ABSTRACT This study seeks exploration of how employees’ moral identity is related to voice behavior in the current organizational dynamics. By integrating the self-consistency theory with a situational strength perspective, a moderated mediation model was constructed to examine connections among moral identity, leader secure-base support, work engagement, and voice behavior. Surveys were collected at 2 time points, 1 month apart, from 206 full-time employees in various organizations and industries in Taiwan. Supporting results indicated that employees’ moral identity was positively related (...) to voice behavior. The mediating impact of work engagement as a motivational mechanism between moral identity and voice behavior was observed. Relative to when LSBS was low, the effect of moral identity on work engagement and the indirect effect of moral identity on voice behavior through work engagement were more substantial when LSBS was high. Academic and managerial implications were discussed. (shrink)

Given that citizenship challenges the basis and workings of the basic institutions market, state, and civil society, organizational citizenship behaviors (OCBs) become an important moral tenet found in some codes of ethical principles. This study explores service-oriented OCBs and their determinants. Three dimensions of service-oriented OCBs (loyalty, service delivery, and participation) are hypothetically influenced by distributive justice, procedural justice, personal cooperativeness, and the need for social approval through the mediation of organizational commitment. The three dimensions of OCBs are hypothetically influenced (...) by personal cooperativeness, need for social approval, task interdependence, and outcome interdependence through the mediation of social network ties. The model is tested using data from contact employees at several financial holding companies in Taiwan. Test results reveal that the relationships between need for social approval and organizational commitment and those between task interdependence and social network ties are insignificant, whereas all other paths are significant. This study also provides managerial implications and limitations. (shrink)

In this study, we examined the role of culture on early adolescents’ social reasoning about peer exclusion. A total of 80 U.S. and 149 Taiwanese early adolescents independently completed a social reasoning essay about peer exclusion. Analyses of the essays based on social-moral theories showed that U.S. students tended to reason about peer exclusion based on social conventional thinking whereas Taiwanese students were more attentive to personal and moral issues. Despite this difference, both groups of students referred to some common (...) social-moral concepts while reasoning about peer exclusion, including consideration of personal benefit, harming others’ welfare, personal concern, and punishment. The use of social reasoning strategies was similar across the two groups of students except that Taiwanese students relied more on judgment whereas U.S. students generated more alternative hypotheses. (shrink)

Existing research on leader humility primarily demonstrates its positive effects. This study challenges this view by proposing the potential negative effects of leader humility on followers’ behaviors. Furthermore, this paper employs the person-situation interactionist perspective to extend the research on integrating followers’ personality traits and leader humility. Specifically, this study proposed that leader humility triggers their followers’ sense of power; moreover, this study wagers that whether followers’ sense of power encourages self-interested or prosocial behavior in followers depends on their particular (...) Machiavellian traits. The theoretical model was tested using the time-lagged supervisor–subordinate matched data obtained. Our findings revealed that follower Machiavellianism fosters the relationship between a sense of power and self-interested behavior but it weakens the relationship between a sense of power and prosocial behavior. Thus, this study provides a better understanding regarding the effect of follower personality and leader humility on follower behavioral reactions. (shrink)

Anthropologists have documented substantial cross-society variation in people’s willingness to treat strangers with impartial, universal norms versus favoring members of their local community. Researchers have proposed several adaptive accounts for these differences. One variant of the pathogen stress hypothesis predicts that people will be more likely to favor local in-group members when they are under greater infectious disease threat. The material security hypothesis instead proposes that institutions that permit people to meet their basic needs through impartial interactions with strangers reinforce (...) a tendency toward impartiality, whereas people lacking such institutions must rely on local community members to meet their basic needs. Some studies have examined these hypotheses using self-reported preferences, but not with behavioral measures. We conducted behavioral experiments in eight diverse societies that measure individuals’ willingness to favor in-group members by ignoring an impartial rule. Consistent with the material security hypothesis, members of societies enjoying better-quality government services and food security show a stronger preference for following an impartial rule over investing in their local in-group. Our data show no support for the pathogen stress hypothesis as applied to favoring in-groups and instead suggest that favoring in-group members more closely reflects a general adaptive fit with social institutions that have arisen in each society. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

In a recent paper, Charles Foster argued that the epistemic uncertainties surrounding prolonged disorders of consciousness make it impossible to prove that the withdrawal of life-sustaining treatment can be in a patient’s best interests and, therefore, the presumption in favour of the maintenance of life cannot be rebutted. In the present response, I argue that, from a legal perspective, Foster has reached the wrong conclusion because he is asking the wrong question. According to the reasoning in two leading cases —Bland (...) and James —the principle of respect for autonomy creates a persuasive presumption against treatment without consent. Therefore, it is the continuation of treatment that requires justification, rather than its withdrawal. This presumption also works as the tiebreaker determining that treatment should stop if there is no persuasive evidence that its continuation is in the best interests of the patient. The presumption in favour of the maintenance of life, on the other hand, should be understood as an evidential presumption on a factual issue that is assumed to be true if unchallenged. However, the uncertainties regarding PDOC actually give reasons for displacing this evidential presumption. Consequently, decision-makers will have to weigh up the pros and cons of treatment having the presumption against treatment without consent as the tiebreaker if the evidence is inconclusive. In conclusion, when the right question is asked, Foster’s argument can be turned on its head and uncertainties surrounding PDOC weigh in to justify the interruption of treatment in the absence of compelling contrary evidence. (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)

Both developing and developed countries face an increasing mismatch between what patients expect to receive from healthcare and what the public healthcare systems can afford to provide. Where there has been a growing recognition of the entitlement to receive healthcare, the frustrated expectations with regards to the level of provision has led to lawsuits challenging the denial of funding for health treatments by public health systems. This book analyses the impact of courts and litigation on the way health systems set (...) priorities and make rationing decisions. In particular, it focuses on how the judicial protection of the right to healthcare can impact the institutionalization, functioning and centrality of Health Technology Assessment (HTA) for decisions about the funding of treatment. Based on the case study of three jurisdictions - Brazil, Colombia, and England - it shows that courts can be a key driver for the institutionalization of HTA. These case studies show the paradoxes of judicial control, which can promote accountability and impair it, demand administrative competence and undermine bureaucratic capacities. The case studies offer a nuanced and evidence-informed understanding of these paradoxes in the context of health care by showing how the judicial control of priority-setting decisions in health care can be used to require and control an explicit scheme for health technology assessment, but can also limit and circumvent it. (shrink)

Remanufacturing widely exists in production activities. Two different game models are involved while considering reverse channels: In Model P, the manufacturer provides new and remanufactured products to two retailers. New products are sold through an online platform, while remanufactured products are sold in offline physical stores in a decentralized scenario. In Model C, the manufacturer provides new and remanufactured units to only one retailer that operates both online and offline channels in a centralized scenario. This research showed that a manufacturer’s (...) profitability and industry profits in Model P were higher than those in Model C from the perspective of economic performance; the sum of the profits of both retailers in Model P was worse than the profits of the retailer in Model C. Moreover, Model P was found to be greener than Model C from the perspective of environmental sustainability. From a social viewpoint, Model P had a higher consumer surplus than Model C; the higher the cost of distributing a remanufactured unit, the more disadvantageous the model to the consumers. (shrink)

We hypothesize that aspects of animal multicellularity originated before the divergence of metazoans from fungi and social amoebae. Polarized epithelial tissues are a defining feature of metazoans and contribute to the diversity of animal body plans. The recent finding of a polarized epithelium in the non‐metazoan social amoeba Dictyostelium discoideum demonstrates that epithelial tissue is not a unique feature of metazoans, and challenges the traditional paradigm that multicellularity evolved independently in social amoebae and metazoans. An alternative view, presented here, is (...) that the common ancestor of social amoebae, fungi, and animals spent a portion of its life cycle in a multicellular state and possessed molecular machinery necessary for forming an epithelial tissue. Some descendants of this ancestor retained multicellularity, while others reverted to unicellularity. This hypothesis makes testable predictions regarding tissue organization in close relatives of metazoans and provides a novel conceptual framework for studies of early animal evolution.Editor's suggested further reading in BioEssays Searching for Eve: Basal metazoans and the evolution of multicellular complexity Abstract. (shrink)

Retrieval database artwork, unlike other artwork, does not present fixed, preset and stable contents; it is formed as external data are retrieved from different sociocultural contexts and combined into the artworks’ content. This article aims to address the intertextual relationships between retrieval database artworks and the mass-produced texts from which the database artworks retrieve their data. After briefly discussing the difference between retrieval database artwork and participatory database artwork, and exploring the main concept of intertextuality, we address why intertextuality is (...) essential and beneficial in understanding retrieval database artworks. Two selected works are used to demonstrate that, as the artwork is executed, the meanings and relationships of retrieval database artwork are ever-changing, and the authorship is constantly shifting due to the viewer’s participation. Shifting authorship in retrieval database artwork is caused by the daily mass cultural production of original text, which might or might not be retrieved by the database to be incorporated into the artwork. We conclude that retrieval database artworks cannot separate themselves from mass data. The dynamic intertextual relationships between the work and its ongoing retrieval of content from other cultural productions, as well as the viewers’ contributions to the work, simultaneously shape and reshape the work and its authorship. (shrink)

BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

This paper discusses the post-trial access to drugs for patients who participated in clinical trials in Brazil. The ethical guidance for clinical trials in Brazil is arguably one of the clearest in the world in attributing to research sponsors the responsibility for providing post-trial drugs to patients who participated in their experiments. The Federal Constitution recognizes health as a fundamental right to be fulfilled by the State. Based on the Brazilian constitution and on the National Health Council resolutions, courts have (...) been accepting patients' claims and ordering the State and the pharmaceutical companies to provide these patients with the tested treatment in the quantity and duration they need it. This generous interpretation of the duties of the pharmaceutical companies and the State makes the Brazilian model for post-trial access unique when compared to the experience of other countries and thus should be followed with attention by future research in order to assess its consequences for patients, research sponsors, and the public health system. (shrink)

This paper discusses so-called post-trial access to drugs for patients who participated in clinical trials in Brazil. Brazil is currently a relevant country for the pharmaceutical industry due to the dimensions of its actual and potential market. As a consequence, the number of pharmaceutical trials has been rising. It is the largest market for pharmaceutical companies in Latin America, the 8th biggest in the world and second only to China among the so-called BRICS’s emerging countries. The demand for pharmaceutical products (...) in the country has been increasing by double digits over the last few years, reaching 20% in 2008. Not surprisingly, we are also witnessing a steady increase in the number of applications by national and international pharmaceutical companies before ethical research authorities for authorization to perform clinical trials of drugs. (shrink)

Companies disclosing negative aspects in sustainability reports often employ legitimation strategies to present mishaps in a favorable light. In incentivized experiments, we find that nonprofessional investors divest from companies with a negative sustainability-related incident, and that symbolic legitimation (which only evasively explains a negative incident) is not a strong enough signal to counter this divestment behavior. Even substantial legitimation (which reports on measures and behavioral change) mitigates the divestment decisions only if the company reports on concrete remediation actions in morally (...) charged situations, such as social or environmental incidents. We elaborate these results in light of signaling and screening theory, and suggest the conceptual extension of “costly signals” to what we call “valuable signals.” We argue that valuable signals need be not only costly for the sender from an economic perspective but also perceived as appropriate by the receiver from a noneconomic perspective. (shrink)

The study of education systems as social phenomena has led scholars to question the role of education in modern society. The question of how to improve education naturally leads to concerns about what is wrong with the present education system. If education is meant to elevate the next generation, how can it meet the goal of ensuring a meaningful existence for those being educated? Scholars have demonstrated that education has been reduced to a process of the construction of objects, where (...) curriculum as techne commodifies students into products with market value. We propose that the tendency of interpreting techne as technology is a perspective of the modern age, and the rules of modern education are based on the rules of modern technology, under the guidance of the paradigm of productivity. We will introduce a broader interpretation of techne which frames it as the cultivation of virtue, i.e., virtue-techne. On this basis, education could be viewed as techne in the sense of praxis, rather than as fabrication in the sense of production. We highlight the rising rate of student suicides in Taiwan in recent years, where we determine the education system lacks a focus on praxis. This article investigates alternative praxis-oriented notions of education, from Aristotle's cultivation of virtue to Hadot's "spiritual exercises," to advocate for a shift away from the production paradigm. Indebted to Heidegger, we clarify his "techne as revealing" by emphasizing two frameworks for education: The first, modern education being valued by its adherence to metrics based in the paradigm of production. The second, education as a process wherein its value is derived from the life context of the participating individual. Finally, as a comparative study, we explore the current state of education in Russia and Taiwan, and present the case of one high school in Taiwan which has adopted the practice of spiritual exercises in its curriculum, including a required hike to the peak of Taiwan's tallest mountain, to cultivate a sense of the liberated life before its students graduate. (shrink)

The strap-down inertial navigation system is a commonly used sensor for autonomous underground navigation, which can be used for shearer positioning under a coal mine. During the process of initial alignment, inaccurate or time-varying noise covariance matrices will significantly degrade the accuracy of the initial alignment of the shearer. To overcome the performance degradation of the existing initial alignment algorithm under complex underground environment, a novel adaptive filtering algorithm is proposed by the integration of the strong tracking Kalman filter and (...) the sequential filter for the initial alignment of the shearer with complex underground environment. Compared with the traditional multiple fading factor strong tracking Kalman filter method, the proposed MSTSKF algorithm integrates the advantage of strong tracking Kalman filter and sequential filter, and multiple fading factor and forgetting factor for east and north velocity measurement are designed in the algorithm, respectively, which can effectively weaken the coupling relationship between the different states and increase strong robustness against process uncertainties. The simulation and experiment results show that the proposed MSTSKF method has better initial alignment accuracy and robustness than existing strong tracking Kalman filter algorithm. (shrink)

Conquering print-sound mappings is vital for developing fluent reading skills. In neuroimaging research, this ability can be indexed by activation differences between audiovisual congruent against incongruent conditions in brain areas such as the left superior temporal cortex. In line with it, individuals with dyslexia have difficulty in tasks requiring print-sound processing, accompanied by a reduced neural integration. However, existing evidence is almost restricted to alphabetic languages. Whether and how multisensory processing of print and sound is impaired in Chinese dyslexia remains (...) underexplored. In this study, we applied a passive audiovisual integration paradigm with functional magnetic resonance imaging to investigate the possible dysfunctions in processing character-sound and pinyin-sound associations in Chinese dyslexic children. Unexpectedly, the dyslexic group did not show reduced neural integration compared with typically developing readers in either character or pinyin experiment. However, the results revealed atypical correlations between neural integration and different reading abilities in dyslexia. Specifically, while the neural integration in the left inferior frontal cortex in processing character-sound pairs correlated with silent reading comprehension in both children with and without dyslexia, it was associated with morphological awareness in controls but with rapid naming in dyslexics. This result indicates Chinese dyslexic children may not use the same grapho-semantic processing strategy as their typical peers do. As for pinyin-sound processing, while a stronger neural integration in the direction of “congruent > incongruent” in the left occipito-temporal cortex and bilateral superior temporal cortices was associated with better oral reading fluency in the control group, an opposite pattern was found in dyslexia. This finding may reflect dyslexia's dysfunctional recruitment of the regions in grapho-phonological processing, which further impedes character learning. (shrink)

In recent years, the method of the complex network has been applied to various fields. Dynamics research in complex networks is also an important branch. There are many types of research into dynamic complex network, but few scholars use bibliometrics to study it. Therefore, this paper adopts the method of bibliometrics to analyze the development history and status quo of dynamic complex network, providing a summary description of this research field. We used CiteSpace and Pajek to analyze 2936 relevant papers (...) on the website of Web of Science and further interpreted and summarized the analysis results. To fully show the bibliometric results, we further derive the productive countries, institutions, sources, and authors and some main research directions in the dynamic complex network research. The research results show that the dynamic complex network research method was applied to various fields after the dynamic research method had been integrated into the complex network. According to the subject analysis of the cited papers, we find that the dynamic complex network method has been widely used in various subjects. Through emergent analysis, we found that the latest hot research trends are the study of infectious diseases and applications in neural networks. At the same time, through the main path analysis, we find the essential literature to elaborate on the development context of a dynamic complex network at different time points. This paper gives a comprehensive analysis of dynamic complex network research and provides some enlightenment for the future research direction. (shrink)

BackgroundParkinson's disease is a chronic neurodegenerative disease, which can be alleviated in drug treatment, but with evident side effects. At the same time, increasing evidence shows that exercise can significantly improve the symptoms of patients with Parkinson's disease, with an effect that cannot be achieved by drug treatment. The related research on exercise on Parkinson's disease increases rapidly with the passage of time. However, the research analysis on Parkinson's disease by means of bibliometrics is rare. The purpose of this study (...) is to perform a bibliometric analysis of the research hotspots and development trends of the global movement on Parkinson's disease from 2012 to 2021.MethodsThe literature was derived from the Web of Science core collection database, and the social science citation index was set as SCI-EXPANDED. The language was set to English, and the literature category was set as article and review and published from 2012 to 2021. CiteSpace and other software were used to analyze the relationship among published documents, countries, institutions, journals, authors, references, disciplines, and keywords.ResultsA total of 2,222 articles were included in the analysis. The analysis showed that the publication volume increased with the increase in years, with a total of 76 countries and 546 academic journals published; the largest number was that of the United States. The journals are mainly concentrated in the fields of neurology, sports, and ophthalmology. Rush University and Movement Disorders journals are the main institutions and journals. The cited keywords show that trial, cognition, and interference are the research hotspots and development trends in recent years.ConclusionThe number of published articles on Parkinson's disease by exercise has increased rapidly in the past 10 years, and the bibliometric analysis can provide useful information for future research teams and researchers. (shrink)

Conditional automated driving [level 3, Society of Automotive Engineers ] requires drivers to take over the vehicle when an automated system’s failure occurs or is about to leave its operational design domain. Two-stage warning systems, which warn drivers in two steps, can be a promising method to guide drivers in preparing for the takeover. However, the proper time intervals of two-stage warning systems that allow drivers with different personalities to prepare for the takeover remain unclear. This study explored the optimal (...) time intervals of two-stage warning systems with insights into the drivers’ neuroticism personality. A total of 32 drivers were distributed into two groups according to their self-ratings in neuroticism. Each driver experienced takeover under the two-stage warning systems with four time intervals. The takeover performance and subjective opinions for time intervals and situation awareness were recorded. The results showed that drivers in the 5-s time interval had the best takeover preparation. Furthermore, both the 5- and 7-s time intervals resulted in more rapid takeover reactions and were rated more appropriate and useful than the 3- and 9-s time intervals. In terms of personality, drivers with high neuroticism tended to take over immediately after receiving takeover messages, at the cost of SA deficiency. In contrast, drivers with low neuroticism responded safely by judging whether they gained enough SA. We concluded that the 5-s time interval was optimal for drivers in two-stage takeover warning systems. When considering personality, drivers with low neuroticism had no strict requirements for time intervals. However, the extended time intervals were favorable for drivers with high neuroticism in developing SA. The present findings have reference implications for designers and engineers to set the time intervals of two-stage warning systems according to the neuroticism personality of drivers. (shrink)

Liver transplantation (LT) activities during the COVID-19 pandemic have been curtailed in many countries. The impact of various policies restricting LT on outcomes of potential LT candidates is unclear. We studied all patients on the nationwide LT waitlists in Hong Kong and Singapore between January 2016 and May 2020. We used continuous time Markov chains to model the effects of different scenarios and varying durations of disruption on LT candidates.

Reorienting the Political examines the reception of two controversial German philosophers, Carl Schmitt and Leo Strauss, in the Chinese-speaking world. This volume explores the powerful resonance of both thinkers in Chinese political thought from a cross-cultural and interdisciplinary perspective.

Drawing on the transactional model of stress and leader-member exchange (LMX) theory, we examine the role of performance pressure in relation to unethical pro-organizational behavior (UPB). We propose that (1) employee perceived performance pressure and LMX interact to increase employees’ willingness to engage in UPB, and (2) employees’ threat appraisal mediates this interaction effect. The results from two studies based on samples of employees in the United States and China supported our theoretical model. We found that LMX moderated the relation (...) between performance pressure and the willingness to engage in UPB, such that the relation was stronger when LMX was high (Study 1). Moreover, the conditional indirect effect (i.e., performance pressure on UPB through threat appraisal with LMX as a moderator at the first stage) was also supported (Study 2). These findings highlight the role of performance pressure and LMX in inducing unethical work behaviors that are aimed at benefiting the organization (i.e., UPB). Theoretical and managerial implications are also discussed. (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)

唯识学种子说通过在微分、刹那层面探讨深层心识的构造活动和存在的本质，论证了佛教缘起性空的非本体立场，属于一种“非本体”的本体诠释。但是，由于受到中国固有思维的影响，中国佛学不再侧重强调法性即空性的“非 本体”立场，而是把法性和心性主体结合起来，倾向于设立一种“实体化”的本体，形成了“心性本体论”。由非本体的本体诠释逐渐转向心性本体的本体诠释是印度唯识学在心识哲学层面中国化的基本趋势。.

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)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (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)