Factors influencing psychological distress among breast cancer survivors using machine learning techniques.

Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings.

Adaptation and validation of moral distress thermometer in Chinese nurses.

BACKGROUND: Moral distress seriously affects professional nurses, and a number of instruments have been developed to measure the level of moral distress. The moral distress thermometer (MDT) is one of the commonly used instruments that can rapidly measure real-time moral distress; however, it remains unclear whether it is still useful in the Chinese cultural context. AIM: This study aimed to adapt and validate the MDT among Chinese registered nurses. RESEARCH DESIGN: An online, cross-sectional, survey study of adapting and validating Chinese version of MDT. PARTICIPANTS AND RESEARCH CONTEXT: A total of 182 registered nurses effectively finished this survey. The correlation between MDT score and the score of the moral distress scale-revised version (MDS-R) was used for evaluating convergent validity, and MDT scores of registered nurses who working in different departments and who made different actions to the final question of the MDS-R were compared by using one-way ANOVA to evaluate construct validity. ETHICAL CONSIDERATIONS: The Ethics Committee of Chongqing Traditional Chinese Medicine Hospital approved this study. RESULTS: The Chinese version of MDT was described as relevant to measure moral distress, with a reported item-level content validity index (I-CVI) and scale-level CVI (S-CVI) of 1. The mean MDT score and mean MDS-R score were 2.54 and 38.66, respectively, and the correlation between these two scores was significantly moderate (r = 0.41). Nurses working different departments reported different levels of moral distress, and those working in intensive care unit reported the highest level of moral distress than those working in other departments (p = 0.04). The MDT scores between nurses who presented different actions to their position were also significantly different, and those who had ever left and those who had considered leaving but did not leave reported significantly higher moral distress. CONCLUSION: The MDT is a reliable, valid, and easy-to-use instrument to rapidly measure the real-time moral distress of registered nurses in China.

Comparison of two non-invasive body temperature measurement methods for the detection of febrile neutropenia in children with cancer.

BACKGROUND: This study was conducted to compare the accuracy of two noninvasive thermometers (axillary and infrared non-contact forehead thermometer) in measuring core temperature compared to the gold standard oral thermometer in the detection of fever in pediatric cancer patients with febrile neutropenia. METHODS: The study was conducted with a single group of 42 children with febrile neutropenia between 23 December 2020 and 25 January 2023 in the pediatric hematology and oncology clinic of a training and research hospital, which provides a specialized environment for both medical education and advanced scientific research in the field of pediatric hematology and oncology. The participants' body temperature was measured with an oral, axillary, and non-contact infrared forehead thermometer immediately after admission to the clinic and at 5 and 10 min after admission. The inter-rater agreement for each method and inter-method agreement between axillary and non-contact infrared temperature readings and oral readings were analyzed for each time point using intraclass correlation coefficients (ICC). RESULTS: The children in the study had a mean age of 11.62 ± 3.00 years and 28 (66.7%) were boys, 19 (45.2%) were younger children (5-10 years of age), and 23 (54.8%) were adolescents (11-16 years of age). In the analysis of agreement between the thermometers at admission and at 5 and 10 min after admission in children with febrile neutropenia, the highest agreement was between the oral and axillary thermometers (ICC: 0.584, 0.835, 0.536, respectively) and the lowest agreement was between the oral and non-contact infrared thermometers (ICC: 0.219, 0.022, 0.473, respectively). CONCLUSION: Compared to orally measured body temperature, axillary temperature readings showed better agreement than non-contact infrared temperature readings from the forehead in pediatric patients with febrile neutropenia. PRACTICE IMPLICATIONS: The research findings may guide nurses and families caring for pediatric patients with febrile neutropenia and should contribute to the prevention of false findings of fever and the reduction of its adverse consequences.

Temperature measurement accuracy of peripheral thermometer in the pediatric emergency department: A meta-analysis and systematic review.

BACKGROUND: It is necessary to evaluate the accuracy of peripheral thermometer in outpatient and emergency temperature measurement of children by diagnostic meta-analysis, to provide evidence for clinical temperature measurement and nursing care of children. METHODS: Two authors searched PubMed, Web of science, CINAHL, EBSCO, OVID, Embase, CNKI, Wanfang and Weipu databases for studies on the temperature measurement accuracy of peripheral thermometer in children in outpatient and emergency department until November 20, 2023. RESULTS: 10 studies involving 3448 children were included. The combined sensitivity was 82 % (95 % CI: 81 % ∼ 84 %), the combined specificity was 88 % (95 % CI: 87 % ∼ 89 %), the combined positive likelihood ratio was 11. 35 (95 % CI: 6. 07 âˆ¼ 21). 20), the combined negative likelihood ratio was 0.20 (95 % CI: 0.14 âˆ¼ 0.29). The odds ratio of combined diagnosis was 58.02 (95 % CI: 30.66 âˆ¼ 109.76), and the area under ROC curve (AUC) was 0.95. CONCLUSIONS: The peripheral temperature measurement can reflect a certain core temperature, among which the infrared tympanic membrane thermometer has the highest sensitivity, which is worthy of clinical application.

A novel microfluidic chip integrated with Pt micro-thermometer for temperature measurement at the single-cell level.

Noninvasive and sensitive thermometry of a single cell during the normal physiological process is crucial for analyzing fundamental cellular metabolism and applications to cancer treatment. However, current thermometers generally sense the average temperature variation for many cells, thereby failing to obtain real-time and continuous data of an individual cell. In this study, we employed platinum (Pt) electrodes to construct an integrated microfluidic chip as a single-cell thermometer. The single-cell isolation unit in the microchip consisted of a main channel, which was connected to the inlet and outlet of a single-cell capture funnel. A single cell can be trapped in the funnel and the remaining cells can bypass and flow along the main channel to the outlet. The best capture ratio of a single MCF7 cell at a single-cell isolation unit was 90 % under optimal condition. The thermometer in the micro-chip had a temperature resolution of 0.007 °C and showed a good linear relationship in the range of 20-40 °C (R2 = 0.9999). Slight temperature increment of different single tumor cell (MCF7 cell, H1975 cell, and HepG2 cell) cultured on the chip was continuously recorded under normal physiological condition. In addition, the temperature variation of single MCF7 cell in-situ after exposure to a stimulus (4 % paraformaldehyde treatment) was also monitored, showing an amplitude of temperature fluctuations gradually decreased over time. Taken together, this integrated microchip is a practical tool for detecting the change in the temperature of a single cell in real-time, thereby offering valuable information for the drug screening, diagnosis, and treatment of cancer.

Computational study of the performance of a solar dryer for improvement in the shelf life of the food materials.

In this study, the thermal and drying characteristics of a thin layer food sample were investigated. An indirect type, simple, efficient, and economically feasible solar dryer was fabricated and used for food preservation. However, a dynamic model of a fabricated solar dryer was also presented to gain a better insight into the drying and thermal actions. This model consists of thermal modeling of the drying chamber, solar collector, and solar-dried food sample. The law of conservation of energy was applied to evaluate the temperature at different sections of the solar dryer with respect to drying time. All listed model equations were solved in the MATLAB environment. This study helps to examine the influence of solar radiation on the collector plate temperature, drying chamber temperature, food sample temperature, and performance parameters such as thermal efficiency with respect to drying time. Model data was found in good agreement with experimental data within a 4% error. It is concluded that the drying of food material is affected by air temperature, the collector temperature, mode of heat transfer, and material characteristics such as dimension and mass of the food sample.

A photothermal aptasensor based on rolling circle amplification-enriched DNAzyme for portable detection of ochratoxin A in grape juice.

Aptasensors for detection of ochratoxin A (OTA) have been extensively studied, but the majority of them require costly and large-scale equipment as signal readers. Herein, a photothermal aptasensor capable of portable detection of OTA through a thermometer was developed on basis of aptamer structural switching and rolling circle amplification (RCA)-enriched DNAzyme. Oligonucleotides and alkaline phosphatase (ALP) modified magnetic beads were prepared. The binding of aptamers to OTA led to the release of ALP labeled complementary DNA. After magnetic separation, ALP catalyzed the padlock dephosphorylation, inhibiting the subsequent RCA reaction. This process converted the OTA concentration into the amount of the photothermal reagent oxTMB produced from the catalytic reaction induced by RCA-enriched DNAzyme. Under the optimal conditions, the detection limit (LOD) of this aptasensor was 2.28 nM in a clean buffer, while the LOD reached 2.43 nM in 2 % grape juice. The good performance of the photothermal aptasensor makes it possible to measure OTA pollution in low resource environments.

Robo-Therm, a pipeline to RNA thermometer discovery and validation.

RNA thermometers are highly structured noncoding RNAs located in the 5'-untranslated regions (UTRs) of genes that regulate expression by undergoing conformational changes in response to temperature. The discovery of RNA thermometers through bioinformatics is difficult because there is little sequence conservation among their structural elements. Thus, the abundance of these thermosensitive regulatory structures remains unclear. Herein, to advance the discovery and validation of RNA thermometers, we developed Robo-Therm, a pipeline that combines an adaptive and user-friendly in silico motif search with a well-established reporter system. Through our application of Robo-Therm, we discovered two novel RNA thermometers in bacterial and bacteriophage genomes found in the human gut. One of these thermometers is present in the 5'-UTR of a gene that codes for σ 70 RNA polymerase subunit in the bacteria Mediterraneibacter gnavus and Bacteroides pectinophilus, and in the bacteriophage Caudoviricetes, which infects B. pectinophilus The other thermometer is in the 5'-UTR of a tetracycline resistance gene (tetR) in the intestinal bacteria Escherichia coli and Shigella flexneri Our Robo-Therm pipeline can be applied to discover multiple RNA thermometers across various genomes.

Adherence to adjuvant endocrine therapy for breast cancer: a qualitative exploration of attribution of symptoms among post-menopausal women.

PURPOSE: Oral adjuvant endocrine therapy (AET) is an effective treatment for hormone receptor positive breast cancer to decrease recurrence and mortality, but adherence is poor. This study explored post-menopausal women's experiences with AET, with a particular focus on adherence to AET as well as distress and symptoms experienced prior to and during AET treatment. METHODS: Participants were recruited from a hospital registry, stratified by adherence to/discontinuation of AET. Telephone interviews followed a semi-structured interview guide and were recorded and transcribed verbatim. Transcripts were systematically coded using team-based coding, with analysis of themes using a grounded theory approach. RESULTS: Thirty-three participants were interviewed; ages ranged from 57 to 86 years. Participants included 10 discontinued patients and 23 patients who completed their AET course or were adherent to AET at the time of interviewing. Both adherent and discontinued patients reported symptoms throughout their AET treatment course, and both attributed symptoms to factors other than AET (e.g., older age and pre-existing comorbidities). However, discontinued patients were more likely to attribute symptoms to AET and to describe difficulty managing their symptoms, with some directly citing symptoms as the reason for discontinuing AET therapy. Conversely, adherent patients were more likely to describe the necessity of taking AET, despite symptoms. CONCLUSIONS: AET adherence was associated with beliefs about AET, symptom attribution, and symptom management. Routine symptom monitoring during AET and addressing both symptoms and patients' understanding of their symptoms may promote adherence to AET.

Performance of Distress Thermometer: A Study among Cancer Patients.

BACKGROUND: The Distress Thermometer accompanied with Problems List is a commonly used screening tool for psychosocial distress. However, it's cut-off score, performance and risk factors for psychosocial distress varies among studies. This is the first study conducted in Nepal to investigate the Distress Thermometer's screening properties, its optimal cut-off score and evaluating the prevalence of psychosocial distress and its risk factors. METHODS: This cross-sectional study enrolled 162 heterogeneous cancer patients. The English form of the Distress Thermometer was translated to Nepali using a forward and backward translation method. Questionnaires including socio-demographic, clinical characteristics, the Hospital Anxiety and Depression Scale and Distress Thermometer accompanied with Problems List were filled. Receiver Operating Characteristic analysis of distress thermometer scores was evaluated against Hospital Anxiety and Depression Scale-Total (≥15). An Area Under the Curve, sensitivity, specificity, positive predictive value and negative predictive value were calculated at each Distress Thermometer cut-off score. RESULTS: Receiver Operating Characteristic analysis showed an excellent discriminating performance (Area Under the Curve =87.4%). A cut-off score of 4 on Distress Thermometer was established and it yielded sensitivity (88.9%), specificity (71.1%), positive predictive value (75.4%) and negative predictive value (86.5%) respectively. Furthermore, 55.6% of participants were distressed and emotional problems (odd ratio = 28.00), practical problems (odd ratio = 12.152) and physical problems (odd ratio = 2.397) were found to be significant risk factors for PD. CONCLUSIONS: PD is a global burden in cancer patients. The DT with a cut-off score of 4 accompanied with PL is valid instrument for screening PD in Nepali cancer patients. PL identified the problems that causes of PD.

Highly Sensitive Temperature Sensors Resulting from the Luminescent Behavior of Sm3+-Doped Ba2MgMoO6 High-Symmetry Double-Perovskite Molybdate Phosphors.

We present double-perovskite molybdate with the formula of Ba2MgMoO6 doped with Sm3+ ions as a potential red phosphor to improve the color characteristics of white-light-emitting dioded (wLEDs). The new orange-red phosphor was synthesized using the co-precipitation (CP) method, and then its structural and spectroscopic properties were determined. Red emission at 642.6 nm dominates, which results from the electric dipole (ED) transition of the 4G5/2 → 6H9/2 type, and the materials are characterized by short luminescence decay times. BMM:Sm3+ is, to our best knowledge, the clearest example of dominant red emission of Sm3+ resulting from the location of the dopant in octahedral sites of high-symmetry cubic structure. In the sample containing 0.1% Sm3+, Sm3+ ions are located in both Mg2+ and Ba2+ sites, while at higher concentrations the Ba2+ site is less preferable for doping, as a result of which the emission becomes more uniform and single-site. The relative sensitivity calculated from FIR has a maximum of 2.7% K-1 at -30 °C and another local maximum of 1.6% K-1 at 75 °C. Such value is, to the best of our knowledge, one of the highest achieved for luminescent thermometry performed using only Sm3+ ions. To sum up, the obtained materials are good candidates as red phosphor to improve the color characteristics of wLEDs, obtaining a color-rendering index (CRI) of 91 and coordinated color temperature (CCT) of 2943 K, constituting a warm white emission. In addition to this, a promising precedent for temperature sensing using high-symmetry perovskite materials is the high sensitivity achieved, which results from the high symmetry of the BMM host.

Highly-sensitive optical thermometer developed based on an intervalence charge transfer mashup.

Optical thermometers based on lanthanide thermal-coupled levels have attracted great attention owing to its fundamental importance in the fields of public health, biology, and integrated circuit. However, the inherent structural properties (shielded effect on 4f configurations, intense non-radiation relaxation) strictly suppress the sensing performance, limiting the relative temperature sensitivity (SR). To circumvent these limitations, we propose an intervalence charge transfer mashup strategy by inducing d0 electron configured transition metals. Specifically, transition metals Ta5+ is incorporated in Tm3+/Eu3+:LiNbO3, which improves the SR from 5.30 to 11.16% K-1. The validity of this component-modulation behavior is observed on other oxide crystals (NaY(Mo1-zWzO4)2) as well. Furthermore, the observed regulation is well explained by DFT calculation that indicates the d-orbit component at valence band minimum remains the core factor governing the electron transfer process. We successfully relate the SR to the band structure of luminescence carrier, offering a novel perspective for the collocation design of lanthanide configurations.

Utility and Implementation of the Distress Thermometer for Cancer Patients: A Cross-Sectional Study From Saudi Arabia.

Background Cancer patients suffer from variable degrees of distress. The distress thermometer (DT) is a valuable tool for screening those patients for distress. Few studies have addressed the utility of DT in screening cancer patients in Saudi Arabia. We aimed to measure the distress level of adult cancer patients utilizing the DT and identify the appropriate measures and interventions required to improve this population's well-being. Methods This cross-sectional study was carried out at the oncology center of King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Enrollment criteria were Saudi adults (≥14 years old), with a diagnosis of cancer, who gave informed consent. They were screened for distress using the DT and its associated problem list (PL). A workflow for a psycho-oncology supportive program was suggested. Results Using DT at a cut-off score of ≥4, 22% of patients had significant distress. The most frequent problems reported were loss/change of physical activity, swelling/edema, change in eating, family health problems, and child care. The multivariable binary regression analysis showed that sadness, depression, worry/anxiety, fear, loss of interest, change in appearance, taking care of myself, swelling/edema, and memory/concentration problems were independent factors for significant distress in our cohort. The suggested workflow could effectively be implemented among cancer patients. Conclusion The current study's findings support previous reports concerning the utility of DT in screening cancer patients for distress. A considerable number of Saudi cancer patients suffered from significant distress, which was significantly related to the emotional, spiritual, social, and religious aspects of their problems. We suggested a workflow by which cancer centers can implement DT screening after developing a plan for timely distress evaluation, with further proper management and referrals accordingly. Additional studies are warranted.

A Rare Case of a Patient Being Alert and Communicative Despite Severe Hypothermia.

Hypothermia is defined as a significant drop in core body temperature below 35°C (95°F). It is traditionally staged as mild, moderate, severe, and profound at temperatures of 35°C to 32°C (95°F to 89.6°F), 32°C to 28°C (89.6°F to 82.4°F), <28°C (<82.4°F), and <24°C (75.2°F), respectively. It can also be classified into the same stages by clinical presentations. We present a patient that fits into two different stages based on core body temperature and clinical presentation.  A 58-year-old homeless male with a history of seizures and alcohol use presented via emergency medical services after spending the night outside and uncovered with a core body temperature of 25.1°C (77.1°F) via a urinary bladder thermometer, meeting criteria for severe, near profound, hypothermia. However, he was alert and communicating, shivering, with tachycardia, tachypnea, normal oxygen saturation, and elevated blood pressure, suggestive of mild hypothermia clinically. Passive and active external and internal rewarming were utilized to treat, with the removal of wet clothing, forced air patient warming system, warm blankets, and warm lactated ringers given intravenously. He was soon transferred to the intensive care unit and first returned to normothermic levels after approximately 10 hours from presentation. An electrocardiogram was obtained after resolution of shivering and revealed atrial fibrillation without Osborn waves. He remained in the hospital for the following week to treat his atrial fibrillation, hypothermia-induced rhabdomyolysis, and alcohol withdrawal. He was discharged without neurologic deficits and medically stable with appropriate resources.  This case demonstrates a unique presentation of severe hypothermia. To our knowledge, there has not been a reported case of severe hypothermia that does not involve severe central nervous system depression, severe slowing of vitals, and/or comatose status. These clinical symptoms normally begin during moderate hypothermic levels near 32°C (89.6°F), yet our patient presented without any central nervous system depression and with accelerated vitals that are more consistent with mild hypothermia yet had a core temperature of 25.1°C (77.1°F). Treatment was dictated by his core body temperature rather than clinical presentation. Because of this incongruence between symptoms and true severity of disease in hypothermia, we recommend diagnosis and treatment of hypothermia always be confirmed and based on core body temperature via a low-reading thermometer instead of clinical presentation alone.

Predictors of significant distress in cervical cancer patients: a cross sectional study.

PURPOSE: This cross-sectional study aims to investigate parameters that predict relevant levels of distress in women in a perioperative setting undergoing treatment for cervical cancer. MATERIALS AND METHODS: Data from 495 patients with cervical cancer that were treated at the university hospital Aachen between 2010 and 2022 were analysed based on their respective National Comprehensive Cancer Network (NCCN) Distress Thermometer score (DT) and Problem List (PL) and their clinical history. 105 patients were enrolled in the study. 18 medical and demographic variables were analysed using multivariate logistic regression. RESULTS: Three variables contributed significantly to the prediction of a DT score ≥ 5. Significant distress was defined as a DT score of ≥ 5, which was observed in 70.5% of the participants (mean: 5.58 ± 2.892). Women who chose to receive psycho-oncological counselling were more likely to have a DT score ≥ 5 (Odds Ratio(OR) = 3.323; Confidence Interval (CI95%): 1.241-8.900; p-value: 0.017). In addition, women who did not receive chemoradiation had significantly higher DT scores (OR = 3.807; CI 95%:1.185-12.236; p-value: 0.025), as did women whose Distress Thermometer was assessed in the first month after their initial diagnosis (OR = 3.967; CI 95%:1.167-13.486; p-value: 0.027). CONCLUSION: Increased distress in women with cervical cancer is common especially in the first month after diagnosis, in patients who do not receive chemoradiation and in patients who seek psycho-oncological counselling. Surgical factors do not play a major role in patient distress.

Monitoring Real-Time Temperature Dynamics of a Short RNA Hairpin Using Förster Resonance Energy Transfer and Circular Dichroism.

RNA molecules play crucial roles in gene expression regulation and cellular signaling, and these functions are governed by the formation of RNA secondary and tertiary structures. These structures are highly dynamic and subject to rapid changes in response to environmental cues, temperature in particular. Thermosensitive RNA secondary structures have been harnessed by multiple organisms to survey their temperature environment and to adjust gene expression accordingly. It is thus highly desirable to observe RNA structural changes in real time over a range of temperatures. Multiple approaches have been developed to study structural dynamics, but many of these require extensive processing of the RNA, large amounts of RNA input, and/or cannot be applied under physiological conditions. Here, we describe the use of a dually fluorescently labeled RNA oligonucleotide (containing a predicted hairpin structure) to monitor subtle RNA structural dynamics in vitro by Förster resonance energy transfer (FRET) and circular dichroism (CD) spectroscopy. These approaches can be employed under physiologically relevant conditions over a range of temperatures and with RNA concentrations as low as 200 nM; they enable us to observe RNA structural dynamics in real time and to correlate these dynamics with changes in biological processes such as translation.

Temperature-Automated Calibration Methods for a Large-Area Blackbody Radiation Source.

High-precision temperature control of large-area blackbodies has a pivotal role in temperature calibration and thermal imaging correction. Meanwhile, it is necessary to correct the temperature difference between the radiating (surface of use) and back surfaces (where the temperature sensor is installed) of the blackbody during the testing phase. Moreover, large-area blackbodies are usually composed of multiple temperature control channels, and manual correction in this scenario is error-prone and inefficient. At present, there is no method that can achieve temperature-automated calibration for a large-area blackbody radiation source. Therefore, this article is dedicated to achieving temperature-automated calibration for a large-area blackbody radiation source. First, utilizing two calibrated infrared thermometers, the optimal temperature measurement location was determined using a focusing algorithm. Then, a three-axis movement system was used to obtain the true temperature at the same measurement location on a large-area blackbody surface from different channels. This temperature was subtracted from the blackbody's back surface. The temperature difference was calculated employing a weighted algorithm to derive the parameters for calibration. Finally, regarding experimental verification, the consistency error of the temperature measurement point was reduced by 85.4%, the temperature uniformity of the surface source was improved by 40.4%, and the average temperature measurement deviation decreased by 43.8%. In addition, this system demonstrated the characteristics of strong environmental adaptability that was able to perform temperature calibration under the working conditions of a blackbody surface temperature from 100 K to 573 K, which decreased the calibration time by 9.82 times.

Progress report on the single transducer ultrasonic thermometer using electrostatic actuator.

This article presents improvements to the practical acoustic thermometer of the Czech Metrology Institute that enable measurements with argon gas. Through a careful comparison with standard platinum resistance thermometers, the device shows its potential as a reference instrument for the calibration of industrial thermometers with traceability to the thermodynamic temperature scale. The extended temperature range, now from -80 to 80 °C, is characterized by the measurement uncertainty of well below 0.15 °C. Challenges arise above 100 °C, where the microphone approaches its maximum permissible temperature, which leads to discrepancies in the time of flight (τ) measurement results. The lower temperature limit is constrained by temperature-controlled enclosures, suggesting possible redesigns for future improvements. Modifications to the waveguide cover could enable isothermal measurements at higher pressures, which would allow calculation of the speed of sound (u0). In addition, the upper temperature limit could be extended by lengthening the waveguide or installing a special high-temperature microphone. These results underline the versatility of PAT and provide insights for further improving its effectiveness over a wider temperature range.

Study on the cut-off point and the influencing factors of distress in newly diagnosed breast cancer patients.

Objective: Our aim is to investigate the cut-off point of distress and the influencing factors associated with distress in patients with newly diagnosed breast cancer. Methods: A cross-sectional survey of distress was conducted in 167 patients with newly diagnosed breast cancer admitted to the Department of General Surgery of a tertiary care hospital from July 2020 to March 2022. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer (DT) questionnaire within 3 days of admission. The HADS ≥15 was used as the gold standard, and the cut-off point of the DT measure was analyzed using the Receiver Operating Characteristic (ROC) curve. The cut-off point obtained by ROC curve analysis was used to analyze the influencing factors of distress in breast cancer patients by univariate and multivariate regression analysis. Results: A total of 167 patients completed the survey, with an average HADS score of 8.43 ± 5.84 and a total HADS score of ≥15 in 37 (22.16%) patients, the mean DT score was 2.96 ± 1.85. ROC curve analysis showed an area under the curve of 0.885, with a maximum Jorden index (0.723) at a DT score of 4, the sensitivity was 100.0% and specificity was 72.3%. There were 73 (43.71%) patients with DT score ≥ 4. Regression analysis showed that insurance/financial problems, dealing with partner problems, tension, bathing/dressing problems, pain, and sleep problems were independent risk factors for l distress in newly diagnosed breast cancer patients. Conclusion: A DT score 4 is the cut-off point for distress in patients with newly diagnosed breast cancer. In clinical practice, target intervention should be carried out according to the risk factors of distress of patients.