Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; (...) and factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic. (shrink)

1. Confirmation Theory One, which we shall construct, when applied to the Raven Hypothesis yields the following results: Any black raven confirms the Raven Hypothesis.Any black non-raven confirms the Raven Hypothesis.Any non-black raven disconfirms the Raven Hypothesis.Any non-black non-raven is neutral to the Raven Hypothesis.Theory One consists of two parts: six basic concepts from confirmation theory proper, and the underlying logic.

We explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) (...) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center. While the plan was never put into operation, the process of preparing for emergency implementation exposed ethical issues that require attention. (shrink)

By empirically testing the scale and structure hypotheses of aging’s impacts on the financial market using Tobit, FRM, and Heckman selection models, this paper proves that the number and proportion of elderly family members change the structure of families’ financial assets, though without significant effects on their overall size. Specifically, aging increases the share of cash and deposits in families’ total financial assets and decreases both the quantity and percentage of investment in risky assets. One more family member aged sixty (...) and over, the risky assets decline by 5, 500RMB and its share decreases by 8.8 percent. A Heckman two-step model verifies the robustness of our results. The heterogeneity analysis reveals that aging plays different roles in different types of financial assets. (shrink)

Purpose Moral orientation can affect ethical decision-making. Very few studies have focused on whether medical education can change the moral orientation of the students. The purpose of the present study was to document the types of moral orientation exhibited by medical students, and to study if their moral orientation was changed after preclinical education. Methods From 2007 to 2009, the Mojac scale was used to measure the moral orientation of Taiwan medical students. The students included 271 first-year and 109 third-year (...) students. They were rated as a communitarian, dual, or libertarian group and followed for 2 years to monitor the changes in their Mojac scores. Results In both first and third-year students, the dual group after 2 years of preclinical medical education did not show any significant change. In the libertarian group, first and third-year students showed a statistically significant increase from a score of 99.4 and 101.3 to 103.0 and 105.7, respectively. In the communitarian group, first and third-year students showed a significant decline from 122.8 and 126.1 to 116.0 and 121.5, respectively. Conclusion During the preclinical medical education years, students with communitarian orientation and libertarian orientation had changed in their moral orientation to become closer to dual orientation. These findings provide valuable hints to medical educators regarding bioethics education and the selection criteria of medical students for admission. (shrink)

Research investigating the underlying mechanisms and boundary conditions under which leader humility influences employee voice remains underdeveloped. Drawing from approach–inhibition theory of power and leader humility literature, we developed a moderated-mediation model in which personal sense of power (i.e., employees’ ability to influence other individuals such as their leader) was theorized as a unique mechanism underlining why employees feel motivated to speak up under the supervision of humble leaders. Additionally, the cultural value of power distance was proposed to be a (...) relevant boundary condition to influence such relationship. We tested the model using time-lagged supervisor–subordinate matched data. Results of mixed models analyses provided support for our hypotheses confirming that employees’ personal sense of power mediates the relationship between leader humility and employee voice, and such relationship was found to be stronger when employees’ power distance was lower rather than higher. (shrink)

End-of-life decision making frequently occurs in the intensive care unit (ICU). There is a lack of information on how a do-not-resuscitate (DNR) order affects treatments received by critically ill patients in ICUs. The objectives of this study were: (1) to compare the use of life support therapies between patients with a DNR order and those without; (2) to examine life support therapies prior to and after the issuance of a DNR order; and (3) to determine the clinical factors that influence (...) the initiation of a DNR order in ICUs in Taiwan. A prospective, descriptive, and correlational study was conducted. A total of 202 patients comprising 133 (65.8%) who had a DNR order, and 69 (34.1%) who did not, participated in this study. In the last 48 hours of their lives, patients who had a DNR order were less likely to receive life support therapies than those who did not have a DNR order. Older age, being unmarried, the presence of an adult child as a surrogate decision maker, a perceived inability to survive ultimate discharge from the ICU, and longer hospitalization in the ICU were significant predictors of issuing a DNR order for critically ill patients. This study will draw attention to how, when, and by whom, critically ill patients’ preferences about DNR are elicited and honored. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

The choice of coping style of recruits under psychological stress in the process of military task execution has been an important topic in the promotion of military operations and cohesion of military forces. Taking a positive coping style under psychological stress can help recruits overcome the negative effects of stress and improve military morale and group combat effectiveness. Although soldiers' psychological stress in the process of military mission execution having an impact on coping style has been studied by a large (...) body of literature, very little literature has focused on the mechanism of self-efficacy and social support between recruits' psychological stress and coping style from the person-environment fit perspective. Therefore, this study was conducted to analyze the impact of recruits' psychological stress on coping style through a chain mediation model and to discuss the role of self-efficacy and social support in this relationship. Two waves of survey data were utilized to test the research hypotheses on a sample of 1028 Chinese recruits performing military tasks. The results indicated that recruits' psychological stress negatively impacted positive coping styles and positively correlated with negative ones. In addition, self-efficacy and social support mediated the relationship between psychological stress and positive coping style, and self-efficacy mediated the relationship between psychological stress and negative coping style. More importantly, self-efficacy and social support play the chain mediating effect between psychological stress and positive coping style. (shrink)

This study empirically examined the effects of ethical leadership and ethical climate on employee ethical behavior in the international port context using survey data collected from 128 respondents who worked in Taiwan International Ports Corporation in Taiwan. Research hypotheses were formulated from the previous literature and tested using structural equation modeling. Results indicated that ethical leadership had a significant impact on ethical climate and the ethical behavior of TIPC employees. Ethical climate was found to be positively associated with employee ethical (...) behavior. The theoretical and practical implications of the research findings are discussed. (shrink)

Business moral values are defined as the personal moral values held by individuals who are engaged in business interactions. Direct supervisors may play an important role in shaping the business moral values of their subordinates. Using 264 supervisor— subordinate dyadic data from Taiwanese organizations, the study investigated the relationships among supervisor business moral values, subordinate business moral values, subordinate organizational commitment, job performance, and attendance. The results indicated that supervisor business moral values were positively associated with subordinate business moral values, (...) and that the latter mediated the relationship between the former and subordinate outcomes. Implications for business moral values research are discussed. (shrink)

In this study, we examined the role of culture on early adolescents’ social reasoning about peer exclusion. A total of 80 U.S. and 149 Taiwanese early adolescents independently completed a social reasoning essay about peer exclusion. Analyses of the essays based on social-moral theories showed that U.S. students tended to reason about peer exclusion based on social conventional thinking whereas Taiwanese students were more attentive to personal and moral issues. Despite this difference, both groups of students referred to some common (...) social-moral concepts while reasoning about peer exclusion, including consideration of personal benefit, harming others’ welfare, personal concern, and punishment. The use of social reasoning strategies was similar across the two groups of students except that Taiwanese students relied more on judgment whereas U.S. students generated more alternative hypotheses. (shrink)

Research investigating the underlying mechanisms and boundary conditions under which leader humility influences employee voice remains underdeveloped. Drawing from approach–inhibition theory of power and leader humility literature, we developed a moderated-mediation model in which personal sense of power was theorized as a unique mechanism underlining why employees feel motivated to speak up under the supervision of humble leaders. Additionally, the cultural value of power distance was proposed to be a relevant boundary condition to influence such relationship. We tested the model (...) using time-lagged supervisor–subordinate matched data. Results of mixed models analyses provided support for our hypotheses confirming that employees’ personal sense of power mediates the relationship between leader humility and employee voice, and such relationship was found to be stronger when employees’ power distance was lower rather than higher. (shrink)

Background: The prevalence of sedentary behavior in adolescents has aroused social attention. The association between sedentary behavior and cognitive flexibility remains unclear, and it may vary depending on the type of sedentary behavior. This study aimed to investigate the associations between specific-type sedentary behaviors and cognitive flexibility in adolescents.Method: A total of 700 Chinese adolescents aged 10–15 years were recruited. The self-report questionnaire was used to assess total sedentary time, recreational screen-based sedentary time, and educational sedentary time. The More-odd shifting (...) task was used to assess cognitive flexibility.Results: The correlation analysis showed that recreational screen-based sedentary time was negatively correlated with cognitive flexibility, whereas educational sedentary time was positively correlated with cognitive flexibility. The regression analysis also further revealed that a significantly negative association between recreational screen-based sedentary time and cognitive flexibility, while a significantly positive association existed between educational sedentary time and cognitive flexibility.Conclusion: The findings shown that the association between recreational screen-based sedentary behavior and cognitive flexibility differs from educational sedentary behavior in adolescents, providing new ideas for a more comprehensive understanding of the association between sedentary behavior and cognitive flexibility in adolescents. (shrink)

This study aims to disclose how the magnetic resonance imaging neuroimaging approach has been applied in education studies, and what kind of learning themes has been investigated in the reviewed MRI neuroimaging research. Based on the keywords “brain or neuroimaging or neuroscience” and “MRI or diffusion tensor imaging or white matter or gray matter or resting-state,” a total of 25 papers were selected from the subject areas “Educational Psychology” and “Education and Educational Research” from the Web of Science and Scopus (...) from 2000 to 2019. Content analysis showed that MRI neuroimaging and learning were studied under the following three major topics and nine subtopics: cognitive function, science education, and brain development. As for the type of MRI neuroimaging research, the most frequently used approaches were functional MRI, followed by structural MRI and DTI, although the choice of approach was often motivated by the specific research question. Research development trends show that the neural plasticity theme has become more prominent recently. This study concludes that in educational research, the MRI neuroimaging approach provides objective and empirical evidence to connect learning processes, outcomes, and brain mechanisms. (shrink)

AimOur study aimed to investigate the effect of social responsibility on the subjective well-being of volunteers for COVID-19 and to examine the mediating role of job involvement in this relationship.BackgroundNowadays, more and more people join volunteer service activities. As we all know, volunteer work contributes to society without any return. Volunteers often have a strong sense of social responsibility and reap subjective well-being in their dedication. Although research shows that social responsibility will drive them to participate in volunteer work actively, (...) it is less clear whether job involvement will impact their subjective well-being.MethodsThe data were collected in the precaution zone in Shanghai, China, from April to May 2022. A sample of 302 volunteers for COVID-19 completed the social responsibility scale, subjective well-being scale and job involvement scale in the form of an electronic questionnaire on their mobile phones. A structural equation model was adopted to verify the research hypotheses.ResultsSocial responsibility was significantly and positively related to volunteers’ subjective well-being and job involvement. Job involvement fully mediates the relationship between volunteers’ social responsibility and subjective well-being.ConclusionSocial responsibility is critical to predicting volunteers’ subjective well-being. Job involvement plays an intervening mechanism in explaining how social responsibility promotes volunteers’ subjective well-being. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

As the negative environmental impacts of transportation systems become more severe, governments and environmental groups are seeking more sustainable transportation options, such as replacing fuel-powered vehicles with electric vehicles and expanding public transportation systems to reduce the number of people driving on their own, in order to reduce the environmental impacts of transportation systems. At present, the rapid expansion of public transportation systems is not an easy task and requires a long period of time to plan for expansion and construction, (...) so people are increasingly looking to find means of transportation that meet sustainable conditions as solutions. In this context, electric bicycles are one of the solutions that people can choose, with benefits such as energy saving, carbon reduction, effective air pollution reduction, and simple and labor-saving riding. However, in Taiwan, despite the many benefits of electric bicycles, their popularity is not high. Therefore, this study focuses on the factors that affect the purchase of electric bicycles in Taiwan. The Influential Network Relation Map generated by the Z-based Decision-making Trial and Evaluation Laboratory technique is used to describe the influence relationships among the factors and to establish the key evaluation criteria of electric bicycle purchase intention. The results indicate that vehicle price, safety, motor performance, battery life, and battery durability are the most important factors in purchasing electric bicycles. Furthermore, the power of motor is considered as the factor that most significantly affects other criteria, while safety and price are most likely to be affected by other criteria. This study has contributed to academia and industry, for the dependency weights of these factors are set to provide a scientific and systematic way to show how consumers think in the decision-making process and to provide more reliable information and management implications for the electric bicycle industry. (shrink)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (shrink)

Growing demand for direct care workers to assist care-dependent elderly people has created an opening for migrant workers from low- income nations to sell their services to middle and high-income nations. Using Singapore as a case example, we draw on capability theory to make the case that receiving nations that import direct care workers should be held to global justice standards that protect workers’ floor level human capabilities. Specifically, we (1) show that Singapore and other receiving nations fail to protect (...) human capabilities at a threshold level required by dignity; (2) identify specific human capabilities placed at risk; and (3) recommend standards for receiving nations that support central capabilities. As populations in both developed and developing nations are rapidly aging, these concerns could not be timelier. (shrink)

Yan Xin Life Science Technology-Optimized Caloric Restriction (YXLST-CR) is a unique food abstinence, which suppresses appetite and sensation of hunger while maintaining physiological homeostasis. The authors review the first clinical case study on YXLST-CR, or YXLST-bigu, a 15-day, 24-hour observation in 1987 on a 21-year-old female undergoing YXLST-bigu for several months. The participant took no food or water and conducted normal physical activities. The daily records of body weight, temperature, pulse rate, blood pressure, and daily urine test results showed no (...) abnormalities. Homeostasis was maintained during YXLST-CR. The authors also report serum leptin levels in a group of individuals undergoing YXLST-CR and a control group before and after a 24-hour water-only period. The leptin level prior to the observation for the YXLST-CR group was lower than that for the control group and remained unchanged during the observation, suggesting the possibilities of an established metabolic adaptation. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Digitalization and advanced technologies are replacing human jobs. Around the world, many people have lost their jobs due to increasing digitalization. Similarly, Chinese expatriates associated with the manufacturing sector in emerging countries such as Vietnam face similar challenges. Therefore, Chinese expatriates need to bring competitiveness in their competencies. This competitiveness brings sustainability to their career. The aim of this study is to investigate the impact of career competencies on career sustainability. Moreover, we test the mediating effect of lifelong learning in (...) the relationship between career competencies and career sustainability. A questionnaire survey approach was used in this study. The target population was the Chinese expatriate managers working at China-invested manufacturing multinational organizations in Vietnam. To estimate the proposed relationships, we use structural equation modeling. The results are confirmed that in the direct relationship career competence has a positive impact on career sustainability. The findings of this study also indicate that career competencies have a positive impact on lifelong learning. Furthermore, outcomes confirmed that lifelong learning has a positive impact on career sustainability. Similarly, results are also confirmed that lifelong learning is positively mediating between career competencies and career sustainability. Therefore, the empirical results of this article identify that lifelong learning has a critical impact on sustainable careers. Specifically, this study is useful for mid-level managers who are associated with multinational organizations. At the end of this article, we also explained the practical implications, limitations, and future research directions. (shrink)

While an increasing number of organizations have introduced artificial intelligence as an important facilitating tool for learning online, the application of artificial intelligence in e-learning has become a hot topic for research in recent years. Over the past few decades, the importance of online learning has also been a concern in many fields, such as technological education, STEAM, AR/VR apps, online learning, amongst others. To effectively explore research trends in this area, the current state of online learning should be understood. (...) Systematic bibliometric analysis can address this problem by providing information on publishing trends and their relevance in various topics. In this study, the literary application of artificial intelligence combined with online learning from 2010 to 2021 was analyzed. In total, 64 articles were collected to analyze the most productive countries, universities, authors, journals and publications in the field of artificial intelligence combined with online learning using VOSviewer through WOS data collection. In addition, the mapping of co-citation and co-occurrence was explored by analyzing a knowledge map. The main objective of this study is to provide an overview of the trends and pathways in artificial intelligence and online learning to help researchers understand global trends and future research directions. (shrink)

In speaker recognition systems, feature extraction is a challenging task under environment noise conditions. To improve the robustness of the feature, we proposed a multiscale chaotic feature for speaker recognition. We use a multiresolution analysis technique to capture more finer information on different speakers in the frequency domain. Then, we extracted the speech chaotic characteristics based on the nonlinear dynamic model, which helps to improve the discrimination of features. Finally, we use a GMM-UBM model to develop a speaker recognition system. (...) Our experimental results verified its good performance. Under clean speech and noise speech conditions, the ERR value of our method is reduced by 13.94% and 26.5% compared with the state-of-the-art method, respectively. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

This volume brings together a group of logic-minded philosophers and philosophically oriented logicians to address a diversity of topics on the structural analysis of non-classical logics. It mainly focuses on the construction of different types of models for various non-classical logics of current interest, including modal logics, epistemic logics, dynamic logics, and observational predicate logic. The book presents a wide range of applications of two well-known approaches in current research: structural modeling of certain philosophical issues in the framework of non-classic (...) logics, such as admissible models for modal logic, structural models for modal epistemology and for counterfactuals, and epistemological models for common knowledge and for public announcements; conceptual analysis of logical properties of, and formal semantics for, non-classical logics, such as sub-formula property, truthmaking, epistemic modality, behavioral strategies, speech acts and assertions. The structural analysis provided in this volume will appeal not only to graduate students and experts in non-classic logics, but also to readers from a wide range of disciplines, including computer science, cognitive science, linguistics, game theory and theory of action, to mention a few. (shrink)