Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer

In the welding of more sensitive metals such as stainless steel, titanium and some specific nickel alloys, the presence and application of a protective gas is essential. Without the use of a nonreactive shielding gas, defects occur in or adjacent to the weld joint, which vary from light discoloration of the weld bead to the direct onset and propagation of cracks. The supply of shielding gas is usually via the welding tool. Unfortunately, when it comes to welding pipes, the problem arises when the root bead comes into contact with the oxygen present within the pipe. Since the shielding gas supplied from the welding tool has no possibility of penetrating into the pipe and protecting the melt from the oxygen, the result consequence will be defects in the weld bead. To prevent this from happening, the pipes are sealed before welding and the oxygen in the pipe is purged and replaced with protective gas. Due to the fact that pipe welding operations concern a vast spectrum of pipe dimensions, complications arise for the welding operator as the solutions available have a low degree of adaptability. Thus, the purpose of this project is to investigate the possibility of designing and developing a new method of supplying root gas protection that can be adapted to several pipe diameters. Field studies at welding companies resulted in the clarification of which diameter spans the root gas protection solution should comply with, the pipe diameter span to cater for was identified as 25-100 mm in diameter. Requests were also made regarding the robustness of the product, with expressed desire for the product to withstand the strenuous working environment often encountered during welding operations. Solution proposals were produced which later developed into six separate concepts. From these six concepts, one was selected as the foremost solution and further developed for construction. The concept was sketched out and reproduced using CAD and a model was made using 3D printers. The model showed a need for modifications as it was not of a sufficiently adaptable nature. A modified model was thus developed and manufactured using a 3D printer, this modified model showed better results of adaptation to different pipe diameters. Furthermore, a flow analysis of the gas as it enters via the root gas plug and into the pipe was conducted, to verify total distribution of the gas within the pipe. The material with which to construct the concept with will be silicone infused with additives to make it more heat resistant and more resistant to wear. However, the exact mixture of silicone and additives in question was not available for this project but is something that is intended for future work. The concept meets the specified requirements of being applicable to multiple pipe diameters, more specifically so meeting the wishes of those active within the industry, covering a pipe span of 25- 100 mm.Vid svetsning av mer känsliga metaller såsom rostfritt stål, titan och vissa specifika nickellegeringar är närvaron och tillämpningen av en skyddsgas väsentligt. Utan nyttjandet av en icke reaktiv skyddsgas uppkommer defekter i eller intill svetsfogen, vilka varierar från lätta missfärgningar av svetssträngen till den direkta uppkomsten och propageringen av sprickor. Tillförseln av skyddsgas sker vanligtvis via svetsverktyget. När det kommer till svetsning av rör uppstår dessvärre problemet att rotsträngen kommer i kontakt med syret som finns på insidan av röret. Eftersom att den skyddsgas som tillförs från svetsverktyget inte har någon möjlighet att tränga sig in i röret och skydda smältan från syret kommer det resultera i en svetssträng med defekter. För att förhindra detta från att ske tätas rören innan svetsning och syret i röret ersätts med skyddsgas. Eftersom att de rör som skall sammanfogas förekommer i flera dimensioner uppstår komplikationer för svetsoperatören ty de lösningar som finns tillgängliga har låg anpassningsgrad. Därmed är syftet med detta projekt att undersöka möjligheten att designa och utveckla ett nytt rotgasskydd som kan anpassas till flera diametrar. Fältstudier hos svetsföretag resulterade i ett tydligt spann för vilka diametrar som bör tillgodoses med sagda rotgasskydd, detta spann av rördiametrar var 25-100 mm. Det uppgavs även önskemål om säkerställning av att produkterna är robusta nog att klara den påfrestande arbetsmiljö som ofta förekommer vid svetsning. Lösningsförslag lades fram vilket senare utvecklades till sex separata koncept. Från dessa sex koncept utsågs en som den främsta lösningen och togs vidare till konstruktion. Konceptet skissades upp i CAD och en modell gjordes i 3D-skrivare. Modellen visade upp behov på modifieringar då den inte var av tillräckligt anpassningsbar karaktär. En modifierad modell togs därmed fram och tillverkades i en 3D-skrivare, denna modifierade modell visade bättre prov på anpassning till olika  rördiametrar. Vidare gjordes en flödesanalys av gasen då den färdas in via rotgaspluggen, vilket visade att gasen fyller röret som önskat. Materialet som konceptet kommer tillverkas i är silikon med tillförda additiv för att göra det mer värmebeständigt och mer resistent mot slitage. Den exakta blandningen av silikon och additiv i fråga var dock inte tillgängliga till detta projekt utan är något som får gå till vidare arbete. Konceptet uppfyller kraven på anpassning till flera rördiametrar och möter mer specifikt även önskemålet från branschaktiva med dess spann på 25-100 mm

Survival Outcomes with Photodynamic Therapy, Chemotherapy and Radiation in Patients with Stage III or Stage IV Non-Small Cell Lung Cancer

Data regarding the association between photodynamic therapy (PDT) and mortality in lung cancer patients are limited. We analyzed the association between PDT and mortality in patients with stage III or IV non-small cell lung cancer (NSCLC) using data from the National Cancer Database (NCDB) between 2004 and 2016. From the NCDB, we identified patients receiving laser ablation/cryosurgery or local tumor destruction/excision (which includes PDT). From Medicare and Medicaid claims between 2000 and 2013, we identified NSCLC patients receiving PDT and those receiving bronchoscopy, then used these to confirm the PDT treatment. From NCDB, we extracted NSCLC patients who received radiation with chemotherapy, radiation alone or chemotherapy alone. We used survival analysis to determine the association between PDT and mortality. Between 2004 and 2016, 457,556 NSCLC patients with stage III or stage IV were identified, of which 147 received PDT with radiation and chemotherapy, 227,629 received radiation with chemotherapy, 106,667 had radiation therapy alone and 122,193 received chemotherapy alone. Compared to the radiation alone group, the PDT group and radiation with chemotherapy group had lower hazard of mortality (50% and 53% lower, respectively). Among the NSCLC patients with stage III or stage IV disease, the addition of PDT to radiation therapy offers survival benefit over radiation therapy alone

Knowledge and attitude for overactive bladder care among women: development and measurement

Abstract Background Overactive bladder (OAB) affects millions of women. It is important to assess knowledge and attitude in affected patients. The study objective was to develop surveys to assess OAB knowledge and OAB related attitude, and its association with OAB treatment status. Methods Systematic literature review and qualitative analysis of patient and provider focus groups helped identify OAB knowledge and attitude survey items. We determined psychometric properties of the two surveys in a cross-sectional sample of 104 women, 27% of whom had received OAB treatment. Results The OAB-knowledge survey consisted of 16 items and 3 condition-related concepts: perception of OAB; cause and information; and signs of OAB. The OAB-attitude survey consisted of 16 items and its concepts were treatment seeking; decision-making and effects. Both surveys demonstrated good construct validity and test-retest reliability ((≥ 0.60). In the cross-sectional validation sample, OAB-knowledge and attitude discriminated between those with different levels of ICIQ-UI scores. We observed some difference in the OAB knowledge, OAB attitude, and severity of symptoms between those treated for OAB vs. treatment naive. Conclusions OAB knowledge and attitude surveys provide a novel tool to assess OAB domains in women. Though we did not find statistical significance in OAB knowledge and attitude scores across treatment status, they may be potentially modifiable factors that affect OAB treatment uptake and treatment compliance. Refinement of these surveys in diverse sub-populations is necessary. Our study provides effect sizes for OAB knowledge and attitude. These effect sizes can help development of fully powered trials to study the association between OAB knowledge and attitude, type and length of treatment, treatment compliance, and quality of life, leading to interventions for enhancing OAB care

Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study.

Results indicate that TM can be effective in improving the quality of life and functional capacity of African American CHF patients. Further validation of outcomes is planned via a large, multicenter trial with long-term follow-up

Additional file 1: of Knowledge and attitude for overactive bladder care among women: development and measurement

Appendix- OAB knowledge and attitude surveys. (DOCX 25 kb

Trajectory of Depression among Prostate Cancer Patients: A Secondary Analysis of a Randomized Controlled Trial

Background: While psychological difficulties, such as depression, among prostate cancer patients are known, their longitudinal burden remains understudied. We assessed the burden of depression across low-, intermediate- and high-risk prostate cancer groups, and the association between regret and long-term depression. Methods: Secondary analysis of data from a multi-centered randomized controlled study among localized prostate cancer patients was carried out. Assessments were performed at baseline, and at 3-, 6-, 12- and 24-month follow-up. Depression was assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. A CES-D score ≥ 16 indicates high depression. Regret was measured using the regret scale of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC). The proportion of patients with high depression was compared over time, for each risk category. Logistic regression was used to assess the association between regret, and long-term depression after adjusting for age, race, insurance, smoking status, marital status, income, education, employment, treatment, number of people in the household and study site. Results: The study had 743 localized prostate cancer patients. Median depression scores at 6, 12 and 24 months were significantly larger than the baseline median score, overall and for the three prostate cancer risk groups. The proportion of participants with high depression increased over time for all risk groups. Higher regret at 24-month follow-up was significantly associated with high depression at 24-month follow-up, after adjusting for covariates. Conclusions: A substantial proportion of localized prostate cancer patients continued to experience long-term depression. Patient-centered survivorship care strategies can help reduce depression and regret, and improve outcomes in prostate cancer care