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This study examined changes in health-related quality of life (HRQoL) and quality of care (QoC) as perceived by terminally ill cancer patients and a stratified set of HRQoL or QoC factors that are most likely to influence survival at the end of life (EoL).
We administered questionnaires to 619 consecutive patients immediately after they were diagnosed with terminal cancer by physicians at 11 university hospitals and at the National Cancer Center in Korea. Subjects were followed up over 161.2 person-years until their deaths. We measured HRQoL using the core 30-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and QoC using the Quality Care Questionnaire–End of Life (QCQ–EoL). We evaluated changes in HRQoL and QoC issues during the first three months after enrollment, performing sensitivity analysis by using data generated via four methods (complete case analysis, available case analysis, the last observation carried forward, and multiple imputation).
Emotional and cognitive functioning decreased significantly over time, while dyspnea, constipation, and pain increased significantly. Dignity-conserving care, care by healthcare professionals, family relationships, and QCQ–EoL total score decreased significantly. Global QoL, appetite loss, and Eastern Cooperative Oncology Group Performance Status (ECOG–PS) scores were significantly associated with survival.
Significance of results:
Future standardization of palliative care should be focused on assessment of these deteriorated types of quality. Accurate estimates of the length of life remaining for terminally ill cancer patients by such EoL-enhancing factors as global QoL, appetite loss, and ECOG–PS are needed to help patients experience a dignified and comfortable death.
We have studied the effects of Al0.1Ga0.9N(150 nm)/AlN Composite Nucleation Layers (CNLs) having different thicknesses of AlN ranging from 20 to 41 nm on the growth characteristics of GaN/Si(111) epitaxy. The surface morphologies of the GaN epitaxial layers which were grown on Al0.1Ga0.9N(150nm)/AlN CNLs showed that the number of thermal etch pits and cracks was abruptly decreased with the increase of AlN thickness from 20 to 35 nm. However, the morphology of GaN epitaxy which was grown on Al0.1Ga0.9N(150 nm)/AlN CNL having AlN of 41 nm thick above 35 nm showed that the number of them was increased again. So, the GaN/Si(111) epitaxy which was grown using Al0.1Ga0.9N(150 nm)/AlN(35 nm) CNL showed the highest crystallinity having the FWHM of 1157 arcsec for the (0002) diffraction. Photoluminescence spectrum at room temperature for GaN/Si(111) epitaxy grown using Al0.1Ga0.9N(150 nm)/AlN(35 nm) CNL showed a sharp band edge emission at 364 nm, which especially doesn't have yellow luminescence related to various defects such as vacancy and dislocation. Meanwhile, the spectra at room temperature for the others showed yellow luminescence at around 580 nm except each band edge emission. Moreover, the FWHM of main exitonic peak at 10 K for the GaN/Si(111) epitaxy which was grown using Al0.1Ga0.9N(150 nm)/AlN(35 nm) CNL is the lowest value of 12.81 meV among them. It is obvious that the Al0.1Ga0.9N(150 nm)/AlN CNL having suitable thickness of AlN plays an important role in improving the crystallinity and optical properties of GaN/Si(111) heteroepitaxy without any defects such as pits and cracks over the surface by reducing the mismatch of thermal expansion coefficient and lattice constant between GaN and Si(111) comparing with AlxGa1-xN or AlN nucleation layer alone.
Tin oxide films were deposited on amorphous SiO2/Si and Si (100) substrates by ion-assisted deposition (IAD) at various ion beam potentials (VI) at room temperature and a working pressure of 8 × 10−5 torr. The structural and chemical properties of the as-grown tin oxide films were investigated to determine the effects of the oxygen ion/atom arrival ratio (Ri). X-ray diffraction patterns indicated that the as-grown films with different average energy per atom (Eave) showed different growth directions. The as-grown films with oxygen/Sn ratio (NO/NSn) of 2.03 and 2.02 had preferred orientation of (101) and (002), respectively. In addition, the as-grown film with low Ri was amorphous. Comparison of the observed d spacings with those for standard SnO2 samples, indicated that the crystalline as-grown films had compressive and tensile stress depending on Eave. In transmission electron microscopy analysis, a buffer layer of amorphous tin oxide was observed at the interface between the substrate and the film, and the crystalline grains were grown on this buffer layer. The crystalline grains were arranged in large spherical clusters, and this shape directly affected surface roughness. Rutherford backscattering spectroscopy spectra showed that the tin oxide thin films were inhomogeneous. The density of films decreased and the porosity and oxygen trapped in the films increased with increasing Ri. The densest film had about 6% porosity.
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