ObjectivesThis study aims to investigate patient safety culture in secondary hospitals of Heilongjiang, Northeast China, and explore the implications of patient safety culture and practices through the perspectives of various healthcare workers.MethodsA cross-sectional survey using the Safety Attitude Questionnaire (SAQ) was conducted to ascertain the status of patient safety culture in nine secondary hospitals across the six dimensions of the SAQ. Among the 900 staff members who were invited to participate, 665 completed the questionnaire. Descriptive statistics were used to calculate the general means and standard deviations of the patient safety culture dimensions and other numerical variables, and F-test and a multivariate regression analysis were used to statistically analyze the differences in perceptions of safety culture considering the differences in demographic characteristics. All statistical analyses were performed using SPSS v. 22.0.ResultsThe respondents rated job satisfaction as the highest among all six dimensions of the SAQ, followed in order by teamwork climate, working conditions, and stress recognition (the lowest). There were significant differences among the dimensions of patient safety culture and other factors, such as gender, age, job position, and education. Compared with previous studies, teamwork climate and working conditions scores were quite high, while stress recognition score was very low. We also found differences in patient safety culture by demographic characteristics.ConclusionsThe findings revealed the patient safety culture attitudes of healthcare workers in secondary hospitals of Heilongjiang, and provided baseline data for related future research. This evidence may also help government health policymakers and hospital administrators understand related challenges and develop strategies to improve patient safety culture in secondary hospitals of China and perhaps also in other developing countries.

Structural health monitoring (SHM) systems can improve the safety and reliability of structures, reduce maintenance costs, and extend service life. Research on concrete SHMs using piezoelectric-based smart aggregates have reached great achievements. However, the newly developed techniques have not been widely applied in practical engineering, largely due to the wiring problems associated with large-scale structural health monitoring. The cumbersome wiring requires much material and labor work, and more importantly, the associated maintenance work is also very heavy. Targeting a practical large scale concrete crack detection (CCD) application, a smart aggregates-based wireless sensor network system is proposed for the CCD application. The developed CCD system uses Zigbee 802.15.4 protocols, and is able to perform dynamic stress monitoring, structural impact capturing, and internal crack detection. The system has been experimentally validated, and the experimental results demonstrated the effectiveness of the proposed system. This work provides important support for practical CCD applications using wireless smart aggregates.

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Background:This study investigates the effect of body mass index (BMI) on complications and satisfaction in patients who underwent thyroidectomy and lateral neck dissection.Methods:We retrospectively reviewed 386 patients with papillary thyroid cancer who underwent total thyroidectomy and lateral neck dissection between January 2013 and December 2016. We compared variables including population characteristics, subjective satisfaction, and complications in nonobese (BMI < 28.0 kg/m2) and obese (BMI ≥ 28.0 kg/m2) patients.Results:Obesity was associated with an increased risk of postoperative hemorrhage (POH) ( P = .014), accessory nerve injury ( P < .001), operative time ( P < .001) and infection ( P = .013). However, obese patients had higher subjective satisfaction and Vancouver Scar Scale (VSS) scores ( P < .05).Conclusions:Obesity was associated with increased risk of POH, injury of the SAN, and infection. Interestingly, we found that obese patients had higher subjective satisfaction and VSS scores.

China's health reforms of the 1980s led to privatization of rural health care with adverse impact on farmers. A decade later a new rural co-operative medical scheme (RCMS), was piloted throughout many provinces to promote better equity. Although many schemes later collapsed owing to inadequate funding, some continue to the present. This article compares such a scheme with the out-of-pocket system in Henan province. We study the township hospitals, focusing on cost of services, utilization rates and impact of RCMS on hospitals' financial sustainability. Our results derive from monthly hospital records and a survey of four hospitals in two adjacent counties, one county with low-premium RCMS and the other with the out-of-pocket system.All hospitals charged for preventive activities (such as antenatal care, immunization), an unfortunate consequence of limited government support. It was not clear that on average, the total cost of individual patient visits in RCMS hospitals was lower than non-RCMS hospitals. Farmers were generally unaware of their insurance entitlements, except the catastrophic illnesses for which there was a real benefit from refund of US$100 or more. Although the effect of the RCMS on hospital charges was unclear it was notable that the utilization rates in RCMS areas were twice those in non-RCMS.We conclude that RCMS hospitals were better funded because of re-imbursements from the insurance scheme and therefore were more viable as sources of good health care. Thus, health care could become more equitable under RCMS than the out-ofpocket system. China is now beginning to test a revised form of RCMS with pooling at the county level, increased premiums (10 yuan per person) and increased government funding. However, it must be followed closely to determine the effect on rural services and health care costs for farmers.

Mandibular resection has been associated with a poor health-related quality of life (HRQOL), particularly in young patients with free fibula flap requiring defect reconstruction. The purpose of our study was to evaluate HRQOL of young patients who have had mandibular resections of huge ameloblastoma and free fibula flap reconstruction. The present study assessed 32 young patients who had undergone immediate mandible reconstruction with free fibula flap for huge ameloblastoma using the University of Washington Quality of Life (UW-QOL) Questionnaire and 49-item Oral Health Impact Profile (OHIP-49). Thirty-two of the forty-seven questionnaires were returned (68.08%). Of the 12 disease-specific domains on the UW-QOL, the best 3 scores from the patients were for shoulder, pain and taste, and the worst 3 scores were for chewing, anxiety and mood. On the OHIP-49, the lowest-scoring domain was physical pain, followed by handicap and social disability. A significant effect was found on the HRQOL of young patients with huge ameloblastoma who had undergone immediate mandible reconstruction with free fibula

Resilient city has attracted global attentions as a new concept for cities to deal with risks and challenges in recent years. Numerous researchers have successively conducted in-depth studies on the resilient city from different perspectives. To acquire an overview of resilient city and grasp the current research hotspots, a bibliometric analysis and visualization of the past decade of research on the resilient city was made. The data were collected from 1249 articles published in the Web of Science database from 2010 to 2019. As the widely used bibliometric analysis tools, CiteSpace and VOSviewer were adopted in this study. The temporal distribution of resilient city research, including annual publication outputs and high-cited papers, was symmetrically analyzed. Then, the spatial distribution of resilient city research, including countries, categories, institutions, co-citation journals, author collaboration network, and author co-citation network, was investigated. Hot topics and evolution trends of resilient city were revealed. The results show that the research of resilient city experienced three periods, namely, germination, rapid diffusion, and reflection and innovation periods. Current research focuses on four aspects, including psychological resilience at the microcommunity and group levels, assessment of urban disaster resilience, multiple theoretical frameworks of urban resilience, and urban resilience promotion strategy. Therefore, this study helps scholars and practitioners to gain a comprehensive understanding of the current research progress and evolution trends of the resilient city field.

Intraoperative neuromonitoring (IONM) facilitates recurrent laryngeal nerve (RLN) protection in thyroid and parathyroid surgeries. This study aimed to investigate a novel transcutaneous electromyography (EMG) recording method for IONM of the RLN during minimally invasive parathyroidectomy (MIP). Twenty patients with primary hyperparathyroidism undergoing MIP were enrolled. Two paired needle electrodes were percutaneously inserted into the bilateral laminas of thyroid cartilage for monitoring the vagus nerve and RLN. A standardized IONM procedure (V1-R1-R2-V2 signals) was strictly followed, and the RLN was routinely located and mapped. Pre- and postoperative laryngofiberoscopy was performed to confirm vocal cord function. The proposed technique was successfully used in all patients, and typical EMG signals were effectively detected. No significant change in EMG signals before and after tumor resection was noted, and a normal vocal cord movement was ensured in all patients with postoperative laryngofiberoscopy. IONM helped localize the position of the RLN and facilitated the safe resection of the parathyroid tumor during MIP. The novel transcutaneous EMG recording method proposed in this study was feasible, convenient, reliable, and inexpensive.