Ying Wu

Science and technology drive research progress but also introduce growing risks, value conflicts and ethical challenges. Science and technology ethics review committees (STERCs) serve as key institutional mechanisms to ensure that scientific activities comply with ethical principles and professional norms. However, the establishment of STERCs worldwide remains at an early developmental stage, and structured, systematic criteria for evaluating their quality are largely absent. This study aims to develop a structured evaluation indicator system for STERCs and to explore its preliminary applicability. This study conducted a literature review and qualitative interviews to develop a preliminary evaluation indicator system, which was organized using Donabedian’s three-dimensional framework of structure, process, and outcome. The final indicator system was established after two rounds of expert consultation. The preliminary self-assessment data were collected from 80 medical institutions and 19 companies across 14 cities in Hunan Province. Both rounds of the Delphi consultation achieved a 100% response rate. The mean authoritative coefficient (Cr) was 0.900, while familiarity (Cs) and judgment basis (Ca) scores were 0.867 and 0.933, respectively. Kendall’s coefficient of concordance (Kendall’s W) was 0.300 (p < 0.001) in round one and 0.213 (p < 0.001) in round two. The final evaluation indicator system consisted of three first-level indicators, nine second-level indicators and 52 third-level indicators. This study proposes a unified framework for science and technology ethics review, integrating activities involving humans, animals, and other potential technological risks into a single evaluation system. The indicator system supports institutional self-assessment, promotes standardization, and guides continuous improvement. Preliminary findings indicate its feasibility and internal consistency, but these results should be interpreted cautiously due to the limited sample scope and reliance on self-reported data.

Clinical ethics consultations (CECs) play an important role in resolving ethical issues in clinical practice worldwide. The government has encouraged the development of CECs in China to address the ethical challenges arising in prenatal diagnosis. So far, the current state and challenges facing CEC remain understudied. This study aimed to explore the perspectives of employees on ethics committees for prenatal diagnosis in 13 medical institutions in Hunan Province, China. Twenty-eight employees participated in interviews. Our qualitative approach employed content analysis to identify major themes in interviewees’ responses, which covered the composition and vision of their prenatal diagnosis ethics committee, as well as the challenges they faced. The results show that CEC in China is in an exploratory stage, with models for CEC composition, and workflow varying significantly. Therefore, we propose the future direction of efforts to improve CECs, including improving CEC working mechanisms and operating procedures, strengthening ethical training for healthcare workers and ethics committee employees, and developing more specific ethical guidance based on the accumulated experiences of ethics committee employees in the early development of CEC for prenatal diagnosis.

The international community has proposed a comprehensive strategy to prevent congenital abnormalities. And China, with a high incidence of congenital diseases, has implemented measures including prenatal screening and diagnosis to reduce the morbidity of congenital abnormalities. However, ethical challenges arise in the practice of prenatal screening and diagnosis among healthcare professionals. Five focus group discussions were conducted with twenty-four health professionals working in maternal and child health services in Hunan Province, China, to explore the ethical challenges they encountered in prenatal testing decision-making and information disclosure practices, as well as their views on these challenges. Participants were selected through purposive sampling, ensuring maximum demographic diversity. Three main themes were identified: 1) balancing between information disclosure and privacy protection; 2) patient-oriented decision-making and tensions within family-oriented decision-making; 3) the disparity between the limited help clinical ethics committees (CECs) can provide and professionals’ need for CECs. Ethical norms for information disclosure and autonomous decision-making within prenatal screening and diagnostic institutions must be established. Utilizing CECs is crucial to guide professionals in delivering prenatal testing services while simultaneously focusing on targeted improvement of communication skills among these professionals.

Background With the extensive integration of digital technology into clinical research, intelligence, virtualization, and decentralization have gradually transformed into emerging clinical research modes, the electronization of informed consent has become indispensable to the development of clinical trial informatization, and the inclination to use electronic informed consent (eIC) has grown. The knowledge and perceptions of research participants, as objects of informed consent acquisition, regarding eIC are crucial. However, few studies have empirically explored such issues. Methods This cross-sectional study was conducted at three general hospitals in south-central China from July to September 2022. An online survey questionnaire was adapted and administered via WeChat to investigate the issues of interest. Results A total of 388 valid questionnaires were included in the analysis. The results showed that the overall response rate for the knowledge section of the questionnaire exceeded 70%. Of the respondents, 53.1% had heard of the term “electronic informed consent,” but only 43.2% had used eIC. The majority of respondents (68%) expressed a preference for using eIC and demonstrated a positive attitude toward it. However, some participants expressed concerns regarding the security and confidentiality (64.4%), operational complexity (52.3%), and effectiveness of online interaction (59.3%) in eIC. Statistically significant relationships were observed between participants’ attitude scores and their age, gender, type of participation, and frequency of involvement in clinical research. Additionally, a positive and statistically significant correlation was found between participants’ knowledge scores and their attitude scores. Conclusion The results of this study indicate that most participants have a good understanding of eIC-related knowledge and hold a positive attitude toward its implementation. However, they also express concerns about data protection and privacy security in eIC. These findings provide a foundation for developing targeted strategies to enhance the adoption and acceptance of eIC among diverse populations.

Background Performance evaluation is vital for IRB operations. As the number of IRBs and their responsibilities in reviewing and supervising clinical research grow in China, there is a significant need to evaluate their performances. To date, little research has examined IRB performance within China. The aim of this study was to ascertain the perspectives and experiences of IRB employees and researchers to understand the current status of IRBs; compare collected results with those of other countries; and identify shortcomings to improve IRB performance. Methods This study was conducted in China from October 2020 to September 2021, using an online survey with the IRB-researcher assessment tool-Chinese version. Results 757 respondents were included in the analysis and classified into IRB employees, researchers, or those who are both IRB employees and researchers. Overall, the score for an ideal IRB was significantly higher than that of an actual IRB. Compared to the US National Validation study, Chinese participants and American participants both agree and differ in their perspectives on the most and least important ideal items. Conclusion This investigation provides a benchmark of the perceived performance of actual IRBs in China. IRBs in China can be precisely adjusted by targeting identified areas of weakness to improve their performances.

BackgroundUsing an effective method for evaluating Institutional Review Board (IRB) performance is essential for ensuring an IRB’s effectiveness, efficiency, and compliance with applicable human research standards and organizational policies. Currently, no empirical research has yet been published in China evaluating IRB performance measures by the use of a standardized tool. This study was therefore conducted to develop a Chinese version of the IRB Researcher Assessment Tool (IRB-RAT), assess the psychometric properties of the Chinese version (IRB-RAT-CV), and validate the tool for use in China.MethodsIn this cultural adaptation, cross-sectional validation study, the IRB-RAT-CV was developed through a back-translation process and then distributed to 587 IRB staff members and researchers in medical institutions and schools in Hunan Province that review biomedical and social-behavioral research. Data from the 470 valid questionnaires collected from participants was used to evaluate the reliability, content validity, and construct validity of the IRB-RAT-CV.ResultsParticipants’ ratings of their ideal and actual IRB as measured by the IRB-RAT-CV achieved Cronbach's alpha 0.989 and 0.992, Spearman-Brown coefficient 0.964 and 0.968, and item-total correlation values ranging from 0.631 to 0.886 and 0.743 to 0.910, respectively.ConclusionThe IRB-RAT-CV is a linguistically and culturally applicable tool for assessing the quality of IRBs in China.

Moments of crisis are always worth analysing. When confronted by visitors’ hands, _The Sunflowers_ and _The Comedian_ represent contrasting attitudes. This divergence is determined by differences in their modes of existence, durations, irreproducibilities, and ways of being experienced. The existence of _The Sunflowers_ depends upon the permanence of its physical substance; however, _The_ _Comedian_ is an ephemeral event, inhering in fluid relationships and forms of interactions. From the former to the latter, artworks have embodied a detachment from their _Objecthood_ and are transforming from _products_ into _processes_. The spectator’s experience also changes from the pure gaze to corporeal, emotional and behavioural engagement. Traditional museum provides a distanced space, reinforcing the untouchability of artworks by maintaining a separation between the spectator and the work, while _The_ _Comedian_ created an interactive space, where the sense of touch is not only corporeal, but also affective.

Moments of crisis are always worth analysing. When confronted by visitors’ hands, _The Sunflowers_ and _The Comedian_ represent contrasting attitudes. This divergence is determined by differences in their modes of existence, durations, irreproducibilities, and ways of being experienced. The existence of _The Sunflowers_ depends upon the permanence of its physical substance; however, _The_ _Comedian_ is an ephemeral event, inhering in fluid relationships and forms of interactions. From the former to the latter, artworks have embodied a detachment from their _Objecthood_ and are transforming from _products_ into _processes_. The spectator’s experience also changes from the pure gaze to corporeal, emotional and behavioural engagement. Traditional museum provides a distanced space, reinforcing the untouchability of artworks by maintaining a separation between the spectator and the work, while _The_ _Comedian_ created an interactive space, where the sense of touch is not only corporeal, but also affective.

In order to fully implement the new development concept, bring into full play the potential of sports development, and maintain the resilience of China’s sports development. This paper studies the resilience evaluation and spatial correlation of Chinese sports development under the new development concept. First, we constructed Resilience Evaluation Indexes System for Sports Development in China based on the analysis of the resilience features of sports development and the DPSIR model, which is from the five aspects of “driving force – pressure – state – influence – response.” Second, used Coefficient of Variation and Technique for Order Preference by Similarity to an Ideal Solution Method to measure the resilience level of sports development in 31 provinces in China from 2013 to 2017. Then, we introduced the obstacle degree model to identify the obstacle factors that hinder the resilience of Chinese sports development in different periods. Finally, we used the global and local Moran indexes to analyze the spatial correlation of China sports regional development. The results showed that: overall, the development level of sports resilience in 31 provinces in China showed an upward trend from 2013 to 2017, while some provinces showed obvious fluctuations. The obstacles to the development of sports resilience in China mainly include sports scientific research equipment, the number of national fitness monitoring stations, the number of national fitness centers, the full-time equivalent of personnel, and the number of sports scientific research projects. The response subsystem is the main obstacle factor that affects the improvement of the resilience level of sports development in China. There is a positive spatial autocorrelation between the resilience level of sports development and regional spatial distribution, and the correlation shows a weakening trend, and the internal difference is significant. Finally, we concluded that we must take the new development philosophy as the guiding principle. First, we should stick to innovation-driven development to fully upgrade the resilience of China’s sports development. Second, we should adhere to the principle of coordinated development to promote the overall and balanced development of sports. Lastly, we should promote shared development so as to deliver benefits for all in an equal way.

The integration of machine learning algorithms into the legal recommendation system marks a burgeoning area of research, with a particular focus on enhancing the accuracy and efficiency of judicial decision-making processes. The application of Bayesian Network (BN) emerges as a potent tool in this context, promising to address the inherent complexities and unique nuances of legal texts and individual case subtleties. However, the challenge of achieving high accuracy in BN parameter learning, especially under conditions of limited data, remains a significant hurdle. This study proposes an Enhanced Maximum Parameter Learning (EMPL) algorithm, tailored for BN parameter optimization in scenarios characterized by small sample sizes. The EMPL algorithm, innovatively incorporating the Synthetic Minority Over-sampling Technique (SMOTE), begins with the formulation of inequality constraints derived from domain expertise. It establishes a minimal dataset threshold necessary for effective parameter learning. Through the introduction of an index weighting factor function that dynamically adjusts according to the sample size, the algorithm facilitates the derivation of refined BN parameters. The core innovation of the EMPL algorithm lies in its use of an exponentially weighted factor function, designed to be responsive to variations in sample size, and its capacity to expand the parameter space using SMOTE to align with qualitative constraints from expert insights. This approach enables the integration of data-derived parameters with those obtained through expert experience in an exponentially weighted manner, culminating in the optimization of BN parameters. Comparative analysis reveals that the EMPL algorithm achieves superior learning accuracy over traditional Maximum Likelihood Estimation (MLE) and qualitative maximum a posteriori (QMAP) approach, particularly in contexts of sparse data. Furthermore, it demonstrates enhanced performance relative to variable weight learning algorithms, underscoring its potential to significantly improve decision-making processes in the legal domain through advanced BN parameter learning.

ObjectivesWomen who underwent chemotherapy for metastatic breast cancer used both adaptive and maladaptive coping strategies but had low implementation levels. The present study explores the qualitative experience of coping strategies for women with MBC undergoing CT in Beijing.MethodsA hermeneutic phenomenological approach was employed on twenty Chinese MBC women undergoing CT. These interviews were transcribed verbatim, coded using thematic analysis, and analyzed using NVivo 11.ResultsThree themes are highlighted: Maintaining hope; Spiritual growth, and Self-perceived support resources.ConclusionThe present study results have led to a greater understanding of the tremendous impact of CT on MBC women’s lives. This research provides insight into the scope of maintaining hope. Spiritual growth and self-perceived support resources were crucial factors to coping strategies among MBC women to improve their quality of life.Clinical RelevanceBy attaining the adaptive coping strategies and further understanding about Chinese MBC women, health care professionals are encouraged to appraise MBC women’s specific problems and adopt effective interventions to improve MBC women’s psychosocial wellbeing.

Poverty alleviation through tourism is an important way for China to achieve targeted poverty alleviation and win the battle of poverty alleviation. As a region with deep poverty and great difficulty in poverty alleviation, whether tourism development has injected key impetus into ethnic minority areas needs to be tested by both qualitative analysis and quantitative measurement. This paper takes eight ethnic provinces in China as an example to conduct an empirical study. Based on the Data Envelopment Analysis -BCC model and Malmquist index, it evaluates the tourism investment and tourism poverty alleviation efficiency of the ethnic regions in the two stages of tourism poverty alleviation, and analyzes them by classification. The results of the study show: The pure technical efficiency in the first stage is relatively high, but the total factor productivity of each region is declining; The pure technical efficiency in the second stage is also relatively high, but the scale efficiency is low, and the change rate of total factor productivity of the provinces in China has increased significantly; The “double high” type includes Guangxi, Inner Mongolia, and Guizhou, and the “double low” type includes Qinghai, Yunnan, Tibet, Xinjiang, and Ningxia. The results of the study generally show that tourism poverty alleviation has brought about the improvement of the living standards of residents and the development of local economy, but the efficiency of tourism poverty alleviation needs to be improved. On this basis, the article puts forward corresponding improvement measures, in order to further help the ethnic minority areas get rid of poverty in a comprehensive way by promoting the efficient and sustainable development of tourism.

Neural markers, such as the mismatch negativity, have been used to examine the phonological underspecification of English feature contrasts using the Featurally Underspecified Lexicon model. However, neural indices have not been examined within the approximant phoneme class, even though there is evidence suggesting processing asymmetries between liquid and glide phonemes. The goal of this study was to determine whether glide phonemes elicit electrophysiological asymmetries related to [consonantal] underspecification when contrasted with liquid phonemes in adult English speakers. Specifically, /ɹɑ/ is categorized as [+consonantal] while /wɑ/ is not specified [i.e., ]. Following the FUL framework, if /w/ is less specified than /ɹ/, the former phoneme should elicit a larger MMN response than the latter phoneme. Fifteen English-speaking adults were presented with two syllables, /ɹɑ/ and /wɑ/, in an event-related potential oddball paradigm in which both syllables served as the standard and deviant stimulus in opposite stimulus sets. Three types of analyses were used: traditional mean amplitude measurements; cluster-based permutation analyses; and event-related spectral perturbation analyses. The less specified /wɑ/ elicited a large MMN, while a much smaller MMN was elicited by the more specified /ɹɑ/. In the standard and deviant ERP waveforms, /wɑ/ elicited a significantly larger negative response than did /ɹɑ/. Theta activity elicited by /ɹɑ/ was significantly greater than that elicited by /wɑ/ in the 100–300 ms time window. Also, low gamma activation was significantly lower for /ɹɑ/ vs. /wɑ/ deviants over the left hemisphere, as compared to the right, in the 100–150 ms window. These outcomes suggest that the [consonantal] feature follows the underspecification predictions of FUL previously tested with the place of articulation and voicing features. Thus, this study provides new evidence for phonological underspecification. Moreover, as neural oscillation patterns have not previously been discussed in the underspecification literature, the ERSP analyses identified potential new indices of phonological underspecification.

The Featurally Underspecified Lexicon theory predicts that [coronal] is the language universal default place of articulation for phonemes. This assumption has been consistently supported with adult behavioral and event-related potential data; however, this underspecification claim has not been tested in developmental populations. The purpose of this study was to determine whether children demonstrate [coronal] underspecification patterns similar to those of adults. Two English consonants differing in place of articulation, [labial] /b/ and [coronal] /d/, were presented to 24 children characterized by either a typically developing phonological system or a phonological disorder. Two syllables, /bɑ/ and /dɑ/, were presented in an ERP oddball paradigm where both syllables served as the standard and deviant stimulus in opposite stimulus sets. Underspecification was examined with three analyses: traditional mean amplitude measurements, cluster-based permutation tests, and single-trial general linear model analyses of single-subject data. Contrary to previous adult findings, children with PD demonstrated a large positive mismatch response to /bɑ/ while the children with TD exhibited a negative mismatch response ; significant group differences were not observed in the /dɑ/ responses. Moreover, the /bɑ/ deviant ERP response was significantly larger in the TD children than in the children with PD. At the single-subject level, more children demonstrated mismatch responses to /dɑ/ than to /bɑ/, though some children had a /bɑ/ mismatch response and no /dɑ/ mismatch response. While both groups of children demonstrated similar responses to the underspecified /dɑ/, their neural responses to the more specified /bɑ/ varied. These findings are interpreted within a proposed developmental model of phonological underspecification, wherein children with PD are functioning at a developmentally less mature stage of phonological acquisition than their same-aged TD peers. Thus, phonological underspecification is a phenomenon that likely develops over time with experience and exposure to language.

The human serum protein α1‐antitrypsin is the major source of antiprotease activity found in the blood. The protein is synthesised primarily by liver cells but, to a lesser extent, by at least one other cell type. Expression of the gene has provided a paradigm for studies on transcriptional regulation in liver and of tissue‐specific promoter activity. The pleiomorphic nature of the gene has given rise to a variety of α1‐antitrypsin variants some of which are clinically important. These abnormal variants may be poorly synthesised, rapidly degraded or inefficiently secreted; studies on the molecular mechanisms which underly these events are providing interesting insights into the general processes of protein transport and intracellular protein degradation.