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S6. Relative abundance of CM and CMM gene pairs across tumor types.

Table S1. Top 10 significant molecular terms (MSigDB c2cp; Curated Pathways) enriched in correlated and inversely-anticorrelated genes with tumor purity. Table S2. The GSEA results from individual tumor types. Table S3. Immune cell type-specific genes. Table S4. GSEA of genes with high/low differential correlation coefficients.

Surgical archives of tumor specimens are often impure. The presence of RNA transcripts from nontumor cells, such as immune and stromal cells, can impede analyses of cancer expression profiles. To systematically analyze the impact of tumor purity, the gene expression profiles and tumor purities were obtained for 7,794 tumor specimens across 21 tumor types (available in The Cancer Genome Atlas consortium). First, we observed that genes with roles in immunity and oxidative phosphorylation were significantly inversely correlated and correlated with the tumor purity, respectively. The expression of genes implicated in immunotherapy and specific immune cell genes, along with the abundance of immune cell infiltrates, was substantially inversely correlated with tumor purity. This relationship may explain the correlation between immune gene expression and mutation burden, highlighting the need to account for tumor purity in the evaluation of expression markers obtained from bulk tumor transcriptome data. Second, examination of cluster membership of gene pairs, with or without controlling for tumor purity, revealed that tumor purity may have a substantial impact on gene clustering across tumor types. Third, feature genes for molecular taxonomy were analyzed for correlation with tumor purity, and for some tumor types, feature genes representing the mesenchymal and classical subtypes were inversely correlated and correlated with tumor purity, respectively. Our findings indicate that tumor purity is an important confounder in evaluating the correlation between gene expression and clinicopathologic features such as mutation burden, as well as gene clustering and molecular taxonomy. Cancer Immunol Res; 6(1); 87–97. ©2017 AACR.

Complex dorsal dislocations of the metacarpophalangeal joint are usually a complication of hyperextension injury and are irreducible to closed maneuvers. The volar plate displaced between the dorsum of the metacarpal head and the volar base of the proximal phalanx is the obstacle that prevents reduction. While the pathophysiology of complexity is relatively clear, such injuries are uncommon and reduction requires experience. We describe a case of complex fracture dislocation of the index metacarpophalangeal joint with a review of the literature on relative anatomy and treatment armamentarium.

PurposeNational Olympic Committees (NOCs) in small states operate in a unique market (e.g. small population, confined market and limited private sector) that brings challenges in securing sponsors and funding athletes. Whereas more than a quarter of International Olympic Committee (IOC)-recognized NOCs represent small states, not much is known about the sponsorship landscape in the market. This study explores the importance and challenges of NOC sponsorship in small states, with a focus on the Caribbean region.Design/methodology/approachInterviews were conducted with representatives from NOCs in Caribbean small states. Textual analyses were conducted with Leximancer to identify key themes on the importance and challenges of NOC sponsorship.FindingsAthletes, funding and community were identified as key themes for the importance of NOC sponsorship. Olympic Movement, time, priority, resources and overcome were themes for sponsorship challenges. Compared to existing sponsorship knowledge driven from developed economies, known determinants for the sponsor's decision-making (e.g. interest in sport, competitor) were found to affect NOC sponsorship in Caribbean small states, but in distinctive ways. Particularly, the lacking appreciation of Olympic values and sport within society, resource constraints (e.g. volunteer-based and operating “within reality”) and competition against member federations and government were highlighted as unique situations/challenges faced in the market.Originality/valueThis study is one of the first to explore NOC sponsorship in the important, yet overlooked, market of Caribbean small states. Theoretical insights on how existing sponsorship knowledge applies to and practical implications for securing NOC sponsorship in the marginalized market are provided.

Pedicle coverage during free flap reconstruction of the digit commonly presents complicated issues. As the finger is a cylindrical unit with small volume, it is difficult to secure ample soft tissue for relaxed coverage of the pedicle. We have applied full-thickness skin grafts (FTSGs) to loosely cover the pedicle of the free flap of the fingertip and report preliminary results. Seven patients who received free toe pulp flap and FTSG for soft tissue coverage of the pedicle were analyzed. Intraoperative parameters collected were defect, flap and graft area size and donor site. Patients were observed postoperatively for up to 2 months for graft take, necrosis, digit contour, and donor site complications. The average area of the free flap was 2.39±1.03 cm2 and the average graft area was 1.37±1.06 cm2. The FTSG survived without sloughing or necrosis in six patients. Early epithelial sloughing with dermis take was noted in one patient who healed with dressings. The pedicle and graft portion showed bulging immediately after the operation but decreased to normal contour by 4 weeks. FTSG is an option that can be safely used as a method of pedicle coverage during free flap reconstruction of digits.

Widespread use of smartphones and wireless internet have made YouTube an easily accessible educational modality. Many residents use YouTube to acquire knowledge regarding microsurgical techniques; however, its quality and effect has not been verified. We included 22 residents working in the Department of Plastic and Reconstructive Surgery at our institute. Using block randomization, seven were allocated to a textbook group (TG), eight to a free-searching group (FSG), and seven to a designated-video group (DVG). After reviewing textbooks, YouTube videos, or designated videos, respectively, each group performed microsurgical anastomosis using artificial vessels. The total procedure time, Objective Structured Assessment of Technical Skills (OSATS), operative errors, and degree of leakage were assessed by blinded evaluators. Self-confidence rates were also compared. The YouTube groups (FSG and DVG) performed better than the TG. Although procedure time was significantly longer in the DVG (p = .006), the performance of DVG was better than that of TG in all assessments (OSATS: p = .012; operative errors: p = .002; leakage: p = .010). FSG showed more operative errors (p = .004) and leakage (p = .007) compared to DVG, but had higher OSATS (p = .008) and fewer operative errors (p = .002) than TG. The post-intervention confidence rates were significantly higher in FSG and DVG compared to TG (p = .002 and p = .001, respectively). Although there are concerns regarding the reliability of YouTube videos, microsurgery videos on YouTube had positive effects on microsurgery practice. Therefore, YouTube may help to improve the microsurgical skills of residents. If a quality control system is introduced for YouTube videos, their educational effects may be enhanced.

Thermoregulation is an essential function of the human body for adapting to the surrounding temperature. Stimuli-responsive smart textiles can provide effective protection of the human skin temperature from a continuously changing environment. Herein, we develop a smart textile based on shape memory polymer (SMP) fibers for adaptive regulation of IR and water transmission on human skin. An SMP textile is fabricated with hierarchical micro/nanoporous structures to enhance thermal insulation performance, and silver nanowires are coated on one side to provide asymmetric IR reflectivity and hydrophilicity. The porous SMP textile shows great tunability of thermal insulation and asymmetric wettability by deformation and recovery of the shape and structure in response to stimuli. The degree of thermal insulation is controlled by 65.7% of the original value, and the surface temperature of the SMP textile on a hot plate is successfully controlled in the IR images due to adaptive IR reflectivity. Additionally, the directional transportation of water droplets can be switched on/off according to the shape of the SMP textiles, which can be employed for sweat removal from the human skin. This IR- and water-gating smart textile can provide a feasible strategy for protecting the human skin from external environmental changes.

In order to provide high-quality sport events and cultivate economic, social, and environmental benefits in the local community, regional sport commissions in the US form partnerships with organizations across sectors. Building on Parent and Harvey's partnership framework, this study seeks to reveal the components and processes of the collaboration between sport commissions and their partners in the delivery of sport events and subsequent outcomes. Using purposive and convenient sampling, data were collected from 12 in-depth interviews with leaders in sport commissions and partnering organizations based on their accessibility and familiarity with the research topic. The study identifies five main areas and multiple subcomponents of event-based partnerships, providing empirical evidence for Parent and Harvey's partnership model. The findings advance this model by specifying the outcomes, challenges, and positive conditions for event-based partnerships and showing interactions between partnership components. More importantly, the findings contribute to a greater understanding of the partnership complexities and dynamics in the sport event-specific context and provide practical insights for sport commissions and other sport event organizers to strategically manage and maintain sport event-based partnerships.

Sport (e.g., mega event, athlete, traditional sport, facility) can be an effective tool for nation branding. Nation branding with sport is a complex process with multiple organizations involved (e.g., National Olympic Committee, Organizing Committee, Ministry of Sport). With focus on collaborative relations and the case of Korea, this study explores the branding strategies of key organizations involved in promoting a nation’s brand through sport and investigates the current and ideal collaborative relations among the organizations with document analysis, interviews, and a simplified MACTOR analysis. Based on the findings, suggestions are made for better utilization of sport in nation branding and for developing collaborative strategies.

Background Central nervous system (CNS) solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a soft tissue neoplasm that accounts for Case Description A 64-year-old woman had visited our institution for treatment of a forehead mass. With the impression that it was a subcutaneous mass, we had planned a simple excision with the patient under local anesthesia. However, the intraoperative findings showed extension of the mass into the skull and attachment to the dura mater. Brain magnetic resonance imaging showed a 1.8-cm solid mass with an adjacent skull defect, and examination of the biopsy specimen confirmed the diagnosis as grade II CNS SFT/HPC. Definitive excision was performed by en bloc tumor resection with a 2-cm safety margin. Adjuvant radiotherapy was performed with 60 Gy in 30 fractions. The patient showed no signs of recurrence or metastasis during 2 years of follow-up. Conclusions The present case has shown that CNS SFT/HPC can infiltrate the full thickness of the skull bone and grow extracranially, even if low grade. However, the unusual presentation of the present made early exploration and total resection possible.

BACKGROUND The effects of behavioral addiction to video games has received increasing attention in the literature, given increased use intensity among subgroups of video game players. OBJECTIVE This study seeks to empirically determine the relationship between intensity of video gaming and hedonic experience of the player. METHODS We conducted a survey of 835 individuals who regularly play video games to determine the relationship between intensity of use and hedonic experience. We divided the sample into quartiles by self-reported video game addictive symptom level (from the Internet Gaming Disorder Scale) and conducted polynomial regressions separately for each quartile. RESULTS We found that the higher video game addictive symptom level groups experienced a U-shaped (curvilinear) relationship between hedonic experience and intensity of play, whereas groups with lower video game addictive symptom levels exhibited no such relationship. The coefficients for the highest addictive symptom level group (quartile 4) for marginal effects for hours played per week and hours played per week squared were significantly negative (P=.005) and significantly positive (P=.004), respectively. CONCLUSIONS Our results are consistent with sensitization and tolerance theories, which suggest that high-symptom groups experience frustration and disappointment until they achieve excessive dopamine release, at which point their hedonic experience is expected to improve with additional play. Conversely, low-symptom groups experience no such fall-and-rise pattern. This result is consistent with the outcome that members of the latter group play the game for the direct experience, such that their hedonic experience is more directly related to events occurring in the game than to the increasingly elusive pursuit of excessive dopamine release. We also find that high-symptom groups spend substantially more time and money to support video game use and are much more likely to engage in video game use at the expense of other important activities, such as working, sleeping, and eating.

Understanding and promoting sport consumer well-being are essential for legitimizing sport in the policy sector and for building long-term relationships with sport consumers. To better understand t...

When it comes to the relationship between sport media consumption (SMC) and sporting event attendance, two contradicting notions have been dominant: symbiosis vs. competition. With a focus on consu...

Consumer engagement concerns the quality (or strength) of the psychological connection with sport properties (or sponsors) perceived by the consumer, which is a valuable asset to sponsored property’s and sponsor’s brand equity and a key determinant of sponsorship effectiveness. In this study, we focus on the phenomenon of ‘flow’ (i.e., state of intense momentary engagement) as an important indicator of consumer engagement and examine the phenomenon’s influence on sponsorship effectiveness. A pre-post survey-based study was conducted to test whether the experience of flow influences the consumer’s attitude and behavioral intention towards the sponsor before and after the sponsorship exposure through a major sporting event. The results showed significant moderating effect of flow, suggesting emphasis on flow as a key indicator of consumer engagement and a key construct explaining sponsorship effectiveness.

Hosting sport events is costly, but the positive impact of hosting sport events has not been studied well. We consider the promotion of physical activity, known as the trickle-down effect, to be a new dimension of this kind of impact. Using exogenous variations in promotion and relegation in the Bundesliga 1, we test the effect of the presence of a Bundesliga 1 club on local non-profit football club membership. Using German city-level annual non-profit sport club membership data from the metropolitan Rhine-Ruhr, we group cities with experience of either promotion or relegation as treatment cities and other cities as the comparison group. Difference-in-difference analyses show that promotion (using a strict definition of promotion) of local professional football clubs increases non-profit football club membership by 14% while relegation does not affect membership. The presence of Bundesliga 1 clubs in a city increases non-profit football club membership by 11%. Falsification tests support the idea that the impact of promotion on membership results in a net increase in membership.

Background: Bibliometric analyses are used to provide information on trends within a specific research field, along with indicators of the impact of a publication. With such an analysis, we map the scientific landscape of chimeric antigen receptor T-cell (CAR-T) research to see the emerging topics and infer directions the field might take. Methods: We extracted the 100 most cited articles, published between 1945 to 2018, from the Web of Science Core Collection. Using their bibliographic details, including year of publication, country of author, funding agencies, research organization, author information, and keywords, we graph the networks created between the articles. Results: Of the 100 papers identified, majority (92%) were written in the United States. US government agencies and non-profit organizations provided the most funding. It was observed that the papers funded by the NIH had the most citations, followed by those funded by the Alliance for Cancer Gene Therapy. Also notable was that 33 papers were published from the University of Pennsylvania. Regarding authors, Carl H. June participated in 30 researches, followed by Bruce L. Levine who participated in 11. As for journals, Blood (n=20) published the most papers, followed by Science Translational Medicine (n=10). Lastly, the most frequently used keywords were “adoptive immunotherapy” (n=37), “lymphocytes” (n=27), and “antitumor-activity” (n=25). Conclusion: By evaluating the top 100 most cited papers in the CAR-T field, this study provides insight into the direction of the scientific growth and its trends, as well as information on the field’s network structure.

Background: Bibliometric analysis of mainly cited articles is used to provide information on trends in a specific research field and objective indicators of the scientific impact of the publication. With bibliometric and network analysis, we map the scientific landscape of chimeric antigen receptors T-cells (CAR-T) research. Methods: Extract 100 most cited articles published over the last decade (from January 1, 2009 to Dec 31, 2018; 10 years) from the Web of Science Core Collection with bibliographic details; year of publication, country of author, funding agencies, research organization, author information, and keywords. Results: Of the 100 papers identified, most (92%) were written in the US. US government agencies and non-profit organizations provided the most funding, and the papers funded by the NIH had the most citations, followed by those funded by the Alliance for Cancer Gene Therapy (US). 33 papers out of the top 100 most cited papers were published from the University of Pennsylvania. As for authors, Carl H. June participated in 30 papers, followed by Bruce L. Levine who participated in 11 papers. As for journals, Blood (n=20), published the most papers, followed by Science Translational Medicine (n=10). The most frequently used keyword was “adoptive immunotherapy” (n=37), followed by “lymphocytes” (n=27), and “antitumor-activity” (n=25). Conclusion: We performed the quantitative bibliometric analysis of funding bodies, countries, organizations, journals, authors, and keywords for the CAR-T research trends and landscape. Moving forward, Analysis of highly influential CAR-T articles provides insight into areas for future development.

Bubbles are one of the primary sources of transferring substances from water to air. When bubbles burst, small droplets containing microparticles and microorganisms previously suspended in water disperse. Hence, visualizing small objects in bubble films can provide a new methodology for investigating the material transfer from water to the environment and the dynamic behavior of objects in the films. We used Schlieren imaging of bubbles to visualize small objects such as bacteria and microplastics. Remarkably, black spots (Schlieren spots) appeared when light rays passed parallel to bubbles formed on the water containing microparticles and bacteria. The simulation method of Schlieren imaging of bubbles was developed to clarify the underlying mechanism and experimentally validated with different sizes and concentrations of microparticles. We found that a specific water meniscus is formed around a particle when the bubble film thickness is smaller than the particle diameter, and the meniscus plays an important role in enlarging the Schlieren spots. The Schlieren spots are forty times larger than the bubble film thickness in this work. To understand the magnification rule, we illuminated the correlation between bubble film thickness, particle diameter, and Schlieren spot diameter.

A bibliometric study is performed to analyze publication patterns in a specific research area and to establish a landscape model that can be used to quantitatively weigh publications. This study aimed to investigate AML research networks and to conduct a trend-related keyword analysis. We analyzed 48,202 studies about AML published from 1999 to 2019 in the Web of Science Core Collection. The network analysis was conducted using the R&R studio software. The journal Blood had the highest number of published articles with an h-index of 410. The USA had the highest number of total publications (18,719, 38.3%) and research funded by the government, institutions, and pharmaceutical companies (5,436, 10.8%). The institute with the largest number of publications was the MD Anderson Cancer Center. Kantarjian H, Garcia-Manero G, and Ravandi F were the leading authors of publications about AML. Keyword analysis revealed that FLT 3, micro-RNA, and NK cell topics were the hotspots in the cell and gene area in all publications. The overall AML research landscape is popular in the field of translational research as it can identify molecular, cell, and gene studies conducted by different funding agencies, countries, institutions, and author networks. With active funding and support from the Chinese government, the productivity of scientific research is increasing not only in the AML field but also in the medical/health-related science field.

Surgical archives of tumor specimens are often impure. The presence of RNA transcripts from nontumor cells, such as immune and stromal cells, can impede analyses of cancer expression profiles. To systematically analyze the impact of tumor purity, the gene expression profiles and tumor purities were obtained for 7,794 tumor specimens across 21 tumor types (available in The Cancer Genome Atlas consortium). First, we observed that genes with roles in immunity and oxidative phosphorylation were significantly inversely correlated and correlated with the tumor purity, respectively. The expression of genes implicated in immunotherapy and specific immune cell genes, along with the abundance of immune cell infiltrates, was substantially inversely correlated with tumor purity. This relationship may explain the correlation between immune gene expression and mutation burden, highlighting the need to account for tumor purity in the evaluation of expression markers obtained from bulk tumor transcriptome data. Second, examination of cluster membership of gene pairs, with or without controlling for tumor purity, revealed that tumor purity may have a substantial impact on gene clustering across tumor types. Third, feature genes for molecular taxonomy were analyzed for correlation with tumor purity, and for some tumor types, feature genes representing the mesenchymal and classical subtypes were inversely correlated and correlated with tumor purity, respectively. Our findings indicate that tumor purity is an important confounder in evaluating the correlation between gene expression and clinicopathologic features such as mutation burden, as well as gene clustering and molecular taxonomy. Cancer Immunol Res; 6(1); 87–97. ©2017 AACR.

Clothing and fabrics used in household and industrial applications can cause human-to-human cross-infection by residual bacteria attached to their surfaces. In particular, for fabrics used in the medical and healthcare sectors, it is vital to use highly antibacterial fabrics to prevent secondary infections caused by body fluids. In this work, antibacterial fabrics with strong water repellency were developed by electrophoretic deposition (EPD) of zinc oxide (ZnO) and hydrophobic silicon dioxide (SiO2) nanoparticles. The top layer of hydrophobic SiO2 nanoparticles prevents direct adhesion of bacterial droplets, while the bottom layer of hydrophilic ZnO nanoparticles provides antibacterial properties against the residual bacteria on the fabric. As a result, the developed fabrics can simultaneously reduce droplet adhesion and bacteria viability, effectively lowering the risk of bacterial infection. The ability to express these opposing wettabilities can be achieved by our EPD process, which can deposit various nanoparticles in porous form using electric fields on a non-conductive substrate. We expect that the fabrics developed in this work can be applied to various fields that require both antibacterial and antiwetting properties.

Malignant transformation of chronic burn scars are usually toward cutaneous lineages, including squamous cell carcinoma, basal cell carcinoma, and malignant melanoma. Sarcomas are less common. Undifferentiated pleomorphic sarcoma(UPS) is a subtype of soft tissue sarcoma with storiform-pleomorphic cells of uncertain origin, and has sparingly been reported to arise from burn scars. The majority are localized lesions probably due to the spatial distance of mesenchymal cells from the epithelium. The authors describe a rare case of UPS of the chronic burn scar of his knee with ipsilateral femoral and external iliac lymph node metastasis.

Understanding sport consumer well-being is essential for enhancing the psychological experience and benefits of sport consumers. While watching a sporting event on TV or Internet is a key means of sport consumption, not much is known about the activity’s influence on well-being. Well-being improves when one’s hedonic, eudaimonic, and social needs are fulfilled. Need fulfillment occurs when hedonic, eudaimonic, and social values are experienced and perceived as one’s own. A pre-post survey and SEM-based research was conducted to examine individuals’ psychological experiences in sport event viewing and its link to well-being. The influences of the sport fanship and media consumption setting on the links were also examined. The results indicate that hedonic, eudaimonic, and social values experienced by sport event viewers fully or partially (moderated by sport fanship and media consumption setting) led to well-being improvement, supporting the notion of hedonic, eudaimonic, and social needs fulfillment as the mechanism of improving well-being in this context.

The role of volunteers is an important factor for the sustainability of mega sports events. Key issues in the literature on sports event volunteers are volunteer satisfaction and its determinants and outcomes. Therefore, the purpose of the current study was to investigate the effects of the fulfillment of volunteers&rsquo, psychological needs and Volunteer Management Practices (VMP) on overall volunteer satisfaction, and to test their conditional effects depending on volunteer involvement. Additionally, the present study aimed to examine the effects of volunteer satisfaction on future volunteer activity, word-of-mouth, and host city visitation. For these purposes, a survey was conducted with 2442 volunteers in the context of the 2018 PyeongChang Winter Olympics in South Korea. The results of a Latent Moderated Structural Equation (LMS) revealed that the fulfillment of volunteers&rsquo, general needs and volunteer satisfaction with the VMP have positive effects on overall volunteer satisfaction. Interestingly, these effects were differently moderated by the level of volunteer involvement. Overall volunteer satisfaction was found to positively affect future volunteering intention, spreading positive words regarding sports event volunteering, and intention to visit the host city as tourists. In conclusion, sports event managers need to design an optimal work environment that can fulfill volunteers&rsquo, psychological needs and improve VMP to enhance the sustainability of mega sports events.

Papillary thyroid carcinoma (PTC) is a heterogeneous tumor with various histological and molecular subtypes. EHD2 is involved in endocytosis and endosomal recycling. This study aimed to investigate the prognostic significance of EHD2 expression in PTC and develop a new model for predicting persistent/recurrent disease after thyroidectomy. Pathologic slides of 512 consecutive patients with PTC >= 1 cm were retrospectively reviewed. BRAF mutation analysis and immunohistochemistry for EHD2 were performed. Clinical significance of EHD2 mRNA expression was analyzed in 388 PTC patients using The Cancer Genome Atlas dataset. The presence of dyscohesive cells and psammoma bodies were found have significant association with persistent/recurrent disease (p = 0.049 and p = 0.038, respectively). The best discrimination of disease-free survival was found by dividing patients into three prognostic groups based on the following two risk factors according to the size category: psammoma bodies >= 4 and dyscohesive cells (>= 1% and >= 20% in PTCs of < 2.0 cm and >= 2.0 cm, respectively). In PTCs of >= 2.0 cm, patients with the two risk factors had a hazard ratio of 13.303 (p = 0.005) compared to those without risk factors. High expression level of EHD2 was associated with BRAFV600E (p < 0.001), presence of dyscohesive cells (p = 0.010), and absence of psammoma bodies (p = 0.001). Increased EHD2 mRNA expression level was associated with extrathyroidal extension (p < 0.001), pT3-4 (p < 0.001), lymph node metastasis (p < 0.001), higher risk of recurrence (p < 0.001), and BRAFV600E (p < 0.001). Our prognostic model is useful for predicting persistent/recurrent disease after surgery of PTC. EHD2 mRNA expression could be a novel prognostic marker for PTC patients.

Purpose: This study was performed to examine vascular pain due to gemcitabine and according to clinical factors. Methods: The survey was performed with 525 cancer patients visiting chemotherapy infusion room in one general hospital. The data were collected via self-reported questionnaire, researchers observation, and reviewing medical records. Data were analyzed descriptive statistics, ttest, Kruskal-Wallis test, Tukey test using ranks, Jonckheere-Terpstra test, and Spearman correlation analysis were used. Results: The mean scores of the intensity and onset time of vascular pain were 3.06 ± 2.16 and 8.13 ± 13.13 min, and each other were negative correlaton. Degree of intensity of vascular pain had a significant difference on gender (p = .003), age (p = .004), weight (p = .019), Body mass index (BMI) (p = .005), Body surface area (BSA) (p = .030), infusion time (p < .001), dose (p = .027), dose per minute (p < .001), the number of administered gemcitabine (p = .005), combination chemotherapeutic drug (p = .013) and tumor type (p = .002). Degree of onset time of vascular pain had a significant difference on infusion time (p = .044), combination chemotherapy (p = .001) and injection site (p = .001). Conclusion: Patients administrated gemcitabine were experiencing various vascular pain, and vascular pain had a difference on clinical factors. Therefore, oncology nurses should be considered significant clinical factors to implement effective interventions to patients administered gemcitabine.