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)

Jian Zhou,* Weiqiang Ju,* Xiaopeng Yuan, Xiaofeng Zhu, Dongping Wang, Xiaoshun HeOrgan Transplant Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China *These authors contributed equally to this work: Hyperosmolar nonketotic hyperglycemic coma is a serious, rare complication induced by methylprednisolone pulse therapy for acute rejection after orthotopic liver transplantation. Herein, we report an unusual case of a 58-year-old woman who experienced acute rejection at 30 months after OLT, only one case in which HNKHC resulted in (...) MP pulse therapy for acute rejection in all 913 recipients in our center. The general morbidity of HNKHC was 1.09‰ in this study. HNKHC is characterized by rapid onset, rapid progression, and a lack of specific clinical manifestations. High-dose MP management was a clear risk factor. The principle of treatment included rapid rehydration, low-dose insulin infusion, and correcting disorders of electrolytes and acidosis. In conclusion, clinicians considering MP pulse therapy after OLT should be alert to the occurrence of HNKHC. Keywords: liver transplantation, complications, hyperosmolar nonketotic hyperglycemic coma, methylprednisolone pulse therapy, principle of treatment. (shrink)

Context: Phenomenology and the enactive approach pose a unique challenge to dream research: during sleep one seems to be relatively disconnected from both world and body. Movement and perception, prerequisites for sensorimotor subjectivity, are restricted; the dreamer’s experience is turned inwards. In cognitive neurosciences, on the other hand, the generally accepted approach holds that dream formation is a direct result of neural activations in the absence of perception, and dreaming is often equated with “delusions.” Problem: Can enactivism and phenomenology account (...) for the variety of dream experiences? What kinds of experiential and empirical approaches are required in order to probe into dreaming subjectivity? Investigating qualities of perception, sensation, and embodiment in dreams, as well as the relationship between the dream-world and waking-world requires a step away from a delusional or altered-state framework of dream formation and a step toward an enactive integrative approach. Method: In this article, we will focus on the “depth” of dream experiences, i.e., what is possible in the dream state. Our article is divided into two parts: a theoretical framework for approaching dreaming from an enactive cognition standpoint; and discussion of the role and strategies for experimentation on dreaming. Based on phenomenology and theories of enactivism, we will argue for the primacy of subjectivity and imagination in the formation of lived experience. Results: We propose that neurophenomenology of dreaming is a nascent discipline that requires rethinking the relative role of third-, first- and second-person methodologies, and that a paradigm shift is required in order to investigate dreaming as a phenomenon on a continuum of conscious phenomena as opposed to a break from or an alteration of consciousness. Implications: Dream science, as part of the larger enterprise of consciousness and subjectivity studies, can be included in the enactive framework. This implies that dream experiences are neither passively lived nor functionally disconnected from dreamers’ world and body. We propose the basis and some concrete strategies for an empirical enactive neurophenomenology of dreaming. We conclude that investigating dream experiences can illuminate qualities of subjective perception and relation to the world, and thus challenge the traditional subject-object juxtaposition. Constructivist content: This article argues for an interdisciplinary enactive cognitive science approach to dream studies. (shrink)

Upshot: A successful program for an enactive view of dreaming would have to clarify phenomenal and neurophysiological similarities and differences between waking perception, imagination, and dreaming. An embodied and skillful view of the dream process would require careful investigation of somatic sources of dream content, including sensory incorporation, and global, indirect ways in which dream content reacts metaphorically to changes in bodily states. Neurophenomenology of dreams would benefit from developing dreaming-specific approaches to training researchers and participants in phenomenological methods.

BackgroundThe merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM).MethodsThis measure was tested on 524 health professionals (i.e., physicians, nurses, and other health professionals) in California (n = 173), urban France (n = 102), and urban China (n = 249). Demographic factors associated with ME-PSM were investigated using analyses of variance (...) (ANOVAs) and t-tests, with results suggesting that ME-PSM is higher among younger health professionals, nurses (when compared with physicians and other health professionals), and Chinese health professionals (when compared with French and American health professionals).ResultsResults provide preliminary support for the psychometric quality of the survey measure introduced in this study, including the existence of a single latent structure and partial invariance of collected data across countries.ConclusionThe survey measure for ME-PSM which was developed and tested in the current study appears to hold potential utility for use as a measure of moral views of patient substance misuse. With development, this measure may be used to examine moral evaluations, both as factors of stigma and of other clinical factors associated with the treatment of patients with substance use disorders. (shrink)

The microstructures of cryogenically ball-milled Cu were investigated by high-resolution electron microscopy. It was found that the grain-size reduction is a dislocation-controlled continuous process which consists of the formation of small-angle grain boundaries , a gradual increase in misorientations as a result of accumulation of more dislocations and, finally, the formation of large-angle GBs. The GBs were generally curved, wavy or faceted, and heavily strained, which are typical characteristics of nanostructured materials. In addition, extrinsic dislocations were found in many GBs, (...) indicating that most are in a high-energy non-equilibrium configuration, which is consistent with observations in equal-channel angular pressing processed Cu, Ni, and Al-Mg, repetitive corrugation and straightening processed Cu and room-temperature ball-milled Cu. These results support a still-disputed concept that GBs in nanostructured metals processed by severe plastic deformation are mostly in non-equilibrium states. (shrink)

The target article retains the traditional account of saccades as conjugate eye movements. However, recent single-unit recordings of premotor cells in the saccade pathway (excitatory burster neurons [EBNs]) found that they do not encode conjugate eye velocity, but rather, monocular eye velocity. These data argue against the traditional concept of saccades as inherently conjugate. Instead, they suggest a monocular mechanism in the sensorimotor transformation stage of saccade generation. This commentary will discuss the implications of these data for the saccade generation (...) model proposed in Findlay & Walker's target article. (shrink)

The purpose of this quantitative study of 401 students is to identify common motivations for Chinese students to plagiarize on written English assignments and ultimately to demystify and understand the mindset of Chinese students who do plagiarize. According to a regression analysis of these data, the most significant factor relating to likelihood to self-report plagiarism for Chinese students is the belief in a “standard answer,” which represents the correct answer to a given question. The regression results also suggest that students (...) who believe that imitation of experts is important to learning are more likely to self-report plagiarism, and that business students are more likely to self-report than non-business students. The other factors examined in our model, such as English writing ability; ability to express one’s self in English writing; embarrassment about English writing ability; concern for accuracy of English writing; and concerns about grade point average, were not significant predictors of self-reported plagiarism. These results give a key insight into the English writing plagiarism behaviors of Chinese students studying in Western higher education. (shrink)