The evaluation index system of ecological security of marine ranching is based on the assumption that there is independence among evaluation indexes in the existing studies, which ignores the complex interactive paths of marine ranching as an artificial ecosystem. In this study, the MRES evaluation network model that includes interdependent relationships is established based on the Driver-Pressure-State-Impact-Response model and the analytic network process method. Then, the probabilistic linguistic term sets and analytic network process methods are used to calculate the weights (...) of the evaluation indexes of MRES. The overall evaluation value and the contribution rate of clusters are consequently defined and analyzed to reflect the performance of MRES. Finally, a case study is carried out for evaluating the MRES of marine ranches in Rongcheng by means of the proposed method. The conclusions are summarized as follows: The weights of clusters are ranked as Responses > Impact > Driver > State > Pressure, and “scientific management of fishery resources” is the most important index; the MRES performance of marine ranches in the city of Rongcheng is at the medium security grade on the whole, and all 11 samples are driven by the response. (shrink)

Since the 1980s, psychoanalysis and psychotherapy have attracted great interest in Chinese society, and in parallel, the psychotherapist as a character has emerged in Chinese literature. Through four novels by three Chinese authors, namely, Xu Xiaobin 徐小斌, Ke Yunlu 柯云路, and Bi Shumin 毕淑敏, this article studies the evolution of the image of the psychotherapist in contemporary Chinese literature, which reflects the reception of psychoanalysis as well as the development of psychotherapy in China. In Xu Xiaobin’s novel, two psychology students (...) attempt to cure a psychotic patient through “transference therapy” based on a complete misunderstanding of the notion; Ke Yunlu features a “life counselor” who, like typical good counselors in Chinese classical novels, simply gives advice without caring about the patients’ needs and desires; and the two novels by Bi Shumin show a significant change in the writer’s understanding of the profession and therapeutic methods, as well as the current, unregulated situation of psychotherapy in China. (shrink)

This article points out, descriptive moral psychology of human behavior patterns in the handling, in fact, from the outset exceed the boundaries of philosophy, and Cole tried to resort to ethics Fort formalism in order to avoid this problem in practice, can not be established. • Henry Rachael is further motivation for ethical behavior and the psychological concept of Cole Castle together. Although this is certainly an important contribution to the Fort Cole, but Cole Fort critical reflection on the lack (...) of methodology adopted only; secondly that the ideology behind their psychological factors; finally made ​​sense to remedy in the treatment program: to give up on life and psychological describe their condition or results of work. Authors propose a new proposal of psychology, first identified the relationship between psychologists and their research object, this object is, as the subject of people; secondly, from the possibility of speech. Description, either by himself or a third person described in the description, will be replaced by speech interaction. Authors proposed the concept of an interactive framework of doctrine, in which Cole and Rachael • Fort Henry's theory of language games can get a different position. This article attempts to demonstrate that the descriptive psychology, in its treatment of ethical problems, seems to have transgressed the boundary line against philosophy. This problematic situation cannot be circumvented by resorting to an ethical formalism-as L. Kohlberg does in his research program. Rachael M. Henry pushes one step forward to tie the psychodynamic aspect of moral behavior with Kohlberg's concept. The present author, all in affirming the important contribution of Kohlberg to psychology, indicates the insufficiency of a mere reflection of methods in Kohlberg's works. Then he dissects the ideologemes behind Kohlberg's psychology. At last he suggests a therapeutic proposal: the demand for describing psychic life, its conditions or effects, shall be dropped. The author proposes instead a program of new psychology that derives first from the relation of psychologist to his object, the human as subject; and second, from the possibilities of speech in communicative interaction. Description, whether made by oneself or by a third person, shall be substituted by speech interactions. These interactions are considered as successful when the partners in a discussion declare themselves to be understood. Within the framework of this interactionist concept, Kohlberg's and Rachael M. Henry 's theories could assume the status of various language-games. (shrink)

Thinking, the process of considering or reasoning about something, is one of the most distinctive qualities that set humans apart from other species. Philosophers around the world, such as Socrates...

While cochlear implantation has benefitted many patients with single-sided deafness (SSD), there is great variability in cochlear implant (CI) outcomes and binaural performance remains poorer than that of normal-hearing (NH) listeners. Differences in sound quality across ears – temporal fine structure (TFS) information with acoustic hearing versus coarse spectro-temporal envelope information with electric hearing – may limit integration of acoustic and electric patterns. Binaural performance may also be limited by inter-aural mismatch between the acoustic input frequency and the place of (...) stimulation in the cochlea. SSD CI patients must learn to accommodate these differences between acoustic and electric stimulation to maximize binaural performance. It is possible that training may increase and/or accelerate accommodation and further improve binaural performance. In this study, we evaluated lateralization training in NH subjects listening to broad simulations of SSD CI signal processing. A 16-channel vocoder was used to simulate the coarse spectro-temporal cues available with electric hearing; the degree of inter-aural mismatch was varied by adjusting the simulated insertion depth (SID) to be 25 mm (SID25), 22 mm (SID22), and 19 mm (SID19) from the base of the cochlea. Lateralization was measured using headphones and head-related transfer functions (HRTFs). Baseline lateralization was measured for unprocessed speech (UN) delivered to the left ear to simulate SSD and for binaural performance with the acoustic ear combined with the 16-channel vocoders (UN+SID25, UN+SID22, and UN+SID19). After completing baseline measurements, subjects completed 6 lateralization training exercises with the UN+SID22 condition, after which performance was re-measured for all baseline conditions. Post-training performance was significantly better than baseline for all conditions (p<0.05 in all cases), with no significant difference in training benefits among conditions. Given that there was no significant difference between the SSD and the SSD CI conditions before or after training, the results suggest that NH listeners were unable to integrate TFS and coarse spectro-temporal cues across ears for lateralization, and that inter-aural mismatch played a secondary role at best. While lateralization training may benefit SSD CI patients, the training may largely improve spectral analysis with the acoustic ear alone, rather than improve integration of acoustic and electric hearing. (shrink)

Recent advances in mobile electroencephalogram (EEG) systems, featuring non-prep dry electrodes and wireless telemetry, have urged the needs of mobile brain-computer interfaces (BCIs) for applications in our daily life. Since the brain may behave differently while people are actively situated in ecologically-valid environments versus highly-controlled laboratory environments, it remains unclear how well the current laboratory-oriented BCI demonstrations can be translated into operational BCIs for users with naturalistic movements. Understanding inherent links between natural human behaviors and brain activities is the key (...) to ensuring the applicability and stability of mobile BCIs. This study aims to assess the quality of steady-state visual-evoked potentials (SSVEPs), which is one of promising channels for functioning BCI systems, recorded using a mobile EEG system under challenging recording conditions, e.g., walking. To systemati-cally explore the effects of walking locomotion on the SSVEPs, this study instructed subjects to stand or walk on a treadmill running at speeds of 1, 2, and 3 mile (s) per hour (MPH) while con-currently perceiving visual flickers (11 and 12 Hz). Empirical results of this study showed that the SSVEP amplitude tended to deteriorate when subjects switched from standing to walking. Such SSVEP suppression could be attributed to the walking locomotion, leading to distinctly deteriorated SSVEP detectability from standing (84.87±13.55%) to walking (1 MPH: 83.03±13.24%, 2 MPH: 79.47±13.53%, and 3 MPH: 75.26±17.89%). These findings not only demonstrated the applicability and limitations of SSVEPs recorded from freely behaving humans in realistic environments, but also provide useful methods and techniques for boosting the translation of the BCI technology from laboratory demonstrations to practical applications. (shrink)

Hydromechanical continuously variable transmission is capable of bearing large torque and has wide transmission range, which is suitable for high-power tractors. Dynamic characteristics could influence the tractor life, especially in a high-power tractor. Wet clutch is the crucial component in the HMCVT, which could smooth and soft power transmission. Therefore, it is important to study the dynamic characteristics and implement the wet clutch test of HMCVT. In this paper, AMESim is used to establish virtual models of gearbox, pump-controlled hydraulic motor (...) system, and shifting hydraulic system. Then, a simulation study of tractor operation under working condition is carried out. The internal and external meshing forces of the planetary row are analyzed. Finally, the wet clutch engagement process of HMCVT in the high-power tractor is tested to verify the oil pressure. The simulation results show that the values of internal and external meshing force become larger as the throttle opening increases. At the moment of shifting change, the meshing forces of the planetary gear have great impact. The clutch test shows that the trend of the oil filling curve obtained from the bench test is similar to that obtained from the theoretical curve, which verifies the simulation results. (shrink)

Concurrent working memory task reduces available attentional control resources to perform the flanker task. However, controversy exists as to whether concurrent WM task increases or decreases flanker-related N2 amplitude. In a flanker task experiment, individuals were confronted with a low, middle, or high WM load task, while electroencephalography data were recorded. The ERP results showed a larger flanker-related N2 amplitude while completing a middle or high WM load task compared to a low one. However, completing an additional high WM load (...) task could not increase flanker-related N2 amplitude versus completing an additional middle WM load task. In sum, these results suggest that WM load can impair top-down cognitive control processes, thereby hampering flanker task performance. Importantly, the present study supports the account of flanker-related N2 processes linked to top-down attentional control resource allocation, but challenges the account of flanker-related N2 reflecting response conflict processes. (shrink)

How physicians can get better ratings and more page views in online healthcare communities is an important issue. Based on 38,457 physicians' profiles from a popular online healthcare community in China, we used Latent Dirichlet Allocation model, which is a common topic model, to analyze the non-English text to obtain more doctor's latent characteristics. We found five of the most frequently mentioned topics. In addition to the first topic, “research ability,” “foreign experience,” “committee position,” and “clinical experience” were included as (...) unstructured descriptions in the doctor's profile. Inferences about physician ratings and page views could be improved if these themes were set as characteristics of physicians. Specifically, in our findings, Physicians' mentions of their “research ability” and “foreign experience” had a significant positive impact on physician ratings. Surprisingly, physicians mentioning more “clinical experience” had a significant negative impact on physician ratings. Moreover, while descriptions about “foreign experience” and “committee position” had a significant positive impact on page views, physician mentions of “research ability” had a significant negative impact on page views. These results provide new insights into the ways in which online healthcare community managers or physicians create their personal online profiles. (shrink)

For linear discrete-time systems with randomly variable input trail length, a proportional- type iterative learning control law is proposed. To tackle the randomly variable input trail length, a modified control input at the desirable trail length is introduced in the proposed ILC law. Under the assumption that the initial state fluctuates around the desired initial state with zero mean, the designed ILC scheme can drive the ILC tracking errors to zero at the desirable trail length in expectation sense. The designed (...) ILC algorithm allows the trail length of control input which is different from system state and output at a specific iteration. In addition, the identical initial condition widely used in conventional ILC design is also mitigated. An example manifests the validity of the proposed ILC algorithm. (shrink)

Breaking with discriminatory views and segregated education for children with disabilities, regions often referred to as Confucian Heritage Regions (CHRs) have been moving towards inclusive education. Although some of these regions have been at the centre of attention in global education recently, there is a lack of research and information about how they ‘do’ inclusive education. Considering that reinforcing legislative foundations is of foremost importance for its fulfillment, this study examines legislation on the education of children with disabilities in four (...) neighbouring CHRs: the Chinese Mainland, Japan, South Korea and China's Taiwan. The core principles that frame such legislation were analyzed and cross-compared. The findings show that despite the common Confucian heritage that is attributed to them systematically in studies of inclusive education – which is often said to influence the way disability is perceived and dealt with – the four Regions treat inclusion differently in terms of legislation. While some CHRs are clearly influenced by e.g. the USA, others are trying to design a specific perspective on inclusive education. The authors argue that the complex example of these CHRs can serve as an important template for studies on both inclusive and comparative education. The article also calls for the careful treatment of inclusive education beyond an essentialist and somewhat simplistic perspective that could reduce certain regions to a monolith. (shrink)

Improving the coordination between technological innovation in high-tech industries and regional economic development is an important measure for all provinces to implement the innovation-driven development strategy. Based on the analysis of the mechanism of high-tech industrial technological innovation and regional economic development, this paper constructs the measurement index system of high-tech industrial technological innovation and regional economic development, and the chain network DEA model, entropy weight method, coupling coordination model, and exploratory spatial data analysis technology are comprehensively used to empirically (...) analyze the technological innovation efficiency of high-tech industries, regional economic development level, and the coupling coordination relationship between them and the spatiotemporal evolution trend in 24 provinces of China from 2009 to 2018. The results show that there are significant differences in the average level of technological innovation efficiency of high-tech industry in each stage, which is the most prominent in the technology research and development stage, followed by the industrialization stage, and finally in the technology transformation stage. The degree of coupling and coordination between high-tech industrial technological innovation and regional economic development is increasing year by year, which is in the adaptation stage of high-tech industrial technological innovation and regional economic development. From the perspective of spatial pattern, there is a positive spatial autocorrelation between the coupling coordination degree of high-tech industrial technological innovation and regional economic development. The number of provinces with low coupling coordination degree is much larger than that with high coupling coordination degree, showing a serious imbalance of regional heterogeneity and forming two spatial aggregation areas of “high-high” diffusion effect and “low-low” low-speed growth. (shrink)

ObjectiveTo explore the relationships between dispositional mindfulness and their post-traumatic stress symptoms of emergency nurses, and the mediating effects of coping styles and emotional exhaustion.MethodsA cross-sectional survey study was conducted to collect data on DM, coping styles, EE, and PTSS among 571 emergency nurses from 20 hospitals in Chongqing, China. Correlation and structural equation models were used to evaluate the relationship among variables.ResultsEmergency nurses with lower dispositional mindfulness, higher emotional exhaustion and preference for negative coping revealed more PTSS. The effect (...) of NC on PTSS was partially mediated by emotional exhaustion. Negative coping and emotional exhaustion played concurrent and sequential mediating roles between dispositional mindfulness and PTSS.ConclusionThis study has made a significant contribution to existing literature. It was suggested to develop interventions aimed at enhancing mindfulness, reducing negative coping strategies, and alleviating emotional exhaustion, which may be effective at reducing or alleviating post-traumatic stress symptoms of emergency nurses. (shrink)

Image similarity metric, also known as metric learning in computer vision, is a significant step in various advanced image tasks. Nevertheless, existing well-performing approaches for image similarity measurement only focus on the image itself without utilizing the information of other modalities, while pictures always appear with the described text. Furthermore, those methods need human supervision, yet most images are unlabeled in the real world. Considering the above problems comprehensively, we present a novel visual similarity metric model named PTF-SimCM. It adopts (...) a self-supervised contrastive structure like SimSiam and incorporates a multimodal fusion module to utilize textual modality correlated to the image. We apply a cross-modal model for text modality rather than a standard unimodal text encoder to improve late fusion productivity. In addition, the proposed model employs Sentence PIE-Net to solve the issue caused by polysemous sentences. For simplicity and efficiency, our model learns a specific embedding space where distances directly correspond to the similarity. Experimental results on MSCOCO, Flickr 30k, and Pascal Sentence datasets show that our model overall outperforms all the compared methods in this work, which illustrates that the model can effectively address the issues faced and enhance the performances on unsupervised visual similarity measuring relatively. (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)

This study aimed to investigate how visual–spatial ability predicted academic achievement through arithmetic and reading abilities. Four hundred and ninety-nine Chinese children aged from 10.1 to 11.2 years were recruited and measured visual–spatial, arithmetic, and reading abilities. Their mathematical and Chinese language academic achievements were collected for two consecutive school years, respectively, during the same year as cognitive tests and 1 year after the cognitive tests. Correlation analysis indicated that visual–spatial, arithmetic, and reading abilities and academic achievements were significantly correlated (...) with each other. The structural equation modelling analyses showed that there were two paths from visual–spatial ability to academic achievement: a major path mediated by arithmetic ability and a minor serial mediation path from visual–spatial ability to arithmetic ability to reading ability, then to academic achievement. Results shed light on the importance of visual–spatial ability in education. (shrink)

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)

This work intends to solve the problem that the traditional education system cannot reasonably adjust the educational integration of children with the arrival of labor force in a short time, and support the education of migrant children in the education policy to integrate them into the local educational environment as soon as possible. Firstly, this work defines the surplus labor force and MC. Secondly, the principles of Artificial Intelligence and Deep Learning are introduced. Thirdly, it analyzes the education of MC (...) and relevant policies, and the data of the education effect of MC are collected and the evaluation effect model is built. Finally, the evaluation model of MC’s education effect is applied to test the effect of EP. The results show that using AI technology combined with DL technology to model the education effect of MC can establish an effective and accurate evaluation model of the education effect of MC, effectively evaluate the impact of local education policies on the education of MC, and give an effective effect analysis of relevant education policies in each period. The result of Adaptive Resonance Theory –Back Propagation algorithm is 65 ∼ 96%, which is much higher than the efficiency of traditional algorithms. This shows that the education integration evaluation model of MC based on AI technology and DL technology can effectively and accurately evaluate the integration effect of MC on the local education system, and then provide reference for local and even national adjustment of education policies. The results provide a new idea for the application of new technology in EP. (shrink)

Construction schedules play an important role in construction project management. However, during construction activities, risks may arise due to unexpected schedule changes, resulting in the ineffective delivery of projects. This study aims to reveal the law of schedule change risk propagation and to analyze the effects on the risk propagation through numerical simulations. First, construction projects are represented by activity-on-node networks. A model of risk propagation is then built based on a susceptible-infected model considering the effects of the nodal characteristics (...) on the propagation process. Next, the model is tested on a real-world project to examine cascading failures with varying parameters. The experimental results demonstrate that the model is effective in identifying the activities most capable of affecting a project schedule and evaluating the impact of schedule change risk propagation. This study will provide a basis for enhancing the robustness of AON networks and controlling the propagation of schedule change risks. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

The COVID-19 pandemic has pressed a pause button on global economic development, and induced significant mental health problems. In order to demonstrate the progressed relationship between the pandemic, economic slowdown, and mental health burden, we overviewed the global-level gross domestic product changes and mental problems variation since the outbreak of COVID-19, and reviewed comprehensively the specific sectors influenced by the pandemic, including international trade, worldwide travel, education system, healthcare system, and individual employment. We hope to provide timely evidence to help (...) with the promotion of policymakers’ effective strategies in mitigating economic losses induced by the pandemic; we suggest different governments or policy makers in different countries to share information and experience in dealing with COVID-19-induced economic slowdown and promote COVID-19 vaccine popularization plan to protect every individual worldwide against the coronavirus essentially; and we appeal international information share and collaboration to minimize stigmatization related to adverse mental consequences of COVID-19 and to increase mental health wellbeings of people all over the world. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (shrink)

The question of what determines brain laterality for auditory cognitive processing is unresolved. Here, we demonstrate a swap of hemisphere dominance from right to left during semantic interpretation of Chinese lexical tones in native speakers using simultaneously recorded mismatch negativity response and behavioral reaction time during dichotic listening judgment. The mismatch negativity, which is a brain wave response and indexes auditory processing at an early stage, indicated right hemisphere dominance. In contrast, the behavioral reaction time, which reflects auditory processing at (...) a later stage, indicated a right ear listening advantage, or left hemisphere dominance. The observed swap of hemisphere dominance would not occur when the lexical tone was substituted with a meaningless pure tone. This swap reveals dependence of hemisphere labor division initially on acoustic and then on functional cues of auditory inputs in the processing from sound to meaning. (shrink)

In this paper, the single-machine scheduling problem is studied by simultaneously considering due-date assignment and group technology. The objective is to determine the optimal sequence of groups and jobs within groups and optimal due-date assignment to minimize the weighted sum of the absolute value in lateness and due-date assignment cost, where the weights are position dependent. For the common due-date assignment, slack due-date assignment, and different due-date assignment, an O n log n time algorithm is proposed, respectively, to solve the (...) problem, where n is the number of jobs. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

This paper presents an adaptive fuzzy sliding-mode controller for multiple Euler–Lagrange systems communicated with directed topology. Based on the graph theory and Lyapunov–Krasovskii functions, a delay-dependent sufficient condition for the existence of sliding surfaces is given in terms of linear matrix inequalities. The asymptotic stability is analyzed by using the Lyapunov method in the presence of unknown parametric dynamics, actuator faults, and time-varying delays. The usage of adaptive techniques is to adapt the unknown parameters so that the objective of globally (...) asymptotic stability is achieved. Finally, simulation results are provided to illustrate the effectiveness of the proposed control scheme. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)