The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

Of the many proposals for inferring genetic regulatory structure from microarray measurements of mRNA transcript hybridization, several aim to estimate regulatory structure from the associations of gene expression levels measured in repeated samples. The repeated samples may be from a single experimental condition, or from several distinct experimental conditions; they may be “equilibrium” measurements or time series; the associations may be estimated by correlation coefficients or by conditional frequencies (for discretized measurements) or by some other statistic. This paper describes two (...) elementary statistical difficulties for all such procedures, no matter whether based on Bayesian updating, conditional independence testing, or other machine learning procedures such as simulated annealing or neural net pruning. One difficulty obtains if large numbers of cells are aggregated in a measurement of expression levels from a common population of cells; the other obtains if small numbers of cells are aggregated or if samples are separately aggregated over different populations of cells. (shrink)

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)

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)

Motivation: One approach to inferring genetic regulatory structure from microarray measurements of mRNA transcript hybridization is to estimate the associations of gene expression levels measured in repeated samples. The associations may be estimated by correlation coefficients or by conditional frequencies or by some other statistic. Although these procedures have been successfully applied to other areas, their validity when applied to microarray measurements has yet to be tested. Results: This paper describes an elementary statistical difficulty for all such procedures, no matter (...) whether based on Bayesian updating, conditional independence testing, or other machine learning procedures such as simulated annealing or neural net pruning. The difficulty obtains if a number of cells from a common population are aggregated in a measurement of expression levels. Although there are special cases where the conditional associations are preserved under aggregation, in general inference of genetic regulatory structure based on conditional association is unwarranted. Contact: tchu@ andrew.cmu.edu. (shrink)

Tianjaou Chu, David Danks, and Clark Glymour. Data Driven Methods for Nonlinear Granger Causality: Climate Teleconnection Mechanisms.

We describe a unification of old and recent ideas for formulating graphical models to explain time series data, including Granger causality, semi-automated search procedures for graphical causal models, modeling of contemporaneous influences in times series, and heuristic generalized additive model corrections to linear models. We illustrate the procedures by finding a structure of exogenous variables and mediating variables among time series of remote geospatial indices of ocean surface temperatures and pressures. The analysis agrees with known exogenous drivers of the indices, (...) not assumed in the analysis. Automated search applied to the residuals after regressing each series on its lags and the lags of its Granger causes yields a graphical model of “comtemporaneous” causal relations identical with the qualitative graphical relations from the time series. A similar analysis produces reasonable results when applied to candidate climate indices obtained by a clustering method from sea surface temperature and sea level pressure data. (shrink)

Based on Vallerand’s dualistic model of passion, this study theorizes and empirically examines the temporal dynamics of two types of entrepreneurial passion in female entrepreneurs, harmonious entrepreneurial passion and obsessive entrepreneurial passion, and examines the mechanisms by which entrepreneurial effort0 and fear of failure influence the temporal dynamics of entrepreneurial passion. Using data collected from a three-wave, lagged survey of female entrepreneurs, we employed Mplus to build a latent growth model for entrepreneurial passion and built a cross-lag model of the (...) relationship between entrepreneurial passion, entrepreneurial effort, and fear of failure. We found that female entrepreneurs’ HmEP and ObEP present different temporal dynamics. Furthermore, the temporal dynamics of HmEP are achieved through changes in entrepreneurial effort, whereas the temporal dynamics of ObEP are achieved through changes in current entrepreneurial effort and fear of failure in the next stage. Therefore, due to traditional gender stereotypes and varying motivations to engage in entrepreneurship, the two entrepreneurial passions have different dynamic evolution processes. Our results underscore the importance of effort and fear of failure in stimulating the dynamics of female entrepreneurial passion. (shrink)

This study examines the effectiveness of the inoculation strategy in countering vaccine-related misinformation among Hong Kong college students. A three-phase between-subject experiment was conducted to compare the persuasive effects of inoculation messages, supportive messages, and no message control. The results show that inoculation messages were superior to supportive messages at generating resistance to misinformation, as evidenced by more positive vaccine attitudes and stronger vaccine intention. Notably, while we expected the inoculation condition would produce more resistance than the control condition, there (...) was little evidence in favor of this prediction. Attitudinal threat and counterarguing moderated the experimental effects; issue involvement and political trust were found to directly predict vaccine attitudes and intention. The findings suggest that future interventions focus on developing preventive mechanisms to counter misinformation and spreading inoculation over the issue is an effective strategy to generate resistance to misinformation. Interventions should be cautious about using health advocacy initiated by governments among populations with low political trust. (shrink)

In this paper, a discrete-time dynamic duopoly model, with nonlinear demand and cost functions, is established. The properties of existence and local stability of equilibrium points have been verified and analyzed. The stability conditions are also given with the help of the Jury criterion. With changing of the values of parameters, the system shows some new and interesting phenomena in terms to stability and multistability, such as V-shaped stable structures and different shape basins of attraction of coexisting attractors. The eye-shaped (...) structures appear where the period-doubling and period-halving bifurcations occur. Finally, by utilizing critical curves, the changes in the topological structure of basin of attraction and the reason of “holes” formation are analyzed. As a result, the generation of global bifurcation, such as contact bifurcation or final bifurcation, is usually accompanied by the contact of critical curves and boundary. (shrink)