Background Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, (...) 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (shrink)

Anxious major depressive disorder is a common subtype of major depressive disorder; however, its unique neural mechanism is not well-understood currently. Using multimodal MRI data, this study examined common and specific alterations of amygdala subregions between patients with and without anxiety. No alterations were observed in the gray matter volume or intra-region functional integration in either patient group. Compared with the controls, both patient groups showed decreased functional connectivity between the left superficial amygdala and the left putamen, and between the (...) right superficial amygdala and the bilateral anterior cingulate cortex and medial orbitofrontal cortex, while only patients with anxiety exhibited decreased activity in the bilateral laterobasal and superficial amygdala. Moreover, the decreased activity correlated negatively with the Hamilton depression scale scores in the patients with anxiety. These findings provided insights into the pathophysiologic processes of anxious major depressive disorder and may help to develop new and effective treatment programs. (shrink)

本书包括:系统自然观、演进自然观、生态自然观、科学技术观、历史科学技术观、社会科学技术观等.

Ben shu zhu yao lun shu ru,Mo liang jia fa zheng si xiang,Bing fu lu xian dai xing fa dui bi fo jiao jie lü lun wen yi pian.Xie zuo te se yao fen wei er:yi,Zai yan jiu fang fa shang,Cai qu bi jiao fa xue yan jiu jin lu,Jian shi chuan tong si xiang yu xian dai jia zhi ti xi xian zhuan gong gou zhi ke neng.Shi gu wen zhang lun shu zhong xin bu zai chan shu ru,Mo (...) nei sheng dao de gong fu lun mian xiang,Er geng ce zhong qi yu xian dai fa li nian ji xian xing fa zhi du zhi dui bi fen xi.Er,Zai lun shu nei rong fang mian,Chuan tong yan jiu zhu yao tong guo jia zhi xi tong nei,Ji ken ding chuan tong wen hua zhi zhuan ye yan jiu zhe li chang chu fa,Zhang xian zhong guo zhe xue shi dai he li xing. (shrink)

Ben shu shi yi ben yan jiu ke xue li shi de shu ji. zhu yao nei rong bao kuo: Xi fang wen hua chuan tong he jin dai ke xue de dan sheng, Wen yi fu xing he Yidali ke xue zhong xin de xing qi, Xin jiao jing shen he Yingguo ke xue zhong xin shi dai de dao lai deng.

Ben shu dui Han dai Huang lao zhi dao zuo le quan mian chan shu, she ji Huang lao dao jia si xiang de yan bian yu zhuan hua, Huang lao yang sheng zhi li deng, jie xi le dang shi zhong yao dian ji suo ti xian de huang lao xue shuo.

Ben shu li zu yu si xiang zheng zhi jiao yu de xue ke shi jiao, ba xian Qin ru jia jiao hua si xiang shi wei yi ge guo cheng he xi tong, jiang yi ge xiang dui wan zheng de, xi tong de xian Qin ru jia "jiao hua" si xiang li ti shi de cheng xian chu lai; bing li zu yu dang dai she hui de xian dai xing jiao hua kun jing wen ti, ji ji (...) cong xian Qin ru jia jiao hua si xiang zhe yi "chuan tong" zhong xun qiu jie jue zhi dao, li tu chan fa xian Qin ru jia jiao hua si xiang de dang dai zhuan hua wen ti. (shrink)

Ru jia jing shen dui yu xian dang dai de Zhongguo ren lai shuo ying xiang shi ju da de, ru jia jing shen yi shen tou dao Zhongguo ren de yi yan yi xing zhong, shi ji shang cheng wei Zhonghua min zu nei ju de jing shen niu dai. ben shu zuo zhe yi qing song, you mei de bi diao xiang guang da du zhe xi tong jie shao liao ru jia jing shen de ji ben nei (...) han, li shi yan bian. ben shu shi guang da du zhe xue xi Zhongguo chuan tong wen hua de tong su du wu. (shrink)

Ben shu jie shao le gong zi zhen, wei yuan, yan fu, kang you wei, tan si tong, liang qi chao, chen tian hua, zhang bing lin deng wan qing si xiang jia de zhe xue si xiang.

v. 1 - 2. Yan Yuan wen ji -- v. 3 - 4. Li Gong wen ji -- v. 5. Yan shi xue ji. Yan Xizhai zhe xue si xiang shu -- v. 6. Yan Xizhai he Du Wei zhe xue si xiang ji jiao yu si xiang de bi jiao yan jiu. Yan Li xue pai -- v. 7. Yan Yuan ping zhuan. Yan Yuan yu Li Gong -- v. 8. Li Gong ping zhuan. Li Gong si xiang yan (...) jiu -- v. 9 - 10. Yan Li xue pai yan jiu wen xuan. (shrink)

Joint attention has been extensively studied in the developmental literature because of overwhelming evidence that the ability to socially coordinate visual attention to an object is essential to healthy developmental outcomes, including language learning. The goal of this study was to understand the complex system of sensory-motor behaviors that may underlie the establishment of joint attention between parents and toddlers. In an experimental task, parents and toddlers played together with multiple toys. We objectively measured joint attention—and the sensory-motor behaviors that (...) underlie it—using a dual head-mounted eye-tracking system and frame-by-frame coding of manual actions. By tracking the momentary visual fixations and hand actions of each participant, we precisely determined just how often they fixated on the same object at the same time, the visual behaviors that preceded joint attention and manual behaviors that preceded and co-occurred with joint attention. We found that multiple sequential sensory-motor patterns lead to joint attention. In addition, there are developmental changes in this multi-pathway system evidenced as variations in strength among multiple routes. We propose that coordinated visual attention between parents and toddlers is primarily a sensory-motor behavior. Skill in achieving coordinated visual attention in social settings—like skills in other sensory-motor domains—emerges from multiple pathways to the same functional end. (shrink)

Culture is surely important in human learning. But the relation between culture and psychological mechanism needs clarification in three areas: (1) All learning takes place in real time and through real-time mechanisms; (2) Social correlations are just a kind of learnable correlations; and (3) The proper frame of reference for cognitive theories is the perspective of the learner.

Several functional magnetic resonance imaging studies have demonstrated abnormalities in static intra- and interhemispheric functional connectivity among diverse brain regions in patients with major depressive disorder. However, the dynamic changes in intra- and interhemispheric functional connectivity patterns in patients with MDD remain unclear. Fifty-eight first-episode, drug-naive patients with MDD and 48 age-, sex-, and education level-matched healthy controls underwent resting-state fMRI. Whole-brain functional connectivity, analyzed using the functional connectivity density approach, was decomposed into ipsilateral and contralateral functional connectivity. We computed (...) the intra- and interhemispheric dynamic FCD using a sliding window analysis to capture the dynamic patterns of functional connectivity. The temporal variability in functional connectivity was quantified as the variance of the dFCD over time. In addition, intra- and interhemispheric static FCD patterns were calculated. Associations between the dFCD variance and sFCD in abnormal brain regions and the severity of depressive symptoms were analyzed. Compared to HCs, patients with MDD showed lower interhemispheric dFCD variability in the inferior/middle frontal gyrus and decreased sFCD in the medial prefrontal cortex/anterior cingulate cortex and posterior cingulate cortex/precuneus in both intra- and interhemispheric comparisons. No significant correlations were found between any abnormal dFCD variance or sFCD at the intra- and interhemispheric levels and the severity of depressive symptoms. Our results suggest intra- and interhemispheric functional connectivity alterations in the dorsolateral prefrontal cortex and default mode network regions involved in cognition, execution and emotion. Furthermore, our study emphasizes the essential role of altered interhemispheric communication dynamics in the DLPFC in patients with MDD. These findings contribute to our understanding of the pathophysiology of MDD. (shrink)

Previous research shows that people can use the co-occurrence of words and objects in ambiguous situations (i.e., containing multiple words and objects) to learn word meanings during a brief passive training period (Yu & Smith, 2007). However, learners in the world are not completely passive but can affect how their environment is structured by moving their heads, eyes, and even objects. These actions can indicate attention to a language teacher, who may then be more likely to name the attended objects. (...) Using a novel active learning paradigm in which learners choose which four objects they would like to see named on each successive trial, this study asks whether active learning is superior to passive learning in a cross-situational word learning context. Finding that learners perform better in active learning, we investigate the strategies and discover that most learners use immediate repetition to disambiguate pairings. Unexpectedly, we find that learners who repeat only one pair per trial—an easy way to infer this pair—perform worse than those who repeat multiple pairs per trial. Using a working memory extension to an associative model of word learning with uncertainty and familiarity biases, we investigate individual differences that correlate with these assorted strategies. (shrink)

Cross-situational word learning, like any statistical learning problem, involves tracking the regularities in the environment. However, the information that learners pick up from these regularities is dependent on their learning mechanism. This article investigates the role of one type of mechanism in statistical word learning: competition. Competitive mechanisms would allow learners to find the signal in noisy input and would help to explain the speed with which learners succeed in statistical learning tasks. Because cross-situational word learning provides information at multiple (...) scales—both within and across trials/situations—learners could implement competition at either or both of these scales. A series of four experiments demonstrate that cross-situational learning involves competition at both levels of scale, and that these mechanisms interact to support rapid learning. The impact of both of these mechanisms is considered from the perspective of a process-level understanding of cross-situational learning. (shrink)

Forensic evidence often involves an evaluation of whether two impressions were made by the same source, such as whether a fingerprint from a crime scene has detail in agreement with an impression taken from a suspect. Human experts currently outperform computer-based comparison systems, but the strength of the evidence exemplified by the observed detail in agreement must be evaluated against the possibility that some other individual may have created the crime scene impression. Therefore, the strongest evidence comes from features in (...) agreement that are also not shared with other impressions from other individuals. We characterize the nature of human expertise by applying two extant metrics to the images used in a fingerprint recognition task and use eye gaze data from experts to both tune and validate the models. The Attention via Information Maximization model quantifies the rarity of regions in the fingerprints to determine diagnosticity for purposes of excluding alternative sources. The CoVar model captures relationships between low-level features, mimicking properties of the early visual system. Both models produced classification and generalization performance in the 75%–80% range when classifying where experts tend to look. A validation study using regions identified by the AIM model as diagnostic demonstrates that human experts perform better when given regions of high diagnosticity. The computational nature of the metrics may help guard against wrongful convictions, as well as provide a quantitative measure of the strength of evidence in casework. (shrink)