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Objective: The aim of this study was to investigate the symptom and symptom clusters of patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE), and to discuss the relationship between symptoms, symptom clusters, and symptom interference. Materials and methods: Patients with HCC who received TACE were asked to rate their symptoms using the M. D. Anderson Symptom Inventory and the symptom checklist particularly for HCC. To determine the interrelationships among symptoms and identify the symptom clusters, a principal component analysis with varimax rotation was carried out on the symptom items. Spearman correlation analysis was done to assess the relationship between symptom clusters and symptom interference. Results: A total of 155 patients finished the whole procedure between November 2010 and May 2011. Before TACE, the five most severe symptoms, ranked in order, were fatigue (3.40 ± 2.26), distress (3.35 ± 2.60), sadness (3.01 ± 2.66), sleep disturbance (2.63 ± 2.57), and lack of appetite (2.26 ± 2.38). After TACE, fatigue (4.88 ± 2.31) was the most serious symptom, followed by sleep disturbance (4.80 ± 2.25), distress (4.59 ± 2.32), sadness (4.45 ± 2.16), lack of appetite (4.25 ± 2.51). Two symptom clusters were found before TACE: psychological symptom cluster and sickness symptom cluster. Two new symptom clusters were found after TACE: upper gastrointestinal symptom cluster and liver function impairment symptom cluster, with the two original symptom clusters remained relatively stable. The highest symptom interference items pre- and post-TACE were work and enjoyment of life, followed by mood. The symptoms of distress, sadness, fatigue, sleep disturbance, and lack of appetite were all significantly associated with the total interference ( r = 0.443-0.615, p < 0.01 or p < 0.05). Symptom clusters were significantly correlated with the total symptom interference before and after TACE ( r = 0.176-0.638, p < 0.01 or p < 0.05). Conclusion: Psychological symptom cluster and sickness symptom cluster are common for HCC patients before and after TACE. Liver function impairment and upper gastrointestinal symptom clusters are directly related to TACE treatment. Both the symptoms and symptom clusters have significant interference on the daily life of HCC patients undergoing TACE. However, more work is needed to further clarify the symptom clusters associated with TACE and to test the effectiveness of TACE in easing symptoms and improving quality of life of HCC patients. [ABSTRACT FROM AUTHOR]

Abstract: Principal components analysis (PCA) and correlation analysis were used to estimate the contribution of four components related to pollutant sources on the total variation in concentrations of Cu, Zn, Pb, Cd, As, Se, Hg, Fe and Mn in surface soil samples from a valley in east China with numerous copper and zinc smelters. Results indicate that when carrying out source identification of inorganic pollutants their tendency to migrate in soils may result in differences between the pollutant composition of the source and the receptor soil, potentially leading to errors in the characterization of pollutants using multivariate statistics. The stability and potential migration or movement of pollutants in soils must therefore be taken into account. Soil physicochemical properties may offer additional useful information. Two different mechanisms have been hypothesized for correlations between soil heavy metal concentrations and soil organic matter content and these may be helpful in interpreting the statistical analysis. [Copyright &y& Elsevier]