Patient-centred care and patient autonomy: doctors' views in Chinese hospitals

Background: Patient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals. Methods: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Results: In total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes. Conclusion: The study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals

Doctors in Chinese public hospitals: demonstration of their professional identities

Background: An increase in the number of medical disputes and violence against doctors indicates a lack of trust in the medical profession by society in Chinese public hospitals. Empirical evidence confirms that one cause is the lack of professional identity demonstrated by doctors. Medical professionals are required to maintain high standards of competence and moral responsibility, and demonstrate qualities such as respect, compassion, integrity, responsiveness to needs, and commitment to sound ethical practice in order to maintain professional privilege. These principles and appropriate professional conduct are the foundation of the professional identity of the medical profession. Methods: A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Findings: In total, 614 doctors and 1184 inpatients on discharge from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the variation amongst doctors in demonstrating their professionalism in terms of respecting patients’ views and preferences when determining diagnostic procedures and treatment plans, and when making ethical decisions. Although 90% patients indicated that they showed respects to doctors, close to 20% of the doctors disagreed that they received high respect from patients. About 12% of doctors prescribed unnecessary diagnostic procedures to patient for the purpose of generating profit and more than 20% of patients indicated that they gave gifts to doctors in order to receive better treatment. Conclusions: Although about 80% of doctors demonstrated certain aspects of professionalism required by practitioners, the inconsistency across the medical workforce may exacerbate tense doctor-patient relationships. A review of medical curricula and focus of the internship program is required in order to assist medical graduates with forming required professional identity in order to improve patient satisfaction and better clinical outcomes. To be effective, a more systematic approach is recommended

Dynamics and hydrodynamic efficiency of diving beetle while swimming

Diving beetle, an excellent biological prototype for bionic underwater vehicles, can achieve forward swimming, backward swimming, and flexible cornering by swinging its two powerful hind legs. An in-depth study of the propulsion performance of them will contribute to the micro underwater vehicles. In this paper, the kinematic and dynamic parameters, and the hydrodynamic efficiency of the diving beetle are studied by analysis of swimming videos using Motion Capture Technology, combined with CFD simulations. The results show that the hind legs of diving beetle can achieve high propulsion force and low return resistance during one propulsion cycle at both forward and backward swimming modes. The propulsion efficiencies of forward and backward swimming are 0.47 and 0.30, respectively. Although the efficiency of backward swimming is lower, the diving beetle can reach a higher speed in a short time at this mode, which can help it avoid natural enemies. At backward swimming mode, there is a long period of passive swing of hind legs, larger drag exists at higher speed during the recovery stroke, which reduces the propulsion efficiency to a certain extent. Reasonable planning of the swing speed of the hind legs during the power stroke and the recovery stroke can obtain the highest propulsion efficiency of this propulsion method. This work will be useful for the development of a bionic propulsion system of micro underwater vehicle

Transcutaneous auricular vagus nerve stimulation on upper limb motor function with stroke: a functional near-infrared spectroscopy pilot study

BackgroundTranscutaneous auricular vagus nerve stimulation (taVNS) emerges as a promising neuromodulatory technique. However, taVNS uses left ear stimulation in stroke survivors with either left or right hemiparesis. Understanding its influence on the cortical responses is pivotal for optimizing post-stroke rehabilitation protocols.ObjectiveThe primary objective of this study was to elucidate the influence of taVNS on cortical responses in stroke patients presenting with either left or right hemiparesis and to discern its potential ramifications for upper limb rehabilitative processes.MethodsWe employed functional near-infrared spectroscopy (fNIRS) to ascertain patterns of cerebral activation in stroke patients as they engaged in a “block transfer” task. Additionally, the Lateralization Index (LI) was utilized to quantify the lateralization dynamics of cerebral functions.ResultsIn patients exhibiting left-side hemiplegia, there was a notable increase in activation within the pre-motor and supplementary motor cortex (PMC-SMC) of the unaffected hemisphere as well as in the left Broca area. Conversely, those with right-side hemiplegia displayed heightened activation in the affected primary somatosensory cortex (PSC) region following treatment.Significantly, taVNS markedly amplified cerebral activation, with a pronounced impact on the left motor cortical network across both cohorts. Intriguingly, the LI showcased consistency, suggesting a harmonized enhancement across both compromised and uncompromised cerebral regions.ConclusionTaVNS can significantly bolster the activation within compromised cerebral territories, particularly within the left motor cortical domain, without destabilizing cerebral lateralization. TaVNS could play a pivotal role in enhancing upper limb functional restoration post-stroke through precise neuromodulatory and neuroplastic interventions

TAW: cost-effective threshold authentication with weights for internet of things

In the Internet of Things, based on the collaboration of sensing nodes, sensing data are collected and transmitted. The collaboration of sensing nodes also plays an important role in the safeguard of the Internet of Things. Owing to the limited ability of the single sensing node, the threshold authentication based on the collaboration of sensing nodes can improve the trust of security authentication of sensing nodes. The current threshold authentication schemes may require high-computational complexity, and more importantly, most of them are instantiated by membership authentication. It’s challenging to apply the current state of the arts to the case where sensing nodes with various weights join together to fulfill a relatively lightweight authentication. In this paper, we first design a communication key distribution scheme for sensing networks based on a symmetric operator. Using the permutation function, the scheme is able to generate characteristic sequences to improve the efficiency of key distribution in sensing networks. In addition, we propose a threshold authentication scheme based on weights, in which the higher weight represents the more important role in authentication. Our authentication scheme only requires lightweight operations, so that, it is extremely friendly to the IoT nodes with restricted computation power. The security analysis and the case verification demonstrate that our novel authentication protects IoT nodes without yielding significantly computational burden to the nodes

Nudel and FAK as Antagonizing Strength Modulators of Nascent Adhesions through Paxillin

Competition for binding to the cellular protein paxillin by the proteins Nudel and focal adhesion kinase is important for the proper regulation of cell adhesion and migration

Output Torque for Electromagnetic Harmonic Drive

The operation principle of an electromagnetic harmonic drive is analyzed and its speed ratio equation is given. The equations of the displacements of the flexible ring under magnetic forces and the equations of the output torque between the flexible ring and rigid one are deduced. Using these equations, the displacement distribution of the flexible ring is investigated, and the effects of the system parameters on output torque are discussed. The results show that the current intensity of the coils, the airgap, the iron core length, and the position of the rigid ring have effects on the output torque for the drive system. The current intensity can be taken as the main control parameter of the output torque