Physicians’ Use of Patients’ Daily Reports of Quality of Life to Evaluate Treatment Response in Phase I Cancer Trials

For cancer patients on Phase I trials, one of the most important physician decisions is whether or not patients are deriving benefit from therapy. With an increasing number of cytostatic treatment agents, the criteria to determine patient response to Phase I treatment has become harder to define. Physicians are increasingly looking to patient-reported outcomes (PROs) such as quality of life (QOL) to help evaluate treatment response. Electronic daily diary (EDD) devices can be used by patients to report their QOL over extended periods of time, thereby providing a more accurate picture of how patients are affected by treatment on a daily basis. However, questions remain about how to integrate this patient-reported information into decisions about Phase I treatment. This study investigated how physicians use patients’ daily QOL reports to evaluate patient response to Phase I treatment. Data were collected over a 4-month period from Phase I patients (N = 30) and physicians (N = 3) in an NCI-designated comprehensive cancer center. Patients completed daily QOL reports using EDD devices and physicians were provided with a summary of patients’ QOL before each visit. After the visit, doctors recorded their treatment decision and also rated the importance of four biomedical factors (Toxicity, Imaging, Labs, and Performance Status) and QOL in their treatment decision for that visit. Although physicians rated QOL as being very important in evaluating treatment response, in practice, when predictors of their decisions were analyzed, results showed they relied exclusively on biomedical data (Toxicity, Imaging) to make Phase I treatment decisions. Questions remain about the utility and effective integration of QOL and biomedical data in clinical decision-making processes in Phase I clinical trials.

Glycaemic control, treatment satisfaction and quality of life in type 2 diabetes patients in Greece: The PANORAMA study Greek results

AIM: To provide an update on glycaemic control inEuropean patients with type 2 diabetes mellitus(T2DM). We present the Greek population data of the study. METHODS: An observational multicenter, cross-sectional study evaluating glycaemic control and a range of other clinical and biological measures as well as quality of life(Qo L) and treatment satisfaction in 375 patients with T2 DM enrolled by 25 primary care sites from Greece. RESULTS: The mean age of the patients was 63.5 years and the male/female ratio 48.9%/51.1%. 79.7% of the patients exerted none or light physical activity, 82.4% were overweight or obese and 32.9% did not meet Hb A1 c target of less than 7.0%(53 mmol/mol). Patients reported high satisfaction to continue with treatment, high satisfaction with administered treatment and increased willingness to recommend treatment to others(mean Diabetes Treatment Satisfaction Questionnaire score 29.1 ± 5.6). However, 80% of the patients reported that their Qo L would be better without diabetes. Finally, the most challenging parameter reported was the lack of freedom to eat and drink. CONCLUSION: This analysis of the Greek Panorama study results showed that a considerable percentage of T2 DM patients in Greece do not achieve glycaemic target levels, despite the favourably reported patient satisfaction from administered therapy. Additionally, the majority of primary care T2 DM patients in Greece depict the negative effect of the disease in their Qo L.

Critical care nurses＇ attitude towards life-sustaining treatments in South East Iran

BACKGROUND:Life-sustaining treatments(LSTs)may prolong life but greatly decrease the quality of death.One factor influencing decision-making about withholding and withdrawing these treatments is the attitude of nurses.This study aimed to evaluate the attitude of critical care nurses towards life-sustaining treatments in South East Iran.METHODS:In this cross-sectional study,"Ethnicity and Attitudes towards Advance Care Directives Questionnaire"was used to investigate the attitude of 104 critical care nurses towards lifesustaining treatments in three hospitals affiliated to Kerman University of Medical Sciences.RESULTS:The findings of this study indicated that although a majority of critical care nurses(77%)did not have personal desire for use of LSTs including CPR and mechanical ventilation,they had moderately negative to neutral attitude towards general use of LSTs(2.95 of 5).CONCLUSIONS:These findings suggest that nurses'attitude towards LSTs can be changed by inclusion of specific courses about death,palliative care and life-sustaining treatments in undergraduate and postgraduate nursing curricula.Educating Muslim nurses about religious aspects of LSTs may also improve their attitudes.

End-of-life vehicles processing,towards a thermal treatment of auto shredder residue

All over the world,the management of End-of-life Vehicles(ELV) and Automobile Shredder Residue(ASR) is an increasing issue for the car industry.The setting up of several environmental directives,among others the notion of extended producer responsibility,encourage car manufacturers to find alternatives solutions to waste disposal.For 2017,China aims for the recyclability and energy recovery of 95% of total weight of used cars,and in order to reach this rate,the development of some ASR thermal processes could be envisaged.With this research,an overview of ELV management was given and the different solutions about ASR thermal treatment were presented.It is showed that in spite of its big heterogeneity,the high heating value of ASR makes pyrolysis and gasification very interesting,compared to incineration or disposal of in landfills.

A Review of Systemic Lupus Erythematosus (SLE): Symptoms, Risk Factors, Treatment, and Health Related Quality of Life Issues

In this paper, we present a thorough review of one of the most life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.

The Influence of Integrated Chinese and Western Medicine Treatment on the Quality of Life and Laboratory Indicators of Patients with Novel Coronavirus Pneumonia

Objective: To investigate the influence of integrated Chinese and Western medicine treatment on the quality of life and laboratory indicators of patients with novel coronavirus pneumonia (COVID-19). Methods: A prospective, self-controlled study was conducted to analyze the changes in corresponding laboratory indicators and quality of life in 75 confirmed COVID-19 patients treated with integrated Chinese and Western medicine in our hospital during the early stage, middle stage, recovery period, and two weeks after discharge. The effectiveness and safety of the treatment regimen were evaluated in conjunction with the time for 2019-nCoV nucleic acid conversion, disease progression, and adverse reactions. Results: The PLT levels in the initial stage were significantly lower than those in the recovery period in 75 patients. The CRP levels in the initial stage were significantly lower than those after discharge for 2 weeks. The TBIL, IBTL, and DHIL levels in the initial stage were significantly lower than those in the middle stage. The K+ levels in the initial stage were significantly lower than those in the recovery period and after discharge for 2 weeks. The LYMGH levels in the initial stage were significantly lower than those in the recovery period and after discharge for 2 weeks. The TP and ALB levels in the initial stage were higher than those in the middle stage and the recovery period. The LDH levels, scores of daily activity limitation, scores of respiratory distress symptoms, scores of psychological emotions, CT imaging scores, and positive rate of nucleic acid were significantly lower than those in the recovery period and after discharge for 2 weeks. The AG, CK, CK-MB, and α-HBDH levels in the initial stage were significantly higher than those in the recovery period. However, the AMY level in the initial stage was significantly lower than that in the recovery period and after discharge for 2 weeks (p Conclusion: Integrated Chinese and Western medicine treatment has a significant impact on laboratory indicators such as PLT, LYMGH, CRP, TBIL, IBTL, DHIL, TP, ALB, K+, AG, LDH, CK, CK-MB, α-HBDH, AMY, CT imaging, and 2019-nCoV nucleic acid in COVID-19 patients. It has good clinical efficacy and safety, and can improve the quality of life of patients.

The quality of life follow-up of 6 months for the patients with intratracheal tumor accepted microwave treatment under fibrobronchoscope

Objective To research treatment effect of microwave heat coagulation assisted laser and local chemotherapy under fibrobron-choscope for the acute respiratory d istress from intratracheal tumor or metastasis neoplasia,and assess qu ality of life after treatment.Method In the emergency,applied microwave histological coagulation treatmen t under fibrobronchoscope to 2patie nts of acute respiratory distress,e ven asphyxia from intratracheal tumor o r metastasis tumor.Removed the mass,and assisted laser and local chemotherapy necessarily to relieve res-piratory distress.Observed quality of life.Results The intratracheal mass of 2patients were eliminated completely,distre ss and asphyxia were relieved and there were no severe sid e effects.The patients lived over 6months,completed self-care,and joined the light physical strength labo r.The muscle power also reachⅣlevel fromⅠlevel.Conclusion The treatment of microwave histolog ical coagulation assisted laser and local chemotherapy is one good method to re lieve the respiratory distress or asphyxia from late intratracheal tumo r or transmission tumor,and promote quality of life obviously.

基于德尔菲法构建的急诊临床护理路径在急性心肌梗死患者中的应用效果

目的:观察基于德尔菲法构建的急诊临床护理路径在急性心肌梗死患者中的应用效果。方法:回顾性分析2021年1月至2023年4月该院收治的90例急性心肌梗死患者的临床资料,按照护理方法不同将其分为对照组和观察组各45例。对照组实施常规护理,观察组实施基于德尔菲法构建的急诊临床护理路径。比较两组急救相关指标(急救时间、心肌再灌注时间、疼痛缓解时间)水平、并发症发生率、生命质量[生活质量综合评定问卷-74(GQOLI-74)]评分和急救满意度。结果:观察组急救时间、心肌再灌注时间、疼痛缓解时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.22%(1/45),低于对照组的17.78%(8/45),差异有统计学意义(P<0.05);观察组躯体功能、心理功能、社会功能、物质生活状态等GQOLI-74各维度评分均高于对照组,差异有统计学意义(P<0.05);观察组急救满意度为95.56%(43/45),高于对照组的77.78%(35/45),差异有统计学意义(P<0.05)。结论:基于德尔菲法构建的急诊临床护理路径应用于急性心肌梗死患者可改善急救相关指标水平,降低并发症发生率,提高生命质量评分和急救满意度,效果优于常规护理。

基于激光表面处理技术的轴承表面性能提高研究现状

真空镀膜设备轴承在工作过程中受交变载荷及循环应力作用,工作面易出现点蚀和剥落等缺陷,导致轴承疲劳失效。通过激光表面处理技术对其工作面进行处理,可以提高轴承工作面的硬度和耐磨性等表面性能,也可以改变轴承工作面的润滑状态,降低轴承磨损,提高轴承使用寿命。为厘清激光表面处理技术在轴承中的应用现状,首先分析了激光熔覆、激光冲击强化、激光淬火和激光表面织构技术原理;然后,阐述了工艺参数,如激光功率、激光扫描速度等对改性层形貌特征、微观组织结构和表面性能的影响;其次,分析了以上技术在轴承领域应用的优缺点,并探讨了激光表面改性过程中需要解决的理论问题和技术瓶颈;最后,对激光表面处理技术在轴承领域的发展进行了展望。激光表面处理技术在提高轴承表面性能方面具有较好的工程应用前景。

椎体强化术治疗超高龄骨质疏松性椎体压缩骨折病人的生存质量分析

目的分析椎体强化术治疗超高龄骨质疏松性椎体压缩骨折(OVCFs)病人的生存质量,探讨影响超高龄OVCFs病人生存质量的相关因素。方法回顾性分析2022年1月至2023年3月在西南医科大学附属医院接受椎体强化术治疗或保守治疗的47例超高龄OVCFs病人的临床资料,根据治疗方式分为手术组(30例,接受椎体强化术治疗)和对照组(17例,接受保守治疗)。比较两组病人的基线资料,记录并比较治疗前、治疗后1周、3个月及末次随访的腰背部疼痛视觉模拟量表(VAS)评分,治疗前和治疗后12个月骨密度T值,治疗前和末次随访时世界卫生组织生存质量测定量表简表(WHOQOL⁃BREF)得分。利用线性相关分析法分析两组病人末次随访时WHOQOL⁃BREF量表得分与病人基线资料的相关性。结果47例病人均完成随访,随访时间12~18个月,无失访、死亡等情况。手术组出现骨水泥轻微渗漏1例,随访期间病人未出现不适;对照组发生骶尾部压疮2例、尿路感染2例,肺部感染1例,予以对症治疗后症状均缓解。两组病人治疗后VAS评分、治疗后12个月骨密度T值和末次随访WHO⁃QOL⁃BREF量表得分均较治疗前好转(P<0.05);与对照组相比,手术组VAS评分显著降低、WHOQOL⁃BREF量表总分显著升高,差异有统计学意义(P<0.05);两组治疗后12个月的骨密度T值比较,差异无统计学意义(P>0.05)。相关性分析显示在两组中,年龄、骨折椎体数量、治疗前VAS评分与末次随访WHOQOL⁃BREF量表得分呈负相关,骨密度T值、治疗前WHOQOL⁃BREF量表得分与末次随访WHO⁃QOL⁃BREF量表得分呈正相关。结论椎体强化术和保守治疗均能有效提高超高龄OVCFs病人的生存质量,但椎体强化术能更明显地提高病人生存质量,同时还能快速缓解超高龄OVCFs病人疼痛症状。病人的年龄、骨质状况、骨折椎体数量、伤后VAS评分及治疗前的生存质量是影响病人治疗后生存质量恢复情况的重要因素。

就医选择对老年人自评健康和生活满意度影响研究

研究不同就医选择对老年人健康状况和生活满意度的影响,为改善老年人健康状况提供依据。本文基于中国老龄社会追踪调查(简称CLASS)2018年的调查数据,利用Ordered logistic回归分析,探讨不同就医选择对老年人健康状况的影响。调查结果显示,老年人在患病时选择去社区医院就医和进行药物治疗的人数较多,选择综合医院就医的人数较少。非农业户口、已婚有配偶、汉族、患有高血压、心脏病、糖尿病、关节炎、使用互联网、受教育程度越高、年收入越高的老年人自评健康和生活满意度更好。不同医疗选择的老年人自评健康和生活满意度存在差异,应引导选择更合适的就医方式,以提高老年人的健康水平和生活满意度。

Quality of life and management project for patients with advanced lung cancer

Compared with best supportive care,chemotherapy can prolong survival a nd improve quality of life,and symptoms associated with society activities and disease.Chemotherapy can improve quality of life of patients with effective treatme nt and stable treatment.Treatment benefit was often underestimated using clin ical relief rate,so which should not chosen as index for evaluating effec t of palliative treatment.So for pat ients with poor status ,and objective of re lieving symptoms,short term,low-d ose chemotherapy should be suggeste d due to its characteristic of low cost,short inhospitalization time,and f avorable improvement of quality of l ife.For patients with good conditio n in limited advanced stage,radical treatment is objective,and hence single chemotherapy of standard dose o r chemotherapy combining radiotherapy should be suggested.

STUDY ON OPTIMUM OF LASER-SHOCKING PARAMETERS FOR IMPROVING FATIGUE LIFE OF AIRCRAFT ALUMINUM ALLOY

The aircraft aluminum 2024-T62 is shock-treated by pulsed laser with the same wavelength and different pulse durations. The laser parameters, arrangements of laser optics and strengthening effects are investigated. The optimal laser-shocking parameters, i.e., a pulse durotion (FWHM) of 30ns, shot spot 7 to 10mm in diameter and pulse energy of 15-20J are obtained under the condition that the Q modulation crystal is KD*P and the laser optical system has three amplification stages. Therefore, the fatigue life of aluminum specimens is increased greatly and the maximum increasement is 23. 7 times.

Diagnosis and Treatment of Swine Toxoplasmosis

Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii, which mainly affects pigs, cattle, sheep, rabbits and other animals. In addition, human beings are also susceptible to Toxoplasma gondii. Because Toxoplasma gondii infections are widely prevalent in human beings and other animals, we should pay more attention to prevention and control of the disease in order to promote the healthy development of breeding industry and the protection of people＇s health. In the present article, the pathogen of swine toxoplasmosis, life history, clinical features and treatment are elaborated.

A Concept Analysis of Decision-Making by Families in Critical Life Situations

Background: In 2017, the elderly made up 27.3% of Japan’s population, accounting for 57.2% of all ambulance trips. When an elderly person is in a critical life situation, it is difficult to ascertain their decisions about treatment choices, and for family members who become surrogate decision-makers, this is a grave responsibility. Aim: This study aimed to shed light on the constructs that support decision-making by family members and medical staff in critical situations, and to investigate decision-making by families of the elderly in critical situations. Method: We selected 29 papers published in Japan and elsewhere that focused on families involved in treatment decisions in critical life situations and analyzed them using Rodgers’ concept analysis approach. Results: From 475 codes, we extracted six attributes, four antecedents, and four consequences. The unusual setting of the “critical care unit”, lack of time, and unstable psychological state are all considered by family members making treatment decisions, along with the patient’s prognosis, their relationship with the patient, conjecture about the patient’s wishes, and taking other family member’s views into account. Medical staff supports the family throughout the process, through provision of treatment, preparing family members to face reality, empathizing with the difficulty of decision-making, building relationships with family members, monitoring the decision-making process, and being attentive to family members’ feelings until the end. Conclusion: Our results indicate the importance of advance confirmation of patients’ wishes, and the role played by cultural context and family relations in decision-making by family members of the elderly.

Quality of life in glaucoma patients after selective laser trabeculoplasty

AIM：To compare quality of life and treatment satisfaction between patients who had selective laser trabeculoplasty（SLT） and those on medication.METHODS：A prospective clinical trial on 143 glaucoma patients that received SLT and a control group that continued using anti glaucoma medication was conducted. Tear break-up time（BUT）, punctuate keratitis, need for help, use of artificial tears and the treatment satisfaction survey of intraocular pressure（IOP） were measured at baseline, 6 and 12 mo. RESULTS：SLT was able to reduce the mean number of medications needed from 1.56±0.81 to 0.42±0.66 at six months and to 0.33±0.69 at one year. Punctuate keratitis was observed significantly less often（12.24%） after SLT than before（35.94%; P=0.03）. Use of artificial tears and BUT did not change significantly after SLT（P〉0.05）. At baseline, patients in the SLT group were significantly less convinced of medication effectiveness（P=0.006） and complained more about side effects（P=0.003）. After SLT, these patients had significantly more confidence in their therapy（P〈0.001）, showed less side effects（P=0.006）, complained less about changes in appearance of the eyes（P=0.003） and were less inconvenienced by the use of eye drops（P〈0.001）.CONCLUSION：SLT is able to improve treatment-related quality of life in glaucoma patients.

口腔根管治疗在牙周病患者中的应用效果及对预后的影响研究

目的观察口腔根管治疗在牙周病患者中的应用效果及对预后的影响。方法选取2023年2月至2024年1月本院收治的80例牙周病患者,根据就诊顺序进行分组,序号为单数的40例为观察组,双数的40例为对照组。对照组行牙周基础治疗,观察组在对照组的基础上实施口腔根管治疗。比较两组治疗效果、牙周健康状况、咀嚼功能、牙齿美观度、生活质量及治疗期间并发症发生率。结果观察组治疗总有效率高于对照组(P<0.05);两组治疗前牙周健康状况指标、咀嚼功能、牙齿美观度及生活质量指标得分比较无统计学意义(P>0.05);观察组治疗后牙周健康状况各指标得分均低于对照组,咀嚼功能、牙齿美观度及生活质量各指标得分高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论口腔根管治疗可有效改善牙周病患者的牙周健康状况,并提升治疗效果,纠正牙齿美观度,降低并发症,促进咀嚼功能和生活质量的恢复。

Effect of heat treatment of titanium substrates on the properties of IrO_2-Ta_2O_5 coated anodes

The Ti substrates of IrO 2 -Ta 2 O 5 coated anodes were treated by solid-solution and aging, stress relieving annealing, and recrystallization annealing, and the coatings were prepared by thermal decomposition of a mixture of H 2 IrCl 6 ·6H 2 O dissolved in hydrochloric acid and TaCl 5 dissolved in alcohol. Scanning electron microscopy （SEM）, cyclic voltammetry （CV）, electrochemical impedance spectroscopy （EIS）, and accelerated life test （ALT） were employed to study the microstructure and electrochemical properties of the anodes. Compared with the anode without heat treatment, the anodes with heat treatment are of higher electrochemical activity and longer accelerated life; especially, the anode with recrystallization annealing treatment has the best electrochemical properties and the longest accelerated life.

Body mass index trends and quality of life from breast cancer diagnosis through seven years’ survivorship

BACKGROUNDWeight gain is a potential negative outcome of breast-cancer treatment,occurringin 50%-to-96%of breast-cancer patients,although the amount of weight gain isinconsistently reported in the literature.Research has also shown a relationshipbetween overweight/obesity and breast-cancer mortality.Correspondingly,weight management is a self-care approach known to benefit quality of life(QOL).These research questions and analysis add to existing literature byexamining participants’body mass index(BMI)trend and its relationship withQOL indicators over seven years.AIMTo examine:(1)BMI trends among breast cancer survivors;and(2)The trends’relationship to QOL indicators over seven years.METHODSDuring the Breast Cancer and Lymphedema Project,378 patients’weight andheight were recorded by nurses prior to or just after beginning breast cancertreatment and repeated at quarterly-to-semiannual intervals over seven years.Additionally,participants annually completed the 36-Item Short Form HealthSurvey(SF-36),a valid and reliable tool assessing QOL and health concepts,including physical function,pain,and emotional well-being.BMI trends,changein BMI,and change in SF-36 subscales over seven years were calculated using arandom-intercept repeated-measures regression.Patients were placed into BMIcategories at each time point:Normal,Overweight and Obese.As patients’weights changed,they were categorized accordingly.RESULTSDuring the seven-year study and while controlling for age and residence,participants gained an average of 0.3534 kg/m^2(P=0.0009).This amountremained fairly consistent across BMI categories with those in the normal-weight category(n=134)gaining 0.4546 kg/m^2(P=0.0003);Overweight(n=190)gaining 0.2985 kg/m^2(P=0.0123);and obese(n=199)gaining 0.3147 kg/m^2,(P=0.0649).Age(under or over 55)and region(metro/micro vs small/rural)weresignificantly associated with BMI increase in both the normal and obesecategories.There were statistically significant(P<0.0100)changes in five of theeight SF-36 domains;however,the directions of change were different andsomewhat divergent from that hypothesized.Controlling for age and region,these five were statistically significant,so there were no change or differencesbetween the micropolitan/metropolitan and small town/rural groups.CONCLUSIONAlthough only modest increases in mean BMI were observed,mean BMI changewas associated with selected QOL indicators,suggesting the continued need forself-care emphasis during breast cancer survivorship.