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...

This study compares the use of interactional metadiscourse in a British newspaper, the Daily Mail, and a British news magazine, The Economist, in reporting on the Brexit referendum. We adopted Hyland’s (2005a:48–54) framework to analyze hedges, boosters, attitude markers, engagements, and self-mentions. One hundred news articles were randomly selected from online archives from February to June in 2016, during which time the debatable issue was discussed ardently. Quantitative and qualitative results of this study revealed both similarities and differences between the (...) newspaper and the news magazine in the use of interactional metadiscourse. For example, quantitatively, the frequencies of boosters in both genres were similar; however, the newspaper used much more engagement markers and self-mentions whereas the magazine used more hedges and attitude markers. Qualitatively, while most self-mentions were the same in both genres, a unique choice of self-mentions was found in the news magazine. (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)

Facial muscle activities are essential for the appearance and communication of human beings. Therefore, exploring the activation patterns of facial muscles can help understand facial neuromuscular disorders such as Bell’s palsy. Given the irregular shape of the facial muscles as well as their different locations, it should be difficult to detect the activities of whole facial muscles with a few electrodes. In this study, a high-density surface electromyogram system with 90 electrodes was used to record EMG signals of facial muscles (...) in both healthy and Bell’s palsy subjects when they did different facial movements. The electrodes were arranged in rectangular arrays covering the forehead and cheek regions of the face. The muscle activation patterns were shown on maps, which were constructed from the Root Mean Square values of all the 90-channel EMG recordings. The experimental results showed that the activation patterns of facial muscles were distinct during doing different facial movements and the activated muscle regions could be clearly observed. Moreover, two features of the activation patterns, 2D correlation coefficient and Centre of Gravity were extracted to quantify the spatial symmetry and the location of activated muscle regions respectively. Furthermore, the deviation of activated muscle regions on the paralyzed side of a face compared to the healthy side was quantified by calculating the distance between two sides of CGs. The results revealed that corr2 of the activated facial muscle region in Bell’s palsy subjects was significantly lower than that in healthy subjects, while CG distance of activated facial region in Bell’s palsy subjects was significantly higher than that in healthy subjects. The correlation between corr2 of these regions and Bell’s palsy [assessed by the Facial Nerve Grading Scale 2.0] was also significant in Bell’s palsy subjects. The spatial information on activated muscle regions may be useful in the diagnosis and treatment of Bell’s palsy in the future. (shrink)

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

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)

Social-bots-mediated information manipulation is influencing the public opinion environment, and their role and behavior patterns in news proliferation are worth exploring. Based on the analysis of bots' posting frequency, influence, and retweeting relationship, we take the diffusion of The New York Times' coverage of Xinjiang issue on the overseas social platform Twitter as an example and employ the two-step flow model. It is found that in the role of second-step diffusion, unlike posting news indiscriminately in first-step diffusion, social bots are (...) more inclined to postcontroversial information in second-step diffusion; in terms of diffusion patterns, although social bots are more engaged in first-step diffusion than in second-step diffusion and can trigger human users to retweet, they are still inferior to humans in terms of influence. (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)

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)

We review recent progress in the stem cell biology of the respiratory system, and discuss its scientific and translational ramifications. Several studies have defined novel stem cells in postnatal lung and airways and implicated their roles in tissue homeostasis and repair. In addition, significant advances in the generation of respiratory epithelium from pluripotent stem cells (PSCs) now provide a novel and powerful platform for understanding lung development, modeling pulmonary diseases, and implementing drug screening. Finally, breakthroughs have been made in the (...) generation of decellularized lung matrices that can serve as a scaffold for repopulation with respiratory cells derived from either postnatal or PSCs. These studies are a critical step forward towards the still distant goal of stem cell‐based regenerative medicine for diseases of lung and airways. (shrink)

Employability is a vital aspect for human development in career fields. In order to explore the factors affecting the employability of finance and trade graduates in higher vocational colleges, the researchers focused on human development in educational settings and conducted a piece of quantitative research within nine higher vocational colleges. The study uses descriptive statistical analysis to demonstrate the sample structure, using t-test, rank sum test, and chi-square test to assess the variables. It also adopts exploratory factor analysis to identify (...) the classification of both educational practice and employability. Then, a multivariable linear regression model was adopted to examine the relationships between three main factors as well as the employability and career development of finance and trade graduates. The findings imply that the soft skills and basic skills of finance and trade college graduates have immensely improved through educational practice; graduates with high motivation for learning could enhance their soft skills and more internships or club engagement brings stronger professional skills. Based on these results, higher vocational colleges, enterprises, policymakers, teachers, and finance and trade graduates will benefit from the findings related to the reform of educational practice for strengthening graduate employability and human development. The originality of this paper is the conceptual evolution of finance and trade college graduate employability, as well as the empirical analysis on educational practice, student engagement, and family background affecting their human development. (shrink)

This study aimed to advance our understanding of 5-year-olds’ behavioral difficulties by modeling and testing both mediational protective and risk pathways simultaneously. Drawing on two national samples from different Western European countries—the United Kingdom and Germany, the proposed model considered observed sensitive parental interactive behaviors and tested child vocabulary as protective pathways connecting parental education with children’s behavioral outcomes; the risk pathways focused on negative parental disciplinary practices linking parental education, parental distress, and children’s difficult temperament to children’s behavioral difficulties. (...) Further, the tested model controlled for families’ income as well as children’s sex and formal child care attendance. Children with comparatively higher educated parents experienced more sensitive interactive behavior, had more advanced vocabulary, and exhibited fewer behavioral difficulties. Children with a comparatively higher level of difficult temperament or with parents who suffered from distress tended to experience more negative disciplinary behavior and exhibited more behavioral difficulties. Additionally, children’s vocabulary skills served as a mechanism mediating the association between parental education and children’s behavioral difficulties. Overall, we found similar patterns of results across the United Kingdom and Germany with both protective and risk pathways contributing simultaneously to children’s behavioral development. The findings suggest that promoting parents’ sensitive interactive behaviors, favorable disciplinary practices, and child’s vocabulary skills have potential for preventing early behavioral difficulties. (shrink)

BackgroundSolution-focused model is an intervention method that fully mobilizes patients’ initiative through their potential. We aimed to investigate the effects of SFM on anxiety and postpartum depression in nulliparous pregnant women compared with routine care services.MethodsWe chose the mothers diagnosed as depressed or with depressive tendency by Edinburgh Postpartum Depression Scale at 28 weeks of gestation and divided them into the intervention and control groups. The control group only took the routine pregnancy healthy nursing, while the SFM group took the (...) regular nursing and SFM counselling. Different assessments were conducted at 28 weeks of gestation, post-delivery, and post-intervention to evaluate the anxiety and depression levels of the patients. Finally, nursing satisfaction was evaluated by the nursing satisfaction questionnaire.ResultsCompared with the control group, SFM could decrease the scores of anxiety and depression more effectively and influence sleep quality more positively. We also found that SFM resulted in significantly higher nursing satisfaction than that in the control group.ConclusionIn conclusion, SFM could effectively alleviate anxiety and PPD in nulliparous pregnant women. (shrink)

本书内容包括:宪法权利的刑法保护——以言论自由为例的解读、宪政,生命权与死刑制度、宪法生命权与死刑的废除和限制——兼论死刑是否违宪等。.

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)

Reinforcement learning relies on the reward prediction error (RPE) signals conveyed by the midbrain dopamine system. Previous studies showed that dopamine plays an important role in both positive and negative reinforcement. However, whether various reinforcement processes will induce distinct learning signals is still unclear. In a probabilistic learning task, we examined RPE signals in different reinforcement types using an electrophysiology index, namely, the feedback-related negativity (FRN). Ninety-four participants were randomly assigned into four groups: base (no money incentive), positive reinforcement (presentation (...) of money rewards), negative reinforcement (removal of money losses), and combined reinforcement (money rewards and removal of money losses) groups. In addition, in order to evaluate the engagement of emotional activity in the different reinforcement processes, Positive and Negative Affect Schedule-Expanded Form (PANAS-X) scales were applied before and after the experiment to detect the emotional changes. The results showed that there was no difference between groups in the dopamine-related learning bias. However, compared to the other three groups, negative reinforcement elicited smaller FRN (the difference-wave measure) during the learning, stronger positive affect and joviality, and less fatigue after the learning, in which the difference between the negative and positive reinforcement groups was smaller. The results indicated that pure avoidance motivation may induce distinct emotional fluctuations, which influence the feedback processing. (shrink)

Project citizenship behavior has an important positive impact on project success. Researching how to promote PCB is an important issue in project management. Based on social learning theory and social cognitive theory, this paper adopted the method of questionnaire survey and hierarchical linear model to analyze the collected data derived from the sample of Chinese construction enterprises and verified this hypothesis. The results show that responsible leadership has a significant positive effect on PCB, moral identity mediates this relationship, and collective (...) moral sensitivity positively moderates this mediating effect. The findings of the study systematically and deeply reveal the intrinsic mechanism of the cross-level influence of responsible leadership on PCB, and provide new enlightenment for the practice of project management. (shrink)

Flight delay is one of the most challenging threats to operation of air transportation network system. Complex network was introduced into research studies on flight delays due to its low complexity, high flexibility in model building, and accurate explanation about real world. We surveyed recent progress about flight delay which makes extensive use of complex network theory in this paper. We scanned analyses on static network and temporal evolution, together with identification about topologically important nodes/edges. And, we made a clarification (...) about relations among robustness, vulnerability, and resilience in air transportation networks. Then, we investigated studies on causal relations, propagation modellings, and best spreaders identifications in flight delay. Ultimately, future improvements are summarized in fourfold. Under Complex Network, flight operation relevant subsystems or sublayers are discarded by the majority of available network models. Hierarchical modelling approaches may be able to improve this and provide more capable network models for flight delay. Traffic information is the key to narrow the gap between topology and functionality in current situations. Flight schedule and flight plan could be employed to detect flight delay causalities and model flight delay propagations more accurately. Real flight data may be utilized to validate and revise the detection and prediction models. It is of great importance to explore how to predict flight delay propagations and identify best spreaders at a low cost of calculation complexity. This may be achieved by analyzing flight delay in frequency domain instead of time domain. Summation of most critical nodes/edges may not be the most crucial group to network resilience or flight delay propagations. Effective algorithm for most influential sequence is to be developed. (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)

Reorienting the Political examines the reception of two controversial German philosophers, Carl Schmitt and Leo Strauss, in the Chinese-speaking world. This volume explores the powerful resonance of both thinkers in Chinese political thought from a cross-cultural and interdisciplinary perspective.

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)