Causes of death among early-onset colorectal cancer population in the United States: a large population-based study.

Background: Early-onset colorectal cancer (EOCRC) has an alarmingly increasing trend and arouses increasing attention. Causes of death in EOCRC population remain unclear. Methods: Data of EOCRC patients (1975-2018) were extracted from the Surveillance, Epidemiology, and End Results database. Distribution of death was calculated, and death risk of each cause was compared with the general population by calculating standard mortality ratios (SMRs) at different follow-up time. Univariate and multivariate Cox regression models were utilized to identify independent prognostic factors for overall survival (OS). Results: The study included 36,013 patients, among whom 9,998 (27.7%) patients died of colorectal cancer (CRC) and 6,305 (17.5%) patients died of non-CRC causes. CRC death accounted for a high proportion of 74.8%-90.7% death cases within 10 years, while non-CRC death (especially cardiocerebrovascular disease death) was the major cause of death after 10 years. Non-cancer death had the highest SMR in EOCRC population within the first year after cancer diagnosis. Kidney disease [SMR = 2.10; 95% confidence interval (CI), 1.65-2.64] and infection (SMR = 1.92; 95% CI, 1.48-2.46) were two high-risk causes of death. Age at diagnosis, race, sex, year of diagnosis, grade, SEER stage, and surgery were independent prognostic factors for OS. Conclusion: Most of EOCRC patients died of CRC within 10-year follow-up, while most of patients died of non-CRC causes after 10 years. Within the first year after cancer diagnosis, patients had high non-CRC death risk compared to the general population. Our findings help to guide risk monitoring and management for US EOCRC patients.

Ferroelectrically Modulated and Enhanced Photoresponse in a Self-Powered α-In2Se3/Si Heterojunction Photodetector.

Photodetectors have been applied to pivotal optoelectronic components of modern optical communication, sensing, and imaging systems. As a room-temperature ferroelectric van der Waals semiconductor, 2D α-In2Se3 is a promising candidate for a next-generation optoelectronic material because of its thickness-dependent direct bandgap and excellent optoelectronic performance. Previous studies of photodetectors based on α-In2Se3 have been rarely focused on the modulated relationship between the α-In2Se3 intrinsic ferroelectricity and photoresponsivity. Herein, a simple integrated process and high-performance photodetector based on an α-In2Se3/Si vertical hybrid-dimensional heterojunction was constructed. Our photodetector in the ferroelectric polarization up state accomplishes a self-powered, highly sensitive photoresponse with an on/off ratio of 4.5 × 105 and detectivity of 1.6 × 1013 Jones, and it also shows a fast response time with 43 µs. The depolarization field generated by the remanent polarization of ferroelectrics in α-In2Se3 provides a strategy for enhancement and modulation of photodetection. The negative correlation was discovered because the enhancement photoresponsivity factor of ferroelectric modulation competes with the photovoltaic behavior within the α-In2Se3/Si heterojunction. Our research highlights the great potential of the high-efficiency heterojunction photodetector for future object recognition and photoelectric imaging.

Data Analysis Model Design of Health Service Monitoring System for China's Elderly Population: The Proposal of the F-W Model Based on the Collaborative Governance Theory of Healthy Aging.

In the era of artificial intelligence, big data and 5G, health care for elderly people is facing an important digital transformation. The objective of this study is to design the data analysis module of the elderly health service monitoring system (HSMS) and attempt to put forward a new healthy aging (HA) model that is applicable not only to the individual HA, but also to the regional HA system. Based on the HA theory of collaborative governance, we divided the elderly HSMS into four modules, including physical health, mental health, ability of daily activity, and social participation. Then, factors that influence HA were assessed by stepwise logistic regression to build the analysis model, using the public micro-panel data of the China Health and Retirement Longitudinal Survey (CHARLS). Age (odds ratio (OR) = 1.55 (95% confidence interval (CI): 1.06-2.27)), living in urban areas (OR = 1.57 (95% CI: 1.03-2.39)), being literate (OR = 1.51 (95% CI: 1.01-2.23)), expecting to get long-term health care in the future from their grown children (OR = 1.69 (95% CI: 1.10-2.61)) and having literate grown children (OR = 2.01 (95% CI: 0.26-0.97)) had a significant positive impact on HA of elderly people. Therefore, the F-W (factors and weighs, also family and welfare) model is proposed in this paper. The outcomes can contribute with designing HSMS for different provinces and several different regions in China and leave a door open to improve the model and algorithm application for HSMS in the future studies.

Factors Associated with Healthy Ageing, Healthy Status and Community Nursing Needs among the Rural Elderly in an Empty Nest Family: Results from the China Health and Retirement Longitudinal Study.

Health care for the rural elderly in and empty nest family is a major problem in such an ageing society such as China. Based on previous studies, China's rural health care services only focus on the physical health of the elderly, while public health care services only provide primary services such as blood pressure and blood glucose measurement. This leads to the question of whether physical health is the most important issue for the Chinese rural empty nest elderly (CREE). It is necessary to find out their health status, nursing needs and influencing factors associated with healthy ageing (HA). Using the method of logistic regression, four dimensions of HA (adding psychological health, social participation and daily activities to physical health) among 618 respondents in total were analyzed based on public panel data from the national survey of the China Health and Retirement Longitudinal Study (CHARLS). Interesting results have been found; for example, the most important factor restricting the HA of the CREE is not physical health but social participation. The independence, health, good employment and economic conditions of their adult children play an important role in protecting the HA of the CREE.

Factors Associated with the Psychological Health of Caregiving Older Parents and Support from Their Grown Children: Results from the China Health and Retirement Longitudinal Study.

In China, older parents have become an important source of childcare for their grown children since 2010. However, caring for grandchildren may affect older parents' psychological health (PH) in both positive and negative ways. Using the method of stepwise decreasing logistic regression, this study aimed to assess the factors associated with PH and support from grown children among caregiving older parents (400 respondents) based on the public panel data of the China Health and Retirement Longitudinal Study (CHARLS). The findings showed that being male (X1, OR = 1.661 (95% CI 1.066-2.590)), being literate (X4, OR = 2.129 (95% CI 1.369-3.309)), and expecting long-term care in the future from their grown children (X6, OR = 2.695 (95% CI 1.736-4.185)) were significant factors associated with PH. Therefore, in such an aging society, we should not regard older parents as a "burden"; we should recognize and appreciate their contribution to caregiving. As family and children, it is important to give older parents the necessary economic and emotional support to maintain their psychological health in the meantime.

Global Long-Term Care Research: A Scientometric Review.

Since the early 1960s, long-term care (LTC) has attracted a broad range of attention from public health practitioners and researchers worldwide and produced a large volume of literature. We conducted a comprehensive scientometric review based on 14,019 LTC articles retrieved from the Web of Science Core Collection database from 1963 to 2018, to explore the status and trends of global LTC research. Using CiteSpace software, we conducted collaboration analysis, document co-citation analysis, and keyword co-occurrence analysis. The results showed a rapid increase in annual LTC publications, while the annual citation counts exhibited an inverted U-shaped relationship with years. The most productive LTC research institutions and authors are located primarily in North American and European countries. A simultaneous analysis of both references and keywords revealed that common LTC hot topics include dementia care, quality of care, prevalence and risk factors, mortality, and randomized controlled trial. In addition, LTC research trends have shifted from the demand side to the supply side, and from basic studies to practical applications. The new research frontiers are frailty in elderly people and dementia care. This study provides an in-depth understanding of the current state, popular themes, trends, and future directions of LTC research worldwide.

[Studies on the doctor-patient relationship in early Chinese missionary hospitals].

During the 19th century, missionary hospitals were set up by the missionaries in China, establishing a new doctor-patient relationship with doctors at the dominant position. In the early Chinese missionary hospitals, the doctor-patient relationship was relatively good, which could be seen from Chinese people's feelings of gratitude to the medical missionaries. The early missionary hospitals were totally controlled by the western Christians during the 1820-1860. Such good doctor-patient relationship was the results of common action of multiple factors, including Christianity, free medical charges, management idea based on humanism, the idea of the hospitals to avoid medical risks, family concept in traditional Chinese culture and so on.

[An exploration of the training of medical talents in China for Ryukyu islands based on the Liu qiu bai wen (One Hundred Question of Ryukyu)].

Ryukyu sent more than 20 batches of returned students to China for studying during the Ming and Qing Dynasties, many of whom were studying medicine. Liu qiu bai wen (One Hundred Question of Ryukyu) was the record of discussion between Cao Cunxin, a famous doctor of the Qing Dynasty, and the oversea disciples of Lü Fengyi from Ryukyu. However, it was not only a medical book, but also served as an important witness on overseas dissemination of TCM, and the fresh case of Chinese training medical talented persons for Ryukyu. Training Ryukyu medical students in the Qing Dynasty was good for the expansion of Chinese medicine in the Ryukyu, and promoted the development and social progress of the Ryukyu medicine and health, made a significant contribution to maintain the friendly relationship between the two countries.