Background Adherence to ethical guidelines and regulations and protecting and respecting the dignity and autonomy of participants by obtaining a valid informed consent form (ICF) prior to participation in research are crucial; The subjects did not add signatures next to the corrections made to signatures or dates on the ICF, Multiple signatures in other fields, ICF missing/missing signature, Incorrect ICF version Signed after modification, Correction tape used to correct signature, Impersonated signature, Non-research-member signature, however, ICFs are often not properly completed, (...) which must be addressed. This study analyzed ICF signing errors and implemented measures to reduce or prevent these errors. Methods We used the plan–do–check–act (PDCA) cycle to help improve the correctness and validity of ICF signing. Results Interim and final reports from January 2016 to February 2020 including 363 ICFs were studied. The total proportion of correct ICF signatures (200, 83.3%) following the PDCA intervention was significantly higher than that before the intervention (P < 0.05). Analysis of the types of signing error demonstrated that signature errors were significantly reduced after the intervention, particularly for subjects did not add signatures next to the corrections made to signatures or dates on the ICF (16, 6.7%) and impersonated signature (0; P < 0.05). Conclusions The proportions of other error types—multiple signatures in other fields, missing or unsigned ICF, incorrect signature order, incorrect ICF version, use of correction tape to correct signature, and non-medical profession members signing the ICF—did not differ significantly. (shrink)

ObjectivesWuhan is the city where coronavirus disease was first reported and developed into a pandemic. However, the impact of the prolonged COVID-19 pandemic on medical staff burnout remains limited. We aimed to identify the prevalence and major determinants of burnout among medical staff 1 year after the beginning of the COVID-19 pandemic in Wuhan, China.Materials and MethodsA total of 1,602 medical staff from three hospitals in Wuhan, China, were included from November 1–28, 2021. Chi-square tests were conducted to compare the (...) prevalence of burnout across groups based on sociodemographic and professional characteristics. A multivariate analysis was performed using a forward stepwise logistic regression model.ResultsApproximately 37.39% of the medical staff experienced burnout 1 year after COVID-19 pandemic. Emotional exhaustion was the most common symptom of burnout, with 1,422 participants reporting a severe EE. Burnout was associated with insufficient social support and “neutral” or “dissatisfied” patient-physician relationships. Respondents who participated in the care of COVID-19 patients had a higher risk of burnout symptoms than those who did not participate. In particular, mental resilience was negatively associated with burnout among the medical staff.ConclusionNearly two-fifths of the participants had symptoms of burnout, with reduced personal accomplishment being the predominant symptom 1 year after COVID-19. Healthcare organizations should regularly measure and monitor burnout among the medical staff. In addition, creating positive work environments and improving the mental resilience of medical staff may be effective ways to reduce burnout. (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)

With the rapid development of society and the dramatic change of environment, previous career counseling focusing on personal choice has been difficult to meet individuals’ needs. It is very meaningful and valuable to introduce the ideology of Life Design Counseling. In this mini review, we introduce and analyze the theory and methodology of LDC. This review puts forward challenges in the field of LDC, including the lack of attention to clients from multiple backgrounds and professional counselors, the lack of diversified (...) methods in the intervention process, and the lack of diversified research. The theoretical research, practical research, and the integration of theory and practice of LDC still need to be further concerned by researchers. (shrink)

Rips et al.'s analyses have boosted the plausibility of proposals that the human mind embodies some critical properties of natural numbers. I suggest that such proposals can be further evaluated by infant studies, neuropsychological data, and evolution-based considerations, and additionally, that Rips et al.'s model may need to be modified in order to more completely reflect infants' quantitative abilities.

Metrics and their weaker forms are used to measure the difference between two data. There are many metrics that are available but not desired by a practitioner. This paper recommends in a plausible reasoning manner an easy-to-understand method to construct desired distance-like measures: to fuse easy-to-obtain pseudo-semi-metrics, pseudo-metrics, or metrics by making full use of well-known t-norms, t-conorms, aggregation operators, and similar operators. The simple reason to do this is that data for a real world problem are sometimes from multiagents. (...) A distance-like notion, called weak interval-valued pseudo-metrics, is defined by using known notions of pseudo-semi-metrics, pseudo-metrics, and metrics; this notion is topologically good and shows precision, flexibility, and compatibility than single pseudo-semi-metrics, pseudo-metrics, or metrics. Propositions and detailed examples are given to illustrate how to fabricate an expected or demanded WIVP-metric in practical problems, and WIVP-metric and its special cases are characterized by using axioms. Moreover, some WIVP-metrics pertinent to quantitative logic theory or interval-valued fuzzy graphs are constructed, and fixed point theorems and common fixed point theorems in weak interval-valued metric spaces are also presented. Topics and strategies for further study are also put forward concretely and clearly. (shrink)

“Carbon neutrality, carbon peaking” is China’s national commitment to the whole world about its plans to manage global climate change. China faces many severe challenges in fulfilling its commitments to reduce emissions. China’s digital economy is currently booming, and whether it can provide opportunities for reducing regional carbon emissions is worth exploring. This study constructed a comprehensive system to evaluate the development of its digital economy based on China’s regional data and empirically tested the direct, indirect, and spatial effects of (...) the comprehensive development of digital economy on regional carbon emissions. In addition, it examined the special stage characteristics using a Hansen threshold model. This study found the following: first, the digital economy significantly suppresses carbon emissions in general, notably with a spatial spillover effect to neighboring provinces. Secondly, an analysis of the mechanism shows that the comprehensive development of a digital economy can restrain regional carbon emissions through industrial progress and the optimization of energy consumption. Third, there are double thresholds, special driving trends and an “inverted N-type” relationship with development. Fourth, a spatial heterogeneity analysis revealed that significant “local” and “neighboring” impacts on the reduction of carbon emissions only exist in the central and eastern areas. This study has a reference value for releasing the dividend of digital economy development and reducing carbon emissions. (shrink)

In this paper, we examine the interactive effects of positive affect and perspective-taking on workplace incivility and family incivility, through moral disengagement. We draw from broaden-and-build and moral disengagement theories to suggest a potential negative consequence of positive affect. Specifically, we argue that positive affect increases incivility toward coworkers and spouses through moral disengagement among employees with low, but not high perspective-taking. Data from two time-lagged field studies and one online experiment provide support for our hypotheses. These findings suggest that (...) the beneficial effects of positive feelings are not universal, and the fostering of positive feelings at work might have unintended negative consequences, namely moral disengagement, and increased incivility at work and at home. Implications for theory and research are discussed. (shrink)

BackgroundThe Basal ganglia (BG) played a crucial role in the brain-level mechanisms of chronic pain disorders. However, the functional changes of BG in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are still poorly understood. This study investigated the BG subregions’ resting-state functional connectivity (rs-FC) in CP/CPPS patients compared with healthy controls.MethodsTwenty eight patients with CP/CPPS and 28 age- and education-matched healthy males underwent clinical measurements and 3T brain MR imaging, including T1-weighted structural images and resting-state functional imaging. The data were analyzed (...) by the seeded-based rs-FC analysis. Then, a machine learning method was applied to assess the feasibility of detecting CP/CPPS patients through the changed rs-FC.ResultsCompared with healthy males, patients presented decreased rs-FC between the BG subregions and right middle cingulate cortex, and correlated with pain (r = 0.51, p-uncorrected = 0.005) and urinary symptoms (r = –0.4, p-uncorrected = 0.034). The left superior temporal gyrus and right supramarginal gyrus showed decreased rs-FC with the BG subregions as well. The area under the receiver operating characteristic curve of 0.943 (accuracy = 80%, F1-score = 80.6%) was achieved for the classification of CP/CPPS patients and healthy males with support vector machine (SVM) based on the changed rs-FC.ConclusionThese findings provide evidence of altered BG subregions’ rs-FC in CP/CPPS, which may contribute to our understanding of the BG’s role in CP/CPPS. (shrink)

Objectives: Autism spectrum disorder (ASD) is a juvenile onset neurodevelopmental disorder with social impairment and stereotyped behavior as the main symptoms. Unaffected relatives may also exhibit similar ASD features due to genetic factors. Although previous studies have demonstrated atypical brain morphological features as well as task-state brain function abnormalities in unaffected parents with ASD children, it remains unclear the pattern of brain function in the resting state.Methods: A total of 42 unaffected parents of ASD children (pASD) and 39 age-, sex-, (...) and handedness-matched controls were enrolled. Multiple resting-state fMRI (rsfMRI) analyzing methods were applied, including amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), degree centrality (DC), and functional connectivity (FC), to reveal the functional abnormalities of unaffected parents in ASD-related brain regions. Spearman Rho correlation analysis between imaging metric values and the severity of ASD traits were evaluated as well.Results: ALFF, ReHo, and DC methods all revealed abnormal brain regions in the pASD group, such as the left medial orbitofrontal cortex (mOFC) and rectal gyrus (ROI-1), bilateral supplementary motor area (ROI-2), right caudate nucleus head and right amygdala/para-hippocampal gyrus (ROI-3). FC decreasing was observed between ROI-1 and right anterior cingulate cortex (ACC), ROI-2, and bilateral precuneus. FC enhancing was observed between ROI-3 and right anterior cerebellar lobe, left medial temporal gyrus, left superior temporal gyrus, left medial frontal gyrus, left precentral gyrus, right postcentral gyrus in pASD. In addition, ALFF values in ROI-1, DC values in ROI-3 were positively correlated with AQ scores in pASD (ρ1 = 0.298, P1 = 0.007; ρ2 = 0.220, P2 = 0.040), while FC values between ROI-1 and right ACC were negatively correlated with AQ scores (ρ3 = −0.334, P3 = 0.002).Conclusion: rsfMRI metrics could be used as biomarkers to reveal the underlying neurobiological feature of ASD for unaffected parents. (shrink)

ObjectiveTo investigate the attitudes of Chinese parents regarding the storage of dried blood spots collected for newborn screening (NBS) and their use in research.MethodsWe conducted a hospital-based survey of parents and examined parental attitudes regarding (a) allowing NBS sample storage, (b) permitting use of children’s NBS samples for research with parental permission, and (c) permitting use of children’s NBS samples for research without parental permission.ResultsThe response rate was 52 percent. Of parents surveyed, 68 percent would permit their infant’s NBS sample (...) to be stored for at least some length of time. If permission is obtained, 69 percent of parents “strongly agreed” or “agreed” to permit use of the NBS sample for research. If permission is not obtained, only 14 percent of parents “strongly agreed” or “agreed.” There was no significant association between permitting use of NBS samples for research and parental gender, education, household income, number of children, or site of residence.ConclusionsThis is the first survey of Chinese parents regarding the use of NBS samples for different types of research, with results indicating that most parents would permit their infant’s sample to be stored and would support the use of NBS dried blood spots for research purposes. (shrink)

From the tape-recording of naturally occurring Chinese psychotherapy sessions, this article explores how repeated occurrences of resistance are managed in the course of interactional sequences and the participants’ actions within these sequences. By employing the methods of conversation analysis, we discuss the main discursive strategies employed by the clients to express their resistance and investigate how the therapist manages this. We find that clients show their resistance to the therapist’s questions in four ways: keeping silence, providing minimal response, making non-answer (...) responses, and being over-talkative. Persistent asking is the main technique we identify in the data for the therapist to manage the resistance; in the meantime, asking questions in a stepwise way, making requests after facing resistance to questions, active retreating and reformulating of the client’s words are employed as subsidiary techniques. The successful management of resistance leads to a smooth sequential development of the psychotherapy, while inappropriate strategies might result in a halt or even breakdown of the therapeutic work. In psychotherapy, resistance is a result of the shared interaction between client and therapist. It is such a complex issue that, in order to understand and manage it, we also take into consideration the broader social and cultural context in which it occurs. (shrink)

Student–teacher relationships have been examined by many studies. However, an omission still exists, the existing scales are not appropriate for studying STRs in private colleges because of the special character of these schools. This paper presents the development and validation of Private-College Student–Teacher Relationship Scale, the first instrument to evaluate student–teacher relationships in private colleges. The PCSTRS has six dimensions: trust, interaction, intimacy, care, approval, and comfort. In our main study, the validity and reliability of the six-factor PCSTRS model were (...) demonstrated. The result of internal consistency coefficient indicated the high reliability of the scale, and the result of concurrent validity indicated the significant correlational relationships between the PCSTRS with other STR measures. In supplementary study, the PCSTRS was administered to 360 participants to confirm the applicability of PCSTRS and investigate the relation of STRs and students’ traits, performance, and wellbeing, as well as the differences between the private school and the public school in this relation; the analyses revealed that there were significant differences in trust, intimacy, and care between private and public colleges; positive correlations were found between STRs and self-esteem, self-efficacy, academic performance, extracurricular activity involvement, and subjective wellbeing. Present research firstly develops the PCSTRS, examined the reliability and validity, and provides the proposed nomological network among related constructs. (shrink)

BackgroundThe underrepresentation of scholarly works from low- and middle-income countries (LMICs) in academic literature is a documented concern, attributed partly to editorial biases. This trend, prevalent across various disciplines, has been less explored in the context of medical ethics journals. This study aimed to examine the composition of editorial board members (EBM) in high-impact medical ethics journals and to evaluate the extent of international diversity within these editorial teams.MethodsThis study incorporated an analysis of 16 high-impact medical ethics journals. Information regarding (...) the EBM of these journals was systematically gathered and categorized based on the World Bank’s country income classifications. An in-depth examination of the editorial board compositions was then conducted.ResultsThe study identified 669 EBM across the selected journals. A predominant 89.84% (601) of these members were from high-income countries (HICs), with upper-middle-income countries contributing 7.47% (50) and lower-middle-income countries 2.69% (18). No EBM were associated with low-income countries. A regional breakdown indicated that North America was the most represented area, accounting for 48.88% (327), followed by Europe & Central Asia (27.50%, 184), East Asia & Pacific (13.45%, 90), Latin America & Caribbean (4.63%, 31), Sub-Saharan Africa (4.19%, 28), Middle East & North Africa (0.75%, 5), and South Asia (0.60%, 4). In total, these EBMs hailed from 46 different countries, with the United States representing the largest proportion (43.80%, 293), followed by the United Kingdom (13.15%, 88), Australia (7.92%, 53), Germany (6.73%, 45), and Canada (5.08%, 34).ConclusionsThere is a significant lack of international representation within the EBM of high-impact medical ethics journals. The majority of editors in this field are affiliated with HICs, leading to a severe underrepresentation of LMICs within the editorial boards. (shrink)

PurposeThis study aims to describe the adverse events following immunization of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.MethodsA cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale before and after the first and second doses of COVID-19 vaccine.ResultsA total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety and HADS (...) Depression scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A and HADS-D scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A and HADS-D scores after the second dose of the SARS-CoV-2 vaccine.ConclusionMild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms. (shrink)

This study examines the characteristics of request sequences in Chinese public service calls. The data analysis indicates that a prominent characteristic of Chinese public service calls is the frequent appearance of insert expansions and non-minimal post-expansions, with the latter occurring after both preferred response and dispreferred response. This is closely related to participants’ institutional identities and epistemic asymmetry; operators handling such service calls should pay due attention to this asymmetry to ensure mutual understanding in conversation.

Improving the resilience of urban road networks suffering from various disruptions has been a central focus for urban emergence management. However, to date the effective methods which may mitigate the negative impacts caused by the disruptions, such as road accidents and natural disasters, on urban road networks is highly insufficient. This study proposes a novel adaptive signal control strategy based on a doubly dynamic learning framework, which consists of deep reinforcement learning and day-to-day traffic dynamic learning, to improve the network (...) performance by adjusting red/green time split. In this study, red time split is regarded as extra traffic flow to discourage drivers to use affected roads, so as to reduce congestion and improve the resilience when urban road networks are subject to different levels of disruptions. In addition, we utilize the convolution neural network as Q-network to approximate Q values, link flow distribution and link capacity are regarded as the state space, and actions are denoted as red/green time split. A small network is utilized as a numerical example, and a fixed time signal control and other two adaptive signal controls are employed for the comparisons with the proposed one. The results show that the proposed adaptive signal control based on deep reinforcement learning can achieve better resilience in most of the cases, particularly in the scenarios of moderate and severe disruptions. This study may shed light on the advantages of the proposed adaptive signal control dealing with major emergencies compared to others. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Recently, social Q&A communities have grown increasingly popular, serving as a primary platform for people to learn and share information. Nonetheless, fewer knowledge producers in these communities are significant than knowledge consumers. Thus, promoting users’ participation in knowledge sharing is a challenge for managers of social Q&A communities. Even though many scholars have studied factors influencing willingness to share knowledge, they tend to start with one theory and ignore the impact of several factors on behaviors. Thus, this manuscript presents a (...) multi-factor model based on three dimensions of technology, cognition, and security to explore the effects of the six factors of perceived ease of use and perceived usefulness, perceived behavioral control and subjective norms, perceived security, and perceived privacy in terms of the three knowledge sharing methods of browsing including like and favorite, publishing and replying, and to compare users’ willingness to use the three knowledge sharing methods. A total of 482 questionnaires were collected online, and the hypotheses were tested and analyzed using structural equation modeling. According to the results, the factors affecting different sharing methods are not the same. Perceived behavioral control and perceived security can have a significant influence on their willingness to browse, users’ willingness to publish and reply to posts is significantly influenced by their perception of behavioral control and subjective norms, while perceived usefulness also affects their willingness to respond, it can be seen that cognition is the most important factor affecting users’ knowledge sharing among the three dimensions. In addition, users’ willingness to browse is significantly greater than their willingness to reply, and their willingness to post is the lowest. (shrink)

Entrepreneurship education has a lot of research on influencing factors of entrepreneurial intention but rarely studies the influence mechanism of emotional competences on entrepreneurial intention from the perspective of social entrepreneurship. This article takes college students’ social entrepreneurs as research objects, drawing on Krueger’s model, theory of planned behavior, social cognitive theory, and triadic reciprocal determinism theory. This paper constructs a conceptual model with emotional ability, entrepreneurial self-efficacy, and entrepreneurial intention, to further study their relationship. The 312 students from China (...) College Students’ Social Entrepreneurship Project engaged in early entrepreneurship practice, conducted a questionnaire survey and used the empirical test of the structural equation model to analyze the relationship between college students’ emotional competences, entrepreneurial self-efficacy, and entrepreneurial intention. The result show: First, social–emotional competence had a positive effect on entrepreneurial intention, and the positive effect of personal affective competence on entrepreneurial intention was not supported or only partially supported. Second, all the dimensions of entrepreneurial self-efficacy were significantly and positively correlated with entrepreneurial intention. Third, emotional competence has a significant positive impact on entrepreneurial self-efficacy. Fourth, entrepreneurial self-efficacy mediated the relationship between emotional competence and entrepreneurial intention. (shrink)

ICAP is a theory of active learning that differentiates students’ engagement based on their behaviors. ICAP postulates that Interactive engagement, demonstrated by co‐generative collaborative behaviors, is superior for learning to Constructive engagement, indicated by generative behaviors. Both kinds of engagement exceed the benefits of Active or Passive engagement, marked by manipulative and attentive behaviors, respectively. This paper discusses a 5‐year project that attempted to translate ICAP into a theory of instruction using five successive measures: (a) teachers’ understanding of ICAP after (...) completing an online module, (b) their success at designing lesson plans using different ICAP modes, (c) fidelity of teachers’ classroom implementation, (d) modes of students’ enacted behaviors, and (e) students’ learning outcomes. Although teachers had minimal success in designing Constructive and Interactive activities, students nevertheless learned significantly more in the context of Constructive than Active activities. We discuss reasons for teachers’ overall difficulty in designing and eliciting Interactive engagement. (shrink)