Chen Feng

By establishing an ethical assessment framework to evaluate the medical ethical reasoning ability of medical students, systematically reveal the current actual situation and problems of medical ethics education in medical schools, and provide empirical evidence and improvement directions for optimizing the medical ethics education system and enhancing educational effectiveness. This study was based on the Medical Ethics Intermediate Concept Measurement (MD-ICM) questionnaire developed by Ponsopa Pinijphon from the University of Alabama in the United States. For the first time in China, it conducted a localization and cultural adaptation of the questionnaire. The questionnaire covers principles such as patient autonomy, confidentiality, beneficence, and fair distribution. The survey subjects were selected through a multi-stage random sampling method. A database was established using EpiData 3.1 software, and the data were statistically analyzed using SPSS 21.0 software. Students who have studied medical ethics performed significantly better in making correct reasoning decisions compared to those who haven’t; in terms of “the teaching methods of the Medical Ethics Course”, students who chose scenario simulation and audio-visual learning methods scored significantly higher in ethical reasoning ability than those who chose theoretical lectures and case analysis; in terms of “the assessment methods of the Medical Ethics Course”, students who chose ethical reasoning tests and did not undergo test assessment scored significantly higher in ethical reasoning ability than those who chose theoretical concept tests and case reflection essays; in terms of “the learning needs of the Medical Ethics Course”, students with learning needs usually have stronger ethical emotions and ethical awareness. The medical ethics reasoning ability of medical students is significantly influenced by their medical ethics learning experiences, teaching methods of courses, assessment methods, and learning needs. Currently, there are shortcomings in medical ethics education in medical colleges. To enhance the ethical reasoning ability of medical students, it is necessary to strengthen the foundational position of medical ethics education, optimize the practice-oriented teaching mode, improve the diversified formative evaluation, and create a supportive educational atmosphere.

Despite growing interest in artificial intelligence (AI) and robotics technologies as tools to enhance energy efficiency and regulatory compliance in buildings, limited research has examined how frontline implementers, including street-level bureaucrats, experience and interpret their adoption in practice, a perspective that is crucial for improving both technology adoption and policy implementation. This study investigates the implementers’ perceptions of carrying out these technologies in New York City’s building sector. Through a mixed-methods approach combining semi-structured interviews, surveys, and focus groups, we assess the perspectives from technology professionals, building operators and staff, and building occupants. Structural topic modeling (STM) of interview data reveals ten distinct topics (i.e., associated with different groups) categorized under four themes: perceived advantages, perceived disadvantages, energy efficiency, and decision-making within regulatory frameworks such as Local Law 97. Notably, it reveals a clear divide between operators’ practical concerns over aging infrastructure, the costs and the inclusiveness of decision-making processes, and professionals’ focus on regulatory compliance and the data-driven approach perceived as more unbiased. Findings from the surveys and focus groups suggest a generally positive orientation toward adoption of AI and robotics. This research expands street-level bureaucracy literature into the realm of technology adoption within energy governance and highlights how frontline workers’ discretion shapes the implementation of emerging technologies in the building sector, while offering practical guidance for designing inclusive and equitable AI and robotics adoption strategies that support climate policy goals.

In this thesis, I examine the significance of Levinas’ phenomenological method between _The Theory of Intuition in Husserl’s Phenomenology_ and _Totality and Infinity_. I argue that the phenomenological method, for Levinas, consists less in the reconstruction or analysis of Husserl’s texts than in the confrontation of the assumed consciousness in concrete life. On the basis of this interpretation of the phenomenological method, _Totality and Infinity_ is read as the phenomenological reduction of the assumed consciousness in concrete life, which brings forth the philosopher’s necessary attendance in the act of philosophizing. I argue that Levinas’ reading of the Western tradition draws attention to the underestimation of the philosopher’s necessary attendance in concrete life and the lack of justification for the possibility of philosophy itself. Lastly, I argue that the phenomenological method brings forth another crucial problem with regard to the positional consciousness in concrete life. I apply the proposed interpretation of the phenomenological method to the philosopher’s inevitable movement on the horizontal; I argue that the significance of the movement on the horizontal has been dissimulated by the pursuit of the vertical, which means the pursuit of that which will remain the same when the next moment comes. The analysis of the philosopher’s movement on the horizontal in concrete life is not only a salient problem for philosophical reflections but also the beginning for other inquiries with regard to the proposed interpretation of the phenomenological method.

ObjectiveThis study used a moderated mediation model to test the mediating effect of anxiety on the relationship between negative perfectionism and sleep quality and the moderating effect of COVID-19 epidemic risk perception during the COVID-19 pandemic in Chinese international students.Materials and methodsA sample of 239 Chinese international students from the south of China, was surveyed with the Negative and Positive Perfectionism Scale, the Pittsburgh Sleep Quality Index, the General Anxiety Disorder Scale, and the COVID-19 Epidemic Risk Perception Inventory. Version 23.0 of SPSS and version 3.4 of PROCESS were used to perform the correlation analyses, mediation analysis, and moderated mediation analysis.Results Negative perfectionism was significantly correlated with anxiety and poor sleep quality. Anxiety was significantly correlated with poor sleep quality. The mediating effect test showed that anxiety had a mediating effect between negative perfectionism and poor sleep quality. Epidemic risk perception moderated the mediating effect of anxiety between negative perfectionism and poor sleep quality.ConclusionNegative perfectionism affected sleep quality indirectly through anxiety. In particular, COVID-19 epidemic risk perception moderated the relationship between anxiety and sleep quality, such that the association was stronger when the COVID-19 epidemic risk perception was high. These results provide a more comprehensive understanding of the negative link between negative perfectionism and poor sleep quality.

The fiscal imbalance between the central and local governments under fiscal centralization may motivate local governments to pass tax burdens on firms. The causal identification of the tax system reform and the sustainable export innovation behavior of firms are of great significance. This study uses the income tax sharing policy of China to examine the impact of fiscal centralization on the sustainable export innovation behavior of firms. We find that this tax reform has significantly inhibited the increase of the export value-added rate of firms, and has an increasing trend with the share ratio between the Central Government and the local government. Moreover, this effect mainly comes from the crowding-out effect of imported intermediate goods on domestic intermediate goods. The tests show that the above conclusions are consistent with the general logic of local governments. When they face greater downward fiscal pressure, they will further pass the tax burden on local firms and force the firms to promote their export performance to expand the tax base. This short-sighted behavior of replacing “quality improvement” with “quantity increase” is an important factor that affects the sustainable export innovation behavior of firms and the climb in the global value chain.

Chinese mind-body exercises are positively associated with executive function, but their effects on EF, from synthesized evidence using systematic and meta-analytic reviews, have not been conducted. Therefore, the present systematic review with meta-analysis attempted to determine whether CMBEs affect EF and its sub-domains, as well as how exercise, sample, and study characteristics moderate the causal relationship between CMBEs and EF in middle-aged and older adults. Seven electronic databases were searched for relevant studies published from the inception of each database through June 2020. Randomized controlled trials with at least one outcome measure of CMBEs on EF in adults of mean age ≥ 50 years with intact cognition or mild cognitive impairment and with or without chronic diseases were included. A total of 29 studies ultimately were included in this study. The results indicated that CMBEs improved overall EF, as well as its sub-domains of working memory and shifting. The beneficial effects of CMBEs on EF occurred regardless of type, frequency of group classes, session time, total training time, and length of the CMBEs, in addition to that more frequent participation in both group classes and home practice sessions resulted in more beneficial effects. The positive effects of CMBEs on EF were also demonstrated, regardless of participants mean age, sex, and cognitive statuses, health status, as well as training mode and study language. This review thus suggests that CMBEs can be used as an effective method with small to moderate and positive effects in enhancing EF, and that more frequent group classes and home practice sessions may increase these effects. However, certain limitations, including strictly design studies, limited ES samples for specific variables, and possible biased publications, required paying particular attention to, for further exploring the effects of CMBEs on EF.

With renewable energy being increasingly connected to power grids, pumped storage plants play a very important role in restraining the fluctuation of power grids. However, conventional control strategy could not adapt well to the different control tasks. This paper proposes an intelligent nonlinear model predictive control strategy, in which hydraulic-mechanical and electrical subsystems are combined in a synchronous control framework. A newly proposed online sequential extreme learning machine algorithm with forgetting factor is introduced to learn the dynamic behaviors of the coupling system. Specifically, the initial learning parameters are optimized by prior-knowledge learning and a new self-adaptive adjustment strategy is also put forward. Subsequently, the stair-like control strategy and artificial sheep algorithm are used in rolling the optimization mechanism to replace the existing complex differential geometric solutions. Comparative experiments are carried out under different working conditions based on a PSP in China. The results show that the influence from coupling factors can be considerable and the proposed MPC strategy indicates superiority in voltage and load adjustment as well as the frequency oscillation suppression.