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ObjectiveTo explore differences in end-of-life healthcare utilisation and medication costs between patients with haematological malignancies and patients with solid tumours.MethodsData on deceased patients with cancer were selected from the sample cohort data of health insurance claims from 2008 to 2015 in South Korea. They were categorised into two groups: patients with haematological malignancies and patients with solid tumours. Longitudinal data comprised the patient-month unit and aggregated healthcare utilisation and medication cost for 1 year before death. Healthcare utilisation included emergency room visits, hospitalisation and blood transfusions. Medication costs were subdivided into anticancer drugs, antibiotics, opioids, sedatives and blood preparation. Generalised linear mixed models were used to evaluate differences between the two groups and time trends.ResultsOf the 8719 deceased patients with cancer, 349 died from haematological malignancies. Compared with solid tumours, patients with haematological malignancies were more likely to visit the emergency room (OR=1.36, 95% CI 1.10 to 1.69) and receive blood transfusions (OR=5.44, 95% CI 4.29 to 6.90). The length of hospitalisation of patients was significantly different (difference=2.49 days, 95% CI 1.75 to 3.22). Medication costs, except for anticancer treatment, increased as death approached. The costs of antibiotics and blood preparations were higher in patients with haematological malignancies than in those with solid tumours: 3.24 (95% CI 2.14 to 4.90) and 4.10 (95% CI 2.77 to 6.09) times higher, respectively.ConclusionsPatients with haematological malignancies are at a higher risk for aggressive care and economic burden at the end of life compared with those with solid tumours. Detailed attention is required when developing care plans for end-of-life care of haematological patients.

IMPORTANCE: A bayesian network meta-analysis (NMA) can help compare the various types of multifocal and monofocal intraocular lenses (IOLs) used in clinical practice. OBJECTIVE: To compare outcomes of presbyopia-correcting IOLs frequently recommended in clinical practice through a bayesian NMA based on a systematic review. DATA SOURCES: Medline (PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched on May 15, 2021, from inception. STUDY SELECTION: Based on the research question, randomized clinical trials assessing multifocal IOLs in patients who underwent bilateral cataract extraction were searched. Nonrandomized studies, studies in patients with unilateral or contralateral cataract extractions, duplicated studies, conference abstracts, and nonpeer-reviewed articles were excluded. DATA EXTRACTION AND SYNTHESIS: Descriptive statistics and outcomes were extracted. The NMA was conducted to compare different types of IOLs. The mean differences for continuous variables, odds ratios for binary variables, 95% credible intervals (CrIs), and ranks of interventions were estimated. MAIN OUTCOMES AND MEASURES: The outcomes examined included binocular visual acuities by distance and optical quality, including glare, halos, and spectacle independence. RESULTS: This NMA included 27 studies comprising 2605 patients. For uncorrected near visual acuity, trifocal IOLs (mean difference, −0.32 [95% CrI, −0.46 to −0.19]) and old bifocal diffractive IOLs (mean difference, −0.33 [95% CrI, −0.50 to −0.14]) afforded better visual acuity than monofocal IOLs. Regarding uncorrected intermediate visual acuity, extended depth-of-focus IOLs provided better visual acuity than monofocal IOLs. However, there were no differences between extended depth-of-focus and trifocal diffractive IOLs in pairwise comparisons. For uncorrected distant visual acuity, all multifocal IOLs were comparable with monofocal IOLs. There were no statistical differences between multifocal and monofocal IOLs regarding contrast sensitivity, glare, or halos. CONCLUSIONS AND RELEVANCE: For patients considering a multifocal IOL due to presbyopia, bilateral implantation of a trifocal IOL might be an optimal option for patients without compromising distant visual acuity.

AbstractAimWe aimed to determine the incidence of and identify the factors associated with treatment-resistant depression (TRD), psychiatric conditions, hospitalization, and cost in patients with major depressive disorder (MDD) who were treated using second-line strategies after an inadequate response to initial antidepressants (AD).Materials and methodsUsing South Korean National Health Insurance claims data (1 January 2013 to 30 June 2018), we conducted a retrospective cohort analysis in newly treated patients with MDD who subsequently switched or added AD, or added atypical antipsychotics (AAPs) as a second-line treatment. We assessed the incidence of treatment-resistant depression (TRD), psychiatric conditions, and hospitalization for the first 2 years and costs in the third year. Odds ratios (ORs) or relative ratios were estimated using logistic and linear regression models to identify the risk factors for clinical and economic outcomes.ResultsIn 15,887 patients, the TRD was 16.81% during the 24-month follow-up period (14.14% in switching AD, 19.65% in adding AD, and 19.91% in adding AAP; p < 0.0001). When adding AD or AAP, the OR of TRD was 1.43 (95% confidence interval (CI): 1.30–1.56) and 1.42 (95% CI: 1.23–1.65), respectively, compared to switching AD. However, these factors were not associated with the incidence of psychiatric conditions. Adding AAP increased hospitalization (OR = 1.25, 95% CI: 1.11–1.41), the number of inpatient days by 2.57-fold (95% CI: 1.75–3.76), and cost by 1.20-fold (95% CI: 1.02–1.40), compared to switching AD; adding AD did not show a significant association with these outcomes.ConclusionsIn patients with MDD with inadequate responses to initial AD, TRD still occurred after subsequent treatments according to clinical guidelines. Since the effectiveness of second treatment strategies can differ in reality, further analysis of the clinical and economic evidence regarding second treatment strategies, such as adding AD or AAP, is needed using real-world data.

AbstractMolded flexible polyurethane (PU) foams were synthesized from a starch/petroleum based polyol, 2,4/2,6-toluene diisocyanate (TDI-80), using a one shot method with water as the blowing agent. The effects of chain extender type [starch (S series), diethanolamine (DEA, D series), glycerol (G series)] and content (0, 2, 5, 10 pphr) were extensively studied. The rate of foam formation, density, compression strength, glass transition temperature (Tg) and rubbery modulus of the foam increased with the addition and increasing content of extender. At the same extender content, DEA showed the highest of these properties, while starch showed the lowest. The rate of biodegradation in a buffer solution decreased with the addition of DEA and glycerol, due to the increased crosslinking density and hard segment content, but increased with starch, owing to its biodegradability.

Misalignment can be an important problem in the integration of GPS/INS. Observability analysis of the alignment errors in the integration of low-grade inertial sensors and multiantenna GPS is presented in this paper. A control-theoretic approach is adopted to study the observability of time-varying error dynamics models. The relationship between vehicle motions and the observability of the errors in the lever arm and relative attitude between GPS antenna array and IMU is given. It is shown that alignment errors can be made observable through maneuvering. The change of acceleration makes the components of the relative attitude error that are orthogonal to the direction of the acceleration change observable. The change of angular velocity makes the components of the lever arm error that are orthogonal to the direction of the angular velocity observable. The motion of constant angular velocity has no influence on the estimation of the lever arm.

Tiotropium has the potential to alleviate asthmatic symptoms caused by the aging of lungs. However, few studies have focused on specific treatments for elderly patients with asthma.