Study on medical dispute prediction model and its clinical-application effectiveness based on machine learning.

BACKGROUND: Medical dispute is a global public health issue, which has been garnering increasing attention. In this study, we used machine learning (ML) method to establish a dispute prediction model and explored the clinical-application efficiency of this model in effectively reducing the occurrence of medical disputes. METHODS: Retrospective study of All disputes filed by Gansu Medical Mediation Committee from 2019 to 2021 and patients with the same hospital level as that of the dispute group and hospitalization year were randomly selected as the control group in 1:1 ratio. SPSS software was used for univariate feature selection of the 14 factors that may cause disputes, and factors with statistical differences were selected. The data were divided into training and test sets in a 7:3 ratio. Six ML models were selected, and Python was used to establish a dispute prediction model. The area under the curve (AUC) of the receiver operating characteristic curve (ROC), sensitivity, specificity, accuracy, precision, average precision (AP), and F1 score were used to characterize the fitting and accuracy of the models, while decision curve analysis (DCA) was used to evaluate their clinical utility. RESULTS: A total of 1189 patients in the dispute and control groups were extracted. Following 11 influencing factors were selected: the inpatient department, doctor title, patient age, patient gender, patient occupation, payment method, hospitalization days, hospitalization times, discharge method, blood transfusion volume, and hospitalization espenses. Compared to other models, the AUC (0.945, 95% CI 0.913-0.981), Sensitivity (0.887), Accuracy (0.887), AP (0.834), and F1 score (0.880) of the random forest model were higher than those of other models, while the DCA curve indicated its high clinical benefits. CONCLUSIONS: Inpatient department, hospitalization expenses, and discharge type are the primary influencing factors of dispute. Random forest exhibited high dispute prediction and clinical-application value and is expected to be promoted for offline dispute prediction.

Healthy Community-Life Circle Planning Combining Objective Measurement and Subjective Evaluation: Theoretical and Empirical Research.

BACKGROUND: The world faces vast health challenges, and urban residents living in high-density areas have even greater demand for healthy lifestyles. METHODS: Based on the data of points of interest, a field survey, and an interview, we explored the healthy community-life circle in the downtown area of Chengdu, China from two perspectives: objective measurement and subjective perception of residents. We evaluated the coverage rate and convenience in accessing eight types of health service facilities within a 15-min walk using linear and logistics regression models to explore the degree of resident satisfaction with facilities and influencing factors. RESULTS: Results showed significant differences in coverage rates between different districts. The overall convenience in accessing health service facilities decreased gradually from the city center to the outskirts. The social environment, the layout of health service facilities, and residents' travel habits were related to health service facility satisfaction. Results also showed significant differences in various facilities' accessibility satisfaction between objective measurement and residents' perception measurement. Compared with subjective measurement, the objective measurements of accessibility for sports venues (objectively measured average minus perceived average: -1.310), sports zones (-0.740), and specialized hospitals (-1.081) were lower; those for community hospitals (0.095), clinics (1.025), and pharmacies (0.765) were higher; and facility accessibility measured by subjective perception had a more significant impact on health facility satisfaction. Pharmacies (OR: 1.932) and community hospitals (OR: 1.751) had the largest impact among the eight types of facilities. CONCLUSION: This study proposed to construct a healthy community-life circle with a category and hierarchy system.

Differing perceptions of the youth and the elderly regarding cultural ecosystem services in urban parks: An exploration of the tour experience.

Parks have become important spaces for supplying cultural ecosystem services (CESs) in cities, and satisfying various needs of different age groups in parks has become a critical issue. Many studies focused on the environmental preferences and behaviours of different age groups in parks. However, results revealing the differences in value demand and acquisition between elderly and youth from a landscape spatial environmental perspective are limited. In this study, the same number of youth and elderly volunteers were recruited, according to the value-labelled photo fed back after their self-driven tour in the Huanhuaxi Urban Forest Park in Chengdu, China. In addition, this study explored the relationship between the perceived CES needs of the youth and elderly and the landscape spatial environment in the urban park ecosystem with the help of the Social Values for Ecosystem Services model. Results showed that, in comparison, to obtain recreation value, playgrounds, pavilions and squares were more important for the elderly, whereas topography, rivers, landscape sketches and trails were more important for the youth. Moreover, in terms of the sense of place, lakes and wetlands were more important for the elderly, whereas landscape sketches and playgrounds were more important for the youth. Furthermore, for the delivery of therapeutic value, squares were more important for the elderly. Spatially, the areas of lakes or wetlands with geographical combinations of landscape sketches and flowers were the high-value spots for supplying multiple CESs in urban parks. Then, squares, rivers, playgrounds and forests were the focus areas where the value identification of the two age groups diverges. This study emphasises the differences in demand and acquisition of cultural added value provided by the environment between the young and the old. The study provides a basis for more targeted land management and landscape planning of urban parks.

Field Study on Indoor Thermal Environments of Monastic Houses and Thermal Comfort of Monks.

Monastic houses are an essential part of the Tibetan monastic system in China. In this study, the monastic houses of Labrang in the Tibetan region of Gannan were used as the research objects. Physical parameters such as indoor temperature, humidity, and radiation temperature of the monastic houses were measured. The measured results were compared with the standard values, while the air temperature was linearly fitted using TSV, PMV, and aPMV. The results show that the temperature inside and outside the monastic houses fluctuates considerably; the theoretical thermal neutral temperature of the tested monks in winter is 22.46 °C, which is higher than the measured thermal neutral temperature in winter of 16.43 °C. When analyzing the results, it was found that the local climate, dress code, and the monks' specific habits all impact the perception of thermal comfort, which creates a discrepancy between the accurate results and the standard values. The above findings provide a more comprehensive reference for the thermal comfort requirements of the monks in cold areas, which can be used as a guide for the improvement and evaluation of the monastic houses in cold areas.

Measurement of Coupling Coordination Degree and Spatio-Temporal Characteristics of the Social Economy and Ecological Environment in the Chengdu-Chongqing Urban Agglomeration under High-Quality Development.

With rapid urbanization and industrialization, ecological disorders and environmental degradation have become serious, and the promotion of the coordinated development of the social economy and ecological environment is not only a pressing problem to be solved, but also an important step towards sustainable development. The coordinated development of the social economy and eco-environment is conducive to sustainable development. Considering the Chengdu-Chongqing urban agglomeration as a case study, this paper adopts panel data and establishes an index system to evaluate the coupling coordination degree (CCD) between the social economy and ecological environment based on the concept of high-quality development. From the perspective of time and space, the changing laws and characteristics of the CCD are analyzed, and the key factors affecting it are determined using regression analysis. The results show the following: (1) the CCD between the social economy and ecological environment of the Chengdu-Chongqing urban agglomeration presents a low level overall; (2) the CCD in more developed regions is significantly higher than that in less developed regions; thus, the characteristics of spatial differences are obvious; (3) the urbanization rate, ratio of actual use of foreign capital and GDP, ratio of total export-import volume and GDP, proportion of days with good air quality, and per capita public green space area are the main factors affecting the coordinated development of the social economy and ecological environment in the Chengdu-Chongqing urban agglomeration; and (4) Chongqing has obvious endogeneity. Finally, corresponding policy recommendations are provided aimed at promoting rapid economic development in the Chengdu-Chongqing urban agglomeration while focusing on environmental protection and promoting high-quality economic development with ecological environmental protection, while putting forward decision-making suggestions for high-quality development of urban agglomerations.

Research on Color Space Perceptions and Restorative Effects of Blue Space Based on Color Psychology: Examination of the Yijie District of Dujiangyan City as an Example.

An increasing number of studies have demonstrated that blue space can promote the recovery of the human body, as does green space. However, the influence of blue space on the color space has been studied much less. Based on research on color psychology and healthy cities, the current study takes Yijie District of Dujiangyan City as the research object. Logistic regression models and the semantic differential method was used to explore residents' perceptions of color space and their restorative ratings of blue space. This study describes the characteristics of the people visiting blue space, investigates whether the benefits brought about by blue space are related to the color space, and studies whether the surrounding colors in the blue space have a positive effect in promoting residents' perceptions of pleasure. Based on residents' choices of environmental pictures containing various colors, a color tendency map was constructed. The results revealed strong correlations between residents' perceived pleasure and color space color collocation. Socio-demographic factors were found to affect the frequency of visiting blue space. Reasonable color planning is necessary for human health. Based on the study findings, relevant planning suggestions are proposed as a reference basis for waterfront space color planning.

Multi-photon imaging of tumor cell invasion in an orthotopic mouse model of oral squamous cell carcinoma.

Loco-regional invasion of head and neck cancer is linked to metastatic risk and presents a difficult challenge in designing and implementing patient management strategies. Orthotopic mouse models of oral cancer have been developed to facilitate the study of factors that impact invasion and serve as model system for evaluating anti-tumor therapeutics. In these systems, visualization of disseminated tumor cells within oral cavity tissues has typically been conducted by either conventional histology or with in vivo bioluminescent methods. A primary drawback of these techniques is the inherent inability to accurately visualize and quantify early tumor cell invasion arising from the primary site in three dimensions. Here we describe a protocol that combines an established model for squamous cell carcinoma of the tongue (SCOT) with two-photon imaging to allow multi-vectorial visualization of lingual tumor spread. The OSC-19 head and neck tumor cell line was stably engineered to express the F-actin binding peptide LifeAct fused to the mCherry fluorescent protein (LifeAct-mCherry). Fox1(nu/nu) mice injected with these cells reliably form tumors that allow the tongue to be visualized by ex-vivo application of two-photon microscopy. This technique allows for the orthotopic visualization of the tumor mass and locally invading cells in excised tongues without disruption of the regional tumor microenvironment. In addition, this system allows for the quantification of tumor cell invasion by calculating distances that invaded cells move from the primary tumor site. Overall this procedure provides an enhanced model system for analyzing factors that contribute to SCOT invasion and therapeutic treatments tailored to prevent local invasion and distant metastatic spread. This method also has the potential to be ultimately combined with other imaging modalities in an in vivo setting.

Conserved amphiphilic feature is essential for periplasmic chaperone HdeA to support acid resistance in enteric bacteria.

The extremely acidic environment of the mammalian stomach (pH 1-3) represents a stressful challenge for enteric pathogenic bacteria, including Escherichia coli, Shigella and Brucella. The hdeA (hns-dependent expression A) gene was found to be crucial for the survival of these enteric bacteria under extremely low pH conditions. We recently demonstrated that HdeA is able to exhibit chaperone-like activity exclusively within the stomach pH range by transforming from a well-folded conformation at higher pH values (above pH 3) into an unfolded conformation at extremely low pH values (below pH 3). This study was performed to characterize the action mechanisms and underlying specific structural features for HdeA to function in this unfolded conformation. In the present study, we demonstrate that the conserved 'amphiphilic' feature of HdeA, i.e. the exposure of the conserved hydrophobic region and highly charged terminal regions, is essential for exhibiting chaperone-like activity under extremely low pH conditions. Mutations that disrupt this amphiphilic feature markedly reduced the chaperone-like activity of HdeA. The results also strongly suggest that this acid-induced chaperone-like activity of HdeA is crucial for acid resistance of the enteric bacteria. Moreover, our new understanding of this amphiphilic structural feature of HdeA helps to better interpret how this unfolded (disordered) conformation could be functionally active.

Real-time measurement of free Ca2+ changes in CNS myelin by two-photon microscopy.

Here we describe a technique for measuring changes in Ca2+ in the cytosolic domain of mature compact myelin of live axons in the central nervous system (CNS). We label the myelin sheath of optic nerve and dorsal column axons by using the Ca2+ indicator X-rhod-1 coupled with DiOC6(3) to produce bright myelin counterstaining, thereby providing unambiguous identification of the myelin sheath for analysis of two-photon excited fluorescence. We present evidence for localization of the Ca2+ reporter to the cytosolic domain of myelin, obtained by using fluorescence lifetime, spectral measurements and Mn2+ quenching. Chemical ischemia increased myelinic X-rhod-1 fluorescence (approximately 50% after 30 min) in a manner dependent on extracellular Ca2+. Inhibiting Na+-dependent glutamate transporters (with TBOA) or glycine transporters (with sarcosine and ALX-1393) reduced the ischemia-induced increase in Ca2+. We show that myelinic N-methyl-D-aspartate (NMDA) receptors are activated by the two conventional coagonists glutamate and glycine, which are released by specific transporters under conditions of cellular Na+ loading and depolarization in injured white matter. This new technique facilitates detailed studies of living myelin, a vital component of the mammalian CNS.

A model for quantitative changes in the magnetic resonance parameters of muscle in children after therapeutic irradiation.

PURPOSE/OBJECTIVE: This study aimed to develop objective models of radiation effects on musculature in children with soft tissue sarcoma using treatment dosimetry and clinical and quantitative magnetic resonance imaging (MRI) parameters that may be used to guide treatment planning or predict side effects. METHODS: In the initial 13 patients undergoing external beam radiation therapy (RT) on a Phase II study of conformal or intensity-modulated RT for the treatment of soft tissue sarcoma approved by an Institutional Review Board, we evaluated quantitative MRI changes in the musculature to assess radiation-related treatment effects. Patients with soft tissue sarcoma, including Ewing's sarcoma, had quantitative T1, T2 and dynamic enhanced MRI (DEMRI) performed before, during (Week 4) and after RT (Week 12). Regions of interest were selected in consistent locations within and outside the high-dose regions (on ipsilateral and contralateral sides when available). Mean RT dose, T1, T2 and DEMRI parameters were calculated and modeled using a mixed random coefficient dose model. RESULTS: The mean doses to the high- and low-dose regions were 56.4 Gy (41.8-75.3 Gy) and 13.0 Gy (0.1-37.5 Gy), respectively. Compared with tissues distant from the tumor bed, maximal enhancement was significantly increased in tissues adjacent to the tumor/tumor bed prior to RT (60.6 vs. 44.2, P=.045) and remained elevated after 12 weeks. T1 was significantly elevated in tissues adjacent to the tumor bed prior to RT (942.4 vs. 759.0, P=.0078). The slope of longitudinal change in T1 was greater for tissues that received low-dose irradiation than those that received high-dose irradiation (P=.0488). The effect of dose on the slope of T2 was different (P=.0333) when younger and older patients are compared. CONCLUSIONS: Acute affects of irradiation in muscle are quantifiable via MRI. These models provide evidence that quantifiable MRI parameters may be correlated with patient parameters of radiation dose and clinical factors including patient age. Long-term follow-up will be required to determine if acute changes correlate with clinically significant late effects.