Formed in context: A mixed-methods study of medical students' mindsets in an Eastern culture.

INTRODUCTION: Mindsets have become an important focus in the fields of social and cognitive psychology. When holding a growth mindset, people appear more likely to engage in hard work and effort to foster success, seeing setbacks as necessary for learning. When holding a fixed mindset, in contrast, people tend to believe success comes from innate ability, seeing setbacks as evidence of inability. As such, mindsets affect students' learning, resilience and personal development. There is little empirical evidence, however, regarding how medical students perceive mindsets and the fundamental determinants of mindset formation, especially in non-Western contexts. This study investigated medical students' mindsets and perceptions of mindset formation with the aim of broadening the cross-cultural understanding of self-theories. METHODS: Using a convergent mixed-methods approach at a medical school in China, the authors conducted a survey and four focus groups with medical students in first to third years. Quantitatively, we used the Dweck Mindset Scale to describe medical students' mindsets in the domains of intelligence and talent. Qualitatively, we analysed focus group data using a grounded theory approach to develop a descriptive model. RESULTS: Survey results included 464 responses for quantitative analysis. Multivariable regression found that Year 3 students had more fixed mindsets for intelligence and talent (p < 0.05) compared with Year 1 students. Rural students reported a more mixed mindset for intelligence compared to urban students (p < 0.05). Qualitative analysis of focus group data yielded four major categories: beliefs about mindsets, conceptualization of mindsets, achievement motivation and source of mindset formation. We developed a Mindset Basis Model to depict connections among the factors students perceived to influence mindset formation-intra- and interindividual factors; contextual factors; and micro-, meso- and macro-system factors-and students' motivation regarding achievement. CONCLUSION: The study describes medical students' mindsets for the domains of intelligence and talent and explores how they conceptualised these mindsets. The findings indicate that factors influencing mindsets do not operate in isolation but through intricate interactions among multilevel factors embedded within a context.

Moral distress from professionalism dilemmas and its association with self-rated professionalism behaviors among Chinese residents.

OBJECTIVES: Residents inevitably witness or participate in a diverse range of professionalism dilemmas. However, few studies have focused on residents' moral distress from professionalism dilemmas and its relationship with residents' professionalism. This study aimed to understand the moral distress that Chinese residents may face after exposure to professionalism dilemmas and to examine the associations between moral distress and residents' perceived fulfillment of professionalism behaviors. METHODS: We conducted a cross-sectional survey of residents from four standardized residency training bases in Liaoning Province, China, using stratified cluster sampling. A checklist of professionalism dilemmas, the Moral Distress Scale, and the Behavior-based Medical Professionalism Inventory were used to assess residents' moral distress from professionalism dilemmas and their perceived fulfillment of professionalism behaviors. Descriptive statistics, non-parametric tests, multiple linear regressions, and binary logistic regressions were used to analyze the data. RESULTS: A total of 647 (81.1%) residents effectively completed the survey. The proportion of residents suffering from moral distress ranged from 58.4 to 90.6% for different professionalism dilemmas. As the number of professionalism dilemmas associated with moral distress increased, residents reported lower fulfillment of professionalism behaviors (ß < 0, p < 0.05). Compared with residents with no distress, residents suffering from distress reported lower fulfillment of professionalism behaviors (OR < 1, p < 0.05). Among residents suffering from distress, as the distress intensity increased, residents reported higher fulfillment of professionalism behaviors (OR > 1, p < 0.05). CONCLUSIONS: Residents suffered a wide range of moral distress from professionalism dilemmas, and residents with moral distress reported lower fulfillment of professional behaviors. A responsive reporting system for residents and reflection on role modeling may help residents cope with the negative effects of moral distress and professionalism dilemmas.

The mediating role of psychological capital in the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Although life satisfaction is a predictor of depressive and anxiety symptoms, the mechanisms underlying this association are poorly understood. This study examined how psychological capital (PsyCap), a positive psychological state, mediated the association between life satisfaction and depressive and anxiety symptoms among Chinese medical students during the COVID-19 pandemic. METHODS: A cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 583 students. Depressive symptoms, anxiety symptoms, life satisfaction, and PsyCap were measured anonymously. A hierarchical linear regression analysis was performed to explore the effects of life satisfaction on depressive and anxiety symptoms. Asymptotic and resampling strategies were used to examine how PsyCap mediates the association between life satisfaction and depressive and anxiety symptoms. RESULTS: Life satisfaction was positively associated with PsyCap and its four components. There were significant negative associations between life satisfaction, psychological capital, resilience, optimism, and depressive and anxiety symptoms among medical students. Self-efficacy was negatively associated with depressive and anxiety symptoms. Psychological capital (a×b = -0.3201, BCa 95% CI: -0.3899, -0.2446; a×b = -0.2749, BCa 95% CI: -0.3817, -0.1996), resilience (a×b = -0.2103, BCa 95% CI: -0.2727, -0.1580; a×b = -0.1871, BCa 95% CI: -0.2520, -0.1414), optimism (a×b = -0.2100, BCa 95% CI: -0.3388, -0.1150; a×b = -0.1998, BCa 95% CI: -0.3307, -0.0980), and self-efficacy (a×b = -0.0916, BCa 95% CI: 0.0048, 0.11629; a×b = 0.1352, BCa 95% CI: 0.0336, 0.2117) significantly mediated the association between life satisfaction and depressive and anxiety symptoms. LIMITATIONS: This was a cross-sectional study, and causal relationships between the variables could not be ascertained. Self-reported questionnaire instruments were used for data collection, which may have recall bias. CONCLUSIONS: Life satisfaction and PsyCap can be used as positive resources to reduce depressive and anxiety symptoms among third-year Chinese medical students during the COVID-19 pandemic. Psychological capital and its components (self-efficacy, resilience, and optimism) partially mediated the relationship between life satisfaction and depressive symptoms, and completely mediated the relationship between life satisfaction and anxiety symptoms. Therefore, improving life satisfaction and investing in psychological capital (especially self-efficacy, resilience, and optimism) should be included in the prevention and treatment of depressive and anxiety symptoms among third-year Chinese medical students. Additional attention is needed to pay for self-efficacy in such disadvantageous contexts.

"It really puts me in a bind", professionalism dilemmas reported by Chinese residents.

Residents play a pivotal role in the healthcare system. However, few tools have systematically revealed the dilemmas and challenges faced by residents. This study aimed to develop a checklist for professionalism dilemmas based on a behavior-based professionalism framework and to examine the range and proportion of professionalism dilemmas heard of, witnessed, or experienced by Chinese residents. Mixed methods were used, comprising qualitative (document analysis and focus group interviews) and quantitative (a small-scale questionnaire survey) data. Document analysis summarized professionalism dilemma items from previous publications. For focus group interviews, we used narrative inquiry to explore and make sense of residents' experiences and perceptions of professionalism dilemmas. A small-scale questionnaire survey was conducted during each focus group to investigate the proportion of professionalism dilemma items that residents reported to have heard of, witnessed, or experienced. Through document analysis and focus group interviews, we developed a checklist of professionalism dilemmas based on a behavior-based professionalism framework. The checklist included 58 items over four domains, with 10 sub-domains (compassion, respect, communication, collaboration, integrity, duty, pursuit of excellence, fair stewardship of health care resources, patient confidentiality, and informed consent). We also sought a preliminarily subjective impression by exploring the proportion of residents who have heard of, witnessed, and experienced each of the professionalism dilemma items and residents' perspectives when faced with professionalism dilemmas. Residents inevitably encounter or experience a diverse range of professionalism dilemmas. This checklist of professionalism dilemmas that was developed could prove to be a significant reference for targeted professionalism education, both for the resident as well as for faculty. It can also act as a helpful tool for improving hospital management guidelines and patient education.

Learning burnout and its association with perceived stress, social support, and the Big Five personality traits in Chinese medical students during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Owing to the coronavirus disease 2019, medical learning burnout has attracted increasing attention in educational research. It has a serious negative impact on medical students and their service quality. This could impair the professional development of medical students; weaken their personal and professional quality; and lead to problems such as increased medical errors and reduced patient care quality and satisfaction. This study aimed to examine the effects of perceived stress, social support, and the Big Five personality traits on learning burnout among medical students. METHODS: In November 2021, a cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 616 third- year students. Learning burnout, perceived stress, social support, and the Big Five personality traits (neuroticism, extroversion, openness, agreeableness, and conscientiousness) were anonymously measured. A total of 583 students were included in the final sample. Hierarchical linear regression was performed to explore the effects of perceived stress, social support, and Big Five personality traits on medical students' learning burnout. RESULTS: Perceived stress was positively associated with learning burnout (emotional exhaustion: ß = 0.577, p < 0.001; cynicism: ß = 0.543, p < 0.001; low professional efficacy: ß = 0.455, p < 0.001) whereas social support was negatively related with it (low professional efficacy: ß = -0.319, p < 0.001). Neuroticism had a positive effect on emotional burnout (ß = 0.152, p = 0.009). Extraversion (ß = -0.116, p = 0.006) and conscientiousness (ß = -0.363, p < 0.001) had a negative effect on low professional efficacy. Agreeableness negatively affected emotional exhaustion (ß = -0.181, p < 0.001) and cynicism (ß = -0.245, p < 0.001) and positively affected low professional efficacy (ß = 0.098, p = 0.008). The associated factors together accounted for an additional variance of learning burnout (emotional exhaustion: 39.0%; cynicism: 36.8%; low professional efficacy: 48.7%). CONCLUSIONS: Social support is a positive resource for fighting medical students' burnout. Perceived stress was the strongest indicator of learning burnout. In addition to reducing perceived stress, developing extraversion, agreeableness, and conscientiousness should be included in burnout prevention and treatment strategies, particularly for medical students.

Exploring the connection between parental bonding and smartphone addiction in Chinese medical students.

BACKGROUND: Smartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students. METHOD: Binary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models. RESULTS: A total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989). CONCLUSIONS: Chinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.

Faculty perspectives on facilitating medical students' longitudinal learning: A mixed-methods study.

INTRODUCTION: Medical students' longitudinal care of patients supports clinical learning and promotes patient-centredness. The literature presents little empirically derived guidance for faculty to facilitate students' longitudinal learning and care. Informed by the conceptual framework of relational learning, this study investigated faculty perspectives about longitudinal teaching, their strategies for facilitating students' longitudinal learning and perceived barriers and enablers. METHODS: Using a convergent mixed-methods approach at a single academic medical centre, the authors conducted a survey and two focus groups in 2018-2019 with faculty members teaching in three longitudinal clinical courses. Quantitative analyses included descriptive statistics and chi-square tests. Qualitative content analysis described deductive categories and identified inductive themes. RESULTS: Forty-three eligible faculty (69%) completed the survey. Ninety-one percent (n = 39) reported that teaching in a longitudinal model enhanced their experience as preceptors. Faculty described activities students performed to provide longitudinal care: spending time with patients independently (n = 38, 88%), making follow-up phone calls (n = 35; 81%) and participating in home- and community-based visits (n = 20, 47%), among others. Twelve faculty participated in two focus groups. Deductive analysis characterised strategies for facilitating students' longitudinal learning and barriers and enablers. Strategies included "encouraging students to follow patients," "faculty adaptability," "offering guidance and setting expectations," and "careful patient selection." Barriers included scheduling limitations, and enablers included student initiative. Inductive analysis identified two themes: faculty goals for students and faculty benefits from teaching. Goals included meaningful engagement with patients and their illness over time. Benefits from teaching included personal gratification, mentorship, and holistic student assessment. DISCUSSION: Our survey and focus group findings demonstrated positive faculty attitudes and experiences, characterised faculty goals and approaches, and identified elements of the educational context that hindered or facilitated longitudinal teaching and learning. This study's faculty perspectives build upon prior investigations of students' and patients' perspectives, offer teaching strategies, and may guide faculty development.

Patient perceptions of students in a longitudinal integrated clerkship in Taiwan: a qualitative study.

BACKGROUND: Longitudinal integrated clerkships (LICs) are a model of clinical education growing rapidly in Western contexts. LICs use educational continuity to benefits students' clinical learning and professional identity formation. Patient-centered care is a core component of medical professionalism in the West. To support patient-centered care, education leaders in Taiwan restructured clinical education and implemented the first longitudinal integrated clerkship in East Asia. We aimed to investigate patients' perceptions of longitudinal relationships with the LIC students within Taiwan's Confucian cultural and social context. METHODS: We invited patients or their family members who were cared for longitudinally by a LIC student to participate in the study. Participating patients or their family members undertook semi-structured interviews. We analyzed data qualitatively using a general inductive approach to identify themes in the patients' descriptions of their experiences interacting with the LIC students. RESULTS: Twenty-five patients and family members participated in interviews: 16 patients and 9 family members. Qualitative analysis of interview transcripts identified three themes from patients' experience receiving care from their LIC students: care facilitation, companionship, and empathy. To provide care facilitation, LIC students served as a bridge between the physicians and patients. Students served patients by reminding, consulting, tracking disease progression, and researching solutions for problems. To provide companionship, students accompanied patients interpersonally like a friend or confidant who listens and provides a presence for patients. To provide empathy, patients reported that students showed sincere concern for patients' experience, feelings, and mood. CONCLUSION: In our study, Taiwanese patients' perspectives of LIC students suggested the value of care facilitation, companionship, and empathy. We discuss these themes within the context of Confucian culture and the Taiwanese context of care.

Enantioselective Synthesis of C-N Axially Chiral N-Aryloxindoles by Asymmetric Rhodium-Catalyzed Dual C-H Activation.

The first enantioselective Satoh-Miura-type reaction is reported. A variety of C-N axially chiral N-aryloxindoles have been enantioselectively synthesized by an asymmetric rhodium-catalyzed dual C-H activation reaction of N-aryloxindoles and alkynes. High yields and enantioselectivities were obtained (up to 99 % yield and up to 99 % ee). To date, it is also the first example of the asymmetric synthesis of C-N axially chiral compounds by such a C-H activation strategy.

Ubiquitin-specific protease 11 serves as a marker of poor prognosis and promotes metastasis in hepatocellular carcinoma.

Ubiquitin-specific protease 11 (USP11) is a deubiquitinating enzyme that exerts its biological functions by regulating multiple signaling pathways such as p53, NF-κB, TGF-ß, and Hippo. A large body of evidence supports a link between UPS11 and tumorigenesis. However, the clinical significance and biological function of USP11 in hepatocellular carcinoma (HCC) remains unclear. Here, USP11 expression was assessed by immunohistochemistry in a pilot series of 71 HCC clinical samples, and the association between USP11 expression and clinicopathological features and overall survival time was analyzed. The cytoplasmic expression rate of USP11 was higher in non-cancerous tissue than that in cancer tissue (36.6 vs. 12.7%, P = 0.001), whereas the nuclear expression rate of USP11 was lower in non-cancerous tissue (5.6 vs. 69.0%, P < 0.001). USP11 expression level was higher in tumor than that in non-tumor tissue (P < 0.001). Chi-square analysis of variances suggested that USP11 expression was associated with vascular invasion (P = 0.033), differentiation (P = 0.027), tumor number (P = 0.009), and recurrence (P = 0.036). USP11 expression was also associated with shorter overall survival time (P = 0.001) by log-rank test. Unconditional logistic regression analysis with multiple covariates indicated that high USP11 expression was associated with a 2.96-fold increase in the risk of death compared with low USP11 levels (P = 0.041) and acted as an independent predictor of overall survival. HCC patients with simultaneously high USP11 and alpha-fetoprotein expression had an adjusted 5-fold higher risk of all-cause-related death (P = 0.006). Moreover, in vitro and in vivo experiments confirmed that USP11 could promote the migration and invasion of HCC cell. Overall, we suggest that USP11 promotes HCC cell metastasis, and we provide the first evidence of the prognostic significance of USP11 expression in HCC, which suggests that USP11 is a promising therapeutic target for the treatment of HCC.

Chinese medical students' agreement with and fulfillment of the Physician Charter.

BACKGROUND: Although it has been nearly 15 years since the Medical Professionalism in the New Millennium: A Physician Charter (the Physician Charter) was proposed to reaffirm medical professionalism in response to the new challenges in healthcare delivery in the new century, the manner in which Chinese medical students agree with and fulfill the principles and responsibilities of professionalism defined in the Physician Charter still remains unknown. METHODS: In March 2016, 748 fifth-year medical students from China Medical University (CMU) participated in a survey in which they indicated their rate of agreement with and manner of fulfillment of the principles and responsibilities defined in the Physician Charter using a 10-point Likert scale. The data were then analyzed by t-tests, exploratory factor analysis, and multiple linear regressions. RESULTS: The total score of agreement with the Physician Charter was significantly higher than that of fulfillment (p < 0.001). The largest difference between agreement and fulfillment scores were with the principle of social justice (P3), commitments to improving access to care (R6), and a just distribution of finite resources (R7). Exploratory factor analysis distinguished two principles - primacy of patient welfare (P1) and patient autonomy (P2) - from the others in terms of the gap between agreement and fulfillment. This is partially because the proportion of students who rated agreement lower than fulfillment of P1 or P2 was much higher than it was for any other principle or responsibility. Additionally, multiple linear regressions show that students who are enrolled in a five-year program or who was registered as a rural resident (i.e. holding a rural Hukou) had significantly higher scores of agreement, but not fulfillment. CONCLUSIONS: Chinese medical students endorsed the Physician Charter and its core values of medical professionalism, although they felt difficult to fulfill in practice. Medical educators and the health authority should act together to support and foster professional values.

Regioselective 1,2-addition of allenamides with N-haloimides: synthesis of 2-halo allylic aminal derivatives.

A strategy for the synthesis of 2-halo allylic aminal derivatives through regioselective 1,2-addition of allenamides with N-haloimides is presented. This reaction was conducted under very mild conditions and gave up to 99% yield. Moreover, the obtained halides allow functional group diversification by palladium-catalyzed coupling reactions, which could act as potential intermediates for the synthesis of valuable compounds.

Lifelong learning of Chinese rural physicians: preliminary psychometrics and influencing factors.

BACKGROUND: There are more than 4.9 million rural health workers undertaking the health care need of rural population of over 629 million in China. The lifelong learning of physicians is vital in maintaining up-to-date and qualified health care, but rural physicians in many developing countries lack adequate medical professional developments. There has also been no empirical research focused on the lifelong learning of rural physician populations. The purpose of this study was to investigate the primary levels of lifelong learning of the rural physicians and to analyze group differences. METHODS: We conducted a cross-sectional study on 1197 rural physicians using the Jefferson Scale of Physician Lifelong Learning (JSPLL). Cronbach's α coefficient, exploratory factor analysis, independent sample t-test, and one-way ANOVA followed by Student-Newman-Keuls test were performed to analyze the data. RESULTS: For Chinese rural physicians, the JSPLL was reliable (Cronbach's α coefficient = 0.872) and valid, with exploratory factor analysis fitting a 3-factor model and accounting for a total of 60.46 % of the variance. The mean lifelong learning score was 45.56. Rural physicians generally performed worse in the technical skills in seeking information domain. Rural physicians with 21-30 working years have a lower score of lifelong learning (P < 0.05) than other phases of working years. Career satisfaction and professional titles had a significantly positive influence on physicians' orientation towards lifelong learning (P < 0.05). The overall lifelong learning scores of physicians who received more training after completion of medical school were higher than those with less additional post-medical school training (P <0.05). CONCLUSIONS: The JSPLL is effective for the Chinese rural physician population. In order to cope with impacting factors on rural physicians' lifelong learning, the results of the study reinforced the importance of continuing medical education and career satisfaction for lifelong learning and the need for medical schools and hospitals to provide reasonable strategies and necessary support for rural physicians with different amounts of working years. Providing rural physicians more educational opportunities and helping them access educational resources may be an effective strategy for improving their orientation to lifelong learning.

A spatio-temporal graph convolutional network for ultrasound echocardiographic landmark detection.

Landmark detection is a crucial task in medical image analysis, with applications across various fields. However, current methods struggle to accurately locate landmarks in medical images with blurred tissue boundaries due to low image quality. In particular, in echocardiography, sparse annotations make it challenging to predict landmarks with position stability and temporal consistency. In this paper, we propose a spatio-temporal graph convolutional network tailored for echocardiography landmark detection. We specifically sample landmark labels from the left ventricular endocardium and pre-calculate their correlations to establish structural priors. Our approach involves a graph convolutional neural network that learns the interrelationships among landmarks, significantly enhancing landmark accuracy within ambiguous tissue contexts. Additionally, we integrate gate recurrent units to grasp the temporal consistency of landmarks across consecutive images, augmenting the model's resilience against unlabeled data. Through validation across three echocardiography datasets, our method demonstrates superior accuracy when contrasted with alternative landmark detection models.

Contour-constrained branch U-Net for accurate left ventricular segmentation in echocardiography.

Using echocardiography to assess the left ventricular function is one of the most crucial cardiac examinations in clinical diagnosis, and LV segmentation plays a particularly vital role in medical image processing as many important clinical diagnostic parameters are derived from the segmentation results, such as ejection function. However, echocardiography typically has a lower resolution and contains a significant amount of noise and motion artifacts, making it a challenge to accurate segmentation, especially in the region of the cardiac chamber boundary, which significantly restricts the accurate calculation of subsequent clinical parameters. In this paper, our goal is to achieve accurate LV segmentation through a simplified approach by introducing a branch sub-network into the decoder of the traditional U-Net. Specifically, we employed the LV contour features to supervise the branch decoding process and used a cross attention module to facilitate the interaction relationship between the branch and the original decoding process, thereby improving the segmentation performance in the region LV boundaries. In the experiments, the proposed branch U-Net (BU-Net) demonstrated superior performance on CAMUS and EchoNet-dynamic public echocardiography segmentation datasets in comparison to state-of-the-art segmentation models, without the need for complex residual connections or transformer-based architectures. Our codes are publicly available at Anonymous Github https://anonymous.4open.science/r/Anoymous_two-BFF2/ .

STGA-MS: AI diagnosis model of regional wall motion abnormality based on 2D transthoracic echocardiography.

Regional wall motion abnormality (RWMA) is a common manifestation of ischemic heart disease detected through echocardiography. Currently, RWMA diagnosis heavily relies on visual assessment by doctors, leading to limitations in experience-based dependence and suboptimal reproducibility among observers. Several RWMA diagnosis models were proposed, while RWMA diagnosis with more refined segments can provide more comprehensive wall motion information to better assist doctors in the diagnosis of ischemic heart disease. In this paper, we proposed the STGA-MS model which consists of three modules, the spatial-temporal grouping attention (STGA) module, the segment feature extraction module, and the multiscale downsampling module, for the diagnosis of RWMA for multiple myocardial segments. The STGA module captures global spatial and temporal information, enhancing the representation of myocardial motion characteristics. The segment feature extraction module focuses on specific segment regions, extracting relevant features. The multiscale downsampling module analyzes myocardial motion deformation across different receptive fields. Experimental results on a 2D transthoracic echocardiography dataset show that the proposed STGA-MS model achieves better performance compared to state-of-the-art models. It holds promise in improving the accuracy and reproducibility of RWMA diagnosis, assisting clinicians in diagnosing ischemic heart disease more reliably.

Multi-residual 2D network integrating spatial correlation for whole heart segmentation.

Whole heart segmentation (WHS) has significant clinical value for cardiac anatomy, modeling, and analysis of cardiac function. This study aims to address the WHS accuracy on cardiac CT images, as well as the fast inference speed and low graphics processing unit (GPU) memory consumption required by practical clinical applications. Thus, we propose a multi-residual two-dimensional (2D) network integrating spatial correlation for WHS. The network performs slice-by-slice segmentation on three-dimensional cardiac CT images in a 2D encoder-decoder manner. In the network, a convolutional long short-term memory skip connection module is designed to perform spatial correlation feature extraction on the feature maps at different resolutions extracted by the sub-modules of the pre-trained ResNet-based encoder. Moreover, a decoder based on the multi-residual module is designed to analyze the extracted features from the perspectives of multi-scale and channel attention, thereby accurately delineating the various substructures of the heart. The proposed method is verified on a dataset of the multi-modality WHS challenge, an in-house WHS dataset, and a dataset of the abdominal organ segmentation challenge. The dice, Jaccard, average symmetric surface distance, Hausdorff distance, inference time, and maximum GPU memory of the WHS are 0.914, 0.843, 1.066 mm, 15.778 mm, 9.535 s, and 1905 MB, respectively. The proposed network has high accuracy, fast inference speed, minimal GPU memory consumption, strong robustness, and good generalization. It can be deployed to clinical practical applications for WHS and can be effectively extended and applied to other multi-organ segmentation fields. The source code is publicly available at https://github.com/nancy1984yan/MultiResNet-SC.