基于Childlife理念的叙事医学干预在隐睾患儿围手术期中的应用

目的探讨Child life理念的叙事医学干预在隐睾患儿围手术期中的应用效果。方法选取2021年1月至2023年8月安徽医科大学第一附属医院收治的120例住院择期手术的隐睾患儿作为研究对象,采用随机数字表法分为观察组和对照组,各60例。对照组采用泌尿外科常规围手术期干预,观察组在对照组基础上采用Child life理念的叙事医学干预。比较两组患儿和家长入院时、术后1 d和出院时的焦虑状态,以及患儿术后疼痛和家长满意度。结果两组患儿和家长焦虑评分组间、时间及交互比较,差异均具有统计学意义(P<0.001);对照组患儿和家长出院时焦虑评分均低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d焦虑评分均低于入院时,出院时低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d、出院时焦虑评分均低于对照组,差异具有统计学意义(P<0.05)。观察组患儿术后疼痛评分显著低于对照组,差异具有统计学意义(P<0.001)。观察组家长满意度显著高于对照组,差异具有统计学意义(P<0.001)。结论基于Child life理念的叙事医学干预可有效减轻隐睾患儿和家长围手术期的焦虑情绪,降低患儿术后疼痛感,提高家长满意度。

Reevaluating health metrics:Unraveling the limitations of disabilityadjusted life years as an indicator in disease burden assessment

In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.

The Sequential Mediating Roles of Body Pain and Self-Reported Health Status in the Relationship between Sleep Duration and Life Satisfaction

Objective This study examines the sequential mediating roles of body pain and self-reported health in the association between sleep duration and self-reported life satisfaction among elderly Chinese adults.Methods Data from the fifth wave of the China Health and Retirement Longitudinal Survey(CHARLS)were used to analyse the relationships between sleep duration and body pain,self-reported health,and life satisfaction through logistic regression and Restricted Cubic Spline(RCS)analyses.The sequential mediation effects of body pain and self-reported health status were examined via chain mediation analysis.Results Logistic regression analysis showed that sleeping fewer than 6 hours or 6-7 hours was linked to higher risks of body pain,poor health,and dissatisfaction with life compared to sleeping 7-8 hours(all P<0.05).Additionally,those sleeping more than 9 hours also had increased risks of poor health and dissatisfaction with life compared to those sleeping 7-8 hours(all P<0.05).Chain mediation analysis showed that body pain and self-reported health status sequentially mediated 46.15%of the association between sleep duration and life satisfaction.Conclusion Body pain and self-reported health may shape the relationship between sleep duration and life satisfaction in elderly Chinese adults.

Distressing symptoms and health-related quality of life in patients with chronic kidney disease

BACKGROUND Chronic kidney disease(CKD)is an incapacitating illness associated with distressing symptoms(DS)that have negative impact on patients’health-related quality of life(HRQOL).AIM To assess the severity of DS and their relationships with HRQOL among patients with CKD in Jordan.METHODS A descriptive cross-sectional design was used.A convenience sampling approach was used to recruit the participants.Patients with CKD(n=140)who visited the outpatient clinics in four hospitals in Amman between November 2021 and December 2021 were included.RESULTS The Edmonton Symptom Assessment System was used to measure the severity of the DS while the Short Form-36 tool was used to measure the HRQOL.Participants’mean age was 50.9(SD=15.14).Most of them were males(n=92,65.7%),married(n=95,67.9%),and unemployed(n=93,66.4%).The highest DS were tiredness(mean=4.68,SD=2.98)and worse well-being(mean=3.69,SD=2.43).The highest HRQOL mean score was for the bodily pain scale with a mean score of 68.50 out of 100(SD=32.02)followed by the emotional well-being scale with mean score of 67.60(SD=18.57).CONCLUSION Patients with CKD had suboptimal HRQOL,physically and mentally.They suffer from multiple DS that have a strong association with diminished HRQOL such as tiredness and depression.Therefore,healthcare providers should be equipped with the essential knowledge and skills to promote individualized strategies that focusing on symptom management.

Data-Driven Method for Predicting Remaining Useful Life of Bearings Based on Multi-Layer Perception Neural Network and Bidirectional Long Short-Term Memory Network

The remaining useful life prediction of rolling bearing is vital in safety and reliability guarantee.In engineering scenarios,only a small amount of bearing performance degradation data can be obtained through accelerated life testing.In the absence of lifetime data,the hidden long-term correlation between performance degradation data is challenging to mine effectively,which is the main factor that restricts the prediction precision and engineering application of the residual life prediction method.To address this problem,a novel method based on the multi-layer perception neural network and bidirectional long short-term memory network is proposed.Firstly,a nonlinear health indicator(HI)calculation method based on kernel principal component analysis(KPCA)and exponential weighted moving average(EWMA)is designed.Then,using the raw vibration data and HI,a multi-layer perceptron(MLP)neural network is trained to further calculate the HI of the online bearing in real time.Furthermore,The bidirectional long short-term memory model(BiLSTM)optimized by particle swarm optimization(PSO)is used to mine the time series features of HI and predict the remaining service life.Performance verification experiments and comparative experiments are carried out on the XJTU-SY bearing open dataset.The research results indicate that this method has an excellent ability to predict future HI and remaining life.

Childlife干预在儿童隐匿阴茎围术期护理中的应用

分析儿童隐匿阴茎围术期护理中采取Child life干预的效果。方法 选取2022年1月-2023年2月纳入的隐匿性阴茎儿童60例作为观察对象,经随机抽签法分组,对照组、观察组各有30例。两组分别采取常规护理、Child life干预,观察围术期患儿的心理状态,并评估患儿术后疼痛评分及护理满意度、护理依从性。结果 护理前,组间SAS及SDS评分相比,p>0.05;护理后,观察组SAS及SDS评分比对照组低,p<0.05;观察组Wong-Baker分值低于对照组,p<0.05;观察组依从性及护理满意度高于对照组,p<0.05。结论 在隐匿性阴茎儿童围术期护理中采取Child life护理模式可提升患儿的依从性、护理满意度,并改善患儿心理状态,减轻其疼痛感。

Investigation of the quality of life,mental status in patients with gynecological cancer and its influencing factors

BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.

Accurate and efficient remaining useful life prediction of batteries enabled by physics-informed machine learning

The safe and reliable operation of lithium-ion batteries necessitates the accurate prediction of remaining useful life(RUL).However,this task is challenging due to the diverse ageing mechanisms,various operating conditions,and limited measured signals.Although data-driven methods are perceived as a promising solution,they ignore intrinsic battery physics,leading to compromised accuracy,low efficiency,and low interpretability.In response,this study integrates domain knowledge into deep learning to enhance the RUL prediction performance.We demonstrate accurate RUL prediction using only a single charging curve.First,a generalisable physics-based model is developed to extract ageing-correlated parameters that can describe and explain battery degradation from battery charging data.The parameters inform a deep neural network(DNN)to predict RUL with high accuracy and efficiency.The trained model is validated under 3 types of batteries working under 7 conditions,considering fully charged and partially charged cases.Using data from one cycle only,the proposed method achieves a root mean squared error(RMSE)of 11.42 cycles and a mean absolute relative error(MARE)of 3.19%on average,which are over45%and 44%lower compared to the two state-of-the-art data-driven methods,respectively.Besides its accuracy,the proposed method also outperforms existing methods in terms of efficiency,input burden,and robustness.The inherent relationship between the model parameters and the battery degradation mechanism is further revealed,substantiating the intrinsic superiority of the proposed method.

Remaining Useful Life Prediction Method for Multi-Component System Considering Maintenance:Subsea Christmas Tree System as A Case Study

Maintenance is an important technical measure to maintain and restore the performance status of equipment and ensure the safety of the production process in industrial production,and is an indispensable part of prediction and health management.However,most of the existing remaining useful life(RUL)prediction methods assume that there is no maintenance or only perfect maintenance during the whole life cycle;thus,the predicted RUL value of the system is obviously lower than its actual operating value.The complex environment of the system further increases the difficulty of maintenance,and its maintenance nodes and maintenance degree are limited by the construction period and working conditions,which increases the difficulty of RUL prediction.An RUL prediction method for a multi-omponent system based on the Wiener process considering maintenance is proposed.The performance degradation model of components is established by a dynamic Bayesian network as the initial model,which solves the uncertainty of insufficient data problems.Based on the experience of experts,the degree of degradation is divided according to Poisson process simulation random failure,and different maintenance strategies are used to estimate a variety of condition maintenance factors.An example of a subsea tree system is given to verify the effectiveness of the proposed method.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas

BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Effect of lens surgery on health-related quality of life in preschool children with congenital ectopia lentis

AIM:To evaluate the effect of lens surgery on health-related quality of life(HRQoL)of preschool children with congenital ectopia lentis(CEL).METHODS:A prospective self-controlled study was conducted in Zhongshan Ophthalmic Center.Children aged from 5 to 7y whom were diagnosed with CEL and underwent phacoemulsification with scleral-fixated posterior chamber intraocular lens implantation and their parents were enrolled in this study.All of them completed the child and proxy(parental)PedsQL™4.0 before and after the surgery.Their preoperative scores were compared to their postoperative ones.Subgroup analyses were performed based on gender and preoperative bilateral presenting visual acuity of the children.RESULTS:Thirty-two children with CEL successfully underwent surgery without any complications,among whom 8 had monocular surgery and 24 had binocular surgery.Preoperative and postoperative questionnaires were completed by 32 child-parent pairs.Surgical intervention could significantly improve the vision of affected children(P<0.001).The medians of physical,psychosocial and total health scores self-reported by the children were 68.75(62.50,81.25),65.00(60.00,80.00)and 67.39(60.87,78.26)preoperatively and were 93.75(87.50,100.00),90.00(83.33,96.67)and 89.13(85.32,95.65)postoperatively.The preoperative scores of the affected children were significantly lower in all scales than age-matched healthy children(P<0.001).All the postoperative scores were significantly higher than the preoperative scores in affected children and their parents(P<0.001).In the physical functioning evaluation,the preoperative score reported by parents of girls was higher than parents of boys(P=0.041),and the postoperative score of girls was higher than that of boys(P=0.036).CONCLUSION:CEL is associated with significantly worse quality of life in preschool children.Surgical intervention can significantly improve the HRQoL in affected children from both personal and family perspective.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

Life cycle assessment as a prospective tool for sustainable agriculture and food planning at a local level

Owing to the far-reaching environmental consequences of agriculture and food systems,such as their contribution to climate change,there is an urgent need to reduce their impact.International and national governments set sustainability targets and implement corresponding measures.Nevertheless,critics of the globalized system claim that a territorial administrative scale is better suited to address sustainability issues.Yet,at the subnational level,local authorities rarely apply a systemic environmental assessment to enhance their action plans.This paper employs a territorial life cycle assessment methodology to improve local environmental agri-food planning.The objective is to identify significant direct and indirect environmental hotspots,their origins,and formulate effective mitigation strategies.The methodology is applied to the administrative department of Finistere,a strategic agricultural region in North-Western France.Multiple environmental criteria including climate change,fossil resource scarcity,toxicity,and land use are modeled.The findings reveal that the primary environmental hotspots of the studied local food system arise from indirect sources,such as livestock feed or diesel consumption.Livestock reduction and organic farming conversion emerge as the most environmentally efficient strategies,resulting in a 25%decrease in the climate change indicator.However,the overall modeled impact reduction is insufficient following national objectives and remains limited for the land use indicator.These results highlight the innovative application of life cycle assessment led at a local level,offering insights for the further advancement of systematic and prospective local agri-food assessment.Additionally,they provide guidance for local authorities to enhance the sustainability of planning strategies.

From Poverty To a Well-Off Life——Chinese people enjoy full rights to subsistence and development

Ⅰ The Chinese government has always attached much importance to human rights and placed the rights to subsistence and development of the more than one billion people above everything else. In the fundamental interests of the broadest possible masses of people, it has adopted a series of major policy measures toward this end, thus winning the support and love of the people. 1. No wavering in making economic development its central task and a matter of the first and foremost importance in invigo-

The early life immune dynamics and cellular drivers at single-cell resolution in lamb forestomachs and abomasum

Background Four-chambered stomach including the forestomachs(rumen,reticulum,and omasum)and abomasum allows ruminants convert plant fiber into high-quality animal products.The early development of this four-chambered stomach is crucial for the health and well-being of young ruminants,especially the immune development.However,the dynamics of immune development are poorly understood.Results We investigated the early gene expression patterns across the four-chambered stomach in Hu sheep,at 5,10,15,and 25 days of age.We found that forestomachs share similar gene expression patterns,all four stomachs underwent widespread activation of both innate and adaptive immune responses from d 5 to 25,whereas the metabolic function were significantly downregulated with age.We constructed a cell landscape of the four-chambered stomach using single-cell sequencing.Integrating transcriptomic and single-cell transcriptomic analyses revealed that the immune-associated module hub genes were highly expressed in T cells,monocytes and macrophages,as well as the defense-associated module hub genes were highly expressed in endothelial cells in the four-stomach tissues.Moreover,the non-immune cells such as epithelial cells play key roles in immune maturation.Cell communication analysis predicted that in addition to immune cells,non-immune cells recruit immune cells through macrophage migration inhibitory factor signaling in the forestomachs.Conclusions Our results demonstrate that the immune and defense responses of four stomachs are quickly developing with age in lamb's early life.We also identified the gene expression patterns and functional cells associated with immune development.Additionally,we identified some key receptors and signaling involved in immune regulation.These results help to understand the early life immune development at single-cell resolution,which has implications to develop nutritional manipulation and health management strategies based on specific targets including key receptors and signaling pathways.

Effect of Interface Form on Creep Failure and Life of Dissimilar Metal Welds Involving Nickel-Based Weld Metal and Ferritic Base Metal

For dissimilar metal welds(DMWs)involving nickel-based weld metal(WM)and ferritic heat resistant steel base metal(BM)in power plants,there must be an interface between WM and BM,and this interface suffers mechanical and microstructure mismatches and is often the rupture location of premature failure.In this study,a new form of WM/BM interface form,namely double Y-type interface was designed for the DMWs.Creep behaviors and life of DMWs containing double Y-type interface and conventional I-type interface were compared by finite element analysis and creep tests,and creep failure mechanisms were investigated by stress-strain analysis and microstructure characterization.By applying double Y-type interface instead of conventional I-type interface,failure location of DMW could be shifted from the WM/ferritic heat-affected zone(HAZ)interface into the ferritic HAZ or even the ferritic BM,and the failure mode change improved the creep life of DMW.The interface premature failure of I-type interface DMW was related to the coupling effect of microstructure degradation,stress and strain concentrations,and oxide notch on the WM/HAZ interface.The creep failure of double Y-type interface DMW was the result of Type IV fracture due to the creep voids and micro-cracks on fine-grain boundaries in HAZ,which was a result of the matrix softening of HAZ and lack of precipitate pinning at fine-grain boundaries.The double Y-type interface form separated the stress and strain concentrations in DMW from the WM/HAZ interface,preventing the trigger effect of oxide notch on interface failure and inhibiting the interfacial microstructure cracking.It is a novel scheme to prolong creep life and enhance reliability of DMW,by means of optimizing the interface form,decoupling the damage factors from WM/HAZ interface,and then changing the failure mechanism and shifting the failure location.

Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids:A retrospective study

BACKGROUND Hemorrhoids are among the most common and frequently encountered chronic anorectal diseases in anorectal surgery.They are venous clusters formed by con-gestion,expansion,and flexion of the venous plexus in the lower part of the rec-tum.Mixed hemorrhoids bleed easily and recurrently,and this can result in severe anemia.Hence,they may have a negative effect on the health of the patient and surgical treatment is required.Milligan-Morgan hemorrhoidectomy has been widely used since 1937 for the treatment of grade III and IV hemorrhoids.How-ever,most patients experience different degrees of postoperative pain that may cause anxiety.with mixed hemorrhoids post-surgery.METHODS The clinical data of patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy were collected retrospectively.The basic character-istics of the enrolled patients with mixed hemorrhoids were recorded,and based on the Goligher clinical grading system,the hemorrhoids were classified as grades III or IV.The endpoint of this study was the disappearance of pain in all patients.Quantitative data were presented as mean±SD,such as age,pain score,and QoL score.Student’s t-test was used to compare the groups.RESULTS A total of 164 patients were enrolled.The distribution of the visual analog scale pain scores of all patients at 3,7,14 and 28 d after surgery showed that post-surgery pain was significantly reduced with the passage of time.Fourteen days after the operation,the pain had completely disappeared in some patients.Twenty-eight days after the surgery,none of the patients experienced any pain.Comparing the World Health Or-ganization Quality of Life-BREF self-reporting questionnaire scores of patients between 14 and 28 d after surgery,we observed that the quality-of-life scores of the patients post-surgery had significantly improved.There were six items that were compared at 14-and 28-d post-surgery.The mean QoL score 28 d after surgery(4.79±0.46)was higher than that at 14 d post-surgery(3.79±0.57).The mean health condition score 28 d after surgery(4.80±0.41)was also higher than that at 14 d post-surgery(4.01±0.62).The mean physical health score 28 d after surgery(32.10±2.96)was significantly higher than that at 14 d post-surgery(23.41±2.85).The mean psychological health score 28 d after surgery(27.22±1.62)was significantly higher than that at 14 d post-surgery(21.37±1.70).The mean social relations score 28 d after surgery(12.21±1.59)was significantly higher than that at 14 d post-surgery(6.32±1.66).The mean surrounding environment score 28 d after surgery(37.13±2.88)was significantly higher than that at 14 d post-surgery(28.42±2.86).The differences in quality-of-life scores at day 14 and day 28 post-surgery were ob-served to be statistically significant(P<0.001).CONCLUSION Milligan-Morgan hemorrhoidectomy can significantly improve the postoperative QoL of patients.Age,sex,and the number of surgical resections were important factors influencing Milligan-Morgan hemorrhoidectomy.

Impact of cancer diagnosis on life expectancy by area-level socioeconomic groups in New South Wales, Australia: a population-based study

Objective: Improvement in cancer survival over recent decades has not been accompanied by a narrowing of socioeconomic disparities. This study aimed to quantify the loss of life expectancy(LOLE) resulting from a cancer diagnosis and examine disparities in LOLE based on area-level socioeconomic status(SES).Methods: Data were collected for all people between 50 and 89 years of age who were diagnosed with cancer, registered in the NSW Cancer Registry between 2001 and 2019, and underwent mortality follow-up evaluations until December 2020. Flexible parametric survival models were fitted to estimate the LOLE by gender and area-level SES for 12 common cancers.Results: Of 422,680 people with cancer, 24% and 18% lived in the most and least disadvantaged areas, respectively. Patients from the most disadvantaged areas had a significantly greater average LOLE than patients from the least disadvantaged areas for cancers with high survival rates, including prostate [2.9 years(95% CI: 2.5±3.2 years) vs. 1.6 years(95% CI: 1.3±1.9 years)] and breast cancer [1.6 years(95% CI: 1.4±1.8 years) vs. 1.2 years(95% CI: 1.0±1.4 years)]. The highest average LOLE occurred in males residing in the most disadvantaged areas with pancreatic [16.5 years(95% CI: 16.1±16.8 years) vs. 16.2 years(95% CI: 15.7±16.7 years)] and liver cancer [15.5 years(95% CI: 15.0±16.0 years) vs. 14.7 years(95% CI: 14.0±15.5 years)]. Females residing in the least disadvantaged areas with thyroid cancer [0.9 years(95% CI: 0.4±1.4 years) vs. 0.6 years(95% CI: 0.2±1.0 years)] or melanoma [0.9 years(95% CI: 0.8±1.1 years) vs. 0.7 years(95% CI: 0.5±0.8 years)] had the lowest average LOLE.Conclusions: Patients from the most disadvantaged areas had the highest LOLE with SES-based differences greatest for patients diagnosed with cancer at an early stage or cancers with higher survival rates, suggesting the need to prioritise early detection and reduce treatment-related barriers and survivorship challenges to improve life expectancy.