Application of scenario simulation combined with "finding fault" teaching method in prevention and control of nosocomial infection training in standardized residency training of cardiovascular surgery / 中华医学教育探索杂志

Objective:To explore the effect of scenario simulation combined with "finding fault" teaching method on prevention and control of nosocomial infection training in standardized residency training of cardiovascular surgery.Methods:A total of 31 residents trained in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Naval Medical University from April 2018 to March 2019 were selected as the control group, and another 31 residents trained from April 2019 to March 2020 were selected as the study group. All subjects were required to receive nosocomial infection prevention and control training. The control group was given conventional teaching method, while the study group was given scenario simulation combined with "finding fault" teaching method, all of which were taught for 1 month. The theoretical and operational assessment results of nosocomial infection prevention and control after teaching, the clinical core competence related to nosocomial infection prevention and control after teaching, and the recognition rate of teaching mode were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:The scores of theoretical assessment [(91.29±6.64) vs. (86.73±6.02)] and operational assessment [(90.32±6.80) vs. (83.51±7.43)] of nosocomial infection prevention and control after teaching in the study group were higher than those in the control group, with statistical differences ( P<0.05). The scores of clinical core competence in learning initiative, doctor-patient communication, problem thinking and problem solving of nosocomial infection prevention and control knowledge after teaching in the study group were higher than those in the control group, with statistical differences ( P<0.05). The recognition rates of innovation, interest, effectiveness and practicability of the teaching mode in the study group were 83.87%, 96.77%, 90.32% and 93.55% respectively, while those in the control group were 61.29%, 58.06%, 67.74% and 74.19% respectively, which were higher in the study group than in the control group, with statistically significant differences ( P<0.05). Conclusion:In the training of prevention and control of nosocomial infection for standardized residency training in the department of cardiovascular surgery, scenario simulation combined with "fault finding" teaching method can improve the theoretical and practical examination results of the residents, enhance their clinical core competence related to nosocomial infection prevention and control, and reach a higher recognition rate of the teaching mode.

Intelligent fault diagnosis expert system for multi-parameter monitor based on fault tree / 生物医学工程学杂志

Aiming at the dilemma of expensive and difficult maintenance, lack of technical data and insufficient maintenance force for modern medical equipment, an intelligent fault diagnosis expert system of multi-parameter monitor based on fault tree was proposed in this study. Firstly, the fault tree of multi-parameter monitor was established and analyzed qualitatively and quantitatively, then based on the analysis results of fault tree, the expert system knowledge base and inference engine were constructed and the overall framework of the system was determined, finally the intelligent fault diagnosis expert system for multi-parameter monitor was developed by using the page hypertext preprocessor (PHP) language, with an accuracy rate of 80% in fault diagnosis. The results showed that technology fusion on the basis of fault tree and expert system can effectively realize intelligent fault diagnosis of multi-parameter monitors and provide troubleshooting suggestions, which can not only provide experience accumulation for fault diagnosis of multi-parameter monitors, but also provide a new idea and technical support for fault diagnosis of medical equipment.

Falta básica, angústia e resistência / Basic fault, anguish and resistance / La falta básica, angustia y resistencia

Debate da resistência em psicanálise, decorrente da formação de defesas psíquicas durante o desenvolvimento psicossexual, as quais têm como finalidade a recuperação do objeto perdido quando do evento traumático, evento esse que constitui um marco para a proposta do conceito de “falta básica”, feita por Balint. O interesse pelo tema surge ao verificar-se crescente demanda de análise de pacientes com profunda angústia relativa ao desamparo e importantes conflitos familiares, descrença na instituição trabalho e em alcançar vida conjugal satisfatória. Trabalhamos na perspectiva de formular hipóteses, sustentadas em experiência clínica e campo teórico da psicanálise stricto sensu e psicanálise dos vínculos, que poderiam contribuir para a clínica de revisão dos vínculos. A análise envolve o Sujeito e os objetos primários bem como seus substitutos embora somente o Sujeito esteja em psicanálise.

Debate in psychoanalysis of resistance resulting from the formation of psychic defenses during psychosexual development. These defenses have as their purpose the recovery of the object that where lost during the traumatic event which is a milestone for the proposal of the concept of “basic fault” by Balint. Our interest in the subject arises because we observe at present increasingly demand for analysis of patients with deep anguish related to helplessness and important family conflicts, disbelief in the work institution and in achieving satisfactory marital life. We work from the perspective of formulating hypotheses, based on clinicai experience and theoretical field of psychoanalysis stricto sensu and psychoanalysis of bonds, that could contribute to the clinical review of the bonds. The analysis involves the Subject and the primary objects as well as their substitutes although only the Subject is in psychoanalysis.

Debate respeto a la resistencia en el psicoanálisis, que es resultante de la formación de defensas psíquicas durante el desarrollo psicosexual, cuyo objetivo es recuperar el objeto perdido durante el evento traumático, trauma ese que constituye un hito para la propuesta del concepto de "falta básica" de Balint. El interés en el tema surge por la constatación de que existe creciente demanda de análisis de pacientes con profunda angustia relacionada con el desamparo e importantes conflictos familiares, la perdida de la confianza en la institución laboral y bien en la esperanza de lograr una vida matrimonial satisfactoria. Trabajamos desde la perspectiva de formular hipótesis basadas en la experiencia clínica y en los campos teóricos del psicoanálisis stricto sensu y del psicoanálisis de los vínculos, que podrían contribuir a la revisión clínica de los enlaces. El análisis involucra al Sujeto y los objetos primarios, así como a sus sustitutos, aunque solo el sujeto esté en psicoanálisis.

Application of day checklist model combined with fault finding and error correction method in the teaching of new nurses in neurology department / 中华医学教育探索杂志

Objective:To analyze the application effect of day checklist model combined with fault finding and error correction method in the teaching of new nurses in neurology department.Methods:A total of 42 new neurology nurses accepted in the department of neurology from January 2019 to June 2020 were selected in the study and they were divided into control group and study group. The conventional group was given the conventional teaching method, while the study group was given the day checklist model combined with fault finding and error correction method, both of which were taught for 3 months. Assessment performance of theoretical knowledge and operational skills before and after teaching, critical thinking ability before and after teaching and satisfaction with the teaching after teaching in neurology nursing were compared between the two groups. SPSS 25.0 was used for t test and rank sum test. Results:After teaching, assessment performance of theoretical knowledge and operational skills, the 7 dimensions of critical thinking ability scores and the total scores were higher than those before teaching, and the study group did better than the control group ( P < 0.05). There were significant differences between the 2 groups of new nurses in the distribution of satisfaction with teaching ( P < 0.05), and the total satisfaction rate of the study group (100.00%) was higher than that of the control group (80.96%) ( P < 0.05). Conclusion:Using the method of day checklist model combined with fault finding and error correction method in the teaching of new nurses in the neurology department can improve their assessment results, enhance their critical thinking ability and improve the teaching satisfaction.

Intelligent fault diagnosis of medical equipment based on long short term memory network / 生物医学工程学杂志

In order to solve the current problems in medical equipment maintenance, this study proposed an intelligent fault diagnosis method for medical equipment based on long short term memory network(LSTM). Firstly, in the case of no circuit drawings and unknown circuit board signal direction, the symptom phenomenon and port electrical signal of 7 different fault categories were collected, and the feature coding, normalization, fusion and screening were preprocessed. Then, the intelligent fault diagnosis model was built based on LSTM, and the fused and screened multi-modal features were used to carry out the fault diagnosis classification and identification experiment. The results were compared with those using port electrical signal, symptom phenomenon and the fusion of the two types. In addition, the fault diagnosis algorithm was compared with BP neural network (BPNN), recurrent neural network (RNN) and convolution neural network (CNN). The results show that based on the fused and screened multi-modal features, the average classification accuracy of LSTM algorithm model reaches 0.970 9, which is higher than that of using port electrical signal alone, symptom phenomenon alone or the fusion of the two types. It also has higher accuracy than BPNN, RNN and CNN, which provides a relatively feasible new idea for intelligent fault diagnosis of similar equipment.

Los cuestionamientos éticos de Freud: psicoanálisis, existencia y muerte / Freud's ethical quandaries: psychoanalysis, existence and death / Os questionamentos éticos de Freud: psicanálise, existência e morte

Resumen 11. Freud no criticó los fundamentos de la ética ni prescribió deberes, prohibiciones, aspiraciones o respuestas alternativas a problemas tradicionales, sino entregó una nueva manera de formular problemas morales. Existen tres áreas en que Freud insinuó una ética que sostiene una dirección diferente a la actual bioética.1. El carácter no ético del psicoanálisis no está incluido entre las técnicas de dominación o adoctrinamiento sino en las de veracidad, en lo que importa es el auto-reconocimiento, la mala comprensión es la ruta necesaria para la comprensión. 2. La postura final de Freud mismo hacia su propia muerte se puede llamar apropiación de su finitud, cuando él asumió su ser-referido-a-la-muerte, no como estar-en-su-final, indicando con ello que comprendió que el final siempre penetró en su vida. 3. En la auténtica comprensión de sí mismo, Freud entendió que la última potencialidad de su existencia fue abandonarse a sí, reveló su potencialidad para su no-potencialidad, haciéndose libre para su propio fin, aceptó su existencia en su finitud.

Abstract 15. Freud did not make a critique of foundations of ethics nor prescribed duties, prohibitions, aspirations or alternative answers to unchanged questions, but he gave a new manner of asking moral questions. There are three areas in which Freud implied an ethic that maintains a different direction from current bioethics.1. The fundamentally nonethical character of Freud´s psychoanalysis is not included in the techniques of domination or indoctrination but of veracity, what is at stake is selfrecognition, misunderstanding is the necessary path to understanding. 2. The final position of Freud himself to his own death can be called appropriation of his finitude, when he assumed his being-unto-death, not as a being-at-his-end, indicating thereby that he understood that the end always penetrated his whole existence. 3. In the authentic comprehension of his self, Freud understood that the ultimate potentiality of his existence was to relinquish his self, he revealed to his self his potentiality for non-potentiality, becoming free for his own end, he accepted his existence in its finitude.

Resumo 19. Freud não criticou os fundamentos da ética nem prescreveu deveres, proibições, aspirações ou respostas alternativas a problemas tradicionais, e sim apresentou uma nova maneira de formular problemas morais. Existem três áreas nas quais Freud insinuou uma ética que indica uma direção diferente da atual bioética. 1. O caráter não ético da psicanálise não está incluído entre as técnicas de dominação ou doutrinamento e sim nas de veracidade, onde o que importa é o auto-reconhecimento, a má compreensão é o caminho necessário para a compreensão. 2. A postura final de Freud, mesmo até sua morte, pode se chamar de "apropriação de sua finitude", quando ele assumiu seu ser-referido-à- morte, não como estar-em-seu-final, indicando com isto que compreendeu que o final sempre infiltrou sua vida. 3. Na autêntica compreensão de si mesmo, Freud entendeu que a última potencialidade de sua existência foi abandonar-se a si, revelou sua potencialidade para sua não-potencialidade, libertando-se para seu próprio fim, aceitou sua existência em sua finitude.

Summary of Fault Maintenance Experience of Multifunctional Digital Flat Plate Radiography System-Carestream DR7500 / 中国医疗器械杂志

This paper is a summary of the three types of faults that have occurred in the recent years in the Carestream DR7500:hardware failure, software failure, and communication failure. The specific cases of three types of faults are introduced in a case-by-case basis.

A comparison of the levels of earthquake awareness and preparedness in a high risk and low risk barangay / The Health Sciences Journal

INTRODUCTION@#Metro Manila is at risk from “the big one”, a magnitude 7.2 earthquake caused by the movement of the West Valley Fault, thus awareness and preparedness of the people are very important. The study compared the levels of earthquake awareness and preparedness of households in a high-risk area and a low risk area.@*METHODS@#This was a cross-sectional study among 376 households each from a high- and a low-risk barangay in Metro Manila using a self-administered household-based survey questionnaire consisting of questions on awareness and preparedness. The prevalence of households classified as aware and wellprepared was computed; the significance of differences between the high- and low risk barangays was determined through Fisher’s exact test. @*RESULTS@#There were fewer households classified as aware in the high-risk barangay compared with the low risk barangay, but the difference was not significant (PR = 0.98, 95% CI 0.84, 1.01, p = 0.078, Fisher’s exact test). Less than half of households were classified as well-prepared in both high- and low risk barangays (49.7 vs 46.5%) and the difference was not significant (PR = 1.07, 95% CI 0.92, 1.24, p = 0.422, Fisher’s exact test). Television was the most common source of information in both barangays. Households in the high-risk barangay were more likely to be well-prepared when a member was at least a high school graduate (PR = 2.54, 95% CI 1.24, 5.22, p = 0.001, Fisher’s exact test).@*CONCLUSION@#There was no difference in the levels of awareness and preparedness between high and low risk barangays. Television was the most common source of information in both high and low risk barangays. The presence of at least one high school graduate in the household from a high-risk barangay was associated with preparedness but not awareness.

Research on Bayesian fault diagnosis model of traditional Chinese medicine dry granulation based on failure model and effect analysis (FMEA) / 中国中药杂志

This paper aims to construct a Bayesian(BN) fault diagnosis model of traditional Chinese medicine dry granulation based on the failure model and effect analysis(FMEA), effectively control risk factors and ensure the quality of granules.Firstly, the risk ana-lysis of dry granulation process was carried out with FMEA, and the selected medium and high risk factors were taken as node variables to establish corresponding BN network with causality.According to the mathematical reasoning method of probability theory, the model was accurately inferred and verified by Netica, and the granule nonconformance was used as the evidence for reversed reasoning to determine the most likely cause of the failure that affected the granule quality.The BN fault diagnosis model of traditional Chinese medicine dry gra-nulation was established based on the medium and high risk factors of process, prescription and equipment screened out by FMEA, such as roller pressure, raw material viscosity, clearance between rollers in the paper.The fault diagnosis of traditional Chinese medicine dry granulation process was then carried out according to the model, and the posterior probability of each node under the premise of nonconforming granule quality was obtained.This method could provide strong support for operators to quickly eliminate faults and make decisions, so as to improve the efficiency and accuracy for fault diagnosis and prediction, with innovation in its application.

Practice of the performance appraisal for medical equipment maintenance quality / 中华医院管理杂志

Assurance of the safety,reliability and effectiveness of in-use medical equipments is key to improving medical risk management and applied quality of medical equipments of a hospital.By means of regular field survey of in-use medical equipments of the hospital,the authors identified key risk exposures in the current equipment quality control system,and took targeted corrective measurements.Data of routine equipment maintenance and that of appraisal were compared and analyzed.Based on such,appraisal points are set dynamically,and a standardized and customized appraisal program is developed for the safety and quality evaluation of medical equipments,featuring comprehensive coverage and operability.Such efforts effectively supplement daily maintenance work and provide data basis for reliability and usability analysis of medical equipments.

Hydraulic System Onboard Monitoring and Fault Diagnostic in Agricultural Machine

Abstract Agricultural Machinery as an off-road vehicle is the backbone of the World agricultural industry. Its main function is to operate as a prime mover and support the power requirements to function the various type of draft implements. In this regards, the hydraulic system is an important part and is controlled by the propagated oil which is cleaned by impurities and debris using a filter system. Once it blocks, the bypass opens to avoid any pressure burst of the system, and the particles find their way into the hydraulic system and get lodged in the gears, pumps, valves, and drive train to hinder the performance of the Agricultural Machinery. This research presents an onboard Multiple Signal Classification Algorithm (MUSIC) and pseudo-spectrum analysis as a computational tool used by cellphones to analyze the particle pollution level of the hydraulic filter. This analysis is carried out on the soundtracks recorded from different cell phones in different incremental stages of fluid contamination to the particles until it being choked, based on the standard of ISO4406.

General Troubleshooting and Preventive Maintenance of the Digestive Electron Microscope System / 中国医疗器械杂志

OBJECTIVE@#Improve the integrity of the digestive electron microscope equipment and reduce the cost of equipment failure maintenance.@*METHODS@#By studying the composition and function of the digestive electron microscope system and analyzing the causes of common faults, a targeted preventive maintenance plan is developed, equipment users are graded, and a training system is established.@*RESULTS@#The user of the device can skillfully analyze the cause of the malfunction and timely deal with the sudden failure of the diagnosis and treatment, thereby reduce the risk of diagnosis and treatment and the investment in hospital maintenance.@*CONCLUSIONS@#Through the analysis and processing of the digestive electron microscope system, point detection leakage, grading training, preventive maintenance can significantly improve the equipment integrity rate, reduce the risk of clinical diagnosis and treatment, effectively reduce the number of equipment failures, and reduce maintenance costs.

Stakeholder analysis of no-fault compensation system on medical damages / 中国卫生政策研究

Using stakeholder involvement analysis to analyze the appeal,position,power and role of stakehold-ers involved in the creation of the no-fault compensation system of medical damage,this paper believes that the gov-ernment,including the health administrative department, is the concrete maker and the important facilitator of the policy implementation,which needs to take advantage of the public power to predominate the creation and trial opera-tion of the system;the medical staffs,patients and their families are the direct beneficiary of the policy,but it is nec-essary to ensure the good operation of the system by establishing diversified financing channels and setting reasonable compensation scope. The judicial appraisal institution and the expert group are the important guarantors of the policy implementation,but the authentication system should be unified and the expert group evaluation mechanism should be introduced. The insurance industry is an important propellant of policy implementation, but it needs to increase its participation by taking measures,such as expanding financing channels. The news media has an important influence on the making and implementation of the policy and should be properly guided to play its positive role.

Research on multi-leaf collimator fault prediction model of Varian Novalis Tx medical linear accelerator based on BP Neural Network realized by R language / 中华放射肿瘤学杂志

Objective To construct and investigate the multi-leaf collimator (MLC) fault prediction model of Varian NovalisTx medical linear accelerator based on BP neural network.Methods The MLC fault data applied in clinical trial for 18 months were collected and analyzed.The total use time of accelerator,the quantity of patients per month,average daily working hours of accelerator,volume of RapidArc plans and time interval between accelerator maintenance were used as the input factors and the prediction of MLC fault frequency was considered as the output result.The BP neural network model of MLC fault prediction was realized by AMORE package of R language and the simulation results were validated.Results The model contained 3 layers of network to realize the input-output switch.There were 5 nodes in the input layer,13 nodes in the hide layer and 1 node in the output layer,respectively.The transfer function from the input layer to the hide layer selected the tansig function and purelin function was used from the hide layer to the output layer.The maximum time of training was pre-set as 150 in the designed model.Actually,111 times of training were performed.The pre-set error was 3％ and the actual error was 2.7％,which indicated good convergence.The simulation results of MLC fault applied in clinical trial for 18 months were similar to the actual data.Conclusions The BP neural network model realized by R language of MLC fault prediction can describe the mapping relationship between fault factors and fault frequency,which provides references for the understanding of accelerator fault and management of spare parts inventory.

Research on risk control of hematodialysis equipment based on statistical data of failure / 中国医学装备

Objective:To investigate various risk factors that influence the safety of using hemodialysis equipment, and carry out risk control and reduce risk of using equipment through analyzed the statistical result of failure data of equipment.Methods:Based on all kinds of fault messages record in 2016, the failure data of 390 cases were carried out classified statistic analysis by using Microsoft Excel.Results: Through the statistic analysis of failure rate of 2016 year, there were four main factors were obtained. Aimed at the three higher percent factors that were equipment fault(85.1％), material(11.2％) and human reason(3.7％), respectively., the current management system of hemodialysis equipment was optimized and operation process was standardized from three aspects that included equipment management, material management, and the training and check for staff.Conclusion: Based on the analysis and research for the failure types of hemodialysis equipment purchased from different years, and the analysis of relevant reasons, the corresponding countermeasure of quality management is established, and the main body of responsibility is clarified, and the operative risk of hemodialysis equipment is effectively reduced.

Application of Quality Control Circle in Reducing Incidence of Leakage in Digestive Endoscopy / 中国医疗器械杂志

To study the role of the activity in reducing the incidence of water leakage in digestive endoscopy, through the activity of the quality control circle (QCC), the reasons for water leakage and high maintenance cost are analyzed deeply. Then, the author formulated and implemented targeted measures to intervene in the non-standard aspects of daily management of endoscopy. Then targeted measures has been taken to improve the nonstandard daily management.Results demonstrate that the application of the quality control circle can significantly reduce the incidence of water leakage in the digestive endoscope and control the other faults caused by the leakage. This not only reduces the high maintenance cost of endoscopy, improves the utilization rate and turnover rate of endoscopy, but also fully explores personal potential, enhances team cohesion, and improves quality management awareness.

Application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator / 医疗卫生装备

Objective To discuss the practicability of application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator.Methods The structure and principle of the electrical system were analyzed,the fault tree for the electrical system was built,and the qualitative analysis and quantitative analysis to the fault tree were made.The electrical system was innovated with effective redundant method,and the qualitative analysis and quantitative analysis were made after innovation.Theoretical analysis and the actual validation were made for the fault tree of electrical system after innovation.Finally,several notes were provided for the innovation to the similar medical equipments.Results The fault tree analysis method was applied to innovating the electrical system,and theoretical analysis indicated that the failure probability to total system reduced obviously.Actually,the actual effect after innovation also validated the correctness of the theoretical analysis.Conclusion Application of fault tree analysis in innovation to electrical system of SL-IE radiotherapy simulator is practical.But,the selection to the innovation event,the change to maintainence after innovation and the event to innovate carefully should be paid attention to.

Development of maintenance learning machine of ventilator for teaching / 中国医学装备

Objective: To design a new type of maintenance learning machine of ventilator for teaching and experiment combined with electronic technology course of higher vocational education. Methods: ACM804 ventilator was chosen as prototype machine and the electronic technology course of higher vocational education was chosen as theory basis. The designs of internal circuit and gas circuit of prototype machine were improved, besides, some test points and failure points were designed for teaching in classroom. Results: This machine not only could realize all functions of prototype machine, but also could carry forward test teaching and contribute students to maintain common failure in accordance with course content. Conclusion: Through the design of teaching experiment and using of learning machine, the new machine has achieved better teaching effect for students to grasp machine theory and operate actual circuit.

Maintenance scheme of computer system failure of color Doppler ultrasound equipment / 中国医学装备

Objective: Through analyzing a fault case for GE P5 Color Doppler Ultrasound to find out the main performance and effect of computer failure in Medical devices fault and the solution for failure. Methods: By consulting with maintenance manuals and relevant information, and combining with the main problems of the computer equipment to make detailed analysis, and then discussed and explored the solution for resolving problem. Results: By using the elimination method of relevant calculating fault, computer system failure of Color Doppler Ultrasound can be effectively eliminated, and the normal operation of equipment can be guaranteed. Conclusion:With the rapid development of computer technology, it is applied wider and wider in the modern medical instrument and has become an important support technology of many medical equipment, and has been inseparable with medical equipment's technology development. Therefore, many computer failure of software and hardware directly become medical equipment failure, even directly affects the normal work of medical devices. Consequently, in the maintenance and repair for medical equipments, maintenance and repair of computer system becomes particularly important, and has been an important part to guarantee the normal work of medical equipment. We should pay more attention to it in work practice.

Research on the application of digital diagnosis technology in maintenance for blood cell analyzer / 中国医学装备

Objective: To clarify the improvement of maintenance efficiency depending on digital diagnosis technology through the application of digital diagnosis tools for the new type blood cell analyzer in equipment maintenance. Methods: Combined with the actual case, to explore the application and expansion of digital diagnosis tool in maintenance for blood cell analyzer from different aspects, such as common cause analysis of partial absorption alarm, communication error, temperature control failure, the problem location of stepper motor encoder fault and other aspects. Results: By effective using digital diagnosis tool, the maintenance efficiency has been improved, the fault cause has been effectively analyzed, and this method can help technician to find fault phenomenon that would not normally be found by accidental fault in common maintenance and help them to locate accidental fault point. Conclusion: Digital diagnosis tools can fully use specialist data, find hidden danger of equipment fault in earlier, put forward judgment information for fault, and provide convenience for equipment maintenance.