Nurses are experiencing new ethical issues as a result of global developments and changes in health care. With health care becoming increasingly sophisticated, and countries facing challenges of graying population, ethical issues involved in health care are bound to expand in quantity and in depth. Blended learning rather as a combination of multiple delivery media designed to promote meaningful learning. Specifically, this study was focused on two questions: (1) the students’ satisfaction and attitudes as members of a scenario-based learning process (...) in a blended learning environment; (2) the relationship between students’ satisfaction ratings of nursing ethics course and their attitudes in the blended learning environment. In total, 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were invited to participate in this study. A cross-sectional survey design was adopted in this study. The participants were asked to fill out two Likert-scale questionnaire surveys: CAAS (Case Analysis Attitude Scale), and BLSS (Blended Learning Satisfaction Scale). The results showed what students felt about their blended learning experiences — mostly items ranged from 3.27—3.76 (the highest score is 5). Another self-assessment of scenario analysis instrument revealed the mean scores ranged from 2.87—4.19. Nearly 57.8% of the participants rated the course ‘extremely helpful’ or ‘very helpful.’ This study showed statistically significant correlations (r = 0.43) between students’ satisfaction with blended learning and case analysis attitudes. In addition, results testified to a potential of the blended learning model proposed in this study to bridge the gap between students and instructors and the one between students and their peers, which are typical of blended learning, and to create meaningful learning by employing blended pedagogical consideration in the course design. The use of scenario instruction enables students to develop critical analysis and problem solving skills through active learning and social exchange of ideas. (shrink)

With the continuous lockdown and staying home strategies of COVID-19, both instructors and learners have met with the presence challenges in language learning. To address the complex and dynamic relationships of different presences in blended learning during COVID-19, based on the Community of Inquiry framework, 215 Chinese English learners were obtained as samples for an empirical test. SPSS 23 and PROCESS for SPSS were utilized to examine the hypotheses. Results indicate that teaching presence has a significant direct positive impact on (...) social presence, sense of community, and cognitive presence. SP has a significant positive impact on CP and partially mediates the relationship between TP and CP. SoC is also found to impact CP and partially mediates the relationship between TP and CP. The findings also validate the chain mediating role of SP and SoC between TP and CP. Pedagogical implications are discussed. (shrink)

With the gradual deepening of environmental problems and the increase in consumer awareness of environmental protection, many enterprises have already begun to pay attention to green supply chain management. However, the price of green products is higher than that of nongreen products, which is an enormous challenge for many small- or medium-sized enterprises. To study the pricing and coordination of green supply chains under capital constraints, a model consisting of a manufacturer and a capital-constrained retailer is established; the manufacturer invests (...) in green products and provides a deferred payment contract. Setting the situation without capital constraints as a benchmark, this study explores the impact of the retailer’s capital constraints on the manufacturer’s product greenness design; an interesting result shows that deferred payment can help encourage the retailer to order more products and improve the profit of the manufacturer and the efficiency of the entire supply chain as well as the product’s greenness level simultaneously. However, the profit of the retailer will be hurt by the deferred payment contract. Therefore, to guarantee the profit of the entire channel and to make the two agents obtain a win-win outcome, a new two-way revenue-sharing contract is designed to coordinate the green supply chain. (shrink)

The establishment of women's literature as the main content of the female sex, should be specifically refers to the implied author of female subjectivity, rather than the main female characters in the works or the narrator's subjectivity; and, in addition to this main gender hegemony, which in fact is an inter-subjectivity. Women's literature should be in the works of women writers and implied male characters, female characters between the intersubjective dialogue between them. In the teleological level, women's literature should be (...) able to guard the true men and women there, asked the dimensions may be life, so it can go beyond the context of a modern reflection of resentment complex. The subjectivity of the feminine literature, as the key factor for the feminine literature, should be the female author's subjectivity rather than the female character's subjectivity in the books, which is a kind of inter-subjectivity without hegemony characteristics. There is a dialogic relationship between the implied female authors and both the female and the male characters in the feminine literature. From the perspective of teleology, the feminine literature should watch the authentic male and female beings, and seek all possible dimensions of life so as to surpass the resentment. (shrink)

Noninvasive brain stimulation provides a promising approach for the treatment of neuropsychiatric conditions. Despite the increasing research on the facilitatory effects of this kind of stimulation on the cognitive processes, the majority of the studies have used the standard stimulation approaches such as the transcranial direct current stimulation and the conventional repetitive transcranial magnetic stimulation which seem to be limited in robustness and the duration of the transient effects. However, a recent specialized type of rTMS, theta-burst stimulation, patterned to mimic (...) the natural cross-frequency coupling of the human brain, may induce robust and longer-lasting effects on cortical activity. Here, we aimed to investigate the effects of the intermittent TBS, a facilitatory form of TBS, over the right DLPFC, a brain area implicated in higher-order cognitive processes, on visuospatial working memory performance. Therefore, iTBS was applied over either the rDLPFC or the vertex of 24 healthy participants, in two separate sessions. We assessed VSWM performance using 2-back and 4-back visuospatial tasks before iTBS, and after the iTBS. Our results indicate that the iTBS over the rDLPFC significantly enhanced VSWM performance in the 2-back task, as measured by the discriminability index and the reaction time. However, the 4-back task performance was not significantly modulated by iTBS. These findings demonstrate that the rDLPFC plays a critical role in VSWM and that iTBS is a safe and effective approach for investigating the causal role of the specific brain areas. (shrink)

ABSTRACTCognitive control enables us to adjust behaviours according to task demands, and emotion influences the cognitive control. We examined how task-irrelevant emotional stimuli impact the ability to inhibit a prepared response and then programme another appropriate response. In the study, either a single target or two sequential targets appeared after emotional face images. Subjects were required to freely viewed the emotional faces and make a saccade quickly upon target onset, but inhibit their initial saccades and redirect gaze to the second (...) target if it appeared. We found that subjects were less successful at inhibiting their initial saccades as the inter-target delay increased. Emotional faces further reduced their inhibition ability with a longer delay, but not with a shorter delay. When subjects failed to inhibit the initial saccade, the longer delay produced longer intersaccadic interval. Especially, positive faces lengthened the intersaccadic interval with a l... (shrink)

Using Bakhtin's notion of polyphony, this study explored the discussion of the end-of-life issues in the Course on Life and Death Education in one Chinese university. Ethnographic methods were adopted to investigate the collision between the classroom voices and the voices of the mainstream culture on end-of-life in the process of developing students' attitudes toward death. The findings revealed that “to understand death” involved challenging the voice of “strangeness and fear of death”; “honestly facing up to and accepting the feelings (...) of the fear, pain, and helplessness” was the response to “be brave”; and the goal “to die peacefully” resisted the notion of “extending life at any cost.” Through the collision between these voices, students developed their attitudes toward death in facing, understanding, accepting, and choosing how to die. The analysis further revealed that providing only one “answer” to death by the teacher is not sufficient or effective to foster students' attitudes toward death because the students are a diverse group holding different views on the end-of-life issues, which demonstrated the importance of creating dialogues in the life and death education. (shrink)

The Depression Anxiety Stress Scale-21 is an instrument in the assessment of mental health status. The current study recruited 1,532 Chinese hospital workers [74.4% female; mean age = 31.97 years] to examine the reliability, latent structure, and measurement invariance of the DASS-21 between genders. The Cronbach’s α values were greater than 0.90 for total score. This study examined four possible models of the DASS-21 using the confirmatory factor analysis in Chinese hospital workers. The results from CFA revealed that the latent (...) structure of the DASS-21 in medical staffs is best represented by a one-factor model. Then we used the one-factor model to examine measurement invariance across genders by using a multiple-group categorical CFA. All values of root mean square error approximation were less than 0.08, all Comparative Fix Index and Tucker–Lewis Index values were greater than 0.90, all ΔCFI values were less than 0.010, and ΔRMSEA were less than 0.015. These findings supported the gender invariance of the DASS-21 among Chinese hospital workers. (shrink)

This article proposes a moderated mediation model of emotional dissonance. In the model, emotional leadership negatively affects emotional dissonance, which, in turn, negatively affects helping behavior. Furthermore, the negative effect of emotional dissonance is assumed to be moderated by work-family conflict. Direct effects from both emotional leadership and work-family conflict to helping other behavior are also considered. Previous studies have neglected the mechanism of emotional dissonance, but this paper fills the gap with a moderated mediation model of emotional dissonance. This (...) article not only provides an incremental contribution to the emotional dissonance literature but also suggests means by which companies might enhance employe helping behaviors in order to achieve greater organizational efficiency. (shrink)

As a generalization of both single-valued neutrosophic element and hesitant fuzzy element, single-valued neutrosophic hesitant fuzzy element is an efficient tool for describing uncertain and imprecise information. Thus, it is of great significance to deal with single-valued neutrosophic hesitant fuzzy information for many practical problems. In this paper, we study the aggregation of SVNHFEs based on some normalized operations from geometric viewpoint. Firstly, two normalized operations are defined for processing SVNHFEs. Then, a series of normalized aggregation operators which fulfill some (...) basic conditions of a valid aggregation operator are proposed. Additionally, a decision-making method is developed for resolving multiattribute decision-making problems based on the proposed operators. Finally, a numerical example is provided to illustrate the feasibility and effectiveness of the method. (shrink)

In a realistic steady-state visual evoked potential (SSVEP) based brain-computer interface (BCI) application like driving a car or controlling a quadrotor, observing the surrounding environment while simultaneously gazing at the stimulus is necessary. This kind of application inevitably could cause head movements and variation of the accompanying gaze fixation point, which might affect the SSVEP and BCI’s performance. However, few papers studied the effects of head movements and gaze fixation switch on SSVEP response, and the corresponding BCI performance. This study (...) aimed to explore these effects by designing a new ball tracking paradigm in a virtual reality (VR) environment with two different moving tasks, i.e., the following and free moving tasks, and three moving patterns, pitch, yaw, and static. Sixteen subjects were recruited to conduct a BCI VR experiment. The offline data analysis showed that head moving patterns [F(2, 30) = 9.369, p = 0.001, effect size = 0.384] resulted in significantly different BCI decoding performance but the moving tasks had no effect on the results [F(1, 15) = 3.484, p = 0.082, effect size = 0.188]. Besides, the canonical correlation analysis (CCA) and filter bank canonical correlation analysis (FBCCA) accuracy were better than the PSDA and MEC methods in all of the conditions. These results implied that head movement could significantly affect the SSVEP performance but it was possible to switch gaze fixation to interact with the surroundings in a realistic BCI application. (shrink)

BackgroundDepression is common psychiatric morbidity in breast cancer survivors, seriously affecting patients’ quality of life and mental health. A growing body of research has investigated depression in breast cancer. However, no visual bibliometric analysis was conducted in this field. This study aimed to visualize the literature to identify hotspots and frontiers in research on breast cancer and depression.MethodsThe publications related to depression in breast cancer were retrieved in the Web of Science Core Collection between 1 January 2002 and 17 March (...) 2022. VOSviewer was used to identify co-occurrences and collaborations among countries, institutions, and keywords. CiteSpace was used to detect keyword bursts.ResultsA total of 7,350 articles and reviews related to depression in breast cancer were identified. From 2002 to 2022, the United States and the People’s Republic of China were the most productive countries in this field. The University of California, Los Angeles, and the University of Toronto were the most productive institutions in this field. The Journal of Psycho-oncology, followed by Supportive Care in Cancer and the Journal of Clinical Oncology, had the most publications on depression in breast cancer. Of the top 10 journals, seven were from the United States, two were from England, and one was from Germany. Five research hotspots of depression in breast cancer were identified by co-word analysis. Research on post-traumatic growth, spiritual interventions, cognitive-behavioral therapy, physical activity, and symptom cluster management of depression in breast cancer was relatively mature in the core hotspots. Burst detection of keywords on depression in breast cancer showed the latest hotspots, such as mental health, cancer survivor mortality, and activity.ConclusionThe research on depression in breast cancer is growing. Attention should be paid to the latest hotspots, such as mental health, cancer survivor, mortality, exercise, and physical activity. (shrink)

PurposeThe aims of the study were first to investigate the association between illness perception and psychological distress and second to determine whether mindfulness affects psychological distress via illness perception and perceived stress in patients with lung cancer.MethodsAmong 300 patients with lung cancer who participated in this cross-sectional study, 295 patients made valid responses to distress thermometer, the Five Facet Mindfulness Questionnaire, the Brief Illness Perception Questionnaire, and the Perceived Stress Scale between January and July 2021. The possible pathways of mindfulness (...) affecting psychological distress were analyzed based on the structural equation modeling analysis.ResultsA total of 24.4% patients with lung cancer had DT > 4. Illness perception and perceived stress had a direct effect on psychological distress. Mindfulness had a direct effect on illness perception and mindfulness indirectly influenced psychological distress through affecting illness perception alone or simultaneously affecting both the illness perception and perceived stress in patients with lung cancer.ConclusionLung cancer suffered from varying levels of psychological distress. Mindfulness may alleviate psychological distress by reducing the level of illness perception and perceived stress. We suggest developing a comprehensive factor model to clarify potential mechanisms of mindfulness on psychological distress due to the very low effect of mindfulness on psychological distress via illness perception and perceived stress. (shrink)

AimsA negative association between the lower level of psychological resilience and increased risk of compassion fatigue and higher Coronavirus disease 2019 stress has been revealed. However, bibliometric studies have not been performed to comprehensively investigate this topic. This study aimed to identify the status and trends in the CF and PR field from 2008 to 2021 and during the COVID-19 pandemic.MethodsWe identified relevant literature from the Web of Science Core Collection® database using “resilience” and “compassion fatigue” on September 30, 2021. (...) All search results were exported in plain text format for collaboration network analysis, reference-based co-citation analysis, analysis of journals, and keywords-based co-occurrence analysis, which were performed using Citespace® 5.8.R1.ResultsA total of 388 publications were identified finally, and there has been an increasing trend in the annual number of publications with light fluctuations. The analysis of journals and keywords indicated that nurses and social workers are the main research targets, and their mental problems are the main research topics. The turnover intention of health care providers has been a research focus, particularly during the COVID-19.ConclusionThe results of the present study help us understand the status of the CF and PR field and its recent developments. (shrink)

The eukaryotic genome is organized into different domains by cis‐acting elements, such as boundaries/insulators and matrix attachment regions, and is packaged with different degrees of condensation. In the M phase, the chromatin becomes further highly condensed into chromosomes. The first step for transcriptional activation of a given gene, at a particular time during development, in any locus, is the opening of its chromatin domain. This locus needs to be kept in this state in each early G1 phase during every cell (...) cycle. Certain distal enhance elements, including locus control regions (LCRs) and enhancers, are believed to perform this target chromatin domain opening process and several models have been proposed to explain distal enhance action. But they did not explain precisely how a given chromatin domain is opened. Based on various studies, we propose a hypothesis for the mechanism of opening chromatin on a large scale. One important mechanism may involved breaking one or two DNA strands and reducing the linking numbers within chromatin domain. The topological changes can overpass some complexes formed on DNA strands and can be transmitted from specific localized points over a broad region, until boundary elements or insulators are reached. These may initiate downstream events such as propagation of histone acetylation and the binding of transcription factors to proximal promoters and may further augment the action mediated by distal enhancer elements. BioEssays 25:507–514, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

It is widespread that the consumers browse relevant reviews for reference before purchasing the products when online shopping. Some stores or users may write deceptive reviews to mislead consumers into making risky purchase decisions. Existing methods of deceptive review detection did not consider the valid product review sets and classification probability of feature weights. In this research, we propose a deceptive review detection algorithm based on the target product identification and the calculation of the Metapath feature weight, noted as TM-DRD. (...) The review dataset of target product is modeled as a heterogeneous review information network with the feature nodes. The classification method of graph is used to detect the deceptive reviews, which can improve the efficiency and accuracy of deceptive review detection due to the sparsity, imbalance of deceptive reviews, and the absence of category probability of feature weight calculation. The TM-DRD algorithm we proposed is validated on the real review dataset Yelp and compared with the SpEagle, NFC, and NetSpam algorithm. The experiment results demonstrate that the TM-DRD algorithm performs better than the other method with regard to the accuracy and efficiency. (shrink)

Implementing the “hierarchical diagnosis and treatment” system highlights the important role of general practitioners as “residents’ health gatekeepers.” Still, the low level of career growth always limits the realization of their service value. Inertial thinking uses a single factor to explain the complexity of career growth in previous studies; in fact, it isn’t easy to assess whether the factor is a sufficient and necessary condition for a high level of career growth. Herein, we have used a set theory perspective to (...) analyze the mechanism of influencing high-level career growth by combining psychological and organizational factors. This research aims to analyze causal complexity relationship between these conditions and results is analyzed in detail. We choose fuzzy-set qualitative comparative analysis with a sample of 407 GPs to test 5 antecedent conditional variables that can affect their career growth. The variables include professional identity, self-efficacy, achievement motivation, training mechanism, and incentive mechanism. To ensure the universality and diversity of data, the samples were selected from community medical institutions in different regions of China. The results show that three pathways can affect the high career growth of GPs, and the optimal pathway A2 is the linkage matching of high incentive mechanism, high professional identity, high achievement motivation, and high self-efficacy. At the same time, we find that professional identity plays an alternative role in the three pathways. When professional identity is at a high level, as long as achievement motivation and self-efficacy are superior, or achievement motivation, self-efficacy, and achievement motivation are superior, a high level of career growth can be achieved. We broke the shackles of previous studies that only focused on the impact of single factors on the career growth of GPs. From the perspective of set theory, we use configurational thinking to construct Influential pathways of high career growth of GPs by integrating antecedents. The results can provide effective support for improving GPs’ service ability and realizing their service value to protect residents’ health. (shrink)

In recent years, the incidence of depressive symptoms among Chinese college students has been increasing. Studies have shown that depressive symptoms are related to a variety of psychosocial factors, among which neuroticism, resilience, and attention bias are most notably related, but the correlation among the three is not clear. This study aimed to investigate the influence mechanisms of different degrees of resilience, attentional bias, and neuroticism in the formation of depressive symptoms. The college freshmen of this study were selected through (...) stratified multi-stage cluster sampling. Students provided informed consent and then completed a general situation questionnaire and four scales: the Chinese version of the Connor–Davidson Resilience Scale, the Attention to Positive and Negative Information Scale, the Eysenck Personality Questionnaire, and the Zung Self-Rating Depressive Symptoms Scale. In total, 1,493 freshmen participated in the research group. Our results showed that low resilience, negative attention bias, and high neuroticism jointly increased the risk of depressive symptoms. There is a significant correlation between these three factors and depressive symptoms. Additionally, strength, tenacity, and attention bias all had more significant effects on the occurrence of depressive symptoms. These findings indicate that there may be an important psychological mechanism for the occurrence, development, and poor prognosis of depressive symptoms. (shrink)

This study developed a measure of autonomy for adolescents in contemporary China. First, data from 44 interviewees—40 secondary school students, 2 parents, and 2 secondary school teachers—were used to explore the connotation and theoretical structure of autonomy in adolescents in China. Next, a preliminary Adolescent Autonomy Questionnaire was created from the interview data and administered to 775 secondary school students. Exploratory factor analysis and confirmatory factor analysis were conducted to verify the factor structure. Finally, 614 secondary school students completed the (...) Adolescent Autonomy Questionnaire, Personal Growth Initiative Scale-II, and Adolescence Ego Identity Crisis Scale to evaluate criterion validity. The final version of the Adolescent Autonomy Questionnaire included 16 items and four subscales: autonomous decision-making, autonomous regulation, autonomous protection, and autonomous problem-solving. The total variance of the cumulative interpretation questionnaire was 62.54%. The CFA results showed that the four-factor model fits the data well: χ2/df = 2.340, CFI = 0.949, RMSEA = 0.042, SRMR = 0.046. Evaluation of the psychometric properties of the Adolescent Autonomy Questionnaire provided support for the reliability and validity of the measure. Thus, it serves as an effective measurement tool for assessing the autonomy of adolescents in China. (shrink)

Studies on the chronology of ancient books are a form of basic research. They involve complex causes and factors that have to do with the formation of ancient books, include many of the mysteries and secrets of hermeneutics, and are a matter that deserves repeated study and research. In the past, the "doubting of antiquity" school of thought viewed ancient books with an attitude of universal skepticism, which might well be described as an overall rethinking with regard to ancient books, (...) and which directly affected people's entire cognition of China's ancient civilization. In recent years, however, in the wake of the increasing numbers of archaeological discoveries and deeper studies into ancient history, a change is fermenting in people's views about the chronology of ancient books. Due to geographical proximity and convenience in obtaining materials, a number of scholars on the Chinese mainland are already strongly aware of this change. For instance, Li Xueqin has time and again written articles proposing that a "second rethinking" should be conducted with regard to ancient books.1 However, up to this day, many people have yet to attach sufficient importance to this change . I am therefore raising this issue and conducting a preliminary analysis from all the aspects that it touches upon. (shrink)

Virtual reality provides an immersive 360-degree viewing experience and has been widely used in many areas. However, the transmission of panoramic video usually places a large demand on bandwidth; thus, it is difficult to ensure a reliable quality of experience under a limited bandwidth. In this paper, we propose a field-of-view prediction methodology based on limited FoV feedback that can fuse the heat map and FoV information to generate a user view. The former is obtained through saliency detection, while the (...) latter is extracted from some user perspectives randomly, and it contains the FoV information of all users. Then, we design a QoE-driven panoramic video streaming system with a client/server architecture, in which the server performs rate adaptation based on the bandwidth and the predicted FoV. We then formulate it as a nonlinear integer programming problem and propose an optimal algorithm that combines the Karush–Kuhn–Tucker conditions with the branch-and-bound method to solve this problem. Finally, we evaluate our system in a simulation environment, and the results show that the system performs better than the baseline. (shrink)