并发症内涵刍议

并发症概念的不明确,使得临床及司法实践中出现诸多问题,如部分医务人员注意力降低、医患矛盾升级,对医疗损害鉴定及判决产生了不利影响.应从疾病诊断和诊疗操作两方面理解并发症的内涵,明确并发症并不一定是医院的免责事由,并规范对这一概念的使用.     

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.     

西方汉学家葛瑞汉《墨子》研究述评——以墨子十论为重心

本文介绍著名西方汉学家葛瑞汉的墨子研究,主要以＂墨子十论＂为讨论重点。本文第一部分简介葛瑞汉之学术研究概况;本文第二部分分别讨论葛氏提出＂墨分为三＂与十论篇次关系之理论,共有：其一,《非攻上》归属问题与《天志》诸篇关系;其二,《非命》诸篇之错简问题;其三,导致三派分歧的主题研究三大主题,逐一述评葛氏之研究成果,并参照相关文献,检讨其得失所在;本文第三部分则略论葛氏提出的墨家分派及其＂十论＂研究的效用与限制;最后则说明中、西学界治学方法、风格之异同,而吾人若能两者并参,截长补短,则必能双赢。     

Dopamine D1 receptors are responsible for stress-induced emotional memory deficit in mice

It is established that stress impairs spatial learning and memory via the hypothalamus-pituitary-adrenal axis response. Dopamine D1 receptors were also shown to be responsible for a stress-induced deficit of working memory. However, whether stress affects the subsequent emotional learning and memory is not elucidated yet. Here, we employed the well-established one-trial step-through task to study the effect of an acute psychological stress (induced by tail hanging for 5, 10, or 20?min) on emotional learning and memory, and the possible mechanisms as well. We demonstrated that tail hanging induced an obvious stress response. Either an acute tail-hanging stress or a single dose of intraperitoneally injected dopamine D1 receptor antagonist (SCH23390) significantly decreased the step-through latency in the one-trial step-through task. However, SCH23390 prevented the acute tail-hanging stress-induced decrease in the step-through latency. In addition, the effects of tail-hanging stress and/or SCH23390 on the changes in step-through latency were not through non-memory factors such as nociceptive perception and motor function. Our data indicate that the hyperactivation of dopamine D1 receptors mediated the stress-induced deficit of emotional learning and memory. This study may have clinical significance given that psychological stress is considered to play a role in susceptibility to some mental diseases such as depression and post-traumatic stress disorder.     

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.     

Stopping speech suppresses the task-irrelevant hand

Some situations require one to quickly stop an initiated response. Recent evidence suggests that rapid stopping engages a mechanism that has diffuse effects on the motor system. For example, stopping the hand dampens the excitability of the task-irrelevant leg. However, it is unclear whether this ‘global suppression’ could apply across wider motor modalities. Here we tested whether stopping speech leads to suppression of the task-irrelevant hand. We used Transcranial Magnetic Stimulation over the primary motor cortex with concurrent electromyography from the hand. We found that when speech was successfully stopped the motor evoked potential from the task-irrelevant hand was significantly reduced compared to when the participant failed to stop speaking, or responded on non stop signal trials, or compared to baseline. This shows that when speech is quickly stopped, there is a broad suppression across the motor system. This has implications for the neural basis of speech control and stuttering.     

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.