Artificial intelligence in arthroplasty

Artificial intelligence (AI) is altering the world of medicine. Given the rapid advances in technology, computers are now able to learn and improve, imitating humanoid cognitive function. AI applications currently exist in various medical specialties, some of which are already in clinical use. This review presents the potential uses and limitations of AI in arthroplasty to provide a better understanding of the existing technology and future direction of this field.Recent literature demonstrates that the utilization of AI in the field of arthroplasty has the potential to improve patient care through better diagnosis, screening, planning, monitoring, and prediction. The implementation of AI technology will enable arthroplasty surgeons to provide patient-specific management in clinical decision making, preoperative health optimization, resource allocation, decision support, and early intervention. While this technology presents a variety of exciting opportunities, it also has several limitations and challenges that need to be overcome to ensure its safety and effectiveness.

Exploring the Optimal Allocation Decision-Making of Expenditure Budget in Hospitals Under Multi-Objective Constraints: Evidence from Urban Public Hospitals, China

Hospitals in many countries face the need for balancing different categories of expenditures to achieve multiple goals within a limited budget. This study established a two-stage fuzzy linear programming (FLP) estimation model to explore the optimal allocation decision-making of expenditure budget under the multi-objective constraints. Taking all urban public hospitals in Henan province of China as a sample, the optimal allocation decision-making of total expenditure budget was tested with the human resources expenditures (HE) as the dependent variable. And the outcome was compared with the actual expenditure data of these hospitals between 2010 and 2016. The study found that when the HE achieves the maximum and minimum feasible scale, the expenditure scales of the budget allocation categories including pharmaceutical expenditures, medical supplies expenditures, and other expenditures were all within a reasonable range. Among them, the observed promoting space for HE was 3.78 billion yuan. The results show that the FLP method can help urban public hospitals to make better total expenditure budget allocation decisions, which can maintain their reasonable expenditure structure under the hospitals’ development goals and the government’s regulatory requirements.

Ethics in extracorporeal life support: a narrative review

During 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges. After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.

Between Joy and Sympathy: Smiling and Sad Recipient Faces Increase Prosocial Behavior in the Dictator Game

In human interactions, the facial expression of a bargaining partner may contain relevant information that affects prosocial decisions. We were interested in whether facial expressions of the recipient in the dictator game influence dictators’ behavior. To test this, we conducted an online study (n = 106) based on a modified version of a dictator game. The dictators allocated money between themselves and another person (recipient), who had no possibility to respond to the dictator. Importantly, before the allocation decision, the dictator was presented with the facial expression of the recipient (angry, disgusted, sad, smiling, or neutral). The results showed that dictators sent more money to recipients with sad or smiling facial expressions and less to recipients with angry or disgusted facial expressions compared with a neutral facial expression. Moreover, based on the sequential analysis of the decision and the interaction partner in the preceding trial, we found that decision-making depends upon previous interactions.