Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

Background: Dignity, an abstract and complex concept, is an essential part of humanity and an underlying guiding principle in healthcare. Previous literature indicates dignity is compromised in people with dementia (PwD), but those PwD maintain the capacity to live with dignity with appropriate external support. Alzheimer’s disease and related dementias (ADRDs) lead to progressive functional decline and increased vulnerability and dependence, leading to heightened risks of PwD receiving inappropriate or insufficient care that diminishes dignity. Considering the increased disease prevalence and (...) the continuously escalating costs of dementia care, establishing a productive value-based guideline may prevent suffering, maximize dignity, and thus promote quality of life (QoL). Aim: The goal of this project is to identify actionable targets for integrating dignity harmoniously and practically into care planning and management for PwD. Research Design: We conducted a concept analysis using Walker and Avant’s eight-step process. A comprehensive literature search was conducted (PubMed and CINAHL) with the keywords “dignity,” “dementia,” “Alzheimer’s disease,” and “dementia care.” Results: A total of 42 out of 4910 publications were included. The concept of dignity in PwD is operationalized as the promotion of worthiness and the accordance of respect that allows the presence and expression of a person’s sense of self, regardless of physical, mental, or cognitive health. The concept has two subdimensions: absolute dignity which encompasses the inherent self and relative dignity characterized by its dynamic reflective nature. Worthiness and respect are the two main attributes, while autonomy is an underlying component of dignity. Specific antecedents of dignity in PwD are empowerment, non-maleficence, and adaptive environmental scaffolding. As a consequence of facilitating dignity in PwD, QoL may be enhanced. Conclusion: As a foundational and necessary humanistic value, incorporating dignity into dementia care can lead to efficient and effective care that optimizes QoL in PwD throughout their disease progression. (shrink)

Producing content-related gestures has been found to impact students’ learning, whether such gestures are spontaneously generated by the learner in the course of problem-solving, or participants are instructed to pose based on experimenter instructions during problem-solving and word learning. Few studies, however, have investigated the effect of (a) performing instructed gestures while learning concepts or (b) producing gestures without there being an implied connection between the gestures and the concepts being learned. The two studies reported here investigate the impact of (...) instructed hand movements on students’ subsequent understanding of a concept. Students were asked to watch an instructional video—focused on the concept of statistical model—three times. Two experimental groups were given a secondary task to perform while watching the video, which involved moving their hands to mimic the placement and orientation of red rectangular bars overlaid on the video. Students were told that the focus of the study was multitasking, and that the instructed hand movements were unrelated to the material being learned. In the content-match group the placement of the hands reinforced the concept being explained, and in the content-mismatch group it did not. A control group was not asked to perform a secondary task. In both studies, findings indicate that students in the content-match group performed better on the posttest, and showed less variation in performance, than did students in the content-mismatch group, with control students falling in between. Instructed hand movement—even when presented as an unrelated, secondary task—can affect students’ learning of a complex concept. (shrink)

As the capabilities of Artificial Intelligence (AI) have increased over recent years, so have the challenges of how to govern its usage. Consequently, prominent stakeholders across academia, government, industry, and civil society have called for states to devise and deploy principles, innovative policies, and best practices to regulate and oversee these increasingly powerful AI tools. Developing a robust AI governance system requires extensive collective efforts throughout the world. It also raises old questions of politics, democracy, and administration, but with the (...) new challenges posed by AI's growing influence on markets, governing structures, international relations, healthcare, science, and political activism. The Oxford Handbook of AI Governance delineates the scope of these issues and addresses the key questions of AI governance. Across forty-nine chapters, organized in nine major sections, the Handbook covers the theoretical and ethical foundations of AI governance, different frameworks for developing a governance structure for AI, practical perspectives on AI governance in different policy domains, economic analyses of AI governance, and concrete lessons about the impact of AI governance domestically and internationally. Chapter authors come from a wide set of disciplines, areas of study, and cultural backgrounds, providing a global perspective on AI governance. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

We agree with many of the principles proposed by Frost but highlight crucial caveats and report research findings that challenge several assertions made in the target article. We discuss the roles that visual processing, development, and bilingualism play in visual word recognition and reading. These are overlooked in all current models, but are fundamental to any universal model of reading.

Aim: To evaluate health-related quality of life of chronic hepatitis B and hepatitis B virus related cirrhosis patients and analyzed specific differences in all dimensions of HRQoL.Methods: A total of 349 patients met selection criteria were enrolled. The 36-Item Short-Form Health Survey was adopted.Results: Results showed that the physiological HRQoL of the cirrhotic group was significantly lower than that of the non-cirrhotic group, the psychological HRQoL was also lower. HRQoL was significantly negatively correlated with liver stiffness. We further evaluated the (...) risk factors associated with poor HRQoL in HBV-related cirrhosis patients. Results showed that positive HBV DNA viral load and HCC family history were independent factors associated with HRQoL in HBV-related cirrhosis. For better risk stratification of patients, multivariable analyses were conducted to explore the independent factors that affected specific physiological and psychological HRQoL. In specific physiological HRQoL, results show that marital status, positive HBV DNA viral load and antiviral drugs were independent factors associated with physiological HRQoL in cirrhosis patients. In psychological HRQoL, only HCC family history was independent risk factors associated with psychological HRQoL.Conclusion: We found that the impaired HRQoL dimensions of HBV related cirrhosis patients differ between the various subpopulations. According to our results, risk stratification, medical decision making and personalizing interventions could be made. (shrink)

Quantum B‐algebras are partially ordered algebras characterizing the residuated structure of a quantale. Examples arise in algebraic logic, non‐commutative arithmetic, and quantum theory. A quantum B‐algebra with trivial partial order is equivalent to a group. The paper introduces a corresponding analogue of quantale modules. It is proved that every quantum B‐module admits an injective envelope which is a quantale module. The injective envelope is constructed explicitly as a completion, a multi‐poset version of the completion of Dedekind and MacNeille.

At present one of the important tasks of the scholarly world is to reevaluate objectively the teachings of Confucius. The discussions of Confucius during the 1960s made a certain amount of progress, but a number of problems remain that were not truly debated in accord with the policy of "let a hundred schools contend." At the time, the self-appointed authority on theory, Guan Feng, disseminated a series of arbitrary theories that had a very unhealthy influence. The later movement to criticize (...) Confucius which was controlled by the "gang of four" included some themes that expanded upon the theories of Guan Feng and which still act as mental blocks to the reopened debate on Confucius. Thus it is essential that we engage in a thorough review of Guan Feng's criticism of the thought of Confucius and liquidate the remaining effects of ultraleftist thought. The present article suggests a few views of my own in an attempt to undertake a preliminary critique of Guan Feng's theory of what he called the three types of "humaneness" [ren] of the Spring and Autumn era [722-481 B.C.]. (shrink)

Smart grids are rolling out internationally, with the United States nearing completion of a significant USD4-plus-billion federal program funded under the American Recovery and Reinvestment Act. The emergence of smart grids is widespread across developed countries. Multiple approaches to analyzing the benefits of smart grids have emerged. The goals of this white paper are to review these approaches and analyze examples of each to highlight their differences, advantages, and disadvantages. This work was conducted under the auspices of a joint U.S.-China (...) research effort, the Climate Change Working Group Implementation Plan, Smart Grid. We present comparative benefits assessments of smart grid demonstrations in the U.S. and China along with a BA of a pilot project in Europe. In the U.S., we assess projects at two sites: the University of California, Irvine campus, which consists of two distinct demonstrations: Southern California Edison’s Irvine Smart Grid Demonstration Project and the UCI campus itself; and the Navy Yard area in Philadelphia, which has been repurposed as a mixed commercial-industrial, and possibly residential, development. In China, we cover several smart-grid aspects of the Sino-Singapore Tianjin Eco-city and the Shenzhen Bay Technology and Ecology City. In Europe, we look at a BA of a pilot smart grid project in the Malagrotta area west of Rome, Italy, contributed by the Joint Research Centre of the European Commission. The Irvine sub-project BAs use the U.S. Department of Energy Smart Grid Computational Tool, which is built on methods developed by the Electric Power Research Institute. The TEC sub-project BAs apply Smart Grid Multi-Criteria Analysis developed by the State Grid Corporation of China based on the analytic hierarchy process with fuzzy logic. The B-TEC and TNY sub-project BAs are evaluated using new approaches developed by those project teams. JRC has adopted an approach similar to EPRI’s but tailored to the Malagrotta distribution grid. (shrink)

Dong Zhongshu [c. 179-104 B.C.] was China's greatest idealist philosopher of the Western Han dynasty. Since Liberation, a great number of people have written works analyzing and criticizing the philosophical thought of Dong Zhongshu revealing its idealistic and metaphysical nature. This is absolutely essential. But is there nothing at all that we can take from the philosophy of Dong Zhongshu? I believe that this merits further research. In fact, the teleology and metaphysical world view of his idealistic pantheism played a (...) progressive role in the historical circumstances of his times. (shrink)

PURPOSE:To report the localization of a gene causing drusen and macular degeneration in a previously undescribed North American family. METHODS:Genetic mapping studies were performed using linkage analysis in a single family with drusen and atrophic macular degeneration. RESULTS:The clinical manifestations in this family ranged from fine macular drusen in asymptomatic middle-aged individuals to atrophic macular lesions in two children and two elderly patients. We mapped the gene to chromosome 6q14 between markers D6S2258 and D6S1644. CONCLUSIONS:In a family with autosomal dominant (...) drusen and atrophic macular degeneration, the gene maps to a 3.2-cM region on chromosome 6q14. This locus appears to be distinct from, but adjacent to, the loci for cone-rod dystrophy 7 (CORD7) and North Carolina macular dystrophy (MCDR1). Future identification of the gene responsible for the disease in this family will provide a better understanding of macular degeneration. (shrink)

Modern technologies have enabled the development of dynamic game- and simulation-based assessments to measure psychological constructs. This has highlighted their potential for supplementing other assessment modalities, such as self-report. This study describes the development, design, and preliminary validation of a simulation-based assessment methodology to measure psychological resilience—an important construct for multiple life domains. The design was guided by theories of resilience, and principles of evidence-centered design and stealth assessment. The system analyzed log files from a simulated task to derive individual (...) trajectories in response to stressors. Using slope analyses, these trajectories were indicative of four types of responses to stressors: thriving, recovery, surviving, and succumbing. Using Machine Learning, the trajectories were predictive of self-reported resilience with high accuracy, supporting construct validity of the simulation-based assessment. These findings add to the growing evidence supporting the utility of gamified assessment of psychological constructs. Importantly, these findings address theoretical debates about the construct of resilience, adding to its theory, supporting the combination of the “trait” and “process” approaches to its operationalization. (shrink)

Tianyi Zhang offers in this study an innovative philosophical reconstruction of Shihāb al-Dīn al-Suhrawardī's (d. 1191) Illuminationism. Commonly portrayed as either a theosophist or an Avicennian in disguise, Suhrawardīappears here as an original and hardheaded philosopher who adopts mysticism only as a tool of philosophical inquiry. Zhang makes use of Plato's cave allegory to explain Suhrawardī's Illuminationist project. Focusing on three areas-the theory of presential knowledge, the ontological discussion of mental considerations, and Light Metaphysics-Zhang convincingly reveals the (...) Nominalist and Existential nature of Illuminationism, and thereby proposes a new way of understanding how Suhrawardī's central philosophical ideas cohere. (shrink)

A P-point ultrafilter over \(\omega \) is called an interval P-point if for every function from \(\omega \) to \(\omega \) there exists a set _A_ in this ultrafilter such that the restriction of the function to _A_ is either a constant function or an interval-to-one function. In this paper we prove the following results. (1) Interval P-points are not isomorphism invariant under \(\textsf{CH}\) or \(\textsf{MA}\). (2) We identify a cardinal invariant \(\textbf{non}^{**}({\mathcal {I}}_{\tiny {\hbox {int}}})\) such that every filter base (...) of size less than continuum can be extended to an interval P-point if and only if \(\textbf{non}^{**}({\mathcal {I}}_{\tiny {\hbox {int}}})={\mathfrak {c}}\). (3) We prove the generic existence of slow/rapid non-interval P-points and slow/rapid interval P-points which are neither quasi-selective nor weakly Ramsey under the assumption \({\mathfrak {d}}={\mathfrak {c}}\) or \(\textbf{cov}({\mathcal {B}})={\mathfrak {c}}\). (shrink)

With the rapid development of the Internet information age, social networks, mobile Internet, and e-commerce have expanded the scope of Internet applications. The “big data” era is a challenge and chance for companies and has a great impact on social economy, politics, culture, and people’s lives. An accurate marketing system is developed based on J2EE, and the architecture is selected from the user layer, business logic layer, and data layer and the B/S3 layer application, including three layers of crip-dm and (...) semma. And, other process methods are used. Data-mining-based marketing system information solutions consist of several parts, such as requirement analysis, design, implementation, and testing. This paper introduces data mining technology to the marketing business based on the practical use and design IT solutions for precision marketing, attribute selection tools, attribute analysis tools, modeling prediction tools, and others. This paper introduces a precision marketing system based on data mining technology. The system passes the actual test and the deployment and the operation of this system are confirmed. The system, which can improve marketing activity, is tested, and the development and operation of this system markedly increase the company’s earnings. (shrink)

The purpose of this study was to examine how culture shapes creativity by reviewing empirical findings across diverse studies. The impact of culture on creativity is typically manifested in three ways: (a) people from different cultures or settings have distinct implicit and/or explicit conceptions of creativity; (b) individuals from different cultures, particularly those from individualist and collectivist cultures, show differences in preferred creative processes and creative processing modes (e.g., usefulness seems more important than novelty in the East, whereas novelty seems (...) equally important as usefulness, if not more so, in the West) when they are engaged in creative endeavors; (c) creativity may be assessed using different measures based on culture-related contents or materials, and findings are accurate only when culturally appropriate or culturally fair measures are used. Potential implications and future directions are also proposed. (shrink)

The creative thinking and ability of top management team members is important in coping with rapid changes in the external environment and improving the competitive advantage of an organization. This research focuses on the CEO–TMT interface to explain how CEOs influence TMT characteristics, which in turn affects TMT outcomes. Based on social learning theory, this study examines the associations among CEO ethical leadership, TMT cohesion and TMT creativity in a Chinese context using a total of 91 top management teams. To (...) verify the reliability and validity of the constructs, a series of confirmatory factor analyses (CFAs) were run. The results showed that the hypothesized model captured distinct constructs and fits the data well. Multistep regression method was used to test hypotheses. The results indicated that (a) CEO ethical leadership has a positive effect on TMT creativity; (b) TMT cohesion plays a mediating role in the relationship between CEO ethical leadership and TMT creativity; and (c) power distance plays a moderating role in the relationship between CEO ethical leadership and TMT creativity. The greater the power distance, the weaker the positive relationship between CEO ethical leadership and TMT creativity. This study demonstrates the value of CEO ethical leadership and advocates the importance of establishing team cohesion and building a psychologically safe environment to motivate top managers within an organization to share information and knowledge to improve creativity. (shrink)

AimsAlcohol consumption could lead to a series of health problems and social issues. In the current study, we investigated the resting-state functional brain networks of healthy volunteers before and after drinking through graph-theory analysis, aiming to ascertain the effects of acute alcohol intake on topology and information processing mode of the functional brain networks.Materials and methodsThirty-three healthy volunteers were enrolled in this experiment. Each volunteer accepted alcohol breathalyzer tests followed by resting-state magnetic resonance imaging at three time points: before drinking, (...) 0.5 h after drinking, and 1 h after drinking. The data obtained were grouped based on scanning time into control group, 0.5-h group and 1-h group, and post-drinking data were regrouped according to breath alcohol concentration (BrAC) into relative low BrAC group (A group; 0.5-h data, n = 17; 1-h data, n = 16) and relative high BrAC group (B group; 0.5-h data, n = 16; 1-h data, n = 17). The graph-theory approach was adopted to construct whole-brain functional networks and identify the differences of network topological properties among all the groups.ResultsThe network topology of most groups was altered after drinking, with the B group presenting the most alterations. For global network measures, B group exhibited increased global efficiency, Synchronization, and decreased local efficiency, clustering coefficient, normalized clustering coefficient, characteristic path length, normalized characteristic path length, as compared to control group. Regarding nodal network measures, nodal clustering coefficient and nodal local efficiency of some nodes were lower in B group than control group. These changes suggested that the network integration ability and synchrony improved, while the segregation ability diminished.ConclusionThis study revealed the effects of acute alcohol intake on the topology and information processing mode of resting-state functional brain networks, providing new perceptions and insights into the effects of alcohol on the brain. (shrink)

The main goal of this paper is to investigate the relation between the meaning of a sentence and its truth conditions. We report on a comprehension experiment on counterfactual conditionals, based on a context in which a light is controlled by two switches. Our main finding is that the truth-conditionally equivalent clauses (i) "switch A or switch B is down" and (ii) "switch A and switch B are not both up" make different semantic contributions when embedded in a conditional antecedent. (...) Assuming compositionality, this means that (i) and (ii) differ in meaning, which implies that the meaning of a sentential clause cannot be identified with its truth conditions. We show that our data have a clear explanation in inquisitive semantics: in a conditional antecedent, (i) introduces two distinct assumptions, while (ii) introduces only one. Independently of the complications stemming from disjunctive antecedents, our results also challenge analyses of counterfactuals in terms of minimal change from the actual state of affairs: we show that such analyses cannot account for our findings, regardless of what changes are considered minimal. (shrink)

It will be proved that the Shoenfield cupping conjecture holds in R/M, the quotient of the recursively enumerable degrees modulo the cappable r.e. degrees. Namely, for any [a], [b] ∈ R/M such that [0] $\prec$ [b] $\prec$ [a] there exists [c] ∈ R/M such that [c] $\prec$ [a] and [a] = [b] ∨ [c].

This book is both a good introduction to Chinese philosophy and an invaluable reference tool for sinologists. Comments by important Chinese thinkers are arranged around sixty-four key concepts to illustrate their meaning and use through twenty-five centuries of Chinese philosophy. This unique guide was prepared by Zhang Dainian, one of China's most famous living philosophers. Zhang reaches back to include concepts in use before the oracle bones (c. 1350-1100 B.C.)-what could be called a philosophical "prehistory." But the focus (...) of the work is those concepts that gained currency in classical Chinese philosophy, especially those whose meanings are deeper and more difficult to grasp. Translated and edited by Edmund Ryden in consultation with the author, the book also includes helpful introductory commentary by Ryden for each section. (shrink)

We investigate the set (ω) of partitions of the natural numbers ordered by ≤* where A ≤* B if by gluing finitely many blocks of A we can get a partition coarser than B. In particular, we determine the values of a number of cardinals which are naturally associated with the structure ((ω),≥*), in terms of classical cardinal invariants of the continuum.

Spirtes, Glymour and Scheines [Causation, Prediction, and Search Springer] described a pointwise consistent estimator of the Markov equivalence class of any causal structure that can be represented by a directed acyclic graph for any parametric family with a uniformly consistent test of conditional independence, under the Causal Markov and Causal Faithfulness assumptions. Robins et al. [Biometrika 90 491–515], however, proved that there are no uniformly consistent estimators of Markov equivalence classes of causal structures under those assumptions. Subsequently, Kalisch and B¨uhlmann (...) [J. Mach. Learn. Res. 8 613–636] described a uniformly consistent estimator of the Markov equivalence class of a linear Gaussian causal structure under the Causal Markov and Strong Causal Faithfulness assumptions. However, the Strong Faithfulness assumption may be false with high probability in many domains. We describe a uniformly consistent estimator of both the Markov equivalence class of a linear Gaussian causal structure and the identifiable structural coefficients in the Markov equivalence class under the Causal Markov assumption and the considerably weaker k-Triangle-Faithfulness assumption. (shrink)