Objective To establish a competency evaluation indicator system for school physicians. Methods A preliminary pool of competency indicators for school physicians was established through systematic literature review and policy document analysis. The Delphi method was used to conduct two rounds of expert consultations with 16 experts who involve in educational administration, clinical medicine, public health management, and school healthcare. Based on the opinions of the experts, the indicator system was screened, revised, and refined to establish the final competency evaluation indicator system for school physicians. Results The questionnaire recovery rates of the two rounds of expert consultations were both 100.0%. The expert authority coefficient were 0.93 and 0.94, and Kendall′s coefficients of concordance were 0.21 and 0.26, respectively (both P<0.01). The final competency evaluation indicator system for school physicians consisted of five primary indicators, including basic medical service capacity, school health service capacity, health education and communication capacity, professional ethics and competency, and self-improvement capacity, as well as 35 secondary indicators (items). All indicators received relatively high importance scores. The system demonstrated a reasonable structure, good scientific validity, and practical applicability. Conclusion The competency evaluation indicator system for school physicians developed in this study demonstrates high scientific validity and practicality. It can serve as an important tool for school physician management, competency development, and performance evaluation, providing references for improving school health service quality and strengthening the construction of school physician teams.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

Humans ; Gastrointestinal Microbiome ; Constipation/therapy* ; Probiotics/therapeutic use* ; Patients

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Deep brain stimulation (DBS) is an invasive treatment that involves implanting electrodes into the brain to electrically stimulate specific brain regions, bringing new hope for the treatment of motor and psychiatric neurological diseases. This technology is closely related to human consciousness and has sparked heated debates on topics such as consciousness autonomy and personality integrity. Starting from the core principles of protecting patients, this paper explored the controversial issues of consciousness autonomy and medical autonomy principles in DBS practice, and discussed the ethical considerations in informed consent, patient inclusion, information collection, and cutting-edge scientific fields from the perspectives of patients, clinicians, and researchers.

ObjectiveTo determine the death level， change trend and life loss of pancreatic cancer among residents in Yuyao， and to provide scientific reference for the prevention and control of pancreatic cancer. MethodsThe death monitoring data of registered residents in Yuyao from 2014 to 2021 were collected to calculate crude mortality rate（CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， PYLL rate （PYLLR）， average annual percent change （AAPC） and other indicators. ResultsFrom 2014 to 2021， 860 cases of pancreatic cancer died in Yuyao， accounting for 6.25% of all malignant tumor deaths in the same period. The average annual mortality rate was 12.86/100 000， the age-standardized rate by Chinese standard population （ASRC） was 7.08/100 000， and the age-standardized rate by world Segi’s population （ASRW） was 5.17/100 1000. The CMR showed an upward trend in eight years （t=-5.076， P=0.002）. 493 men died of pancreatic cancer with an average annual mortality of 14.95/100 000， ASRC of 8.13/100 000， and ASRW was of 6.24/100 000. 367 women died of pancreatic cancer with an average annual mortality rate of 10.82/100 000， ASRC of 6.02/100 000， and ASRW of 4.14/100 000. The mortality rate of men was higher than that of women （χ²=22.191， P<0.001）. The minimum death age of pancreatic cancer is 27.52 years old， the maximum death age is 94.52 years old， and median age （Q₁， Q₂） of death was ［71.13（63.21， 78.87）］ years old. The death age of men ［69.61（62.30， 77.06）］ was less than that of women ［72.48（64.63， 81.09）］ （t=-3.820， P<0.001）. The mortality rate of pancreatic cancer showed an upward trend with age （χ²_trend=1 110.844， P<0.001）， and the 75 year old mortality rate （75.58/100 000） fell after reaching the peak. PYLL caused by death of pancreatic cancer in 8 years was 9 775.00 person years， AYLL was 14.33 person years， and PYLLR was1.53‰. ConclusionPancreatic cancer is an important cause of death for residents in Yuyao， which has a huge loss of life. It is necessary to formulate targeted prevention and control strategies， with the middle-aged and elderly as the key population， to reduce the incidence and death of pancreatic cancer.

The protection of language function is one of the major challenges of brain surgery. Over the past century, neurosurgeons have attempted to seek the optimal strategy for the preoperative and intraoperative identification of language-related brain regions. Neurosurgeons have investigated the neural mechanism of language, developed neurolinguistics theory, and provided unique evidence to further understand the neural basis of language functions by using intraoperative cortical and subcortical electrical stimulation. With the emergence of modern neuroscience techniques and dramatic advances in language models over the last 25 years, novel language mapping methods have been applied in the neurosurgical practice to help neurosurgeons protect the brain and reduce morbidity. The rapid advancements in brain-computer interface have provided the perfect platform for the combination of neurosurgery and neurolinguistics. In this review, the history of neurolinguistics models, advancements in modern technology, role of neurosurgery in language mapping, and modern language mapping methods (including noninvasive neuroimaging techniques and invasive cortical electroencephalogram) are presented.
Brain Mapping ; Brain Neoplasms ; Humans ; Language ; Neurosurgery ; Neurosurgical Procedures

Objective: To describe online learning and eye strain situation of college students during the COVID-19 outbreak, to provide a scientific basis for guiding students eye health. Methods: A self-filled electronic questionnaire survey through questionnaire star was administered to college students across China. Information about online learning and eye strain of 1 046 college students during the epidemic was collected in Hefei, Anhui Province from March 16 to 20, 2020. The univariate and multivariate Logistic regression analysis were performed to analyze the association between online learning and eye strain of college students. Results: The rate of eye strain during online learning was 72.1%, totally of 68.4% in 421 male students and 74.6% in 625 female students. Boys with online learning time <6 h/d, slow internet access，difficulty in understanding online class reported higher rate of eye strain than girls( χ 2=17.36,8.72,7.02, P ＜0.05). Freshmen reported the highest rate of slow internet access occasionally and active online class( χ 2=15.26,16.11, P ＜0.05), junior students reported highest rate of online learning time <6 h/d, and easy understandable online class( χ 2=15.33,32.59, P ＜0.05), medical college students reported higher rate of slow internet access, inactive online class than non-medical college students( χ 2=11.79,11.03, P ＜0.05). Multivariate Logistic regression analysis showed that odds ratio( OR ) of eye strain in females was 1.40 (1.06-1.87), compared with males; the OR of eye strain were 1.43 (1.01-2.03) and 1.54 (1.10-2.15) in the groups with online learning time 6-<8 h/d and ≥8 h/d, respectively, compared with the group with online learning time <6 h/d, the OR of eye strain in the groups with slow internet access was 2.28 (1.25-4.14), compared with students without slow internet access, the OR of eye strain in the capable to understand and difficult to understand group were 2.54 (1.73-3.74) and 5.40 (2.70-10.80) respectively, compared with the easy to understand group. Conclusion Female students, online learing time ≥ 8 h/d, slow internet access, difficult to understand class content were positively related with college students eye strain. Attention should be paid to the eye health of college students to reduce the adverse effects of online learning on vision.during the COVID-19 epidemic.