Fecal microbiota transplantation has demonstrated efficacy and is increasingly being used in the treatment of patients with recurrent Clostridium difficile infection. Despite a lack of high-quality trials to provide more information on the long-term effects of FMT, there has been great enthusiasm about the potential for expanding its applications. However, FMT presents many serious ethical and social challenges that must be addressed as part of a successful regulatory policy response. In this article, we draw on a sample of the scientific (...) and bioethics literatures to examine clusters of ethical and social issues arising in five main areas: informed consent and the vulnerability of patients; determining what a “suitable healthy donor” is; safety and risk; commercialization and potential exploitation of vulnerable patients; and public health implications. We find that these issues are complex and worthy of careful consideration by health care professionals. Desperation of a patient should not be the basis for selecting treatment with FMT, and the patient's interests should always be of paramount concern. Authorities must prioritize development of appropriate and effective regulation of FMT to safeguard patients and donors, promote further research into safety and efficacy, and avoid abuse of the treatment. (shrink)

Business Ethics: A European Review, EarlyView.

Fecal microbiota transplantation is reportedly the most effective therapy for relapsing Clostridium Difficile infection and a potential therapeutic option for many diseases. It also poses important ethical concerns. This study is an attempt to assess clinicians’ perception and attitudes towards ethical and social challenges raised by fecal microbiota transplantation. A questionnaire was developed which consisted of 20 items: four items covered general aspects, nine were about ethical aspects such as informed consent and privacy issues, four concerned social and regulatory issues, (...) and three were about an FMT bank. This was distributed to participants at the Second China gastroenterology and FMT conference in May 2015. Basic descriptive statistical analyses and simple comparative statistical tests were performed. Nearly three quarters of the 100 respondents were gastro-enterologist physicians. 89% of all respondents believed FMT is a promising treatment modality for some diseases and 88% of whom chose clinical efficacy as the primary reason for recommending FMT. High expectation from patients and pressure on clinicians was reported as the most frequent reasons for not recommending FMT. The clinicians who had less familiarity with FMT reported significantly more worry related to the dignity and psychological impact of FMT compared to those who have high familiarity with FMT.More than half of the respondents were concerned about the commercialization of FMT, although almost one in five respondents did not see this as a problem. We found most respondents have positive attitudes towards FMT but low awareness of published evidence. Informed consent for vulnerable patients, privacy and protection of donors were perceived as the most challenging ethical aspects of FMT. This study identified areas of limited knowledge and ways of addressing ethical issues and indicates the need to devise the education and training for clinicians on FMT. (shrink)

Objectives: This study aimed to provide a comprehensive understanding of all intervention for learning burnout by meta-analyzing their effects.Methods: Relevant studies that had been published up to September 18, 2020, were identified through a systematic search of the PubMed, Web of Science, the China National Knowledge Infrastructure, and Wan Fang databases. Eligible studies included randomized control trials of any learning burnout intervention conducted among students. The Jadad scale was used to evaluate the quality of the study. Random-effect meta-analyses, subgroup analyses, (...) meta-regression analysis, and sensitivity analysis were conducted. Funnel plots and Egger's tests were used to evaluate publication bias. Duval and Tweedie's non-parametric trim-and-fill method was used to adjust the effect of publication bias.Results: Of the 5,245 articles found, 39 met the inclusion criteria for the systematic review. There were 3,400 students, including 1,847 students in the intervention group and 1,553 in the control group. A meta-analysis of 44 studies showed that the interventions were effective. Subgroup analyses were conducted according to education, scales, intervention measures, and intervention time. The results showed that, compared with the control group, the learning burnout scores of undergraduates, secondary vocational students, and middle school students were significantly lower. Based on different scales, all interventions were also effective. The funnel plot was asymmetric and consistent with the results of Egger's test. The trim-and-fill method was used, and seven missing studies were merged to obtain a symmetric funnel plot.Conclusions: This meta-analysis indicated that learning burnout interventions are effective. The subgroup analyses showed that group counseling is the most widely used, exercise intervention is probably the most effective, and 8 weeks or more is the appropriate intervention time. An integrated intervention study based on the factors of learning burnout adds value. More studies are needed to supplement the results in the future. (shrink)

BackgroundProblem-Based Learning is an instructional method of hands-on, active learning centered on investigating and resolving messy, real-world problems. This study aims to systematically analyze the current status and hotspots of PBL research and provide insights for research in the field.MethodsProblem-based learning-related publications were retrieved from the Web of Science Core Collection using “Problem-Based Learning”. Annual publications, countries, institutions, authors, journals, references, and keywords in the field were visually analyzed using the R, VOSviewer, and Microsoft Excel 2019 software.ResultsA total of 2,790 (...) articles and reviews were analyzed, with a steady increase in publications in the field of PBL. Overall, the United States was the major contributor to the study of PBL. Van Der Vleuten CPM was the key researcher in this field. Moreover, most of the publications were published in Medical Education. Keyword analysis showed that current research hotspots focus on the extensions of PBL teaching mode, application of PBL teaching method, and reform of PBL.ConclusionResearch on PBL is flourishing. Cooperation and exchange between countries and institutions should be strengthened in the future. These findings will provide a better understanding of the state of PBL research and inform future research ideas. (shrink)

Instructional interactions, which includes student–student interaction, student–teacher interaction, and student–content interaction, are crucial factors affecting the learning outcomes in online education. The current study aims to explore the effects of instructional interactions on individuals’ learning outcomes based on the Interactive Equivalence Theory by conducting two empirical studies. In Study 1, we explored the direct relationships between instructional interactions and learning outcomes. A quasi-experimental design was used to manipulate the two groups of subjects, and the results show that not all of (...) the three types of interaction can significantly positively predict learning satisfaction, among which ST cannot significantly predict learning satisfaction. When the total amount of instructional interactions is constant, adjusting the relative level of the three types of instructional interactions can effectively improve the learning outcomes to some extent. We further probed into the mediating effects of task value and self-regulated learning on the relationships between instructional interactions and learning outcomes in Study 2. We conducted an online survey and collected 374 valid data. The results showed that task values mediated the relationship between SS and learning satisfaction. In addition, SC can not only directly affect learning satisfaction, but also affect it through task value and self-regulated learning respectively, or via chain mediations of both task value and self-regulated learning. Our findings enrich the previous instructional interactions research and provide reference for online education curriculum design. (shrink)

Porter’s five forces model is an authoritative management tool used in analyzing the profitability and attractiveness of industries through an outside-in viewpoint. In the past decade, dramatic and rapid changes have prompted some criticism of the model. The comparison between new and old economy analysis makes the fundamentals of the model seem weak. Moreover, the past decade has shown that strategy and entrepreneurship in China are not completely dependent on the model. This study first aims to verify the sustainability of (...) the five forces model and analyze its integration into China’s entrepreneurial economy. By conducting in-depth interviews among the upper echelons from various industries, it was found that along with the competitive factors emphasized by the model, Chinese entrepreneurs attend to cooperative factors such as Guanxi, the Chinese term for relationship, and the possibilities of technology integration with the five forces. They also tend to enlarge the strategic view to consider factors such as how the market evaluates the forces. To verify these findings, the authors carried out a large-scale survey with a modified questionnaire analyzing the data collected using exploratory factor analysis with SPSS 22. The outcome shows that Porter’s model is still valid to some extent. Companies are still working in a network of buyers, suppliers, substitutes, new entrants, and competitors. However, reinventions are necessary to include the new factors of Guanxi, technology, and marketing and branding, which have changed the structure of the industry. These factors arise from the cooperative nature of Chinese culture and may have equal or even larger significance compared with their competitive counterparts in today’s business world. (shrink)

With the accelerating aging of the population and the worsening psychological conditions of older people, the traditional mode of family support for the elderly in China does not always meet the physical and psychological needs of the elderly, and more social support modes for the elderly are needed. Based on 3,513 valid questionnaires on the long-term care and protection needs of Chinese residents, this paper uses a logit regression model to analyze the factors influencing the willingness of the elderly to (...) choose nursing care. The results show that intergenerational family support for the elderly is a significant psychological driver on the willingness of the elderly to choose nursing care. Compared with the elderly living with family, empty nesters or older people living alone are more inclined to select nursing care when they have difficulties taking care of themselves. The physical health of the elderly affects their willingness to choose nursing care, and elderly individuals with more hospitalizations are less likely to select nursing care. In addition, elderly females who are relatively young, have a high level of education, have a high income, have a nursing home near the residence, and are already covered by medical insurance are more willing to choose nursing care. The results of this study are of great importance for improving the medical services and aging care services for the elderly and providing theoretical support for alleviating the psychological and social pressure brought by population aging. (shrink)

BackgroundExercise self-efficacy is a vital determinant of an individual’s active participation in regular exercise, and exercise is a critical component of improving health-related quality of life in dialysis patients. This study aimed to describe the relationship between exercise self-efficacy and HRQOL in dialysis patients.Materials and MethodsA cross-sectional study was conducted in Shanghai, China. Structured questionnaires distributed to the patients collected socio-demographic and disease-related information. Physical activity was assessed by a self-administered questionnaire, and the exercise self-efficacy scale was used to measure (...) exercise self-efficacy. HRQOL was evaluated by the kidney disease quality of life instrument-short form version 1.3. Data were analyzed using a univariate generalized linear model, Spearman correlation, and hierarchical multiple regression.ResultsA positive association was observed between exercise self-efficacy and HRQOL. Physical activity as a predictor variable explained 9.8% of the variance in overall HRQOL. Exercise self-efficacy explained an additional 7.1% of the HRQOL variance. In total, 24.6% of the variation in the HRQOL was explained by the socio-demographic variables, disease-related factors, physical activity, and exercise self-efficacy.ConclusionOverall, only 16.9% of the change in HRQOL was explained by physical activity and exercise self-efficacy. Future research is still needed to further explore the factors influencing the HRQOL in dialysis patients. However, this finding suggests the need to consider the importance of HRQOL and physical activity as well as exercise self-efficacy when developing intervention programs. (shrink)

With the advent of Complex dynamic systems theory in the field of second language question, the need for suitable CDST compatible methods for the investigation of temporal change in L2 affective variables has been felt more than before. One of the innovative methods for this purpose is latent growth curve modeling, which has recently drawn the attention of SLA scholars. However, the application of this method is still a burgeoning demand in SLA. In response to this demand, the present study (...) provides a review of the conceptualization, significance, and technical features of the implementation of LGCM. In doing so, this review suggests a number of practices via which LGCM has been introduced in SLA. Additionally, some practical implications are provided for SLA researchers to enhance their literacy of LGCM. Finally, future research suggestions for the progress of the use of this method in SLA are discussed. (shrink)

Indirectness is often used in our daily communication as a major communicative skill to keep a harmonious interpersonal relationship. From an Asian perspective, this paper is to discuss the various motives of indirectness, such as: politeness, self-protection, humor, rejection or denial, etc.

Active participation closely associates with the sustainable operation of co-creation communities. Different from recent studies on the promotion of sustainable operation by identifying the internal and external motivations of user participation, this paper aims to analyze the mechanism regarding how different motivations affect the decision of user participation from group-level perspective. To better understand the mechanism, internal and external motivations are, respectively, captured by return-cost analysis and user interactive network. Afterwards, a network evolutionary game model was formulated to analyze the (...) dynamic strategy selection of all users. In addition, the stable equilibrium and evolutionary path of strategies are analyzed through computational experiments. Results indicate the following: Rewards have an influence on the promotion of active participation. However, with the continued growth of rewards, this promotion does not make sense sustainably. The promotional effect of information noise on the selection of active participation can be found when passive participation is the dominant strategy. However, the inhibitory effect can be seen in populations that mainly adopt active participation. The scale-free feature of user interactive network inhibits the selection of active participation when active participation is the dominant strategy in populations. Results found here is beneficial for managers to implement the specified policies and thus to achieve the sustainability of co-creation community. (shrink)

Learning burnout is a pressing issue among Chinese medical undergraduates and Postgraduates and has drawn continuous attention worldwide. Studies have found that problematic smartphone use could affect learning burnout, but more research is needed in this direction. Furthermore, few studies focused on the mediating effect of psychological capital on the relationship between problematic smartphone use and learning burnout. The present study was a cross-sectional survey that recruited 1,800 participants from a medical university in Chongqing, China. A questionnaire based on the (...) Mobile Phone Addiction Tendency Scale, Psychological Capital Questionnaire, Learning Burnout Scale, and demographic variables were administered to these students, and 1,475 provided valid responses. 771 were undergraduates and 704 were postgraduates. Hierarchical regression and the bootstrap method were used to examine the mediating effect of psychological capital. After controlling for demographic variables, problematic smartphone use positively predicted learning burnout in undergraduates and in postgraduates. The partial mediating effect of psychological capital was 0.068 in undergraduates and 0.074 in postgraduates, accounting for 20.67 and 21.64%, respectively, of the total effect of problematic smartphone use on learning burnout. All the 95% confidence intervals did not contain 0. Problematic smartphone use can directly predict learning burnout and their relationship was mediated by psychological capital in Chinese medical undergraduates and postgraduates. Strategies to alleviating problematic smartphone use and enhance psychological capital in medical undergraduates and postgraduates may provide useful suggestions for future interventions on dealing with learning burnout in Chinese medical undergraduates and postgraduates. (shrink)

Recent advances in differential topology single out four-dimensions as being special, allowing for vast varieties of exotic smoothness structures, distinguished by their handlebody decompositions, even as the coarser algebraic topology is fixed. Should the spacetime we reside in takes up one of the more exotic choices, and there is no obvious reason why it shouldn’t, apparent pathologies would inevitably plague calculus-based physical theories assuming the standard vanilla structure, due to the non-existence of a diffeomorphism and the consequent lack of a (...) suitable portal through which to transfer the complete information regarding the exotic physical dynamics into the vanilla theories. An obvious plausible consequence of this deficiency would be the uncertainty permeating our attempted description of the microscopic world. We tentatively argue here, that a re-inspection of the key ingredients of the phenomenological particle models, from the perspective of exotica, could possibly yield interesting insights. Our short and rudimentary discussion is qualitative and speculative, because the necessary mathematical tools have only just began to be developed. (shrink)

全书共分为三篇,内容包括:20世纪西方美学原理体系、20世纪中国美学原理体系、中西美学原理体系比较。.

Ben shu miao shu le20shi ji80nian lai mei xue si chao de yan bian, xian dai mei xue ji ben fan chou de jian gou, bing jie shao le jin16ge mei xue liu pai, zhu yao dai biao ren wu de guan dian, ben pai de te zheng deng.

The flow of high-level talents in China is becoming more and more active and has a profound impact on the innovation and development of cities. Based on the research on the spatial distribution of the school and work stages of high-level talent in China, we study the structure and evolution of China’s high-level talent mobility network by using the data on the flow trajectory of talent among cities in China. The results show that: the spatial distribution of talents in the (...) two stages has greater consistency, but there is a change characteristic of “large dispersion, small agglomeration.” Compared with the school stage, the network in the work stage has much more connections; the centrality gap of cities has narrowed. “Core-periphery” structure of two networks is relatively significant and similar. The core layer in the two networks has not changed, but the subcore layer and the subedge layer have undergone changes. In addition, talents mainly flow to core and subcore cities. The space structure of network is more complex in the work stage, and it is expanding to the Guangdong-Hong Kong-Macao Greater Bay Area in southeastern China. (shrink)

本书选取中国美学史上的体系性著作,呈现中国型美学的体系特色,内容是:从先秦到宋代,每一时代选一具有典型性的体系性著作、汉代《诗大序》、六朝刘勰《文心雕龙》、唐代司空图《二十四诗品》、宋代郭熙《林泉高致 》,进行了详细的分析。明清是中国美学的总结时期,选其各艺术门类里最重要的体系性著作进行分析。.

《中西美学与文化精神》从文化精神的角度研究中西美学. 作者从文化范式入手. 在把握中西美学基本精神和对中西美学作宏观整体比较的前提下, 切入到中西美学中 "和谐", "悲剧", "崇高", "荒诞与逍遥", "文与形式", "典型与意境"等基本概念, 以及"创作理论", "灵感理论", "灵感的主体构成" 和 "审美具体方式"等具体问题. 并结合了大量的中西艺术实践, 作了观念的梳理与理论的分析概括, 来寻找横跨不同范式之间的共同规律. 文化精神是一文化中一切时代, 一切思想的总和.

Ben shu xi tong chan shu liao Zhongguo zhe xue de yuan qi, fa zhan he wei lai.quan shu gong fen cheng si ge da bu fen:yuan qi yu chu xing; er, ge ming hua de ding xing; san, xin shi dai de zhuan xiang;si, zou xiang quan qiu hua shi dai de Zhongguo zhe xue.