An Investigation of Medical Students’ Cognition on the Doctor-Patient Relationship and Their Career Choice

Objective:To investigate medical students’cognition on the doctor-patient relationship and its influence on their career choice as well as to provide reference for medical education and communication education.Methods:A self-compiled questionnaire survey was carried out at a medical university in W city,and descriptive statistics as well as chi-square tests were conducted.Results:There were significant differences in medical students’cognition of doctor-patient relationship among different genders,registered residence,only-child status,whose parents are working in the medical field,and their own evaluation of the major(p<0.05);the different cognitions of doctor-patient relationship have a significant influence on medical students’career choice.Conclusion:Medical students’vocational cognition and educational guidance should be strengthened,hospital information should be open and transparent,media reporting of medical events should be standardized,and a doctor-patient conflict regulation mechanism should be established.

Study on the Relationship between Psychological Stress and Doctor-Patient Relationship of Cancer Patients and Their Families

Objective: To research the relationship between psychological stress and doctor-patient relationship of cancer patients and their families. Methods: The patients were randomly divided into the intervention group and the control group, and PDRQ-15, pcl-c, SAS and SDS scales were selected as evaluation indexes, and the levels of norepinephrine and dopamine were compared between the patients diagnosed with PTSD cancer and those without PTSD. Results: 1) The total score of PCL-C, SAS, SDS, PDRQ-15 scale of the cancer patients and their families after the intervention of clinical psychological care was significantly lower than that of before intervention and the control group. 2) The correlation coefficients between PCL-C, SAS, SDS and PDRQ-15 of cancer patients and their relatives were 0.971, 0.952 and 0.939 respectively. The significant test P value was less than 0.05 and the difference was statistically significant. 3) The plasma levels of dopamine and norepinephrine in cancer patients under stress were significantly higher than those in cancer patients without stress (P Conclusion: After psychological Intervention of cancer patients and their families, post-traumatic stress disorder, anxiety, depression and doctor-patient relationship were all improved.

Time to rebuild the doctor-patient relationship in China

In China,the doctor-patient relationship(DPR)has been tense in recent years and continues to deteriorate.From 2009 to 2018,295 severe medical violence events were reported on social media,in which 362 doctors were injured and 24 lost their lives(1).According to a survey conducted in 2018 by the national Chinese Medical Doctor Association(CMDA),62% of doctors had experienced varying degrees of medical disputes and 66% had experienced varying degrees of doctor-patient conflict,dominated by verbal violence(accounting for 51%of cases).

E-mail Could Enhance Doctor-Patient Relationship

病人和医生之间的传统关系是本文所说的normal clinie basedconsultation。然而,这种沿袭了许多年的关系正在被打破！ E-mail,正在成为病人和医生之间联系的重要桥梁。 本文有几个重要信息: …nearly 40％ of American patients say they have used e-mail to contact ahealth professional(专家)in the past. …by the year 2000 nearly every library will offer(Internet and E-mail)services in the United States,allowing even low-income patients some means ofe-mail access. Web experts now estimate more than 10,000 health-oriented websites (站点)already exist. 这两个信息让我们感到:美国在这方面又领先世界一步！ 值得一提的是,病人有通过e-mail和医生联系的积极性,而医生却缺乏这方面的积极性。原因是: …for fear of increasing workload(工作量)and uncertainty about paymentror the time involved. 当然,病人方面也并非100％地欢迎这个新生事物: …patients may worry that sensitive medical information might be read byothers.然而,以上这些“阻力”终将被克服！

What diameter?What height?Influence of measures of average tree size on area-based allometric volume relationships

Volume is an important attribute used in many forest management decisions.Data from 83 fixed-area plots located in central New Brunswick,Canada,are used to examine how different measures of stand-level diameter and height influence volume prediction using a stand-level variant of Honer's(1967)volume equation.When density was included in the models(Volume=f(Diameter,Height,Density))choice of diameter measure was more important than choice of height measure.When density was not included(Volume=f(Diameter,Height)),the opposite was true.For models with density included,moment-based estimators of stand diameter and height performed better than all other measures.For models without density,largest tree estimators of stand diameter and height performed better than other measures.The overall best equation used quadratic mean diameter,Lorey's height,and density(root mean square error=5.26 m^3·ha^(-1);1.9%relative error).The best equation without density used mean diameter of the largest trees needed to calculate a stand density index of 400 and the mean height of the tallest 400 trees per ha(root mean square error=32.08 m^(3)·ha^(-1);11.8%relative error).The results of this study have some important implications for height subsampling and LiDAR-derived forest inventory analyses.

Three anti-inflammatory polysaccharides from Lonicera japonica Thunb.:insights into the structure-function relationships

This study demonstrates the feasibility of producing three polysaccharides(neutral LJP-1,acidic LJP-2 and acidic LJP-3)with significant in vitro and in vivo anti-inflammatory activities from the flowers of Lonicera japonica.The three polysaccharides differed in chemical composition,molecular weight(Mw)distribution,glycosidic linkage pattern,functional groups and morphology.They exhibited excellent protective effects(in a dose-dependent manner)in lipopolysaccharide-injured RAW264.7 macrophages and Cu SO4-damaged zebrafish via reducing NO production and inhibiting the overexpressions of inflammation-related transcription factors,inflammatory proteins and cytokines in the NF-κB/MAPK signaling pathways.Their antiinflammatory effects varied owing to their different molecular characteristics and chemical compositions.Overall,LJP-2 at 400μg/m L was the most effective.LJP-2 consisted mainly of→5)-α-L-Araf(1→,→4)-α-LGalp A(1→and→2)-α-L-Rhap(1→residues with terminal T-β-D-Glcp.Thus,honeysuckle flowers are good sources of anti-inflammatory polysaccharides,and precise fractionation enables the production of potent antiinflammatory agents for the development of functional foods and healthcare products.

Floristic composition and edaphic relationships in ferruginous campo rupestre reference ecosystems

Land use change and occupation have led to modifications in the environment causing loss of biodiversity and ecosystem services throughout the planet.Some environments with high economic relevance,such as the ferruginous campo rupestre(rupestrian grassland known as Canga in Brazil),are even more susceptible to severe impacts due to their extreme habitat conditions and low resilience.The determination of reference ecosystems based on the intrinsic characteristics of the ecosystem is essential for conservation as well as to the implementation of ecological restoration.We proposed the reference ecosystem of the three main types of habitats of the ferruginous campo rupestre based on their floristic composition.We described the floristic composition of each habitat and evaluated the physicochemical properties of the soils and the relationship between plants and soils.All three habitats showed high diversity of plant species and many endemic species,such as Chamaecrista choriophylla,Cuphea pseudovaccinium,Lychnophora pinaster,and Vellozia subalata.The distribution of vegetation was strongly related with the edaphic characteristics,with a set of species more adapted to high concentration of base saturation,fine sand,organic carbon,and iron,while another set of species succeeded in more acidic soils with higher S and silt concentration.We provide support for the contention that the ferruginous campo rupestre is a mosaic of different habitats shaped by intrinsic local conditions.Failure to recognize the floristic composition of each particular habitat can lead to inappropriate restoration,increased habitat homogenization and increased loss of biodiversity and ecosystem services.This study also advances the knowledge base for building the reference ecosystem for the different types of ferruginous campo rupestre habitats,as well as a key database for highlighting those species contribute most to community assembly in this diverse and threatened tropical mountain ecosystem.

The Relationship between Father-Love Absence and Loneliness:Based on the Perspective of the Social Functionalist Theory and the Social Needs Theory

Fathers play an important role in adolescents’development,which is significant for their development and influences their mental health,including feeling of loneliness.However,the effects and mechanisms of father-love absence on individual loneliness are not clear.Based on the social functionalist theory and the social needs theory,this study examines the influence of individual fatherlove absence on loneliness and its underlying mechanisms.A questionnaire survey was administered to 319 junior high school students and 1,476 high school students.The results showed that adolescents with father-love absence had higher levels of loneliness,and that father-love absence affected loneliness levels through mediating pathways of individual gratitude,peer relationships,and gratitude to peer relationships.This study not only confirms the negative effects of father-love absence on adolescents’loneliness,but also explains the mediate roles of individual gratitude and peer relationships.It enriches the theoretical system related to family education and has important theoretical and practical implications for further interventions on adolescents’mental health from the perspective of fatherless parenting.

Different mechanisms underlie similar species-area relationships in two tropical archipelagoes

Despite much research in the field of island biogeography,mechanisms regulating insular diversity remain elusive.Here,we aim to explore mechanisms underlying plant species-area relationships in two tropical archipelagoes in the South China Sea.We found positive plant species-area relationships for both coral and continental archipelagoes.However,our results showed that different mechanisms contributed to similar plant species-area relationships between the two archipelagoes.For coral islands,soil nutrients and spatial distance among communities played major roles in shaping plant community structure and species diversity.By contrast,the direct effect of island area,and to a lesser extent,soil nutrients determined plant species richness on continental islands.Intriguingly,increasing soil nutrients availability(N,P,K)had opposite effects on plant diversity between the two archipelagoes.In summary,the habitat quality effect and dispersal limitation are important for regulating plant diversity on coral islands,whereas the passive sampling effect,and to a lesser extent,the habitat quality effect are important for regulating plant diversity on continental islands.More generally,our findings indicate that island plant species-area relationships are outcomes of the interplay of both niche and neutral processes,but the driving mechanisms behind these relationships depends on the type of islands.

A Large-Scale Group Decision Making Model Based on Trust Relationship and Social Network Updating

With the development of big data and social computing,large-scale group decisionmaking(LGDM)is nowmerging with social networks.Using social network analysis(SNA),this study proposes an LGDM consensus model that considers the trust relationship among decisionmakers(DMs).In the process of consensusmeasurement:the social network is constructed according to the social relationship among DMs,and the Louvain method is introduced to classify social networks to form subgroups.In this study,the weights of each decision maker and each subgroup are computed by comprehensive network weights and trust weights.In the process of consensus improvement:A feedback mechanism with four identification and two direction rules is designed to guide the consensus of the improvement process.Based on the trust relationship among DMs,the preferences are modified,and the corresponding social network is updated to accelerate the consensus.Compared with the previous research,the proposedmodel not only allows the subgroups to be reconstructed and updated during the adjustment process,but also improves the accuracy of the adjustment by the feedbackmechanism.Finally,an example analysis is conducted to verify the effectiveness and flexibility of the proposed method.Moreover,compared with previous studies,the superiority of the proposed method in solving the LGDM problem is highlighted.

Nonlinear Relationship and Its Evolutionary Trace between Node Degree and Average Path Length of China Aviation Network Based on Complex Network

In order to reveal the complex network characteristics and evolution principle of China aviation network,the relationship between the node degree and the average path length of China aviation network in 1988,1994,2001,2008 and 2015 was studied.According to the theory and method of complex network,the network system was constructed with the city where the airport was located as the network node and the airline as the edge of the network.On the basis of the statistical data,the node average path length of China aviation network in 1988,1994,2001,2008 and 2015 was calculated.Through regression analysis,it was found that the node degree had a logarithmic relationship with the average length of node path,and the two parameters of the logarithmic relationship had linear evolutionary trace.Key word:China aviation network,complex network,node degree,average length of node path,logarithmic relationship,evolutionary trace.

Effective doctor-patient communication skills training optimizes functional organization of intrinsic brain architecture:a restingstate functional MRI study

We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI(rs-fMRI) with a regional homogeneity(ReHo) method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training(P<0.001). After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions(P <0.05, Alphasim corrected). The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline(r=-0.734, P= 0.036). The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain's architecture toward optimizing locally functional organization.

A Literature Review in Immuno-Oncology: Pathophysiological and Clinical Features of Colorectal Cancer and the Role of the Doctor-Patient Interaction

This review is intended to describe the features of colorectal cancer both in terms of pathophysiology and clinical features of the pathology. It also describes the anatomical and clinical features of different primary tumor locations in colorectal cancer. It is also to note how relevant it is to identify rectal cancer and colon cancer as different pathologies due to the clinical, pathophysiological and immuno-oncological features of rectal cancer compared to the ones of colon cancer while remarking the importance of medical doctors in the interaction with oncological patients. Background: Colorectal Cancer (CRC) is a major public health problem, representing the third most commonly diagnosed cancer in males and the second in females and it is fundamental to note and discuss doctor-patient interaction, fundamental for proper adherence and psychological status of the oncological patient, when discussing such important and impactful pathologies. Conclusions: This review highlights the possibility of an update in the terminology of Colorectal Cancer (CRC) into different clinically relevant pathologies within the umbrella term colorectal cancer (for instance rectal and colon cancer as different tumors). It also remarks on the importance of medical doctors in the interaction with oncological patients.

Review on mechanisms and structure-activity relationship of hypoglycemic effects of polysaccharides from natural resources

Diabetes mellitus(DM)is a common multifactorial disease,causing various complications,such as chronic metabolism.The current therapies for diabetes mellitus are commercial diabetic drugs that have different definite side effect.However,polysaccharides mainly extracted from natural resources,have advantages of safety,accessibility,and anti-diabetic potential.We have summarized recent research of natural polysaccharides with hypoglycemic activities,focusing on different pharmacological mechanisms in various cell and animal models.The relationships of structure-hypoglycemic effect are also discussed in detail.This review could provide a comprehensive perspective for better understanding on development and mechanism of natural polysaccharides against diabetes mellitus,which have been required by clinical studies yet.

Interpersonal Functions of Doctor-Patient Conversations

As an indispensable part of medical practice.doctor-patient conversation is drawing more and more attention in the field of sociology,psychology and linguistics.Little attention,however,has been paid to the interpersonal aspect of the conversation between doctors and patients,which is regarded as one of the most complex interpersonal relationships.Being dominant in the interaction,doctors'words,mainly in the form of questions,deserve more studies,especially for the interpersonal functions delivered.This study mainly focuses on this aspect.

Functional Health Literacy and Doctor-Patient Communication: Experiences of HIV/AIDS Patients in Homa Bay County, Kenya

Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.

A novel binary effective medium model to describe the prepeak stressstrain relationship of combined bodies of rock-like material and rock

Combined bodies of rock-like material and rock are widely encountered in geotechnical engineering,such as tunnels and mines.The existing theoretical models describing the stress-strain relationship of a combined body lack a binary feature.Based on effective medium theory,this paper presents the governing equation of the“elastic modulus”for combined and single bodies under triaxial compressive tests.A binary effective medium model is then established.Based on the compressive experiment of concretegranite combined bodies,the feasibility of determining the stress threshold based on crack axial strain is discussed,and the model is verified.The model is further extended to coal-rock combined bodies of more diverse types,and the variation laws of the compressive mechanical parameters are then discussed.The results show that the fitting accuracy of the model with the experimental curves of the concretegranite combined bodies and various types of coal-rock combined bodies are over 95%.The crack axial strain method can replace the crack volumetric strain method,which clarifies the physical meanings of the model parameters.The variation laws of matrix parameters and crack parameters are discussed in depth and are expected to be more widely used in geotechnical engineering.

Mediating role of physical activity in the relationship between psychological distress and intimate relationships among stroke patients

BACKGROUND Stroke patients often experience psychological distress,which can impact their intimate relationships with spouses,subsequently influencing their treatment and recovery.Physical activity is considered a key rehabilitation method for stroke patients.This paper aims to analyze whether psychological distress affects intimate relationship between spouses through physical activity.AIM To explore the mediating effect of physical activity between psychological distress and intimate relationship in stroke patients.METHODS A total of 256 stroke patients who underwent treatment at the First People’s Hospital of Shangqiu between July 2021 and July 2022 were enrolled in this study.The participants completed questionnaires,including the Kessler Psychological Distress Scale(K10),the Quality of Relationship Index(QRI),International Physical Activity Questionnaire,and a general information questionnaire.Data analysis were performed using SPSS 23.0.The Harman test was employed to detect common method deviations,and Spearman correlation was used for correlation analysis.The mediating effect was assessed using Process 3.4.1,with significance testing of the regression coefficients conducted using the bias-corrected percentile Bootstrap method(5000 iterations,95%confidence interval).Statistical significance was set at P<0.05.RESULTS The results showed that patients scored an average of 21.61±6.44 points on the K10,32.40±6.19 points on the QRI;the median physical activity level according to the International Physical Activity Questionnaire was 1861(566,2846)MET·min/w.The level of physical activity(the physical activity intensity of the patients reflected by the Interna-tional Physical Activity Questionnaire-Long Form scale)negatively correlated with psychological distress and intimacy(P<0.05),and positively correlated with each other(P<0.05),with the correlation stronger at lower physical activity levels compared to higher ones.The mediating effect of physical activity between psychological distress and intimate relationship was calculated to be 40.23%.Bootstrap analysis further validated the results.The mediating effect of psychological distress on intimate relationships through physical activity level was-0.284,with a confidence interval of-0.409 to-0.163,excluding 0,confirming a significant mediating effect of psychological distress on intimate relationships.CONCLUSION Physical activity significantly affects relationship between psychological distress and intimate relationships among stroke patients.Addressing the role of physical activity may have implications for improving patient outcomes and rehabilitation strategies.

A Study on Doctor-patient Communication under Defler Interaction Process Model

At present,doctor-patient relationship has become a sensitive topic in society,and frequent doctor-patient communication problems have become an important factor affecting the tension of the relationship.From the perspective of communication,this paper analyzes the causes of doctor-patient communication barriers based on the communication mode of interaction process proposed by Deffler and puts forward relevant solutions.