Cardiovascular disease is a major complication of type 2 diabetes mellitus. In addition to traditional risk factors, psychological determinants play an important role in CVD risk. This study applied Deep Neural Network to develop a CVD risk prediction model and explored the bio-psycho-social contributors to the CVD risk among patients with T2DM. From 2017 to 2020, 834 patients with T2DM were recruited from the Department of Endocrinology, Affiliated Hospital of Harbin Medical University, China. In this cross-sectional study, the patients' bio-psycho-social (...) information was collected through clinical examinations and questionnaires. The dataset was randomly split into a 75% train set and a 25% test set. DNN was implemented at the best performance on the train set and applied on the test set. The receiver operating characteristic curve analysis was used to evaluate the model performance. Of participants, 272 were diagnosed with CVD. The developed ensemble model for CVD risk achieved an area under curve score of 0.91, accuracy of 87.50%, sensitivity of 88.06%, and specificity of 87.23%. Among patients with T2DM, the top five predictors in the CVD risk model were body mass index, anxiety, depression, total cholesterol, and systolic blood pressure. In summary, machine learning models can provide an automated identification mechanism for patients at CVD risk. Integrated treatment measures should be taken in health management, including clinical care, mental health improvement, and health behavior promotion. (shrink)

Transformational leadership has been becoming increasingly vital to the provision of high-quality health care, particularly during major public health emergencies. The present study aims to investigate the impact of transformational leadership on physicians’ performance and explore the cross-level underlying mechanisms with achievement motivations and coping styles among Chinese physicians. During 2017–2019, 1,527 physicians of 101 departments were recruited from six hospitals in China with a cluster random sampling method. Participants completed several questionnaires regarding their job performance, achievement motivations, coping styles, (...) and transformational leadership. Multilevel mediation effects were tested using cross-level path analysis. The result of this study indicated that transformational leadership was applied well in Chinese medical settings with a score of 101.56 ± 6.42. The hierarchical linear model showed that transformational leadership had a cross-level direct positive effect on physicians’ performance. Furthermore, results of cross-level path analyses revealed that transformational leadership contributed to physicians’ performance by sequentially influencing achievement motivations first and then coping styles. In addition, the path “transformational leadership → positive coping style → physicians’ performance” showed the strongest cross-level indirect effect. In summary, public health leaders should enhance physicians’ performance by promoting individual development, especially achievement motivation and PC style. (shrink)

The counterfactual account of physical computation is simple and, for the most part, very attractive. However, it is usually thought to trivialize the notion of physical computation insofar as it implies ‘limited pancomputationalism’, this being the doctrine that every deterministic physical system computes some function. Should we bite the bullet and accept limited pancomputationalism, or reject the counterfactual account as untenable? Jack Copeland would have us do neither of the above. He attempts to thread a path between the two horns (...) of the dilemma by buttressing the counterfactual account with extra conditions intended to block certain classes of deterministic physical systems from qualifying as physical computers. His theory is called the ‘algorithm execution account’. Here we show that the algorithm execution account entails limited pancomputationalism, despite Copeland’s argument to the contrary. We suggest, partly on this basis, that the counterfactual account should be accepted as it stands, pancomputationalist warts and all. (shrink)

Understanding the role of teachers’ facial expressions in students’ learning is helpful to improve online teaching. Therefore, this study explored the effects of teacher’s facial expressions on students’ learning through analyzing three groups of video lectures. Participants were 78 students enrolled in three groups: one with an enhanced-expression teacher, one with a conventional-expression teacher, and one with the teacher’s audio only. ANOVA was used to explore whether video lectures instructed by the enhanced-expression teacher were better than those instructed by the (...) conventional-expression teacher and the audio-only teacher for facilitating students’ learning, and what is the role of the teacher’s emotions in students’ perceived social presence, arousal level, cognitive load, and learning. The results showed that the video lecture by the enhanced-expression teacher was better than those with the conventional-expression teacher and with the audio-only for facilitating students’ social presence, arousal level, and long-term learning. Interestingly, it was found that the teacher’s emotions could relieve students’ cognitive load. These results explained the inconsistency of existing studies by exploring the mechanism of teachers’ emotions in students’ learning. It also provides teachers with practical guidance for video lecture design. (shrink)

For synchronization of a class of chaotic systems in the presence of nonvanishing uncertainties, a novel time-varying gain observer-based sliding mode control is proposed. First, a novel time-varying gain disturbance observer is developed to estimate the uncertainties. Then, by using the output of TVGDO to modify sliding mode control, a new TVGDO-based SMC scheme is developed. Although the observation and control precision of conventional fixed gain disturbance observer-based control for chaotic systems can be guaranteed by a high observer gain, the (...) undesirable spike problem may be caused by the high gain if the initial values of estimate and true states are not equal. The most attractive feature of this work is that the newly proposed TVGDO can eliminate the spike problem by developing a time-varying gain scheme. Finally, the effectiveness of the proposed method is demonstrated by the numerical simulation. (shrink)

The pressure control for a liquid nature gas ship is vital for the cargo handling system which is a nonlinear, unstable, and controllable complex system accompanied by the dynamics of time delay. To improve the control effect, this article proposed a robust controller based on closed-loop gain shaping algorithm by mirror-mapping approach. In addition, the complete mechanism models for the system are established to predict the changes of temperature, pressure, and liquid inventory in the cargo tank. The heat exchanges and (...) evaporation of liquid are also considered. By collecting the data from the LNG ship “Dapeng,” the system models are validated. At the same time, the comparative experiment is introduced to verify the reliability and effectiveness. The scheme has been compared with the 2-DOF structure control law of modified Smith predictor. The comparative experimental results show that the scheme proposed in this note has a strong disturbance rejection ability and steady-state performance. The controller designed in this note has advantages of simplified construction method, satisfactory control effect and robustness. (shrink)

As the most frequently used tool for measuring empathy, the Interpersonal Reactivity Index (IRI) is often scored by researchers arbitrarily and casually. Many commonly used IRI scoring approaches and their corresponding measurement models are unverified, which may make the conclusions of subsequent variable relation studies controversial and even misleading. We make the first effort to summarize these measurement models and to evaluate rationality of the common scoring methods of the IRI by confirmatory factor analysis, focusing on model fitting, factor loading, (...) and model-based reliability simultaneously. The results show that most of these models do not fit well, indicating that the scoring approaches of the IRI corresponding to these models may be problematic. Relatively speaking, better scoring approaches of the IRI include summing empathic concern and perspective taking as the total score of the IRI and reporting the score of perspective taking as cognitive empathy. (shrink)

The purpose of this note is to study impulsive control and synchronization of memristor based chaotic circuits shown by Muthuswamy. We first establish a less conservative sufficient condition for the stability of memristor based chaotic circuits. After that, we discuss the effect of errors on stability. Meanwhile, we also discuss impulsive synchronization of two memristor based chaotic systems. Our results are more general and more applicable than the ones shown by Yang, Li, and Huang. Finally, several numerical examples are (...) given to show the effectiveness of our methods. (shrink)

In China, many private entrepreneurs have obtained political offices in the government. In this study, we argue that Chinese private entrepreneurs who are formally connected with government institutions, compared to other Chinese private entrepreneurs, tend to contribute more to philanthropic causes not only for instrumental concerns but also out of altruistic values. We submit this argument to an empirical test through a secondary data analysis of a representative sample of Chinese entrepreneurs collected by a coalition of government and industry groups. (...) The results of this analysis show that politically connected entrepreneurs are more likely to make major philanthropic donations and, at the same time, hold a stronger sense of the responsibility for doing so. The most important contribution of this research is that it reveals the ethical basis of the philanthropic activities of Chinese private entrepreneurs, especially those with political connections, that has been unappreciated by extant literature. (shrink)

This paper proposes a novel robust fixed-time control for the robot manipulator system with uncertainties. Based on the uniform robust exact differentiator algorithm, a robust control term is constructed. Then, a robust fixed-time inverse dynamics control is proposed. For the proposed control method, the fixed-time stability of a closed-loop system with uncertainties is strictly proved. The newly proposed method exhibits the following two attractive features. First, the proposed control scheme extends the existing fixed-time IDC for the robot manipulator system to (...) the robust control scheme. Second, the proposed method is strictly nonsingular rather than the commonly used approximate approach. Simulation result demonstrates the effectiveness of the proposed control scheme. (shrink)

In 2011, Jiangsu Province set up the guidance fund for sports industry. In 2016, Jiangsu Provincial Finance Department jointly issued the document with Jiangsu Provincial Sports Bureau, which was changed to “Jiangsu Special Fund for Sports Industry Development.” By 2019, Jiangsu Province has funded 1,009 sports industry development projects with a total investment of 796.6 million yuan. The effect of the investment has attracted extensive attention from the government, society, and enterprises. Entrusted by Jiangsu Sports Industry Guidance Center, this research (...) team spent one year on the performance research of 1,009 projects supported by special funds for the development of sports industry, from the construction of evaluation index system to the design, issuance, collection, and processing of questionnaires. Using the methods of literature, questionnaire, expert interview, and mathematical statistics, this paper takes the performance management of the special funds for the development of sports industry in Jiangsu Province as the research object, based on the investigation and analysis of the current situation of the special funds for the development of sports industry in Jiangsu Province. It analyzes the special funds from four aspects: the rate of funds in place, the ratio of funds pulled, the completion rate of project implementation, and the rate of fund prerecovery. Then, this paper expounds the current situation, effectiveness, and problems of the performance management of the special funds for the development of sports industry and puts forward some countermeasures and suggestions for improvement. (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)

The present study investigated the crossover effects of employee perceptions of servant leadership and job social support on the family satisfaction and quality of family life experienced by the employees’ spouses. These effects were explored through a focus on the mediating role of employee organization-based self-esteem. Results from a three-wave field survey of 199 employee–spouse dyads in the People’s Republic of China support our hypotheses, indicating that OBSE fully mediates the positive effects of servant leadership and job social support on (...) family satisfaction and quality of family life. These findings provide new theoretical directions for work–family research. (shrink)

In China, many private entrepreneurs have obtained political offices in the government. In this study, we argue that Chinese private entrepreneurs who are formally connected with government institutions, compared to other Chinese private entrepreneurs, tend to contribute more to philanthropic causes not only for instrumental concerns but also out of altruistic values. We submit this argument to an empirical test through a secondary data analysis of a representative sample of Chinese entrepreneurs collected by a coalition of government and industry groups. (...) The results of this analysis show that politically connected entrepreneurs are more likely to make major philanthropic donations and, at the same time, hold a stronger sense of the responsibility for doing so. The most important contribution of this research is that it reveals the ethical basis of the philanthropic activities of Chinese private entrepreneurs, especially those with political connections, that has been unappreciated by extant literature. (shrink)

In the medical practice in China, giving and taking “red envelopes” is a common phenomenon although few openly admit it. This paper, based on our empirical study including data collected from interviews and questionnaires with medical professionals and patients, attempts to explore why “red envelopes” have become a serious problem in the physician-patient relationship and how the situation can be improved. Previous studies show that scholars tend to correlate the spread of “red envelopes” in health care sector to the commercialization (...) trend, the general erosion of traditional values, and the lowering of the moral level in the medical field. However, in this paper, the authors argue that medical professionals’ choice of taking “red envelopes” is actually more a way to compensate for their problematic self-image and marred dignity in real practice. Medical professionals in China as a whole are in an embarrassing situation where the work pressure and income, and the sense of pride that used to be part of their profession are not comparable to each other. Under this circumstance, we believe that the effective way to deal with the “red envelopes” issue does not lie solely in introducing more stringent regulations or granting medical professionals higher payments, but rather in protecting and enhancing the professional dignity of all those working in healthcare. And on top of that, there must also be effort to cultivate a more favorable moral environment. (shrink)

According to the three-tier hierarchy of motivational potency in the self system, the self can be divided into individual self, relational self, and collective self, and individual self is at the top of the motivational hierarchy in Western culture. However, the motivational primacy of the individual self is challenged in Chinese culture, which raises the question about whether the three-tier hierarchy of motivational potency in the self system can be differentiated in the collectivist brain. The present study recorded the event-related (...) potentials (ERPs) to evaluate brain responses when participants gambled for individual self, for a close friend (relational self), or for the class (collective self). The ERP results showed that when outcome feedback was positive, gambling for individual self evoked a larger reward positivity compared with gambling for a friend or for the class, while there is no difference between the latter two conditions. In contrast, when outcome feedback was negative, no significant effect was found between conditions. The present findings provide direct electrophysiological evidence that individual self is at the top of the three-tier hierarchy of the motivational system in the collectivist brain, which supports the classical pancultural view that individual self has motivational primacy. (shrink)

Background Nurses frequently experience ethical issues in their area of practice. In the challenging reality of today’s healthcare environment, nursing students need to be prepared to deal with ethical issues in their future roles. Nevertheless, Chinese nursing students’ ethical sensitivity status and the factors influencing it have not been described. Objective This study aims to explore the level of ethical sensitivity and its influencing factors among Chinese nursing students. Research design This was a cross-sectional study. We firstly cross-culturally adapted the (...) Japanese version of the Ethical Sensitivity Questionnaire for Nursing Students (ESQ-NS) into a Chinese version. Then, we administered the Chinese version of ESQ-NS, the Caring Ability Inventory (CAI), and general information questionnaire to nursing undergraduates. Participants and research context The invitations were sent to 600 nursing undergraduates from four universities in Hunan, China. Ethical considerations The study was supported by the Institutional Review Board (IRB) of the lead university. The Approval No. was E202092. Results A total of 489 undergraduate nursing students participated in the study. The mean score for ethical sensitivity of the samples was 36.34 ± 4.90, and 187.99 ± 22.64 for their humanistic care ability. Pearson’s correlation coefficient test indicated a meaningful and positive relationship between the ethical sensitivity and humanistic care ability (r = 0.576 and p <.01). And regression analysis showed that age, school year, experience in studying nursing ethics, how much you like nursing major, and humanistic care ability were of relevance to nursing students' ethical sensitivity. Discussion Our findings suggest that the mean ethical sensitivity score of Chinese nursing students is 36.34 (13–52). The humanistic caring ability of Chinese nursing students is still at a low level. Conclusion Future interventions for improving the ethical sensitivity of the nursing students should consider general information of participants and their humanistic care ability. (shrink)

Employing a unique dataset of Chinese non-listed firms, this paper investigates the effects of the presence of 19 governance structures on 20 employees’ interest indicators. In general, we find that firms with the governance structures pay workers higher hourly wages, require less monthly working hours, and have a smaller chance of wage arrears. Meanwhile, the shares of total wage and welfare expenditures in total sales revenue are lower in these firms, which results in higher profitability. Moreover, firms with the governance (...) structures invest significantly more into training and provide employees with better fringe benefits. Considering the low labor protection standard and the weak external regulations of China’s labor market, we explain the positive findings thusly: corporate governance structures induce managers to adjust wage payments to the “efficiency wage” level, which is the best balance point for the interests of both shareholders and employees and, therefore, for maintaining the stakeholder relationships. We also find the governance structures that give blockholders superpower are negatively associated with employees interests. These results highlight the importance of giving enough discretion to managers in order to successfully find the common ground for creating mutual values for shareholders and employees. (shrink)

A growing body of research has started to examine how individuals from different countries may differ in their use of ethically questionable tactics during business negotiations. Whereas prior research focused on the main effect of the national culture or nationality of the negotiator, we add a new factor, which is the nationality of the counterpart. Looking at both these variables allows us to examine whether and how people may change their likelihood of using ethically questionable tactics in inter-cultural negotiations as (...) opposed to intra-cultural ones. Results of an experiment show that overall, American participants were less likely than Chinese participants to use ethically questionable tactics in negotiations. However, American participants were more likely to use ethically questionable tactics, particularly those related to false promises and inappropriate information gathering, in inter-cultural negotiations with Chinese counterparts, than in intra-cultural negotiations with American counterparts. By contrast, Chinese participants were less likely to use ethically questionable tactics, particularly those related to false promises and attacking opponent’s network, in inter-cultural negotiations with American counterparts, than in intra-cultural negotiations with Chinese counterparts. Implications and future directions are discussed. (shrink)

This paper identifies that Information and Communication Technology (ICT) has a negative effect on software piracy rates in addition to consolidating prior research that economic development and the cultural dimension of individualism also negatively affect piracy rates. Using data for 59 countries from 2000 to 2005, the findings show that economic well-being, individualism and technology development as measured by ICT expenditures explain between 70% and 82% of the variation in software piracy rates during this period. The research results provide important (...) implications for policy makers and business practitioners to help reduce software piracy. (shrink)

The Wigner’s friend type of thought experiments manifest the conceptual challenge on how different observers can have consistent descriptions of a quantum measurement event. In this paper, we analyze the extended version of Wigner’s friend thought experiment in detail and show that the reasoning process from each agent that leads to the no-go theorem is inconsistent. The inconsistency is with respect to the requirement that an agent should make use of updated information instead of outdated information. We then apply the (...) relational formulation of quantum measurement to resolve the inconsistent descriptions from different agents. In relational formulation of quantum mechanics, a measurement is described relative to an observer. Synchronization of measurement result is a necessary requirement to achieve consistent descriptions of a quantum system from different observers. Thought experiments, including EPR, Wigner’s Friend and it extended version, confirm the necessity of relational formulation of quantum measurement when applying quantum mechanics to composite system with entangled but space-like separated subsystems. (shrink)