阻塞性睡眠呼吸暂停低通气综合征与舒张性心力衰竭相关性研究进展

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)可诱发舒张性心力衰竭,引起多种临床症状,对患者预后及生活质量产生更多不良影响.其主要病理生理学变化为慢性间歇性或持续性乏氧和高碳酸血症.舒张性心力衰竭发生机制复杂,OSAHS可通过乏氧、神经系统功能改变、炎症反应及水钠潴留而诱发或加重舒张性心力衰竭.OSAHS与舒张性心力衰竭有密切关系,OSAHS可引起并加重心衰,而心衰患者可能会伴发OSAHS,其互为因果,互相促进.在临床治疗方面,我们应充分重视两者相关性及其危害性,制定合理治疗方案.     

构建高质量的外科医学教育体系

医学教育是贯穿医疗职业生涯全过程的行为,是伴随医学进步和发展的重要工程.医学教育的质量直接影响医疗的质量和医学人才的素质,尤其是外科学领域,是以有创性的手段、方法治疗疾病.医生的职业素养、医疗水平均取决于医学教育的结果.医疗质量不能简单地用医生的学历衡量,学历教育是载体,其中应充实培养能力的教育项目、内容,以适应未来就职、就业的社会需求.医疗质量、医疗水平对医院而言是生命线,是生产力.同时,医生的教育及教育的质量是医疗质量的基础与保障.随着医学的飞速发展,医疗技术的日新月异,医学模式的改变,构建新的医疗环境下的医学教育体系,显得更为重要.     

急性心肌梗死患者院前延误的影响因素

急性心肌梗死(AMI)患者的治疗关键在于早期诊断和及时开通闭塞的冠状动脉,患者在发病后能否及早到院接受再灌注治疗,对患者的治疗效果和预后有重要影响.院前延误时间(PDT)即为从患者出现症状至到达医院接受治疗的时间.AMI患者就医大多是延迟的,主要原因是患者不能决定自己的症状是否需要治疗,也就是患者决定就医时间延长.本研究目的是分析造成急性心肌梗死患者院前延误的相关影响因素,为患者赢得最佳治疗时间提供理论依据.     

一种多级评分的广义认知诊断模型

认知诊断是近些年教育测量研究中的热点,大多数的认知诊断模型仅适用于0～1评分的情况.本文提出一种有多个潜变量多个滑动参数的多级评分认知诊断模型——GP-D1NA,只要由评分标准和知识状态能确定理想反应模式,就可以利用此方法进行认知诊断分析.在该方法中,我们给出项目滑动矩阵的概念,将被试的观测得分均看成由某个理想得分的滑动,并采用EM算法估计滑动矩阵.在模拟研究中,采用每掌握一个属性得1分的评分标准,结果表明线性型、收敛型、发散型、无结构型和独立型五种属性层级结构均有较高的判准率.     

Between an Example and a Precept,Which Has Greater Importance? A Comparison of the Channels of Socialization in Military Ethics

In this study, I examined what channels of socialization influence the moral behavior of cadets. We conducted a regression analysis of the effects of parents' attitudes to moral education, the standard and potential curriculum of schools, peer groups, and communication media on individual ethics and discipline using 399 sample participants. The participants were recruited through a questionnaire survey on cadets from academy of military, naval, and air force, and four-year based students from R.O.C. National Defense University. The analysis results showed that the cultivation of morality among cadets was directly influenced by the school's potential curriculum (i.e., intern cadres and officers in company) and their parents' attitudes to moral education during early childhood. The results also indicated that the influence of teaching by example was more significant than that of teaching by precept.     

Differentiation of stages in joke comprehension: Evidence from an ERP study

This study aimed to investigate the mechanisms underlying joke comprehension using event‐related potentials (ERPs). Fourteen healthy college students were presented with the context of a story without its joke or nonjoke ending, and then, when the story ending was presented, they were asked to make a funny/unfunny judgment about these endings. The behavioral results showed that there was no significant difference between funny and unfunny items, which meant that subjects could understand funny items as easily as unfunny ones. However, the ERP results showed that funny items initially elicited a more negative ERP deflection (N350–450) over frontocentral scalp regions. Dipole analysis localized the generators in the left temporal gyrus and the left medial frontal gyrus; it is suggested that these areas might be involved in detecting the incongruent element in joke comprehension. Between 600 and 800 ms, funny items subsequently elicited a more negative ERP deflection (N600–800) over frontocentral scalp regions and a more positive ERP deflection (P600–800) over posterior scalp regions. Dipole analysis localized the generator in the anterior cingulate cortex (ACC), an area involved in the breaking of mental set/expectation and the forming of novel associations. Finally, funny items elicited a more positive ERP deflection (P1250–1400) over anterior and posterior scalp regions. Dipole analysis localized the generators in the middle frontal gyrus and the fusiform gyrus, areas that might be related to the affective appreciation stage in joke process. Unlike that of Coulson and Kutas (2001), the present study might support the hypothesis of a three stage model of humor processing (humor detection, resolution of incongruity and humor appreciation).     

Exploring trust of mobile applications based on user behaviors: an empirical study

This paper explores trust of mobile applications based on users' behaviors. It proposes a trust behavior construct through principal component analysis, reliability analysis, and confirmatory factor analysis based on the data collected from a questionnaire survey with more than 1,500 participants. It is indicated that a user's trust behavior is composed of three principal constructs: using behavior, reflection behavior, and correlation behavior. They are further delineated into 12 measurable sub‐constructs and relate to a number of external factors. The data analysis showed that the questionnaire has positive psychometric properties with respect to construct validity and reliability. We also discuss the practical significance and limitations of our work toward usable trust management.     

Perceptions of Age and Creativity in the Workforce

As the workforce ages it becomes important to examine if there is misperception of creativity and age in work contexts. A laboratory experiment examined perceptions of the creativity of a team with both young and old workers and of a team composed entirely of young workers. Scripted videos portrayed such teams engaged in designing an outdoor advertising campaign. Altogether, 220 participants were randomly assigned to watch one of the video clips and complete a structured questionnaire. No significant differences were observed in the perceptions of the two teams' performance or of the quality of the resulting advertising proposal. In general, there was also no significant difference in the individual characteristics attributed to the four characters on the teams. However, participants aged 35 or above evaluated both teams and all four characters more favorably than participants aged 20–34.     

Paternal Family Expressiveness as a Mediator Between Father's Dispositional Optimism and Child's Dispositional Optimism

Although dispositional optimism serves as a resource for psychological and physical well-being, very little research has explored how to promote child dispositional optimism within the family context. The authors evaluated paternal emotional expressiveness within the family as a mediator of the association between father's and child's dispositional optimism. Participants were 422 father (M age = 44.97 years, SD = 4.21 years)–child (M age = 11.75 years, SD = 0.77 years) dyads in South Korea. Results showed that fathers’ dispositional optimism was positively linked to their expressiveness, which in turn was positively linked to their children's dispositional optimism. No significant gender or socioeconomic status differences were found. The findings have important implications for future research and for preventive interventions.     

Bidirectional Mediating Role of Loneliness in the Association Between Shyness and Generalized Pathological Internet Use in Chinese University Students: A Longitudinal Cross-Lagged Analysis

Abstract

This 1-year longitudinal study examined the bidirectional mediating role of loneliness in the association between shyness and generalized pathological Internet use (GPIU) in a sample of 291 Chinese university students (143 men, mean age =?19.07?years). A fully cross-lagged panel design was used in which shyness, loneliness, and GPIU were assessed at 3 time points separated by 6-month intervals (named T1, T2, and T3). The results indicated that relationships among shyness, loneliness, and GPIU were dynamic and bidirectional. Specifically, T1 shyness positively predicted increased T2 loneliness, T2 shyness positively predicted increased T3 loneliness, and T2 loneliness positively predicted increased T3 shyness. Additionally, T1 GPIU positively predicted increased T2 loneliness, T2 GPIU positively predicted increased T3 loneliness, and T2 loneliness positively predicted increased T3 GPIU. Loneliness was found to play a bidirectional mediating role in the association between shyness and GPIU. Specifically, T1 shyness and T3 GPIU were mediated through increased loneliness at T2, and T1 GPIU and T3 shyness were mediated through increased loneliness at T2. Furthermore, relationships among shyness, loneliness, and GPIU were the same across the 2 groups, with the strength of relationships being stronger for men.