Drowsy driving is a major cause of automobile accidents. Previous studies used neuroimaging based approaches such as analysis of electroencephalogram (EEG) activities to understand the brain dynamics of different cortical regions during drowsy driving. However, the coupling between brain regions responding to this vigilance change is still unclear. To have a comprehensive understanding of neural mechanisms underlying drowsy driving, in this study we use transfer entropy, a model-free measure of effective connectivity based on information theory. We investigate the pattern of (...) information transfer between brain regions when the vigilance level, which is derived from the driving performance, changes from alertness to drowsiness. Results show that the couplings between pairs of frontal, central, and parietal areas increased at the intermediate level of vigilance, which suggests that an enhancement of the cortico-cortical interaction is necessary to maintain the task performance and prevent behavioral lapses. Additionally, the occipital-related connectivity magnitudes monotonically decreases as the vigilance level declines, which further supports the cortical gating of sensory stimuli during drowsiness. Neurophysiological evidence of mutual relationships between brain regions measured by Transfer entropy might elucidate the understanding of cortico-cortical communication during drowsy driving. (shrink)

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban (...) residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients.. (shrink)

Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Researchers are enthusiastically concerned about neural stem cell (NSC) therapy in a wide array of diseases, including stroke, neurodegenerative disease, spinal cord injury (SCI) and depression. Although enormous evidences have demonstrated that neurobehavioral improvement may benefit from NSC-supporting regeneration in animal models, approaches to endogenous and transplanted NSCs are blocked by hurdles of migration, proliferation, maturation and integration of NSCs. Electrical stimulation (ES) may be a selective nondrug approach for mobilizing NSCs in the central nervous system (CNS). This technique is (...) suitable for clinic application, because it is well established and its potential complications are manageable. Here, we provide a comprehensive review of the emerging positive role of different electrical cues in regulating NSC biology in vitro and in vivo, as well as biomaterial-based and chemical stimulation of NSCs. In the future, ES combined with stem cell therapy or other cues probably becomes an approach for promoting brain repair. (shrink)

Students often face difficulties and experience negative emotions toward second language learning. The affective tutoring system is a next-generation learning approach that can detect the affective status of learning to increase performance. Therefore, for the purposes of this study, an innovative affective mobile language tutoring system was designed to support Japanese language learning. The effects of AMLTS, along with asynchronous discussion, that were intended to improve performance, were examined using a triangulation method. To investigate the effect on emotion, the proposed (...) AMLTS provides a virtual emotion agent that can interact with users and record emotional events, learning assessments, and the results of the interaction into a database. Learning effectiveness evaluations were conducted via two experiments: prototype evaluation and final evaluation. Sixty-three students, all beginners, were invited to use the AMLTS to learn Japanese. The research results show that the proposed AMLTS affective interaction design significantly improves learner engagement and performance. In the emotion feedback analysis and learning process, AMLTS helped students deepen their understanding of the content, enabled them to clearly understand the content, and to engage in peer interaction and experience positive emotions. In the evaluation of system usability, AMLTS reveals good usability for foreign language acquisition. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 4, Page 999-1013, October 2022.

This paper examines the effect of the image of destinations on the wage income of resident households, and the corresponding income inequality, from a novel perspective. This work uses China’s excellent tourism city image program, which is an urban planning policy implemented by the central government across cities to enhance the image of the city destination in the minds of tourists, and then promote tourist motivation and local tourism development to assess the effect on household wage income and its distribution. (...) Results show that the program significantly increases household wage income by increasing employment opportunities, promoting business and population agglomeration, and improving urban infrastructure. Additionally, the image of the city destination promotion causes an increase in income inequality among households. (shrink)

Background Adherence to ethical guidelines and regulations and protecting and respecting the dignity and autonomy of participants by obtaining a valid informed consent form (ICF) prior to participation in research are crucial; The subjects did not add signatures next to the corrections made to signatures or dates on the ICF, Multiple signatures in other fields, ICF missing/missing signature, Incorrect ICF version Signed after modification, Correction tape used to correct signature, Impersonated signature, Non-research-member signature, however, ICFs are often not properly completed, (...) which must be addressed. This study analyzed ICF signing errors and implemented measures to reduce or prevent these errors. Methods We used the plan–do–check–act (PDCA) cycle to help improve the correctness and validity of ICF signing. Results Interim and final reports from January 2016 to February 2020 including 363 ICFs were studied. The total proportion of correct ICF signatures (200, 83.3%) following the PDCA intervention was significantly higher than that before the intervention (P < 0.05). Analysis of the types of signing error demonstrated that signature errors were significantly reduced after the intervention, particularly for subjects did not add signatures next to the corrections made to signatures or dates on the ICF (16, 6.7%) and impersonated signature (0; P < 0.05). Conclusions The proportions of other error types—multiple signatures in other fields, missing or unsigned ICF, incorrect signature order, incorrect ICF version, use of correction tape to correct signature, and non-medical profession members signing the ICF—did not differ significantly. (shrink)

Against the backdrop of economic internationalization and market globalization, the world has witnessed faster competitive contents with a more dynamic market environment, a more rapid technological innovation, and more diverse customer needs. Thus, for every enterprise especially led by entrepreneurs, the focus is to maintain the sustainability of competitive advantages and dynamically transform core capacity to avoid rigidity. This paper introduces the process of the deepened rigidity in WS Co. Company, which occurs due to the wrong cognition of Dr. S (...) and his teams who managed or failed to respond to the rigidity encountered by the company during different periods. The rigidity of its capacity is believed to be caused by the cognitive errors of the entrepreneur and his team facing every period of potential rigidity, which makes them fail to deal with it, thus leading to complete rigidity. This paper intends to explain how rigidity takes shape from the cognitive aspect of senior managers, which may serve as illuminations for the similar enterprises led by entrepreneurs. (shrink)

This paper demonstrated the influences of initiation, development, turn-down, and reinitiation of the dynamic capability of an entrepreneurial firm in the solar energy industry. The focus is on the impact of entrepreneurial hubris, which may affect the decision of ambidexterity that can vitalize dynamic capability. The findings indicate that, when the major decision maker has the trait of hubris, the decision-making process may be overly arbitrary, and a decision of being exploratory or exploitative alone is likely to be made. On (...) the contrary, when the founder entrepreneur is aware of the hubris and shares decisive power, the decision of being ambidextrous as a dynamic capability is more freely achieved. This paper contributes by discovery of the cognitive-based microfoundation of entrepreneurial ventures and linkage of such microfoundation to organizational ambidexterity. (shrink)

Based on attribution theory, this research defines pseudo-transformational leadership to be driven by the interaction between transformational leadership and the subordinates’ perception of their supervisor’s manipulative intention. We investigate the effects of pseudo-transformational leadership on contextual performance through organizational identification. The results of hierarchical linear modeling using a sample of 214 subordinates reporting to 66 supervisors show that when subordinates perceive that their supervisor has a high level of manipulative intention, the impact of group-level transformational leadership on the subordinates will (...) be reduced. More specifically, when subordinates perceive the manipulative intention of transformational leadership, they are less likely to identify with the organization, which ultimately limits their willingness to demonstrate contextual performance activities. The implications of these findings for theory as well as managerial practice are discussed. (shrink)

In 2016, Taiwan’s President Tsai Ing-wen officially apologised to the island’s indigenous peoples. This national apology not only plays a persuasive role in informing the general public about the historical wrongdoings inflicted on the Taiwanese aborigines, but also constitutes a therapeutic and restorative role in the process of reconciliation with the indigenous victims. This article provides a critical discourse analysis of President Tsai’s apology. In particular, it examines the power and ideology embedded in both the speech and the related ceremony, (...) and is supplemented with extracts from interviews with a cross-section of key stakeholders, such as a former Constitutional/supreme Court Justice, indigenous/tribal leaders and members/staff/advisers from the Presidential Office Indigenous Historical Justice and Transitional Justice Committee. The analysis reveals that, despite President Tsai’s apology and reconciliation policies, instead of facilitating reconciliation, the apology appears to exacerbate the long-standing latent tension between indigenous and non-indigenous groups. While the apology opens a window for reconciliation, a higher level of commitment is required to promote structural and systemic changes, such as land restitution, before the apology can be deemed adequate. (shrink)

Informing children about their HIV status is a complex challenge and the most difficult part for parents and health care providers. As more children with HIV reaching adolescence and adulthood, the...

Language is central to the interactional nature of the social life within which it is situated. To react or respond in a particular situation, we must be able to recognize the social situation. Growing evidence has demonstrated the negative impact of perceived loneliness on late-life executive functions. Yet little is known about how social factors impact language processing for older people. The current study aims to fill this gap, first by assessing age-related changes in lexical processing during Chinese word reading, (...) second, by examining whether older adults’ individual differences, such as processing speed and verbal abilities, modulate meaning retrieval and, third, by investigating whether perceived loneliness can hinder word reading. The use of compound words in Chinese enables significant sublexical ambiguity, requiring varying executive load during word recognition: when a word’s constituent characters carry multiple meanings, readers must consider the meaning contributions of both constituent characters and use top-down word information to determine the most accurate meaning of the ambiguous character, a process termed “sublexical ambiguity resolution.” In this study, adults read real Chinese words and pseudowords, and they were asked to make lexical decisions. Older adults exhibited greater lexicality effects and similar sublexical ambiguity effects compared with young adults. Among older participants, processing speed could account for their ability to differentiate between words and pseudowords. In contrast, the level of perceived loneliness modulated the efficacy of sublexical ambiguity resolution: the participants with higher perceived loneliness displayed a greater sublexical ambiguity disadvantage effect. These results indicate that perceived loneliness may affect the use of contextual information in meaning retrieval during reading. The findings provide an important link between social connections and language processing. (shrink)

New types of artificial intelligence products are gradually transferring to voice interaction modes with the demand for intelligent products expanding from communication to recognizing users' emotions and instantaneous feedback. At present, affective acoustic models are constructed through deep learning and abstracted into a mathematical model, making computers learn from data and equipping them with prediction abilities. Although this method can result in accurate predictions, it has a limitation in that it lacks explanatory capability; there is an urgent need for an (...) empirical study of the connection between acoustic features and psychology as the theoretical basis for the adjustment of model parameters. Accordingly, this study focuses on exploring the differences between seven major “acoustic features” and their physical characteristics during voice interaction with the recognition and expression of “gender” and “emotional states of the pleasure-arousal-dominance (PAD) model.” In this study, 31 females and 31 males aged between 21 and 60 were invited using the stratified random sampling method for the audio recording of different emotions. Subsequently, parameter values of acoustic features were extracted using Praat voice software. Finally, parameter values were analyzed using a Two-way ANOVA, mixed-design analysis in SPSS software. Results show that gender and emotional states of the PAD model vary among seven major acoustic features. Moreover, their difference values and rankings also vary. The research conclusions lay a theoretical foundation for AI emotional voice interaction and solve deep learning's current dilemma in emotional recognition and parameter optimization of the emotional synthesis model due to the lack of explanatory power. (shrink)

The transition of gene switch induced by external noises and external signals is investigated in the genetic regulatory system. Results show that the state-to-state transition of gene switch as well as resonant behaviors, such as the explicit coherence resonance, implicit coherence resonance and control parameter coherence biresonance, can appear when noises are injected into the genetic regulatory system. The ECR is increased with the increase of the control parameter value when starting from the supercritical Hopf bifurcation parameter point, and there (...) exists a critical control parameter value for the occurrence of ECR. However, the ICR is decreased as the control parameter value is increased when starting from the subcritical Hopf bifurcation point. In particular, the coherence of ECR is higher and more sensitive to noise than that of ICR. When an external signal is introduced into the system, the enhancement or suppression of the CPCBR and the number of peaks strongly depend on the frequency and amplitude of the external signal. Furthermore, the gene regulation system can selectively enhance or decrease the noise-induced oscillation signals at preferred frequency and amplitude of an external signal. (shrink)

The COVID-19 pandemic has brought hunger to millions of people around the world. Social distancing measures coupled with national lockdowns have reduced work opportunities and the overall household incomes. Moreover, the disruption in agricultural production and supply routes is expected to continue into 2021, which may leave millions without access to food. Coincidentally, those who suffer the most are poor people. As such, food security and tourism poverty alleviation are interlinked when discussing social problems and development. While the corporate interest (...) in tourism poverty alleviation is as old as the industrial revolution, little research has been conducted to show how social innovation can be leveraged to reinforce food security and alleviate poverty. Thus, this case study examines the food industry in rural China to establish how it conducts social innovation in food production and distribution to facilitate social development and mitigate poverty. (shrink)

The relationship between intuition and ethical decision-making has been researched extensively during the past two decades. This study aimed at exploring empirically observable associations between intuition and the moral intensity of ethical decision-making processes. A scenario-based quantitative approach was used to collect data from 157 practising professional spirit mediums. It was found that only collective universal intuition had a significant positive association with the moral intensity of ethical decision-making processes. Personal experience intuition and collective archetype intuition were not significantly associated (...) with moral intensity. This may explain why previous studies were unable to gauge the effects of intuition on ethical decision-making. The results suggest that a pure mind can improve one’s ability to make decisions. Thus, decision-makers would benefit by being more attuned to their sense of morality. (shrink)

Purpose: Sensory feedback for prosthetics is an important issue. The area of forearm stump skin that has evoked tactile sensation of fingers is defined as the projected finger map, and the area close to the PFM region that does not have ETS is defined as the non-projected finger map. Previous studies have confirmed that ETS can restore the tactile pathway of the lost finger, which was induced by stimulation of transcutaneous electrical nerve stimulation on the end of stump skin. This (...) study aims to reveal EEG features between the PFM and the NPFM regions of the stumps under the same TENS stimulation condition.Methods: The PFM and NPFM regions of the two subjects were stimulated with the same intensity of TENS, respectively. TENS as target stimuli are modulated according to the Oddball paradigm to evoke the P300 components.Result: The PFM regions of both subjects were able to elicit P300 components, while their NPFM regions were not able to elicit P300 components. However, this P300 appears early and has continuous positive peaks in front of it.Discussion: N30 and P300 can prove that the two subjects with PFM can perceive and recognize ETS. The heteromorphisms of the P300 waveform may be related to the difficulty in subjects’ cognition of ETS or caused by the fusion of P150, P200, and P300. (shrink)

Indonesia is recognized as a nurse exporting country, with policies that encourage nursing professionals to emigrate abroad. This includes the country’s adoption of international principles attempting to protect Indonesian nurses that emigrate as well as the country’s own participation in a bilateral trade and investment agreement, known as the Indonesia–Japan Economic Partnership Agreement that facilitates Indonesian nurse migration to Japan. Despite the potential trade and employment benefits from sending nurses abroad under the Indonesia–Japan Economic Partnership Agreement, Indonesia itself is suffering (...) from a crisis in nursing capacity and ensuring adequate healthcare access for its own populations. This represents a distinct challenge for Indonesia in appropriately balancing domestic health workforce needs, employment, and training opportunities for Indonesian nurses, and the need to acknowledge the rights of nurses to freely migrate abroad. Hence, this article reviews the complex operational and ethical issues associated with Indonesian health worker migration under the Indonesia–Japan Economic Partnership Agreement. It also introduces a policy proposal to improve performance of the Indonesia–Japan Economic Partnership Agreement and better align it with international principles focused on equitable health worker migration. (shrink)

Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...

Evidence suggests divergent thinking is the cognitive basis of creative thoughts. Neuroimaging literature using resting-state functional connectivity has revealed network reorganizations during divergent thinking. Recent studies have revealed the changes of network organizations when performing creativity tasks, but such brain reconfigurations may be prolonged after task and be modulated by the trait of creativity. To investigate the dynamic reconfiguration, 40 young participants were recruited to perform consecutive Alternative Uses Tasks for divergent thinking and two resting-state scans were used for mapping (...) the brain reorganizations after AUT. We split participants into high- and low-creative groups based on creative achievement questionnaire and targeted on reconfigurations of the two brain networks: default-mode network and the network seeded at the left inferior frontal gyrus because the between-group difference of AUT-induced brain activation located at the left IFG. The changes of post-AUT RSFCs indicated the prolonged effect of divergent thinking. More specifically, the alterations of RSFCIFG−AG and RSFCIFG−IPL in the high-creative group had positive relationship with their AUT performances, but not found in the low-creative group. Furthermore, the RSFC changes of DMN did not present significant relationships with AUT performances. The findings not only confirmed the possibility of brain dynamic reconfiguration following divergent thinking, but also suggested the distinct IFGN reconfiguration between individuals with different creativity levels. (shrink)

This article endeavours to prove that there were creation myths of human beings or certain things, but there were seldom creation myths of ontological cosmology in ancient China. This will be warranted through the distinction between the concepts of ‘to create’ and ‘to beget’, the distinction between ‘Cosmology I of creationism’ and ‘Cosmology II of begetting’, and the relationship between the One and Many. The only exception is the myth of Nüwa 女娲 as the creator of human beings, but not (...) the creator of the cosmos. Therefore, in ancient Chinese tradition, there were mainly myths of begetting rather than myths of complete creation in the sense similar to creatio ex nihilo.Contribution: Previous research frequently underscores the profound differences between ‘Cosmology I of creationism’ and ‘Cosmology II of begetting’. Based on the discussion of concepts of ‘to create’ [zao 造] and ‘to beget’ [sheng 生], this article argues that, there were mainly myths of begetting rather than myths of complete creation in the sense similar to creatio ex nihilo. (shrink)