BackgroundAging and type 2 diabetes mellitus are important risk factors for the development of cognitive deterioration and dementia. The objective of this research was to investigate the effects of an exercise intervention on cognitive function in older T2DM patients.MethodsEight literature databases were searched from inception to 20 January 2022. The researchers examined randomized controlled trials that evaluated the impact of exercise on the cognitive performance of older T2DM patients. The Cochrane risk-of-bias tool for RCTs was used to assess each study. (...) The quality of evidence was assessed using the GRADE approach. The mini-mental state examination, Modified MMSE, and Montreal cognitive assessment were used to evaluate the cognitive outcomes. We performed a subgroup analysis with stratification according to exercise intervention modality, duration, and cognitive impairment.ResultsFive trials were eligible, with a total of 738 T2DM patients. The combined findings revealed that exercise improved global cognitive function significantly. In the studies that were included, no relevant adverse events were reported.ConclusionExercise is beneficial in improving global cognitive function in older adults with T2DM. Studies with bigger sample sizes and higher quality are additionally expected to draw more definite conclusions.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/#recordDetails], identifier [CRD42022296049]. (shrink)

Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...

This book is a translation of a key commentary on the Book of Changes, or Yijing, perhaps the most broadly influential text of classical China. The Yijing first appeared as a divination text in Zhou-dynasty China and later became a work of cosmology, philosophy, and political theory as commentators supplied it with new meanings. While many English translations of the Yijing itself exist, none are paired with a historical commentary as thorough and methodical as that written by the Confucian scholar (...) Cheng Yi, who turned the original text into a coherent work of political theory. (shrink)

The Zhoushu 《周書》 section of the Shangshu 《尚書》, reflecting on the dynastic changes from Xia to Shang and from Shang to Zhou, understands “heavenly mandate” as the common element that brings about all changes within a historical continuum. For Zhoushu, it is “heavenly mandate” that makes historical continuity possible. Furthermore, “heavenly mandate” is understood to manifest itself with the hopes of the common people and to be realized by the freewill of the king. Thus historical changes can be accommodated. The (...) Chinese idea of historical identity continued to be enriched after the Chun Qiu 春秋 Period. But in terms of its characteristic understandings of history, it remained much the same as in the Zhoushu: Interpreting history with a common element recognized therein, with the stress always on continuity though historical changes are accommodated from a humanist perspective. (shrink)

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)

Many factors affect the teaching of massively open online courses. In this study, to explore the factors that influence the effective teaching of MOOCs, a large number of relevant studies are analyzed. Based on grounded theory, semi-structured interviews were conducted with 30 students and teachers who used MOOCs for online teaching. The interview data were subjected to four research processes –open coding, axial coding, selective coding, and saturation testing– to explore the factors influencing MOOCs’ effective teaching and the interactions between (...) them. The results demonstrate that: Effective teachers, effective tuition, effective communication, active online learning, social support guarantees, and online course design have important positive effects on effective teaching, while only certain online learning behaviors will seriously affect the teaching effectiveness of MOOC, resulting in negative effects. Effective communication is essential for effective teaching in MOOCs; effective teachers are the leading factor, thus teachers should take the initiative to study and understand the students to understand their various learning needs and difficulties. Reasonable and effective classroom teaching design is key to improving MOOCs’ teaching efficiency. E-learning is respected, cared for, and valued by society, including cognition, emotion, and learning platform support from family, school, teachers, and classmates, and has an important impact on students’ motivation and the effects of online learning. The results of this study further clarify factors influencing effective teaching of MOOCs, thus helping to enrich and supplement the theory of effective teaching and evaluation and providing theoretical guidance for teachers to effectively implement MOOC teaching. (shrink)

The information in the working environment of industrial Internet is characterized by diversity, semantics, hierarchy, and relevance. However, the existing representation methods of environmental information mostly emphasize the concepts and relationships in the environment and have an insufficient understanding of the items and relationships at the instance level. There are also some problems such as low visualization of knowledge representation, poor human-machine interaction ability, insufficient knowledge reasoning ability, and slow knowledge search speed, which cannot meet the needs of intelligent and (...) personalized service. Based on this, this paper designs a cognitive information representation model based on a knowledge graph, which combines the perceptual information of industrial robot ontology with semantic description information such as functional attributes obtained from the Internet to form a structured and logically reasoned cognitive knowledge graph including perception layer and cognition layer. Aiming at the problem that the data sources of the knowledge base for constructing the cognitive knowledge graph are wide and heterogeneous, and there are entity semantic differences and knowledge system differences among different data sources, a multimodal entity semantic fusion model based on vector features and a system fusion framework based on HowNet are designed, and the environment description information such as object semantics, attributes, relations, spatial location, and context acquired by industrial robots and their own state information are unified and standardized. The automatic representation of robot perceived information is realized, and the universality, systematicness, and intuition of robot cognitive information representation are enhanced, so that the cognition reasoning ability and knowledge retrieval efficiency of robots in the industrial Internet environment can be effectively improved. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

This paper makes a quantitative analysis of the comprehensive influence of music networks. Firstly, 11 music features are selected from energy, popularity, and other aspects to build a comprehensive evaluation index of music influence, and the PageRank algorithm is used to quantify the music influence. Secondly, the multiobjective logistic regression is used to construct the music similarity measurement model and, combined with music influence and music similarity, to judge whether the influence of different musicians is the actual influence. Thirdly, the (...) influence and similarity of the same music genre and different music genres are analyzed by using the two-way cluster analysis method. Finally, the lasso region is used for feature selection to obtain the change factors in the process of music evolution and analyze the dynamic changes in the process of music development. Therefore, this paper uses network science to build a dynamic network to analyze the similarity of music, the evolution process, and the impact of music on culture, which has certain research significance and practical value in the fields of music, history, social science, and practice. (shrink)

This study attempts to identify customer retention strategies for legal software and discusses their effectiveness for three consumer groups (stayers, dissatisfied switchers, and satisfied switchers). Although previous studies propose several antipirating strategies, they do not discuss how to enhance customer intentions to use legal software, which is crucial for software companies. The authors provide four generic retention strategies developed from both antipiracy and customer loyalty literature. The results indicate lower-pricing, legal, communication, and product strategies all enhance customer purchase intentions toward (...) legal software. The lower-pricing strategy is more useful for stayers and dissatisfied switchers, and the communication strategy is most useful for dissatisfied switchers. Both the legal and product strategies have similar impacts on purchase intentions across the three segments. From a firm perspective, a product strategy is most worthwhile and useful across all segments. (shrink)

While dynamic epistemic logics with common knowledge have been extensively studied, dynamic epistemic logics with distributed knowledge have so far received far less attention. In this paper we study extensions of public announcement logic ( $\mathcal{PAL }$ ) with distributed knowledge, in particular their expressivity, axiomatisations and complexity. $\mathcal{PAL }$ extended only with distributed knowledge is not more expressive than standard epistemic logic with distributed knowledge. Our focus is therefore on $\mathcal{PACD }$ , the result of adding both common and (...) distributed knowledge to $\mathcal{PAL }$ , which is more expressive than each of its component logics. We introduce an axiomatisation of $\mathcal{PACD }$ , which is not surprising: it is the combination of well-known axioms. The completeness proof, however, is not trivial, and requires novel combinations and extensions of techniques for dealing with $S5$ knowledge, distributed knowledge, common knowledge and public announcements at the same time. We furthermore show that $\mathcal{PACD }$ is decidable, more precisely that it is $\textsc {exptime}$ -complete. This result also carries over to $\mathcal{S 5\mathcal CD }$ with common and distributed knowledge operators for all coalitions (and not only the grand coalition). Finally, we propose a notion of a trans-bisimulation to generalise certain results and give deeper insight into the proofs. (shrink)

While the existing literature finds that corporate social responsibility (CSR) can provide insurance-like protection in negative events, it remains unclear how CSR buffers firms from market penalties for negative events. To address this concern, we conduct event studies and regressions using data from the environmental violations by Chinese publicly traded companies and their interlocked companies from 2009 to 2021. Our results show that the market reacts negatively to environmental violations. The market penalty diffuses through director networks and leads to the (...) collective punishment of interlocked firms. CSR has an insurance-like effect that buffers market penalties and collective punishment for environmental violations. Long-term CSR has a stronger insurance-like effect than short-term CSR. Additionally, the insurance-like effect of CSR still exists during repeated environmental violation events. This paper contributes to the literature on the insurance-like effect of CSR and provides a reference for corporate CSR practice and investors' CSR decisions. (shrink)

ObjectiveBasic combat training is a kind of necessary high-intensity training to help each military recruit convert into a qualified soldier. In China, both the physical fatigue and passive psychological state have been observed in new recruits during BCT. However, after same-intensity training, the degree of fatigue and passive mood vary among recruits. Therefore, this study aimed to explore the effect of BCT on mood state of recruits with different physical fitness levels from a perspective of fatigue.Materials and methodsBefore and after (...) BCT, the degree of fatigue and mood state of participants were evaluated via the Borg Rating of Perceived Exertion Scale and Profile of Mood States Questionnaire immediately after 20 push-ups as RPE and POMS scores [total mood disturbance, passive mood and positive mood ]. The participants were divided into two groups according to the RPE score measured after BCT: group 1: RPE score after BCT < 13 and group 2: RPE score after BCT ≥ 13.ResultA total of 564 recruits were included. After BCT, in group 1, TMD and passive mood Ttension, Tfatigue, Tdepression, Tconfusion declined significantly, but positive mood both increased significantly ; while in group 2, only Tanger and Testeem increased significantly.ConclusionBCT could alleviate passive mood and add to positive mood for recruits with better physical fitness, while had no ameliorative effects on or even deteriorate most of the passive mood for recruits with worse physical fitness. (shrink)

Background The Patient Right to Autonomy Act (PRAA), implemented in Taiwan in 2019, enables the creation of advance decisions (AD) through advance care planning (ACP). This legal framework allows for the withholding and withdrawal of life-sustaining treatment (LST) or artificial nutrition and hydration (ANH) in situations like irreversible coma, vegetative state, severe dementia, or unbearable pain. This study aims to investigate preferences for LST or ANH across various clinical conditions, variations in participant preferences, and factors influencing these preferences among urban (...) residents. Methods Employing a survey of legally structured AD documents and convenience sampling for data collection, individuals were enlisted from Taipei City Hospital, serving as the primary trial and demonstration facility for ACP in Taiwan since the commencement of the PRAA in its inaugural year. The study examined ADs and ACP consultation records, documenting gender, age, welfare entitlement, disease conditions, family caregiving experience, location of ACP consultation, participation of second-degree relatives, and the intention to participate in ACP. Results Data from 2337 participants were extracted from electronic records. There was high consistency in the willingness to refuse LST and ANH, with significant differences noted between terminal diseases and extremely severe dementia. Additionally, ANH was widely accepted as a time-limited treatment, and there was a prevalent trend of authorizing a health care agent (HCA) to make decisions on behalf of participants. Gender differences were observed, with females more inclined to decline LST and ANH, while males tended towards accepting full or time-limited treatment. Age also played a role, with younger participants more open to treatment and authorizing HCA, and older participants more prone to refusal. Conclusion Diverse preferences in LST and ANH were shaped by the public’s current understanding of different clinical states, gender, age, and cultural factors. Our study reveals nuanced end-of-life preferences, evolving ADs, and socio-demographic influences. Further research could explore evolving preferences over time and healthcare professionals’ perspectives on LST and ANH decisions for neurological patients.. (shrink)

Job shop scheduling problem is one of the most difficult optimization problems in manufacturing industry, and flexible job shop scheduling problem is an extension of the classical JSP, which further challenges the algorithm performance. In FJSP, a machine should be selected for each process from a given set, which introduces another decision element within the job path, making FJSP be more difficult than traditional JSP. In this paper, a variant of grasshopper optimization algorithm named dynamic opposite learning assisted GOA is (...) proposed to solve FJSP. The recently proposed dynamic opposite learning strategy adopts the asymmetric search space to improve the exploitation ability of the algorithm and increase the possibility of finding the global optimum. Various popular benchmarks from CEC 2014 and FJSP are used to evaluate the performance of DOLGOA. Numerical results with comparisons of other classic algorithms show that DOLGOA gets obvious improvement for solving global optimization problems and is well-performed when solving FJSP. (shrink)

Journal Name: Cognitive Linguistics Issue: Ahead of print.

This study aimed at exploring the impact of post-epidemic era on teachers’ behavioral intention of distance education. In this study, purposive sampling method was used to enroll 390 teachers in colleges and universities, high schools and vocational schools, and junior high and elementary schools to be the research subjects for the questionnaire survey. A total of 360 questionnaires were collected for statistics, and AMOS 23.0 statistical software was used to analyze the correlation between variables. Meanwhile, a structural equation model was (...) used to analyze and verify the impact of the technology acceptance model, information system success model, and diffusion of innovations theory. According to the results, the system quality of distance teaching platforms certainly affected perceived usefulness, and perceived usefulness affected teachers’ attitudes toward using distance teaching systems. In addition, perceived ease of use had an impact on perceived usefulness, and trialability had an impact on teachers’ attitudes toward using distance teaching systems. Finally, teachers’ attitude toward using a distance teaching system also affected their behavioral intention. According to the results, suggestions were made in this study to teachers and students for distance teaching. Additionally, the main contribution of this study lies in providing specific strategies for further distance teaching through empirical results in combination with on-site teaching. (shrink)

The debate between the dynamical and the statistical interpretations of natural selection is centred on the question of whether all explanations that employ the concepts of natural selection and drift are reducible to causal explanations. The proponents of the statistical interpretation answer negatively, but insist on the fact that selection/drift arguments are explanatory. However, they remain unclear on where the explanatory power comes from. The proponents of the dynamical interpretation answer positively and try to reduce selection/drift arguments to some of (...) the most prominent accounts of causal explanation. In turn, they face the criticism raised by statisticalists that current accounts of causation have to be violated in some of their core conditions or otherwise used in a very loose manner in order to account for selection/drift explanations. We propose a reconciliation of both interpretations by conveying evolutionary explanations within the unificationist model of scientific explanation. Therefore, we argue that the explanatory power in natural selection arguments is a result of successful unification of individual- and population-level facts. A short case study based on research on sympatric speciation will be presented as an example of how population- and individual-level facts are unified to explain the morphological mosaic of bill shape in island scrub jays. (shrink)

Research concerning the relationship between psychological ethical climate and job satisfaction is popular in the literature. However, to date, no study in the literature has simultaneously investigated both the effects of individual-level and organization-level ethical climates on employees’ job satisfaction. On the basis of a multilevel analysis, the present study used a sample of 472 full-time employees from 31 organizations in Taiwan to examine the above two effects. Results from the analyses showed that within the organizations, individual employees’ instrumental climate (...) perceptions were negatively related to job satisfaction, whereas their caring climate perceptions and rules climate perceptions were positively related to job satisfaction. Also, the results indicated that between organizations, organizational instrumental climate was negatively related to job satisfaction, whereas organizational caring, independence, and rules climates were positively related to job satisfaction. Implications for research and managerial practices were derived from these findings. (shrink)

The study reported here, building on the research methods of Conversation Analysis, Politeness Theory, and Relevance Theory, attempts to examine the distribution of Mandarin qishi and shishishang across two different discourse modes in formal speech settings: formal lectures and TV panel news discussions. The results indicate that qishi is prevalent in TV panel news discussion data, which fall into the interactional mode, whereas shishishang is more prevalent in formal speech data, which fall into the transactional mode. The study shows that (...) in interaction, qishi is addressee-oriented and signals alignment or divergence, whereas shishishang is message-oriented and asserts a proposition with a tone of certainty. In addition, the study suggests that although the literal meanings of qishi and shishishang, which are concerned with factuality, are seemingly unrelated to emotive expressivity, they offer a rhetorical strategy for expressing the speaker’s attitudinal position, and can both serve to indicate the speaker’s epistemic inference. (shrink)

Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn victims (...) of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: the calling must be answered, the calling provoked my feelings, and the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving. (shrink)

The ideology about the relation between goodness and beauty for Confucius and the early Confucians is the continuation of the aesthetic tradition long before Confucius’s time, which sees more value in Yuejiao, namely, music/beauty education, than in Lijiao, Moral education. No doubt Confucius’s aesthetic idea is featured as the juxtaposition of Li and Yue, goodness and beauty. But we must not forget that Confucius, taking himself as a preserver of the sages’ tradition, personally values Yue (music/beauty) over Li (ritual/moral). It (...) is in this context that we argue that taking the unity of beauty and goodness as a Confucian aesthetic feature is a misinterpretation of his teaching and is poles apart from the ancient Chinese aesthetic tradition and from Confucius’ aesthetics. (shrink)

Interest in sustainability is increasing, and research on ESG management continues. The first issue to be discussed in the present situation is the environment. The study between the environment and internationalization was conducted around two conflicting arguments. First, the pollution haven hypothesis states that multinational corporations move to countries with looser regulations depending on environmental regulation. Next is the Porter Hypothesis, which argues that well-designed environmental regulations offset the cost of compliance and ultimately help firms gain a competitive advantage through (...) innovation that enhances performance. However, the two arguments have not yet reached a consensus conclusion. In addition, studies on the national level and studies considering the distance between countries, an important factor in international management, are lacking. This manuscript aims to revisit the relationship between the strength of environmental regulation and foreign direct investment in the context of increasing environmental concerns. Differences between countries are an important field of international management, but research on environmental regulations is lacking. The purpose of this study is to examine the relationship between existing environmental regulations and FDI and to discuss how the distance between countries can affect existing theories. (shrink)

Attentional biases have received considerable focus in research on cognitive biases and body dissatisfaction (BD). However, most work has focused on spatial allocation of attention. The current two experiments employed a rapid serial visual presentation (RSVP) task to investigate the temporal allocation of attention to body-related words among young females with high and low BD. Experiment 1 assessed the stimulus-driven attention of body-related stimuli. Participants identified a neutral second target (T2) as accurately as possible while ignoring the preceding neutral, fat-, (...) or thin-related first target (T1). As expected, we observed spontaneous attentional blink effects elicited by fat- and thin-related T1s among participants with high BD, suggesting enhanced awareness of body-related stimuli even when this information does not have to be identified. Such effects did not emerge among participants without BD. Experimental 2 investigated the goal-directed attention of body-related stimuli, during which participants needed to identify both the T1 and neutral T2. Participants with BD showed reduced attentional blink effects after both fat- and thin-related T1, suggesting facilitated consolidation of body-related information in goal-directed attention among participants with BD. The findings may have important clinical implications for understanding how to decrease and even prevent body image dissatisfaction. (shrink)

We introduce a type of weighted modal logic with explicit weights both in the language and in the models. The framework has its applications in epistemic logic for reasoning about agents’ knowledge based on their capability, and in deontic logic for agents’ choices based on their deontic capability or utilities. We make use of weighted Kripke models with the weights understood epistemically as a similarity measure between states and deontically as a measure of expected utilities. We present sound and complete (...) axiomatizations for the logics, and discuss variants and possible extensions. (shrink)

This study was designed to estimate the associations between self-efficacy and professional identity. A total of 1,051 freshmen nursing students from the Be Resilient to Nursing Career program were recruited from four universities between September and November 2020. A latent profile and moderated meditation analysis were performed. Four profiles of self-efficacy were identified and named as Lowest, Med-low, Med-high, and Highest. The mediating role of resilience and the moderating effect of role models were also identified. Therefore, self-efficacy, resilience, and role (...) models may be three important factors to professional identity in FNSs and these relationships should be further validated in longitudinal or interventional studies. (shrink)

This study proposes a research model based on social identity theory, which examines the moderating role of organizational trust on the relationship between corporate citizenship and organizational commitment. In the model, organizational commitment is positively influenced by organizational trust and four dimensions of perceived corporate citizenship, including economic, legal, ethical and discretionary citizenship. The model paths are hypothesized to be moderated by organizational trust. Empirical testing using a survey of personnel from 12 large firms confirms most of our hypothesized effects. (...) Theoretical and managerial implications of our findings are discussed. (shrink)

This study proposes a research model based on social identity theory, which examines the moderating role of organizational trust on the relationship between corporate citizenship and organizational commitment. In the model, organizational commitment is positively influenced by organizational trust and four dimensions of perceived corporate citizenship, including economic, legal, ethical and discretionary citizenship. The model paths are hypothesized to be moderated by organizational trust. Empirical testing using a survey of personnel from 12 large firms confirms most of our hypothesized effects. (...) Theoretical and managerial implications of our findings are discussed. (shrink)