External validation of the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer colorectal(CR29)module:Monocentric study

BACKGROUND Quality of life(QoL)outcomes are a focal endpoint of cancer treatment strategies.AIM To externally validate the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer(EORTC)QoL Questionnaire(QLQ)for colorectal cancer(CRC)patients(CR29).METHODS Both Moroccan Arabic modules of QLQ-CR29 and QLQ-C30 were administered to Moroccan CRC.Psychometric properties were retested by measuring Cronbach’s alpha coefficient for reliability and Intraclass correlation coefficient(ICC)to examine test-retest reproducibility.The multitrait-scaling analysis was performed to demonstrate the validity of the instrument and known-groups comparison was used to test the score’s ability to discriminate between different groups of patients.RESULTS In total,221 patients were included in our study and 34 patients completed the questionnaire twice.The Urinary Frequency scale and Stool Frequency scale had good internal consistency with alpha Cronbach coefficients of 0.79 and 0.83 respectively,while the same coefficients were moderately lower for the Blood and Mucus in Stool scale(0.61)and the Body Image scale(0.67).The ICCs ranged from 0.88 to 1 indicating good to excellent reproducibility.In multitrait scaling analyses,the criterion for item convergent and divergent validity was satisfactory.The known-group comparison showed statistically significant differences between patients according to age,gender,stoma status,tumor location,and radiotherapy.CONCLUSION The Moroccan Arabic version of the EORTC QLQ-CR29 is a valid and reliable tool that can be used safely for research and clinical purposes in Moroccan CRC patients.

Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.

A New Lease of Life Organ donation gains wider acceptance in China as an efficient donation system raises awareness

Wu Yue, a lung transplant recipi ent. now regards August 31, the day she underwent surgery, as her re-birth day. In the eyes＇ of many people, the 30-year- old woman is an embodiment of love, dili gence and intelligence.

Extracorporeal Cardiopulmonary Resuscitation in Children of Asia Pacific： A Retrospective Analysis of Extracorporeal Life Support Organization Registry

Background： Recent advances in extracorporeal membrane oxygenation （ECMO） have led to increasing interest in its use during cardiopuhnonary resuscitation （CPR）. However, decisions regarding extracorporeal CPR （ECPR） in children are difficult as a result of limited studies, especially in Asia Pacific. The objective of this study was to investigate trends in survival and demographic details for children with ECPR in Asia Pacific recorded in the Extracorporeal Life Support Organization （ELSO） registry from 1999 to 2016 and identify the risk factors associated with in-hospital mortality. Methods： The data of children younger than 18 years of age who received ECPR over the past 18 years in Asia Pacific were retrospectively analyzed. The data were extracted from the ELSO registry and divided into two 9-year groups （Group 1 1999-2007 and Group 2： 2008-2016） to assess temporal changes using univariate analysis. Then, univariate and multiple logistic regression analyses were performed between survivors and nonsurvivors to identify factors independently associated with in-hospital mortality. Results： A total of 321 children were included in final analysis, with an overall survival rate of 50.8%. Although survival rates were similar between Group 1 and Group 2 （43.1% vs. 52.5%,χ^2= 1.67, P - 0.196）, the median age （1.7 [0.3, 19.2] months for Group 1 vs. 5.6 [0.8, 64.9] months for Group 2, t = 2.93, P = 0.003） and weight （3.7 [3.0, 11.5] kg for Group 1 vs. 6.0 [3.4, 20.3] kg for Group 2, t = -3.14, P 0.002） of children increased over time, while the proportion of congenital heart disease （75.9% for Group 1 vs. 57.8% for Group 2, χ^2=6.52, P 0.011 ） and cardiogenic shock （36.2% for Group 1 vs. 7.2% for Group 2, χ^2=36.59, P 〈 0.001 ） decreased. Patient conditions before ECMO were worse, while ECMO complications decreased across time periods, especially renal complications. Multiple logistic regress!on analysis of ECMO complications showed that disseminated intravascular coagulation （DIC）, myocardial stunning, and neurological complications were independently associated with increased odds of hospital mortality. Conclusions： The broader indications and decreased complication rates make EPCR to be applicated more and more extensive in children in Asia Pacific region. ECMO complications such as myocardial stunning are independently associated with decreased survival.

Universal organic anodes enable safe low-cost aqueous rechargeable batteries with long cycle life,high capacity, and fast kinetics

Future battery advances and economies of scale will help scrub CO2emissions from transportation and the grid.Economical energy storage lets battery-powered electric vehicles replace internal combustion engines in the transportation sector,which now accounts for the plurality of CO2emissions.For grid-scale applications,the benefits of adding storage are many and well documented[1–2].Beyond increased penetration of intermittent renewable energy generated from such as solar panels