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.

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.

Investigating the Influence of Glaucoma on the Quality of Life among Adult Patients

Background: Research exploring the influence of glaucoma on quality of life has gained momentum in recent years. Numerous studies have investigated the multifaceted aspects of quality of life in glaucoma patients, utilizing various assessment tools and methodologies. Objective: To determine the influence that glaucoma has on the quality of life among adult patients. Study site: kitwe teaching eye hospital, Zambia. Method: It was a cross-sectional study that was conducted from 30th June 2022 to 17th April 2023. The study included 106 diagnosed glaucoma patients who were above the age of 55 years. Data was collected using validated 25-item national eye institute visual function Questionnaire (NEI VFQ-25). The data was analyzed using SPSS version 26 and Microsoft excel to present frequencies and percentages that generated graphical presentation. Results: 62% of the participants worry about their eye sight most of the time, 26% sometimes and 12% a little time. 9% of the participants had little difficulty to read ordinary prints, 14% moderate difficulties and 58% extremely difficult. 40% of the participants could drive despite glaucoma damaging their eyes while 60% could not. Majority of the patients said it was difficult noticing things around them while walking or sitted in one place. There was a significant difference between effects of glaucoma on patients and the existing relationship between glaucoma and quality of life (ANOVA, p = 0.019 and ANOVA, p = 0.023). Conclusion: This study has demonstrated the magnitude of impact that glaucoma has on the Quality of Life (QoL) in diagnosed patients and the relationship between glaucoma and the Quality of Life. Due to the progressive visual loss, the amount of activities these patients would perform is negatively affected especially where social and economic activities are concerned which also affects their monthly earnings for those living in middle to low-income countries. Therefore, social welfare and psycho-social institutions need to increase their support for these glaucoma patients.

Life Review the Impact of Combined Watson Care Theory Intervention on Psychological Status and Quality of Life in Patients with Terminal Lung Cancer

Objective: To analyze the impact of combined Watson care theory intervention on the psychological state and quality of life in patients with terminal lung cancer. Methods: 72 patients with terminal lung cancer admitted from March 2021 to January 2024 were selected, which were divided into research group (life review combined with Watson care theory intervention) and control group (conventional intervention), with 36 cases each. Compare the nursing effect between the two groups. Results: The anxiety self-rating scale (SAS) and depression self-rating scale (SDS) scores were significantly lower than those of the control group, and the quality of life score was significantly higher than that of the control group (P < 0.05). Conclusion: Life review combined with Watson care theory intervention can improve the psychological state and improve the quality of life of patients with terminal lung cancer.

Quality-adjusted life years and surgical waiting list:Systematic review of the literature

BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures.Surgical waiting lists(SWLs)represent a pressing problem in public healthcare.The QALY measure has rarely been used in the context of surgery.It would be interesting to know how many QALYs are lost by patients on SWLs.AIM To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.An unlimited search was carried out in PubMed,updated on January 19,2024.Data on the following variables were investigated and analyzed:Specialty,country of study,procedure under study,scale used to measure QALYs,the use of a theoretical or real-life model,objectives of the study and items measured,the economic value assigned to the QALY in the country in question,and the results and conclusions published.RESULTS Forty-eight articles were selected for the study.No data were found regarding QALYs lost on SWLs.The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery,with 15 articles each.The country in which the most studies of QALYs were carried out was the United States(n=21),followed by the United Kingdom(n=9)and Canada(n=7).The most studied procedure was organ transplantation(n=39),including 15 kidney,14 liver,5 heart,4 lung,and 1 intestinal.Arthroplasty(n=4),cataract surgery(n=2),bariatric surgery(n=1),mosaicplasty(n=1),and septoplasty(n=1)completed the surgical interventions included.Thirty-nine of the models used were theoretical(the most frequently applied being the Markov model,n=34),and nine were real-life.The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions,but in 32 articles the survey was not specified.The willingness-to-pay per QALY gained ranged from$100000 in the United States to€20000 in Spain.CONCLUSION The relationship between QALYs and SWLs has only rarely been studied in the literature.The rate of QALYs lost on SWLs has not been determined.Future research is warranted to address this issue.

Correlation of personality with individual reproductive success in shrub-nesting birds depends on their life history style

Two questions in the research of animal personality—whether there is a correlation between a personality trait and individual reproductive success,and what is the genetic basis underlying a personality trait—remain unresolved.We addressed these two questions in three shrub-nesting birds,the Azure-winged Magpie(Cyanopica cyanus,AM),White-collared Blackbird(Turdus albocinctus,WB),and Brown-cheeked Laughingthrush(Trochalopteron henrici,BL).The personality type of an individual was first identified according to its response to a territorial intruder.Then,we compared the fleeing distance,breeding parameters,and differential expressed genes(DEGs) in the brain transcriptome between bold and shy breeders.In the three species,bold breeders exhibited more aggressiveness towards an intruder of their territory than did shy breeders.The reproductive success of bold breeders was significantly higher than that of shy breeders in AM but not in WB and BL.The three species shared one DEG,crabp1,which was up-regulated in bold relative to in shy individuals.By regulating the expression of corticotropin-releasing hormone,higher crabp1 gene expression can decrease cellular response to retinoic acid.Therefore,bold individuals are insensitive to external stresses and able to exhibit more aggressiveness to intruders than their shier counterparts.Aggressiveness is beneficial to bold individuals in AM but not in WB and BL because the former could evoke neighbors to make the same response of defending against intruders but the latter could not.Although a personality trait may have the same genetic basis across species,its correlation with reproductive success depends largely on the life history style of a species.

The impact of foliar application of calcium nitrate fertilizer on the yield,quality,and post harvest life of two varieties of roses(Rosa hybrida L.)in a soilless cultivation system

【Objectives】Rose(Rosa hybrida L.)is a beautiful and widely cultivated flowering plant around the world whose quality is of great commercial importance.The objective of this study was to investigate the impact of foliar application of calcium nitrate on the quality and postharvest life of two rose varieties(cvs.Samurai,and Jumilia)in a soilless culture system.【Methods】The research used a hydroponic culture method,the roses plants were grown in Hoagland nutrient solution containing 50%less Ca for a total span of 4 months.One month was dedicated to plant acclimatization,and 3 months for spray treatment.Two rose varieties(Rosa hybrida L.),cvs.Samurai and Jumilia plants were used as test materials and planted in pots containing 100%perlite(3-5 mm).After one month of culture,160 mg/kg CaNO3 solution was sprayed,and each treatment corresponded to the first,second,and third harvests,respectively.The plant and flower growth indicators and flower vase life were investigated after each harvesting immediately.【Results】A positive impact of foliar-applied Ca on stem characteristics,pedicel dimensions,corolla size,flower attributes,and vase life was found.Furthermore,a general trend was observed,wherein an increase in the number of harvesting stages led to improved traits.Notably,Jumilia rose consistently exhibited lower values for all studied traits,except for flower vase life,in comparison to the Samurai rose.While there were no significant differences in length values between Samurai and Jumilia roses due to calcium foliar application across the three harvesting stages.Duncan’s grouping revealed a specific effect on Jumilia roses during the third harvest stage.Calcium fertilizer significantly increased photosynthesis rates of of rose leaves in the calcium treatments compared with the control treatment.【Conclusions】Foliar spraying of calcium nitrate is an effective measure to promote the growth of roses and improve the yield,quality and bottle life of fresh cut flowers.

Investigation into the Methodology and Implementation of Life Cycle Engineering under China’s Carbon Reduction Target in the Process Industry

The industrial sector is the primary source of carbon emissions in China.In pursuit of meeting its carbon reduction targets,China aims to promote resource consumption sustainability,reduce energy consumption,and achieve carbon neutrality within its processing industries.An effective strategy to promote energy savings and carbon reduction throughout the life cycle of materials is by applying life cycle engineering technology.This strategy aims to attain an optimal solution for material performance,resource consumption,and environmental impact.In this study,five types of technologies were considered:raw material replacement,process reengineering,fuel replacement,energy recycling and reutilization,and material recycling and reutilization.The meaning,methodology,and development status of life cycle engineering technology abroad and domestically are discussed in detail.A multidimensional analysis of ecological design was conducted from the perspectives of resource and energy consumption,carbon emissions,product performance,and recycling of secondary resources in a manufacturing process.This coupled with an integrated method to analyze carbon emissions in the entire life cycle of a material process industry was applied to the nonferrous industry,as an example.The results provide effective ideas and solutions for achieving low or zero carbon emission production in the Chinese industry as recycled aluminum and primary aluminum based on advanced technologies had reduced resource consumption and emissions as compared to primary aluminum production.

Mediating Effect of Mindfulness,Self-Esteem and Psychological Resilience in the Relation between Childhood Maltreatment and Life Satisfaction

Childhood maltreatment,as a typical early adverse environment,is known to have a negative impact on one’s life satisfaction.Mindfulness,on the other hand,may serve as a protective factor.This study explored the mediating role of mindfulness and its related variables–positive thoughts,psychological resilience and self-esteem.In order to testify the mechanism,we administered Childhood Trauma Questionnaire(CTQ),Satisfaction with Life Scale(SWLS),Mindful Attention Awareness Scale(MAAS),Connor–Davidson Resilience Scale(CD-RISC)and Rosenberg Self-Esteem Scale(RSES)to a non-clinical sample of Chinese university students(N=1021).The results indicated that positive thoughts did not mediate the relationship between childhood maltreatment and life satisfaction,but self-esteem(β=−0.194,95%CI=[−0.090,−0.040])and psychological resilience(β=−0.063,95%CI=[−0.059,−0.020])mediated the relationship,as well as the“mindfulness-selfesteem”(β=−0.061,95%CI=[−0.287,−0.126])and“mindfulness-psychological resilience”(β=−0.035,95%CI=[−0.115,−0.034]).The results of this study were helpful to understand the relationship between childhood maltreatment and life satisfaction and provided a theoretical basis for the development of mindfulness intervention programs from the perspective of positive psychology.

Multi-Objective Optimization of the Ultrasonic Scalpel Rod and Tip with Improved Performance:Vibration Frequency,Amplitude,and Service Life

Ultrasonic scalpel design for minimally invasive surgical procedures is mainly focused on optimizing cutting performance.However,an important issue is the low fatigue life of traditional ultrasonic scalpels,which affects their long-term reliability and effectiveness and creates hidden dangers for surgery.In this study,a multi-objective optimal design for the cutting performance and fatigue life of ultrasonic scalpels was proposed using finite element analysis and fatigue simulation.The optimal design parameters of resonance frequency and amplitude were determined.By setting the transition fillet and keeping the gain structure away from the node position to enable the scalpel to have a high service life with excellent cutting performance.The frequency modulation method of setting the vibration node bosses at the node position and setting the vibration antinode grooves at the antinode position was compared.Then,the mechanism of the influence of various design elements,such as tip,shank,node position,and antinode position,on the resonance frequency,amplitude,and fatigue life of the ultrasonic scalpel was analyzed,and the optimal design principles of the ultrasonic scalpel were obtained.The proposed ultrasonic scalpel design was confirmed by simulations,impedance measurements,and liver tissue cutting experiments,demonstrating its feasibility and enhanced performance.This research introduces innovative design strategies to improve the fatigue life and performance of ultrasonic scalpels to address an important issue in minimally invasive surgery.

Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Growth of RB Population in the Conversion Phase of Chlamydia Life Cycle

Upon infecting a host cell,the reticulate body(RB)form of the Chlamydia bacteria simply proliferates by binary fission for an extended period.Available data show only RB units in the infected cells 20 hours post infection(hpi),spanning nearly half way through the development cycle.With data collected every 4 hpi,conversion to the elementary body(EB)form begins abruptly at a rapid rate sometime around 24 hpi.By modeling proliferation and conversion as simple birth and death processes,it has been shown that the optimal strategy for maximizing the total(mean)EB population at host cell lysis time is a bang-bang control qualitatively replicating the observed conversion activities.However,the simple birth and death model for the RB proliferation and conversion to EB deviates in a significant way from the available data on the evolution of the RB population after the onset of RB-to-EB conversion.By working with a more refined model that takes into account a small size threshold eligibility requirement for conversion noted in the available data,we succeed in removing the deficiency of the previous models on the evolution of the RB population without affecting the optimal bang-bang conversion strategy.

Development, Translation and Validation of the Circle of Life (CoL) Satisfaction Scale Assessment Tool: An Integrative Nutrition Approach

Objectives: This study was designed to validate, test and translate a newly developed assessment tool for health coaches to assess client’s satisfaction rates of the Circle of Life (CoL), as a guide for weight management and also to monitor clients’ health and wellbeing improvements. This includes development of the assessment content, content validity, translating and pretesting the tool among potential clients. Method: 18 participants enrolled in a telenutrition weight loss program was and received a hypocaloric diet that was supported with monthly telemonitoring and health coaching sessions remotely for 6 months. Thus, we developed content of the assessment tool and created a rating scale of three levels of satisfaction (completely satisfied, slightly satisfied and not satisfied). The process of validation included content and language validity by experts in the field and language. Results: High scores according to the content validity rating were seen on both English and language versions of the CoL assessment tool by experts. Followed by a pre-testing process by participants, which showed reliability and consistency of the (CoL) variables using a multilevel analysis seeks across all individuals and all individuals had similar correlational pattern. Conclusions: The new (CoL) satisfaction scale have demonstrated a good capacity for identifying lifestyle factors associated with participants weight, which is a useful tool for integrative nutrition practice in weight management interventions. Future studies must be directed towards using the tool in assessing different populations and cultures to understand the main root of obesity in relation to behavior and day to day life factors.

Extraterrestrial Life in the Thermosphere: Plasmas, UAP, Pre-Life, Fourth State of Matter

“Plasmas” up to a kilometer in size and behaving similarly to multicellular organisms have been filmed on 10 separate NASA space shuttle missions, over 200 miles above Earth within the thermosphere. These self-illuminated “plasmas” are attracted to and may “feed on” electromagnetic radiation. They have different morphologies: 1) cone, 2) cloud, 3) donut, 4) spherical-cylindrical;and have been filmed flying towards and descending from the thermosphere into thunderstorms;congregating by the hundreds and interacting with satellites generating electromagnetic activity;approaching the Space Shuttles. Computerized analysis of flight path trajectories documents these plasmas travel at different velocities from different directions and change their angle of trajectory making 45°, 90°, and 180° shifts and follow each other. They’ve been filmed accelerating, slowing down, stopping, congregating, engaging in “hunter-predatory” behavior and intersecting plasmas leaving a plasma dust trail in their wake. Similar life-like behaviors have been demonstrated by plasmas created experimentally. “Plasmas” may have been photographed in the 1940s by WWII pilots (identified as “Foo fighters”);repeatedly observed and filmed by astronauts and military pilots and classified as Unidentified Aerial—Anomalous Phenomenon. Plasmas are not biological but may represent a form of pre-life that via the incorporation of elements common in space, could result in the synthesis of RNA. Plasmas constitute a fourth state of matter, are attracted to electromagnetic activity, and when observed in the lower atmosphere likely account for many of the UFO-UAP sightings over the centuries.

The Correlation between Psychological Resilience and Professional Quality of Life in Saudi Psychiatric Nurses:A Cross-Sectional Study

In recent years,significant focus has been placed on resilience,with ongoing studies aiming to identify strategies for reducing the negative effects of job stress and protecting nurses from negative psychosocial outcomes.Nevertheless,as far as this topic is concerned,no research has yet been conducted in the context of Saudi psychiatric nurses.The aim of this research,therefore,is to determine how Saudi Arabian psychiatric nurses’professional quality of life and psychological resilience relate to one another.To this aim,a cross-sectional study has been performed in Saudi Arabia incorporating a population of 167(a 66.4%response rate)mental health nurses taken from the largest psychiatric hospital in the capital city Riyadh.Data collection was performed using the popular Arabic version of the Connor–Davidson Resilience and the Arabic version of the Professional Quality of Life Scales.To assess the variables related to both Professional Quality of Life and psychological resilience levels,statistical analyses such as Pearson correlation,ANOVA,t-tests,and linear regression were utilized.The findings show compassion satisfaction and burnout to have a moderate inverse relationship(r=−0.502),while compassion satisfaction(CS)and resilience have a moderate positive correlation(r=0.594).Compared to their morning-shift counterparts,nurses working night shifts reported higher mean scores for resilience(72.70),CS(40.20),burnout(24.52),and compassion fatigue(CF)(28.11).Participants with less than five years’experience in a psychiatric clinic had the highest mean resilience score(72.96).Finally,a positive relationship between resilience and compassion satisfaction(CS)was revealed using linear regression analysis(β=0.536,t=7.080,p=0.000).The study reveals significant differences in the scores assigned to resilience and work-life quality based on educational qualifications,shift-work type,and experiences.Burnout and compassion satisfaction(CS)are found to be significantly correlated,as are compassion satisfaction(CS)and resilience,and burnout and compassion fatigue(CF).

Impact of the Rapid Recovery Concept on Complications and Patient Quality of Life in the Perioperative Nursing of Robot-Assisted Radical Oesophageal Cancer

Aim: This study evaluates the impact of Enhanced Recovery After Surgery (ERAS) nursing on postoperative complications and quality of life in patients undergoing robot-assisted minimally invasive esophagectomy (RAMIE). Methods: A total of 150 patients who underwent RAMIE from January 2020 to January 2022 at our hospital were randomly assigned to either the observation group or the control group, with 75 patients in each. The control group received standard perioperative management and nursing care, while the observation group was treated with ERAS nursing strategies. Interventions continued until discharge, and outcomes such as postoperative complications, quality of life, and nutritional status were compared between the groups. Results: The observation group exhibited a significantly lower incidence of postoperative adverse reactions compared to the control group (P ionally, all dimension scores of the Short-Form 36 Health Survey (SF-36), including the total score, were higher in the observation group (P < 0.05). Furthermore, the Nutritional Risk Screening (NRS) scores for impaired nutritional status and disease severity, along with the total NRS score, were significantly lower in the observation group compared to the control group (P Conclusion: Implementing ERAS nursing in the perioperative care of patients undergoing RAMIE is associated with reduced postoperative complications and enhanced postoperative quality of life and nutritional status. .

Impacts of radiation therapy on quality of life and pain relief in patients with bone metastases

Bone metastases(BM)are a common complication in advanced cancer patients,significantly contributing to morbidity and mortality due to their ability to cause pain,fractures,and spinal cord compression.Radiation therapy(RT)is vital in managing these complications by targeting metastatic lesions to ease pain,improve mobility,and reduce the risk of skeletal-related events such as fractures.Evidence supports the effectiveness of RT in pain relief,showing its ability to provide significant palliation and lessen the need for opioid painkillers,thereby enhancing the overall quality of life(QoL)for patients with BM.However,optimizing RT outcomes involves considerations such as the choice of radiation technique,dose fractionation schedules,and the integration of supportive care measures to mitigate treatment-related side effects like fatigue and skin reactions.These factors highlight the importance of personalized treatment planning tailored to individual patient needs and tumor characteristics.This mini-review aims to provide comprehensive insights into the multifaceted impacts of RT on pain management and QoL enhancement in BM patients,with implications for refining clinical practices and advancing patient care through the synthesis of findings from various studies.

Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer:A 1-year longitudinal study

Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

A Translator’s Feed-Back About the Practice of Pun-Translation-From the Chinese Version of The Life of Napoleon Bonaparte

It has been acknowledged by Chinese translators that in translating English puns the center should be put on the thorough comprehension of the original expression that more often than not has more than one meanings and the flexible handling of conversion from the native language to the target one. Literal translation will often be impossible, annotation redundant, and the restructuring and remaking of new ways that create and maintain balance or similarity in function and value will be more preferred as a possible way-out for pun-translation. Examples attached are from the writer of this article who is also the translator of a published historical book where punning can be found.

Evaluation of the Quality of Life of Patients Suffering from Chronic Rhinosinusitis in a Hospital Setting in Kinshasa

Background and objective: Chronic rhinosinusitis (CRS), a common disease worldwide, has a major impact on patients’ quality of life (QoL). In recent years, the measurement of health-related QoL has made it possible to assess the patient’s state of health, the severity of the CRS and the treatment. The aim of this study was to assess the QoL of patients with CRS in a hospital setting in Kinshasa. Methods: This was a cross-sectional analytical study conducted from June 2020 to May 2021 in the ENT service of the Kinshasa University Hospital and the Monkole Hospital Center. The study involved 113 patients aged at least 18 years, whose QOL was compared with that of a control group consisting of 100 non-patients. QOL was assessed using the Sino-Nasal Outcome Test (SNOT-22) Questionnaire. Results: The mean age of the patients was 41.0 years (18 - 74 years) and that of the controls was 39.1 years (19 - 77 years). More than half of the participants were university graduates. The median SNOT-22 score was 44 (14 - 78) in patients and 7 (1 - 40) in controls. Compared with subjects without CRS, patients with CRS had significantly higher scores in all four domains of the SNOT-22. Around 9 out of 10 patients had a severely impaired QoL compared with 2 out of 10 controls. Considering mildly impaired QoL, we found that in the otological and sleep domains, scores were not significantly different between patients and controls. In the case of severely impaired QoL, however, only the otological domain showed a non-significant difference in scores between the two groups. Conclusion: CRS is a real public health problem in our environment and significantly alters the QoL of patients suffering from it, with repercussions on their professional productivity;hence the need for better management.