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Abstract Aims This study aims to investigate the association between fear of cancer recurrence (FCR) and death anxiety (DA) among Chinese cancer patients, while considering the mediating effects of experiential avoidance (EA) and meaning in life (MIL). Methods From February to June 2023, convenience sampling was used to select newly diagnosed cancer patients in a tertiary Cancer Hospital in Chinese Hunan Province as the survey objects. A total of 436 cancer patients completed the Fear of Cancer Recurrence Inventory, the Meaning in Life Questionnaire, the Acceptance and Action Questionnaire-II, and the Templer’s death anxiety scale. Descriptive analysis and Pearson correlation analysis were conducted using SPSS 28.0 software. Serial mediation analysis was performed by Hayes’ PROCESS macro. Results Gender, age, educational level, marital status, residence, occupation, per capita monthly household income, tumor type, and cancer stage were controlled in the model. The results revealed that fear of cancer recurrence had a significant direct effect on death anxiety (Effect = 0.075, 95% CI: 0.064 to 0.087). Additionally, three indirect pathways were identified: (1) through experiential avoidance (Effect = 0.037, 95% CI: 0.026 to 0.049), (2) through meaning in life (Effect = 0.022, 95% CI: 0.014 to 0.031), and (3) through the serial mediators involving meaning in life and experiential avoidance (Effect = 0.016, 95% CI: 0.010 to 0.023). The total indirect effect of the three mediation paths was 63.56%. Conclusion Fear of cancer recurrence is a significant psychological distress experienced by cancer patients, which not only directly contributes to death anxiety but also may triggers changes, such as experiential avoidance and meaning in life. Ultimately, this comprehensive psychological distress leads to death anxiety.

Abstract Background Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. Methods A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer’s Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. Results A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p

Abstract Objectives To gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management. Methods From July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis. Results The experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action). Conclusion Most patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients’ pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

Abstract Background Nursing informatics (NI) competency is a required core competency for high-quality care in digitally enabled healthcare environments. Given the increasing reliance on digital health in palliative care settings, it becomes crucial to evaluate the NI competency of nurses to ensure the seamless integration and effective utilization of digital health in their clinical practice. This study aimed to investigate the level of NI competency and explore its associated factors among palliative care nurses in mainland China. Methods A cross-sectional design was conducted for this study, involving a total of 409 palliative care nurses from 302 hospitals in mainland China. Anonymous data were collected through a self-designed sociodemographic questionnaire, the Nursing Informatics Competency Scale (NICS) and the Innovative Self-Efficacy Scale. Results The total score of the NICS was 129.19 ± 22.02, which indicated that Chinese palliative care nurses had a moderate level of NI competency. There was a positive correlation between innovative self-efficacy and NI competency (r = 0.602, P

Abstract Background Despite being driven by a strong sense of duty and familial obligation, providing care for patients nearing the end of life poses challenges for family caregivers. Telemedicine has rapidly gained traction as a transformative approach to healthcare delivery, offering an array of benefits that could be particularly valuable in end-of-life care. However, research on the perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer is limited. Therefore, this study aims to explore the perspectives and preferences of telemedicine-based services among family caregivers of patients with end-of-life cancer and provide a framework for developing and executing a tailored telemedicine-based end-of-life care program that addresses the unique needs of family caregivers in mainland China. Method A descriptive phenomenological approach was used. Family caregivers were selected using purposive sampling at a tertiary cancer hospital. One-on-one semi-structured interviews were conducted with the participants from November to December 2022. Colaizz’s method was used to analyze the interviews. Results Fourteen participants participated in interviews. Three themes and ten subthemes were identified: motivation to receive telemedicine services (relief from the burden of home care; access to professional health care services), supportive care needs for telemedicine services (support for symptom management; negative emotional adjustment; death education; daily life care guidance), and functional expectations of telemedicine service platforms (ease of use; real-time online guidance and response; personalized automatic reminder; targeted matching push of health knowledge). Conclusion Family caregivers expressed interest in telemedicine-based services and identified various care needs before receiving telemedicine services. The findings of this study can help policymakers and healthcare providers develop more effective and culturally appropriate telemedicine-based service programs that can better support family caregivers of end-of-life cancer patients.

Objectives Death anxiety (DA) refers to the negative emotions experienced when a person reflects on the inevitability of their own death, which is common among patients with cancer. It is crucial to understand the causes, coping styles and adjustment processes related to DA. The purpose of this qualitative study is to explore the adaptation process and outcome of patients with advanced cancer with DA and to provide evidence-based support for the development of targeted intervention measures to improve the mental health of such patients.Design This cross-sectional qualitative study sampled patients with advanced cancer (n=20). Grounded theory procedures were used to analyse transcripts and a theoretical model generated.Setting All interviewees in this study were from a tertiary oncology hospital in Hunan Province, China. The data analysis followed the constructive grounded theory method, involving constant comparison and memo writing.Participants A purposive and theoretical sampling approach was used to recruit 20 patients with advanced cancer with diverse characteristics.Results A total of 20 participants were included in the study. Four stages of DA in patients with advanced cancer were extracted from the interview data: (1) death reminder and prominence; (2) perception and association; (3) defence and control; (4) transformation and Acceptance.Conclusions This study highlights the psychological status and coping strategies of dynamic nature of patients with advanced cancer when confronted with negative emotions associated with death. It emphasises the importance of timely identification of DA in psychological nursing for patients with advanced cancer and the need for targeted psychological interventions based on their specific psychological processes.Implications Knowing interventions that aim to promote the integration of internal and external resources, enhance self-esteem and facilitate a calm and accepting attitude towards death could ultimately reduce the overall DA of patients with advanced cancer.

Abstract Introduction Older stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high experiential avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for older stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in older stroke survivors after group-based ACT. Methods and analysis This study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2). Discussion The results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors. Trial Registration ChiCTR2200066361.

Abstract Backgrounds The majority of Chinese people who are nearing the end of their lives prefer to receive home-based palliative care. Telehealth, as a new service model, has the potential to meet the increasing demand for this service, especially in remote areas with limited resources. However, nurse-led telehealth-based palliative care services are still in the pilot implementation phase. Assessing the telehealth readiness among palliative care specialist nurses and identifying associated factors is crucial to facilitate the successful implementation of telehealth services. Therefore, this study aimed to examine TH readiness and its related factors among Chinese palliative care specialist nurses. Methods Four hundred nine Chinese palliative care specialist nurses from 28 provinces or municipalities participated in this study between July and August 2022. The Chinese version of Telehealth Readiness Assessment Tools (TRAT-C), and Innovative Self-Efficacy Scale (ISES-C) were used to assess the degree of TH readiness and the levels of innovative self-efficacy. Results The total score of the TRAT-C was 65.31 ± 9.09, and the total score of ISES was 29.27 ± 5.78. The statistically significant factors that influenced telehealth readiness were the experience of using telehealth platforms or services, the willingness to provide telehealth to patients, and the level of nurses’ innovative self-efficacy. The innovative self-efficacy is positively correlated to telehealth readiness (r = 0.482, P

Security is paramount in public places such as subways, airports, and train stations, where security screeners use X-ray imaging technology to check passengers’ luggage for potential threats. To streamline this process and make it more efficient, researchers have turned to object detection techniques with the help of deep learning. While some progress has been made, there are few comprehensive literature reviews. This paper provides a comprehensive overview of the standard object detection algorithms and principles in X-ray dangerous goods detection. The article begins by classifying and describing the more popular deep learning object detection techniques in detail and presenting the commonly used publicly available datasets and metrics. And then go on to summarize previous applications of deep learning techniques in X-ray dangerous goods detection, highlighting their successes and limitations. Finally, based on an analysis of the experimental results, it summarizes some of the limitations of deep learning in X-ray baggage detection thus far. It offers insights into the future of this exciting field. With this review, we hope to provide valuable insights and guidance for those seeking to improve public safety through X-ray imaging and deep learning technology.

IntroductionWe aimed to investigate the nutritional risk status and dynamic changes in patients with perioperative oral cancer at different stages and analyze the factors influencing nutritional risk and the correlation among body mass index, nutrition-related symptoms, and nutritional risk.MethodsIn total, 198 patients with oral cancer who were hospitalized in the Head & Neck Surgery Departments of a tertiary cancer hospital in Hunan Province, China, from May 2020 to January 2021, were selected as participants. The Nutritional Risk Screening 2002 scale and Head and Neck Patient Symptom Checklist were used to assess patients on admission day, 7 days post-surgery, and 1 month post-discharge. Multivariate analysis of variance, paired t-test, and generalized estimating equation were used to analyze the trajectory and influencing factors of nutritional risk in patients with perioperative oral cancer. Spearman’s correlation analysis was used to explore the correlation among body mass index, symptoms, and nutritional risk.ResultsThe nutritional risk scores of patients with oral cancer at the three time points were 2.30 ± 0.84, 3.21 ± 0.94, and 2.11 ± 0.84, respectively, and the differences were significant (p

Objective: The aim of this study was to perform across-cultural adaptation of the English version of the personalized psychological flexibility index (PPFI) into Chinese, and to evaluate its psychometric properties in patients with cancer. Methods: This study was conducted in two phases. In phase 1, we followed Beaton's guidelines for cross-cultural adaptation of PPFI. In phase 2, we conducted a cross-sectional study to assess the validity and reliability of the PPFI among a total of 455 patients with cancer in Hunan Province of China. Item analysis was used to evaluate and screen items, while content validity, construct validity, convergent validity, and concurrent validity were used to evaluate the validity. Reliability was assessed using Cronbach's ɑ coefficient, retest reliability, and composite reliability. Results: The item-level content validity index of the modified Chinese version of PPFI (PPFI-C) ranged from 0.89 to 1.00, the scale-level CVI/universal agreement was 0.87, and the S-CVI/average was 0.99. Exploratory factor analysis identified a 14-item, three-factor structure of PPFI (item 11 deleted). Confirmatory factor analysis showed χ2/df ​= ​2.42, RMSEA ​= ​0.07, GFI ​= ​0.92, NFI ​= ​0.91, TLI ​= ​0.93, CFI ​= ​0.95, and IFI ​= ​0.95. PPFI-C demonstrated positive correlations with the 8-item Commitment Action Questionnaire, and negative correlations with Acceptance and Action Questionnaire-II, Hospital Anxiety and Depression Scale, and Short Form Quality Life Scale. The Cronbach's ɑ coefficient of modified PPFI-C stood at 0.84. Conclusions: The results suggest that the 14-item PPFI-C is a reliable and valid tool for measuring PF in Chinese patients with cancer. However, additional studies are needed to validate the psychometric properties of PPFI-C in other populations.

Ensemble fuzzing in parallel with heterogeneous fuzzers has been proposed to leverage the advantages of diverse fuzzers and improve testing efficiency. However, in current ensemble fuzzing methods, the collaboration among different fuzzers is achieved solely by synchronizing the seeds discovered by each fuzzer. This results in a high likelihood of different fuzzers choosing the same seeds and creating a large number of equivalent testcases, thus reducing overall fuzzing efficiency. Meanwhile, the existing task division method proposed by AFLTeam is highly coupled with the fuzzer specially designed for it, making it challenging to apply to ensemble fuzzing directly. So, in this paper, we proposed a callgraph-based task division method suitable for ensemble fuzzing. Firstly, we divided the target program’s callgraph into subgraphs (subtasks) balancing expected workloads. Then, we divided the global seed corpus into subcorpora, each corresponding to a subtask, making fuzzers easily accept the subtasks. Finally, we designed synchronization mechanisms for coverage bitmaps and seeds to realize the collaborative fuzzing among different fuzzers and a cyclic subtask scheduling strategy to fully leverage the benefits of ensemble fuzzing. We implemented a prototype called TAEF. The evaluation results show that in the best-case scenario, our method has up to 24% more branch coverage than previous work.

Introduction With the worsening of population ageing globally, the number of the elderly with chronic and incurable diseases such as malignant tumours is gradually increasing, and the need for palliative care is growing. As a primary task in the end-of-life phase, symptom management is an essential aspect of palliative care, which aims to alleviate distressing symptoms of terminally ill patients and improve their quality of life. Virtual reality (VR) technology, which allows the creation of simulated environments in which a three-dimensional experience is generated, has been increasingly used in palliative care for symptom management. Therefore, we aim to conduct a systematic review to investigate the effects of VR-based interventions on end-of-life patients.Methods and analysis This protocol for conducting a systematic review and meta-analysis will be prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. We will conduct a series of searches from inception to 31 July 2022 in the following databases: PubMed, Embase, Web of Science, the Cochrane Library, JBI, EBSCO, CNKI, Wanfang and SinoMed. The key concepts of ‘virtual reality’ and ‘end-of-life’ will be combined in each database using both free-text terms and controlled vocabulary terms (eg, MeSH/Emtree terms), if available. Two independent reviewers will use raw data to explore the effectiveness of VR for symptom management in end-of-life patients. The Cochrane Risk-of-Bias tool will be used to assess the risk of bias of included studies. Disagreements will be resolved by a third independent reviewer to reach a consensus. For the included articles, Review Manager software will be used for data synthesis and I2 statistics will be used to measure the heterogeneity. Subgroup analyses and sensitivity analyses will be used to identify the source of heterogeneity.Ethics and dissemination As this is a protocol for a systematic review and meta-analysis, patients will not be included in this study. For this reason, ethical approval is not required. In order to disseminate the research findings, the results and conclusions of this review will be submitted to a worldwide journal.PROSPERO registration number CRD42022344679.

BackgroundThe purpose of this study was to assess willingness of advanced cancer patients to receive palliative care and its determinants at Cancer Care Centre in Kilimanjaro Christian Medical Centre Northern Tanzania.ObjectiveThe purpose of this study was to assess willingness of advanced cancer patients to receive palliative care and its determinants at Cancer Care Centre in Kilimanjaro Christian Medical Centre Northern Tanzania.MethodsThis was an institution-based cross-sectional study and the target population was all advanced cancer patients attending care at Cancer care Centre in Northern Tanzania. Data was collected using a structured questionnaire and analysed using Stata for windows 15. A descriptive analysis was conducted to summarize the data using mean standard deviation, while categorical data was summarized using frequency and percentages. Both bivariate and multivariate logistic regression analysis was used to determine the predictors associated with willingness to receive palliative care.ResultsThe results showed that more than half of the respondents had willingness to accept palliative care. The degree of willingness PC among advanced cancer patients was high 60.6% (95%CI: 55.8-65.3). The predictors which remained significant associated with willingness to receive palliative care in multivariate analysis were the knowledgeable of palliative care [AOR: 2.86; 95%CI: 1.69-4.85] and high perceived benefits of palliative care [AOR: 3.58; 95%CI: 2.12-6.04].ConclusionWillingness to accept palliative care services was more than half of the patients just 60.6% among patients with advanced cancer from the study site. Advanced age of a patient, occupations, better knowledge, and perceived benefits for palliative care was the significant predictor for patients' willingness to accept palliative care.

Objective The purpose of this study was to investigate death anxiety status among Chinese patients with cancer and identify factors that affect death anxiety.Design Cross-sectional study.Setting Changsha, Hunan Province, China.Participants A total of 286 inpatients diagnosed with cancer were randomly recruited from a tertiary cancer centre and completed the questionnaires between January and June 2021.Primary and secondary outcome measures The primary outcome was the status of death anxiety. The secondary outcomes were the factors that affect death anxiety among Chinese patients with cancer.Methods A total of 286 Chinese patients with cancer were recruited from a tertiary cancer hospital to complete the demographic and clinical characteristics questionnaire, Templer’s Death Anxiety Scale, Acceptance and Action Questionnaire-second edition, and Meaning in Life Questionnaire from January to June 2021. Data were analysed using t-test, analysis of variance, Kruskal-Wallis H test, Pearson correlation analysis and multiple linear regression analysis.Results On average, patients with cancer scored 7.72±4.17 for death anxiety, 25.71±9.69 for experiential avoidance and 45.19±8.22 for meaning in life. Ultimately, the statistically significant factors influencing death anxiety were education levels, insurance, pain scores, experiential avoidance and meaning in life. These factors explained 40.6% of the difference in death anxiety.Conclusions Patients with cancer in China experienced a high level of death anxiety. This study showed that experiential avoidance and meaning in life were important factors that affected death anxiety in patients with cancer. Further studies should be conducted to explore effective interventions to prevent experiential avoidance and increase meaning in life for patients with cancer. Attention should be paid to patients without insurance but with lower education levels and higher pain scores to ultimately relieve death anxiety and improve their quality of life.

Abstract A newly developed frosting simulation method, p-VOF method, is applied to simulate the dynamic frost formation on the NACA0012 airfoil under strong convection. The p-VOF method is a pseudo VOF method of the multiphase flow simulation with phase change. By solving a simplified mass conservation equation explicitly instead of the original volume fraction equations in CFD software, the efficiency and robustness of calculation are greatly improved. This progress makes it possible to predict a long-time frost formation. The p-VOF method was successfully applied to the simulation of dynamic frosting on the two-dimensional NACA0012 airfoil under strong convection conditions with constant frost physical properties. The simulation result shows that the average thickness of the frost layer increases, and the frost bulges and flow separation appear earlier, when the airfoil surface temperature decreases or the air humidity increases. The frost bulges and flow separation appear earlier, when the air velocity is faster, the growth rate of the frost layer at the early stage is greater, but the final frost layer is thinner.

PurposeThis study aims to develop and validate a stigma scale for Chinese patients with breast cancer.MethodsPatients admitted to the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, for breast cancer treatment participated in this study. Development of the Breast Cancer Stigma Scale involved the following procedures: literature review, interview, and applying a theoretical model to generate items; the Breast Cancer Stigma Scale’s content validity was assessed by a Delphi study (n = 15) and feedback from patients with breast cancer (n = 10); exploratory factor analysis (n = 200) was used to assess the construct validity; convergent validity was assessed with the Social Impact Scale (n = 50); internal consistency Cronbach’s α (n = 200), split-half reliability (n = 200), and test–retest reliability (N = 50) were used to identify the reliability of the scale.ResultsThe final version of the Breast Cancer Stigma Scale consisted of 15 items and showed positive correlations with the Social Impact Scale (ρ = 0.641, P < 0.001). Exploratory factor analysis (EFA) revealed four components of the Breast Cancer Stigma Scale: self-image impairment, social isolation, discrimination, and internalized stigma, which were strongly related to our perceived breast cancer stigma model and accounted for 69.443% of the total variance. Cronbach’s α for the total scale was 0.86, and each subscale was 0.75–0.882. The test–retest reliability with intra-class correlation coefficients of the total scale was 0.947 (P < 0.001), and split-half reliability with intra-class correlation coefficients of the total scale was 0.911 (P < 0.001). The content validity index (CVI) was 0.73–1.0.ConclusionThe newly developed Breast Cancer Stigma Scale offers a valid and reliable instrument for assessing the perceived stigma of patients with breast cancer in clinical and research settings. It may be helpful for stigma prevention in China.

Short videos are popular information carriers on the Internet, and detecting events from them can well benefit widespread applications, e.g., video browsing, management, retrieval and recommendation. Existing video analysis methods always require decoding all frames of videos in advance, which is very costly in time and computation power. These short videos are often untrimmed, noisy and even incomplete, adding much difficulty to event analysis. Unlike previous works focusing on actions, we target short video event detection and propose Recurrent Compressed Convolutional Networks (RCCN) for discovering the underlying event patterns within short videos possibly including a large proportion of non-event videos. Instead of using the whole videos, RCCN performs representation learning at much lower cost within the compressed domain where the encoded motion information reflecting the spatial relations among frames can be easily obtained to capture dynamic tendency of event videos. This alleviates the information incompleteness problem that frequently emerges in user-generated short videos. In particular, RCCN leverages convolutional networks as the backbone and the Long Short-Term Memory components to model the variable-range temporal dependency among untrimmed video frames. RCCN not only learns the common representation shared by the short videos of the same event, but also obtains the discriminative ability to detect dissimilar videos. We benchmark the model performance on a set of short videos generated from publicly available event detection database YLIMED, and compare RCCN with several baselines and state-of-the-art alternatives. Empirical studies have verified the preferable performance of RCCN.

Objectives This study aimed to investigate the knowledge and attitudes of patients with cancer of palliative care and their preferences regarding end-of-life care in mainland China.Design A cross-sectional study.Setting This study was conducted in a tertiary cancer hospital.Participants Two hundred forty-seven patients with cancer were recruited and consented to fill out the questionnaires.Outcome measures The participants’ knowledge and attitudes of palliative care and their preferences of end-of-life care involving place of care, place of death, truth disclosure and treatments during end-of-life were measured.Results In total, 239 questionnaires were valid. The vast majority of patients with cancer (81.2%) had never heard about palliative care or related policies, and only a few of them (5.8%) had somewhat or totally understanding of palliative care. Most participants (75.3%) had supportive attitudes towards palliative care. In terms of preferences for end-of-life care, most patients with cancer preferred to be cared for at home at the end of their life and to die at home. The majority of patients with cancer (65.7%) wanted to know their diagnosis or prognosis of the disease, regardless of the type of disease. More than half of the participants (54%) wished to improve their quality of life rather than prolong their life expectancy. More than a third of the patients with cancer preferred to entrust a family member or agent to sign medical decision agreements for them.Conclusions It is essential for healthcare providers to improve the understanding of patients with cancer of palliative care and be aware of the end-of-life care preferences of patients with cancer, in order to provide support that enables patients with cancer to receive end-of-life care that is accordant with their wishes.

Objective: The purpose of this qualitative study was to describe the experiences of pain acceptance in Chinese cancer patients with chronic pain. Methods: Twelve hospitalized cancer patients with chronic pain participated in this qualitative descriptive study from August to November 2017. In-person semi-structured interviews were conducted, recorded, transcribed, and analyzed using Colaizzi’s seven-step method. Results: The following four main themes and 15 subthemes emerged. Theme 1 (adaptation): pain is overwhelming and pain relief is a top priority, avoidance of pain-inducing factors, and resignation; theme 2 (emotional reactions to pain): feeling misunderstood, hopelessness, frustration, irritability, and concern for loved ones; theme 3 (functional limitations): daily life activities, social communication, and work; theme 4 (coping strategies): pharmacological therapies, behavioral strategies, social support strategies, and spiritual strategies. Conclusions: This study provides a description of cancer patients’ experiences related to the need for pain acceptance. These findings provide insight into the essential role of pain acceptance and underline the need to apply acceptance-based cognitive behavioral interventions as adjunctive non-pharmacological alternatives for chronic cancer pain. Keywords: Adaptation, Cancer pain, Chronic pain, Cognition, Frustration, Pain management, Neoplasms, Social support

Since most of the previous video watermark algorithms regard a video as a series of consecutive images, the embedding and extraction of watermark are performed on these images, and the correlation and redundancy among frames of a video are not considered. Such algorithms are weak in protecting against frame attacks. In order to improve the robustness, we take into consideration the correlation and redundancy among the frames of a video to propose a blind video watermark algorithm based on tensor decomposition. First, a grayscale video is represented as a 3-order tensor, and the core tensor is obtained by tensor decomposition. Second, the watermark embedding position is selected based on the stability of the maximum value in the core tensor because the core tensor represents the main energy of a video. Then, the watermark is embedded by quantifying the maximum value in the core tensor. Finally, the watermark is uniformly distributed across frames of a video by inverse tensor decomposition. The experiments show that our algorithm based on tensor decomposition has better imperceptibility and robustness against common video attacks.

Objective: To translate the English work-related acceptance and action questionnaire (WAAQ), make cross-cultural adaptations, and examine its psychometric properties when used by Chinese oncology nurses. Methods: After translation, the psychometric properties of the Chinese WAAQ were analyzed among 417 nurses, and content validity was determined by six experts. Results: Item-level content validity index (CVI) values were between 0.83 and 1.00; scale-level CVI/universal agreement (S-CVI/UA) and S-CVI/average were 0.86 and 0.98, respectively, which implicated a good content validity. The correlation of the Chinese WAAQ with AAQ-II (rs= −0.247, P < 0.001) suggested criterion validity, and those with General Health Questionnaire-12 (−0.250,

Background. Pain acceptance is associated with disability, pain interference, depression, and anxiety. Few studies have been conducted on the acceptance of cancer pain and its correlates. Objectives. The aim of this study was to examine the level and correlates of pain acceptance in cancer patients from mainland China. Setting and Participants. The study comprised 156 cancer patients in a tertiary cancer hospital in Hunan Province of China. Design. The study is based on a cross-sectional survey design. Subjects and Methods. The 8-item Chronic Pain Acceptance Questionnaire (CPAQ-8) was completed by 156 cancer patients with chronic pain from a tertiary cancer hospital. Demographics, pain, and negative mood assessed by the Hospital Anxiety and Depression Scale (HADS) were explored in relation to the CPAQ-8 scores using descriptive univariate analysis. Results. For the 156 patients, the mean CPAQ-8 score was 25.99 (SD = 8.56; range: 9 to 44). The scores were associated with age, gender, marital status, pain duration, number of pain sites, and duration of taking analgesics. The total scores on the CPAQ-8 and its two subscales (activity engagement and pain willingness) were negatively correlated with the HADS scores. Conclusions. The findings suggest that the prevalence of pain acceptance is relatively low for Chinese cancer patients. The cancer pain acceptance is affected by age, gender, pain duration, number of pain sites, and duration of taking analgesics. The acceptance of cancer pain is negatively correlated with depression and anxiety. Therefore, patients with risk factors for low pain acceptance should receive more attention in Chinese medical settings.

Carotenoids in citrus fruits have health benefits and make the fruits visually attractive. Red-fleshed 'Chuhong' ('CH') and pale green-fleshed 'Feicui' ('FC') pummelo (Citrus maxima (Burm) Merr.) fruits are interesting materials for studying the mechanisms of carotenoid accumulation. In this study, particularly high contents of linear carotenes were observed in the albedo tissue, segment membranes and juice sacs of 'CH'. However, carotenoids, especially β-carotene and xanthophylls, accumulated more in the flavedo tissue of 'FC' than in that of 'CH'. Additionally, the contents of other terpenoids such as limonin, nomilin and abscisic acid significantly differed in the juice sacs at 150 days postanthesis. A dramatic increase in carotenoid production was observed at 45 to 75 days postanthesis in the segment membranes and juice sacs of 'CH'. Different expression levels of carotenogenesis genes, especially the ζ-carotene desaturase (CmZDS), β-carotenoid hydroxylase (CmBCH) and zeaxanthin epoxidase (CmZEP) genes, in combination are directly responsible for the largely different carotenoid profiles between these two pummelo fruits. The sequences of eleven genes involved in carotenoid synthesis were investigated; different alleles of seven of eleven genes might also explain the largely different carotenogenesis observed between 'CH' and 'FC'. These results enhance our understanding of carotenogenesis in pummelo fruits.

Wireless link correlation has shown significant impact on the performance of various sensor network protocols. Many works have been devoted to exploiting link correlation for protocol improvements. However, the effectiveness of these designs heavily relies on the accuracy of link correlation measurement. In this paper, we investigate state-of-the-art link correlation measurement and analyze the limitations of existing works. We then propose a novel lightweight and accurate link correlation estimation (LACE) approach based on the reasoning of link correlation formation. LACE combines both long-term and short-term link behaviors for link correlation estimation. We implement LACE as a stand-alone interface in TinyOS and incorporate it into both routing and flooding protocols. Simulation and testbed results show that LACE: (1) achieves more accurate and lightweight link correlation measurements than the state-of-the-art work; and (2) greatly improves the performance of protocols exploiting link correlation.

Wireless Power Transfer (WPT) is a promising technology to replenish energy of sensors in Rechargeable Wireless Sensor Networks (RWSN). In this paper, we investigate the mobile directional charging optimization problem in RWSN. Our problem is how to plan the moving path and charging direction of the Directional Charging Vehicle (DCV) in the 2D plane to replenish energy for RWSN. The objective is to optimize energy charging efficiency of the DCV while maintaining the sensor network working continuously. To the best of our knowledge, this is the first work to study the mobile directional charging problem in RWSN. We prove that the problem is NP-hard. Firstly, the coverage utility of the DCV’s directional charging is proposed. Then we design an approximation algorithm to determine the docking spots and their charging orientations while minimizing the number of the DCV’s docking spots and maximizing the charging coverage utility. Finally, we propose a moving path planning algorithm for the DCV’s mobile charging to optimize the DCV’s energy charging efficiency while ensuring the networks working continuously. We theoretically analyze the DCV’s charging service capability, and perform the comprehensive simulation experiments. The experiment results show the energy efficiency of the DCV is higher than the omnidirectional charging model in the sparse networks.

Heterogeneous Bistatic Radars (BR) have different sensing ranges and couplings of sensing regions, which provide more flexible coverage for the boundary at complex terrain such as across rivers and valleys. Due to the Cassini oval sensing region of a BR and the coupling of sensing regions among different BRs, the coverage problem of BR sensor networks is very challenging. Existing works in BR barrier coverage focus mainly on homogeneous BR sensor networks. This paper studies the heterogeneous BR placement problem on a line barrier to achieve optimal coverage. 1) We investigate coverage differences of the basic placement sequences of heterogeneous BRs on the line barrier, and prove the optimal basic placement spacing patterns of heterogeneous BRs. 2) We study the coverage coupling effect among adjacent BRs on the line barrier, and determine that different placement sequences of heterogeneous BR transmitters will affect the barrier’s coverage performance and length. The optimal placement sequence of heterogeneous BR barrier cannot be solved through the greedy algorithm. 3) We propose an optimal BRs placement algorithm on a line barrier when the heterogeneous BR transmitters’ placement sequence is predetermined on the barrier, and prove it to be optimal. Through simulation experiments, we determine that the different placement sequences of heterogeneous BR transmitters have little influence on the barrier’s maximum length. Then, we propose an approximate algorithm to optimize the BR placement spacing sequence on the heterogeneous line barrier. 4) As a heterogeneous barrier case study, a minimum cost coverage algorithm of heterogeneous BR barrier is presented. We validate the effectiveness of the proposed algorithms through theory analysis and extensive simulation experiments.

This paper investigates the use of wireless sensor networks for multiple event source localization using binary information from the sensor nodes. The events could continually emit signals whose strength is attenuated inversely proportional to the distance from the source. In this context, faults occur due to various reasons and are manifested when a node reports a wrong decision. In order to reduce the impact of node faults on the accuracy of multiple event localization, we introduce a trust index model to evaluate the fidelity of information which the nodes report and use in the event detection process, and propose the Trust Index based Subtract on Negative Add on Positive (TISNAP) localization algorithm, which reduces the impact of faulty nodes on the event localization by decreasing their trust index, to improve the accuracy of event localization and performance of fault tolerance for multiple event source localization. The algorithm includes three phases: first, the sink identifies the cluster nodes to determine the number of events occurred in the entire region by analyzing the binary data reported by all nodes; then, it constructs the likelihood matrix related to the cluster nodes and estimates the location of all events according to the alarmed status and trust index of the nodes around the cluster nodes. Finally, the sink updates the trust index of all nodes according to the fidelity of their information in the previous reporting cycle. The algorithm improves the accuracy of localization and performance of fault tolerance in multiple event source localization. The experiment results show that when the probability of node fault is close to 50%, the algorithm can still accurately determine the number of the events and have better accuracy of localization compared with other algorithms.

Blur is an important factor affecting the image quality. This paper presents an efficient no-reference (NR) image blur assessment method based on a response function of singular values. For an image, the grayscale image is computed to the acquire spatial information. In the meantime, the gradient map is computed to acquire the shape information, and the saliency map can be obtained by using scale-invariant feature transform (SIFT). Then, the grayscale image, the gradient map, and the saliency map are divided into blocks of the same size. The blocks of the gradient map are converted into discrete cosine transform (DCT) coefficients, from which the response function of singular values (RFSV) are generated. The sum of the RFSV are then utilized to characterize the image blur. The variance of the grayscale image and the DCT domain entropy of the gradient map are used to reduce the impact of the image content. The SIFT-dependent weights are calculated in the saliency map, which are assigned to the image blocks. Finally, the blur score is the normalized sum of the RFSV. Extensive experiments are conducted on four synthetic databases and two real blur databases. The experimental results indicate that the blur scores produced by our method are highly correlated with the subjective evaluations. Furthermore, the proposed method is superior to six state-of-the-art methods.

ABSTRACT: Cardiovascular diseases are the most frequent and costly complication of diabetes. Many previous studies showed that ATP-sensitive potassium channels (KATP) and inward rectifier potassium channels (Kir) play important regulatory roles in functions of cardiovascular tissues. Its still not very clear how these potassium channels are involved in cardiovascular complications of diabetes. We used the streptozotocin (STZ)-induced diabetic rats model to study the expressions of KATP and Kir channel subtypes in diabetic cardiovascular tissues. The mRNA expression levels of Kir2.1, Kir3.1, Kir6.1, Kir6.2, and sulfonylurea receptor (SUR) 2A and 2B subunits in heart and aortal smooth muscles were determined by the reverse-transcription polymerase chain reaction. The results showed that in comparison with the control rats, mRNA expression of SUR 2A was reduced significantly in the diabetic heart (SUR 2A/GAPDH, 1.04 ± 0.16 vs 0.38 ± 0.09, P

Wireless charging is an important issue in wireless sensor networks, since it can provide an emerging and effective solution in the absence of other power supplies. The state-of-the-art methods employ a mobile car and a predefined moving path to charge the sensor nodes in the network. Previous studies only consider a factor of the network (i.e., residual energy of sensor node) as a constraint to design the wireless charging strategy. However, other factors, such as the travelled distance of the mobile car, can also affect the effectiveness of wireless charging strategy. In this work, we study wireless charging strategy based on the analysis of a combination of two factors, including the residual energy of sensor nodes and the travelled distance of the charging car. Firstly, we theoretically analyze the limited size of the sensor network to match the capability of a charging car. Then, the networked factors are selected as the weights of traveling salesman problem (TSP) to design the moving path of the charging car. Thirdly, the charging time of each sensor node is computed based on the linear programming problem for the charging car. Finally, a charging period for the network is studied. The experimental results show that the proposed approach can significantly maximize the lifetime of the wireless sensor network.

Coverage is a fundamental issue in the research field of wireless sensor networks (WSNs). Connected target coverage discusses the sensor placement to guarantee the needs of both coverage and connectivity. Existing works largely leverage on the Boolean disk model, which is only a coarse approximation to the practical sensing model. In this paper, we focus on the connected target coverage issue based on the probabilistic sensing model, which can characterize the quality of coverage more accurately. In the probabilistic sensing model, sensors are only be able to detect a target with certain probability. We study the collaborative detection probability of target under multiple sensors. Armed with the analysis of collaborative detection probability, we further formulate the minimum ϵ-connected target coverage problem, aiming to minimize the number of sensors satisfying the requirements of both coverage and connectivity. We map it into a flow graph and present an approximation algorithm called the minimum vertices maximum flow algorithm (MVMFA) with provable time complex and approximation ratios. To evaluate our design, we analyze the performance of MVMFA theoretically and also conduct extensive simulation studies to demonstrate the effectiveness of our proposed algorithm.

Sensing coverage is a fundamental problem in wireless sensor networks (WSNs), which has attracted considerable attention. Conventional research on this topic focuses on the 0/1 coverage model, which is only a coarse approximation to the practical sensing model. In this paper, we study the target coverage problem, where the objective is to find the least number of sensor nodes in randomly-deployed WSNs based on the probabilistic sensing model. We analyze the joint detection probability of target with multiple sensors. Based on the theoretical analysis of the detection probability, we formulate the minimum ϵ-detection coverage problem. We prove that the minimum ϵ-detection coverage problem is NP-hard and present an approximation algorithm called the Probabilistic Sensor Coverage Algorithm (PSCA) with provable approximation ratios. To evaluate our design, we analyze the performance of PSCA theoretically and also perform extensive simulations to demonstrate the effectiveness of our proposed algorithm.