BackgroundThe prognosis of hypertensive intracerebral hemorrhage is poor at high altitudes. The objective of this study was to explore whether hyperbaric oxygen can improve the results of computed tomography perfusion imaging and the neurological function of patients with HICH, and influence the hemoglobin concentration.MethodThe patients with HICH were treated with puncture and drainage. Twenty-one patients were treated with HBO after the operation, and the other patients received conventional treatment. CTP was performed twice, and all indices were measured. Scatter plots were (...) used to determine the effect of hemoglobin concentration on CTP imaging. Receiver operating characteristic curves were plotted to analyze the effects of hemoglobin concentration and hematoma volume on recovery results. The patients were followed up for 6 months.ResultsForty-one patients with HICH were treated with puncture and drainage. In total, 21 were treated with HBO after the operation, and 20 received conventional treatment as the control group. No significant differences in the CBV and CBF values of the two groups were noted before treatment. After 10 days, the values of CBV and CBF in the HBO group were significantly higher than those in the control group. A scatter diagram showed there was no significant in the HBO group, but significant correlation for the CBV and CBF values in the control group’s hematoma center and margin. The ROC curves showed that hematoma volume had an influence on prognosis of the control group. The Glasgow Coma Scale scores of the HBO group were significantly higher than those of the control group.ConclusionsHBO therapy can improve the postoperative CBV and CBF values of patients with HICH and ameliorate their prognoses. There was no significant correlation between HBO group and hemoglobin concentration on admission. (shrink)

Time-varying formation-containment problems for a second-order multiagent system are studied via pulse-modulated intermittent control in this paper. A distributed control framework utilizing the neighbors’ positions and velocities is designed so that leaders in the multiagent system form a formation, and followers move to the convex hull formed by each leader. Different from the traditional formation-containment problems, this paper applies the PMIC framework, which is more common and more in line with the actual control scenarios. Based on the knowledge of matrix (...) theory, algebraic graph theory, and stability theory, some sufficient conditions are given for the time-varying formation-containment problem of the second-order multiagent system. Some numerical simulations are proposed to verify the effectiveness of the results presented in this paper. (shrink)

From the popularity of flipped teaching in United States primary and high schools, it is thought that students have more learning control to adjust to the learning progress and are assisted in problem solving and learning guidance during class period. It is believed that flipped teaching could prompt underachieving learners’ active learning and thereby enhance learning effectiveness. A total of 386 high school students in Chungli, Taiwan, were part of an experimental study and the research results are summarized below: Students (...) who participated in the flipped teaching models demonstrated better comprehension levels with the teaching content due to this change in learning style and attitude, which in turn, enhanced learning effectiveness. To eliminate poor language performance of underachieving students, it is necessary to lay solid foundations to gradually enhance language learning effectiveness regarding this particular group of students. Films suitable for students’ individual ability could be combined with new language learned in the unit to genuinely assist underachieving learners’ language learning effectiveness. For students who care about their performance, a “system of play” style grouping should be determined in order to enable the tracking of group performance and term performance. According to the results, further developments regarding active learning ability, boosts in learning interests, enhanced learning effectiveness, and the prompting of creativity resulting in a shift from passive learner to active learner have been proposed. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit pathways to (...) ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

We study the synchronization of complex networks by using event-sampling information. The nodes of the network are connected with event-triggered communication via multiple couplings. The couplings are split into several channels. Not all the channels are connected. Only a part of the states of each node can be communicated by the channels. An event detector is designed for each channel to independently determine the sampling moments. The couplings of the network are partial and event-triggered. Both features make that less information (...) can be used for synchronization. The pinning controllers are also designed based on the sampled information. By establishing a time-dependent Lyapunov functional and utilizing an efficient event condition, we derive less conservative criteria for the synchronization of complex networks. Finally, the effectiveness of our main results is verified by an illustrative example, and comparisons are also presented to show how much conservatism can be reduced. (shrink)

The whale optimization algorithm is a powerful swarm intelligence method which has been widely used in various fields such as parameter identification of solar cells and PV modules. In order to better balance the exploration and exploitation of WOA, we propose a novel modified WOA in which both the mutation strategy based on Levy flight and a local search mechanism of pattern search are introduced. On the one hand, Levy flight can make the algorithm get rid of the local optimum (...) and avoid stagnation; thus, it is able to prevent the algorithm from losing diversity and to increase the global search capability. On the other hand, pattern search, a direct search method, has not only high convergence rate but also good stability, which can boost the local optimization ability of the WOA. Therefore, the combination of these two mechanisms can greatly improve the capability of WOA to obtain the best solution. In addition, MWOA may be employed to estimate parameters in single diode model, double diode model, and PV modules and to identify unknown parameters of two different types of PV modules under diverse light irradiance and temperature conditions. The analytical results demonstrate the validity and the practicality of MWOA for estimating parameters of solar cells and PV modules. (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.

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)

Life education, also known as life and death education, is an important subject in Taiwan with institutions offering degree programs and courses that focus on quality learning and implementation of life education. What is interesting from the perspective of Taiwanese Education is that the teaching of life education also incorporates a number of Eastern-derived and conceptualized tenets, for example, Buddhist teaching and the importance of spiritual wisdom. This premise contends then that life education in Taiwan, in general, is concerned with (...) the promotion, fulfillment, and cherishing of quality life experiences (e.g., personal contentment, happiness). One example of life education, which resonates with other spiritual beliefs and religious faiths (e.g., Hinduism), is related to spiritual cultivation and the enlightenment of life wisdom. Our own teaching of the subject, likewise, places emphasis on the goal of teaching students to seek meaningful understanding of and appreciation for three major, interrelated components of life education: life wisdom, life practice, and life care. Life education is a beneficial subject as its theoretical understanding may help individuals cope with pathologies and negative life experiences. One negative life experience, in this case, is the ultimate fate of humankind: death. Approaching death and/or the onset of grief is something that we all have to experience. How does one approach death? It is not easy feat and, of course, grief for a loved one is personal and some of us struggle with this. We contend that spiritual cultivation and enlightenment, arising from life education, may assist us with the coping of death (e.g., the possibility of transcendence beyond the realm of life). Forming the premise of the present article, we propose that a person’s ‘spiritual and enlightened self’, reflecting the convergence of three major aspects of life education (i.e., Philosophical reflection, Enrichment of personal well-being, and Spiritual cultivation), would result in the initiation and creation of a number of virtues and positive characteristics – for example: having a positive outlook in life, showing compassion, forgiveness, etc. These virtues and quality characteristics, from our philosophical reasoning, are equivalent to those qualities that positive psychology advocates for. (shrink)

A critical issue in executive control is how the nervous system exerts flexibility to inhibit a prepotent response and adapt to sudden changes in the environment. In this study, force measurement was used to capture “partial” unsuccessful trials that are highly relevant in extending the current understanding of motor inhibition processing. Moreover, a modified version of the stop-signal task was used to control and eliminate potential attentional capture effects from the motor inhibition index. The results illustrate that the non-canceled force (...) and force rate increased as a function of stop-signal delay, offering new objective indices for gauging the dynamic inhibitory process. Motor response was a function of delay in the presentation of novel/infrequent stimuli. A larger lateralized readiness potential amplitude in go and novel stimuli indicated an influence of the novel stimuli on central motor processing. Moreover, an early N1 component reflects an index of motor inhibition in addition to the N2 component reported in previous studies. Source analysis revealed that the activation of N2 originated from inhibitory control associated areas: the right inferior frontal gyrus, pre-motor cortex, and primary motor cortex. Regarding partial responses, LRP and error-related negativity were associated with error correction processes, whereas the N2 component may indicate the functional overlap between inhibition and error correction. In sum, the present study has developed reliable and objective indices of motor inhibition by introducing force, force-rate and electrophysiological measures, further elucidating our understandings of dynamic motor inhibition and error correction. (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)

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)

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)

Various walking speeds may induce different responses on the plantar pressure patterns. Current methods used to analyze plantar pressure patterns are linear and ignore nonlinear features. The purpose of this study was to analyze the complexity of plantar pressure images after walking at various speeds using nonlinear bidimensional multiscale entropy. Twelve participants were recruited for walking at three speeds for 20 minutes. A plantar pressure measurement system was used to measure plantar pressure patterns. Complexity index, a summation of MSE2D from (...) all time scales, was used to quantify the changes of complexity of plantar pressure images. The analysis of variance with repeated measures and Fisher’s least significant difference correction were used to examine the results of this study. The results showed that CI of plantar pressure images of 1.8 mph was significantly lower compared with 3.6 and 5.4 mph. The results also showed that CI significantly increased from the 1st min to the 10th min and 20th min with slow walking. Our results indicate that slow walking at 1.8 mph may not be good for postural control compared with moderate walking and fast walking. This study demonstrates that bidimensional multiscale entropy is able to quantify complexity changes of plantar pressure images after different walking speeds. (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 study examines the influence of three components of corporate social responsibility on team performance. In the proposed model of this study, team performance is indirectly affected by three dimensions of perceived corporate citizenship (i.e., economic, legal, and ethical citizenship) via the mediation of team efficacy and team self-esteem. Surveying members of 172 teams confirms most of our hypothesized effects. Our results show that economic citizenship influences team performance via the mediation of both team efficacy and team self-esteem. However, legal (...) citizenship influences team performance via team efficacy alone, whereas ethical citizenship influences team performance only via team self-esteem. We discuss the theoretical and managerial implications of our findings. (shrink)

The essays on aesthetics in recent publications, beginning with the criticisms of Chu Kuang-ch'ien's point of view in aesthetics and continuing down to his article "How Can Aesthetics be Materialistic and Dialectic?" [Mei-hsüeh tsen-yang ts'ai neng shih wei-wu ti yu shih pien-cheng ti?"], have focused on the problem of the relationship between the subjective and the objective in beauty and in sense of beauty. This is a fundamental problem in aesthetics, and only when we have solved this problem can we (...) answer the questions of what beauty is and wherein beauty lies. Some people have presented their own tentative answers to these questions, and these have been discussed by our comrades. (shrink)