bacterial composition, and their interactions significantly affected the variations in GHG fluxes with understory species. Specifically, structural equation modeling suggested that soil bacterial composition and temperature had direct close links with variations in soil GHG fluxes among types of larch forest. Moreover, soil NO3 --N and NH4 + - N content also affected soil CO2, CH4, and N2O fluxes indirectly, via their effects on soil bacterial composition. Discussion: Our study highlights the importance of understory species in regulating soil GHG fluxes in boreal forests, which furthers our understanding of the role of boreal forests in sustainable development and climate change mitigation.

Resveratrol protects retinal ganglion cells against ischemia induced damage by increasing Opa1 expression.

Loss of idiopathic retinal ganglion cells (RGCs) leads to irreversible vision defects and is considered the primary characteristic of glaucoma. However, effective treatment strategies in terms of RGC neuroprotection remain elusive. In the present study, the protective effects of resveratrol on RGC apoptosis, and the mechanisms underlying its effects were investigated, with a particular emphasis on the function of optic atrophy 1 (Opa1). In an ischemia/reperfusion (I/R) injury model, the notable thinning of the retina, significant apoptosis of RGCs, reduction in Opa1 expression and long Opa1 isoform to short Opa1 isoform ratios (L­Opa1/S­Opa1 ratio) were observed, all of which were reversed by resveratrol administration. Serum deprivation resulted in reductions in R28 cell viability, superoxide dismutase (SOD) activity, Opa1 expression and induced apoptosis, which were also partially reversed by resveratrol treatment. To conclude, results from the present study suggest that resveratrol treatment significantly reduced retinal damage and RGC apoptosis in I/R injury and serum deprivation models. In addition, resveratrol reversed the downregulated expression of Opa1 and reduced SOD activity. Mechanistically, resveratrol influenced mitochondrial dynamics by regulating the L­Opa1/S­Opa1 ratio. Therefore, these observations suggest that resveratrol may exhibit potential as a therapeutic agent for RGC damage in the future.