Linguistic intuitionistic fuzzy multi-attribute bilateral matching considering satisfaction and fairness degree.

Aiming at the multi-attribute bilateral matching problem with unknown attribute weights under a linguistic intuitionistic fuzzy environment, a decision method based on TODIM considering satisfaction and fairness degrees is proposed. First, the theories of linguistic intuitionistic fuzzy sets and bilateral matching are given, and the multi-attribute bilateral matching problem under a linguistic intuitionistic fuzzy environment is described. To solve this problem, according to linguistic intuitionistic fuzzy preference matrices, the overall attribute dominances are calculated based on TODIM; considering group consensus, a new method is proposed to calculate attribute weights based on linguistic intuitionistic fuzzy induced ordered weighted averaging (LIFIOWA) operator; then, the overall dominances of bilateral subjects are obtained by aggregating the overall attribute dominances and attribute weights. Furthermore, the overall dominances are standardized to calculate the satisfaction degrees of bilateral subjects; the fairness degrees of bilateral subjects are calculated considering the loss attenuation coefficient. Based on satisfaction degree matrices, fairness degree matrices and bilateral matching matrices, multiple bilateral matching models are established and then solved to obtain the optimal bilateral matching scheme. Finally, an example shows the effectiveness, reliability and accuracy of the proposed method. The research results indicate the following main characteristics of the proposed method: (1) A new method for calculating the unknown attribute weights using LIFIOWA operator is proposed. (2) According to the TODIM idea, a calculation method for fairness degree considering the loss attenuation coefficient is proposed. (3) Considering satisfaction and fairness degrees, multiple bilateral matching models under a linguistic intuitionistic fuzzy environment are established.

Progress in the legislations regarding school nutrition lunch and nutrition status in China and some other countries / 上海预防医学

This paper summarized the school nutrition lunch legislations and nutrition status in China and abroad. School lunch system is relatively well-established and mature in Japan， the United States and Sweden and the lunch system has been gradually as an important part of basic education， which is worth learning by other countries and regions. China started its pilot school nutrition lunch program in 1987， and has improved the nutritional status of students， especially the students in rural areas， significantly. However， there still exists certain gaps compared with developed countries. We should actively learn from those countries， so as to provide reference for the formulation and improvement of China’s nutritional lunch policies.

Survey on satisfaction and employment intention of general practice residents in Shanxi province / 中华全科医师杂志

Objective:To survey the satisfaction and employment intention of general practice residents (GPRs) in Shanxi Province.Methods:A cross-sectional questionnaire survey was conducted in May 2021 among GPRs in Shanxi Province through the residency training information management platform. The questionnaire included general demographic information, clinical competency and independent practice ability, the status of the training base, their satisfaction with the training, career prospects and employment intention. The survey results were analyzed.Results:A total of 452 questionnaires were distributed, and 434 valid ones were recovered with an effective recovery rate of 96.02%. The age of respondents was (27.4±4.6) years, there were 155 GPRs (35.71%) enrolled in 2018, 131 GPRs (30.18%) in 2019, and 148 GPRs (34.10%) in 2020. A total of 286 GPRs (65.9%) thought that they were able to independently complete some procedures such as abdominal puncture, lumbar puncture, chest puncture, and bone puncture, and the proportion of GPRs who were able to complete the above procedures increased with the training time (49.3%(73/148), 70.2%(92/131), and 78.1%(121/155) in 2020, 2019, and 2018 batches, respectively, χ2=29.39, P<0.001); 372 respondents (85.7%) thought that they were able to independently receive patients with common diseases and make preliminary diagnosis and treatment, while there was no significant difference in the proportion of GPRs enrolled in 2020, 2019, and 2018 ( χ2=3.35, P=0.188); 425 GPRs (97.9%) expressed that the base arranged rotation according to the training syllabus; 390 GPRs (89.9%) thought that the proportion of knowledge and skill assessment in the final examination was appropriate. The survey showed that 70 GPRs (16.1%) thought that the number of cases and types of diseases in the teaching base fully met the requirements of the training program, 144 GPRs (33.2%) thought that mostly met the requirements, 197 GPRs (45.4%) thought that basically met the requirements, 22 GPRs (5.1%) thought that most of them did not meet the requirements, and 1 GPR (0.2%) thought that completely did not meet the requirements. Most of the respondents (368 (84.8%)) reported that they received guidance from clinical instructors for medical record writing; 174 (40.1%) and 172 (39.6%) GPRs were very satisfied or satisfied with general practice teachers and teaching base instructors; 207 GPRs (47.7%) were satisfied with accommodation (or subsidies), while 38 GPRs (8.3%) were very dissatisfied; 203 GPRs (46.8%) were satisfied with basic salary and benefit, while 35 GPRs (8.1%) were very dissatisfied. For general practice as the career, 88 GPRs (20.3%) liked it very much, 255 GPRs (58.8%) liked it, 67 GPRs (15.4%) did not like it very much, and 24 GPRs (5.5%) disliked it. For the prospects of general practice, 108 GPRs (24.9%) considered it very optimistic, 219 GPRs (50.5%) considered it relatively optimistic, 92 GPRs (21.2%) considered it not very optimistic, and 15 GPRs (3.5%) considered it very pessimistic. Regarding employment intentions, 174 GPRs (40.1%) intended to choose municipal hospitals, 170 GPRs (39.2%) to choose county level hospitals, only 9 GPRs (2.1%) to choose village clinics. Conclusions:The survey indicates that for GPRs the most dissatisfied aspects are the salary and benefit, as well as the living conditions during their training; after completing the contract, most GPRs hope to work in hospitals at county and above levels.

Study on the Construction of Harmonious Doctor-patient Relationship under the Family Doctor Contract Service System / 中国医学伦理学

【Objective:】 To understand the current status and problems of the doctor-patient relationship under the family doctor contract service system through the investigation on residents contracted by community family doctors, and to provide reference for constructing harmonious doctor-patient relationship and promoting the healthy operation of the family doctor contract service system. 【Methods:】 A questionnaire survey was conducted on 1 655 residents of a certain university community in Xi’an from January to February 2023 who completed family doctor contract services in 2022. Through the general situation of signed residents, the willingness of signed family doctors, and the satisfaction and opinions with signed family doctors’ services, this paper investigated the current status of the doctor-patient relationship and proposed corresponding improvement strategies. 【Results:】 A total of 856 residents(52.68%) were willing to sign the contract, 322 residents(19.82%) were unwilling to sign the contract, 397 residents(24.43%) expressed indifference, and 50 residents(3.07%) abstained from signing the contract. There was no statistical difference in service satisfaction between residents of different genders(P=0.292). The satisfaction of working staff aged 40-60(72.33%) was higher than that of retirees aged over 60(61.05%, P<0.001). The satisfaction of those with bachelor’s degree or above(58.23%) was higher than that of those with bachelor’s degree below(51.77%, P=0.008). The satisfaction of individuals living alone(70.21%) was significantly higher than that of non-solitary individuals(54.35%, P<0.001). The overall satisfaction score of contracted residents with contracted services was(4.48±0.14) points, including 4.31 points for satisfaction with service methods, 4.47 points for satisfaction with service attitudes, 4.52 points for satisfaction with service content, and 4.60 points for satisfaction with service effectiveness. 【Conclusion:】 Most community residents have a positive attitude towards family doctor contract services. Improving service satisfaction and strengthening doctor-patient communication are feasible ways to improve grassroots doctor-patient relationships and promote the operation of the family doctor contract service system.

Diseño de entorno virtual en la asignatura Sistema Nervioso, Endocrino y Reproductor, como apoyo al proceso de enseñanza-aprendizaje / Design of virtual environment in the subject Nervous, Endocrine and Reproductive System as support to the teaching-learning process

RESUMEN Introducción: la utilización del entorno virtual de aprendizaje en la asignatura Sistema Nervioso, Endocrino y Reproductor, por parte de los estudiantes de primer año de la carrera de Medicina, constituye una meta a lograr en el contexto cubano. Esto requiere de tareas que permitan modular el manejo de los entornos virtuales de aprendizaje al perfeccionamiento de las asignaturas presenciales. Objetivo: diseñar un entorno virtual como espacio de aprendizaje en la asignatura Sistema Nervioso, Endocrino y Reproductor. Materiales y métodos : se realizó un estudio observacional descriptivo transversal. La población estuvo constituida por 285 estudiantes. Se le aplicó la encuesta a una muestra de 165 estudiantes, para un nivel de confianza del 95 % y un margen de error del 5. Los individuos se escogieron a través del método de muestreo probabilístico aleatorio simple. Resultados: de modo general, se observó un alto grado de satisfacción en todos los indicadores, destacándose el 3, el 7 y el 9. Conclusiones: el entorno virtual descrito constituye un espacio de aprendizaje importante para los estudiantes -como soporte al proceso de enseñanza-aprendizaje-, valorado con alto grado de satisfacción por los participantes.

ABSTRACT Introduction: the use of a virtual learning environment in the subject Nervous, Endocrine and Reproductive System by first-year students of Medicine, is a goal to be achieved in the Cuban context. This requires tasks which will allow modulating the management of virtual learning environments to the classroom subjects' improvement. Objective: to design a virtual environment as learning space in the subject Nervous, Endocrine and Reproductive System. Materials and methods: a cross-sectional, descriptive, observational study was performed. The population was constituted by 285 students. The survey was applied to a sample of 165 students, for a confidence level of 95 % and an error margin of 5. Individuals were chosen through simple random probabilistic sampling. Results: in general, a high degree of satisfaction was found in all indicators, standing out indicators 3, 7 and 9. Conclusions: the described virtual environment is an important learning space for students-as support to the teaching learning process-, valued with high satisfaction degree by the participants.

A global satisfaction degree method for fuzzy capacitated vehicle routing problems.

There are several uncertain capacitated vehicle routing problems whose delivery costs and demands cannot be estimated using deterministic/statistical methods due to a lack of available and/or reliable data. To overcome this lack of data, third-party information coming from experts can be used to represent those uncertain costs/demands as fuzzy numbers which combined to an iterative-integer programming method and a global satisfaction degree is able to find a global optimal solution. The proposed method uses two auxiliary variables α , λ and the cumulative membership function of a fuzzy set to obtain real-valued costs and demands prior to find a deterministic solution and then iteratively find an equilibrium between fuzzy costs/demands via α and λ. The performed experiments allow us to verify the convergence of the proposed algorithm no matter the initial selection of parameters and the size of the problem/instance.

Issues related to the health status, work pressure and occupational environments of medical staff at level A tertiary public hospitals in Shanghai.

BACKGROUND: Medical staff is the main force behind the construction of a healthy China. As a result of increasing social pressure, doctors are at high risk for diseases such as "sudden death" and "overwork death". It is essential that the physical and mental health of medical staff be assessed and long-term mechanisms be introduced to care for medical staff. This study sought to investigate the health status, work pressure, and occupational environments of medical staff at level A tertiary public hospitals in Shanghai to provide a basis for exploring the establishment of long-term mechanisms for the exquisite and precise care of medical staff. METHODS: A questionnaire was administered to employees at 10 level A tertiary public hospitals in Shanghai using a random sampling method; 50 medical staff were surveyed at each hospital. A descriptive analysis of the data was conducted using R language. RESULTS: A total of 478 questionnaires were collected; thus, the recovery rate was 95.6%. The analysis revealed that 61% of the medical staff surveyed believed that their health was "good," and 57% believed that they were under high pressure. Over 50% of medical staff were moderately satisfied with their practice environment and salary; however, staff's satisfaction evaluations were affected by their academic qualifications (degrees), work positions, and other factors. Reasonable salary is the primary motivating and demotivating factor. CONCLUSIONS: The party organization can play a leading role in contacting and serving employees. Further, 4 caring systems for health protection, welfare benefits, safety protection, and career planning should be offered to medical staff to ensure they are cared for with elaboration and precision.

Application of Telemedicine Services Based on a Regional Telemedicine Platform in China From 2014 to 2020: Longitudinal Trend Analysis.

BACKGROUND: Telemedicine that combines information technology and health care augments the operational model of traditional medical services and brings new opportunities to the medical field. China promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development in this field. OBJECTIVE: Our work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the system design scheme and remote consultations that were conducted via the system to understand the deployment and service delivery processes of a representative telemedicine platform in China. METHODS: We collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We used graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographic distribution of patients, and waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multivariable linear regression models and binary logistic regression models, respectively. The attitudes toward telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method. RESULTS: The regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some interprovince hospitals. From 2015 to 2020, 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. A total of 86.64% (90,069/103,957) of medical institutions (as clients) that applied for remote consultations were tier 1 or 2 and from less-developed regions; 65.65% (68,243/103,945) of patients who applied for remote consultations were aged over 50 years. The numbers of consultations were high for departments focusing in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited experts were mainly experienced doctors with senior professional titles. Year of consultation, tier of hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. In surveys, we found that 60.4% (136/225) of medical practitioners and 53.8% (121/225) of patients had high satisfaction and believed that telemedicine is of vital importance for the treatment of illness. CONCLUSIONS: The development of telemedicine in China shows a growing trend and provides great benefits especially to medical institutions located in less developed regions and senior citizens who have less mobility. Cases of remote consultations are mainly for chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services.

Practical value of hierarchical teaching combined with simulation scenario training for operating-room nurses.

OBJECTIVE: This study explored the application value of combined training by hierarchical teaching with situational simulations for operating-room (OR) nurses. METHODS: A total of 41 nurses that received pre-job training for the operating room from January 2018 to December 2019 were selected as the research subjects and randomly divided into a control group and a study group. The control group was given the hierarchical nurse-teaching method, while the study group was given combined training with the hierarchical teaching and scenario simulations. In this study, the operating room capability, clinical work ability, results of theoretical assessment and specialized operation, and nurses' satisfaction with the teaching patterns were compared between the two groups. RESULTS: After training, the scores of the operating-room operations in the study group, such as laying of aseptic towels, surgical hand washing, wearing of surgical gowns and gloves, and the setting up of the operating table, were higher than that in the control group (P<0.05). The scores of clinical work abilities in the study group, such as emergency handling ability, standardized operation ability, mastery of professional knowledge, observation and evaluation ability of disease, and clinical thinking ability, were higher than those in the control group (P<0.05). The theoretical examination scores and specialized operation scores of nurses in the study group were higher than those in the control group (P<0.05). The satisfaction with the degree of teaching methods in the study group was higher than that in the control group (P<0.05). CONCLUSION: The application of the combined training methods of hierarchical teaching with situational simulations for OR nurses can effectively improve their operational and clinical work ability, deepen their mastery of theoretical knowledge, and enable junior nurses to master the professional skills required in the operating room in a faster way, which is worthy of clinical teaching application.

Dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia increases female patients' global satisfaction degree after thoracoscopic surgery.

BACKGROUND: There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients' global satisfaction degree. METHODS: One hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients' global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery. RESULTS: Compared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups. CONCLUSIONS: Dexmedetomidine combined with sufentanil and dezocine increased female patients' global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry number, ChiCTR2000030429 . Registered on March 1, 2020.

[Comparison of three medical goggle sterilizing approaches].

OBJECTIVE: To compare three sterilizing methods for reusable medical goggles. METHODS: A total of 180 medical goggles of the same brand and same model were randomly divided into three groups. In group A the goggles were first soaked with 2000 mg/L chlorine-containing disinfectant and then cleaned manually; goggles in other two groups were sterilized using pre-programmed automatic spray cleaning and disinfection machine, the disinfection program was set to 90 ℃ for 5 min in group B and 70 ℃ for 30 min in group C. The quality of the sterilization was monitored by visual inspection with luminous magnifying glass and residual protein detection assay. User satisfaction on cleanliness of medical goggles, clarity of mirror surface and suitability of elastic bands was investigated with questionnaire survey. RESULTS: The qualification rates verified by visual inspection were 82.4%, 84.6%and 98.3%in group A, B and C, respectively, the qualification rate in group C was significantly higher than those in group B and group C (all P<0.05). The qualification rates verified by residual protein detection assay were 96.7%, 100.0%and 100.0%in group A, B and C, respectively (P>0.05). A total of 54 questionnaires were submitted for the survey. The satisfaction rates were 100.0%, 90.7%and 94.4% for cleanliness of medical goggles, clarity of mirror surface and suitability of elastic bands, respectively. CONCLUSIONS: Machinery sterilization set 70 ℃ for 30 min has better cleaning and sterilizing effects for reusable medical goggles.

Green development of Yangtze River Delta in China under Population-Resources-Environment-Development-Satisfaction perspective.

This paper explores green development of Yangtze River Delta (YRD) under PREDS (Population-Resources-Environment-Development-Satisfaction) perspective. Based on gray relevance analysis, synergy evaluation model and factor analysis model are constructed with improvement of weight determination and relevance degree calculation. Synergy evaluation results show that for the entire YRD the relevance degree of green development increases strictly. As the synergistic effect of the inner system continues to rise, the green development tend toward equilibrium (2003-2017). The provincial level green development ranking is put forward. The results of factor analysis show that four dimensions' impacts on public satisfaction are different. The prediction of "13th Five-Year Plan" suggests that, improving environmental indicators is the most potential solution to promote green development of YRD. Investment completed in industrial pollution treatment is taken as an example to show how the index will affect satisfaction under different growth rates. It turns out that when the growth rate is below or over the critical value (16%), the influence will go out of the trough and continue to increase, forming a "J" curve.

The impact of clean development mechanism on energy-water-carbon nexus optimization in Hebei, China: A hierarchical model based discussion.

Clean development mechanism (CDM) is an important principle in CO2 emissions mitigation since it was proposed. However, there will be a long way for the large-scale application of CDM in China, for thermal power is still in the dominant position, while renewable power is far from being competitive. In this study, a mix integer bi-level hierarchical programming model (MIBLHP) is developed to investigate the potential impact of the CDM application on the regional energy-water-carbon nexus optimization in electric power system in China. The model integrates the advantages of bi-level programming and mix integer liner programming in dealing with conflicting objectives with hierarchical and sequential decision making process and help to achieve the optimized strategies with the highest overall system satisfaction degree. Results show that CDM will play an important role in the regional energy-water-carbon nexus optimization, the MIBLHP is able to stabilize the increasing trend of system cost and make better tradeoffs between the economic and environmental goals. Optimal strategies including power generation and capacity expansion path, system cost control, CO2 emissions abatement strategies, water consumption and waste water discharge are presented. The system would reach the supreme satisfaction degrees (λ = 0.934) when the CO2 reduction level is 40%, which means that every part of the system has achieved the best condition. The proposed model has great potential in dealing with similar regional planning problems in energy-water-carbon nexus optimization.

A Stochastic Multi-Attribute Method for Measuring Sustainability Performance of a Supplier Based on a Triple Bottom Line Approach in a Dual Hesitant Fuzzy Linguistic Environment.

China is a developing country and with the speeding up of its industrialization, the environmental problems are becoming more serious, environmental pollution is a major environmental health problem in China. In order to have a more effective management and control of the significant growth issues of environment pollution, green supply chain incentives have started, which is kind of market incentive aiming to moderate the adverse effects of environmental pollution. Proper green chain supply selection and evaluation of companies is becoming very essential in sustainable green supply chain management. Generally speaking, decision-makers (DMs) prefer to provide a set of feasible and quantitative information for making performance evaluation, which motivates us to propose a framework using dual hesitant fuzzy linguistic term set (DHFLTS) and hesitant fuzzy linguistic term set (HFLTS) to select green suppliers. In this paper, group satisfaction and the regret theory are adopted for elicitation of preference information. The DHFLTS and HFLTS provide qualitative preferences of the DMs as well as reflect their hesitancy, inconsistency, and vagueness. Further, two new group satisfaction degrees are defined called the group satisfaction of hesitant fuzzy linguistic term set and dual hesitant fuzzy linguistic term set. Some properties of group satisfaction with DHFLST and HFL are also discussed. Unknown attribute weights are obtained to construct a novel Lagrange function optimization model to maximize the group satisfaction degree, which is an extension of general group satisfaction degree. A novel methodological approach based on two group satisfaction degrees framework and regret theory is developed to rank and select green chain suppliers focusing on specific selection objectives. The proposed model and method of this paper allow the DM to execute different fuzzy scenarios by changing importance weights attached to the triple-bottom-line areas. In the final part, the advantage of the proposed group satisfaction degree under DHFL and HFL background over the existing group satisfaction degree using examples have been presented with different computational combinations.

Comparison of three medical goggle sterilizing approaches / 浙江大学学报·医学版

OBJECTIVE@#To compare three sterilizing methods for reusable medical goggles.@*METHODS@#A total of 180 medical goggles of the same brand and same model were randomly divided into three groups. In group A the goggles were first soaked with 2000 mg/L chlorine-containing disinfectant and then cleaned manually; goggles in other two groups were sterilized using pre-programmed automatic spray cleaning and disinfection machine, the disinfection program was set to 90 ℃ for 5 min in group B and 70 ℃ for 30 min in group C. The quality of the sterilization was monitored by visual inspection with luminous magnifying glass and residual protein detection assay. User satisfaction on cleanliness of medical goggles, clarity of mirror surface and suitability of elastic bands was investigated with questionnaire survey.@*RESULTS@#The qualification rates verified by visual inspection were 82.4%, 84.6%and 98.3%in group A, B and C, respectively, the qualification rate in group C was significantly higher than those in group B and group C (all @*CONCLUSIONS@#Machinery sterilization set 70 ℃ for 30 min has better cleaning and sterilizing effects for reusable medical goggles.

Preferencia y grado de satisfacción de productos panaderos con una mezcla cereal-leguminosa en adultos de Chile / Preference and degree of satisfaction of bakery products with a cereal-legume mixture in adults from Chile

El presente trabajo tuvo como objetivo determinar la preferencia y el grado de satisfacción de cuatro productos de panadería (galletas y grissinis) elaborados a base de una mezcla de trigo y frijol común (Phaseolus vulgaris) o trigo y lupino (Lupinus albus) en adultos de Chile, y comparar los resultados obtenidos para estos productos en población mexicana. El análisis sensorial se realizó mediante dos pruebas sensoriales hedónicas, una de preferencia y otra de grado de satisfacción. Los participantes fueron 60 adultos de Concepción, Chile. Los resultados mostraron que los cuatro productos fueron del agrado de los participantes, siendo las versiones elaboradas a base de harina de trigo y lupino las más preferidas y mayor puntuadas (2,05 ± 1,05 galleta y 1,28 ± 1,22 grissini) respecto a las elaboradas a base de harina de trigo y frijol (1,90 ± 1,22 galleta y 1,28 ± 1,22 grissini). Al comparar los valores obtenidos de los cuatro productos, se encontró diferencia estadística significativa en los puntajes otorgados a las galletas. En los grissinis los puntajes otorgados fueron idénticos. Los resultados de los participantes mexicanos mostraron una mayor preferencia y grado de satisfacción para los productos elaborados a base de harina de trigo y frijol. De acuerdo a los resultados se puede concluir que los productos de panadería elaborados con mezclas de cereales y leguminosas son una opción mediante la cual se puede favorecer el consumo de leguminosas, el cual ha disminuido en los últimos años(AU)

The purpose of this work was to determine the preference and degree of satisfaction of four bakery products (cookies and grissinis) made from a mixture of wheat and common beans (Phaseolus vulgaris) or wheat and lupine (Lupinus albus) in adults from Chile, and compare the results with the results recently obtained for these products in the Mexican population. The sensory analysis was performed using two hedonic sensory tests, one of preference and the other of degree of satisfaction. The participants were 60 adults from Concepción, Chile. The results showed that the four products were liked by the participants, the versions made from wheat and lupine flour were most preferred and highest rated (2.05 ± 1.05 cookie and 1.28 ± 1.22 grissini ) regarding those made of wheat flour and beans (1.90 ± 1.22 cookie and 1.28 ± 1.22 grissini). When comparing the values obtained from the four products, significant statistical difference was found in the scores given to the cookies. The grissinis scores were identical. The results of the Mexican participants showed a greater preference and degree of satisfaction for products made from wheat flour and beans. According to the results, it can be concluded that bakery products made with mixtures of cereals and legumes are an option by which the consumption of legumes can be favored, which has declined in recent years(AU)

Inverse radiotherapy planning in reconstructive surgery for breast cancer.

BACKGROUND: Post-mastectomy radiotherapy reduces the risk of local-regional relapse and distant disease, and increases global survival in women with axillary involvement. With the new reconstruction techniques and increasing use of directed external radiotherapy, immediate reconstruction can be performed with good cosmetic results and low complication rates. MATERIALS AND METHODS: Observational study with consecutive sampling conducted in patients undergoing reconstructive surgery for breast cancer, between 2010 and 2016, with a 12-months minimum follow-up period. A group of patients radiated after receiving an expander (RT-Expander) were compared with a control group of non-radiated patients (Non-RT), who had been treated with the same surgical technique. We compare general complications, reconstruction failure, aesthetic results and satisfaction degree with software IBM® SPSS® Statistics v. 21 and BREAST-Q scores. RESULTS: Reconstruction failure was observed in 15.6% of patients in a similar proportion in both groups. External radiotherapy was not an independent significant factor influencing the occurrence of general complications, capsular contracture grade ≥3 or reconstruction failure. The Kaplan-Meyer curve showed no differences in reconstruction survival between groups. Aesthetic results were excellent-very good in 78.1% of patients. Absence of a contralateral procedure for symmetrization, occurrence of general complications, occurrence of capsular contracture grade ≥3 and reconstruction failure were significantly associated to fair-poor cosmetic results. The satisfaction degree of operated patients was similar in both groups. CONCLUSIONS: The evolution of external radiotherapy towards more directed techniques, which modulate the dose administered to the mammary tissue and adjacent structures, allowed us to make immediate reconstruction a reality for most patients, with complication rates, cosmetic results and satisfaction degrees similar to those of non-radiated patients.

Investigation of students' satisfaction degree on blending learning in physiology under the background of audit assessment / 中华医学教育探索杂志

Objective To investigate students' satisfaction degree and goal-achieving degree for cultivating applicative medical talents by analyzing the results of satisfaction degree survey on blending teaching in physiology from 2016 to 2018 under the background of audit assessment.Methods Grade 2015 undergraduates majoring in oral medicine(n=60),grade 2016 undergraduates in medical laboratory science(n=59),grade 2016 undergraduates in Traditional Chinese Medicine(n=27),and grade 2017 undergraduates in oral medicine(n=58)were selected as study subjects.Blending learning in physiology was adopted and the teaching process was designed according to the training objectives for applicative medical talents.Questionnaires were conducted among students at the beginning and end of the semester to rate the satisfaction degree of learning in physiology.The questionnaire scores were put into SPSS 19.0 for independent t-test.Results Grade 2015 oral,2016 grade medical examination technology,2016 grade traditional Chinese medicine,2017 grade stomatology majors.In the scoring indicators of the questionnaire,teaching method scores,semester knowledge mastery scores,semester analysis problem solving ability scores,semester autonomy Both the learning ability score and the final expression communication ability score were significantly higher than the beginning of the semester,and the differences were statistically significant(P＜0.01).Conclusion Students are satisfied with the blending learning in physiology which fits the cultivating goal for applied medical talents and reaches the standard line of audit assessment.

Investigation and analysis of clinical teaching satisfaction degree in residents standardized training in Zhejiang University / 中华医学教育探索杂志

Objective To investigate and analyze the clinical teaching of residents standardized training in Zhejiang University, so as to provide references to improve the quality of residents standardized training. Methods Questionnaires were designed and electronic surveys via WJX software were conducted among residents from six affiliated hospitals of Zhejiang University School of Medicine on management, clinical teaching and assessment of residents. SPSS 19.0 was used to perform the χ2 test of relevant data. Results A total of 799 residents, including 312 males and 487 females, took part in this survey. In terms of satisfaction degree, trained residents had a relatively high satisfaction degree on training base (73.46％), satisfaction degrees of residents from Grade one, two and three were 69.05％, 74.72％and 79.30％, respectively. Satisfaction degree of residents with different identities to training base was social men (85.71％) > staff working in units (74.08％) > professional postgraduates (56.7％). In terms of teaching, 64.45％ residents thought that clinical teachers spent 20％ more time on the clinical teaching than on the daily routine work, 39.42％ residents thought that clinical teachers spent 30％ more and 18.52％ residents thought clinical teachers spent 40％more. In addition, 70.47％residents responded that their teachers revised and instructed the medical history writing more than twice a week; 78.84％ trained residents admitted that all teachers made full preparations for clinical teaching rounds. Besides, the process evaluation of training base was well implemented. Implementation rate of after-department examination and annual examination were 99.37％and 98.50％, respectively. Conclusion Residents of Zhejiang University have a high satisfaction degree on training management and clinical teaching . Homogenized management of training base should be strengthened, and evaluation and feedback should be stressed.

Investigation on knowledge of tumor-related occupational protection among medical staffs in cancer related departments of comprehensive hospitals / 中国职业医学

OBJECTIVE: To analyze the current status of tumor-related occupational protection knowledge among medical staffs in comprehensive hospitals. METHODS: A stratified random sampling method was used to select 572 medical workers from 24 comprehensive hospitals as study subjects, including 289 nurses and 283 medical doctors. The Survey on Occupational Protection Knowledge and Management of Hospital Tumors was used to investigate the research subjects. RESULTS: i) The awareness status of the tumor-related occupational protection knowledge: the awareness rate of sharps injuries that should be included in occupational protection management was as high as 93.7%, while the awareness rate of standard operating procedures for occupational protection in working post was only 32.9%. ii) Evaluation on the management of tumor-related occupational protection in the hospital: most medical personnel think that medical occupational protection is very important to medical quality and safety, and they are not satisfied with personal protective equipment(PPE), various protective facilities and medical devices. The satisfaction scores of subjects in the nursing group on the use of PPE, the convenience of PPE, the reliable quality of PPE, the use of occupational health protection facilities, and the degrees of satisfaction with the occupational protective functions of medical devices and materials were lower than those in the medical group(P<0.05). iii) The awareness status on the knowledge of the management of tumor-related occupational protection in medical staffs of hospital: The awareness rate of items that the hospital′s prominent warning signs for medical waste places, equipment and materials was 89.9%, and the awareness rate of items that the contents of occupational safety and personal protection in the operating procedures of the workplace can meet the protection needs was only 38.1%. The awareness rates of understood that occupational exposure management department has regular inspections and supervision for related work in various departments, and can easily obtain occupational protection standard procedures and emergency treatment plans, the purchase information of work injury insurance, hospital′s prominent warning signs for places, equipment and materials were setting up in the nursing group were higher than that of the medical group(P<0.05). CONCLUSION: Hospitals should strengthen the related training on occupational protection operation specification and protective measures, improve the protection awareness of medical staffs, and make them actively use medical equipment and consumables with occupational protection functions, so as to reduce occupational exposure.