ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Incidental findings in research with human participants may have implications for a person’s present health or future health outcomes. Current guidelines focus on methods for handling and reporting incidental findings from biological test data but incidental findings might also arise from non-biological tests. This article presents three examples in which the results from non-biological test data can be predictive of future disease and should be disclosed to research participants. It is intended to increase awareness and facilitate further discussion about the (...) reporting of incidental findings from non-biological data. (shrink)

Examines the myriad ways contemporary residents of Beijing understand and nurture the good life, practice the embodied arts of everyday well-being, and in doing so draw on cultural resources ranging from ancient metaphysics to modern media.

Objective:The purpose of this study was to describe the current situation of moral distress and to explore its influencing factors among Chinese nurses.Methods:This is an exploratory, descriptive design study. A total of 465 clinical nurses from different departments in three Grade-III, Level-A hospitals in Jinan, Shandong Province, completed the questionnaires, including demographics questionnaire, Chinese version of Moral Distress Scale–Revised, and Job Diagnostic Survey.Ethical considerations:The study was approved by the university ethics board and the local health service director.Results:The total score of (...) Moral Distress Scale–Revised was 36.01 ± 24.02 points. The mean frequency and intensity scores of moral distress were 1.13 ± 0.49 and 1.09 ± 0.58, respectively. The level of moral distress among Chinese clinical nurses was low, and the frequency and intensity of moral distress were on low to moderate level. The level of moral distress experienced by clinical nurses is associated with demographics features and job characteristics, including age, education degree, department, task significance, autonomy, and dealing with others.Conclusion:Our conclusion suggests that hospital and organizational administrations should attach much importance to the moral distress experienced by clinical nurses in China. Further studies should focus on interventions about how to reduce the levels of the frequency and intensity of moral distress among clinical nurses. (shrink)

In this paper, a 3D jerk chaotic system with hidden attractor was explored, and the dissipativity, equilibrium, and stability of this system were investigated. The attractor types, Lyapunov exponents, and Poincare section of the system under different parameters were analyzed. Additionally, a circuit was carried out, and a good similarity between the circuit experimental results and the theoretical analysis testifies the feasibility and practicality of the original system. Furthermore, a robust feedback controller was designed based on the finite-time stability theory, (...) which guarantees the synchronization of 3D jerk master-slave system in finite time and asymptotically converges to the origin. Finally, we also give verification for the discussion in this paper by numerical simulation. (shrink)

The purpose of this study was to examine how culture shapes creativity by reviewing empirical findings across diverse studies. The impact of culture on creativity is typically manifested in three ways: (a) people from different cultures or settings have distinct implicit and/or explicit conceptions of creativity; (b) individuals from different cultures, particularly those from individualist and collectivist cultures, show differences in preferred creative processes and creative processing modes (e.g., usefulness seems more important than novelty in the East, whereas novelty seems (...) equally important as usefulness, if not more so, in the West) when they are engaged in creative endeavors; (c) creativity may be assessed using different measures based on culture-related contents or materials, and findings are accurate only when culturally appropriate or culturally fair measures are used. Potential implications and future directions are also proposed. (shrink)

As a value-led entity, the nonprofit depends on its staff for the delivery of the brand value outsides and thus promoting the brand inside is crucial to the development of the nonprofits. Using a sample of 290 full-time staff working in 270 nonprofits in China, two related studies were conducted. Study 1 aimed to develop and validate a new scale for internal branding in the nonprofit context, while Study 2 aimed to investigate the linking mechanism between internal branding and brand (...) performance with the mediating roles of the person–organization fit and intent to stay with the brand. As predicted, the results revealed that: the nonprofit internal branding scale is a three-dimensional construct that is composed of brand-centered training, internal brand communication, and brand-oriented leadership, internal branding positively predicts POF, IntSB, and brand performance, and POF and IntSB sequentially mediate the internal branding–brand performance relationship. The implications of our findings for internal branding in the nonprofit context are discussed. (shrink)

In fear differential conditioning, stimuli that resemble the conditioned stimulus (CS+) are more likely to trigger fear responses. Excessive fear responses on stimuli not like CS + are often associated with anxiety. However, the threat judgments process and how this process manifests itself differently in subgroups with different generalisation rule applications, is unclear. This study examines whether anxiety biases the threat decision process in fear generalisation paradigm and whether subgroups characterised by different generalisation gradients was interpreted differently by drift-diffusion model. (...) We gathered behavioural data through a binary fear generalisation judgment task and clustered participants based on their responses. Reaction time distributions and individual scale scores were analyzed using the hierarchical drift-diffusion model. The model results suggested that similarity and state anxiety facilitated evidence-gathering processes that favoured “threat” judgments, but at the same time, state anxiety weakened the effect of stimulus similarity as evidence. Further cluster analyses revealed that this effect of anxiety on threat judgments only held true for specific subgroups of participants. This pioneering computational modelling effort in fear generalisation underscores the significant role of strategy preference and its complex interaction with anxiety in shaping stimulus processing. (shrink)

Recent studies support a model in which the progeny of SOX9+ epithelial progenitors at the distal tip of lung branches undergo cell allocation and differentiation sequentially along the distal‐to‐proximal axis. Concomitant with the elongation and ramification of lung branches, the descendants of the distal SOX9+ progenitors are distributed proximally, express SOX2, and differentiate into cell types in the conducting airways. Amid subsequent sacculation, the distal SOX9+ progenitors generate alveolar epithelial cells to form alveoli. Sequential cell allocation and differentiation are integrated (...) with the branching process to generate a functional branching organ. This review focuses on the roles of SOX9+ cells as precursors for new branches, as the source of various cell types in the conducting airways, and as progenitors of the alveolar epithelium. All of these processes are controlled by multiple signaling pathways. Many mouse mutants with defective lung branching contain underlying defects in one or more steps of cell allocation and differentiation of SOX9+ progenitors. This model provides a framework to understand the molecular basis of lung phenotypes and to elucidate the molecular mechanisms of lung patterning. It builds a foundation on which comparing and contrasting the mechanisms employed by different branching organs in diverse species can be made. (shrink)

The Y chromosome in the XY sex-determination system is often shorter than its X counterpart, a condition attributed to degeneration after Y recombination ceases. Contrary to the traditional view of continuous, gradual degeneration, our study reveals stabilization within large mating populations. In these populations, we demonstrate that both mutant and active alleles on the Y chromosome can reach equilibrium through a mutation-selection balance. However, the emergence of a new species, particularly through the founder effect, can disrupt this equilibrium. Specifically, if (...) the male founders of a new species carry only a mutant allele for a particular Y-linked gene, this allele becomes fixed, leading to the loss of the corresponding active gene on the Y chromosome. Our findings suggest that the rate of Y-chromosome degeneration may be linked to the frequency of speciation events associated with single-male founder events. (shrink)

How should the philosophical thought of the past be treated? Is the philosophical thought of the past two thousand years to be treated simply as an object of criticism, or does it contain a content that is worth inheriting and continuing? Those of us who are studying the history of philosophy must, in the process of our research, resolve this question, or at least we must have a clear understanding of this problem.

In the era of the Warring States, the school of Confucianism and the school of Mohism were acclaimed, equally and at the same time, as the two "prominent teachings" of Chinese thought. Nonetheless, by the time of the Han dynasty, the teaching of Mohism had receded and become terminated. On the other hand, while the school of Daoism was originally an eremetic school and was not considered a "prominent teaching," it nonetheless had widespread influence in China. Since the Han dynasty, (...) Confucianism became the dominant ideology in Chinese society. At the same time, the teachings of the Daoists also continued to grow and prosper, and became an important supplement to Confucianism. In any event, the philosophical ideas of both the Confucian school and the school of Daoism had major, profound, and longlasting impact on the development and evolution of China's traditional culture. (shrink)

In the Spring and Autumn and Warring States periods, scholarship flourished and the hundred schools contended. The term "the hundred schools" is of ancient origin.

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Differential leadership as a localized leadership style gradually developed on the basis of the Pattern of Differential Sequence. It plays a dual role in stimulating “insider subordinates” and “outsider subordinates” through the dynamic transformation of the roles. Using the process of game reasoning, the study identifies the differing principles used by insider subordinates and outsider subordinates in implementing deviant innovative behaviors. The simulation graph presents the perceived benefits of employees performing or not performing deviant innovative behaviors as clues during the (...) reasoning process, and implements deviant innovative behaviors for the high risk-taking trait of insider subordinates and the high internal control personality of outsider subordinates who implement deviant innovation. The theoretical derivation of behavior provides relevant references, and provides counter measures for effectively promoting employees’ deviant innovative behavior in the context of differential leadership. (shrink)

Food safety risk is becoming a vital issue for public health, and improving public awareness of FSR through social media is necessary. This study aims to explore specific mechanisms of FSR perception; it first categorizes 19 risk characteristics into two variables, dread and efficacy, and then examines how social media use affects perceived FSR through both variables. Additionally, the study explores the moderating effects of source credibility and science literacy on the mechanisms of FSR perception. Based on a nationwide online (...) survey of more than six salient food safety issues in China, the study found that exposure to food safety risk information on social media can help improve perceived FSR based on the proposed “dread–efficacy processing model”, where dread stimulates perceived risk, while efficacy suppresses risk perception. Moreover, source credibility intensifies the effect of social media use on efficacy appraisal, whereas science literacy exerts a “double-weakening” influence on dread appraisal. Theoretical and practical implications of the findings are discussed. (shrink)

Detailed summary in vernacular field only.

本书分为十章,主要内容包括:“理论”的论丧;元理论缺失与真理、价值的双重迷惘;体制性扭曲与意识形态修辞;未完成的历史主体性表述;理论的历史性与历史性的理论等.

Political cartoons make meaning by drawing on scenarios that must be immediately recognizable by their intended audience. Crucial meaning-making mechanisms in these scenarios are verbo-visual ensembles of metaphors and metonymies. In this paper we investigate 69 Chinese and 60 American political cartoons published in 2018 and 2019 that pertain to the two nations’ trade conflict. By examining the cross-cultural similarities and differences between metaphors and metonymies, we chart how Chinese and American cartoonists portray this trade conflict. We end by showing (...) how a complete interpretation of the cartoons requires enrichment with insights provided by yet other analytical instruments. (shrink)

New genes have frequently formed and spread to fixation in a wide variety of organisms, constituting abundant sets of lineage‐specific genes. It was recently reported that an excess of primate‐specific and human‐specific genes were upregulated in the brains of fetuses and infants, and especially in the prefrontal cortex, which is involved in cognition. These findings reveal the prevalent addition of new genetic components to the transcriptome of the human brain. More generally, these findings suggest that genomes are continually evolving in (...) both sequence and content, eroding the conservation endowed by common ancestry. Despite increasing recognition of the importance of new genes, we highlight here that these genes are still seriously under‐characterized in functional studies and that new gene annotation is inconsistent in current practice. We propose an integrative approach to annotate new genes, taking advantage of functional and evolutionary genomic methods. We finally discuss how the refinement of new gene annotation will be important for the detection of evolutionary forces governing new gene origination. (shrink)

Philosophy and religion keep close connection by the intermediary belief of philosophers. The Greek philosophers criticized the object of masses’ and themselves religion depending on their rationality, finally gave up the masses’ belief and its object (religion). The Christian thinkers defended the masses’ religion and its object based upon philosophy and rationality. Modern philosophers appeared, going on with tradition of Greek philosophers, they reflected and criticized belief and its object, finally break away from masses ’ belief and its object and (...) found themselves system of philosophy, and defended their belief and its object.In this way, philosophy broke away from traditional religion (Christianity). After the ancient philosophy of German, the philosophy is on the way of religion criticism; this phenomenon is related to the science directly. The philosophy which is not restricted by the religion could not help itself in the scientific world view. The philosophers who are swayed in the room between religion and science have not found their fairyland concerning the belief; as a result, their belief is thespian. The philosophy which could overcome the belief tragedy could be the other kind of philosophy. The western philosophy was searching for this new kind perpetually. This new kind of philosophy will emerge and boost in culture field. (shrink)

Teachers’ emotions may be affected by structural reforms of education that emphasizes performance-based accountability and by individual psychological processes like thinking style, but there is a lack of research concerning the relationship between the three factors. In this study, thus, we attempted to test the influence of PBA on teacher emotions and to examine whether the relationship was moderated by a zhongyong thinking style in a Chinese context. A sample of 402 primary and secondary schoolteachers from Hubei, Liaoning, and Beijing (...) in China participated in this study. Structural equation modeling was applied to develop moderation models. The results demonstrated that PBA is a singificant factor with respect to teachers’ joy, sadness/frustration, anger, and fear, as related to their job of teaching, but not love of their profession. Moreover, the ZYT style may moderate the relationship between PBA and joy. (shrink)

The lateral mobility of membrane lipids and proteins is presumed to play an important functional role in biomembranes. Photobleaching studies have shown that many proteins in the plasma membrane have diffusion coefficients at least an order of magnitude lower than those obtained when the same proteins are reconstituted in artificial bilayer membranes. Depending on the protein, it has been shown that either the cytoplasmic domain or the ectodomain is the key determinant of its lateral mobility. Single particle tracking microscopy, which (...) allows the motions of single or small groups of membrane molecules to be followed, promises not only to reveal new features of membrane dynamics, but also to help explain longstanding puzzles presented by the photobleaching studies, particularly the so‐called immobile fraction. The combination of the two complementary technologies should measurably enhance our understanding of membrane microstructure. (shrink)

The rapid development of Internet technology has facilitated the dissemination of information that can threaten national security and public health, and effectively controlling the process of public opinion communication is an important topic in contemporary social network research. This paper establishes an official information-controlled public opinion propagation model based on the delay, latency, and conversion of public opinion communication under the control of official information. According to the influence and importance of the network nodes, we theoretically derive the attitude conversion (...) probability of the nodes, making the model more in line with the actual situation. Through actual cases, we analyzed the important influence of official information on the public opinion communication process and provided a theoretical basis for the government and relevant departments to supervise and correctly guide the public opinion network, which has certain practical significance. (shrink)