In "Canonization and Variations of Shakespeare's Work in China," Qing Yang discusses the role of cross-linguistic and inter-cultural variations with regard to William Shakespeare's intercultural travel and canonization in China. In the context of globalization, Shakespeare's texts outside Western cultures undergo cross-national, cross-linguistic and inter-cultural variations in the process of translation. From a symbol of Western powers and cultures to a bearer of Confucianism, a fighter for the survival of the nation during the anti-Japanese struggle, and to a (...) literary master with abundant possibilities of interpretation and adaption today, Shakespeares change and vary in modern and contemporary China. The inter-cultural communication of Shakespeare with clear markings of Chinese culture and history progresses through variation. Yang argues that it is the paradigm of Shunqing Cao’s variation theory central to the formations of world literature that has facilitated the canonization of Shakespeare’s work in China. (shrink)

The concept of brain death as equivalent to cardiopulmonary death was initially conceived following developments in neuroscience, critical care, and transplant technology. It is now a routine part of medicine in Western countries, including the United States. In contrast, Eastern countries have been reluctant to incorporate brain death into legislation and medical practice. Several countries, most notably China, still lack laws recognizing brain death and national medical standards for making the diagnosis. The perception is that Asians are less likely to (...) approve of brain death or organ transplant from brain dead donors. Cultural and religious traditions have been referenced to explain this apparent difference. In the West, the status of the brain as home to the soul in Enlightenment philosophy, combined with pragmatism and utilitarianism, supports the concept of brain death. In the East, the integration of body with spirit and nature in Buddhist and folk beliefs, along with the Confucian social structure that builds upon interpersonal relationships, argues against brain death. However, it is unclear whether these reasoning strategies are explicitly used when families and medical providers are faced with acknowledging brain death. Their decisions are more likely to involve a prioritization of values and a rationalization of intuitive responses. Why and whether there might be differences between East and West in the acceptance of the brain death concept requires further empirical testing, which would help inform policy-making and facilitate communication between providers and patients from different cultural and ethnic backgrounds. (shrink)

Background: An overview of ethical sensitivity among Chinese registered nurses is needed to develop and optimize the education programs and interventions to cultivate and improve ethical sensitivity. Aim: The study was conducted to explore the barriers to and facilitators of ethical sensitivity among Chinese registered nurses working in hospital settings. Research design: A convergent parallel mixed-methods research design was adopted. Participants and research context: In the cross-sectional quantitative study, the Chinese Moral Sensitivity Questionnaire–revised version was used to assess the levels (...) of ethical sensitivity among registered nurses, and the scores were correlated with key demographics, training experiences in ethics, and workplace cultural environments ( n = 306). In the qualitative study, semi-structured interviews were used to elicit the nurses’ perceptions of the barriers and facilitators in nurturing ethical sensitivity ( n = 15). The data were collected from February to June 2014. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Results: Despite moderately high overall Chinese Moral Sensitivity Questionnaire–revised version scores, the ethical sensitivity among Chinese nurses lags in practice. Barriers to ethical sensitivity include the lack of knowledge related to ethics, lack of working experience as a nurse, the hierarchical organizational climate, and the conformist working attitude. The positive workplace cultural environments and application of ethical knowledge in practice were considered potential facilitators of ethical sensitivity. Discussion: The findings of this study were compared with studies from other countries to examine the barriers and facilitators of ethical sensitivity in Chinese nurses. Conclusion: This mixed-methods study showed that even though the Chinese nurses have moderately high sensitivity to the ethical issues encountered in hospitals, there is still room for improvement. The barriers to and facilitators of ethical sensitivity identified here offer new and important strategies to support and enhance the nurses’ sensitivity to ethical issues. (shrink)

BackgroundThe brain death standard allowing a declaration of death based on neurological criteria is legally endorsed and routinely practiced in the West but not in Asia. In China, attempts to legalize the brain death standard have occurred several times without success. Cultural, religious, and philosophical factors have been proposed to explain this difference, but there is a lack of empirical studies to support this hypothesis.Methods476 medical providers from three academic hospitals in Hunan, China, completed a selfadministered survey including a 12-question (...) brain death clinical knowledge assessment and hypothetical vignettes describing brain dead patients.ResultsThe response rate was 95.2 %. Almost all of the providers had heard of the term “brain death.” More than half have encountered presumed brain dead patients. Two-thirds accepted brain death as an ethical standard to determine human death. The mean knowledge score was 8.50 ± 1.83 out of 12. When given the description of a brain dead patient, 50.7 % considered the patient dead, 51.9 % would withdraw life support, and 40.6 % would allow organ procurement. Both provider and patient characteristics contributed to the providers’ decisions. Ethical acceptance was the most important independent predictor for brain death acknowledgement, followed by high knowledge scores, and the belief that the soul lives in the brain. Religious faith and associated beliefs did not have a significant effect.ConclusionsNotwithstanding scarce official accounts, recognition of the brain death standard is not uncommon in China. Chinese medical providers can adequately define the medical characteristics of brain death and accept it in theory, but hesitate to apply it to practice in the vignettes. Legalization is paramount in providing the protection providers need to comfortably declare brain death. However the medical decision-making surrounding brain death is complex and the provider's past experiences and emotions may also influence the process. (shrink)

Background: Ethical issues pose challenges for nurses who are increasingly caring for patients in complicated situations. Ethical sensitivity is a prerequisite for nurses to make decisions in the best interest of their patients in daily practice. Currently, there is no tool for assessing ethical sensitivity in Chinese language, and no empirical studies of ethical sensitivity among Chinese nurses. Research objectives: The study was conducted to translate the Moral Sensitivity Questionnaire–Revised Version (MSQ-R) into Chinese and establish the psychometric properties of the (...) Moral Sensitivity Questionnaire–Revised Version into Chinese (MSQ-R-CV). Research design: This research was a methodological and descriptive study. Participants and research context: MSQ-R was translated into Chinese using Brislin’s model, and the Translation Validity Index was evaluated. MSQ-R-CV was then distributed along with a demographic questionnaire to 360 nurses working at tertiary and municipal hospitals in Changsha, China. Ethical considerations: This study was approved by the Institutional Review Boards of Yale University and Central South University. Findings: MSQ-R-CV achieved Cronbach’s alpha 0.82, Spearman-Brown coefficient 0.75, significant item discrimination (p < 0.001), and item-total correlation values ranging from 0.524 to 0.717. A two-factor structure was illustrated by exploratory factor analysis, and further confirmed by confirmatory factor analysis. Chinese nurses had a mean total score of 40.22 ± 7.08 on the MSQ-R-CV, and sub-scores of 23.85 ± 4.4 for moral responsibility and strength and 16.37 ± 3.75 for sense of moral burden. Discussion: The findings of this study were compared with studies from other countries to examine the structure and meaningful implications of ethical sensitivity in Chinese nurses. Conclusion: The two-factor MSQ-R-CV (moral responsibility and strength, and sense of moral burden) is a linguistically and culturally appropriate instrument for assessing ethical sensitivity among Chinese nurses. (shrink)

Along with urban development globally, the NIMBY crisis has been a complex social problem, which requires urgent remedial action. The inevitable management of Municipal Solid Waste has been one of the toughest risk management tasks in the worldwide modernization process. At present, certain fuzzy and unstructured results and methods have been formed for MSW-NIMBY crisis response, mainly focusing on the sociology and politics which scatter in complex and sensitive reports and news. Aiming at enhancing the effectiveness of data mining from (...) specific sparse text of MSW-NIMBY crisis, an improved knowledge extraction method is developed. Through rule-based text mining and complex network analysis, the Entity Relationship network of MSW-NIMBY crisis is reconstructed. Meanwhile, a novel transitivity for relationship between entities in semantic analysis is proposed to improve the feasibility and accuracy of information extraction. Characteristics and regularity of MSW-NIMBY crisis evolution and experience of crisis governance could be identified effectively. Results show that knowledge integration and ER transitivity can enhance knowledge recognition and major other factors, which could help formulate the governance strategies of NIMBY crisis from academic texts. (shrink)

Conservative agriculture practice adoption literature advocates that adoption is caused by many factors comprising cognitive, social, economic, personal, and CAP-related factors. Evaluating the adoption of CAPs as the outcome is complex and challenging with regression-based models as the systemic interdependencies of the factors offer diverse or varying results. Farmer production and environmental orientations as cognitive stances are notable interpreters of CAP adoption. The appetite level for risk-taking, innovativeness, and trust facilitates the adoption of CAPs. However, a causal-predictive technique should be (...) used to investigate the adoption of CAP. Hence, this study engages in a configuration approach using a fuzzy-set qualitative comparative analysis to analyze the patterns of different types of farmers' orientations, personal level of trust on extension services, and innovativeness risk-taking attitude on the intention to adopt CAPs. The analysis is based on the 155-farmer data collected employing a structured interview from Pakistan. The results suggest that a higher level of environment orientation and innovativeness is sufficient to increase the intention to adopt CAPs. Moreover, a higher intention to adopt CAPs is achieved with a lower production orientation, a higher personal level of innovativeness, and a risk-taking attitude of the farmer. The innovativeness can help to develop the intention to adopt the CAPs among the environment and production-oriented farmers. Causal solutions offer a unique understanding that the farmers' environment and production orientation can combine to suggest inclined to adopt CAPs by having an attitude of innovativeness and risk-taking. The causal solutions achieved significant predictive validity in the holdout samples. Policy and farmer-level suggestions were made to raise the intention to adopt CAPs among the farmers. (shrink)

The study examined the effect of celebrity attractiveness, celebrity trustworthiness, and celebrity cause fit on the attitude toward green cosmetics. This was followed by the effect of brand awareness, brand associations, brand loyalty, perceived quality, brand credibility on brand equity, including the impact of attitude toward green cosmetics and brand equity on the willingness to purchase green cosmetics among of young Chinese consumers. This study adopted a cross-sectional design and collected quantitative data from 301 respondents using a structured questionnaire, which (...) was distributed online using various social media platforms. It was found that celebrity attractiveness, celebrity trustworthiness, and celebrity cause-fit had a significant impact on the attitudes toward green cosmetic, while brand loyalty, perceived quality, and brand credibility substantially affected brand equity. Moreover, the attitudes toward green cosmetics and brand equity had a strong impact on the willingness to purchase green cosmetics. To increase the sales for green cosmetics, the advertisements for it should have appeal, trustworthiness, and cause-fit celebrities to improve consumers’ attitudes and willingness to purchase green cosmetics. Finding of this study provide a guideline for green cosmetic manufacturers, to direct their resources to enhance brand loyalty, credibility, and perceived quality of the product they produce by highlighting the difference between conventional and green cosmetics. (shrink)

The global progress empowers the development of new business and expansion of existing business. The availability of sufficient accounting professional are necessary to manage and document the business activities. However, youth are less inclined to purse accounting as profession to keep the progress of global and local economic development. The current study aimed to explore the formation of the intention to pursue Certified Professional Accountancy Qualification with factor of capabilities, career opportunities, job security with respect to the extended theory of (...) planned behavior, i.e., attitude, subjective norms and perceived behavioral control. The study adopted a cross-sectional design and collected quantitative data from a total of 339 accounting students from Malaysia using an online survey. The finding revealed that capabilities and career opportunities influenced the students’ intention to pursue CPAQ. Meanwhile, perceived behavioral control had significantly affect the students’ decision to pursue CPAQ, which is in line with the TPB. The study concentrated on the importance of these factors in influencing the students’ intention and decision to pursue CPAQ. The study offered vital implications for accounting educators and educational institutions to promote the accounting profession as choice and students engage in pursuing CPAQ. The Malaysian government should encourage and support accounting students financially for pursuing CPAQ by providing job security and enhancing subjective norms that may enable these students to complete the required professional qualifications. The study’s limitations and future research opportunities are documented at the end of this article. (shrink)

As global warming has received widespread attention, the disclosure of firms’ carbon information has been expected by increasing stakeholders. This study extends the previous literature on the determinants of firms’ carbon information disclosure by examining the influence of academic independent directors and Confucianism on the quality of carbon information disclosure. Using a sample of Chinese listed firms in the CSI 300 Index during the period of 2012–2018, our empirical results show that academic independent directors have a significantly positive association with (...) the quality of carbon information disclosure. The results also reveal that Confucianism positively affects the quality of carbon information disclosure. Moreover, Confucianism positively moderates the relationship between academic independent directors and the quality of carbon information disclosure. The results imply that Confucianism, as an informal system, can promote the governance effect of academic independent directors on firms’ carbon information disclosure behaviour. Our findings offer shareholders, regulators, and other stakeholders an integrating perspective on motivating firms to disclose high quality carbon information. (shrink)

This study explored the effect of attitude towards entrepreneurship, need for achievement, risk-taking propensity, proactive personality, self-efficacy, opportunity recognition competency, entrepreneurship education, uncertainty avoidance, and entrepreneurial knowledge on entrepreneurial intention among university students in Malaysia. This quantitative study had adopted the cross-sectional design approach and involved 391 university students in Malaysia via the online survey. The study outcomes revealed that the NFA, PRP, and SLE significantly affect students’ attitudes towards entrepreneurship. Moreover, entrepreneurship education and UNA significantly affect ORC. Finally, ATE (...) has a positive and significant effect on ENIN among university students in Malaysia. As entrepreneurship offers an alternative career path for people seeking economic prosperity and addressing social issues, including unemployment, the government should formulate effective policies and regulations that support entrepreneurship activities. Universities and other institutions should play a pivotal role in providing the proper exposure via entrepreneurship education while honing the essential traits for a career in entrepreneurship. (shrink)

BackgroundThe cognitive level of post-stroke aphasia patients is generally lower than non-aphasia patients, and cognitive impairment affects the outcome of stroke. However, for different types of PSA, what kind of cognitive assessment methods to choose is not completely clear. We investigated the Montreal Cognitive Assessment, the Mini-Mental State Examination, and the Non-language-based Cognitive Assessment to observe the evaluation effect of CI in patients with fluent aphasia and non-fluent aphasia.Methods92 stroke patients were included in this study. Demographic and clinical data of (...) the stroke group were documented. The language and cognition were evaluated by Western Aphasia Battery, MoCA, MMSE, and NLCA. PSA were divided into FA and NFA according to the Chinese aphasia fluency characteristic scale. Pearson’s product–moment correlation coefficient test and multiple linear regression analysis were performed to explore the relationship between the sub-items of WAB and cognitive scores. The classification rate of CI was tested by Pearson’s Chi-square test or Fisher’s exact test.ResultsThe scores of aphasia quotient, MoCA, MMSE, and NLCA in NFA were lower than FA. AQ was positively correlated with MoCA, MMSE, and NLCA scores. Stepwise multiple linear regression analysis suggested that naming explained 70.7% of variance of MoCA and 79.9% of variance of MMSE; comprehension explained 46.7% of variance of NLCA. In the same type of PSA, there was no significant difference in the classification rate. The classification rate of CI in NFA by MoCA and MMSE was higher than that in FA. There was no significant difference in the classification rate of CI between FA and NFA by NLCA.ConclusionMoCA, MMSE, and NLCA can be applied in FA. NLCA is recommended for NFA. (shrink)

The purpose of this paper is to analyze the relationship between positive psychological quality and college students’ sense of responsibility for innovation and entrepreneurship from the perspective of positive psychology, explore the cultivation model that can effectively improve college students’ sense of responsibility for innovation and entrepreneurship, and promote their success in entrepreneurship. In this study, a total of 1,500 college students were selected for questionnaire survey. ANOVA was used to analyze the differences of innovation and entrepreneurship responsibilities in demographic (...) variables; factor analysis models were used to explore the factors that influence college students’ sense of responsibility for innovation and entrepreneurship; and Spearsman correlation and linear regression were used to analyze the relationship between college students’ positive quality and innovation and entrepreneurship. The results showed that the average scores of individual responsibility, team responsibility and social responsibility were 3.290, 3.624 and 3.720, respectively; individual responsibility differed significantly at the grade level; group responsibilities and social responsibilities were significantly different at the grade and gender levels; the linear fitting between benevolence, super-excellence, bravery, restraint, and wisdom with team responsibilities all reached significant levels, among which the wisdom coefficient was the highest; the linear fitting between syngroup, excellence, bravery, modesty and wisdom with social responsibility reached a significant level, among which the wisdom coefficient was the highest; the linear fitting between syngroup, excellence, bravery, modesty and wisdom with personal responsibility reached a significant level, among which the coefficient of excellence was the highest. This indicated that positive psychological qualities such as syngroup, excellence, modesty, benevolence, super-excellence, bravery, restraint, and wisdom were the influencing factors of college students’ sense of responsibility for innovation and entrepreneurship. Among them, the role of wisdom is the most noteworthy in predicting social and group responsibilities, and super-excellent is the most significant predictor for individual responsibility. (shrink)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

Ataxia is a kind of external characteristics when the human body has poor coordination and balance disorder, it often indicates diseases in certain parts of the body. Many internal factors may causing ataxia; currently, observed external characteristics, combined with Doctor’s personal clinical experience play main roles in diagnosing ataxia. In this situation, different kinds of diseases may be confused, leading to the delay in treatment and recovery. Modern high precision medical instruments would provide better accuracy but the economic cost is (...) a non-negligible factor. In this paper, novel non-contact sensing technique is used to detect and distinguish sensory ataxia and cerebellar ataxia. Firstly, Romberg’s test and gait analysis data are collected by the microwave sensing platform; then, after some preprocessing, some machine learning approaches have been applied to train the models. For Romberg’s test, time domain features are considered, the accuracy of all the three algorithms are higher than 96%; for gait detection, Principal Component Analysis is used for dimensionality reduction, and the accuracies of Back Propagation neural Network, Support Vector Machine, and Random Forest are 97.8, 98.9, and 91.1%, respectively. (shrink)

The digital transformation of the innovation ecosystem is not only an inevitable direction of innovation activities in the era of digital economy but also a highly complex and uncertain process. The way to facilitate transformation with policies has become a topic of common concern of academia and policymakers. This paper builds a multiagent model and studies the impacts of supply-side policies, demand-side policies, and environmental policies on enterprises’ transformation willingness, digital level, and income level as well as the proportion of (...) enterprises that carry out transformation in the whole innovation ecosystem and innovation network structure by numerical experiments. According to research findings, supply-side policies play the biggest role in the facilitation of transformation, demand-side policies are second important to them, and environmental policies have comparatively weak impacts. (shrink)

The human brain shows neuroplastic adaptations induced by motor skill training. However, the description of the plastic architecture of the whole-brain network in resting-state is still limited. In the present study, we aimed to detect how motor training affected the density distribution of whole-brain resting-state functional connectivity (FC) brain in fast-ball student-athletes using resting-state functional magnetic resonance imaging (fMRI) data of student-athletes (SA), and non-athlete healthy controls (NC). The voxel-wise data-driven graph theory approach, namely global functional connectivity density (gFCD) mapping (...) was applied. The results showed that the SA group exhibited significantly decreased gFCD in brain regions centered at left triangular part of inferior frontal gyrus (IFG), extending to opercular part of left IFG and middle frontal gyrus (MFG) compared with NC group. The findings supported the idea of an increased neural efficiency of athletes’ brain in the brain regions associated with attentional-motor modulation and executive control. Furthermore, the behavioral results demonstrated that in the SA group, faster executive control reaction time was associated with smaller gFCD values in left IFG. The findings implied that the motor skill training would decrease the numbers of FC in IFG to accelerate the execution control with high attentional demands, and focus the attention to the target detection the athletes are interested in. (shrink)

This study focuses on two specific privacy policies, namely privacy assurance and personalization declaration. Specifically, we investigate how these distinct privacy policies affect customers’ privacy concerns and subsequent purchase responses. We have developed a conceptual model that addresses the independent effects of privacy assurance and personalization declaration, as well as the mechanism of these effects. Our model is grounded in motivation theory and supported by a field experiment and a controlled experiment. Our study demonstrates that privacy assurance that claims security (...) protection negatively affects customers’ purchase probability and purchase amount. By contrast, personalization declaration that addresses personalized benefits positively affects customers’ purchase probability and purchase amount. Privacy concerns significantly mediate the negative effects of privacy assurance on purchase responses and the positive effects of personalization declaration on purchase responses. Overall, our findings inform managers of how to deploy privacy policies to reduce customers’ privacy concerns and boost purchase responses. (shrink)

Diffusion plays an essential role in the distribution of predator and prey. We mainly research the diffusion network’s effect on the predator-prey model through bifurcation. First, it is found that the link probability and diffusion parameter can cause Turing instability in the network-organized predator-prey model. Then, the Turing stability region is obtained according to the sufficient condition of Turing instability and the eigenvalues’ distribution. Finally, the biological mechanism is explained through our theoretical results, which are also illustrated by numerical simulation.

Marxism in China must be accompanied by a category system of the Chinese process. Latest results of this process is the congress report of the "theoretical system of socialism with Chinese characteristics," the category of Marxism in China is the scientific summary of the latest theories, but also the formation of a new category system, with important theoretical and practical significance. Marxism in China logical starting point for new category system is people-oriented, and its structure contains the whole of the (...) area, the basic categories and three levels of practice areas. The process of adapting Marxism to conditions in China must be accompanied by the course of category system of sinicization. The latest achievement is the "The Theory of Socialism with Chinese Characteristics" presented in report of the Seventeenth National Congress of the Communist Party of China. The logical starting point of the new category is putting people first, and its structure contains three-level of category: totality category, basic category, and practical category. (shrink)

The aim of this study was to examine the interactive effects of situational variables on teams’ technical performance in the UEFA Champion League. Match data of 19 technical actions and events were collected and classified into three groups during eight seasons. Repeated-measures analysis of variance was used to identify the differences in the technical performances among teams. Results showed that the significant differences in the technical performance between the group stage and the knockout stage were only found in dribble and (...) yellow card. However, differences in the variables related to goal scoring and offense were more significant than in the variables related to defense under the comparisons across competition situations, and the differences in the variables related to defense were mainly detected in the yellow card. The number of variables that showed significant differences among match location and match outcome in the group stage were less than in the knockout stage. Therefore, the identified key performance indicators by considering the interactive effects of situational variables may provide detailed and practical insights for coaches to develop useful training interventions and match strategies for upcoming match playing in specific competition situations. (shrink)

The initial online publication contained a typesetting mistake in the author information. The original article has been corrected.

To address the need for a valid and reliable scale of youth leadership potential based on the development theory of leadership, the current study developed the Youth Leadership Potential Scale (YLPS) and investigated its factor structure and psychometric properties in a sample of 696 students (grades 7-9) in China. Exploratory structural equation modeling (ESEM) identified a five-factor solution comprising leadership information, leadership attitude, communication skills, decision-making skills, and stress management skills. ESEM within confirmatory factor analysis demonstrated an adequate fit for (...) this structure. The scale showed good composite reliability and measurement invariance across different gender and grade/age groups. The scale also showed sufficient concurrent validity with the Coping Self-Efficacy Scale, the Chinese Roets Rating Scale for Leadership, and the Leadership Skills Inventory. Furthermore, criterion-related validity was supported by the relationship between YLPS scores and the length of student leadership positions. The results suggest that the YLPS is a valid and pragmatic measure for assessing youth leadership potential. The current study is the first to develop a youth leadership potential scale based on the development theory of leadership. (shrink)

The present study is a cross-sectional survey that investigates ethical practices among Chinese psychotherapists from the perspective of a large representative sample of Chinese clients (N?=?1,100). In reports from clients, we found that psychotherapists did poorly in providing informed consent and had other ethical difficulties in the therapeutic setting and with dual relationships. We conclude that Chinese culture, especially Confucianism, had significant impact on the attitudes toward the psychotherapists' ethical practices, which complicated ethical dilemmas. It is important for cross-cultural psychotherapists (...) to become sensitive to the influences of traditional Chinese culture when counseling Chinese clients. (shrink)

Electroacupuncture (EA) and electroconvulsive therapy (ECT) are often used in the management of schizophrenia. This study sought to determine whether additional EA and ECT could augment antipsychotic response and reduce related side effects. In this retrospective controlled study, 287 hospitalized schizophrenic patients who received antipsychotics (controls, n = 50) alone or combined with EA (n = 101), ECT (n = 55) or both (EA+ECT, n = 81) were identified. EA and ECT were conducted for 5 and 3 sessions per week, (...) respectively, with a maximum of 12 sessions for ECT during hospitalization. The Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) were used to assess the severity of psychotic symptoms. Clinical response on SAPS and SANS, weight gain, and adverse events were compared. Survival analysis revealed that the ECT and EA+ECT groups had markedly greater clinical response rate than controls on SAPS [72.7% and 90.1% vs. 64.0%; relative risk (RR), 1.974 and 2.628, respectively, P ≤ 0.004] and on SANS (67.3% and 70.4% vs. 42.0%; RR, 1.951 and 2.009, respectively, P ≤ 0.015). A significantly greater response rate on SANS than controls was also observed in the EA group (64.4% versus 42.0%; RR = 1.938, P = 0.008). EA-containing regimens remarkably reduced weight gain and incidences of headache, insomnia, dry mouth, and electrocardiographic abnormalities. These results suggest that EA and ECT can serve as additional treatment for enhancing antipsychotic response and reduce the side effects in hospitalized patients with schizophrenia. (shrink)

A core feature of drug-resistant epilepsy is hyperexcitability in the motor cortex, and low-frequency repetitive transcranial magnetic stimulation is a suitable treatment for seizures. However, the antiepileptic effect causing network reorganization has rarely been studied. Here, we assessed the impact of rTMS on functional network connectivity in resting functional networks and their relation to treatment response. Fourteen patients with medically intractable epilepsy received inhibitive rTMS with a figure-of-eight coil over the vertex for 10 days spread across two weeks. We designed (...) a 6-week follow-up phase divided into four time points to investigate FNC and rTMS-induced timing-dependent plasticity, such as seizure frequency and abnormal interictal discharges on electroencephalography. For psychiatric comorbidities, the Hamilton Depression Scale and the Hamilton Anxiety Scale were applied to measure depression and anxiety before and after rTMS. FNC was also compared to that of a cohort of 17 healthy control subjects. The after-effects of rTMS included all subjects that achieved the significant decrease rate of more than 50% in interictal epileptiform discharges and seizure frequency, 12 patients with the reduction rate above 50% compared to the baseline, as well as emotional improvements in depression and anxiety. In the analysis of RSNs, we found a higher synchronization between the sensorimotor network and posterior default-mode network in epileptic patients than in healthy controls. In contrast to pre-rTMS, the results demonstrated a weaker FNC between the anterior DMN and SMN after rTMS, while the FNC between the aDMN and dorsal attention network was greater. Importantly, the depressive score was anticorrelated with the FNC of the aDMN-SMN, which was markedly different in the good and bad response groups treated with rTMS. Based on the vertex suppression by rTMS, it is possible to achieve temporary clinical efficacy by modulating network reorganization in the DMN and SMN for patients with refractory epilepsy. (shrink)

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed to assess the status of two types of learning passion; to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; to examine the mediating role of psychological capital (...) in the relationship between self-esteem and two types of learning passion, respectively; and to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap.ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education. (shrink)