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OBJECTIVES: This study investigated the autopsy rate of hospital deaths in Shenzhen megacity and identified factors that may impact the decision to perform an autopsy in hospital deaths. DESIGN: This is a population-based retrospective cohort study. SETTING: Shenzhen is a megacity in China with a population of more than 17 million and a total of 151 hospitals. The official dataset of the inpatient medical record home page was used. Demographic, clinical and hospital information was extracted. PARTICIPANTS: All the 35 272 inpatient deaths between 2016 and 2022 with known autopsy status were included to calculate the overall autopsy rate. Among them, a total of 34 577 cases with complete data, classified hospital and Chinese nationality, were included for further multivariable rare events logistic regression and Poisson pseudo maximum likelihood regression. OUTCOME MEASURES: Whether the inpatient death was autopsied or not. RESULTS: The autopsy procedure was performed in 0.9% (319/35 272) of hospital deaths. The autopsy decision was significantly and positively associated with being married (OR= 1.60, 95% CI: 1.16 to 2.21), self-paying (OR=1.56, 95% CI: 1.07 to 2.26), death due to external causes of injury and poisoning (OR=1.69, 95% CI: 1.02 to 2.81) and pregnancy (OR=13.58, 95% CI: 4.94 to 37.36), but negatively associated with age (OR=0.97, 95% CI: 0.96 to 0.98), emergency admission (OR=0.66, 95% CI: 0.49 to 0.88), referral (OR=0.47, 95% CI: 0.25 to 0.88), neoplasms (OR=0.35, 95% CI: 0.22 to 0.56), respiratory diseases (OR=0.49, 95% CI: 0.26 to 0.95) and for-profit hospitals (OR=0.45, 95% CI: 0.23 to 0.91). There were no statistically significant differences in autopsy rates between large teaching hospitals and other hospitals. CONCLUSIONS: The autopsy rate of hospital deaths was extremely low, largely due to healthcare providers. Even large teaching hospitals do not request more autopsies compared with other hospitals, after controlling for the patient characteristics. More efforts are urged to encourage hospitals and healthcare providers to proactively request autopsies, helping to revive this important procedure.

Aims: This study aims to explore the association between the implementation of the adverse event reporting system (AERS), burnout, and job satisfaction among psychiatric nurses, with a focus on examining the mediating effect of workplace violence from patients. Background: Many organizational and personal factors contribute to burnout and job satisfaction experienced by nurses. AERS, serving as a key component of organizational‐level quality improvement system, impacts the overall workplace wellness of nurses. Methods: A national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China participated. Burnout was measured by the Maslach Burnout Inventory. Job satisfaction was measured using the Minnesota Satisfaction Questionnaire. Workplace violence was assessed by nurses' experience of verbal and physical violence. Multilevel linear regression analyses were carried out to examine if AERS impacts burnout and job satisfaction and to identify the mediating role of workplace violence. Results: AERS was positively associated with job satisfaction, but negatively with burnout and workplace violence. Workplace violence exhibited a positive association with burnout and a negative association with job satisfaction. Mediation analyses indicated that the associations between AERS, burnout, and job satisfaction were mediated by workplace violence. Conclusions: The application of AERS is associated with a reduction in workplace violence in hospitals, which contributes to the diminished burnout and heightened job satisfaction among psychiatric nurses. Implications for nursing practice and health policy: The study highlights the importance of organizational efforts and mechanisms in promoting nurses' well‐being. It is necessary for hospital management to create a safe workplace through the implementation of AERS. [ABSTRACT FROM AUTHOR]

Advanced encryption/decryption strategies are of great significance for information protection and data security. It is highly desirable yet quite challenging to develop functional materials for encrypting/decrypting information more effectively. Herein, a novel emissive liquid crystal elastomer (LCE) for multidimensional and multistage encryption is proposed for the first time, through synergistic utilization of phototunable fluorescence and the photoprogrammable shape. The fluorescent LCE is fabricated by incorporating an aggregation‐induced‐emission α‐cyanodiarylethene‐based hydrogen‐bonded complex and azobenzene derivative into the LCE networks through covalent bonding. Because of the photoisomerization of both these two photosensitive derivatives under the same exciting light, the consequent LCE films exhibit photoinduced reversible fluorescence changes and shape deformations that are suitable for data storage and encryption. On this basis, the collaborative usage of photolithography‐based 2D fluorescent images and photoprogramming 3D shape configurations can lead to multidimensional and multistage encryption. Moreover, this encryption strategy is reprogrammable, allowing for repeatable encoding and decrypting. The results demonstrated here reveal that the reversible phototunable fluorescent LCE materials exhibit promising applications in data storage and encryption. [ABSTRACT FROM AUTHOR]

Circularly polarized luminescence, handedness inversion, hydrogen-bonded chiral fluorescent switch, luminescent helical superstructures Innenrücktitelbild: Irradiation-Wavelength Directing Circularly Polarized Luminescence in Self-Organized Helical Superstructures Enabled by Hydrogen-Bonded Chiral Fluorescent Molecular Switches (Angew. Keywords: circularly polarized luminescence; handedness inversion; hydrogen-bonded chiral fluorescent switch; luminescent helical superstructures EN circularly polarized luminescence handedness inversion hydrogen-bonded chiral fluorescent switch luminescent helical superstructures 27539 27539 1 12/15/21 20211220 NES 211220 B Zirkular polarisierte Lumineszenz b in emittierenden selbstorganisierten helikalen Überstrukturen kann durch die Wellenlänge der Strahlung gesteuert werden, wie Jinbao Guo, Quan Li et al. in ihrem Forschungsartikel auf S. 27364 zeigen. [Extracted from the article]

Background: Medical error (ME) is a serious public health problem and a leading cause of death. The reported adverse incidents in China were much less than western countries, and the research on patient safety in rural China's primary care institutions was scarce. This study aims to identify the factors contributing to the under-reporting of ME among general practitioners in township health centres (THCs)., Methods: A qualitative semi-structured interview study was conducted with 31 general practitioners working in 30 THCs across 6 provinces. Thematic analysis was conducted using a grounded theory approach., Results: The understanding of ME was not unified, from only mild consequence to only almost equivalent to medical malpractice. Common coping strategies for THCs after ME occurs included concealing and punishment. None of the participants reported adverse events through the National Clinical Improvement System website since they worked in THCs. Discussions about ME always focused on physicians rather than the system., Conclusions: The low reported incidence of ME could be explained by unclear concept, unawareness and blame culture. It is imperative to provide supportive environment, patient safety training and good examples of error-based improvements to rural primary care institutions so that ME could be fully discussed, and systemic factors of ME could be recognised and improved there in the future., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)