Health professionals had difficulty choosing the right time to discuss life-sustaining treatments (LSTs) since the Korean Act was passed in 2018. This study aimed to understand how patients decide to undergo LSTs in clinical practice and to compare the perceptions of these decisions among health professionals, patients, and families with suggestions to support the self-directed decisions of patients. A retrospective observational study with electronic medical records (EMRs) and a descriptive survey was used. The data obtained from the EMRs included all (...) adult patients who died in end-of-life care at a university hospital in 2021. We also conducted a survey of 214 health professionals and 100 patients and their families (CNUH IRB approval no. 2022-07-006). Based on the EMR data of 916 patients in end-of-life care, 78.4% signed do-not-attempt-resuscitation consents, 5.6% completed the documents for LSTs, and 10.2% completed both forms. LST decisions were mostly made by family members (81.5%). Most survey participants agreed that meaningless LSTs should be suspended, and the decision should be made by patients. Patients and family members (42–56%) and health professionals (56–58%) recommended discussing LST suspension when the patient is still conscious but with predicted deterioration of their condition. The suffering experienced by the patient was considered to be a priority by most patients (58%) and families (54%) during the decision-making process, while health professionals considered “the possibility of the patient’s recovery” to be the highest priority (43–55%). There is still a significant discrepancy in the perceptions of LST decisions among health professionals, patients, and their families despite high awareness of the Act. This situation makes it challenging to implement the Act to ensure respect for the rights of patients to self-determination and dignified end-of-life. Further effort is needed to improve the awareness of LSTs and to clarify the ambiguity of document preparation timing. (shrink)

Maximum likelihood (ML) estimation of categorical multitrait-multimethod (MTMM) data is challenging because the likelihood involves high-dimensional integrals over the crossed method and trait factors, with no known closed-form solution. The purpose of the study is to introduce three newly developed ML methods that are eligible for estimating MTMM models with categorical responses: Variational maximization-maximization (e.g., Rijmen and Jeon, 2013 ), alternating imputation posterior (e.g., Cho and Rabe-Hesketh, 2011 ), and Monte Carlo local likelihood (e.g., Jeon et al., under revision). Each (...) method is briefly described and its applicability for MTMM models with categorical data are discussed. (shrink)

Study with reference to philosophy of Joseph F. Fletcher on christian ethics.

Cross-classified random effects models have been developed for appropriately analyzing data with a cross-classified structure. Despite its flexibility and the prevalence of cross-classified data in social and behavioral research, CCREMs have been under-utilized in applied research. In this article, we present CCREMs as a general and flexible modeling framework, and present a wide range of existing models designed for different purposes as special instances of CCREMs. We also introduce several less well-known applications of CCREMs. The flexibility of CCREMs allows these (...) models to be easily extended to address substantive questions. We use the free R package PLmixed to illustrate the estimation of these models, and show how the general language of the CCREM framework can be translated into specific modeling contexts. (shrink)

This study examined the role of religion in xenophobic responses to the threat of Ebola. Religious communities often offer members strong social ties and social support, which may help members cope with psychological and physical threat, including global threats like Ebola. Our analysis of a nationally representative sample in the U.S. found that overall, the more vulnerable to Ebola people felt, the more they exhibited xenophobic responses, but this relationship was moderated by importance of religion. Those who perceived religion as (...) more important in their lives exhibited weaker xenophobic reactions than those who perceived religion as less important. Furthermore, social connectedness measured by collectivism explained the moderating role of religion, suggesting that higher collectivism associated with religion served as a psychological buffer. Religious people showed attenuated threat responses because they had a stronger social system that may offer resources for its members to cope with psychological and physical threats. The current research highlights that different cultural groups react to increased threats in divergent ways. (shrink)

BackgroundAttention deficit hyperactivity disorder is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and (...) controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.MethodsThirty-seven children and adolescents with and without ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test was conducted under four conditions: control, no-cue, visual cue, and visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions using a head-mounted display in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.ResultsThe magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control groups.ConclusionChildren and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner. (shrink)

T‐bet and Eomes are two related transcription factors (TFs) that regulate the differentiation of cytotoxic lymphocytes such as Natural Killer (NK) cells and CD8 T cells. Recent genome‐wide analyses suggest they have complementary roles in instructing the transcriptional program of NK cells, although their DNA binding sites appear to be very similar. In this essay, we discuss the mechanisms that could specify their action, addressing their expression profile, the cofactors they interact with, as well as their roles in the epigenetic (...) regulation of chromatin accessibility. Based on the recent literature on these TFs, we propose different models to describe how they regulate gene expression in NK cells at steady state, or in the context of activation or exhaustion. We also discuss recent findings in the field of CD8 T cell differentiation and residency, where Eomes and T‐bet appear to be major regulators, and the parallels that can be drawn between mechanisms of NK and CD8 T cell differentiation and trafficking. (shrink)

Excerpt from Poetarum Philosophorum Fragmenta Plagulis correctis indicibusque non sine taedio confectis dum respiro et laetiore animo quid praefandum sit meditor, ecce nuntius longe tris tissimus afi'ertur, georgium kaibelium nobis litterisque acerba morte ereptum esse, qui non solum studiorum societate inde a beatissimo oon tu'oernio - Bonnensi mihi erat coniunctissimus, sed in hoc quoque communi amicorum opere velut auspex et signifer, cuius auctoritatem me aequi et decebat et iuvabat. Nam singularis graecae artis cognitio, quae in illo fuit, in nullo genere (...) litterarum magis enituit quam in Comicis, unde splendidum ante biennium factum est huius Corporis initium. Iam adu lescentem prima tirocinia in Aristophane ponere memini eundemque audio supremam fuisse moribundi curam ac querelem. Inter bos vitae laboriosae et fructuosae terminos omnem graecitatem peragravit et undique messem uberrimam rettulit; at nusquam libentius et intentius versabatur quam in atticae comoediae reliquiis. Dorienses enim, quos edidit, propter illos cpinor tetigerat.' quodsi verum est cum primi illins voluminis perfectione vix unam alteramve aequalium editionem recte posse eom parari, quid prasstaturum eum fuisse credimus, si fatum concessisset, ut ipsam 'atticam comoediam nobis ex fragmentis instauraret, in qua totus habitabat et spirabat! Aut nemo mortalium aut, si quisquam, ille et natus erat et paratus ad Menandri et aequalium umbras ex inferis citandas et in vitae lucem revocandas. Adeo in intimam eorum consuetudinem inde fesso labore atque fortasse magis etiam sensus quadam cognatione se insinuaverat. Nam tota eius indoles ad atticum istum saporem facta erat. Ut scripture eius elegantia apicum prae ceteris nitebat, ut suavissima sermocinatio mirum quantum amicos tenebat, priusquam morbi ingra veseentie tormentis animi serenitas obscurari coepta est, ita tota eius ars versus graecos et exblicandi et pangendi Praxiteleo quodam perfusa erat nitore. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

The appearance of the time derivative of the acceleration in the equation of motion (EOM) of an electric charge is studied. It is shown that when an electric charge is accelerated, a stress force exists in the curved electric field of the accelerated charge, and in the case of a constant linear acceleration, this force is proportional to the acceleration. This stress force acts as a reaction force which is responsible for the creation of the radiation (instead of the “radiation (...) reaction force” that actually does not exist at low velocities). Thus the initial acceleration should be supplied as an initial condition for the solution of the EOM of an electric charge. (shrink)

ObjectiveWe aim to investigate the feasibility of using diffusion tensor imaging to evaluate changes in extraocular muscles and lacrimal gland in patients with thyroid-associated ophthalmopathy and to evaluate disease severity.Materials and MethodsA total of 74 participants, including 17 healthy controls, 22 patients with mild TAO, and 35 patients with moderate-severe TAO, underwent 3-Tesla DTI to measure fractional anisotropy and mean diffusivity of the EOMs and LG. Ophthalmological examinations, including visual acuity, exophthalmos, intraocular pressure, and fundoscopy, were performed. FA and MD (...) values were compared among patients with different disease severity. Multiple linear regression was adopted to predict the impact of clinical variables on DTI parameters of orbital soft tissue.ResultsTAO patients’ EOMs and LG showed significantly lower FA values and higher MD compared to HCs’. Moderate-severe TAO patients’ EOMs and LG had dramatically lower FA and higher MD compared with HCs. In addition, only the DTI parameters of the medial rectus were considerably different between mild and moderate-severe TAO patients. Multiple linear regression showed that disease severity had a significant impact on the DTI parameters of orbital soft tissue.ConclusionDTI is a useful tool for detecting microstructural changes in TAO patients’ orbital soft tissue. DTI findings, especially medial rectus DTI parameters, can help to indicate the disease severity in TAO patients. (shrink)