急诊科医生要重视构建和谐的医患关系

随着目前医患关系日趋紧张的状况,构建和谐的医患关系成为急诊科医生面临的一个重要课题.从救死扶伤为灵魂、有效解除患者痛苦、尊重和理解患者、良好的医患沟通、语言艺术为桥梁等不同角度深入探讨了急诊科医生如何构建和谐的医患关系.     

先秦诸子学说对中国现代能源资源战略的启示

当代中国在经济发展的压力之下,用牺牲自然资源来获取经济增长,这无疑是最简捷的途径,但资源的有限性则约束了利用资源的质量、数量以及时空范围。中国先秦时代,诸子百家的许多论断就闪现了对资源合理利用的认识,用这些理念反观当今科学发展观视角下的能源资源战略,仍具有鲜明的借鉴意义和历史价值。     

On the nature of sustainable Economic systems

The theme of the 1982 Tokyo Conference of the Club of Rome is ‘Approaching the 21st Century: Global Problems and Human Choices.’ This is a topic of crucial importance that our generations will have to tackle in all its breadth and depth. Within its context are presented some ideas about the alternatives of the human future.     

A Guide to Thinking about Emergence

A basic survey of the issues that arise in discussing emergence is presented, together with suggestions on how the concept should be approached. Emergence is an alternative to reductionism. The emergence story invites us to see that nothing transcends nature like nature itself; it is a radically new way to think about the natural order, and it reshapes our ideas of matter. Special attention is given to the idea of meaning in life. Three options are discussed for thinking about the meaning of life: that it is fundamental to the nature of things, that it is an illusion, and that it is an emergent property of matter. The third option is favored—that the universe has no telos, and yet makes possible the spontaneous emergence of purpose. Caution is advised against exploiting the idea of emergence. The most important task is to understand the science of emergence and only then to move into interpretations from the humanities and theology.     

Quantum Paradoxes, Time, and Derivation of Thermodynamic Law: Opportunities from Change of Energy Paradigm

Summary  Well known quantum and time paradoxes, and the difficulty to derive the second law of thermodynamics, are proposed to be the result of our historically grown paradigm for energy: it is just there, the capacity to do work, not directly related to change. When the asymmetric nature of energy is considered, as well as the involvement of energy turnover in any change, so that energy can be understood as fundamentally “dynamic”, and time-oriented (new paradigm), these paradoxes and problems dissolve. The most basic consequence concerns the particle-wave dualism. For a reversible inter-conversion of a particle into a wave, subject to a dynamic energy, a self-image of information has to be generated: quantum theory has to be complemented by a theory of information. Then, quantum processes can be derived from classical ones and the second law of thermodynamics with the tendency of increasing entropy follows in a straightforward way.     

在医学学术期刊中营造人文氛围的意义和作用

我国的医学人文期刊仅有5~6种,发行量少、覆盖面窄,受众极其有限。而我国的医学学术期刊有1400多种,如果能够善加利用,在医学学术期刊中构建具有学科特色的人文平台,进行人文导向,可有效地推广医学人文理念,有利于医学人文精神的传承与发扬,对促进医学人文学向各专业学科的延伸与交融及推动医学人文学的发展有着积极的作用。     

Looking for Trouble: Preventive Genomic Sequencing in the General Population and the Role of Patient Choice

Advances in genomics have led to calls for developing population-based preventive genomic sequencing (PGS) programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the sequencing or analysis of specific genomic conditions (the menu approach) or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations.     

The effect of exercise intensity on joint power and dynamics in ergometer double-poling performed by cross-country skiers

The purpose of this study was to examine the effect of increasing exercise intensity on the role of joint powers in ergometer double poling (DP), while taking specific dynamic constraints into account. One main question was whether lower-body power contribution increased or decreased with increasing intensity. Nine male Norwegian national-level cross-country skiers performed ergometer DP at low, moderate, high and maximal intensity. Kinematics, and ground (GRF) and poling (F_poling) reaction forces were recorded and used in link segment modeling to obtain joint and whole-body dynamics. Joint powers were averaged over the cycle, the poling (PP) and recovery (RP) phases. The contribution of these average powers was their ratios to cycle average poling power. At all intensities, the shoulder (in PP) and hip (mostly in RP) generated most power. Averaged over the cycle, lower-body contribution (sum of ankle, knee and hip power) increased from ∼37% at low to ∼54% at maximal intensity (p < .001), originating mostly from increased hip contribution within PP, not RP. The generation of larger F_poling at higher intensities demanded a reversal of hip and knee moment. This was necessary to appropriately direct the GRF vector as required to balance the moment about center of mass generated by F_poling (control of angular momentum). This was reflected in that the hip changed from mostly absorbing to generating power in PP at lower and higher intensities, respectively. Our data indicate that power-transfer rather than stretch-shortening mechanisms may occur in/between the shoulder and elbow during PP. For the lower extremities, stretch-shortening mechanisms may occur in hip, knee and trunk extensors, ensuring energy conservation or force potentiation during the countermovement-like transition from body lowering to heightening. In DP locomotion, increasing intensity and power output is achieved by increased lower-body contribution. This is, at least in ergometer DP, partly due to changes in joint dynamics in how to handle dynamic constraints at different intensities.