Background Little is known about the care that adolescent and young adult (AYA) cancer patients receive at the end-of-life (EOL). Objective To evaluate use of intensive measures and hospice and location of death of AYA cancer patients insured by Medicaid in New York State. Design Using linked patient-level data from the New York state cancer registry and state Medicaid program, we identified 705 Medicaid patients who were diagnosed with cancer between the ages of 15 and 29 in the years 2004–2011, who subsequently died, and who were continuously enrolled in Medicaid in the last 60 days of life. We evaluated use of intensive EOL measures (chemotherapy within 14 days of death; intensive care unit care, >1 emergency room visit, and hospitalizations in the last 30 days of life), hospice use, and location of death (inpatient hospice, long-term care facility, acute care facility, home with hospice, home without hospice). Results 75% of AYA Medicaid decedents used at least one aspect of intensive EOL care. 38% received chemotherapy in the last 2 weeks of life; 21% received intensive care unit care, 44% had >1 emergency room visit, and 64% were hospitalized in the last month of life. Only 23% used hospice. 65% of patients died in acute care settings, including the inpatient hospital or emergency room. Conclusions Given high rates of intensive measures and low utilization of hospice at the EOL among AYA Medicaid enrollees, opportunities to maximize the quality of EOL care in this high risk group should be prioritized.

BackgroundIn China, the rapid rate of population aging and changes in the prevalence of disability among elderly people could have significant effects on the demand for long-term care. This study aims to describe the urban-rural differences in use and cost of long-term care of the disabled elderly and to explore potential influencing factors.MethodsThis study uses data from a cross-sectional survey and a qualitative investigation conducted in Zhejiang province in 2012. The participants were 826 individuals over 60 years of age, who had been bedridden or suffered from dementia for more than 6 months. A generalized linear model and two-part regression model were applied to estimate costs, with adjustment of covariates.ResultsPensions provide the main source of income for urban elderly, while the principal income source for rural elderly is their family. Urban residents spend more on all services than do rural residents. Those who are married spend less on daily supplies and formal care than the unmarried do. Age, incapacitation time, comorbidity number, level of income, and bedridden status influence spending on medical care (β=-0.0316, -0.0206, 0.1882, 0.3444, and -0.4281, respectively), but the cost does not increase as the elderly grow older. Urban residents, the married, and those with a higher income level tend to spend more on medical equipment. Urban residence and living status are the two significant factors that affect spending on personal hygiene products.ConclusionsThe use of long-term care services varies by living area. Long-term care of the disabled elderly imposes a substantial burden on families. Our study revealed that informal care involves huge opportunity costs to the caregivers. Chinese policy makers need to promote community care and long-term care insurance to relieve the burden of families of disabled elderly, and particular attention should be given to the rural elderly.

The aim of this study was to evaluate the quality of life (QoL) in the older rural and urban Chinese populations in Zhejiang province. An analysis of the association between potential factors and QoL for these two groups was conducted. A cross-sectional study was conducted from October to December 2007. The total sample consisted of 2,441 rural and 2,554 urban participants. A Chinese version of the 36-item Short Form Health Survey (SF-36) was used to quantify the QoL of participants. A comparison between the QoL of rural and urban participants was made. The association between potential factors and QoL was performed using a multiple linear regression model. The study revealed all scale scores of SF-36 in the rural population were significantly lower than those in the urban population except general health (GH; p < .001). The common factors associated with high QoL in both older rural and urban populations were gender (male), tea consumption, income, and consumption of alcohol.

Coronavirus disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China, with 11,669,259 positive cases and 539,906 deaths globally as of July 8, 2020. The objective of the present study was to determine whether meteorological parameters and air quality affect the transmission of COVID-19, analogous to SARS. We captured data from 29 provinces, including numbers of COVID-19 cases, meteorological parameters, air quality and population flow data, between Jan 21, 2020 and Apr 3, 2020. To evaluate the transmissibility of COVID-19, the basic reproductive ratio ( R 0 ) was calculated with the maximum likelihood “removal” method, which is based on chain-binomial model, and the association between COVID-19 and air pollutants or meteorological parameters was estimated by correlation analyses. The mean estimated value of R 0 was 1.79 ± 0.31 in 29 provinces, ranging from 1.08 to 2.45. The correlation between R 0 and the mean relative humidity was positive, with coefficient of 0.370. In provinces with high flow, indicators such as carbon monoxide (CO) and 24-h average concentration of carbon monoxide (CO_24 h) were positively correlated with R 0 , while nitrogen dioxide (NO 2 ), 24-h average concentration of nitrogen dioxide (NO 2 _24 h) and daily maximum temperature were inversely correlated to R 0 , with coefficients of 0.644, 0.661, −0.636, −0.657, −0.645, respectively. In provinces with medium flow, only the weather factors were correlated with R 0 , including mean/maximum/minimum air pressure and mean wind speed, with coefficients of −0.697, −0.697, −0.697 and −0.841, respectively. There was no correlation with R 0 and meteorological parameters or air pollutants in provinces with low flow. Our findings suggest that higher ambient CO concentration is a risk factor for increased transmissibility of the novel coronavirus, while higher temperature and air pressure, and efficient ventilation reduce its transmissibility. The effect of meteorological parameters and air pollutants varies in different regions, and requires that these issues be considered in future modeling disease transmissibility.

Our study firstly investigated CSF-CTCs characteristics of five LUAD-LM patients and one CUP-LM patient. CSF-CTCs enriched metabolism and cell-adhesion pathways. CSF-CTCs exhibited heterogeneity manifested by cell cycle, mesenchymal and cancer stem cell, and cancer-testis antigen properties

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BACKGROUND: Sepsis is a common complication of infections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4 + CD25+ regulatory T cells (Treg) in peripheral blood of patients with sepsis.

This study examines whether students perceive three different types of fit in an academic environment (i.e., interest–major [I–M] fit, demands–abilities [D–A] fit, and needs–supplies [N–S] fit) and whether these factors predict important academic and well-being criteria using a Chinese student sample. Results from confirmatory factor analyses support the assumption that students differentiate among the three fit perceptions. Incremental validity analysis and relative importance analysis reveal that the three types of fit each have a unique relationship with situational outcomes. Specifically, I–M fit predicts greater proportions of variance in major change intention; D–A fit predicts greater proportions of variance in academic performance; and N–S fit predicts greater proportions of variance in well-being (e.g., academic satisfaction and depression). Practical and theoretical implications of these results are discussed.