BackgroundMedical disputes, medical disturbances, verbal and physical violence against physicians, and burnout have reached epidemic levels. They may negatively impact both physicians and the healthcare system. The experience of medical disputes, medical disturbances, verbal, and physical violence, and burnout and the correlates in physicians working in public hospitals in China needed to be investigated.MethodsA nationwide cross-sectional survey study was conducted between 18 and 31 March 2019. An anonymous online questionnaire was administered. The questionnaire included the 22-item Maslach Burnout Inventory-Human Services (...) Survey. We also collected data on demographic and job-related factors, as well as physicians’ experiences of medical disputes, medical disturbances, verbal and physical violence from patients and the patients’ family members.FindingsIn total, 22,213 physicians from 144 tertiary public hospitals in all of China’s 31 provinces completed the survey. The overall burnout rate among the surveyed physicians was 31.28%. Moreover, 33.48% of physicians experienced disputes, 20.86% experienced disturbances, 48.52% experienced verbal violence, and 5.84% experienced physical violence in the past 12 months. Factors found to be significantly associated with burnout included younger age, being divorced or widowed, having a lower educational background, working in internal medicine departments, longer working hours per day, working in general hospitals, being in East China, as well as having experienced disputes, disturbances, and physical and verbal violence.InterpretationClose to a third of the Chinese doctors working in the tertiary hospitals reportedly experienced burnout, and the problem is related to the unsafe working environment caused by the worsening doctor-patient relationship. (shrink)

This study draws on Relevance Theory, Conversation Analysis, and Politeness Theory in investigating a full range of discourse functions for hao and dui with reference to recurrent patterns, distributions, and forms of organization in a large corpus of talk. Special emphasis is placed on a comparison of hao and dui in combination with a small subset of discourse particles: in particular hao/hao le/ hao la/hao a/hao ba and dui/dui a/dui le in spoken discourse. We find that both of the markers (...) signal special sequential relatedness in talk and carry information which is relevant in determining the boundaries of conversational exchange. However, in interaction hao is used for expressing acceptance of the other speaker’s move or act, whereas dui conveys acknowledgment of the propositional content of the utterance produced by the other speaker. (shrink)

Discourse marker analysis has been widely studied, leading Fraser to call this subject `a growth market in linguistics'. In our present research, we extended the study of discourse markers to the Chinese marker meiyou, which has traditionally been treated as a negator. The corpus studied here contains 40 conversations, totaling 482'27”. The analytical framework adopted in the study was drawn from van Dijk's model, which mainly consists of a semantic/textual level and a pragmatic/interactional level. A total of 141 occurrences of (...) meiyou were identified as discourse markers in the corpus: 13 of them occur at the textual level and 128 of them at the interactional level. Thus, meiyou occurs more frequently at the interactional level than at the textual level. At the textual level, meiyou introduces an answer to a self-inquiry or self-correction. At the interactional level, meiyou mainly serves as a response to provide information, as a marker of correction/clarification or evasion, and as a response to praise or gratitude. In particular, with respect to meiyou's interactive functions, we use the concepts of preference structure and face-threatening acts to analyze the collected data. We further demonstrate that intersubjectification, a mechanism whereby meanings become more centered on the addressee, is involved in the development of the discourse marker meiyou. (shrink)

ObjectiveTo explore the relations among perceived stress, fatigue, sleepiness, and the pathway of their effects on the ambulatory arterial stiffness index among medical staff.MethodsThis cross-sectional study was conducted at a tertiary hospital in Wuhan, China. Perceived stress, fatigue, and sleepiness were measured using the perceived stress scale, Fatigue assessment scale, and Epworth Sleepiness Scale, respectively. AASI was obtained from 24-h ambulatory blood pressure monitoring. Path analysis was used to clarify the relations among the PSS, FAS, and ESS scores, and their (...) relations to AASI values.ResultsA total of 153 participants were included herein. The PSS and FAS correlated with the ESS, and the PSS correlated with the FAS. In addition, the ESS correlated with the AASI. According to the path analysis results, the PSS and FAS had no direct effect on the AASI, but did have an indirect effect on this index by influencing the ESS.ConclusionSleepiness was a mediator of the effects of perceived stress and fatigue on AASI. (shrink)

ObjectiveTo survey the prevalence of burnout in a national sample of endocrinologists in China and to examine its correlates, with a special focus on gender differences.MethodsAn anonymous online survey was conducted among endocrinologists in 31 provincial government-owned “People’s Hospitals” of each province in mainland China. Demographic and work-related factors were collected from participants. The Maslach Burnout Inventory-Human Services Survey was used to assess burnout, including emotional exhaustion, depersonalization, and reduced personal accomplishment.ResultsA total of 711 endocrinologists completed the survey. Burnout was (...) reported by 32.8% of the participants. There were no significant gender differences in the overall prevalence of burnout or EE, DP, and PA. A multi-level linear regression revealed: In male participants, PA was significantly associated with age, DP was inversely associated with age, EE was significantly associated with shorter sleep duration, and longer work hours. In females, PA was significantly associated with age, EE and DP were both significantly associated with shorter sleep duration. EE and DP were also associated with work hours.ConclusionNearly one-third of endocrinologists in China experienced burnout. Although there were no significant gender differences in the prevalence of overall burnout or EE, DP, and PA scores, male and female participants differed in factors associated with EE, DP, and PA. Interventions need to be tailored to target different aspects in male and female endocrinologists and target different subgroups. (shrink)

Acid fracturing is the most important stimulation method in the carbonate reservoir. Due to the high cost and high risk of acid fracturing, it is necessary to predict the reservoir productivity before acid fracturing, which can provide support to optimize the parameters of acid fracturing. However, the productivity of a single well is affected by various construction parameters and geological conditions. Overfitting can occur when performing productivity prediction tasks on the high-dimension, small-sized reservoir, and acid fracturing dataset. Therefore, this study (...) developed a stacking heterogeneous ensemble model with a hybrid wrapper-based feature selection strategy to forecast reservoir productivity, resolve the overfitting problem, and improve productivity prediction. Compared to other baseline models, the proposed model was found to have the best predictive performances on the test set and effectively deal with the overfitting. The results proved that the hybrid wrapper-based feature selection strategy introduced in this study reduced data acquisition costs and improved model comprehensibility without reducing model performance. (shrink)

While many publications have reported brain hemodynamic responses to decision-making under various conditions of risk, no inventory management scenarios, such as the newsvendor problem, have been investigated in conjunction with neuroimaging. In this study, we hypothesized that NP stimulates the dorsolateral prefrontal cortex and the orbitofrontal cortex joined with frontal polar area significantly in the human brain, and that local brain network properties are increased when a person transits from rest to the NP decision-making phase. A 77-channel functional near infrared (...) spectroscopy system with wide field-of-view was employed to measure frontal cerebral hemodynamics in response to NP in 27 healthy human subjects. NP-induced changes in oxy-hemoglobin concentration, Δ[HbO], were investigated using a general linear model and graph theory analysis. Significant activation induced by NP was shown in both DLPFC and OFC+FPA across all subjects. Specifically, higher risk NP with low-profit margins activated left-DLPFC but deactivated right-DLPFC in 14 subjects, while lower risk NP with high-profit margins stimulated both DLPFC and OFC+FPA in 13 subjects. The local efficiency, clustering coefficient, and path length of the network metrics were significantly enhanced under NP decision making. In summary, multi-channel fNIRS enabled us to identify DLPFC and OFC+FPA as key cortical regions of brain activations when subjects were making inventory-management risk decisions. We demonstrated that challenging NP resulted in the deactivation within right-DLPFC due to higher levels of stress. Also, local brain network properties were increased when a person transitioned from the rest phase to the NP decision-making phase. (shrink)

ObjectiveAnti-epidemic work against coronavirus disease has become routine work in China. Our study was intended to investigate the emotional and psychological state of healthcare workers and look for the association between sociodemographic factors/profession-related condition and emotional state.MethodsA cross-sectional survey was conducted online among healthcare workers from various backgrounds. Symptoms of anxiety and depression were assessed by the Chinese versions of the seven-item Generalized Anxiety Disorder and the nine-item Patient Health Questionnaire, respectively. Supplementary questions were recorded to describe the participants’ information (...) about workplace violence, profession, and attitude related to the COVID pandemic. Wherever suitable, independent t-test, and one-way ANOVA were performed to detect group differences of GAD-7 and PHQ-9 total scores after grouping by sociodemographic variables, respectively, such as age, gender, marital status, educational level, after-tax income, department category, job title, experience of workplace violence, and anti-epidemic participation. Multiple linear regression analyses were utilized in order to look for the potential associated factors of GAD-7 and PHQ-9 total scores.ResultsA total of 2,139 questionnaires with valid response were completed. Approximately 86.44% of participants had minimal symptoms of anxiety, 11.08% mild, 1.59% moderate, and 0.89% severe. Meanwhile, 81.34% had minimal symptoms of depression, 14.07% mild, 2.90% moderate, 1.17% moderately severe, and 0.51% severe. Student’s t-test showed that participants with female gender, with experience of workplace violence scored higher on both GAD-7 and PHQ-9, and participants with experience of anti-epidemic front-line work during pandemic scored lower on both GAD-7 and PHQ-9. ANOVA showed that participants aging from 31 to 40, with higher educational level, with middle level of annual after-tax income, with department of internal medicine or surgery, or with middle level of job title scored higher on both GAD-7 and PHQ-9. Regression analyses showed that female gender, high job title, and the experience of workplace violence positively were associated with anxiety or depression. Doctoral education, department, job enthusiasm, and professional self-identity were negatively associated with anxiety or depression. Additionally, psychological support was negatively associated with depression.ConclusionAs the epidemic prevention and control against COVID-19 become normalized in China, emotional state of healthcare workers deserves extensive attention. Our study revealed that gender, educational level, department category, job title, the experience of workplace violence, job enthusiasm, and professional self-identity are the most important influencing factors of physician’s anxiety and depression. Self-tailored psychological intervention should be based on the predisposing factors above to mentally prepare healthcare workers for this long-lasting battle against COVID-19. (shrink)

Xue xi he yan jiu Zhongguo zhe xue, yi ban lai shuo, Feng xian sheng shi ke chao er bu ke yue de. Yi si shi, hou ren wan quan ke neng er qie ye ying dang sheng guo Feng xian sheng, dan shi que bu neng rao guo Feng xian sheng. Rao guo Feng xian sheng, bu dan bi ran yao duo fei li qi, er qie rong yi zou wan lu er nan yu shen ru tang ao. Feng (...) Youlan zuo wei wo guo jin dai zhe xue de yi dai ju bo, zai mou zhong yi yi shang, ying xiang liao zheng ge jin dai Zhongguo zhe xue de ge ju. Er dui yu Feng Youlan zhe xue ji qi xue shu sheng ya de yan jiu, ye sui zhe dang dai guo xue yan jiu de xing qi, shou dao yue lai yue duo de guan zhu. Minguo shi qi de Zhongguo xue shu jie, ying gai shuo shi hui ju le yi da pi kua shi dai de xue shu jing ying, te bie shi zai chuan tong xue shu ling yu, kan cheng yi chang si xiang de sheng yan.ben shu zuo zhe zai hao ru yan hai de Minguo wen xian zhong, jing xin zheng li chu dang shi xue jie dui Feng Youlan zhe xue de hui ying he dui hua, qi zhong bao kuo zhu ru Chen Yinke, Jin Yuelin, Hu Shi, Zhang Dainian, Cai Shangsi deng yi da pi xue jie tai dou de wen zhang, zi liao xing fei chang qiang, bu jin fan ying le zhu wei xue zhe ge ren de du dao jian jie, geng cong yi ge ce mian fan ying le Minguo shi qi Feng Youlan zhe xue yan jiu de sheng kuang, dui dang xia yan jiu Feng Youlan zhe xue si xiang ju you zhong yao de can kao jia zhi. (shrink)

Ben shu yi dong zhong shu zi ran guan wei shi jiao,Chan shu le dong zhong shu de"tian ren gan ying"lun,"wu lei lei bi"he"xun ming de li"de fang fa lun,Yi tian wei yuan ben de yu zhou lun,"bian er you chang"de bian zheng tian dao guan,Yi ji dong zhong shu you guan yuan qi,Yin yang,Wu xing de zi ran ke xue si xiang,Zai zong ti shang ken ding le dong zhong shu zai jie shi he ren shi zi ran gui (...) lü shang de jin bu xing,Ken ding le dong zhong shu dui zhong guo gu dai zi ran ke xue de gong xian,Bing pi ping le yi wang dui dong zhong shu bu gong zheng di ping pan.Ben shu tong shi ye zhi chu le dong zhong shu de mou xie si xiang dui hou shi de fu mian ying xiang. (shrink)

The direction and specificity of endolysosomal membrane trafficking is tightly regulated by various cytosolic and membrane‐bound factors, including soluble NSF attachment protein receptors (SNAREs), Rab GTPases, and phosphoinositides. Another trafficking regulatory factor is juxta‐organellar Ca2+, which is hypothesized to be released from the lumen of endolysosomes and to be present at higher concentrations near fusion/fission sites. The recent identification and characterization of several Ca2+ channel proteins from endolysosomal membranes has provided a unique opportunity to examine the roles of Ca2+ and (...) Ca2+ channels in the membrane trafficking of endolysosomes. SNAREs, Rab GTPases, and phosphoinositides have been reported to regulate plasma membrane ion channels, thereby suggesting that these trafficking regulators may also modulate endolysosomal dynamics by controlling Ca2+ flux across endolysosomal membranes. In this paper, we discuss the roles of phosphoinositides, Ca2+, and potential interactions between endolysosomal Ca2+ channels and phosphoinositides in endolysosomal dynamics. (shrink)

本书就文化哲学的核心问题文明论,对法兰克福学派理论研究,强调其学派文明论的重要性,论述其学派对启蒙精神、文化工业、合法化危机的批判等。.

The main purpose of this paper is to present a formal systemPin which we enjoy a smooth-running technique and which countenances a universe of classes which is symmetrical as between large and small. More exactly,Pis a system which differs from the inconsistent system of [1] only in the introduction of a rather natural new restrictive condition on the defining formulas of the elements. It will be proved that if the weaker system of [2] is consistent, thenPis also consistent.After the discovery (...) of paradoxes, it may be recalled, Russell and Zermelo in the same year proposed two different ways of safeguarding logic against contradictions. Since then various simplifications and refinements of these systems have been made. However, in the resulting systems of Zermelo set theory, generation of classes still tends to be laborious and uncertain; and in the systems of Russell's theory of types, complications in the matter of reduplication of classes and meaningfulness of formulas remain. In [2], Quine introduced a system which seems to be free from all these complications. But later it was found out that in it there appears to be an unavoidable difficulty connected with mathematical induction. Indeed, we encounter the curious situation that although we can prove in it the existence of a class V of all classes, and we can also prove particular existence theorems for each of infinitely many classes, nobody has so far contrived to prove in it that V is an infinite class or that there exists an infinite class at all. (shrink)

Recently discovered transcription‐independent features of p53 involve the choice of DNA damage repair pathway after PARylation, and p53's complex formation with phosphoinositide lipids, PI(4,5)P2. PARylation‐mediated rapid accumulation of p53 at DNA damage sites is linked to the recruitment of downstream repair factors and tumor suppression. This links p53's capability to sense damaged DNA in vitro and its relevant functions in cells. Further, PI(4,5)P2 rapidly accumulates at damage sites like p53 and complexes with p53, while it is required for ATR recruitment. (...) These findings help explain how p53 and PI(4,5)P2 maintain genome stability by directing DNA repair pathway choice. Additionally, there is a strong correlation between p53 sequence homology, genome mutation rates as well as lifespans across various mammalian species. Further investigation is required to better understand the connections between genome stability, tumor suppression, longevity and the transcriptional‐independent function of p53. (shrink)

Objectives The objectives of the study are to understand the current practice of informed consent in medical research in public hospitals in Shanghai, and to share our views with other countries, especially developing countries. Methods In the study, 145 consent forms (CFs) of the selected research projects in eight public hospitals with ethics committees in Shanghai were audited, and the principle investigators (PIs) of these research projects and 40 student subjects who had participated in clinical drug tests were surveyed by (...) questionnaires. Results The CFs of medical researches in public hospitals with ethics committees in Shanghai were generally acceptable. However, there were some defects in the CFs. Although most of the surveyed PIs had correct recognition of informed consent, some processes of informed consent were not in accordance with generally accepted requirements. A large number of the PIs considered the greatest difficulty with informal consent was lack of correct recognition of subjects or legally authorised representatives on medical research. Discussion Informed consent in medical research should consider the research ethics, the background of potential subjects, the local resources and culture of medical research. In addition, special protection is needed for student subjects in informed consent as well as efforts for building and restoring the public's trust in biomedical research. Conclusion The informed consent in Shanghai's public hospitals with ethics committees was generally acceptable and the achievement of adequate informed consent is influenced by many factors. (shrink)

Adaptive dynamic programming, which belongs to the field of computational intelligence, is a powerful tool to address optimal control problems. To overcome the bottleneck of solving Hamilton–Jacobi–Bellman equations, several state-of-the-art ADP approaches are reviewed in this paper. First, two model-based offline iterative ADP methods including policy iteration and value iteration are given, and their respective advantages and shortcomings are discussed in detail. Second, the multistep heuristic dynamic programming method is introduced, which avoids the requirement of initial admissible control and achieves (...) fast convergence. This method successfully utilizes the advantages of PI and VI and overcomes their drawbacks at the same time. Finally, the discrete-time optimal control strategy is tested on a power system. (shrink)

Translating Chinese Classics in a Colonial Context: James Legge and His Two Versions of the Zhongyong, by Hui Wang, Peter Lang Content Type Journal Article Pages 166-167 Authors Paul Boshears, Europäische Universität für Interdisziplinäre Studien/The European Graduate School Journal Comparative and Continental Philosophy Online ISSN 1757-0646 Print ISSN 1757-0638 Journal Volume Volume 4 Journal Issue Volume 4, Number 1 / 2012.

Ben shu fen wu ge zhuan ji,Xuan lu le wang wei guang,Zhang quan jing,Tian xin ming,Liang zhu,Li shen ming,Liu run wei,Zhou xin cheng deng fa biao zai deng qi kan shang de pi pan li shi xu wu zhu yi de wen zhang,Zhi zai yin dao guang da dang yuan gan bu shen ke ren shi li shi xu wu zhu yi de wei hai,Shi zhong jian chi wei wu shi guan,Jian jue fan dui li shi xu wu zhu (...) yi. (shrink)

It has often been argued that Humean accounts of natural law cannot account for the role played by laws in scientific explanations. Loewer (Philosophical Studies 2012) has offered a new reply to this argument on behalf of Humean accounts—a reply that distinguishes between grounding (which Loewer portrays as underwriting a kind of metaphysical explanation) and scientific explanation. I will argue that Loewer’s reply fails because it cannot accommodate the relation between metaphysical and scientific explanation. This relation also resolves a puzzle (...) about scientific explanation that Hempel and Oppenheim (Philosophy of Science 15:135–75, 1948) encountered. (shrink)

Buch 1. Geschichte des Materialismus bis auf Kant.--Buch 2. Geschichte des Materialismus seit Kant.

Why do forces compose according to the parallelogram of forces? This question has been controversial; it is one episode in a longstanding, fundamental dispute regarding which facts are not to be explained dynamically. If the parallelogram law is explained statically, then the laws of statics are separate from and “transcend” the laws of dynamics. Alternatively, if the parallelogram law is explained dynamically, then statical laws become mere corollaries to the dynamical laws. I shall attempt to trace the history of this (...) controversy in order to identify what it would be for one or the other of these rival views to be correct. I shall argue that various familiar accounts of natural law not only make it difficult to see what the point of this dispute could have been, but also improperly foreclose some serious scientific options. I will sketch an alternative account of laws that helps us to understand what this dispute was all about. (shrink)