Changes in Doctor-Patient Relationships in China during COVID-19: A Text Mining Analysis.

Doctor-patient relationships (DPRs) in China have been straining. With the emergence of the COVID-19 pandemic, the relationships and interactions between patients and doctors are changing. This study investigated how patients' attitudes toward physicians changed during the pandemic and what factors were associated with these changes, leading to insights for improving management in the healthcare sector. This paper collected 58,600 comments regarding Chinese doctors from three regions from the online health platform Good Doctors Online (haodf.com, accessed on 13 October 2022). These comments were analyzed using text mining techniques, such as sentiment and word frequency analyses. The results showed improvements in DPRs after the pandemic, and the degree of improvement was related to the extent to which a location was affected. The findings also suggest that administrative services in the healthcare sector need further improvement. Based on these results, we summarize relevant recommendations at the end of this paper.

Effect of EAP Psychological Intervention on Improving the Mental Health of Medical Workers Under the Novel Coronavirus Epidemic in China.

Background: Due to the novel coronavirus epidemic, medical workers are under immense psychological pressure. As such, the East Campus of Shanghai Sixth People's Hospital actively adopted the Symptoms Checklist 90 (SCL-90) to evaluate the mental health of hospital staff before and after the psychological intervention from the Employee Assistance Program (EAP). Methods: Medical workers from the East Campus of Shanghai Sixth People's Hospital were recruited for this study. Psychological evaluations were conducted using the SCL-90, with a score of >160 regarded as a positive result, or in other words, an indication of abnormal psychological symptoms. The EAP adopted different forms of psychological interventions for healthcare professionals, and participation in these measures was entirely voluntary. Medical workers completed the SCL-90 again after participating in the psychological intervention, and we analyzed the changes between their two assessments. Results: Of the 1,198 total medical staff present at the hospital, 844 participated in the initial survey, while only 652 completed the survey a second time (i.e., post-psychological intervention). Multivariate logistic regression analysis found that the psychological status of hospital staff was correlated with gender, education background, and fertility status (P < 0.05). The results showed that, compared with women, men's mental health status was better, with an OR value of 0.598 (0.372-0.962). Groups with high school, junior high school, and below education levels were at higher risk of psychological problems, with OR values of 23.655 (2.815-198.784) and 9.09 (2.601-31.801), respectively. Administrative occupations and having two or more children were protective factors for mental health, and the OR values were 0.400 (0.175-0.912) and 0.327 (0.152-0.703), respectively. Following the psychological intervention, we found that the mental health of hospital workers improved, as indicated by their second SCL-90 evaluations, although the proportion of medical staff willing to participate in the second evaluation was lower than the initial assessment. There were differences in the SCL-90 scores among different occupations, and there were also differences in the scores of employees of different occupations who had participated in the two evaluations. The employees of different positions who participated in the two evaluations were matched and analyzed and found that the depression and anxiety of the doctor group were significantly reduced. In the nursing group, the total score, somatization, interpersonal sensitivity, depression, and anxiety were significantly reduced. In the medical technician group, depression, anxiety, and paranoia were reduced considerably. Among office staff, no significant differences were found. Among workers, the total score, depression, and anxiety were significantly reduced. Conclusion: Hospitals have the potential to alleviate and reduce the psychological pressure placed on medical staff members through the EAP, which can actively adopt intervention and guidance measures. The findings of this study have important implications, as reducing abnormal psychological symptoms of healthcare professionals can be helpful in the fight against the coronavirus epidemic.

Solitary Pulmonary Inflammatory Nodule: CT Features and Pathological Findings.

PURPOSE: Solitary pulmonary inflammatory nodules (SPINs) are frequently misdiagnosed as malignancy. We aimed to investigate CT features and pathological findings of SPINs for improving diagnosis strategies. PATIENTS AND METHODS: In this retrospective study, 225 and 310 consecutive patients with confirmed SPINs and lung cancerous nodules were enrolled from January 2013 to December 2020. Nodules were classified into different types based on the key CT features: I, homogeneous and well-defined nodules with smooth (Ia), coarse (Ib), or spiculated margins (Ic); II, nodules with blurred boundaries, peripheral patches, or both; III, nodules exhibiting heterogeneous density; and IV, polygonal nodules. The pathological findings of SPINs were simultaneously studied and summarized. RESULTS: Among the 225 SPINs, type I (Ia, Ib, and Ic), II, III, and IV were 137 (60.9%) (47 [20.9%], 33 [14.7%], and 57 [25.3%]), 62 (27.6%), 12 (5.3%) and 14 (6.2%), respectively. Correspondingly, those in 310 cancerous nodules were 275 (88.7%) (119 [38.4%], 70 [22.6%], and 86 [27.7%]), 20 (6.5%), 15 (4.8%), and 0, respectively. Compared with lung cancers, type I nodules were less common but type II and IV nodules were more common in SPINs (each P < 0.0001). Though the frequencies of subtype I (P = 0.095) and type III (P = 0.796) nodules were similar between two groups, their specific CT features were significantly different. The main pathological findings of each type of SPINs were most extensively identical (82.2 - 100%). CONCLUSION: Between cancerous nodules and SPINs, differences in overall or specific CT features exist. The type II and IV nodules are highly indicative of SPINs, and each type of SPINs have almost similar pathological findings.

Gout involved the cervical disc and adjacent vertebral endplates misdiagnosed infectious spondylodiscitis on imaging: case report and literature review.

BACKGROUND: Gout in spine is rare and commonly mimics some infectious or tumoral lesions, the differentiation of spinal gout from other diseases is not always easy. We report a case of gout involved cervical disc and adjacent vertebral endplates whose etiology was initially not determined. Compared with the previous published 10 similar cases, this case displayed a complete and continuous image data with higher image quality and resolution than before. So we give a brief literature review for concerning cervical gout, with the emphasis on the discussion of radiological findings. CASE PRESENTATION: A 50-year-old male with a 5-year history of neck and shoulder pain had muscle atrophy and weakness in both arms. Physical examination revealed multiple tophi were seen in left wrist, both feet and knee; bilateral superficial sensory declined below level of mastoid portion and the muscle strengths of limbs decreased. Laboratory findings showed hyperuricemia and the C-reactive protein level was very high. Imaging studies including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed abnormality of the C5-6 intervertebral disc and irregular osteolytic destruction of both adjacent C5-6 endplates, narrowing of C5-6 disc space and swelling of prevertebral soft tissue. Under the circumstance of the lesions being not determined and nerve root symptoms, surgical treatment was performed and pathological examination of the specimen revealed deposited uric acid crystals surrounded by granulomatous inflammation. After surgery combined with pharmaceutical and rehabilitation treatment, the muscle strengths of limbs, the pain of neck and shoulder and the level of serum uric acid were all improved. CONCLUSIONS: Cervical spinal gout involving the disc and adjacent vertebral endplates is uncommon and may misunderstand infectious spondylodiscitis. Physician and radiologist should take the gouty spondylitis into account with a combination with previous history and clinical manifestations when encountering with such this condition.

Modeling forest fire occurrences using count-data mixed models in Qiannan autonomous prefecture of Guizhou province in China.

Forest fires can cause catastrophic damage on natural resources. In the meantime, it can also bring serious economic and social impacts. Meteorological factors play a critical role in establishing conditions favorable for a forest fire. Effective prediction of forest fire occurrences could prevent or minimize losses. This paper uses count data models to analyze fire occurrence data which is likely to be dispersed and frequently contain an excess of zero counts (no fire occurrence). Such data have commonly been analyzed using count data models such as a Poisson model, negative binomial model (NB), zero-inflated models, and hurdle models. Data we used in this paper is collected from Qiannan autonomous prefecture of Guizhou province in China. Using the fire occurrence data from January to April (spring fire season) for the years 1996 through 2007, we introduced random effects to the count data models. In this study, the results indicated that the prediction achieved through NB model provided a more compelling and credible inferential basis for fitting actual forest fire occurrence, and mixed-effects model performed better than corresponding fixed-effects model in forest fire forecasting. Besides, among all meteorological factors, we found that relative humidity and wind speed is highly correlated with fire occurrence.