Sleep Status and the Associated Factors: A Large Cross-Sectional Study in Shaanxi Province, China

This study aimed at investigating the sleep status and its associated factors in Shaanxi province, China. We conducted a cross-sectional study among 11,399 subjects in Shaanxi Province, China. Data were collected via spot field questionnaire surveys. The contents included demographic characteristics, sleep status, lifestyles, disease history and other associated factors. Logistic regression analysis was used to estimate the effect of associated factors on sleep quality. A total of 11,036 subjects were included in the final analysis. In total, 12.8% of the participants had bad or very bad sleep. In the last month, 8.4% of the participants had difficulty in initiating sleep, 7.6% of the participants had difficulty in maintaining sleep, 8.8% of the participants suffered from awakening earlier and 10.3% of the participants had the problem of feeling sleepy during the day ≥3 times per week. Poorer sleep quality was associated with being female, being unmarried or without cohabiting with a boyfriend/girlfriend, being divorced or widowed, heart diseases, musculoskeletal diseases, concerns about their own health, drinking alcohol, taking hypnotics, and a longer daily screen time. Better sleep quality was associated with medium education level, high family monthly income, good self-reported health status, and having breakfast regularly. In conclusion, more than one in ten people did not sleep well and suffered from different sleep problems in Shaanxi, China. Sleep quality was associated with sex, marital status, educational level, family monthly income, heart disease, musculoskeletal diseases, degree of concerning about their own health, self-reported health status, drinking alcohol, having breakfast, taking hypnotics and daily screen time

Photo-Induced Vertical Alignment of Liquid Crystals via In Situ Polymerization Initiated by Polyimide Containing Benzophenone

Vertical alignment of liquid crystal (LC) was achieved in an easy and effective way: in situ photopolymerization of dodecyl acrylate (DA) monomers initiated by polyimide based on 3,3′,4,4′-benzophenonetetracarboxylic dianhydride and 3,3′-dimethyl-4,4′-diaminodiphenyl methane (BTDA-DMMDA PI). The alignment behavior and alignment stabilities were characterized by a polarizing optical microscope (POM), which showed a stable vertical alignment after 12 h of thermal treatment. The chemical structures, morphology, and water contact angles of alignment films peeled from LC cells with and without DA monomers were analyzed by means of a Fourier transform infrared spectrometer (FTIR), a scanning electron microscope (SEM), and a contact angle tester, separately. The results confirmed that the DA monomers underwent self-polymerization and grafting polymerization initiated by the BTDA-DMMDA PI under ultraviolet irradiation, which aggregated on the surfaces of PI films. The water contact angles of the alignment films were about 15° higher, indicating a relative lower surface energy. In conclusion, the vertical alignment of LC was introduced by the low surface free energy of PI films grafted with DA polymer and intermolecular interactions between LC and DA polymers

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research