Gao Yu

With the widespread use of smartphones, patient-initiated recording in emergency departments (EDs) has become an increasing concern. In the high-pressure EDs environment, physicians frequently perceive such recordings as being motivated less by a desire to enhance understanding and more by a defensive intent to preserve evidence for potential disputes. This study investigates emergency physicians’ exposure to and perceptions of this phenomenon in Southwestern China. A cross-sectional survey was conducted via online snowball sampling among 306 emergency physicians from tertiary hospitals in Southwestern China between September and October 2025. The study assessed the frequency with which physicians encounter patient-initiated recording, associated clinical scenarios, response strategies, and perceptions of ethical and legal implications. A total of 90.20% of respondents reported encountering patient-initiated recording within the past year. Among these physicians, 90.22% reported experiencing covert (undisclosed) recording, identifying the behavior through observation rather than patient disclosure. Commonly reported scenarios by the affected physicians included emergency diagnosis and treatment (77.90%) and dispute mediation (59.06%). Regarding attitudes, physicians rated perceived risks significantly higher than benefits on a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree); while acknowledging moderate utility for elderly patients (mean score = 3.29), they indicated that recording was perceived to promote defensive medical behavior (mean score = 4.82) and induced psychological pressure (mean score = 4.74). Moreover, 72.55% believed the practice negatively impacted the physician-patient relationship. Furthermore, 90.20% expressed a strong demand for professional training, prioritizing case-based analysis of legal disputes (88.89%) and informed consent protocols (88.24%). The high reported exposure to patient-initiated recording—particularly in covert forms—among the surveyed emergency physicians in Southwestern China highlights physicians’ prevalent concerns about a perceived strain on trust and their self-reported association with defensive medical behaviors. Moving beyond strict prohibitions, healthcare institutions should consider prioritizing transparent governance and standardized communication protocols. Furthermore, targeted medico-legal training is essential to clarify rights and obligations, which could potentially help establish clearer institutional boundaries for managing patient-initiated recording. Not applicable (this study is a cross-sectional survey and does not involve any health care intervention).

This study aims to investigate the cognitive differences and ethical concerns regarding artificial intelligence in healthcare between the public and healthcare professionals and to provide empirical evidence for ethical governance and risk communication. A text mining approach was adopted to comparatively analyze Chinese public social media and professional medical forums. A total of 4,042 valid texts were included, comprising 2,088 from the public corpus and 1,954 from the healthcare professional corpus. SnowNLP sentiment analysis, the Latent Dirichlet Allocation (LDA) topic model, and co-word network analysis were applied to reconstruct and compare the structures of concern between the two groups. Both groups were dominated by positive sentiment toward artificial intelligence in healthcare, although healthcare professionals showed a higher positive tendency (75.2%) than the public (68.0%), while the public exhibited a higher degree of caution. LDA topic analysis and co-word network analysis showed that both groups focused heavily on the role positioning and replacement boundaries of artificial intelligence. However, their specific focal concerns differed significantly. Healthcare professionals placed greater emphasis on occupational impact and practice-related concerns, mainly involving clinical application, responsibility, and humanistic care. In contrast, the public focused more on technical conditions and risk perception, emphasizing practical uses in healthcare settings, the reliability of data and models, and issues of responsibility and risk. Although both the public and healthcare professionals hold relatively positive attitudes toward artificial intelligence in healthcare, their cognitive structures exhibit clear group differences. The subsequent ethical governance and advancement of artificial intelligence in healthcare require clarifying its functional boundaries while simultaneously addressing the practice-related concerns of healthcare professionals and the risk-related concerns of the public.

Predictive analytics and early warning systems are now widely used in nursing practice worldwide. While these tools can improve efficiency and patient safety, but at the same time posing ethical challenges related to data privacy, algorithmic fairness, accountability, professional autonomy, and patient rights. Through a systematic rapid review, we identify the major ethical risks in nursing contexts and propose actionable governance pathways to inform clinical practice and policy. This study used a systematic rapid review, searching eight databases—PubMed, Embase, Web of Science, Scopus, Cochrane Library, Ovid, EBSCOhost, and ProQuest—for English-language articles published from 2015 through May 2025. Two reviewers independently screened records and extracted data, with a third reviewer resolving disagreements, yielding 22 included studies. Using inductive thematic analysis, we summarized the ethical-risk dimensions and governance pathways of predictive analytics and early warning systems in nursing practice, and conducted an overall quality appraisal of the included literature. The included studies came from 11 countries, with publication volume rising markedly in recent years—reflecting growing attention to ethical issues in nursing. Most were reviews or commentaries, with fewer qualitative and mixed-methods studies. Thematic analysis identified five ethical-risk dimensions: (i) Data- and Algorithm-Related Ethical Risks; (ii) Professional Role and Responsibility Attribution Risks; (iii) Patient Rights and Humane-Care Ethical Risks; (iv) Ethical-Governance and Misuse Risks; and (v) Technological Accessibility and Social Acceptance Barriers. In response, the literature proposes four governance pathways—Technical–Data Governance, Clinical Human–Machine Collaboration, Organizational-Capacity Building, and Institutional–Policy Regulation—with concrete measures including privacy protection, algorithmic-bias monitoring and fairness audits, transparency and explainability enhancement, nurse training and digital literacy, interdisciplinary collaboration and co-creation, and policy and regulatory guidelines. Predictive analytics and early warning systems in nursing practice show substantial promise yet are accompanied by multidimensional ethical risks. For the first time in a nursing context, this study proposes a “five ethical-risk dimensions–four governance pathways” framework, offering actionable ethical-governance guidance for nurses, administrators, and policymakers. Future work should pursue interdisciplinary, multicenter empirical studies to evaluate the framework’s feasibility and effectiveness and to align technological benefits with ethical values, thereby improving nursing quality and patient safety.

This study aimed to explore the psychological mechanisms behind the relationship between kindergarten parental satisfaction and parental loyalty. This study used the parental satisfaction scale, parental trust scale, parental relationship commitment scale, and parental loyalty scale on 923 kindergarten parents. The test was conducted on 923 kindergarten parents. The results of this study showed that parental satisfaction significantly and positively affected parental loyalty. Parental trust was partially mediated between parental satisfaction and parental loyalty. Parental relationship commitment was also partially mediated between parental satisfaction and parental loyalty. Regarding to parental satisfaction and parental loyalty, parental trust and parental relationship commitment had chain mediation effect between parental satisfaction and parental loyalty. The findings of this study provided valuable insights into the effect of parental satisfaction on parental loyalty and offer concrete practical suggestions for kindergarten operators to improve the loyalty of kindergarten parents.

BackgroundNurses working in the intensive care unit clung tenaciously to their job during the COVID-19 pandemic in spite of enduring stressed psychological and physical effects as a result of providing nursing care for the infected patients, which indicates that they possessed a high degree of professionalism and career calling. The aim of this study was to explain the associations between resilience, thriving at work, and ethical leadership influencing the calling of ICU nurses.MethodsFrom December 2020 to January 2021 during the COVID-19 pandemic, a cross-sectional survey of 15 provinces in China was conducted using an online questionnaire. A total of 340 ICU nurses completed sufficient responses to be used in the study. Sociodemographic factors, job demographic factors, resilience, calling, thriving at work, and ethical leadership were assessed using the questionnaire. General linear modeling, hierarchical linear regression analysis, and generalized additive model were performed to examine all the considered research hypotheses.ResultsResilience was positively and significantly associated with calling. Moreover, thriving at work partially mediated the relationship between resilience and calling. The indirect effect of resilience on calling was 0.204, and the direct effect of resilience on calling through thriving at work was 0.215. The total effect of resilience on calling was 0.419. In addition, ethical leadership played a moderating role in the relationship between resilience and calling.ConclusionGreater resilience can positively predict increased calling among Chinese ICU nurses during the COVID-19 pandemic. Moreover, thriving at work is a mechanism that partly transmits the positive effects of resilience on calling. Overall, nurses possessing greater resilience tend to maintain thriving at work in the face of such adversity, further resulting in subsequently increased calling. Besides, findings suggest that there is stronger influence of resilience on calling among nurses working in an organization managed by an ethical leader. The current findings may offer two insights for nursing practitioners and policymakers in the postpandemic world. First, resilience training and intervention are necessary to foster nurses' sense of thriving at work in the nursing industry, further promoting career calling. Second, better training and effort on the development of ethical leadership for leaders in nursing practice are essential to encourage followers to engage in social learning of ethical behaviors and abiding by normatively appropriate conduct, further enacting prosocial values and expressing moral emotions.

Exploring the factors influencing entrepreneurial intention is crucial to entrepreneurial practice and education. For a comprehensive understanding of the influence of narcissistic personality on entrepreneurial intention, this study analyzed the relationship between narcissistic personality, entrepreneurial self-efficacy, and entrepreneurial intention in college students sampled from three higher vocational colleges in Beijing, China. A total of 252 valid questionnaires were collected. The results show that the narcissistic personality of the college students has a significant positive effect on entrepreneurial intention and entrepreneurial self-efficacy. Entrepreneurial self-efficacy of the college students has a significant positive effect on entrepreneurial intention and plays a partial mediation role in the relationship between narcissistic personality and entrepreneurial intention. Thus, the study results provide some reference for further improving entrepreneurial practice and education.

Significant research has been conducted on the influence of entrepreneurial intention on entrepreneurial education and entrepreneurship practice. Similarly, this study aims to explore how creativity plays a mediating role in the influence of personality traits on entrepreneurial intention. As many as 674 valid questionnaires were collected from college students in China, allowing the relationship between personality traits, creativity, and entrepreneurial intention to be analyzed in detail. The following results are found through a series of explorations. First, neuroticism in personality traits has a significant negative impact on entrepreneurial intention, while conscientiousness, openness, and extraversion have a significant positive impact. Second, neuroticism has a significant negative impact on creativity, while conscientiousness, openness, and extraversion have a significant positive impact. Third, creativity has a significant positive impact on entrepreneurial intention, it has a partial mediating role between neuroticism, conscientiousness, extraversion, and entrepreneurial intention along with a complete mediating role between openness and entrepreneurial intention. The research results further provide a reference value for the improvement and optimization of entrepreneurial practice.

Purpose: Although psychopathy is characterized by amoral behavior, literature on the association between psychopathy and moral judgment pattern is mixed. Recent evidence suggests that this may be due to the moderation effect of anxiety (Koenigs, Kruepke, Zeier, & Newman, 2011). The current study aims to examine the psychopathy-utilitarian judgment association in college students. Method: In this study, a group of 302 college students completed a moral judgment test involving hypothetical dilemmas. Their psychopathic traits were assessed by the Psychopathic Personality Inventory – Short Form (PPI-SF) (Lilienfeld & Andrews, 1996). Results: Individuals with higher psychopathic traits were more likely to make utilitarian responses to moral dilemmas. Furthermore, the association between utilitarian responses and psychopathy was more salient for the behavioral factor of psychopathy (PPI-II), and this association was mediated by self-reported aggression. However, the moderating effect of anxiety was not found. Conclusions: These results build upon work on utilitarian moral judgment in psychopathic individuals in a non-incarcerated, non-institutionalized sample, and have important implications for the behavioral correc- tion system.

Background— Although one of the main characteristics of psychopaths is a deficit in emotion, it is unknown whether they show a fundamental impairment in appropriately recognizing their own body sensations during an emotion-inducing task. Method— Skin conductance and heart rate were recorded in 138 males during a social stressor together with subjective reports of body sensations. Psychopathic traits were assessed using the Psychopathy Checklist – Revised (PCL-R) 2nd edition (Hare, 2003). Results— Nonpsychopathic controls who reported higher body sensations showed higher heart rate reactivity, but this verbal-autonomic consistency was not found in psychopathic individuals. This mind-body disconnection is particularly associated with the interpersonal-affective factor of psychopathy. Conclusions— Findings are the first to document this body sensations– autonomic mismatch in psychopaths, and suggest that somatic aphasia the inaccurate identification and recognition of one‘s own somatic states may partly underlie the interpersonal-affective features of psychopaths.

In fear differential conditioning, stimuli that resemble the conditioned stimulus (CS+) are more likely to trigger fear responses. Excessive fear responses on stimuli not like CS + are often associated with anxiety. However, the threat judgments process and how this process manifests itself differently in subgroups with different generalisation rule applications, is unclear. This study examines whether anxiety biases the threat decision process in fear generalisation paradigm and whether subgroups characterised by different generalisation gradients was interpreted differently by drift-diffusion model. We gathered behavioural data through a binary fear generalisation judgment task and clustered participants based on their responses. Reaction time distributions and individual scale scores were analyzed using the hierarchical drift-diffusion model. The model results suggested that similarity and state anxiety facilitated evidence-gathering processes that favoured “threat” judgments, but at the same time, state anxiety weakened the effect of stimulus similarity as evidence. Further cluster analyses revealed that this effect of anxiety on threat judgments only held true for specific subgroups of participants. This pioneering computational modelling effort in fear generalisation underscores the significant role of strategy preference and its complex interaction with anxiety in shaping stimulus processing.