The influence of legal training for doctors on medical disputes

In the context of rule by l aw in China and law based management in hospitals, it is an efficient way to reduce the occurrence of disputes through improving the medical staff professional literacy and keeping doctors abreast of the latest legal provisions concerning the rights and obligations of patients. Many studies have proposed measures to reduce medical disputes and to strengthen the legal knowledge training for medical staff. However, legal training for medical staff in Chinese medical institutions is still relatively traditional, which cannot reach the goal of reducing medical disputes. Considering the root causes of medical disputes in China, the realistic background of high incidence of medical disputes and the necessity of legal training for doctors, the following issue s are studied: (1) What are the factors that affect the effectiveness of legal training for doctors? (2) What are the impacts of training for doctors to practice by law on reducing patient complaints, medical disputes and enhancing doctors’ law awareness? This thesis adopts quantitative research methods. On the premise of analyzing 10 year data and big data of medical dispute litigation, the research data was obtained through t he doctor’s legal demand scale, the doctor’s cognition scale and the sample collection ( such as questionnaire) With SPSS statistical analysis software, all the questionnaires were analyzed by single factor, multiple factor analysis and linear regression analysis. The effectiveness evaluation of legal training for doctors adopts Kirkpatrick’s four level evaluation model , filling the application blank of the Chinese doctors’ legal training evaluation theory in the field of Kirkpatrick’s four level evaluation. The findings may be of reference significance for doctors’ legal training, reducing the incidence of medical disputes and improving the doctor patient relationship. However, due to the shortcomings of sample data an d cross sectional research design, the research results s till have some limitations.De acordo com a legislação para a governação dos hospitais há uma modo eficiente de reduzir a ocorrência de litígios através da melhoria da literacia profissional do corpo clínico providenciando lhes a informação respeitant e aos direitos e obrigações dos doentes. Autores diversos têm vindo a propor medidas para reduzir os disputas litigiosas dos médicos e todos referem a importância do fortalecimento do conhecimento jurídico na formação do corpo clínico. No entanto, a formaç ão nesta área do pessoal médico em instituições médicas chinesas ainda é relativamente tradicional, não tendo este tipo de formação atingido ainda o objetivo de reduzir significativamente os litígios. Considerando a sequência de causas dos litígios médicos na China, a constatação da alta incidência de disputas litigiosas e a necessidade de formação jurídica dos médicos, coloca questões a serem estudadas: (1) Quais são os fatores que afetam a eficácia da formação dos médicos para atuarem de acordo com a lei? (2) Quais são os impactos da formação jurídica dos médicos na redução de reclamações dos doentes, diminuindo os litígio e controvérsias e aumentando a consciencialização dos médicos sobre a legislação existente? A presente pesquisa adota método quantitativos. Foram analizados dados de 10 anos do contencioso médico. Os dados da pesquisa foram obtidos de acordo com várias escalas. Utilizando o software de análise estatística SPSS, analisamos os questionários recorrendo à análise fatorial e análise de regress ão linear simples e multifatorial. A avaliação da validade da formação jurídica dos médicos adota a avaliação dos quatro níveis de Kirkpatrick, que vem preencher as lacunas da avaliação existente da formação jurídica dos médicos chineses . As conclusões podem ser significativas e servirem de referência para a formação jurídica dos médicos, reduzindo a incidência de disputas litigiosas e melhorando a relação médico doente. No entanto, devido às limitações da amostra e design da pesquisa, os resultados apre sentam algumas limitações

Probabilistic Memory Model for Visual Images Categorization

During the past decades, numerous memory models have been proposed, which focused mainly on how spoken words are studied, whereas models on how visual images are studied are still limited. In this study, we propose a probabilistic memory model (PMM) for visual images categorization which is able to mimic the workings of the human brain during the image storage and retrieval. First, in the learning phase, the visual images are represented by the feature vectors extracted with convolutional neural network (CNN) and each feature component is assumed to conform to a Gaussian distribution and may be incompletely copied with a certain probability or randomly produced in accordance to an exponential distribution. Then, in the test phase, the likelihood ratio between the test image and each studied image is calculated based on the probabilistic inference theory, and an odd value in favor of an old item over a new one is obtained based on all likelihood values. Finally, if the odd value is above a certain threshold, the Bayesian decision rule is applied for image classification. Experimental results on two benchmark image datasets demonstrate that the proposed PMM can perform well on categorization tasks for both studied and non-studied images

The Impact of Wire Stent Fabrication Technique on the Performance of Stent Placement

Braided wire stents demonstrate distinct characteristics compared to welded ones. In this study, both braided and welded wire stents with the same nominal dimensions were crimped inside a sheath and then deployed into a stenosed artery using finite element analysis. The braided wire stent was generated by overlapping wires to form crisscross shape. A welded wire stent was created by welding the intersection points of wires to avoid sliding between wires. The effect of fabrication technique on mechanical behavior of Nitinol wire stents was evaluated. The results showed that relative sliding between wires reduced the deformation of the braided stent, which led to less radial strength than the welded one; therefore, the deployed braided stent was more conformed to the anatomic shape of the lesion and much less efficient for restoring the patency of the stenotic artery. Post balloon-dilation was commonly used to improve its performance in terms of lumen gain and deployed shape of the stent. On the contrary, the welded wire stent exhibited a high capacity for pushing the occlusion outward. It reached an approximately uniform shape after deployment. The welded joints caused larger deformation and high strain on the stent struts, which indicate a potential earlier failure for the welded stent. In addition, higher contact pressure at the stent-lesion interface and higher arterial stresses were observed in the artery supported by the welded stent. The peak stress concentration may increase the occurrence of neointimal hyperplasia

Engineered Microenvironment for Manufacturing Human Pluripotent Stem Cell-Derived Vascular Smooth Muscle Cells

Human pluripotent stem cell-derived vascular smooth muscle cells (hPSC-VSMCs) are of great value for disease modeling, drug screening, cell therapies, and tissue engineering. However, producing a high quantity of hPSC-VSMCs with current cell culture technologies remains very challenging. Here, we report a scalable method for manufacturing hPSC-VSMCs in alginate hydrogel microtubes (i.e., AlgTubes), which protect cells from hydrodynamic stresses and limit cell mass to \u3c400 \u3eμm ensure efficient mass transport. The tubes provide cells a friendly microenvironment, leading to extremely high culture efficiency.We have shown that hPSC-VSMCs can be generated in 10 days with high viability, high purity, and high yield (~5.0 x 108 cells/mL). Phenotype and gene expression showed that VSMCs made in AlgTubes and VSMCs made in 2D cultures were similar overall. However, AlgTube-VSMCs had higher expression of genes related to vasculature development and angiogenesis, and 2D-VSMCs had higher expression of genes related to cell death and biosynthetic processes

A prediction model for short-term neurodevelopmental impairment in preterm infants with gestational age less than 32 weeks

IntroductionEarly identification and intervention of neurodevelopmental impairment in preterm infants may significantly improve their outcomes. This study aimed to build a prediction model for short-term neurodevelopmental impairment in preterm infants using machine learning method.MethodsPreterm infants with gestational age  < 32 weeks who were hospitalized in The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, and were followed-up to 18 months corrected age were included to build the prediction model. The training set and test set are divided according to 8:2 randomly by Microsoft Excel. We firstly established a logistic regression model to screen out the indicators that have a significant effect on predicting neurodevelopmental impairment. The normalized weights of each indicator were obtained by building a Support Vector Machine, in order to measure the importance of each predictor, then the dimension of the indicators was further reduced by principal component analysis methods. Both discrimination and calibration were assessed with a bootstrap of 505 resamples.ResultsIn total, 387 eligible cases were collected, 78 were randomly selected for external validation. Multivariate logistic regression demonstrated that gestational age(p = 0.0004), extrauterine growth restriction (p = 0.0367), vaginal delivery (p = 0.0009), and hyperbilirubinemia (0.0015) were more important to predict the occurrence of neurodevelopmental impairment in preterm infants. The Support Vector Machine had an area under the curve of 0.9800 on the training set. The results of the model were exported based on 10-fold cross-validation. In addition, the area under the curve on the test set is 0.70. The external validation proves the reliability of the prediction model.ConclusionA support vector machine based on perinatal factors was developed to predict the occurrence of neurodevelopmental impairment in preterm infants with gestational age  < 32 weeks. The prediction model provides clinicians with an accurate and effective tool for the prevention and early intervention of neurodevelopmental impairment in this population

Clinical-radiomics nomogram using contrast-enhanced CT to predict histological grade and survival in pancreatic ductal adenocarcinoma

ObjectivesTumor grading is important for prognosis of pancreatic ductal adenocarcinoma (PDAC). In this study, we developed preoperative clinical-radiomics nomograms using features from contrast-enhanced CT (CECT), to discriminate high-grade and low-grade PDAC and predict overall survival (OS).MethodsIn this single-center, retrospective study conducted from February 2014 to April 2021, consecutive PDAC patients who underwent CECT and had pathologically identified grading were randomized to training (n=200) and test (n=84) cohorts for development of model to predict histological grade based on radiomics scores from CECT (HGrad). Another 42 patients were used as external validation cohort of HGrad. A nomogram (HGnom) was constructed using radiomics score, CA12-5 and smoking to predict histological grade. A second nomogram (Pnom) was constructed using radiomics score, CA12-5, TNM, adjuvant treatment, resection margin and microvascular invasion to predict OS in radical resection patients (217 of 284).ResultsAmong 326 patients, 122 were high-grade (120 poorly differentiated and 2 undifferentiated). The HGrad yielded AUCs of 0.75 (95% CI: 0.64, 0.85) and 0.76 (95% CI: 0.60, 0.91) in test and validation cohorts. The HGnom achieved AUCs of 0.77 (95% CI: 0.66, 0.87), and the predicted grades calibrated well with actual grades (P=.13). OS was different between the grades predicted by radiomics scores (P=.01). The integrated AUC of the Pnom for predicting OS was 0.80 (95% CI: 0.75, 0.88).ConclusionCompared with the HGrad using features from CECT, the HGnom demonstrated higher performance for predicting histological grade. The Pnom helped identify patients with high survival outcome in pancreatic ductal adenocarcinoma

The Impact of Wire Stent Fabrication Technique on the Performance of Stent Placement

Braided wire stents demonstrate distinct characteristics compared to welded ones. In this study, both braided and welded wire stents with the same nominal dimensions were crimped inside a sheath and then deployed into a stenosed artery using finite element analysis. The braided wire stent was generated by overlapping wires to form crisscross shape. A welded wire stent was created by welding the intersection points of wires to avoid sliding between wires. The effect of fabrication technique on mechanical behavior of Nitinol wire stents was evaluated. The results showed that relative sliding between wires reduced the deformation of the braided stent, which led to less radial strength than the welded one; therefore, the deployed braided stent was more conformed to the anatomic shape of the lesion and much less efficient for restoring the patency of the stenotic artery. Post balloon-dilation was commonly used to improve its performance in terms of lumen gain and deployed shape of the stent. On the contrary, the welded wire stent exhibited a high capacity for pushing the occlusion outward. It reached an approximately uniform shape after deployment. The welded joints caused larger deformation and high strain on the stent struts, which indicate a potential earlier failure for the welded stent. In addition, higher contact pressure at the stent-lesion interface and higher arterial stresses were observed in the artery supported by the welded stent. The peak stress concentration may increase the occurrence of neointimal hyperplasia