BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

The massive social change in urban China today has led to a decline in the adaptive implications of shyness for child adjustment, yet evidence of this trend in young children is limited. Moreover, the underlying mechanisms that help to explain the associations between shyness and maladjustment remains poorly understood. The primary goal of the present study was to explore the moderating role of conflict resolution skills in the links between shyness and socio-emotional and school adjustment among urban Chinese preschoolers. (...) Data were collected from 360 children in kindergartens using parent ratings, teacher ratings, and child interviews. The analyses indicated that the relations between shyness and adjustment were moderated by child conflict resolution skills, which served to buffer shy children from adjustment problems. The results were discussed in terms of the implications of conflict resolution skills for early adjustment of shy preschoolers in the Chinese context. (shrink)

This paper examines the antecedents of organizational commitment for adopting corporate environmental responsibility and green practices in the case of the logistics industry in South Korea. Seven hundred and eighty employees and top management from logistics companies were sampled. The data were analyzed using factor analysis, structural equation modeling techniques, and one-way analysis of variance. The results showed that social expectations, organizational support, and stakeholder pressure were the important antecedents for the adoption of corporate environmental responsibility and green practices. In (...) the path analysis, social expectations had the greatest impact on both stakeholder pressure and green practice adoption. Moreover, we found that the higher the job titles were, the more willing they were to adopt green practices. This indicated that the current top management of Korean logistics companies is well aware of being mandated to make a commitment to corporate environmental responsibility and green practices. (shrink)

Chinese mind-body exercises are positively associated with executive function, but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through (...) June 2020. Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment and with or without chronic diseases were included. A total of 29 studies ultimately were included in this study. The results indicated that CMBEs improved overall EF, as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type, frequency of group classes, session time, total training time, and length of the CMBEs, in addition to that more frequent participation in both group classes and home practice sessions resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age, sex, and cognitive statuses, health status, as well as training mode and study language. This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF. (shrink)

PurposeEven low intensity exercise bouts of at least 15 min can improve feelings of energy and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue.MethodsThirty-six young adult participants were randomized to either stair walking or seated (...) control groups. All participants walked on level-ground from a laboratory to a nearby stairwell and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion, and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables.ResultsThe stair climbing group experienced significant increases in heart rate [F = 13.167, p < 0.001] and RPE [F = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF.ConclusionAlthough a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test. (shrink)

This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 young elite athletes were recruited for no-treatment control purposes. The ethical decision-making training comprised six 30-min online sessions in which the participants had to work through 18 ethical dilemmas related to doping. The standard-knowledge-based educational program was also conducted (...) in six online sessions of comparable length to that of the ethical training. A short version of the Performance Enhancement Attitude Scale was administered to measure the effects of the trainings on doping attitude. Prior to as well as after the intervention, the mean doping attitude scores of the young athletes were low to very low, indicating vehement rejections of doping. The results of our experiment showed that the ethical training led to an attenuation of these rejections. No intervention effect was found in the standard education group. The observed slight increase in the doping attitude score could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping. (shrink)

Fundamental movement skill proficiency does not develop solely due to maturation, but also via diverse perceptual-motor experiences across childhood. Practicing gymnastics has been shown to improve postural control. The purpose of the present study was to examine potential changes to postural control of children following a course of educational gymnastics. Two groups of children both completed 20 × 45-min physical education lessons; one group completed educational gymnastics lessons in school delivered by a professional coach, the other group completed their typical (...) PE classes. Unipedal balancing performance was assessed by calculating the percentage of successful trials made. Postural sway dynamics were explored by calculating center-of-pressure sample entropy, 95% ellipse sway area and sway velocity. Measurements were taken before the lessons began and immediately after the lessons were completed. The gymnastics group performed better than the typical PE group at unipedal balancing. Females outperformed males in both groups. Males made different changes to postural control compared to females across 3 months. Educational gymnastics enabled children in a critical period of development to make more rapid improvements to postural performance and control. Novel movement experiences, like those offered by educational gymnastics, may have a positive influence on postural control and importantly, physical literacy. Future work should examine how sex effects the development of postural control strategies in young children. (shrink)

The purpose of this research is to gain a better understanding of the role of abstraction and idealization in Galileo’s scientific inquiries about the law of inertia, which occupies an important position in the history of science. We argue that although the terms “abstraction” and “idealization” are variously described in the recent literature, the concepts must be adopted to highlight important epistemological problems. In particular, we illustrate the importance of abstraction and idealization for the formation of the law of inertia (...) by establishing a distinction between two types of entities: quasi-ideal entities and idealized entities. These theoretical laws should therefore be justified, using deduction and induction, through quasi-idealized entities based on data from the everyday world. (shrink)

The notions of a hyper MV-deductive system, a -hyper MV-deductive system, a - hyper MV-deductive system, a -hyper MV-deductive system, a -hyper MV-deductive system and a -hyper MV-deductive system are introduced, and then their relations are investigated.

Despite the prevailing discourses on the importance of top management ethical leadership, related theoretical and empirical developments are lacking. Drawing on institutional theory, we propose that top management ethical leadership contributes to organizational outcomes by promoting firm-level ethical and procedural justice climates. This theoretical framework was empirically tested using multi-source data obtained from 4,468 employees of 147 Korean companies from various industries. The firm-level analysis shows that top management ethical leadership significantly predicts ethical climate, which then results in procedural justice (...) climate that fully mediates the effects of top management ethical leadership on two organizational outcomes, namely, firm-level organizational citizenship behavior and firm financial performance. The present study provides a plausible theoretical account and empirical validation of a mechanism through which top management ethical leadership enhances organizational performance. (shrink)

The appearance of mass media and a versatile medium of videos can serve the convenience and instructive information for children; on the other hand, it could abet them in implicit image consumption. Now is the time for kids' to be in need of thinking power which enables them to make a choice, applications andcriticism of information within such visual cultures. In spite of these social changes, the realities are that our curriculum still doesn't meet a learner's demand properly. This research, (...) in this context, is aimed at looking out on the currently implemented art appreciation learning process in a critical fashion, and also aimed at suggesting a plan for visual culture learning by applying the philosophy program for kids as a new alternative. The purpose of such education is toenhance the capability to solve a variety of problems they are facing in the course of daily life by reflecting their matter of concern in a curriculum. What we have to pay attention to in visual culture learning is 'visual literacy.' Such an interpretative faculty of a critical reading of images is a must especially when kids should make a judgment of value hidden in images in their daily events, make an analysis of an ideological message and make an information-oriented decision. Therefore, learners have to enrich their higher-order thinking power as well as critical thinking faculty in modern society. If there is no objection to these social surroundings, it is quite natural that philosophy education, which forms a base of a higher-order thinking for children should be handled significantly at school. (shrink)

Previous studies in Western contexts have examined the relationships between various board characteristics and CSR, yet the relationships need to be re-examined in non-Western contexts given differential theoretical premises across contexts. We specifically propose that the effects of board characteristics on CSR in Korea should be patterned distinctively from Western-based existing literature, focusing on three important board characteristics, such as a board’s independence, social ties, and diversity. Using a panel dataset from large Korean firms, we found that various relationships between (...) board characteristics and CSR were non-linear, whereas most of the previous research on Western contexts found that the same relationships were linear. Specifically, curvilinear relationships were found between CSR and board independence, CEO-outside director social ties, and educational diversity. Our findings suggest that there is no universal feature of CSR-supportive board characteristics due to the unique characteristics of various institutional contexts. (shrink)

Previous studies have examined the outcome evaluation related to the self and other, and recent research has explored the outcome evaluation of the self and other with pro-social implications. However, the evaluation processing of outcomes in the group in need remains unclear. This study has examined the neural mechanisms of evaluative processing by gambling for the self and charity, respectively. At the behavioral level, when participants make decisions for themselves, they made riskier decisions following the gain than loss in small (...) outcomes and engage in more risky behaviors following the loss than gain in large outcomes. However, magnitude and valence did not affect the next risky behavior when participants made decisions for the charity. At the neurophysiological level, the results found that the FRN was larger for the charity outcome than for the self-outcome. For FRN, the valence difference of small outcomes was smaller than that of large outcomes. The P3 response was larger for the self-outcome than for the charity outcome. Meanwhile, compared with the small outcome, the self-charity discrepancies have a significant difference in large outcomes. In addition, the FRN amplitude for self in large outcomes was negatively correlated with the upcoming risky choices, regardless of outcome valence. The behavioral results suggest that people are more likely to optimize strategies for themselves than for the charity. The ERP findings indicated that people focus more on charity outcome than self-outcome in the early stage. In the middle and late stages, people turn attention to their outcomes, and the difference between self’s and charity’s outcome varies with the magnitude. Specifically, it is only in large outcomes that people engage more emotional attention or motivation in their outcomes, but self and charity outcomes had a similar emotional engagement in small outcomes. (shrink)

The structure and “metabolism” (movement and conversion of goods and energy) of urban areas has caused cities to be identified as “super‐organisms”, placed between ecosystems and the biosphere, in the hierarchy of living systems. Yet most such analogies are weak, and render the super‐organism model ineffective for sustainable development of cities. Via a cluster analysis of 15 shared traits of the hierarchical living system, we found that industrialized cities are more similar to eukaryotic cells than to multicellular organisms; enclosed systems, (...) such as factories and greenhouses, paralleling organelles in eukaryotic cells. We further developed a “super‐cell” industrialized city model: a “eukarcity” with citynucleus (urban area) as a regulating centre, and organaras (enclosed systems, which provide the majority of goods and services) as the functional components, and cityplasm (natural ecosystems and farmlands) as the matrix. This model may improve the vitality and sustainability of cities through planning and management. (shrink)

The demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA’s impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors. We conducted (...) a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1–4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation. Of the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09–12.12), with non-medical aetiology as associated factors. The enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions. (shrink)

Despite the increasing number of studies on user experience and user interfaces, few studies have examined emotional interaction between humans and deformable objects. In the current study, we investigated how the anthropomorphic design of a flexible display interacts with emotion. For 101 unique 3D images in which an object was bent at different axes, 281 participants were asked to report how strongly the object evoked five elemental emotions (e.g., happiness, disgust, anger, fear, and sadness) in an online survey. People rated (...) the object’s shape using three emotional categories: happiness, disgust–anger, and sadness–fear. It was also found that a combination of axis of bending (horizontal or diagonal axis) and convexity (bending convexly or concavely) predicted emotional valence, underpinning the anthropomorphic design of flexible displays. Our findings provide empirical evidence that axis of bending and convexity can be an important antecedent of emotional interaction with flexible objects, triggering at least three types of emotion in users. (shrink)

Despite their potential for facilitating interaction between a user and computer, an embodied agent and voice command have not been examined enough for their matching effects. The current study proposes that an embodied agent and voice command generate positive evaluative outcomes, particularly when they are accompanied by each other. To test this prediction, we conducted a 2 (visual output: embodied agent vs. geometric figure) × 2 (input modality: voice command vs. remote controller) between-subjects experiment (N = 52), and examined whether (...) visual output and input modality jointly influence participants’ social attribution (i.e., anthropomorphism, animacy, likability, and perceived intelligence), social presence, and satisfaction. Results show that voice command does facilitate users’ social attribution and social presence, but only when an embodied agent was presented. Also, the effects of voice command on social presence and satisfaction were mediated by anthropomorphism and perceived intelligence respectively, but only when the interface displayed an embodied agent. The present study evidences the holistic nature of human-computer interaction, revealing the importance of matches in the input and output interface. (shrink)

This paper examines the influence of CEO career horizon problems on corporate social responsibility. We assume that as CEOs are getting older, they tend to disengage in CSR due to their shorter career horizons. We further argue that high levels of industry-level discretion and blockholder ownership amplify the negative effects of CEO age on CSR. Using a panel sample of US-based firms over 2004–2009, we do not find the main effect of CEO age on CSR, but find support for the (...) moderating effects, such that CEO age is negatively associated with CSR when there are high levels of ILD and blockholder ownership. Therefore, results suggest that CEO career horizon problems matter for CSR when CEOs have sufficient discretion over the firm’s strategic decisions and outside blockholders put more pressure on CEOs to engage in financial earning management. (shrink)

Vehicle type recognition algorithms are broadly used in intelligent transportation, but the accuracy of the algorithms cannot meet the requirements of production application. For the high efficiency of the multilayer perceptive layer of Network in Network, the nonlinear features of local receptive field images can be extracted. Global average pooling can avoid the network from overfitting, and small convolution kernel can decrease the dimensionality of the feature map, as well as downregulate the number of model training parameters. On that basis, (...) the residual error is adopted to build a novel NIN model by altering the size and layout of the original convolution kernel of NIN. The feasibility of the algorithm is verified based on the Stanford Cars dataset. By properly setting weights and learning rates, the accuracy of the NIN model for vehicle type recognition reaches 97.2%. (shrink)

With the continuous progress and penetration of automated data collection technology, enterprises and organizations are facing the problem of information overload. The demand for expertise in data mining and analysis is increasing. Self-efficacy is a pivotal construct that is significantly related to willingness and ability to perform a particular task. Thus, the objective of this study is to develop an instrument for assessing self-efficacy in data mining and analysis. An initial measurement list was developed based on the skills and abilities (...) about executing data mining and analysis, and expert recommendations. A useful sample of 103 university students completed the online survey questionnaire. A 19-item four-factor model was extracted by exploratory factor analysis. Using the partial least squares-structural equation modeling technique, the model was cross-examined. The instrument showed satisfactory reliability and validity. The proposed instrument will be of value to researchers and practitioners in evaluating an individual’s abilities and readiness in executing data mining and analysis. (shrink)