ARDS:现状与挑战

ALI/ARDS是以难治性低氧性呼吸衰竭为主要临床特点的症候群,是重症医学最具挑战性的领域之一.近期其诊断标准更新为“柏林标准”;治疗方面除了常规机械通气策略之外,因潜在的降低病死率的作用,高频震荡通气(HFOV)、体外膜肺氧合(ECMO)的价值越来越受到重视,而大环内酯类抗生素和干细胞基因治疗则成为药物治疗的热点.根据现有趋势,相信未来ALI/ARDS的病死率将会随着研究的深入和新疗法的开展而逐渐降低.     

Construct validity of the Anxiety Sensitivity Index-3 in clinical samples

Using two clinical samples of patients, the presented studies examined the construct validity of the recently revised Anxiety Sensitivity Index-3 (ASI-3). Confirmatory factor analyses established a clear three-factor structure that corresponds to the postulated subdivision of the construct into correlated somatic, social, and cognitive components. Participants with different primary clinical diagnoses differed from each other on the ASI-3 subscales in theoretically meaningful ways. Specifically, the ASI-3 successfully discriminated patients with anxiety disorders from patients with nonanxiety disorders. Moreover, patients with panic disorder or agoraphobia manifested more somatic concerns than patients with other anxiety disorders and patients with nonanxiety disorders. Finally, correlations of the ASI-3 scales with other measures of clinical symptoms and negative affect substantiated convergent and discriminant validity. Substantial positive correlations were found between the ASI-3 Somatic Concerns and body vigilance, between Social Concerns and fear of negative evaluation and socially inhibited behavior, and between Cognitive Concerns and depression symptoms, anxiety, fear of negative evaluation, and subjective complaints. Moreover, Social Concerns correlated negatively with dominant and intrusive behavior. Results are discussed with respect to the contribution of the ASI-3 to the assessment of anxiety-related disorders.     

A mixed model approach to meta-analysis of diagnostic studies with binary test outcome

We propose 2 related models for the meta-analysis of diagnostic tests. Both models are based on the bivariate normal distribution for transformed sensitivities and false-positive rates. Instead of using the logit as a transformation for these proportions, we employ the tα family of transformations that contains the log, logit, and (approximately) the complementary log. A likelihood ratio test for the cutoff value problem is developed, and summary receiver operating characteristic (SROC) curves are discussed. Worked examples showcase the methodology. We compare the models to the hierarchical SROC model, which in contrast employs a logit transformation. Data from various meta-analyses are reanalyzed, and the reanalysis indicates a better performance of the models based on the tα transformation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Confucian dynamism work values and team performance: A multiple‐level analysis

In this study we clarified the multiple‐level effects of Confucian‐related work values, including self‐discipline and interpersonal ethics, on the performance of individuals and the team. Empirical data of 70 work teams with 472 team members from Taiwanese enterprises were collected to test our hypotheses. Results showed that, at the group level, shared team values of interpersonal ethics were positively related to team performance through the partial mediation of team cooperation. For cross‐level effect, shared team values of interpersonal ethics and individual member's self‐discipline values were both positively related to individual performance. The implications of Confucian dynamism work values on contemporary organizational management and indigenous Chinese team theories were provided.     

Age effects on rotational hand action

We investigated age-related differences in finger coordination during rotational hand actions. Two hypotheses based on earlier studies were tested: higher safety margins and lower synergy indices were expected in the elderly. Young and elderly subjects held a handle instrumented with five six-component force sensors and performed discrete accurate pronation and supination movements. The weight of the system was counterbalanced with another load. Indices of synergies stabilizing salient performance variables, such as total normal force, total tangential force, moments produced by these forces, and total moment of force were computed at two levels of a hypothetical control hierarchy, at the virtual finger-thumb level and at the individual finger level. At each level, synergy indices reflected the normalized difference between the sum of the variances of elemental variables and variance of their combined output, both computed at comparable phases over repetitive trials. The elderly group performed the task slower and showed lower safety margins for the thumb during the rotation phase. Overall, the synergy indices were not lower in the elderly group. In several cases, these indices were significantly higher in the elderly than in the younger participants. Hence, both main hypotheses have been falsified. We interpret the unexpectedly low safety margins in the elderly as resulting from several factors such as increased force variability, impaired feed-forward control, and the fact that there was no danger of dropping the object. Our results suggest that in some natural tasks, such as the one used in this study, healthy elderly persons show no impairment, as compared to younger persons, in their ability to organize digits into synergies stabilizing salient performance variables.     

Entrepreneurship,professionalism, leadership: A framework and measure for understanding boundaryless careers

We propose a person-centered framework for conceptualizing subjective careers in an increasingly boundaryless work context. Specifically, we argue that entrepreneurship, professionalism, and leadership (EPL) can serve as three key dimensions of subjective career space. We relate this framework to earlier macro-level national and organizational career models proposed by Kanter (1989) and Schein (1978). Our empirical study involving 10,326 Singaporean university students demonstrated that entrepreneurial, professional, and leadership career aspirations (including motivations, efficacies, and intentions) can be measured independently, that these career dimensions are independent of vocational interests, and that they are to some degree viewed as competing career alternatives. We also show that EPL motivation profiles can operationalize the boundaryless and protean career concepts. Individuals concurrently high in entrepreneurial, professional, and leadership career motivations, and those high in entrepreneurial and leadership motivations are highest in boundaryless and self-directed career attitudes, while those primarily motivated for professional careers hold the most traditional career attitudes. We conclude by discussing the potential of the framework for understanding human resource issues at organizational and national levels and for enhancing the study of entrepreneurship, professionalism, and leadership.     

Lexical and sublexical semantic preview benefits in Chinese reading

Semantic processing from parafoveal words is an elusive phenomenon in alphabetic languages, but it has been demonstrated only for a restricted set of noncompound Chinese characters. Using the gaze-contingent boundary paradigm, this experiment examined whether parafoveal lexical and sublexical semantic information was extracted from compound preview characters. Results generalized parafoveal semantic processing to this representative set of Chinese characters and extended the parafoveal processing to radical (sublexical) level semantic information extraction. Implications for notions of parafoveal information extraction during Chinese reading are discussed.     

不稳定控制感剥夺损害工作记忆刷新功能

控制感剥夺会阻碍工作记忆中的转换功能,但对工作记忆中刷新功能的影响机制尚不清楚。据此,本文通过两个实验来探究控制感剥夺对工作记忆刷新功能的影响。结果发现,相较于基线水平,无论是通过行为无助任务（实验1）还是通过信息无助任务（实验2）操纵的稳定控制感剥夺均未阻碍随后的刷新任务;但在不稳定控制感剥夺的条件下（实验2）,刷新任务的成绩显著降低。这表明,控制感剥夺对工作记忆刷新功能的影响依赖于对其操纵的稳定性。     

教养方式的母子感知差异与儿童抑郁的关系：母子依恋的中介作用

本研究以300个三至六年级双亲家庭中的儿童和母亲为研究对象,采用儿童版和家长版教养方式问卷、父母与同伴依恋问卷、流调中心抑郁量表,通过响应面分析法探讨了母子感知到的教养方式差异与儿童抑郁的关系,并使用标准分差法计算感知差异,通过结构方程模型分析了母子依恋是否在其中起到中介作用。研究发现:(1)母亲感知到的权威型、独裁型教养方式显著高于儿童感知,而纵容型教养方式则显著低于儿童;(2)权威型教养方式的母子感知差异正向线性预测儿童抑郁,独裁型教养方式的母子感知差异负向线性预测儿童抑郁,纵容型教养方式的感知差异对儿童抑郁没有显著预测作用;(3)母子依恋质量在权威型教养方式的母子感知差异和儿童抑郁之间起完全中介作用,但在独裁型教养方式的母子感知差异对儿童抑郁的预测中没有起到中介作用。