Assessing attitudes towards biostatistics education among medical students: adaptation and preliminary evaluation of the Chinese version survey of attitudes towards statistics (SATS-36).

BACKGROUND: Despite the numerous advantages of mastering biostatistics, medical students generally perceive biostatistics as a difficult and challenging subject and even experience anxiety during the courses. Evidence for the correlation between students' academic achievements and their attitudes, indicating that attitudes at the beginning of the biostatistics course may affect cognitive competence at the end of the course and subsequently influence student academic performance. However, there are current disagreements regarding the measurement and evaluation of attitudes related to statistics. Thus, there is a need for standard instruments to assess them. This study was conducted to develop a Chinese version of the Survey of Attitudes Toward Statistics (SATS-36) in order to acquire a valid instrument to measure medical students' attitudes toward biostatistics under Chinese medical educational background. METHODS: The Chinese version SATS-36 was developed through translation and back-translation of the original scale, with subsequent revisions based on expert advice to ensure the most appropriate item content. The local adaption was performed with a cohort of 1709 Chinese-speaking medical undergraduate and graduate students enrolled in biostatistics courses. And then, the reliability, validity and discrimination of the questionnaires were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods. RESULTS: The Chinese version SATS-36 consisted of 36 items and loaded a five-factor structure by factor analysis, which offered an alternative similar but not equal to that original six-factor structure. The cumulative variance contribution rate was 62.20%, the Cronbach's α coefficient was 0.908, the Guttman split-half reliability coefficient was 0.905 and the test-retest reliability coefficient was 0.752. Discriminant analysis revealed small to large significant differences in the five attitude subscales. CONCLUSIONS: The Chinese version SATS-36 with good validity and reliability in this study can be used to evaluate the learning framework of Chinese medical students.

Case report: A rare combination of aldosterone-secreting adrenocortical carcinoma and papillary thyroid carcinoma with Graves' disease.

Adrenocortical carcinoma (ACC) is a rare malignancy originating in the adrenal glands, aldosterone-producing ACC, even rarer. Papillary thyroid carcinoma (PTC), by contrast, accounts for the majority of thyroid carcinomas. We herein describe the first reported case of a female with comorbidities of aldosterone-producing ACC, PTC, and Graves' Disease(GD). The patient achieved transient clinical remission following adrenalectomy. However, three months later, aldosterone-producing ACC lung metastases emerged. Subsequently, within another three-month interval, she developed thyroid eye disease(TED). The patient died roughly one year after the adrenal operation. Exome sequencing did not reveal associations between aldosterone-producing ACC, PTC, and GD, and the underlying concurrence mechanism has yet to be elucidated. Further research of similar cases are needed to confirm potential links between the three pathologies.

Preparation and thermal responsiveness of microencapsulated fluorinated liquids for automatic fire extinguishing.

Most early-stage fires originating in small confined spaces may not be effectively mitigated by automatic fire-extinguishing systems. Leveraging the unique controlled release capability and barrier properties of microcapsules presents a promising avenue for developing multifunctional and intelligent fire-extinguishing agents tailored for early-stage fire suppression. This paper introduces two types of microcapsules that integrate automatic detection and fire extinguishing functions, utilizing fluorinated liquids specifically perfluoro(2-methyl-3-pentanone) and 1,1,1,2,2,3,4,5,5,5 decafluoro-3-methoxy-4(trifluoromethyl)-pentane as core materials. The preparation process was optimized, and the thermal response of the microcapsules was evaluated by directly incorporating them into combustible materials. The results indicated a correlation between the preparation method, coating efficiency, and thermal stability of microcapsules with the core-wall materials. When the fluoride solution in the core material reaches the thermal response threshold temperature, the gas pressure generated during vaporization and phase change can break through the shell, enabling early active fire protection. Beyond a specific threshold of additive microcapsules in the material, the material exhibits self-extinguishing potential during combustion. In cases where the additive amount falls short of achieving self-extinguishing, the fire-resistant performance of materials can be enhanced through various measures. For instance, reducing the amount of fire-extinguishing agents, delaying the ignition time of fuel, and lowering the heat release rate during combustion are effective strategies. Moreover, the degree of improvement is related to the additional amount and the type of core-wall materials. The thermal-response mechanism of microcapsules constitutes a comprehensive mechanism with physical and chemical effects. The finding of this research offer a new technical approach for microencapsulating high-boiling-point gas extinguishing agents, facilitating intelligent and precise prevention of early fires resulting from combustible materials.

Elaboration and validation of a novelty nomogram for the prognostication of anxiety susceptibility in individuals suffering from low back pain.

Low back pain (LBP) constitutes a distressing emotional ordeal and serves as a potent catalyst for adverse emotional states, notably anxiety. We dedicated to discerning methodologies for identifying patients who are predisposed to heightened levels of anxiety and pain. A self-assessment questionnaire was administered to patients afflicted with LBP. The pain scores were subjected to analysis in conjunction with anxiety scores, and a clustering procedure was executed using the scientific k-means methodology. Subsequently, six machine learning algorithms, including Logistics Regression (LR), K-Nearest Neighbor (KNN), Decision Tree (DT), Support Vector Machine (SVM), Random Forest (RF), and Extreme Gradient Boosting (XGB), were employed. Next, five pertinent variables were identified, namely Age, Course, Body Mass Index (BMI), Education, and Marital status. Furthermore, a LR model was utilized to construct a nomogram, which was subsequently subjected to assessment for discrimination, calibration, and evaluation of its clinical utility. As a result, 599 questionnaires were valid (effective rate: 99 %). The correlation analysis revealed a significant association between anxiety and pain scores (r = 0.31, P < 0.001). LBP patients could be divided into two clusters, Cluster1 had higher pain scores (P < 0.05) and SAS scores (P < 0.001). The proposed nomogram demonstrated an area under the receiver operating characteristics curve (ROC) of 0.841 (95 %CI: 0.804-0.878) and 0.800 (95 %CI: 0.733-0.867) in the training and test groups, respectively. Briefly, the established nomogram has demonstrated remarkable proficiency in discerning individuals afflicted with LBP who are at a heightened risk of experiencing anxiety.

Transparent and Planar Cs3Cu2Cl5 Crystals for Micrometer-Resolution X-ray Imaging Screen.

Copper-based (I) halide perovskites have emerged as a promising candidate for scintillation screens in X-ray inspection and imaging areas due to their solution processability and high light yield. Here, a centimeter-sized Cs3Cu2Cl5 single crystal was grown by a slow-cooling method. The planar orientation was controlled in a space-confined chamber, generating a planar crystal which is readily used for a scintillation screen without any further shaping. The crystal exhibited a unity photoluminescence quantum yield and superior scintillation performance. The Cs3Cu2Cl5 single crystal exhibited a high light yield up to 95,000 photons/MeV, which enabled an X-ray detector of a detection limit down to 2.7 µGyair/s. The homemade imager demonstrated a spatial resolution of 105 lp/mm, representing an unprecedented micrometer resolution in laboratory. Importantly, the stability of Cs3Cu2Cl5 was significantly improved by a new surface passivation procedure, whereby the passivated crystal reserved its phase after 6 months' storage in a vial. This work introduced a new solution-based synthetic method for two-dimensional scintillating crystals, opening many avenues to high-performance X-ray imaging applications.

Factors influencing work engagement among male nurses: A structural equation model.

AIM: To investigate the male nurses' engagement in nursing work and the influencing factors. DESIGN: A cross-sectional study. METHODS: A cross-sectional survey was conducted in 13 hospitals in China to collect data from 328 male nurses from August to October 2021. A structural equation model design was tested with validated measurement instruments. RESULTS: The work engagement of male nurses in China was at a medium level. There was a high correlation of the male nurses' work engagement with career identity (r = 0.764, p < 0.01), career success (r = 0.735, p < 0.01) and social support (r = 0.477, p < 0.01). The linear multivariate regression analysis showed that career satisfaction (ß = 0.393), career identity (ß = 0.392) and subjective support (ß = 0.116) entered regression equation of male nurses' work engagement (all p < 0.05). The structural equation model results showed that career identity and social support were the influencing factors of the male nurses' work engagement and the model explained variation of 66.4% variables. CONCLUSION: To know the male nurses' work engagement and influencing factors in China has certain enlightening significance for male nurses themselves and nursing manager. On the one hand, it is necessary to enhance the male nurses' career recognition to nursing work. On the other hand, the society should provide more aid and support to the male nurses. Therefore, the male nurses could devote more into nursing work and promote the nursing development.

Afterglow Phosphor Goes Transparent.

Recently, transparent afterglow phosphors have attracted increasing interest due to the mitigated self-absorption and the ensuing improved light output, which have inspired many advanced applications, including volumetric display and three-dimensional optical encryption. To date, the most successful afterglow phosphors remain those traditional oxide, nitride, or sulfide powders which are not transparent due to a severe scattering effect. By reduction of the number of interfaces and engineering the refractive index, the scattering effect could be circumvented effectively. To this end, four material systems, including transparent afterglow single crystals, transparent phosphorescent organics, transparent afterglow glass, and luminescent nanocomposites, were reviewed in this Perspective. We started with the discussion of the nontransparency origin. Through a careful inspection of Rayleigh scattering theory, a general solution involving both refractive index and particle size was proposed to reduce the scattering effect. Many representative works on transparent afterglow phosphors were systematically reviewed, where the typical synthesis methods and the advantages and disadvantages of each system were critically presented. In the last part, bottlenecks, prospects, and future development directions based on transparent afterglow phosphors are proposed.

The nutritional literacy of breast cancer patients receiving chemotherapy and its association with treatment self-regulation and perceived social support.

PURPOSE: Chemotherapy can lead to malnutrition and post-menopausal recurrence among breast cancer (BC) patients, who need to achieve nutritional literacy (NL) to cope. The objective of this study was to explore the NL level in Chinese BC patients receiving chemotherapy and its predictors including both internal motivation and the external environment. METHODS: A total of 326 BC female patients from three hospitals were enrolled. Participants completed the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA), Chinese version from the Treatment Self-Regulation Questionnaire (TSRQ-C), and the Perceived Social Support Scale (PSSS) to assess NL, treatment self-regulation, and social support. Stepwise multivariate linear regression was used to identify the main factors of NL. RESULTS: The total NL score was 151.31 ± 16.85, the "knowledge understanding" dimension had the lowest score. In the final regression model, patients with higher scores for "autonomous motivation" and "introjected regulation" on the TSRQ-C and "family support" and "other support" on the PSSS, higher educational levels and average monthly household incomes and endocrine therapy had higher NL levels (adjusted R2 = 66.7%, p < 0.05). CONCLUSIONS: The overall NL score among Chinese BC patients receiving chemotherapy was satisfactory, but the knowledge understanding score was low. Higher autonomous motivation, introjected regulation, family support and other support scores, higher educational and household income levels, and endocrine therapy were predictors of NL in female patients. Interventions should be designed according to the specific performances and predictors of NL in female patients.

Influencing factors of quality of life among front-line nurses who collected nucleic acid samples during COVID-19: a path analysis.

Aim: The aim of this study is to investigate the quality of life of nurses who collected nucleic acid samples throughout the COVID-19 epidemic's routine management, as well as the factors that may have influenced it. Background: After the outbreak of COVID-19, normalized epidemic prevention and control throughout China were implemented. Nucleic acid testing has become an effective measure for the early detection of virus-infected individuals. Nurses collecting nucleic acid samples undertake important tasks. Their quality of life is significant to maintaining team stability and containing the epidemic. However, research on their quality of life is still limited. Methods: A cross-sectional survey was conducted on 1,292 nurses who collected nucleic acid samples from five tertiary general hospitals in Xi'an through self-reported electronic questionnaires (including general demographic information, the Connor-Davidson Resilience Scale, the Social Support Rating Scale, and the World Health Organization Quality of Life Brief Scale). Descriptive, one-way ANOVA and multiple linear regression were performed using SPSS 26.0. Structural equation modeling was used to analyze the influencing factors. Results: The nurses collecting nucleic acid samples had a modest level of quality of life. Age, marital status, average daily sleep duration, frequency of exercise, psychological resilience, and social support were all influencing factors of quality of life, according to multiple linear regression analysis. Quality of life was found to be significantly related to psychological resilience and social support. Conclusion: Demographic characteristics, psychological resilience, and social support are the factors affecting the quality of life of nurses who collect nucleic acid samples. Nursing managers should focus more on these factors to improve the quality of life for nurses. Relevance to clinical practice: Nursing managers should realize the importance of the quality of life of nurses who collect nucleic acid samples in maintaining a vigorous nursing team and ensuring optimized epidemic control. Social support should also be provided to nurses to improve their psychological resilience, thereby improving their quality of life.

Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China.

Background: Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes. Methods: This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA). Results: Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (ß = 0.449, p < 0.001) and dietary attitude (ß = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores. Conclusion: There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.

Psychological capital and alienation among patients with COVID-19 infection: the mediating role of social support.

BACKGROUND: COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. METHODS: The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. RESULTS: Psychological capital was significantly and negatively related to the COVID-19 patients' social alienation (p < .01). And social support partially mediated the correlation between psychological capital and patients' social alienation (p < .01). CONCLUSION: Psychological capital is critical to predicting COVID-19 patients' social alienation. Social support plays an intermediary role and explains how psychological capital alleviates the sense of social alienation among patients with COVID-19 infection.

The influence of nutrition literacy, self-care self-efficacy and social support on the dietary practices of breast cancer patients undergoing chemotherapy: A multicentre study.

PURPOSE: Breast cancer patients undergoing chemotherapy experience adverse reactions, which lead to poor nutritional status. The objective of this study was to explore the dietary practice of Chinese breast cancer patients undergoing chemotherapy and to analyse the influence of nutrition literacy, self-care self-efficacy and perceived social support on dietary practice. METHOD: A total of 295 participants from three hospitals in China were enrolled. The Dietary Nutritional Knowledge, Attitude and Practice Questionnaire; Nutrition Literacy Measurement Scale for Chinese Adults; Strategies Used by People to Promote Health and Perceived Social Support Scale were administered. Multiple linear regressions were used to identify influencing factors. RESULTS: The dietary practice of patients were generally satisfactory. Nutrition literacy (r = 0.460, p < 0.001), self-care self-efficacy (r = 0.513, p < 0.001) and perceived social support (r = 0.703, p < 0.001) were positively correlated with dietary practice. The main factors influencing participants' dietary practice were nutrition literacy, self-care self-efficacy, perceived social support, living environment, cancer stage, body mass index, chemotherapy cycle and average monthly household income (all p < 0.05). The model explained 59.0% of the variance in dietary practice. CONCLUSIONS: Health professionals should emphasize breast cancer patients' dietary practice throughout the entire chemotherapy course, and dietary interventions should be designed by oncology nurses based on patients' nutrition literacy, self-care self-efficacy and perceived social support. Female patients who have a higher body mass index and income, live in rural areas, have a lower education level, have stage I cancer and have undergone numerous chemotherapy cycles are the focus population of intervention.

Accelerating the solar-thermal energy storage via inner-light supplying with optical waveguide.

Solar-thermal storage with phase-change material (PCM) plays an important role in solar energy utilization. However, most PCMs own low thermal conductivity which restricts the thermal charging rate in bulk samples and leads to low solar-thermal conversion efficiency. Here, we propose to regulate the solar-thermal conversion interface in spatial dimension by transmitting the sunlight into the paraffin-graphene composite with side-glowing optical waveguide fiber. This inner-light-supply mode avoids the overheating surface of the PCM, accelerates the charging rate by 123% than that of the traditional surface irradiation mode and increases the solar thermal efficiency to ~94.85%. Additionally, the large-scale device with inner-light-supply mode works efficiently outdoors, indicating the potential of this heat localization strategy in practical application.

Duplicated adrenal veins in primary aldosteronism misdiagnosed with ectopic aldosteronoma due to apparent bilateral aldosterone suppression.

BACKGROUND: Primary aldosteronism (PA) is considered the number one aetiology for secondary hypertension. Apart from confirmatory tests and localisation of PA determined by computed tomography (CT), adrenal venous sampling (AVS) is used to define whether aldosterone hypersecretion occurs inside one or both adrenal glands. However, even correctly-performed AVS may lead to undiagnostic results such as apparent bilateral adrenal suppression (apparent bilateral aldosterone suppression), in which the adrenal aldosterone-to-cortisol ratios (AC ratios) are decreased bilaterally compared to the peripheral blood sample, with several causes contributing to it. CASE DESCRIPTION: Here, we describe the case of a 48-year-old man who was referred to our department for further investigation with a history of refractory hypertension, hypokalaemia, and aortic dissection. His hypertension and hypokalaemia were initially attributed to ectopic aldosteronoma due to his adrenal CT scan and AVS results. However, the correct diagnosis of an adenoma with duplicated right adrenal veins (duplicated adrenal veins) due to apparent bilateral aldosterone suppression was confirmed during surgery. CONCLUSION: AVS is the gold standard accepted for PA subtyping, but sometimes when apparent bilateral aldosterone suppression is present, it can give ambiguous results. Duplicated right adrenal veins, may impact results, thus, AVS may not accurately provide evidence of unilateral hypersecretion for all PA patients. Repeat AVS or adrenal surgery can provide worthwhile diagnostic conclusions.

The recognition and diagnosis of primary aldosteronism (PA) have increased in recent years and clinicians usually require adrenal venous sampling (AVS) to identify the affected side, and it's crucial for further treatments of PA patients (surgery or medicine).We presented an example of unilateral aldosteronoma with duplicated adrenal veins whose AVS results suggested apparent bilateral aldosterone suppression (the adrenal venous aldosterone/cortisol ratios are bilaterally lower than the peripheral ratios). He was misdiagnosed with ectopic aldosteronoma due to computed tomography (CT) features, but surgery findings revealed duplicated adrenal veins.Unclear AVS results such as apparent bilateral aldosterone suppression can lead to a missed diagnosis of unilateral PA, preventing patients from receiving potentially curative adrenal resection.Our case can serve as an example for clinicians that encounter the same condition to provide further investigational clues to ensure the correct aetiological diagnosis for patients with PA.

Development and validation of the patient reported outcomes questionnaire of children with asthma in China: A Caregiver's proxy-reported measure.

Background: Research on asthma control levels and quality of life is essential for children with asthma during their growth stage. Therefore, it is necessary to develop a questionnaire that can be used for monitoring and evaluating the disease control effectiveness and quality of life of children with asthma in China and to conduct a preliminary evaluation for its reliability, validity, and discriminative ability. Methods: The questionnaire was created through a literature review and qualitative interviews for a targeted population. Based on the previous work, 30 caregivers of children with asthma and 5 experienced pediatricians reviewed and discussed a collection of items. Then, 72 items were screened and selected to form the draft questionnaire. After three rounds of investigation (with 240, 503, and 360 participants, respectively), the final questionnaire was established according to the evaluation results. The structure of the questionnaire was explored through confirmatory factor analysis. Exploratory factor analysis and variability analysis were applied based on the first two rounds of investigation. Reliability, construct validity, and discriminative ability were evaluated based on the third round of investigation. Results: The questionnaire contains 6 dimensions and 34 items, and the total cumulative variance contribution rate was 54.96%; Cronbach's α coefficient was 0.91; the split-half reliability coefficient was 0.75, and the test-retest reliability coefficient was 0.74. The children's age, gender, residence, asthma attack in the last three months, caregivers' education background, and monthly income per caregiver were correlated with patient-reported outcomes of children with asthma. Conclusion: The questionnaire appeared to have good reliability, construct validity, and discriminative ability in children with asthma in China.

A universal hydrochloric acid-assistant powder-to-powder strategy for quick and mass preparation of lead-free perovskite microcrystals.

Lead-free halide perovskite materials possess low toxicity, broadband luminescence and robust stability compared with conventional lead-based perovskites, thus holding great promise for eyes-friendly white light LEDs. However, the traditionally used preparation methods with a long period and limited product yield have curtailed the commercialization of these materials. Here we introduce a universal hydrochloric acid-assistant powder-to-powder strategy which can accomplish the goals of thermal-, pressure-free, eco-friendliness, short time, low cost and high product yield, simultaneously. The obtained Cs2Na0.9Ag0.1In0.95Bi0.05Cl6 microcrystals exhibit bright self-trapped excitons emission with quantum yield of (98.3 ± 3.8)%, which could retain (90.5 ± 1.3)% and (96.8 ± 0.8)% after continuous heating or ultraviolet-irradiation for 1000 h, respectively. The phosphor converted-LED exhibited near-unity conversion efficiency from ultraviolet chip to self-trapped excitons emission at ~200 mA. Various ions doping (such as Cs2Na0.9Ag0.1InCl6:Ln3+) and other derived lead-free perovskite materials (such as Cs2ZrCl6 and Cs4MnBi2Cl12) with high luminous performance are all realized by our proposed strategy, which has shown excellent availability towards commercialization.

Potential predictors for progression of moyamoya disease: A systematic review and meta-analysis.

Background: The progress of Moyamoya disease (MMD) is often accompanied by the occurrence of new ischemia or hemorrhagic events, which was difficult to predict. This systematic review and meta-analysis aimed to identify predictors for progression in MMD patients. Methods: We searched PubMed, Web of Science, Cochrane Library, and Embase databases up to December 10th, 2022 for randomized controlled trials, case-control studies, or cohort studies reporting predictors of disease progression in MMD patients. The results of each predictor were pooled by meta-analysis and further analyzed by subgroup analysis for predictors of unilateral to bilateral progression of MMD. Results: A total of 842 patients from 12 studies were included. The estimated pooled means indicated lower age (standard mean difference [SMD]: -0.29, 95% confidence interval [CI]: -0.55 to -0.03; P = 0.03), family history (odds ratio [OR] 3.97, 95% CI: 1.96 to 8.03; P < 0.001) and contralateral abnormality (OR 3.95, 95% CI: 1.10 to 14.20; P = 0.04) were associated with progression in MMD patients. Subgroup analyses indicated that the same three factors were associated with the progression of unilateral to bilateral MMD. Conclusions: This meta-analysis revealed that lower age, family history and contralateral abnormality were associated with progression in MMD patients. The same three factors are associated with the progression of unilateral to bilateral MMD. Further studies are needed to validate our results.

Knowledge, attitudes and behaviors toward healthy eating among Chinese cancer patients treated with chemotherapy: A systematic review.

Side effects from chemotherapy may disturb healthy eating. There are many food taboos among Chinese patients with cancer treated with chemotherapy; they may be conservative in food intake and seek help from traditional Chinese medicine to adjust to healthy eating. Differences in eating cultures may lead Chinese patients with cancer to generate different knowledge, attitudes, and behaviors toward healthy eating. This systematic review explored the knowledge, attitudes, and behaviors toward healthy eating and summarized influencing factors among Chinese patients with cancer treated with chemotherapy. Two English and three Chinese databases were searched since 2007. The eligibility criteria were quantitative descriptive studies, participants who were adult Chinese patients with cancer who received chemotherapy, and primary outcomes that included knowledge, attitudes, or behaviors toward healthy eating. A total of 12 studies were identified. The 11-item tool from the Agency for Healthcare Research and Quality was used to assess quality. All studies were of moderate quality. Narrative qualitative analysis was considered to summarize the findings, and the results were reported by scores or percentages. Four studies measured knowledge, and the information about what to eat and how much to eat was contradictory and confused patients, with little known about Chinese food therapy. Ten studies involved attitudes, and patients were aware of the importance and willingness for eating guidance before, during, and after chemotherapy. Strategies to relieve vomiting and nausea, engage in healthy food choices, and seek food therapy were the main behaviors. The influencing factors were found only in behaviors, including demographic and psychological factors. Knowledge, attitudes, and behaviors toward healthy eating are not satisfactory and need to be improved. More high-quality studies should regard health behavior as a distal outcome and explore the influences of knowledge and attitudes on behaviors.

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital.

Aim: COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods: A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results: Three latent profiles were identified-low security (Class 1), moderate security (Class 2), and high security (Class 3)-accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3; Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions: Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.