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It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented global health crisis that may cause mental health problems and heighten suicide risk. We investigated the impact of the COVID-19 pandemic on trends in suicide attempts and suicide deaths in New Taipei City, Taiwan.
The current study used the official daily data on suicide attempts and deaths in New Taipei City, Taiwan (4 million inhabitants) between 2015 and 2020 from the Taiwan National Suicide Prevention Reporting System. Interrupted time-series (ITS) analyses with parameters corrected by the estimated autocorrelations were applied on weekly aggregated data to examine whether the suicide trends during the early COVID-19 pandemic (late January to July 2020) deviated from previous trends (January 2015 to late January 2020). The impact due to the suicide prevention policy change was also examined (since August 2020).
ITS analyses revealed no significant increases in both mean and trend on weekly suicide deaths during the COVID-19 pandemic and after the policy change. In contrast, there was a significant increasing trend in weekly suicide attempts since the COVID-19 outbreak at the rate of 1.54 attempts per week (95% confidence interval 0.49–2.60; p = 0.004). Sex difference analysis revealed that, however, this increasing trend was observed only in females not in males.
The COVID-19 pandemic has different impacts on suicides attempts and deaths during the early pandemic in New Taipei City, Taiwan. The COVID-19 outbreak drastically increased the trend of suicide attempts. In contrast, the number of suicide deaths had remained constant in the investigated periods.
Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.
This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.
A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.
Significance of results
Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.
Morphological evolution and phase transformation of metastable intermediate precipitates are critical to their mechanical properties for the non-isothermal processing. During the non-isothermal precipitation, the formation of the new phases usually couples with structural evolution. Traditional structural characterization has limitation to resolve comprehensive changes simultaneously. In this study, we report direct observation, precipitation sequence, and the details of concurrent morphological and structural changes of various intermediate precipitates during non-isothermal heating in the Al–Cu systems with different pretreatments. The structural heterogeneity during the non-isothermal precipitation processes is resolved into coexistence of two different precipitate phases and quantitatively studied in terms of the phase transition and the morphological evolution. This paper presents the in situ small- and wide-angle synchrotron x-ray scattering (SAXS and WAXS) to refine and to identify the mixed structural information during multiple precipitation stages. The WAXS results show that the precipitation sequence is θ″ → (θ″ + θ′) → θ′ → (θ′ + θ) → θ upon heating. Due to the fact of the specifically oriented SAXS intensity, the evolution of the aforementioned phase transformation is resolved by the refinement of the SAXS intensity integrated over the selected area. These methods reveal multiscale information that is not trivial comparing to the traditional characterization methods.
Catalyst-free vapor phase transport was applied for the growth of ZnO nanoemitters. A single-crystalline ZnO:Al seed layer was deposited and used as a pseudo-catalyst. The desired morphology of nanostructures can be achieved by means of modifying the growth rates of crystal planes via adjustment in the growth conditions. The field emission characteristics of ZnO nanoemitters satisfied the Fowler-Nordheim relationship. The high aspect ratio of nanoemitters had a low turn-on electric field of 0.18 MV/m at emission current density of 0.1 μA/cm2. A stable electron emission with a variation of less than 14% was measured.
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