Personalized and continuous care intervention affects rehabilitation,living quality,and negative emotions of patients with breast cancer

BACKGROUND Breast cancer is among the most common malignancies worldwide.With progress in treatment methods and levels,the overall survival period has been prolonged,and the demand for quality care has increased.AIM To investigate the effect of individualized and continuous care intervention in patients with breast cancer.METHODS Two hundred patients with breast cancer who received systemic therapy at The First Affiliated Hospital of Hebei North University(January 2021 to July 2023)were retrospectively selected as research participants.Among them,134 received routine care intervention(routing group)and 66 received personalized and continuous care(intervention group).Self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Functional Assessment of Cancer Therapy-Breast(FACT-B)scores,including limb shoulder joint activity,complication rate,and care satisfaction,were compared between both groups after care.RESULTS SAS and SDS scores were lower in the intervention group than in the routing group at one and three months after care.The total FACT-B scores and five dimensions in the intervention group were higher than those in the routing group at three months of care.The range of motion of shoulder anteflexion,posterior extension,abduction,internal rotation,and external rotation in the intervention group was higher than that in the routing group one month after care.The incidence of postoperative complications was 18.18%lower in the intervention group than in the routing group(34.33%;P<0.05).Satisfaction with care was 90.91% higher in the intervention group than in the routing group(78.36%;P<0.05).CONCLUSION Personalized and continuous care can alleviate negative emotions in patients with breast cancer,quicken rehabilitation of limb function,decrease the incidence of complications,and improve living quality and care satisfaction.

Personalized Perioperative Care for a Patient with a 10-Year-Old Postpartum Old Thrombus after Neoadjuvant Therapy for Breast Cancer

Breast cancer is one of the most common malignant tumors in women, and has become the main cause threatening women’s health. A case of breast cancer with neoadjuvant chemotherapy was discharged after active treatment and nursing.

Optimizing outcomes:Implementing enhanced recovery after surgery in orthopedic surgery

In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.

A Pilot Study of Health Coaching on Older Adults’ Personal Healthcare and Maintenance during the Outbreak of Covid-19 in Singapore

With a rapidly ageing population in Singapore, older adults and their family members face challenges of age-related diseases, caregiver stress, and increasing demand for caregiving services. To address this pressing issue, this pilot study aims to introduce online health coaching for older adults in Singapore and evaluate its effectiveness on maintenance of personal healthcare. In the midst of the COVID-19 outbreak, older adults’ activities were largely restricted by measures on social distancing. The online health coaching provided a solution for older adults to achieve a healthy lifestyle in a contactless manner. In this pilot study, 18 older adults (≥55 years old) who were willing to be coached by trained health coaches (n = 10) for 8 weeks (once a week) were recruited. Pre- and post-surveys with older adults were conducted. Furthermore, health coaching booklet was used to control the quality of coaching and to record diet and exercise plans. The pilot study demonstrated that the health coaching provided older adults with knowledge of nutrition and exercise, raised their awareness of well-being in terms of daily meals and regular exercise, and provided an alternative to maintain a healthy lifestyle amidst global pandemic. Additionally, we also identified that the older adults’ satisfactions with health coaching were positively associated with educational levels (R2 = 0.31). Lastly, this pilot study highlighted that health coaching standardization process for older adults is critical for researchers and healthcare practitioners in the future.

Status and Prospect of the Beauty and Personal Care Market in China

The Chinese beauty and personal care market has been mainly dominated by big foreign brands such as L＇Oreal and Maybelline, due to their good product reputation, high quality and other advantages. On the back of ＂Korean Wave＂ in China, the Korean cosmetics are expanding their presence in the Chinese market. Local companies must upgrade their brand image and enhance the competitiveness of their brands in the high-end market. In the future, with the increase of people＇s purchasing power, and the demand for high-end cosmetics, the competition in the Chinese cosmetic market will become fiercer.

Occurrence and risks of pharmaceuticals,personal care products,and endocrine-disrupting compounds in Chinese surface waters

The continuous and rapid increase of chemical pollution in surface waters has become a pressing and widely recognized global concern.As emerging contaminants(ECs)in surface waters,pharmaceutical and personal care products(PPCPs),and endocrine-disrupting compounds(EDCs)have attracted considerable attention due to their wide occurrence and potential threat to human health.Therefore,a comprehensive understanding of the occurrence and risks of ECs in Chinese surface waters is urgently required.This study summarizes and assesses the environmental occurrence concentrations and ecological risks of 42 pharmaceuticals,15 personal care products(PCPs),and 20 EDCs frequently detected in Chinese surface waters.The ECs were primarily detected in China’s densely populated and highly industrialized regions.Most detected PPCPs and EDCs had concentrations between ng/L toμg/L,whereas norfloxacin,caffeine,and erythromycin had relatively high contamination levels,even exceeding 2000 ng/L.Risk evaluation based on the risk quotient method revealed that 34 PPCPs and EDCs in Chinese surface waters did not pose a significant risk,whereas 4-nonylphenol,4-tert-octylphenol,17α-ethinyl estradiol,17β-estradiol,and triclocarban did.This review provides a comprehensive summary of the occurrence and associated hazards of typical PPCPs and EDCs in Chinese surface waters over the past decade,and will aid in the regulation and control of these ECs in Chinese surface waters。

Inverted Simulations Demonstrating Strong Ecological Fallacies in Cohort Studies

We start with a description of the statistical inferential framework and the duality between observed data and the true state of nature that underlies it. We demonstrate here that the usual testing of dueling hypotheses and the acceptance of one and the rejection of the other is a framework which can often be faulty when such inferences are applied to individual subjects. This follows from noting that the statistical inferential framework is predominantly based on conclusions drawn for aggregates and noting that what is true in the aggregate frequently does not hold for individuals, an ecological fallacy. Such a fallacy is usually seen as problematic when each data record represents aggregate statistics for counties or districts and not data for individuals. Here we demonstrate strong ecological fallacies even when using subject data. Inverted simulations, of trials rightly sized to detect meaningful differences, yielding a statistically significant p-value of 0.000001 （1 in a million） and associated with clinically meaningful differences between a hypothetical new therapy and a standard therapy, had a proportion of instances of subjects with standard therapy effect better than new therapy effects close to 30%. A ―winner take all‖ choice between two hypotheses may not be supported by statistically significant differences based on stochastic data. We also argue the incorrectness across many individuals of other summaries such as correlations, density estimates, standard deviations and predictions based on machine learning models. Despite artifacts we support the use of prospective clinical trials and careful unbiased model building as necessary first steps. In health care, high touch personalized care based on patient level data will remain relevant even as we adopt more high tech data-intensive personalized therapeutic strategies based on aggregates.

Method Optimization and Application Extension of Bovine Corneal Opacity and Permeability Assay

This paper systematically summarizes the improvements in bovine corneal opacity and permeability assay(BCOP),an alternative method of eye irritation test,further explores the usage mode of combinatorial methods with BCOP at the core module,introduces the application of each single method and their combination in the assessment of pesticides,plant extracts,medical devices and medicines.By optimizing traditional methods,the alternative method is more scientific and individually applicable.

Nursing Students’Clinical Learning Environment in Norwegian Nursing Homes:Lack of Innovative Teaching and Learning Strategies

Background: Nursing students hesitate to choose aged care as a career, and the aged care sectors are on an edge regarding nursing positions. Clinical learning environments may influence nursing students’ career choices. Few studies have explored learning environments in nursing homes, although students increasingly have placements there. Objectives: The aim was to produce information for developing nursing students’ learning opportunities in nursing homes. Design: A cross-sectional survey design was used. Settings: The study was conducted at a university college in southeast Norway. Participants: Students in two cohorts of a bachelor degree program in nursing participated, N = 499. Methods: Data were collected on nursing students’ perceptions of clinical learning environments during placements in five nursing homes. A 42-item validated questionnaire with the subscales personalization, individualization, involvement, task orientation, innovation, and satisfaction was used. Data analysis used descriptive statistics, t-tests, and linear regression analysis. Results: Total scores showed overall satisfaction with clinical learning environments in nursing homes. However, innovation subscale scores were very low. First year students had significantly higher scores than third year students on the total scale, and most subscales. Age was significantly associated with total scale scores and subscale satisfaction scores. Higher education and work experience before entering nursing education were significantly associated with involvement subscale scores. Conclusions: Students are more positive than negative about their clinical learning environments. Low valuation of innovation seems to be a consistent finding in studies in both nursing homes and hospitals internationally. For innovative learning strategies to function they must be anchored at the organizational level. Future research should develop and test more innovative learning strategies for nursing students.

Fabrication of the TiO_(2)/Ti_(3)C_(2) loaded ceramic membrane targeting for photocatalytic degradation of PPCPs:ciprofloxacin,tetracycline,and ibuprofen

Photocatalytic membranes offer an effective strategy to overcome the difficulties of solid-liquid separation and secondary contamination of powdered photocatalysts.MXene is a 2D material of layered Ti_(3)C_(2),which is considered to limit electron-hole separation and contribute to photocatalysis.In this work,the etched Ti_(3)C_(2) MXene was loaded on the surface of ceramic membranes using polydopamine(PDA)as a binder,followed by one-step calcination to produce TiO_(2) nanoparticles(NPs)in situ.The characterizations supported that the TiO_(2)/Ti_(3)C_(2) ceramic membranes had high mechanical strength while retaining the layered structure of Ti_(3)C_(2),which was conducive to the inhibition of electron and hole complexation,improving the photocatalytic performance.Degradation experiments revealed that the material showed enhanced degradation of pharmaceuticals and personal care products(PPCPs)such as ciprofloxacin(CIP),tetracycline(TCN)and ibuprofen(IBP).The LC-MS and toxicity prediction models indicated that the developmental toxicity of CIP degradation products decreased with prolonged photocatalytic reaction,exhibiting no acute toxicity to fish.The MT650 exhibited significantly enhanced water flux properties(320 L/(m^(2)·h).The TiO_(2)/Ti_(3)C_(2) ceramic membranes explored in this work are expected to target the treatment of PPCPs with excellent engineering promise.

A review on analytical methods for pharmaceutical and personal care products and their transformation products

Pharmaceutical and personal care products(PPCPs)and corresponding transformation products have caused widespread concern due to their persistent emissions and potential toxicity.They have wide octanol-water partition coefficients(K_(ow))and different ionization constants(pK_(a))resulting in a poor analysis accuracy and efficiency.A suitable analytical method is the first prerequisite for further research on their environmental behavior to prioritize the substances.This study reviewed a full-scale analytical protocol for environmental samples in the recent ten years:from sampling to instrumental methods.Passive sampling techniques were compared and recommended for long-term continuous and scientific observation.A quick and effective sample extraction and clean-up method are highly required.Chromatographic methods coupled to mass spectrometry for determining PPCPs with a wide range of logK_(ow)(-7.53 to 10.80)were summed up.High-resolution mass spectrometry was confirmed to be a promising strategy for screening unknown transformation products,which would provide a nanogram level of detection limits and more accurate mass resolution.Screening strategies and mass change principles were summarized in detail.The recovery rate was important in multiple contaminants analysis identification and factors affecting the recovery rate of PPCPs were also discussed in this review,including sample matrix,target compounds characteristics,extraction method and solid-phase adsorbent.This review provides useful information for the selection of appropriate analytical methods and future development directions.

An efficient resin for solid-phase extraction and determination by UPLCMS/MS of 44 pharmaceutical personal care products in environmental waters

In this study,a hydrophilic resin named GCHM was fabricated based on poly(N-vinyl pyrrolidone-codivinylbenzene),characterized,and applied as a solid-phase extraction(SPE)material.Up to 44 pharmaceuticals and personal care products(PPCPs)belonging to 10 classes were recovered in environmental water samples.Different variables affecting extraction,such as adsorbent amount,sample pH,and loading speed,were optimized.Under optimal conditions,the average absolute recovgy of 44 PPCPs was 75.6%using GCHM,indicating a better performance than the commercial Oasis^HLB.SPE with home-made hydrophilic polymeric sorbent followed by ultra-performance liquid chromatography and tandem mass spectrometry was validated,and the method achieved good linearity(r2>0.991,for all analytes).In addition,the method detection limits of target compounds ranged from 0.03 to 0.6 ng/L.The developed method was applied to determine PPCPs in 10 environmental water samples taken from the Yangtze River,Huaihe River,and Taihu Lake,1 groundwater sample from Changzhou in Jiangsu Province,1 wastewater sample from Xiamen and 2 seawater samples from the Jiulong River in Fujian Province,China.In these samples,22 compounds were determined at levels ranging from 0.5 to 1590 ng/L.

Pharmaceuticals and personal care products (PPCPs) in the freshwater aquatic environment

Pharmaceuticals and personal care products(PPCPs)are a unique group of emerging environmental contaminants,due to their inherent ability to induce physiological effects in human at low doses.An increasing number of studies has confirmed the presence of various PPCPs in different environmental compartments,which raises concerns about the potential adverse effects to humans and wildlife.Therefore,this article reviews the current state-of-knowledge on PPCPs in the freshwater aquatic environment.The environmental risk posed by these contaminants is evaluated in light of the persistence,bioaccumulation and toxicity criteria.Available literature on the sources,transport and degradation of PPCPs in the aquatic environment are evaluated,followed by a comprehensive review of the reported concentrations of different PPCP groups in the freshwater aquatic environment(water,sediment and biota)of the five continents.Finally,future perspectives for research on PPCPs in the freshwater aquatic environment are discussed in light of the identified research gaps in current knowledge.

Occurrence, sources and fate of pharmaceuticals and personal care products in the groundwater: A review

The presence of pharmaceuticals and personal care products(PPCPs)in the aquatic environment may pose potential threat to the ecosystem and human health,hence PPCPs have aroused much concern over the world.The contamination of PPCPs in the groundwater,the main source of drinking water supply in many countries and regions,has been extensively studied in the last decade.This paper reviews the occurrence of frequently detected PPCPs,including antibiotics,anti-inflammatories,lipid-regulators,carbamazepine,caffeine,and N,N-diethyl-m-toluamide in groundwater,with special concern to the progress made over the past three years.Possible emission sources for PPCPs in groundwater,such as wastewater and contaminated surface water,landfills,septic systems,livestock breeding and sewer leakage,are summarized.Besides,adsorption,migration and degradation,the dominant mechanisms in the subsurface transport and fate of PPCPs,are discussed,and the insights into the future study of PPCPs in the groundwater are provided.

Occurrence,seasonal variation and human exposure to pharmaceuticals and personal care products in surface water,groundwater and drinking water in Lagos State,Nigeria

The occurrence of 28 pharmaceuticals and personal care products(PPCPs)was investigated in 17 surface water samples(rivers,canals,and lagoons),12 groundwater samples(wells and boreholes,which can also be consumed for drinking)and 8 drinking water samples(bottles and sachets)during dry and rainy seasons in Lagos state,Nigeria.The most prevalent compound detected in all samples was amoxicillin(an antibiotic)at median concentrations of 1614,238 and 358 ng/L in surface water,ground water and drinking water,respectively.This is of concern due to potential impact on development of antibioticresistant microbial strains.Other frequently-detected compounds include acetaminophen,nicotine,ibuprofen,and codeine with detection frequencies of more than 70%.Investigation of seasonal variability revealed that glyburide,caffeine,naproxen and diclofenac concentrations were significantly(P<0.05)higher during the dry season(winter),while Nicotine and Codeine levels were higher during the rainy season(summer).The factors influencing such seasonal variability include:dilution by extensive rainfall,agricultural activity(for nicotine)and usage patterns of pharmaceuticals among the local community.Measured concentrations in drinking water samples were used to assess inadvertent human exposure to PPCPs in Nigerian adults.Results revealed average daily exposures of 81,14 and 3 ngƩPPCPs/kg BW/day via drinking borehole,sachet water and bottled water,respectively.While there exists no health-based limit value(HBLV)for chronic exposure to mixtures of PPCPs,our results raise concern and warrant further investigation of the potential health implications of such unintended PPCPs exposure.

Occurrence and discharge of pharmaceuticals and personal care products in dewatered sludge from WWTPs in Beijing and Shenzhen

This study mainly focused on the occurrence of pharmaceutical and personal care products(PPCPs)in sewage dewatered sludge and their discharges through sludge disposal from wastewater treatment plants(WWTPs).The data were obtained and calculated from seven PPCPs in dewatered sludge collected from 12WWTPs in two typical cities,Beijing and Shenzhen in China.Four of seven PPCPs,diclofenac acid,carbamazepine,mefenamic acid and N,N-diethyl-m-toluamide were detectable in dewatered sludge from Beijing and Shenzhen with concentration up to 4240,11,060,92 and 219μg/kg respectively.While,the other three compounds,trimethoprim,chloramphenicol and bezafibrate were not detected in collected samples from these two cities.The highest discharge of diclofenac acid and carbamazepine were 1023 g/d and 494 g/d respectively.In addition,the total discharge of these four detected PPCPs from each plant ranged from 5 to 1092 g/d in Beijing and 4e497 g/d in Shenzhen.Thus,PPCP discharge through sludge disposal cannot be neglected,and further research on transfer of PPCPs during sludge disposal onto agriculture land and influence of sludge application is required and essential.

Occurrence of pharmaceutical and personal care products(PPCPs)in wastewater and receiving waters in South Africa using LC-Orbitrap™MS

There is continued interest in the occurrence and monitoring of emerging contaminants(ECs)in wastewater treatment plants(WWTPs)to assess their potential impact when released into the environment.The objective of this study was to determine the occurrence of pharmaceutical and personal care products(PPCPs)in WWTP influents and effluents and receiving river waters in Pretoria,South Africa.Targeted screening and identification of PPCPs in the samples was done using liquid chromatography(LC)coupled with high resolution mass spectrometry(HRMS)Orbitrap™HRMS,after clean-up and preconcentration with Waters Oasis®hydrophilic-lipophilic-balanced(HLB)solid phase extraction(SPE)cartridges.Of the 156 target analytes screened in the study,120 could be satisfactorily determined under the study conditions,with 71 and 73 compounds being detected and quantified in the influent and effluent samples,respectively.Concentrations in the influents ranged from<ILOQ-14.2 mgL^-1and those in the effluent from<ILOQ-2.45 mgL^-1.It was found that 84%of the quantified compounds belonged to various classes of pharmaceuticals.Ibuprofen,caffeine,paracetamol and estradiol were the major individual contaminants in influent samples with average concentrations of 14.2,8.68,4.79 and 1.02 mgL^-1,respectively.In the effluent samples,the highest concentrations were recorded for estradiol(2.45 mgL^-1),ibuprofen(1.03 mgL^-1)and efavirenz(0.58 mgL^-1).The highest mean concentrations(above 0.5 mgL^-1)recorded in the river water samples were for ibuprofen,(4.14 mgL^-1downstream;3.19 mgL^-1upstream),caffeine(2.98 mgL^-1downstream;1.42 mgL^-1upstream),paraxanthine(1.22 mgL^-1downstream;0.798 mgL^-1upstream).Analysis of river water samples also revealed that PPCP contamination in the river system cannot be solely attributed to the WWTP effluents.Twenty-four compounds presented in this study are reported for the first time in South African surface waters.

Discharge inventory of pharmaceuticals and personal care products in Beijing,China

Pharmaceuticals and personal care products(PPCPs)are emerging environmental contaminants,whose potential risk for the ecological environment has caused wide attention in recent years.In China,quite a large amount of PPCPs were annually emitted into the environment.Their existence in different matrix has been reported frequently,including river water,sediment and soil.However,the contribution from different sources was seldom reported and still unclear in China.Wastewater treatment plant(WWTP)was usually considered to be the main source to the urban river,but livestock and aquaculture farms were also reported as significant pollution sources of PPCPs due to poor environmental management in China.This study summarized environmental discharges of different PPCPs from various sources and obtained the discharge data through different environment media in Beijing,the statistical source of PPCPs was analyzed in detail.The sources comprised WWTPs,excess sludge,hospital wastewater,municipal untreated wastewater,aquaculture wastewater and landfill leachate.This article helps understand the general situation and the potential risk of PPCPs in Beijing.

Determination and occurrence of endocrine disrupting compounds, pharmaceuticals and personal care products in fish （Morone saxatilis）

Endocrine disrupting compounds （EDCs）, pharmaceuticals and personal care products （PPCPs） have attracted much attention due to widespread contamination in aquatic environment. In this study, we determined 13 EDCs and PPCPs in fish blood, bile and muscle by using gas chromatography-mass spectrometry （GC-MS）. The limits of quantitation （LOQ） were in the ranges of 0.23-2.54, 0.22-2.36ng·mL^-1, and 0.24-2.57 ng· g^-1 dry weight （dw） for fish blood, bile and muscle, respectively. Recoveries of target compounds spiked into sample matrices and passed through the entire analytical procedure ranged from 65% to 95%, from 60% to 92% and from 62% to 91% for blood, bile and muscle, respectively. The methods were applied to the analysis of fish from a lake in California. Target compounds were relatively low in bile, and only bisphenol A （BPA） and diclofenac were measurable near the LOQ. Seven of 13 compounds were detected in blood, with total concentrations up to 39 ng· g^-1. Only BPA was frequently found in muscle, with mean concentration of 7.26 ng· g^-1 dw. The estimated daily intake of BPA through fish consumption for U.S. resident was significantly lower than the tolerable daily intake recommended by the European Food Safety Authority. This study showed that the exposure to the bisphenol A from fish diet is unlikely to pose a health risk.

Enhanced antibiotic degradation performance of Cd_(0.5)Zn_(0.5)S/Bi_(2)MoO_(6) S-scheme photocatalyst by carbon dot modification

S-scheme heterojunction engineering is an effective strategy to attain distinctive photocatalysts.Herein,a carbon dots modulated S-scheme hetero-structured photocatalyst of Cd_(0.5)Zn_(0.5)S nanoparticles/Bi_(2)MoO_(6) microspheres/carbon dots (CZCBM),aiming to conquer the photo-corrosion and strengthen the photocatalytic property of Cd_(0.5)Zn_(0.5)S,was developed via a facile solvothermal route.Under visible light,the optimal CZCBM-2 affords a 1.8-,1.5-,or 0.6-time reinforcement in the oxytetracycline degradation rate constant compared to Bi_(2)MoO_(6),Cd_(0.5)Zn_(0.5)S or Cd_(0.5)Zn_(0.5)S/Bi_(2)MoO_(6),which is credited to the strengthened visible-light response,increased reactive sites,and efficient dissolution of photo-carriers with optimal redox capacity because of the co-effect of carbon dots and S-scheme heterostructure.Significantly,the photo-corrosion of Cd_(0.5)Zn_(0.5)S is significantly suppressed and CZCBM-2 affords superior stability and reusability during cycling tests.Besides,CZCBM-2 can be well adapted to various environments.The toxicology appraisement unravels the decreased eco-toxicity of most intermediates compared to oxytetracycline.Lastly,an S-scheme charge transfer mechanism with carbon dots as electron reservoir in CZCBM is deduced,which uncloses that •O_(2)− and h+ dominantly account for oxytetracycline eradication and detoxification.This study demonstrates the design of unique carbon dots favored S-scheme heterostructures as an effective “Two Birds with One Stone” strategy to achieve high anti-photo-corrosion performance and reinforced photocatalytic performance of sulfides.