Multiplication-free and hardware-efficient baud-rate timing error detector for Nyquist and faster than Nyquist optical IM/DD systems.

Clock recovery (CR) algorithms that support higher baud rates and advanced modulation formats are crucial for short-distance optical interconnections, and it is desirable to push CR to operate at baud rate with minimal computing resources and power. In this Letter, we proposed a hardware-efficient and multiplication operation-free baud-rate timing error detector (TED) as a solution to meet these demands. Our approach involves employing both the absolute value of samples and the nonlinear sign operation to emphasize the clock tone, which is deteriorated by severe bandwidth limitation in Nyquist and faster than Nyquist (FTN) systems. Through experimental investigations based on a transceiver system with a 3 dB bandwidth of 30 GHz, the proposed baud-rate TED exhibits excellent performance. The proposed scheme successfully achieves clock synchronization of the received signals with the transmitted signals, including 50 GBaud PAM4/8, 80 GBaud PAM4, and up to 120 GBaud PAM4 FTN signals. To the best of our knowledge, the CR based on the proposed baud-rate TED is the most optimal solution for ultrahigh-speed short-reach IM/DD transmission, comprehensively considering the timing jitter, bit error rate (BER), and implementation complexity.

Mindfulness-Based Therapy for Military Populations with Chronic Pain: A Systematic Review.

Background: Due to the limited role of chronic pain medication in military personnel and the distress caused to the military population, mindfulness-based therapy has been considered for the follow-up treatment of military personnel with chronic pain. The purpose of this review is to explore the effect and the implementation of mindfulness-based therapy for the military population with chronic pain. Methods: The keywords for the search included "mindfulness" AND ("pain" OR "chronic pain") AND ("military" OR "veteran"). The PubMed, Embase, and Cochrane Library databases were searched. The Cochrane Collaboration tool was used to independently assess the risk of bias of the included randomized controlled trials, and the Newcastle-Ottawa Scale was used to independently assess the risk of bias of the included case-control studies. Results: A total of 175 papers were identified; 65 duplicates were excluded, and 59 papers that did not meet the inclusion criteria were excluded after reading the titles and abstracts. The remaining 51 papers were read in full, 42 of which did not meet the inclusion criteria. Nine papers met the inclusion criteria and were included in the study. The nine studies included 507 veterans and 56 active-duty female military personnel. All pain interventions were mindfulness-based therapy, and all of them were integrated into or adapted from standard mindfulness courses. The results all showed that after mindfulness-based therapy, the relevant indicators improved. Conclusions: Mindfulness-based therapy is an effective treatment method for the military population with chronic pain. The review indicates that future research should focus on the best setting for mindfulness-based therapy, including the course content and time.

Application and value of anxiety and depression scale in patients with functional dyspepsia.

BACKGROUND: Patients with functional dyspepsia (FD) cannot be assessed for their mental health using a suitable and practical measure. The purpose of the study is to investigate the usefulness of several anxiety and depression scales in patients with FD, offering recommendations for clinical identification and therapy. METHODS: From September 2021 to September 2022, patients were sought and selected. The psychological symptoms were assessed using ten depression or anxiety questionnaires. The receiver operating characteristic (ROC) curve, Spearman analysis, Pearson correlation analysis, and single factor analysis were applied. RESULTS: Prospective analysis was performed on 142 healthy individuals and 113 patients with FD. In the case group, anxiety and depression symptoms were more common than in the control group, and the 10 scales showed strong validity and reliability. HAMD had the strongest connection with the PHQ-9 score on the depression scale (0.83). The score correlation between SAS and HAMA on the anxiety analysis scale was the greatest at 0.77. The PHQ-9, SAS, HAMD, and HAMA measures performed exceptionally well in detecting FD with anxiety or depression symptoms (AUC = 0.72, 0.70, 0.70, 0.77, and 0.77, respectively). CONCLUSIONS: PHQ-9, SAS, HAMD, and HAMA scales have good application performance in FD patients. They can assist gastroenterologists in evaluating anxiety and depression symptoms, and provide reference and guidance for subsequent treatment.

Risk factors associated with the comprehensive needs of cancer caregivers in China.

BACKGROUND: Cancer incidence and mortality rates have been rising in developing countries, especially in Asia. Cancer caregivers face unique challenges which put them at risk for burden, poor quality of life, and burnout. The purpose of this study was to investigate the comprehensive needs and associated factors of cancer caregivers, and explore the correlation with cancer patients. METHODS: In Mainland China, 200 cancer patient-caregiver dyads were chosen and interviewed for a cross-sectional questionnaire survey by convenient sampling method. Cancer caregivers' comprehensive needs were assessed with Comprehensive Needs Assessment Tool in cancer for Caregivers(CNAT-C), including seven domains (health and psychological problems, family and social support, healthcare staffs, information, religious/spiritual support, hospital facilities and services, and practical support). The comprehensive needs assessment tool in cancer for patients (CNAT) was used to assess patients' comprehensive needs. The sociodemographic survey was completed by both cancer patients and caregivers. The mean differences in domain scores for different groups of characteristics were compared by one-way ANOVA or non-parametric analyses, and those factors that had significant differences were selected for the multivariate regression analysis to determine the final influencing factors. The correlation between cancer patients' and caregivers' needs was evaluated by Spearman's correlation analysis. RESULTS: The cancer caregivers' need for healthcare staff (82.60±19.56) was the highest among the seven domains, followed by the need for information (72.17±14.61) and the need for hospital facilities and services (56.44±18.22). The lowest score was the need for religious/spiritual support (28.33±16.05). Caregivers who were younger, highly educated, with high household income, and less than 1 year since diagnosis had higher scores of CNAT-C. Also sociodemographic characteristics were associated with each domain of cancer caregivers' need. Correlations between patients' and caregivers' comprehensive needs were low to moderate (0.013~0.469). CONCLUSION: Cancer caregivers experience high levels of comprehensive needs, which are closely related to their sociological characteristics. The tailored interventions and mobilization of social and health care support may thus provide multiple levels of benefit across cancer trajectories. The patient-caregiver dyad should be regarded as a unit for treatment in cancer care.

Life insurance salespeople linking work stressors to proactive behaviors by passion: Servant leadership as a moderator.

As the main sales force of life insurance companies, salespeople have accounted for more than 50% of life insurance sales channels over the years, playing a pivotal role in the development of the industry. Since the adoption of the model of employment at an agency, the commission income of life insurance salespeople has largely relied on their sales volume, which requires employee proactivity under a great number of stressors. However, because previous studies have analyzed stressors in a single dimension, our understanding of the relationship between work stressors and proactive behaviors remains limited. Applying self-determination theory, we investigated differential relationships between challenge/hindrance stressors and proactive behaviors, which were expected to be mediated by passion and moderated by servant leadership. In the sample of 332 insurance salespeople, there was a positive (negative) relationship between challenge (hindrance) stressors and proactive behaviors. In addition, passion mediated the relationship between stressors and proactive behaviors, and servant leadership moderated the relationship between stressors and passion. Theoretical and practical implications are discussed.

Cluster-Based Ensemble Learning Model for Aortic Dissection Screening.

Aortic dissection (AD) is a rare and high-risk cardiovascular disease with high mortality. Due to its complex and changeable clinical manifestations, it is easily missed or misdiagnosed. In this paper, we proposed an ensemble learning model based on clustering: Cluster Random under-sampling Smote-Tomek Bagging (CRST-Bagging) to help clinicians screen for AD patients in the early phase to save their lives. In this model, we propose the CRST method, which combines the advantages of Kmeans++ and the Smote-Tomek sampling method, to overcome an extremely imbalanced AD dataset. Then we used the Bagging algorithm to predict the AD patients. We collected AD patients' and other cardiovascular patients' routine examination data from Xiangya Hospital to build the AD dataset. The effectiveness of the CRST method in resampling was verified by experiments on the original AD dataset. Our model was compared with RUSBoost and SMOTEBagging on the original dataset and a test dataset. The results show that our model performed better. On the test dataset, our model's precision and recall rates were 83.6% and 80.7%, respectively. Our model's F1-score was 82.1%, which is 4.8% and 1.6% higher than that of RUSBoost and SMOTEBagging, which demonstrates our model's effectiveness in AD screening.

Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer: A qualitative research.

Objective: There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer. However, due to the complex healthcare system and advanced care settings, it is quite challenging for the patients to gain sufficient support from the institute and the government. This research aimed to investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients. Methods: A phenomenological approach of qualitative research based on the results of semi-structured interviews was adopted, to explore the influencing factors which hinder the participation in surgical decision-making. Consolidated Criteria for Reporting Qualitative Research were utilized. Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs, were purposively recruited in this research. This retrospective study was carried out from September 2018 to August 2019. After recording and transcribing the interviews, the interview materials were evaluated via the Colaizzi's seven step approach and the NVivo Version 10 software to analyze the interview content. Results: According to the analysis and summary of the interviews, there were three factors affecting the degree of participation in surgical decision-making. Firstly, insufficient information was provided by medical and nursing staffs because of their lack of time, proper communication skills, and career experience, as well as difficulties in the development of patient decision aid and inconsistent resource availability. Secondly, the cognitive level of decision-making among patients was relatively low due to poor psychological endurance, insufficient amount of education, senility, and less knowledge and information demand. Ultimately, decisions were constantly made by family members with/without patients. Conclusions: The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.

Psychometric Evaluation of the Spiritual Perspective Scale in Palliative Care Nurses in China.

This study aimed to translate the Spiritual Perspectives Scale (SPS) into a Mandarin Chinese version (C-SPS) and evaluate its psychometric properties among 154 palliative care nurses from twelve community healthcare centres in Shanghai, China. Exploratory factor analysis suggested two factors (spiritually related activities and spiritual beliefs), accounting for 67.49% of the total variance. The Cronbach's α of the total C-SPS score was 0.89, and its split-half coefficient (Spearman-Brown reliability coefficient) was 0.72. The C-SPS showed consistently acceptable psychometric properties of reliability and validity. It can be used to evaluate the level of spiritual perspectives of nurses in China.

Development and Evaluation of Innovative and Practical Table-top Exercises Based on a Real Mass-Casualty Incident.

PURPOSE: The aim of this work was to develop a table-top exercise (TTX) program for mass-casualty incident (MCI) response based on a real incident to evaluate the program. METHODS: The TTX program was developed based on the 8 TTX design steps. Convenience sampling was adopted to recruit recently graduated physicians in China. After the TTX training, the participants completed a self-designed questionnaire, as well as the Simulation Design Scale (SDS) and Educational Practices in Simulation Scale (EPSS). RESULTS: In total, 148 valid questionnaires were collected. The difficulty score of the TTX program was 3.69 ± 0.8. The participants evaluated the program highly, with a score of 4.72 ± 0.54 out of 5. Both the SDS and the EPSS had average scores higher than 4.5. Guided reflection/feedback (M = 4.68, SD = 0.41) and fidelity (M =4.66, SD = 0.57) were the 2 highest-rated SDS subscales. For the EPSS, diverse ways of learning and collaboration were the 2 highest-rated subscales. Multivariate stepwise regression analysis showed that the participants' evaluations of the TTX training course were related to the EPSS score, the difficulty rating, the evaluation of the instructional props, and the degree of participant involvement (F = 24.385, P < 0.001). CONCLUSIONS: A TTX program for MCIs was developed based on the 2014 Shanghai New Year Crush. The TTX kit is practical and sophisticated, and it provides an effective strategy for MCI training.

Analgesic efficacy of nitrous oxide in adults in the emergency department: A meta-analysis of randomized controlled trials.

BACKGROUND: Nitrous oxide (N2O) has a rapidly analgesic effect, but evidence regarding its role in managing pain in adults in the emergency department (ED) is conflicting. The purpose of this meta-analysis is to investigate the analgesic efficacy and safety of N2O in adults in ED. METHODS: We systematically searched PubMed, the Cochrane Library, Embase, Web of science, China National Knowledge Infrastrusture (CNKI) and Wanfang Database up to August 10th, 2021. Randomized controlled trials (RCTs) were included if they compared N2O/O2 to placebo or other analgesic methods for management of pain in adults in ED or prehospital. The primary outcome was the analgesic efficacy of N2O. Secondary outcomes included adverse events, satisfaction of patients and the duration of procedure. RESULTS: 14 RCTs with 1751 patients were included. Pooled analysis suggested that N2O had better analgesia than placebo in the pain score (WMD = -3.00, 95% CI = -3.99 to -2.02, P < 0.00001, I2 = 91%) and the number of patients with pain relief (OR = 6.18, 95% CI = 3.22 to 11.85, P < 0.00001, I2 = 0%), while there were no significant difference in the pain score (WMD = 0.93, 95% CI = -1.09 to 2.95, P = 0.37, I2 = 97%) or the number of patients with pain relief (OR = 0.07, 95% CI = 0.00 to 3.47, P = 0.18, I2 = 86%) between the N2O group and the other analgesic method group. Although N2O did not increase nausea (OR = 1.52, 95% CI = 0.44 to 5.21, P = 0.50, I2 = 54%) or satisfaction of patients (OR = 1.06, 95% CI = 0.16 to 7.18, P = 0.96, I2 = 81%), it was associated with higher tendency of vomiting (OR = 6.50, 95% CI = 2.07 to 20.42, P = 0.001, I2 = 29%) and dizziness (OR = 4.54, 95% CI = 2.27 to 9.09, P < 0.0001, I2 = 26%), and shorter procedure time (WMD = -5.73 min, 95% CI = -10.14 min to -1.32 min, P = 0.01, I2 = 98%). CONCLUSIONS: The present meta-analysis suggested that N2O could provide better analgesia than placebo and similar analgesia to other methods with more vomiting and dizziness in adults in ED.

Attitudes toward and Perceptions of Educational Needs for End-of-Life Care among Health Professions Students: A Cross-Sectional Study in China.

CONTEXT: To provide effective end-of-life care education for health professions students, it is important to understand students' views of death in addition to their perceptions of educational needs and preferences. However, there is a lack of studies addressing interindividual variability in perceptions of end-of-life care educational needs among health professions students. OBJECTIVES: This study aimed to identify latent profiles of perceptions of end-of-life care educational needs among health professions students and examine whether the demographic characteristics, death-related events, death attitude, and death anxiety differed by need subgroup. METHODS: Through convenience sampling, health professions students from three universities in China were recruited between March 2020 and June 2020. Data were collected using a demographic information and death-related experience questionnaire, the End-of-Life Care Curriculum Needs Questionnaire, the End-of-Life Care Educational Needs Questionnaire, the Death Attitudes Profile-Revised, and the Templer's Death Anxiety Scale. RESULTS: A total of 1048 students completed the survey. Two classes of perceptions of end-of-life care educational needs were identified: approximately 29.80% of students belonged to a medium-need group class (1), and 70.20% belonged to a high-need group class (2). Being female and having knowledge of end-of-life care significantly increased the probability of membership in class 2. Students with the two latent profiles reported having varied curriculum needs. In addition, a positive attitude toward death and low death anxiety increased the probability of membership in class 1. CONCLUSION: Two classes of perceptions of end-of-life care educational needs were identified, and these classes were significantly associated with sex and death-related knowledge (P < 0.05). Interindividual variability should be considered in the future development of end-of-care curricula.

A Highly Magnetic Field Sensitive Photonic Crystal Fiber Based on Surface Plasmon Resonance.

A novel magnetic field sensor comprising a photonic crystal fiber (PCF) is designed and investigated based on surface plasmon resonance (SPR). We use finite element analysis in order to analyze the sensing characteristics of the magnetic field sensor. The simulation results show that the sensor is very sensitive to the change of refractive index and has good linearity in the refractive index range from 1.43-1.45. The thickness of the metal film and the metal material has great influence on the resonance wavelength and the peak of the loss spectrum, the diameter of the central air hole will affect SPP excitation. When the thickness of gold layer is 50 nm, the refractive index sensitivity is 4125 nm/RIU in the refractive index range from 1.43-1.45. Using the designed sensor for magnetic field sensing, the loss spectrum is red-shifted with the increase of the magnetic field, the highest magnetic field sensitivity can reach 61.25 pm/Oe in the range from 50 Oe to 130 Oe. The sensor not only has high sensitivity of refractive index, but it can also realize accurate measurement of magnetic field. It has huge application potential in complex environment, remote sensing, real-time monitoring, and other fields.

Double Electromagnetically Induced Transparency and Its Slow Light Application Based On a Guided-Mode Resonance Grating Cascade Structure.

In recent years, the achievement of the electromagnetically induced transparency (EIT) effect based on the guided-mode resonance (GMR) effect has attracted extensive attention. However, few works have achieved a double EIT-like effect using this method. In this paper, we numerically achieve a double EIT-like effect in a GMR system with a three-layer silicon nitride waveguide grating structure (WGS), using the multi-level atomic system model for theoretical explanation. In terms of slow light performance, the corresponding two delay times reach 22.59 ps and 8.43 ps, respectively. We also investigate the influence of wavelength detuning of different GMR modes on the transparent window and slow light performance. Furthermore, a wide-band flat-top transparent window was also achieved by appropriately adjusting the wavelength detuning between GMR modes. These results indicate that the EIT-like effect in the WGS has potential application prospects in low-loss slow optical devices, optical sensing, and optical communications.

Strong interface scattering induced low thermal conductivity in Bi-based GeTe/Bi2Te3 superlattice-like materials.

The thermal conductivities of GeTe/Bi2Te3 superlattice-like materials are calculated based on density functional perturbation theory (DFPT) and measured using a 3ω method. The calculated results show that the lattice thermal conductivity or thermal diffusivity of GeTe/Bi2Te3 superlattice-like materials significantly decrease due to the effects of interfaces and Bi atoms in Bi2Te3. Our measured results are in line with the theoretical calculations, and reach an extremely low thermal conductivity at 0.162 W mK-1 compared with published work on Ge-Sb(Bi)-Te, indicating the effectiveness of modulating the thermal properties of phase change materials by using Bi-based GeTe/Bi2Te3 superlattice-like materials. Our findings give a calculation method to modify the thermal characteristics of superlattice-like materials and confirm Bi-based GeTe/Bi2Te3 superlattice-like materials as promising candidates for phase change materials with lower thermal conductivity.

Observation of carrier localization in cubic crystalline Ge2Sb2Te5 by field effect measurement.

The tunable disorder of vacancies upon annealing is an important character of crystalline phase-change material Ge2Sb2Te5 (GST). A variety of resistance states caused by different degrees of disorder can lead to the development of multilevel memory devices, which could bring a revolution to the memory industry by significantly increasing the storage density and inspiring the neuromorphic computing. This work focuses on the study of disorder-induced carrier localization which could result in multiple resistance levels of crystalline GST. To analyze the effect of carrier localization on multiple resistant levels, the intrinsic field effect (the change in surface conductance with an applied transverse electric field) of crystalline GST was measured, in which GST films were annealed at different temperatures. The field effect measurement is an important complement to conventional transport measurement techniques. The field effect mobility was acquired and showed temperature activation, a hallmark of carrier localization. Based on the relationship between field effect mobility and annealing temperature, we demonstrate that the annealing shifts the mobility edge towards the valence-band edge, delocalizing more carriers. The insight of carrier transport in multilevel crystalline states is of fundamental relevance for the development of multilevel phase change data storage.

Synthesis, characterization, and photocatalytic activity of porous La-N-co-doped TiO2 nanotubes for gaseous chlorobenzene oxidation.

The photocatalytic oxidation of gaseous chlorobenzene (CB) by the 365nm-induced photocatalyst La/N-TiO2, synthesized via a sol-gel and hydrothermal method, was evaluated. Response surface methodology (RSM) was used to model and optimize the conditions for synthesis of the photocatalyst. The optimal photocatalyst was 1.2La/0.5N-TiO2 (0.5) and the effects of La/N on crystalline structure, particle morphology, surface element content, and other structural characteristics were investigated by XRD (X-ray diffraction), TEM (Transmission Electron Microscopy), FTIR (Fourier transform infrared spectroscopy), UV-vis (Ultraviolet-visible spectroscopy), and BET (Brunauer Emmett Teller). Greater surface area and smaller particle size were produced with the co-doped TiO2 nanotubes than with reference TiO2. The removal of CB was effective when performed using the synthesized photocatalyst, though it was less efficient at higher initial CB concentrations. Various modified Langmuir-Hinshelwood kinetic models involving the adsorption of chlorobenzene and water on different active sites were evaluated. Fitting results suggested that competitive adsorption caused by water molecules could not be neglected, especially for environments with high relative humidity. The reaction intermediates found after GC-MS (Gas chromatography-mass spectrometry) analysis indicated that most were soluble, low-toxicity, or both. The results demonstrated that the prepared photocatalyst had high activity for VOC (volatile organic compounds) conversion and may be used as a pretreatment prior to biopurification.

Inhibition of microtubule dynamics affects podosome belt formation during osteoclast induction.

Osteoclast is the only cell that can degrade bone tissue in vivo. Recent studies have shown the important role of cytoskeleton dynamics in osteolysis and the formation of podosome belt in osteoclasts. This process is regulated by the dynamic microtubule (MT) network. We treated osteoclast precursor cells Raw264.7 with low concentration of nocodazole (10 nM) and antineoplastic drug taxol (10 nM) to block MT turnover, and used end binding protein 1 fused to GFP to track the movement of microtubules in induced osteoclasts. We show that low concentrations of nocodazole and taxol interfere with the formation of podosome belt, and reduce TRAP activity of induced osteoclasts. These results suggest that the effect of taxol on MT dynamics may be used clinically to reduce osteoclast activity and potentially prevent development of osteoporosis and other metabolic bone diseases.

Ultrasound guidance for radial artery catheterization: an updated meta-analysis of randomized controlled trials.

BACKGROUND: Since a previous meta-analysis reported that ultrasound guidance was associated with a higher first-attempt success rate in catheterization of the radial artery, a number of randomized controlled trials (RCTs) have reported inconsistent results. The aim of the present study is to conduct an updated meta-analysis to clarify the role of ultrasound guidance for radial artery catheterization. METHODS: A systematic literature search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted using specific search terms. Eligible studies were RCTs that compared ultrasound guidance with traditional palpation for radial artery catheterization. The Mantel-Haenszel method using the random effects model was adopted in this meta-analysis. RESULTS: Seven RCTs with 482 patients were included. Compared with traditional palpation, ultrasound guidance significantly increased the first-attempt success rate of radial artery catheterization (RR 1.51, 95% CI 1.07-2.14, P = 0.02). Subgroup analyses suggested that the superiority of ultrasound guidance for radial artery catheterization was significant when the technique was operated by experienced users, performed in small children and infants, and on elective procedures in the operating room. In addition, ultrasound guidance significantly reduced mean-attempts to success (WMD -1.13, 95% CI -1.58 to -0.69, P<0.00001), mean-time to success (WMD -74.77s, 95% CI -137.89s to -11.64s, P = 0.02), and the occurrence of hematoma (RR 0.17, 95% CI 0.07-0.41, P = 0.0001). CONCLUSIONS: The present meta-analysis suggests a clear benefit from ultrasound guidance for radial artery catheterization compared with the traditional palpation. Preliminary training and familiarization with the ultrasound-guided technique is needed before applying it for radial artery catheterization, especially for inexperienced operators.

Quality of life in patients with advanced cancer at the end of life as measured by the McGill quality of life questionnaire: a survey in China.

CONTEXT: Quality of life (QOL) is the main outcome measure for patients with advanced cancer at the end of life. The McGill Quality of Life Questionnaire (MQOL) is designed specifically for palliative care patients and has been translated and validated in Hong Kong and Taiwan. OBJECTIVES: This study aimed to investigate the QOL of patients with advanced cancer using the MQOL-Taiwan version after cultural adaptation to the Chinese mainland. METHODS: A cross-sectional survey design was used. QOL data from patients with advanced cancer were gathered from 13 hospitals including five tertiary hospitals, six secondary hospitals, and community health care service centers in Shanghai and analyzed. QOL was assessed using the MQOL-Chinese version. Statistical analyses were performed using descriptive statistics, multiple regression analysis, and Spearman rank correlation analysis. RESULTS: A total of 531 cancer patients (297 male and 234 female) in 13 hospitals were recruited into the study and administered the MQOL-Chinese. The score of the support subscale was highest (6.82), and the score of the existential well-being subscale was the lowest (4.65). The five physical symptoms most frequently listed on the MQOL-Chinese were pain, loss of appetite, fatigue, powerless, and dyspnea. Participants' sex, educational level, number of children, disclosure of the disease, and hospital size were associated with their overall QOL. The Spearman rank correlation analysis found that Karnofsky Performance Status scores correlated with the MQOL-Chinese single-item score, physical well-being, psychological well-being, existential well-being, and support domains (P < 0.05). CONCLUSION: Our results revealed the aspects of QOL that need more attention for Chinese palliative care patients with advanced cancer. The association between the characteristics of patients, Karnofsky Performance Status, and their QOL also was identified.

Predicting survival time in noncurative patients with advanced cancer: a prospective study in China.

BACKGROUND: Accurate prediction of prognosis for cancer patients is important for good clinical decision making in therapeutic and care strategies. The application of prognostic tools and indicators could improve prediction accuracy. OBJECTIVE: This study aimed to develop a new prognostic scale to predict survival time of advanced cancer patients in China. METHODS: We prospectively collected items that we anticipated might influence survival time of advanced cancer patients. Participants were recruited from 12 hospitals in Shanghai, China. We collected data including demographic information, clinical symptoms and signs, and biochemical test results. Log-rank tests, Cox regression, and linear regression were performed to develop a prognostic scale. RESULTS: Three hundred twenty patients with advanced cancer were recruited. Fourteen prognostic factors were included in the prognostic scale: Karnofsky Performance Scale (KPS) score, pain, ascites, hydrothorax, edema, delirium, cachexia, white blood cell (WBC) count, hemoglobin, sodium, total bilirubin, direct bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) values. The score was calculated by summing the partial scores, ranging from 0 to 30. When using the cutoff points of 7-day, 30-day, 90-day, and 180-day survival time, the scores were calculated as 12, 10, 8, and 6, respectively. CONCLUSIONS: We propose a new prognostic scale including KPS, pain, ascites, hydrothorax, edema, delirium, cachexia, WBC count, hemoglobin, sodium, total bilirubin, direct bilirubin, AST, and ALP values, which may help guide physicians in predicting the likely survival time of cancer patients more accurately. More studies are needed to validate this scale in the future.