PurposeThis study aims to study the effects of depression and demoralization on suicidal ideation and to determine the feasibility of the Distress Thermometer as a screening tool for patients with cancer who experience depression and demoralization, and thus to establish a model screening process for suicide prevention.MethodsPurposive sampling was used to invite inpatients and outpatients with lung cancer, leukemia, and lymphoma. Two hundred participants completed the questionnaire, which included the Distress Thermometer (DT), Patient Health Questionnaire-9 (PHQ-9), Demoralization Scale-Mandarin Version (DS-MV), and Beck Scale for Suicide Ideation. All data obtained were analyzed using SPSS 18.0 and SAS 9.3.ResultsTobit regression analysis showed that demoralization influenced suicidal ideation more than depression did (t = 2.84, p < 0.01). When PHQ-9 ≥ 10 and DS-MV ≥42 were used as criteria for the DT, receiver operating characteristic analysis revealed that the AUC values were 0.77–0.79, with optimal cutoff points for both of DT ≥5; sensitivity 76.9 and 80.6 %, respectively; and specificity of 73.9 and 72.2 %, respectively.ConclusionsDemoralization had more influence on suicidal ideation than depression did. Therefore, attention should be paid to highly demoralized patients with cancer or high demoralization comorbid with depression for the purposes of suicide evaluation and prevention. The DT scale (with a cutoff of ≥5 points) has discriminative ability as a screening tool for demoralization or depression and can also be used in clinical settings for the preliminary screening of patients with cancer and high suicide risk.

Electrospinning has been widely used to prepare polymer fibers with diameters ranging from a few nanometers to micrometers. While most studies focus on controlling the sizes and morphologies of electrospun polymer fibers by changing electrospinning conditions, the effect of post-treatments such as thermal annealing on the properties of electrospun polymer fibers has been less studied. Here, we investigate the effect of thermal annealing on the morphology changes of electrospun polystyrene (PS) fibers on substrates. Different from annealing the fibers in a uniform environment, annealing the fibers on substrates results in a substrate-dependent morphology transformation. When the electrospun PS fibers are annealed on a glass substrate, wetting of the fibers on the glass substrate occurs. When the electrospun PS fibers are annealed on a poly(methyl methacrylate) (PMMA)-coated substrate, a Rayleigh-instability-driven morphology transformation is observed. The polymer fibers transform into hemispherical polymer particles caused by the lower surface tension of PS than that of PMMA and the interfacial tension between PS and PMMA. This transformation process is influenced by the annealing time and temperature. The characteristic time of the transformation process is shorter when the sample is annealed at a higher temperature because of the lower polymer viscosity. The size of the polymer particles fits well with the theoretical prediction, which is dependent on the initial fiber diameter and is independent of the annealing temperature.

Morphology transformation of electrospun polymer fibers is studied by in situ optical microscopy and stimulated Raman scattering microscopy.

Electrospun polymer core−shell fibers have gained much attention because of their promising applications in areas such as electronic devices, drug delivery, and tissue engineering. The morphology transformation of polymer core− shell fibers, however, has been rarely investigated. Here, we study the effect of thermal annealing on the morphology transformation of electrospun polystyrene (PS)/poly(methyl methacrylate) (PMMA) core−shell fibers on PMMA films. Two types of transformation processes are discovered. In the first type of the transformation process (type I), the PS cores transform to hemispherical particles after the annealing process; in the second type of the transformation process (type II), the PS cores transform to spherical particles after the annealing process. The measured sizes of the hemispherical and spherical PS domains fall into two classified regions, as predicted for the two different types of transformation processes. It is also observed that the growth rates of the undulated amplitude are similar for the two different types of transformation processes, but the type I fibers start to undulate at later annealing times than the type II fibers do. When the PS particles are selectively removed, the PMMA films with linearly arranged cavities are used for the tearing experiments, demonstrating a proof of concept on the potentials in studying the mechanical properties of cavity-containing films.