Combined influence of nutritional and inflammatory status and depressive symptoms on mortality among US cancer survivors: Findings from the NHANES.

BACKGROUND: Inflammation and nutrition and depression are interrelated, and both are related to changes in mortality rates. We investigated the association of nutritional and inflammation index or depressive symptoms with the risk of all-cause mortality or cause-specific mortality among cancer survivors. METHODS: A prospective cohort of a nationally representative sample of cancer survivors, aged 40 years or older (n = 2331; weighted population, 15 248 255; 67.6 ± 11.0 years; 50.6 % males), were recruited from the US National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Advanced lung cancer inflammation index (ALI) reflected inflammation and nutritional status and Patient Health Questionnaire 9 (PHQ-9) demonstrated depressive symptoms. The independent and joint associations of ALI and PHQ-9 score with mortality outcomes were examined among cancer survivors and Cox regression analysis based on weights was used to calculate the relative risk. RESULTS: We identified 605 all-cause deaths (cancer, 204; non-cancer, 401) over a median of 6.2 years of follow-up (15,385 person-years; interquartile range, 3.3-9.8 years). High ALI was observed to be consistently associated with lower risks of all-cause (hazard ratio [HR], 0.516; 95 % CI, 0.400-0.667) and non-cancer (HR, 0.414; 95 % CI, 0.291-0.588) mortality compared with low ALI in a series of adjusted models. Meanwhile, lower PHQ-9 score (0-4) was associated with lower risks of all-cause (HR, 0.686; 95 % CI, 0.521-0.903) and non-cancer (HR, 0.686; 95 % CI, 0.474-0.992) mortality compared with higher PHQ-9 score (≥10). Furthermore, joint analyses showed that high ALI was associated with a decreased risk of death among cancer survivors who were not depressive. Specifically, survivors with high ALI but not depressive symptoms had the lowest overall (HR, 0.404; 95 % CI, 0.228-0.715) risks. CONCLUSION: In this cohort study, we observed impact of nutritional and inflammatory status and depressive symptoms on mortality among cancer survivors, with the lowest risks of death from both all causes and non-cancer being noted among the combination of high level ALI with no depression.

Pain Incidence and Associated Risk Factors among Cancer Patients within 72 Hours after Surgery: A Large Retrospective Analysis.

BACKGROUND: A fundamental principle of pain management is to determine the distribution and causes of pain. However, relevant data among postoperative cancer patients based on a large amount of data remain sparse. OBJECTIVE: We aimed to investigate the incidence of postoperative pain in cancer patients and to explore the associated risk factors. METHODS: We retrospectively collected information on postoperative pain-evaluation records of cancer patients who underwent surgery between 1 January 2014 and 31 December 2019. Descriptive statistics were presented, and multinominal logistic regression analysis was performed to explore the risk factors associated with postoperative pain. RESULTS: Among the 11,383 patients included in the study, the incidence of mild/moderate to severe pain at the 24th hour after surgery was 74.9% and 18.3%, respectively. At the 48th and 72nd hour after surgery, the incidence of mild pain increased slightly, while the incidence of moderate to severe pain continued to decrease. Female patients experienced a higher risk of pain (ORs: 1.37-1.58). Undergoing endoscopic surgery was associated with a higher risk of pain (ORs: 1.40-1.56). Patients with surgical sites located in the respiratory system had a higher risk of pain compared to in the digestive system (ORs: 1.35-2.13), and other patients had a relatively lower risk of pain (ORs: 0.11-0.61). CONCLUSION: The majority of cancer patients experienced varying degrees of postoperative pain but may not receive adequate attention and timely treatment. Female, young age and endoscopic surgery were associated with increased pain risk, and effective identification of these high-risk groups had positive implications for enhanced postoperative pain management.

Postoperative Pain in Patients Undergoing Cancer Surgery and Intravenous Patient-Controlled Analgesia Use: The First and Second 24 h Experiences.

INTRODUCTION: Postoperative cancer pain imposes severe physical and psychological problems. We aimed to investigate the pain experiences of patients with cancer after surgery, analyze the impact of infusion volume by patient-controlled analgesia (PCA), and explore the variations between day 1 and day 2. METHODS: Data were retrospectively extracted from a large health data platform. Descriptive statistics were presented for the demographic and clinical profiles of patients. Multiple logistic regression analyses were performed to evaluate associations between intensity of pain and PCA use after adjustment for risk factors. RESULTS: Among 11,383 patients with cancer, the incidence of pain (moderate to severe pain) was 93.3% (18.3%) at the first 24 h after operation, while the respect values decreased to 91.1% and 9.5% at the second 24 h. Further, female patients consistently experienced higher risk of pain over the whole 48 h postoperatively. Surgical sites were related to pain risk, with the highest risk among the respiratory system (OR 2.077, 95% CI 1.392-3.100). High doses of continuous volume (OR 2.453, 95% CI 1.742-3.456) and total volume (OR 2.830, 95% CI 2.037-3.934) of infusions were related to 1-3-fold elevated pain risk. Additionally, the observed associations were mostly repeated and could be up to over 10 times when pain was evaluated with number of PCA pump compressions instead of Numerical Rating Scale (NRS). CONCLUSIONS: High risk of postoperative cancer pain, particularly among the high PCA dose group, could possibly indicate inadequate pain control, and presence of modifiable risk factors warrants more aggressive pain management strategies perioperatively.

Cladding softened fiber for sensitivity enhancement of distributed acoustic sensing.

Fiber-optic distributed acoustic sensing (DAS) technology with high spatial and strain resolutions has been widely used in many practical applications. New methods to enhance the phase sensitivity of sensing fiber are worth exploring to further improve DAS performances, although the standard single-mode fiber (SSMF) has been widely used for DAS technology. In this work, we propose and demonstrate the concept of enhancing the phase sensitivity of DAS by softening the cladding of the sensing fiber, for the first time. The theoretical analysis indicates that softening sensing fiber cladding is an effective way to improve phase sensitivity. Thus, we fabricated cladding softened fibers (CSFs) and tested their phase sensitivities experimentally. According to the results, it is found that the phase sensitivity of the CSF with 0.48 WT% phosphorus-doping concentration and 80 µm cladding diameter is 22% and 54% higher than that of the non-phosphorus-doping fiber with 80 µm cladding diameter and SSMF, respectively. The results show that by reducing fiber cladding Young's modulus with higher phosphorus-doping concentration, the DAS phase sensitivity can be enhanced effectively, verifying the theoretical analysis. Also, we found that the phase sensitivity enhancement of the sensing fiber has a linear relationship with the cladding phosphorus-doping concentration, i.e. Young's modulus. In conclusion, the reported CSF paves a way for improving the DAS phase sensitivity and would be applied to other major optical fiber sensing systems as a better sensing element over SSMF due to the enhancement in the elasto-optical effect of the sensing fiber.

Low-noise high-order Raman fiber laser pumped by random lasing.

Raman fiber lasers (RFLs) have been widely utilized in long-haul optical transmission systems as pump sources for distributed Raman amplification (DRA) to increase transmission distance and capacity. However, RFLs with relatively large temporal intensity fluctuations would deteriorate signal quality due to the transfer of relative intensity noise (RIN). In this Letter, a low-noise high-order RFL common cavity pumped by an ytterbium-doped random fiber laser (YRFL) is proposed and demonstrated for the first time, to the best of our knowledge. Stable 4th-order random Raman lasing operating at 1365 nm is generated with 8.9 W of output power, without use of a multi-stage master oscillation power amplification system. Thanks to the YRFL common-cavity pumping where a wavelength division multiplexer (WDM)-assisted fiber-loop mirror is used to generate stable 1090 nm ytterbium-doped random lasing and cascaded random Raman lasing simultaneously, the RIN of the 1365 nm RFL is suppressed as low as -120dB/Hz without any peak over a 0-100 MHz span. Furthermore, the output power and lasing wavelength of this RFL can be flexibly tuned by adjusting the laser diode pump power, high-reflectivity fiber Bragg grating center wavelength, and single-mode fiber length. Hence, such a low-noise high-order RFL paves a way for the development of novel tunable RFLs with stable temporal output, leading to potential replacement of conventional RFLs for DRA in long-haul optical transmission systems to achieve better performances.