The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

Background and aimDuring the COVID-19 pandemic, an Internet-Mindfulness-Based Stress Reduction program was delivered and may be better than an in-person approach. Our study evaluated the effects of iMBSR intervention on mental health, self-efficacy, and body image in women with breast cancer in Taiwan.Materials and methodsSixty-seven women with breast cancer were allocated to a 6-week iMBSR program or a waitlist control group, without heterogeneity between group characteristics. Patients from both groups were measured at baseline and postintervention using three scales: Depression, Anxiety, (...) and Stress Scale, General self-efficacy scale, and Body Image Scale. Descriptive dataset analysis, paired t-test, and Student’s t-test were used to evaluate the data.ResultsAlthough iMBSR did not significantly improve depression and stress between groups, iMBSR could improve anxiety with medium effect sizes. Significant benefits were found for body image and self-efficacy, with large effect sizes.ConclusionOur preliminary study supports iMBSR as a program that can improve mental health, body image, and self-efficacy in women with breast cancer. During the COVID-19 pandemic, medical professionals can use Internet-based clinical health education. (shrink)

Students often face difficulties and experience negative emotions toward second language learning. The affective tutoring system is a next-generation learning approach that can detect the affective status of learning to increase performance. Therefore, for the purposes of this study, an innovative affective mobile language tutoring system was designed to support Japanese language learning. The effects of AMLTS, along with asynchronous discussion, that were intended to improve performance, were examined using a triangulation method. To investigate the effect on emotion, the proposed (...) AMLTS provides a virtual emotion agent that can interact with users and record emotional events, learning assessments, and the results of the interaction into a database. Learning effectiveness evaluations were conducted via two experiments: prototype evaluation and final evaluation. Sixty-three students, all beginners, were invited to use the AMLTS to learn Japanese. The research results show that the proposed AMLTS affective interaction design significantly improves learner engagement and performance. In the emotion feedback analysis and learning process, AMLTS helped students deepen their understanding of the content, enabled them to clearly understand the content, and to engage in peer interaction and experience positive emotions. In the evaluation of system usability, AMLTS reveals good usability for foreign language acquisition. (shrink)

This study is based on the situation of Taiwan listed companies as derivative financial products from 2015 to 2017, analyzing the relationship between the hedging of derivative financial products and characteristics of enterprises and the factors that affect the hedging decision-making of companies. It is found that even after the announcement of Taiwan’s No. 34 and No. 36 bulletins, there are still some problems that are needed to improve in the disclosure of derivative financial product investment information by Taiwan’s listed (...) companies, at least in the disclosure of the reasons for this conduct which is still insufficient. In this study, two-stage regression analysis method is applied to empirical analysis, and it is found that hedging activities are related to corporate characteristics, such as expected financial crisis costs, corporate size, equity issues, growth investment opportunities, and information asymmetry. In the investment of derivative financial products, enterprises should evaluate their own financial characteristics as a reference for the risk avoidance decision. At the same time, it is necessary to investigate different natures of hedging tools used in appropriate risk categories, so as to fully achieve the hedging effect and maximize the hedging benefits. This study also found that companies with higher growth investment opportunities, larger size, and higher financial crisis costs will tend to use derivative financial products for hedging. As for the impact of other industries, it is found that the electronic and electrical machinery industries are more active than other industries in hedging behaviors of undertaking derivative financial products’ transaction. (shrink)

We applied the theoretical perspective of the dual filial piety model to consider the diversity of parent–child conflict resolution strategies in order to determine whether Chinese adolescents use strategies other than self-sacrifice to practice filial piety when in conflict with their parents. Study 1 utilized a cross-sectional design with 247 valid responses. The structural equation modeling analysis indicated that Taiwanese adolescents’ authoritarian filial piety beliefs are positively related to use of a self-sacrifice strategy, and reciprocal filial piety beliefs are positively (...) related to use of compatibility and compromise strategies. Adolescents’ AFP and RFP beliefs are negatively related to use of utility and escape strategies. Study 2 applied a temporal separation procedure with a 1-year lag to remedy common method variance bias. Analysis of 1,063 valid responses replicated the findings of Study 1 and indicated that adolescents’ function-oriented appraisal of conflict can play a mediating role between RFP and the use of the compatibility and compromise strategies. These findings broaden the understanding of filial piety in modern Chinese societies and have implications for adolescents’ well-being and family life. (shrink)

Selections from the sayings of Zhuangzi rendered into cartoon form and translated into English.

Two experiments were conducted to examine adult learners' ability to extract multiple statistics in simultaneously presented visual and auditory input. Experiment 1 used a cross‐situational learning paradigm to test whether English speakers were able to use co‐occurrences to learn word‐to‐object mappings and concurrently form object categories based on the commonalities across training stimuli. Experiment 2 replicated the first experiment and further examined whether speakers of Mandarin, a language in which final syllables of object names are more predictive of category membership (...) than English, were able to learn words and form object categories when trained with the same type of structures. The results indicate that both groups of learners successfully extracted multiple levels of co‐occurrence and used them to learn words and object categories simultaneously. However, marked individual differences in performance were also found, suggesting possible interference and competition in processing the two concurrent streams of regularities. (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)

This study aimed to develop cross-domain deep learning courses of artificial intelligence in vocational senior high schools and explore its impact on students’ learning effects. It initially adopted a literature review to develop a cross-domain SPOC-AIoT Course with SPOC and the Double Diamond 4D model in vocational senior high schools. Afterward, it adopted participatory action research and a questionnaire survey and conducted analyses on the various aspects of the technology acceptance model by SmartPLS. Further, this study explored the impact on (...) the effects of deep learning and knowledge-ability learning of artificial intelligence after 16 weeks of course teaching among 36 Grade I students from the electrical and electronic group of a vocational senior high school. This study revealed that the four stages of the SPOC-AIoT Teaching Mode of the Double Diamond 4D model may effectively guide students to learn AIoT knowledge and skills. Based on the technology acceptance model, the analysis of learning and participation in SmartPLS indicated that this model conformed to the academic fitness requirements of the overall model. After learning with the SPOC-AIoT Teaching Mode, the learning effects of students in AIoT have been significantly improved to a positive aspect. Finally, some suggestions were put forward to promote the development of the SPOC-AIoT Teaching Mode Course in the future. (shrink)

In numerous peripheral sense organs, external stimuli are detected by primary sensory neurons compartmentalized within specialized structures composed of cuticular or epithelial tissue. Beyond reflecting developmental constraints, such compartmentalization also provides opportunities for grouped neurons to functionally interact. Here, the authors review and illustrate the prevalence of these structural units, describe characteristics of compartmentalized neurons, and consider possible interactions between these cells. This article discusses instances of neuronal crosstalk, examples of which are observed in the vertebrate tastebuds and multiple types (...) of arthropod chemosensory hairs. Particular attention is paid to insect olfaction, which presents especially well‐characterized mechanisms of functional, cross‐neuronal interactions. These examples highlight the potential impact of peripheral processing, which likely contributes more to signal integration than previously considered. In surveying a wide variety of structural units, it is hoped that this article will stimulate future research that determines whether grouped neurons in other sensory systems can also communicate to impact information processing. (shrink)

A large number of studies have investigated achievement goals and their related antecedents and consequences above elementary school level. However, few studies have implemented achievement goal assessment to investigate achievement goals and their relevance for preschoolers. In particular, no valid measurement has been developed for preschoolers’ self-reporting of their achievement goals. The main purposes of this study were twofold: To develop an innovative achievement goal measurement for preschoolers, and to investigate the best theoretical model for understanding preschoolers’ achievement goal across (...) gender. To examine the effectiveness and efficiency of the pictorial and pure text measurement format and approaches. A total of 364 preschoolers aged 5 years participated in self-report activity, and 32 preschool teachers obtained consent to rate 193 out of 364 preschoolers. Results showed: the developed achievement goal measurement was a valid tool for understanding preschoolers’ achievement goals and was equally suitable for boys and girls. The 6-factor achievement goal model was the best theoretical perspective for understanding preschoolers’ achievement goals for both boys and girls. The pictorial measurement format for preschoolers’ self-reporting of achievement goals was a more effective but less efficient way to investigate preschoolers’ achievement goals, while the opposite was the case for the pure text measurement format for teachers’ ratings. Implications for achievement goal literature and future research are discussed. (shrink)

To many, recent allegations of accounting fraud (or earnings management; EM) at Enron, coupled with similar ones at many other corporations, are a strong indication of a serious decay in business ethics. In academics, this raises the concern between EM and corporate social responsibility (CSR). Since it has neither been documented, nor globally tested whether CSR mitigates or increases the extent of EM, three kinds of EM are studied: earnings smoothing, earnings aggressiveness, and earnings losses and decreases avoidance. The extents (...) to which financial characteristics and institutional variables have an impact on the extent to which companies conduct EM are also tested. Our study investigates whether the CSR-related features of 1,653 corporations in 46 countries had a positive or negative effect on the quality of their publicly released financial information during the 1993-2002 period. There is no question that with a greater commitment to CSR, the extent of earnings smoothing is mitigated, that of earnings losses and decreases avoidance is reduced, but the extent of earnings aggressiveness is increased. (shrink)

Entrepreneurship has flourished in recent years; however, since education on how to raise funds has received little attention from scholars, obtaining funds remains a difficult task. The development of crowdfunding has provided new opportunities to entrepreneurs, thus solving the funding, marketing, and distribution problems they previously faced. The main purpose of this study is to organize crowdfunding literature and to develop a crowdfunding curriculum grounded on output-based education. Students are asked to develop a product and a crowdfunding plan within the (...) span of one semester. This study explains the teaching content separately from the crowdfunding plan competition, course elements, and timetable. (shrink)

Co-creativity focuses on how individuals produce innovative ideas together. As few studies have explored co-creativity using standardized tests, it is difficult to effectively assess the individual’s creativity performance within a group. Therefore, this study aims to develop a platform that allows two individuals to answer creativity tests simultaneously. This platform includes two divergent thinking tasks, the Straw Alternative Uses Test and Bottle Alternative Uses Test, and Chinese Radical Remote Associates Test A and B, which were used to evaluate their open-and (...) closed-ended creative problem-solving performance. This platform has two modes: single-player mode and paired-player mode. Responses from 497 adults were collected, based on which the fluency, flexibility, and originality of divergent thinking were measured. This study also developed a computer scoring technique that can automatically calculate the scores on these creativity tests. The results showed that divergent thinking scores from computer-based calculation and manual scoring were highly positively correlated, suggesting that the scores on a divergent thinking task can be calculated through a system that avoids time-consuming, uneconomical manual scoring. Overall, the two types of tests on this platform showed considerable internal consistency reliability and criterion-related validity. This advanced application facilitates the collection of empirical evidence about co-creativity. (shrink)

Only problems that cannot be solved without representational changes can be regarded as pure insight problems; others are classified as pseudo-insight problems. Existing studies using neuroimaging...

This study aims to disclose how the magnetic resonance imaging neuroimaging approach has been applied in education studies, and what kind of learning themes has been investigated in the reviewed MRI neuroimaging research. Based on the keywords “brain or neuroimaging or neuroscience” and “MRI or diffusion tensor imaging or white matter or gray matter or resting-state,” a total of 25 papers were selected from the subject areas “Educational Psychology” and “Education and Educational Research” from the Web of Science and Scopus (...) from 2000 to 2019. Content analysis showed that MRI neuroimaging and learning were studied under the following three major topics and nine subtopics: cognitive function, science education, and brain development. As for the type of MRI neuroimaging research, the most frequently used approaches were functional MRI, followed by structural MRI and DTI, although the choice of approach was often motivated by the specific research question. Research development trends show that the neural plasticity theme has become more prominent recently. This study concludes that in educational research, the MRI neuroimaging approach provides objective and empirical evidence to connect learning processes, outcomes, and brain mechanisms. (shrink)

The attitudes and the self?efficacy that characterize learners relative to the Internet have been identified as important factors that affect learners? motivation, interests and performance in Internet?based learning environments. Meanwhile, learners? perceptions of the Internet may shape learners? attitudes and online behaviours. This study investigates university students? attitudes and self?efficacy towards the Internet, and explores the role that university students? perceptions of the Internet may play in their Internet attitudes and self?efficacy. The results indicate that university students demonstrate positive attitudes (...) and adequate Internet self?efficacy and that these students are more inclined to view the Internet as a functional tool?a functional technology. Gender differences exist in university students? attitudes towards, and perceptions of, the Internet; that is, male students demonstrate Internet attitudes that are more positive than those of their female peers. Furthermore, students who perceive the Internet as a leisure tool (e.g. as a tour or a toy) show more positive attitudes and communicative self?efficacy than students who use the Internet as a functional technology. Educators and researchers need to be aware of these differences and to take them into consideration in their instruction. Lastly, this study serves as a starting?point for research that more broadly explores learners? perceptions of the Internet. (shrink)

Adopting deep approaches to learning can have a profound impact on learning outcomes. The extent of change in the learning approach could be attributed to the effect of contextual factors. After a substantive review, it was found that research interested in investigating the longitudinal effect of deep approaches to learning on learning outcomes were rarely directly concerned with the longitudinal state and trend of the approach itself. Moreover, the limitations of past analytical methods, has not been appropriately acknowledged. This study (...) examined deep approaches to learning in students from kindergarten to third grade using a multilevel structural equation modeling indicator-specific growth model. This was used to highlight the methodological issues to investigate the effect of context and the states, stability, and changes in deep approaches to learning over this developmental period. The current study comprised of a large-scale sample of 21,490 kindergarteners in kindergarten. Results showed: there was a contextual effect on the longitudinal changes of deep approaches to learning; deep approaches to learning was high but showed considerable individual differences; most indicators relating to deep approaches to learning declined, whereas the trend were relatively stable over time. Corresponding suggestions were proposed at the end of this article. (shrink)

Multiple versions of the Chinese Remote Associates Test have been developed. Thus far, all CRATs have employed verbal stimuli; other forms of stimuli have not yet been used. In this context, the present study compiled a Chinese Visual Remote Associates Test that conforms to the Chinese language and culture based on a picture naming database. The developed CVRAT has two versions, CVRAT-A and CVRAT-B, each comprising 20 test questions. A typical CVRAT question consists of three stimuli pictures, requiring respondents to (...) propose a target word that is semantically associated with all the pictures. When compiling the CVRAT, this study first selected target words, sifted through stimuli words and corresponding pictures, and analyzed pilot test questions. After compilation, their reliability and validity were examined. The results showed that the CVRAT had moderate internal consistency reliability, good criterion-related validity for the Chinese Word Remote Associates Test, Chinese Radical Remote Associates Test, Chinese Compound Remote Associates Test, insight problem-solving, as well as acceptable discriminant validity for fluency, flexibility, and originality of a divergent thinking test. In other words, CVRAT can effectively measure remote associative capability and provides a figural creativity test that facilitates the understanding of different kinds of remote associations. (shrink)

Evidence suggests divergent thinking is the cognitive basis of creative thoughts. Neuroimaging literature using resting-state functional connectivity has revealed network reorganizations during divergent thinking. Recent studies have revealed the changes of network organizations when performing creativity tasks, but such brain reconfigurations may be prolonged after task and be modulated by the trait of creativity. To investigate the dynamic reconfiguration, 40 young participants were recruited to perform consecutive Alternative Uses Tasks for divergent thinking and two resting-state scans were used for mapping (...) the brain reorganizations after AUT. We split participants into high- and low-creative groups based on creative achievement questionnaire and targeted on reconfigurations of the two brain networks: default-mode network and the network seeded at the left inferior frontal gyrus because the between-group difference of AUT-induced brain activation located at the left IFG. The changes of post-AUT RSFCs indicated the prolonged effect of divergent thinking. More specifically, the alterations of RSFCIFG−AG and RSFCIFG−IPL in the high-creative group had positive relationship with their AUT performances, but not found in the low-creative group. Furthermore, the RSFC changes of DMN did not present significant relationships with AUT performances. The findings not only confirmed the possibility of brain dynamic reconfiguration following divergent thinking, but also suggested the distinct IFGN reconfiguration between individuals with different creativity levels. (shrink)

The financial crisis of 2007–2008 and the COVID-19 pandemic have caused many enterprises to suffer great losses. Thus, companies have to take measures such as pays cut, furloughs, or layoffs, which caused dissatisfaction among employees and triggered labor disputes. Therefore, this study explores the service-oriented organizational citizenship behavior based on the decomposed theory of planned behavior in order to understand the behavioral intentions of employees through their mental states, job attitudes, subjective norms, and perceived behavioral control. This study conducted questionnaire (...) surveys for employees in different industries, collected 281 valid questionnaires, and applied Structural Equation Model for the analysis. The results show: employees believe organizational justice in the organization is important, and when they feel treated fairly, their job attitudes and beliefs are enhanced. Employees’ job attitudes and beliefs support service-oriented organizational citizenship behavior, in other words, they have positive job attitudes and beliefs and will actively provide better service to customers. When employees are treated reasonably and fairly by the organization and have positive job attitudes and perceived behavior control, their spontaneous service-oriented organizational citizenship behavior is stimulated, thus increasing organizational development. (shrink)

Most neuroimaging research in stroke rehabilitation mainly focuses on the neural mechanisms underlying the natural history of post-stroke recovery. However, connectivity mapping from resting-state fMRI is well suited for different neurological conditions and provides a promising method to explore plastic changes for treatment-induced recovery from stroke. We examined the changes in resting-state functional connectivity (RS-FC) of the ipsilesional primary motor cortex (M1) in 10 post-acute stroke patients before and immediately after 4 weeks of robot-assisted bilateral arm therapy (RBAT). Motor performance, (...) functional use of the affected arm, and daily function improved in all participants. Reduced interhemispheric RS-FC between the ipsilesional and contralesional M1 (M1-M1) and the contralesional-lateralized connections were noted before treatment. In contrast, greater M1-M1 functional connectivity and disturbed resting-state networks were observed after RBAT relative to pre-treatment. Increased changes in M1-M1 RS-FC after RBAT were coupled with better motor and functional improvements. Mediation analysis showed the pre-to-post difference in M1-M1 RS-FC was a significant mediator for the relationship between motor and functional recovery. These results show neuroplastic changes and functional recoveries induced by RBAT in post-acute stroke survivors and suggest that interhemispheric functional connectivity in the motor cortex may be a neurobiological marker for recovery after stroke rehabilitation. (shrink)

There has been a lack of research into candidate selection outside the developed world. In this paper we attempt to fill this gap, with a detailed examination of the factors leading to the introduction of party primaries, their operations and their future prospects, in a third wave democracy, Taiwan. Although Taiwan is a late democratizer, the high degree of party institutionalization makes it more appropriate to compare its nomination system with those of older political parties, we particularly contrast it with (...) the leading German and British political parties. Our discussion also finds many similar trends with developments of intra-party democracy in European parties, particularly in terms of a decentralization of candidate selection and reduced mediation between party centre and members. In addition, despite technical changes in electoral campaigning, parties in Taiwan have not abandoned the mass membership model. In Taiwan, direct primary elections have been a controversial subject. By analyzing relevant data, we argue that the core problem of the party primary was its lack of fairness, because party cadres tried to monopolize the candidate selection and thus failed to remain neutral. We find signs that leaders in all parties are wary of allowing inner party democracy to go too far and losing their control over nomination. When the party centre fears the wrong candidates will be selected, they are prepared to manipulate the rules in their favour or re-centralize the selection process. (shrink)

This study proposed and examined a conceptual framework on the influence of real estate brokers’ personalities, psychological empowerment, social capital, and knowledge sharing on their innovation performance, and used moral hazard as a moderating variable. We used structural equation modeling for data analysis and estimation. The participants were real estate brokers in Kaohsiung City. A total of 1,000 questionnaires were administered to 100 branch offices of real estate companies, 571 of which were later recovered from 80 branch offices. After removing (...) 52 for being invalid, we were left with 519 valid questionnaires, indicating a 51.9% recovery rate. The empirical results suggest that the real estate brokers’ personalities and psychological empowerment positively and significantly influence social capital; personality and psychological empowerment also positively and significantly influence their innovation performance; and social capital significantly influences knowledge sharing, which in turn positively and significantly influences the brokers’ innovation performance. In environments with higher levels of moral hazard, the influence of social capital on the brokers’ knowledge sharing is significantly diminished. (shrink)

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the (...) changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time. (shrink)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (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...

The aim of this study was to compare the learning effectiveness of peer tutored problem-based learning and conventional teaching of nursing ethics in Taiwan. The study adopted an experimental design. The peer tutored problem-based learning method was applied to an experimental group and the conventional teaching method to a control group. The study sample consisted of 142 senior nursing students who were randomly assigned to the two groups. All the students were tested for their nursing ethical discrimination ability both before (...) and after the educational intervention. A learning satisfaction survey was also administered to both groups at the end of each course. After the intervention, both groups showed a significant increase in ethical discrimination ability. There was a statistically significant difference between the ethical discrimination scores of the two groups (P < 0.05), with the experimental group on average scoring higher than the control group. There were significant differences in satisfaction with self-motivated learning and critical thinking between the groups. Peer tutored problem-based learning and lecture-type conventional teaching were both effective for nursing ethics education, but problem-based learning was shown to be more effective. Peer tutored problem-based learning has the potential to enhance the efficacy of teaching nursing ethics in situations in which there are personnel and resource constraints. (shrink)