Shared decision making with Oncologists and Palliative care specialists (SOP) model help advanced pancreatic cancer patients reaching goal concordant care: A prospective cohort study.

BACKGROUND: Pancreatic cancer is often diagnosed at a late stage with a poor prognosis due to insidious symptoms and lack of evidence-based screening in general population. Palliative care's acceptance in Asian cultures is hindered by misconceptions and ineffective communication about management that improve quality of life other than cancer directed treatment. Our study aimed to determine the effect of the Shared decision-making with Oncologists and Palliative care specialists (SOP) model developed from the traditional shared decision-making (SDM) model on the palliative care acceptance rate and medical resource utilization. METHODS: This is a prospective cohort study implementing the SOP model at the National Taiwan University Hospital from January 2018 to December 2019 for patients with advanced pancreatic cancer. Medical resource utilization was defined and recorded as the rate of hospitalization, emergency room (ER), and intensive care unit admissions. We compared the results between two groups: patients who received the SOP model in 2019 and patients who did not receive it in 2018. RESULTS: 137 patients with advanced pancreatic cancer were included in our study. The result showed that the acceptance rate of palliative care significantly increased from 50% to 78.69% after the SOP model (p = 0.01). The hospitalization rate did not show a significant difference between 2018 (93.42%, 95% CI: 0.88-0.99) and 2019 (93.44%, 95% CI: 0.87-1.00). 83.61% (95% CI: 0.74-0.93) of our patients in 2019 had at least one ER visit; the rate was 81.5% (95% CI: 0.73-0.91) in 2018 (p = 0.28). The percentage of patients admitted to the ICU increased from 3.95% in 2018 to 8.2% (95% CI: -0.05-0.08) in 2019 (95% CI: 0.11-0.15) (p = 0.00). The hospitalization and ER visit showed no statistically difference between 2 years. CONCLUSIONS: The modified SOP model markedly augmented palliative care's acceptance of patients with advanced pancreatic cancer. Adoption of the SOP model would provide these patients a more proactive and systematic approach to deliver needed healthcare.

Wetting Properties and Thin-Film Quality in the Wet Deposition of Zeolites.

Zeolites are microporous crystalline materials widely used in catalysis and adsorption applications. The fabrication of zeolite thin films and membranes has also opened up the possibility of using zeolites in electronic devices and membrane separations. The existing approach to growing zeolite films involves exposing the substrate to a high-pH environment; however, this process is applicable to only specific types of substrates. Our group has developed the direct wet deposition of zeolites via ultrasonic nozzle spray deposition to address this issue; however, the relationship between wetting properties and thin-film quality has yet to be investigated. In this study, we prepared zeolite CHA (Si:Al:P = 3:10:20) suspensions using different solvents and surfactants in various concentrations. We then examined the relationships among the composition of the cast solution, their wetting behavior on the glass substrate, and the uniformity of the resulting thin films. We found that using ethanol as a solvent with zeolite crystals in low concentrations with added surfactant yielded zeolite films of high quality. We were also able to produce low-haze zeolite coatings on glass. The zeolite coatings with high hydrophilicity and adsorption capacity presented excellent antifogging capability.

Zeolite-Based Antifogging Coating via Direct Wet Deposition.

Zeolites are strongly hydrophilic materials that are widely used as water adsorbents. They are also promising candidates for antifogging coatings; however, researchers have yet to devise a suitable method for coating glass substrates with zeolite-based films. Here, we report on a direct wet deposition technique that is capable of casting zeolite films on glass substrates without exposing the glass to highly basic solutions or the vapors used in zeolite synthesis. We began by preparing cast solutions of pure silica zeolite MFI synthesized in hydrothermal reactions of various durations. The solutions were then applied to glass substrates via spin-on deposition to form zeolite films. The resulting zeolite MFI thin films were characterized in terms of transmittance to visible light, surface topography, thin film morphology, and crystallinity. Wetting and antifogging properties were also probed. We found that hydrophilicity and antifogging capability increased with the degree of thin film crystallinity. We also determined that the presence of the amorphous silica in the thin films is critical to transparency. Fabricating high-performance zeolite-based antifogging coatings requires an appropriate composition of zeolite crystals and amorphous silica.