Family roles in informed consent from the perspective of young Chinese doctors: a questionnaire study.

BACKGROUND: Based on the principle of informed consent, doctors are required to fully inform patients and respect their medical decisions. In China, however, family members usually play a special role in the patient's informed consent, which creates a unique "doctor-family-patient" model of the physician-patient relationship. Our study targets young doctors to investigate the ethical dilemmas they may encounter in such a model, as well as their attitudes to the family roles in informed consent. METHODS: A questionnaire was developed including general demographic characteristics, the fulfillment of the obligation to fully inform, who will be informed, and the ethical dilemmas in decision-making. We recruited a total of 421 doctors to complete this questionnaire, of which 368 met the age requirements for this study. Cross tabulation and Pearson's chi-squared test were used to analyze the differences between types of patients for categorical variables, and a p-value < 0.05 was considered statistically significant. RESULTS: Our data shows that only 20 doctors (5.40%) stated "informing the patient alone is sufficient" when it comes to informing patients of their serious conditions. The rest of the participants would ensure that the family was informed. When facing elderly patients with decision-making capacity, the data was statistically different (3.8%; P < 0.001) The primary reason for ensuring that family members be informed differs among the participants. In addition, when family members asked doctors to conceal the patient's medical condition for the best interests of patients, 270 doctors (73.4%) would agree and cooperate with the family. A similar proportion (79.6%) would do so when it comes to elderly patients. CONCLUSIONS: (1) Chinese doctors pay extra attention to informing the patient's family, which may not be in the patient's best interests. (2) Chinese doctors treat adult (but not elderly) patients and elderly patients differently when it comes to informing family members. (3) When family members request that doctors withhold information from patients "in the best interest of the patient," the majority choose to comply with the request, although this may cause them distress.

The red packet phenomenon from the perspective of young Chinese doctors: a questionnaire study.

BACKGROUND: In China, informal payments in the medical profession, which workers in the public health care system receive from patients in the course of performing profession-related activities, are usually referred to as "red packets" (Hongbao ). The phenomenon of red packets is widespread and has become one of the most negative factors affecting the doctor-patient relationship in China. Our study aims to explore the situation concerning the phenomenon of red packets in China after the "Red Packet Ban". METHODS: A questionnaire was developed including general demographic characteristics, asking whether they had ever been offered red packets, whether they had ever accepted red packets, their reasons for accepting the first red packet and so on. We recruited a total of 413 doctors to complete this questionnaire and conducted in-depth telephone interviews with 18 doctors from the initial group. RESULTS: Our data shows that 73 doctors claimed to have accepted red packets, accounting for 17.7% (73/413) of all respondents and 27.8% (73/263) of doctors who had been provided with red packets. 23.2% of red packets were offered after the operation and 67.1% of the doctors declared that the main reason for accepting the red packet was that they "refused the red packets more than once, but the patients/family members were sincere and it was difficult to refuse." The total amount of the red packets they received each month accounted for no more than 5% of their income. CONCLUSIONS: (1) The acceptance of red packets does exist among young doctors in China, but shows a significant decrease compared to previous studies. (2) There has been a sharp rise in the proportion of gratitude red packets. (3) Patients should also be educated regarding their behaviour in providing red packets.

Gender differences in response to medical red packets (Hongbao, monetary gifts): a questionnaire study on young doctors in China.

BACKGROUND: The acceptance of informal payments by doctors is usually viewed as unethical behavior. However, in China, such behavior is a common practice. In this study, we focus on the gender differences in accepting red packets (informal payments) by young doctors in China. METHODS: A total of 413 young doctors were selected for the study, all of whom were grouped by gender. The questionnaire was designed to include general demographic characteristics, whether they had ever been offered red packets, whether they had ever accepted red packets, the reasons for accepting red packets and so on. Wilcoxon rank-sum test, Pearson's chi-squared test, univariable and multi-variable logistic regressions were used for all analyses by Stata 17.0 SE and p-value < 0.05 was considered statistically significant. RESULTS: Compared to women, men were more likely to be offered red packets (69.5% [180/259] vs.53.9% [83/154]), and the odds ratio (OR) was statistically significant after adjusting for age, education, position and geographical areas (adjusted OR 1.81, p = 0.012). In terms of the question of whether or not they had accepted red packets, more male doctors answered "yes" compared to female doctors (33.3% [60/180] vs.15.7% [13/83], adjusted OR 2.80, p = 0.004). However, among those who had accepted red packets, we found that only 42.0% [25/60] of male doctors considered that it was normal to accept such red packets, compared to 85.0% [11/13] of women (adjusted OR 12.01, p = 0.023). CONCLUSION: The study revealed that Chinese patients and their families were more likely to offer red packets to male doctors. Secondly, among doctors who had been offered red packets, male doctors were more likely to accept red packets than female doctors. In addition, among doctors who had accepted red packets, female doctors were more likely to believe that it was not morally wrong to accept such red packets.

What should adult children do for their parents?

Adult children's particular obligations to their parents are filial obligations. The gratitude of filial obligations that treats one's filial obligations as duties of gratitude to one's parents is a mainstream view. However, in terms of the requirements of such obligations, the gratitude account fails to provide practical guidance. The general requirement seems that children should benefit their parents as the beneficiary should benefit the benefactor. The question is what kinds of benefits adult children should provide to their parents? In some cases, adult children feel obligated to provide particular benefits to their parents like paying their medical bills or spending time with them. While in some other cases, it seems that they can use their own discretion to decide how to satisfy the filial obligations so long as what they do benefits their parents. In this article, I am trying to argue that although the general requirement of the filial obligations is to benefit the parents, there are two kinds of benefits that adult children are strongly obligated to provide. These are special goods that parents can only get from their children and things that meet their parents' basic needs. In addition, although adult children have filial obligations to benefit their parents, there should be some limitations on the requirements of filial obligation. Namely, adult children do not have a filial obligation to meet their parents' desires that could only be satisfied at the cost of adult children's liberty related to significant aspects of their lives, or to meet their parents' desires that could only be satisfied at the cost of infringing their capacity to fulfil other important duties.

[Application Development of Blood Irradiation Indicator -Review].

Transfusion-associated graft-versus-host disease (TA-GVHD) is known as one of common complications of blood transfusion. The blood irradiation is generally accepted as a proven method to prevent from this disease, for the reason that it makes lymphocytes inactivated in blood products. The blood irradiation indicator provides a guarantee of proper radiation dose, thus improving the transfusion safety. Though widely used in developed countries for decades, the blood irradiation indicator is still in the initial stage in our country. In this review, the action principle, applications and applied value of the blood irradiation indicator are summarized briefly.

Combined nonlinear metrics to evaluate spontaneous EEG recordings from chronic spinal cord injury in a rat model: a pilot study.

Spinal cord injury (SCI) is a high-cost disability and may cause permanent loss of movement and sensation below the injury location. The chance of cure in human after SCI is extremely limited. Instead, neural regeneration could have been seen in animals after SCI, and such regeneration could be retarded by blocking neural plasticity pathways, showing the importance of neural plasticity in functional recovery. As an indicator of nonlinear dynamics in the brain, sample entropy was used here in combination with detrended fluctuation analysis (DFA) and Kolmogorov complexity to quantify functional plasticity changes in spontaneous EEG recordings of rats before and after SCI. The results showed that the sample entropy values were decreased at the first day following injury then gradually increased during recovery. DFA and Kolmogorov complexity results were in consistent with sample entropy, showing the complexity of the EEG time series was lost after injury and partially regained in 1 week. The tendency to regain complexity is in line with the observation of behavioral rehabilitation. A critical time point was found during the recovery process after SCI. Our preliminary results suggested that the combined use of these nonlinear dynamical metrics could provide a quantitative and predictive way to assess the change of neural plasticity in a spinal cord injury rat model.

Asymmetric catalysis with chiral oxazolidine ligands.

Asymmetric catalysis with chiral 1,3-oxazolidine ligands, which have a sterically tunable, rigid structure that can accommodate several chiral centers, has found increasing attention in recent years. This trend is partly due to the intriguing ring topology of oxazolidines and the prospect of modular synthesis of a diverse set of ligands from a wide range of readily available amino alcohols. The general promise and pitfalls of the synthesis of chiral oxazolidines and the success of selected catalysts including pyridinyl and phosphine derivatives in asymmetric alkylations, alkynylations, allylic alkylations, cycloadditions, and aldol reactions is discussed.

Synthesis of chiral tertiary trifluoromethyl alcohols by asymmetric nitroaldol reaction with a Cu(II)-bisoxazolidine catalyst.

A highly enantioselective and diastereoselective copper(II)-bisoxazolidine catalyzed nitroaldol reaction with aliphatic and aromatic trifluoromethyl ketones is described.

Efficient copper-catalyzed coupling of aryl chlorides, bromides and iodides with aqueous ammonia.

The copper(I)-catalyzed synthesis of a range of primary anilines from electron-rich and electron-deficient aryl halides including aryl chlorides has been achieved with aqueous ammonia, avoiding the need for inert atmosphere, expensive catalysts and ligands, anhydrous solvents, and additional base or other additives.

Copper catalyzed coupling of aryl chlorides, bromides and iodides with amines and amides.

A copper(I) catalyzed procedure for carbon-nitrogen bond formation utilizing aryl halides and either amines, including amino acids and diphenylamine, or aliphatic and aromatic amides is described.

Palladium-phosphinous acid-catalyzed cross-coupling of aryl and acyl halides with aryl-, alkyl-, and vinylzinc reagents.

Several palladium-phosphinous acids have been prepared and employed in cross-coupling reactions of aryl or acyl halides with aliphatic and aromatic organozinc reagents. The POPd7-catalyzed reaction of aryl halides, including electron-rich aryl chlorides, and arylzinc reagents was found to afford biaryls exhibiting alkoxy, alkylthio, amino, ketone, cyano, nitro, ester, and heteroaryl groups in 75-93% yield. Excellent results were obtained with sterically hindered substrates which gave di- and tri -ortho-substituted biaryls in up to 92% yield. Aryl halides also undergo POPd7-catalyzed aryl-vinyl and aryl-alkyl bond formation under mild conditions. Styrenes and alkylarenes were prepared in 79-93% yield from aryl halides and vinyl or alkylzinc reagents. The replacement of aryl halides by acyl halides provides access to ketones which were produced in up to 98% yield when POPd was used as catalyst. This approach overcomes the limited substrate scope, reduced regiocontrol, and low functional group tolerance of traditional Friedel-Crafts acylation methods.

Efficient synthesis of sterically crowded biaryls by palladium-phosphinous acid-catalyzed cross-coupling of aryl halides and aryl grignards.

A series of sterically hindered biaryls have been obtained by palladium- and nickel-phosphinous acid-catalyzed Kumada-Corriu cross-coupling of ortho-substituted aryl halides and Grignard reagents. This method allows formation of di- and tri-ortho-substituted biaryls in 87-98% yield under mild reaction conditions even when electron-rich aryl chlorides are used. The reaction also proceeds with aryl iodides at -20 degrees C, and under these conditions, functional groups that are generally not compatible with Grignard reagents are tolerated.

Three-dimensional nets from star-shaped hexakis(arylthio)triphenylene molecules and silver(I) salts.

This article reports a number of functional 3D networks based on the coordination bonds between the silver(I) ion and polycyclic aromatic 2,3,6,7,10,11-hexakis(organylthio)triphenylene (HRTT) molecules. First, 2,3,6,7,10,11-hexakis(phenylthio)triphenylene (HPhTT) chelates with AgBF4 (or AgTf, where Tf is triflate) in the presence of hexafluorobenzene to form a 3D network (composition, HPhTT x AgBF4; space group, I4), where each Ag(I) atom is bonded to three HPhTT molecules and acts as a three-connected node that interconnects the trigonal HPhTT ligands. In addition to the relatively rare 8(2) x 10-a topology, the network features distinct channel-like domains that incorporate various solvent molecules (e.g., acetone and tetrahydrofuran). The solvent molecules can be evacuated to produce a stable and crystalline apohost network, in which the solvent-accessible fraction of the cell volume is calculated to be about 16%. Second, chelation of 2,3,6,7,10,11-hexakis(4-methoxyphenylthio)triphenylene (HMOPhTT) and AgSbF6 in a 1:1 ratio results in a 3D network featuring a similar 8(2) x 10-a topology and Ag(I) coordination environment. However, the crystallographic symmetry (space group Cc) is lowered, and the feature of porosity is much less distinct. The 3D networks show strong room-temperature fluorescence bands with lambda(F,max) = 450 nm, due to the pi-electron fragment of the triphenylene group.

Semiconductive coordination networks from bismuth(III) bromide and 1,2-bis(methylthio)phenylacetylene-based ligands.

This paper reports our initial efforts to integrate phenylacetylene-based conjugate pi-electron systems into hybrid semiconductive coordination networks, as part of the larger scheme to fully synergize organic functionalities and electronic properties in crystalline solid-state materials. On the basis of a well-established Pd-catalyzed procedure, ligands of 3,3',4,4'-tetrakis(methylthio)tolan (L1) and 1,3,5-tris[[3,4-bis(methylthio)phenyl]ethynyl]benzene (L2) were efficiently synthesized in relatively simple procedures. Molecule L1 reacts with BiBr3 to form a 2D semiconductive coordination network (L1.2BiBr3), which consists of infinite chains of the BiBr3 component cross-linked by L1 through the chelation between the 1,2-bis(methylthio) groups and the Bi(III) centers. Molecule L2 reacts with BiBr3 to from a 1D semiconductive coordination network (L2.2BiBr3), which features discrete tetrameric Bi4Br12 units linked by the thioether groups from L2 [only two of the three 1,2-bis(methylthio) groups from each L2 molecule are bonded to the Bi(III) centers]. Diffuse reflectance spectra of both L1.2BiBr3 and L2.2BiBr3 feature strong optical absorptions at energy levels significantly lower than those of the corresponding molecular solids (L1 and L2) and BiBr3, indicating significant electronic interaction between the organic pi-electron systems and the BiBr3 components. Both L1.2BiBr3 and L2.2BiBr3 readily form in high yields and are stable to air, providing advantages for further studies as potentially applicable semiconductive materials.