基于晶闸管导通角控制的脉宽调制旋转阳极控制技术的设计与实验

针对X线检查大型医疗设备整机价格昂贵、维保费用高、生命周期短、场地要求严苛等问题,研究一种能够应用于教学示教及技能培训、故障演练测试的教学器具,结合旋转阳极电路的基本功能要素,涵盖高压启动、低压维持、延时保护、运转检测等基本流程,结果表明,该装置能够准确地演练实际工作环境,起到培育医疗设备维修人员检修旋转阳极时所需要的实际技能的作用,降低了实际教学成本,满足了工位数需求,增加了实践动手训练机会,提升了技能培训效果。     

Accessibility and Perceived Clinical Utility of the GMFM-66

The 66-item Gross Motor Function Measure (GMFM-66) requires a computer program for scoring. The primary purpose of this study was to pilot test the scoring software and examine the perceived clinical utility of the GMFM-66 as judged by 48 pediatric physical therapists. Sixty-one percent of therapists were confident in their ability to interpret the information from the computer program following one hour spent reading the tutorial and interpretation guidelines. Ninety-three percent of respondents perceived the overall clinical utility of the GMFM-66 in terms of administration, scoring and interpretation to be the same or more clinically useful than the GMFM-88.     

An Integrated Model for Patient Care and Clinical Trials (IMPACT) to support clinical research visit scheduling workflow for future learning health systems

We describe a clinical research visit scheduling system that can potentially coordinate clinical research visits with patient care visits and increase efficiency at clinical sites where clinical and research activities occur simultaneously. Participatory Design methods were applied to support requirements engineering and to create this software called Integrated Model for Patient Care and Clinical Trials (IMPACT). Using a multi-user constraint satisfaction and resource optimization algorithm, IMPACT automatically synthesizes temporal availability of various research resources and recommends the optimal dates and times for pending research visits. We conducted scenario-based evaluations with 10 clinical research coordinators (CRCs) from diverse clinical research settings to assess the usefulness, feasibility, and user acceptance of IMPACT. We obtained qualitative feedback using semi-structured interviews with the CRCs. Most CRCs acknowledged the usefulness of IMPACT features. Support for collaboration within research teams and interoperability with electronic health records and clinical trial management systems were highly requested features. Overall, IMPACT received satisfactory user acceptance and proves to be potentially useful for a variety of clinical research settings. Our future work includes comparing the effectiveness of IMPACT with that of existing scheduling solutions on the market and conducting field tests to formally assess user adoption.     

The association of nurses' assessment and certainty to pain management and outcomes for nursing home residents in Jordan

Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables. This study may provide a new understanding of the relationship between nurses' certainty, assessment scope, and patient outcomes for people with dementia. Improved understanding of this relationship and how it relates to the problem of unrelieved pain in people with dementia is crucial.     

The evolution of medical informatics in China: A retrospective study and lessons learned

BackgroundIn contrast to China’s giant health information technology (HIT) market and tremendous investments in hospital information systems the contributions of Chinese scholars in medical informatics to the global community are very limited. China would like to have a more important position in the global medical informatics community.ObjectiveA better understanding of the differences between medical informatics research and education in China and the discipline that emerged abroad will better inform Chinese scholars to develop right strategies to advance the field in China and help identify an appropriate means to collaborate more closely with medical informatics scholars globally.MethodFor the first time, this paper divides the evolution of medical informatics in China into four stages based on changes in the core content of research, the educational orientation and other developmental characteristics. The four stages are infancy, incubation, primary establishment and formal establishment. This paper summarizes and reviews major supporting journals and publications, as well as major organizations. Finally, we analyze the main problems that exist in the current disciplinary development in China related to medical informatics research and education and offer suggestions for future improvement.ConclusionsThe evolution of medical informatics shows a strong and traditional concentration on medical library/bibliographic information rather than medical (hospital information or patient information) information. Misdirected-concentration, a lack of formal medical informatics trained teaching staff and mistakenly positioning medical informatics as an undergraduate discipline are some of the problems inhibiting the development of medical informatics in China. These lessons should be shared and learned for the global community.     

Differential diagnosis of jaw pain using informatics technology

This study aimed to deduce evidence‐based clinical clues that differentiate temporomandibular disorders (TMD)‐mimicking conditions from genuine TMD by text mining using natural language processing (NLP) and recursive partitioning. We compared the medical records of 29 patients diagnosed with TMD‐mimicking conditions and 290 patients diagnosed with genuine TMD. Chief complaints and medical histories were preprocessed via NLP to compare the frequency of word usage. In addition, recursive partitioning was used to deduce the optimal size of mouth opening, which could differentiate TMD‐mimicking from genuine TMD groups. The prevalence of TMD‐mimicking conditions was more evenly distributed across all age groups and showed a nearly equal gender ratio, which was significantly different from genuine TMD. TMD‐mimicking conditions were caused by inflammation, infection, hereditary disease and neoplasm. Patients with TMD‐mimicking conditions frequently used “mouth opening limitation” (P < .001), but less commonly used words such as “noise” (P < .001) and “temporomandibular joint” (P < .001) than patients with genuine TMD. A diagnostic classification tree on the basis of recursive partitioning suggested that 12.0 mm of comfortable mouth opening and 26.5 mm of maximum mouth opening were deduced as the most optimal mouth‐opening cutoff sizes. When the combined analyses were performed based on both the text mining and clinical examination data, the predictive performance of the model was 96.6% with 69.0% sensitivity and 99.3% specificity in predicting TMD‐mimicking conditions. In conclusion, this study showed that AI technology‐based methods could be applied in the field of differential diagnosis of orofacial pain disorders.