Objective: Based on the theoretical framework of Risk Perception-Efficacy Appraisal-Behavioral Response, the study aims to explore the group heterogeneity in high temperature health risk perception and behavioral responses among college students in Chongqing, so as to provide a scientific basis for implementing differentiated health interventions. Methods: A multi stage cluster sampling method was used to select 856 students from five universities in Chongqing. Data were collected using a validated questionnaire. One way analysis of variance and independent samples t-test were used to analyze individual differences, Pearson correlation analysis was employed to examine relationships between variables, multiple linear regression was used to identify influencing factors, a structural equation model was constructed to validate the theoretical pathways, and the Bootstrap method was applied to test mediating effects. Results: In the risk perception dimension, the severity score of high temperature health hazards among college students (3.28±0.89) was higher than that of susceptibility score (2.94±0.93). Efficacy appraisal showed that the response efficacy score was the highest (3.91±0.81). In behavioral responses, adaptive behaviors were most prominent (5.43±2.75), while emergency preparedness behaviors were the lowest (2.71±1.33). The structural equation model validated the pathway of "threat appraisal → efficacy appraisal → behavioral response" ( χ 2/df=2.49, RMSEA =0.05). Self efficacy played a fully mediating role between threat appraisal and behavioral response, with a mediation effect value of 0.10 (95% CI =0.02-0.19). K means cluster analysis categorized the subjects into three groups, with the core barriers to behavior being economic constraints (22.3%), lack of motivation (34.8%), and insufficient cognition (34.1%), respectively. Conclusions Decision making regarding high temperature health behaviors among college students follows psychological pathway of "cognition-appraisal-action" with self efficacy serving as a key mediating variable driving behavioral change. Targeted interventions should be implemented for groups with different characteristics.

OBJECTIVE To analyze the influential factors on trough concentration （cmin） and area under the drug concentration time curve （AUC） of voriconazole （VRZ） in pediatric patients with thalassemia undergoing hematopoietic stem cell transplantation （HSCT）. METHODS A total of 60 pediatric patients with thalassemia undergoing HSCT who used VRZ for prevention or treatment of invasive fungal infection were collected in our hospital from January 2021 to January 2024. The plasma concentration of VRZ was measured by high-performance liquid chromatography and the AUC was calculated. The factors affecting cmin and AUC of VRZ were analyzed using multiple linear regression. RESULTS A total of 120 cases of VRZ cmin in 60 pediatric patients was obtained and 27 cases of VRZ AUC in 26 pediatric patients were obtained. The median concentration of VRZ cmin was 0.31 mg/L； 46 cases had a cmin in 0.5-5 mg/L（ 38.33%）， 2 cases had a cmin＞5 mg/L（ 1.67%）， and 72 cases had a cmin＜0.5 mg/L. The median AUC of VRZ was 11.68 mg·h/L. The patient’s body weight， HSCT postoperative days， lymphocyte count， and combined use of phenytoin sodium， tacrolimus or cyclosporine had significant effects on VRZ cmin （P＜0.05）. Lymphocyte count and combined use of phenytoin sodium had significant effects on VRZ AUC （P＜0.05）. CONCLUSIONS The body weight， HSCT postoperative days， lymphocyte count， and combined use of phenytoin sodium， tacrolimus or cyclosporine are independent factors affecting VRZ cmin. Lymphocyte count and combined use of phenytoin sodium are independent factors affecting VRZ AUC.

Objective:To investigate the feasibility and clinical effects of the application of augmented reality (AR) navigation on assisted design of the chimeric twin-paddled anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue defects in extremities.Methods:From June 2017 to June 2023, 8 patients with soft tissue defects in extremities received reconstruction of chimeric twin-paddled ALTPF designed with the assistance of AR navigation in Department of Hand & Foot Microsurgery Orthopaedics, Guigang City People’s Hospital. All of them were traffic accidents or machine injuries, with 3 cases of calf, 2 cases of ankle, 1 case of foot, and 2 cases of hand defects. All the wounds were wide or irregular (defect sized 14 cm×14 cm-25 cm×13 cm). The images of bilateral thighs were acquired by CT angiography preoperatively. The dominant side and dominant perforators were selected. Three dimensional reconstruction was performed by Mimics software. AR technology was applied to guide the design and harvest of the chimeric twin-paddled ALTPF. Flap area was 15 cm × 16 cm to 26 cm × 14 cm. The donor site was sutured directly. Follow-up with outpatient visits or WeChat images and videos at 1, 3, 6 and 12 months postoperatively to record the appearance, colour, texture, recurrence of infection, and knee extension function of the flap donor site.Results:According to the preoperative design, the perforator flaps were harvested and transferred in all the 8 patients. All flaps survived and the recipient and donor sites healed in one stage. All patients entered postoperative follow-up for 3 to 12 (mean, 8.6)months. The colour and texture of the flaps were excellent, and the appearance of donor and recipient sites was satisfactory. Two patients with hand injuries were evaluated using the brief Michigan Hand Outcomes Questionnaire (MHQ), with scores of 43.74 and 81.25, respectively. Six patients with lower limb injuries were evaluated using the Maryland foot score, with scores of 2 excellent, 3 good and 1 fair.Conclusion:The application of AR navigation can effectively assist the design of a chimeric twin-paddled ALTPF. It also provides an effective basis for clinical personalised flap design.

This article provides an interpretive review of the "2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation", which was updated and published by the American College of Cardiology (ACC), the American Heart Association (AHA), the American College of Chest Physicians (ACCP), and the Heart Rhythm Society (HRS) based on the latest clinical evidence. It delves into the classification and management strategies for atrial fibrillation (AF), grounded in the most current evidence-based medical research. The guideline offers significant updates in various aspects such as the definition and staging of AF, clinical evaluation and treatment, modification of risk factors, prevention of thromboembolism, and management of specific populations. Notably, the introduction of a new staging model for AF and corresponding management strategies stands out, underscoring the importance of prevention and early intervention. This article focuses on the three pillars of integrated AF management—stroke risk assessment, modification of risk factors, and management of specific patient groups, in addition to rate and rhythm control, analyzes their substantial significance in clinical practice and guides clinicians in providing more precise treatment.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.

Objective:To carry out a study on the cost analysis of the clinical use of Artificial Intelligence-assisted Diagnosis Technology for Coronary CT Angiography(CCTA-AI)to explore the cost differences and cost effects of Coronary CT Angiography(CCTA)examinations before and after the introduction of Artificial Intelligence(AI),and analyze the impact of the application of AI technology on the high-quality development of public hospitals.Methods:The operation cost method was used to measure the changes in the cost and efficiency of CCTA examinations before and after the application of AI technology in five sample hospitals in Beijing,and diagnostic accuracy was used as the effect value to calculate the cost effect of CCTA-AI diagnosis versus CCTA-manual diagnosis,and to analyze the main factors affecting the unit cost.Results:The average cost of examination in 5 sample hospitals after the application of AI-assisted diagnosis system was 1 074.90 yuan,and 1 266.61 yuan before the application,with a large difference between institutions.The cost-effectiveness analysis based on diagnostic accuracy showed that the AI group had an absolute advantage over the manual group,with a cost of 1 074 900 yuan for the AI group and an effectiveness of 855.05 persons,and a cost of 1 266 610 yuan for the physician group,with an effectiveness of 815.07 persons for the high-year-end physician group,and an effectiveness of 793.40 persons for the low-year-end physician group;0.46 man-hours could be saved for each patient examined;the unit cost of CCTA examination was affected by a number of factors,among which"the number of annual examinations"and"the number of CT units involved in CCTA examination"had the greatest influence on the unit cost of CCTA examination.Conclusion:The application of AI-assisted diagnostic technology can promote the improvement of quality and efficiency in public hospitals in a certain extent,and help optimize the overall distribution of medical resources at the system level.In the future,the cost analysis of AI technology should be further strengthened to comprehensively assess its actual contribution to the healthcare system.