Backgrounds Moral distress significantly affects pediatric ICU nurses, leading to nurse burnout, increased turnover and reducing patient care quality. Despite its importance, there’s a notable gap in knowledge on how to manage it effectively. Aims This review aimed to systematically identify and analyze coping strategies and interventions targeting moral distress among pediatric nurses in ICU, uncovering research gap and future studies directions. Methods A scoping review was conducted followed framework by Levac, Colquhoun, and O'Brien and Arksey and O'Malley. Searches were (...) performed in 11 electrical databases, like PubMed and China Biology Medicine disc, within a timeframe of the database construction to November 2023, and performed literature screening and data extraction. Results Sixteen articles were ultimately included. Coping strategies adopted by pediatric ICUs nurses can be categorized into adaptive and maladaptive strategies, with the latter including passive acceptance, taking leave, and drinking, while the former involve pursuing interests outside of work, reflection and philosophizing, and communication. Nine articles described and evaluated the effectiveness of interventions for moral distress, categorizing them into individual and institutional levels. Individual-level interventions include Interprofessional Perspective-Taking, the PICU Resiliency Bundle, Ethics Education/Skills, and the Center for Caring. Institutional-level interventions encompasses Comprehensive Care Round, Goals of Care Conversations, Pediatric Ethics and Communication Excellence Rounds, Nursing Ethics Council, and Medical Ethical Decision-Making, though not all were effective in alleviating moral distress. Conclusions Nurses often use self-adjustment strategies for moral distress, institutional ethical support focusing on enhancing nurses’ moral resilience, promoting reflective thinking and improving communication remains crucial. Various interventions for moral distress are currently available, but nurse engagement is low and their effectiveness remained to be verified. Future studies should explore what aids or hinders these interventions. There’s also a need for large, multicenter trials and ongoing evaluations to create effective support systems for pediatric ICU nurses. (shrink)

Blasting in water-conveyance tunnels that cross rivers is vital for the safety and stability of embankments. In this work, a tunnel project that crosses the Yellow River in the north district of the first-phase Eastern Line of the South-to-North Water Diversion Project was selected as the research object. A complex modeling and numerical simulation on embankment stability with regard to the blasting power of the tunnel was conducted using the professional finite difference software FLAC3D to disclose the relationships between the (...) blasting seismic waves with vibration velocity and embankment displacement under different excavation steps. Calculation results demonstrated that displacement generally attenuated from the tunnel wall to the internal structure of rocks under the effect of blasting seismic waves. The tunnel wall was in tension, and tensile stress gradually transformed into compressive stress with increased depth into the rocks. The curtain-grouting zone was mainly concentrated in the compressive zones. For different excavation steps, the vibration velocity at different feature points was high at the beginning of blasting and then gradually decreased. The resultant displacement was relatively small in the early excavation period and slowly increased as blasting progressed. The effects of different excavation steps on the safety of surrounding rocks and embankment under blasting seismic waves were simulated. We found that the blasting-induced vibration velocity was within the safe range of the code and that the calculated displacement was within the allowed range. Numerical simulation was feasible to assess the safety and stability of engineering projects. (shrink)

BackgroundNurses working in the intensive care unit clung tenaciously to their job during the COVID-19 pandemic in spite of enduring stressed psychological and physical effects as a result of providing nursing care for the infected patients, which indicates that they possessed a high degree of professionalism and career calling. The aim of this study was to explain the associations between resilience, thriving at work, and ethical leadership influencing the calling of ICU nurses.MethodsFrom December 2020 to January 2021 during the COVID-19 (...) pandemic, a cross-sectional survey of 15 provinces in China was conducted using an online questionnaire. A total of 340 ICU nurses completed sufficient responses to be used in the study. Sociodemographic factors, job demographic factors, resilience, calling, thriving at work, and ethical leadership were assessed using the questionnaire. General linear modeling, hierarchical linear regression analysis, and generalized additive model were performed to examine all the considered research hypotheses.ResultsResilience was positively and significantly associated with calling. Moreover, thriving at work partially mediated the relationship between resilience and calling. The indirect effect of resilience on calling was 0.204, and the direct effect of resilience on calling through thriving at work was 0.215. The total effect of resilience on calling was 0.419. In addition, ethical leadership played a moderating role in the relationship between resilience and calling.ConclusionGreater resilience can positively predict increased calling among Chinese ICU nurses during the COVID-19 pandemic. Moreover, thriving at work is a mechanism that partly transmits the positive effects of resilience on calling. Overall, nurses possessing greater resilience tend to maintain thriving at work in the face of such adversity, further resulting in subsequently increased calling. Besides, findings suggest that there is stronger influence of resilience on calling among nurses working in an organization managed by an ethical leader. The current findings may offer two insights for nursing practitioners and policymakers in the postpandemic world. First, resilience training and intervention are necessary to foster nurses' sense of thriving at work in the nursing industry, further promoting career calling. Second, better training and effort on the development of ethical leadership for leaders in nursing practice are essential to encourage followers to engage in social learning of ethical behaviors and abiding by normatively appropriate conduct, further enacting prosocial values and expressing moral emotions. (shrink)

The cellular internal ribosomal entry site (IRES) is one of the most important elements to mediate cap‐independent translational initiation, especially under conditions of stress and pathology. However, a high‐throughput method to discover IRESs in these conditions is still lacking. Here, a possible way IRES long‐read sequencing based on the latest high‐throughput technologies is proposed to solve this problem. Based on this design, diversity and integrity of the transcriptome from original samples can be kept. The micro‐environment that stimulates or inhibits IRES (...) activity can also be mimicked. By using long read‐length sequencing technology, additional experiments that are essential for ruling out the cryptic promoters or splicing events in routine IRES identification processes can be circumvented. It is hoped that this proposed methodology may be adopted for IRES element discovery, hence uncovering the full extent of the role of IRESs in disease, development, and stress. Also see the video abstract here https://youtu.be/JuWBbMzWXS8. (shrink)

Graphical AbstractCellular internal ribosomal entry site (IRES) is important for cap-independent translational initiation during stress and pathology. In article number 1900180, Lei-Yun Wang et al. propose an idea to discover IRES based on the latest high-throughput technologies, hence facilitating the understanding of IRES in disease development and treatment.

因為現代醫藥之發達與進步，我們身體的痛已大多有了消解之道；但思想、心理與性靈的病卻是越來越讓我們感到憂傷，越來越教我們心生恐懼，也越來越侵犯到我們原本一心盼望單單純純地「活在此時此刻」這極其謙卑的權利 與心願。 顯然，現代科技仍然效力有限，而無端的生命苦難更是難以預期與估量。我們還是得時時回頭看看自己這一身，回頭想想自己這一生，並同時回頭思量自己這一顆心到底蘊藏著什麼寶貝，或許，這樣的自力救濟與自力更生纔是生 活的王道。 且讓我們一起來細細品味兩千多年前這一位東方的「生命療癒先行者」――莊子到底是怎麼看待他自己這一身、這一生、這一世以及時時刻刻跳動在「此時此刻」的這一顆心，而其中又有何特殊光景值得莊子大書特書，這也許是 人類千年不變的生命共業。 原本，我們一出生就無法自外於大自然，而「自然」原來就在我們完完整整的這一身，它的符碼（甚至是密碼）就藏在我們人人心底，就靠我們自己來記憶，來存取，來開啟我們與生俱來的自我療癒的能力，而莊子如是言，如是 行，如是思量，如是觀想，如是腳踏實地，如是心無旁鶩，如是存活於此時此刻──而他已然為我們落下這八個無比精采的篇章： ◆逍遙之遊──莊子一心渴望真自由，而他到底是如何滿足這心底深沉的渴望？又是如何從地面起身躍向那無邊無界的天空？ ◆齊物之論──莊子彷彿心無是非，口無虛言，而只是靜觀萬物，平等看待這世上的一切，他是如何能夠保有這份真真切切的「自知之明」？如何在夢醒之際清清楚楚地守著這僅有的清明之心？ ◆養生之主──莊子先是如同一般人，一心只盼望健健康康，無疾也無病，但他還深刻地警覺生命最大的痛──死亡隨時隨處在窺伺著我們，我們又能如何真正地跳出這幾乎無所不在的死亡的幽谷？ ◆人間之世──莊子深知世上難免無妄之災，更難防故意之敵，但我們還是得盡量避禍，盡力解厄，同時盡心地處理好所有與我們相連相繫的人際關係；不過，當不順心不如意之事迎面而來之際，我們又當如何舉重若輕地一肩承 擔？莊子顯然有他自己的法子。 ◆真人之身──莊子不是教主，也不想開宗立派，他只是始終關心本來無價無償的生命到底該怎麼被我們認真地看待，而那「無用之用」的奧妙又有誰能真正了解？ ◆渾沌之死──就莊子看來，「渾沌」本無生亦無死；而如果說我們總是自己在「找死」，並不是死亡找上我們，這雖然看似重話，卻可能有警醒人心的作用。原來，莊子的「生命之壺」暗藏玄機，而縱然生死之謎究竟無解，但 我們又何妨放下心來，自由自在地在這世上走上一回。 ◆自然之道──莊子當然不懂現代科技，但他已經知道運用機械的後遺症。設想時下所謂的「科技新貴」能夠放下「釣魚上鉤」的念頭，靜靜地佇立水岸，觀賞那魚兒水中游，大概就將別有一番生活情趣與生命體悟。 ◆幸福之夢──莊子應該和任何人一樣，都想幸幸福福過一生，但我們到底該怎麼尋找終生的伴侶（甚至是「絕配」）？日子又該怎麼過得舒適？而和自己又能如何做一輩子的至親好友？這些問題的解答，可能就是打開那幸福之 門的鑰匙吧！ 作者：葉海煙 輔仁大學哲學博士，美國哈佛大學訪問學人、東吳大學哲學系教授兼系主任、長榮大學哲學與宗教學系教授兼系主任、台灣哲學學會會長、錢穆故居執行長、台南市哲學學會會長。現任南神神學院神學研究所專任哲學教授、國立 成功大學兼任哲學教授。專長道家哲學，當代新儒學，當代倫理學比較研究，台灣文化研究。著有《莊子的生命哲學》、《老莊哲學新論》、《道德、理性與人文的向度》、《中國哲學的倫理觀》、《人文與哲學的對話》、《傳 統倫理的現代挑戰》、《莊子的處世智慧》、《老子診療室》、《臺灣學入門》、《道家倫理學：理論與實踐》、《哲學與人生》、《哲學在哪裡》等近二十種著作。.

[1] Xian Qin juan (shang) -- [2] Xian Qin juan (xia) -- [3] Qin Han juan -- [4] Wei Jin Nan Bei chao juan (shang) -- [5] Wei Jin Nan Bei chao juan (xia) -- [6] Sui Tang Wu dai juan (shang) -- [7] Sui Tang Wu dai juan (xia) -- [8] Song Liao Jin juan (shang) -- [9] Song Liao Jin juan (xia) -- [10] Yuan dai juan -- [11] Ming dai juan (shang) -- [12] Ming dai (...) juan (zhong) -- [13] Ming dai juan (xia) -- [14] Qing dai juan (shang) -- [15] Qing dai juan (zhong) -- [16] Qing dai juan (xia) -- [17] Jin dai juan (shang) -- [18] Jin dai juan (xia) -- [19] Suo yin juan. (shrink)

本书从魏晋南北朝历史条件、文学艺术、哲学、宗教诸方面入手,展示了人性觉醒的历史画面。从人性和人本角度对魏晋南北朝的社会变化与文化转型进行了探讨,关注历史转型期人们对自身、宇宙和传统伦理的批判。.

本辑主要从现代性视角出发, 深入探讨从西方传入的各种思潮与观念-进化论, 激进主义, 无政府主义, 平等, 自由, 科学-在中国的传播, 及中国的传统文化如何影响了国人对这些观念的理解.

Chu tu wen xian yu ru dao guan xi " nei rong jian jie: ru dao guan xi shi yi xiang gui mo hong da de yan jiu ke ti, ta she ji daozheng ge Zhongguo si xiang shi de nei zai jie gou he fa zhan guo cheng, she ji dao Zhongguo wen hua jin hou de zou xiang, yi yi zhong da. Er shi shi ji yi hou, yi huo de le shu liang ke guan de yan (...) jiu cheng guo. Zui jin chu tu wen xian de da liang yong xian you wei zhe ge wen ti de tao lun ti gong le xu duo xin cai liao, xin shi ye, xin guian dian."Chu tu wen xian yu ru dao guan xi " shou ji le 30 duo pian you dai biao xing de lun wen, tong guo "Kong Lao Meng Zhuang zhi bian", "Ru dao hu bu yu ying xiang", "Chu tu wen xian xin shi ye" san ge ban kuai jia yi cheng xian, xi wang du zhe jie ci dui yi wang ru dao guan xi yan jiu de fa zhan mai luo yu kuang jia you zong ti de ba wo, bing you ci kai chu xin de yan jiu tian di. (shrink)

This paper introduces a refined single-valued neutrosophic set (RSVNS) and presents a similarity measure of RSVNSs. Then a multicriteria decision-making method with RSVNS information is developed based on the similarity measure of RSVNSs. By the similarity measure between each alternative and the ideal solution (ideal alternative), all the alternatives can be ranked and the best one can be selected as well. Finally, an actual example on the selecting problems of construction projects demonstrates the application and effectiveness of the proposed method.

Current work in language models (LMs) helps us speed up or even skip thinking by accelerating and automating cognitive work. But can LMs help us with critical thinking -- thinking in deeper, more reflective ways which challenge assumptions, clarify ideas, and engineer new concepts? We treat philosophy as a case study in critical thinking, and interview 21 professional philosophers about how they engage in critical thinking and on their experiences with LMs. We find that philosophers do not find LMs to (...) be useful because they lack a sense of selfhood (memory, beliefs, consistency) and initiative (curiosity, proactivity). We propose the selfhood-initiative model for critical thinking tools to characterize this gap. Using the model, we formulate three roles LMs could play as critical thinking tools: the Interlocutor, the Monitor, and the Respondent. We hope that our work inspires LM researchers to further develop LMs as critical thinking tools and philosophers and other 'critical thinkers' to imagine intellectually substantive uses of LMs. (shrink)

本书将佛学中一些大师们重点强调的智慧闪光点重新编创,内容包括:活一天就要有一天的意义、感情上的事不可太执着、该出手时便出手、生在红尘中便忙人间事等。.

本书以通俗白话的形式演绎深奥的哲学问题,对于哲学定义、古人与哲学、世界观、哲学的分支等论题进行论述。.

In Sahan et al ’s article,1 they present the ethical challenges faced by clinical laboratory scientists in genetic medicine, including labour allocation and responsibility, interpretation and accuracy of results with new technologies, and the need for better standardisation and ethical consistency. At the same time, they also propose a potential solution to the aforementioned challenges: ethical preparedness(EP). Along with their vivid case discussions and insightful analysis, I would like to propose two more points that are worth further examination and discussion (...) to aid stakeholders in better comprehending the ethical issues that clinical laboratory scientists face in the practice of genetic medicine. The case 1 reported by Sahan et al raises concerns about who should be responsible for tracking families or individuals with genetic results, particularly in the absence of mainstream services to track future risks. However, this should not be a factor influencing the decision to inform gene carriers. If there is a clear division of responsibilities in current practice, clinical laboratory scientists can report detected gene carriers without psychological burden. However, the decision to report gene carriers should be based on who is being served when clinical laboratory scientists face genetic problems in clinical practice and who is being considered when …. (shrink)

Impurism says that practical factors encroach on knowledge. An important version of impurism is called ‘Threshold-Impurism,’ which says that practical factors encroach on the threshold that rational credence must pass in order for one to have knowledge. A prominent kind of argument for Threshold-Impurism is the so-called ‘principle-based argument,’ which relies on a principle of fallibilism and a knowledge-action principle. This paper offers a new challenge against Threshold-Impur- ism. I attempt to show that the two principles Threshold-Impurists are committed to—KJ (...) and Fallibilism—are jointly in tension with a widely-held principle of credence that’s called ‘Truth-Directedness,’ in the sense that the former two principles cannot both apply to those who know the third. This tension constitutes a serious challenge to Threshold-Impurists, because it leaves them two options, both of which are undesirable: denying Truth-Directedness, or accepting Truth-Directedness and accepting that whether KJ and Fallibilism apply to a person depends on whether she knows Truth-Directedness. (shrink)

v. 1. Qian Sugeladi zhe xue yan jiu, Sugeladi ji qi zhe xue si xiang -- v. 2. Si, shi, shi.