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Political trust, which signifies the belief in the responsible exercise of power by political institutions, is a fundamental prerequisite for democratic legitimacy. However, even amidst a democratic deficit, the public's trust in the military can remain firm. This study aims to illuminate the prevailing trend and potential factors influencing public trust in the military in Taiwan from 2001 to 2022. The trajectory of trust in Taiwan's military implies fluctuating trust levels in response to the varying intensity of external threats. However, in general, confidence in the armed forces remains higher than that in other political institutions, a trend that is also observed in other nations. The statistical evidence demonstrates substantial support for both cultural and institutional explanations of political trust in the military in Taiwan throughout the initial two decades of the twenty-first century. However, the institutional explanation appears to be more robust than the cultural explanation. Notably, statistical results on trust in the government are consistent across all six survey rounds, with institutional factors showing higher overall significance in the pooled dataset compared to cultural factors, thereby emphasizing the institutional perspective.
Bacterial infection risk in work environments has been extensively reported for healthcare workers, while this risk is rarely researched in other occupations. This study aimed to identify occupational environments in Taiwan’s agricultural and healthcare industries with elevated bacterial infection risks by comparing risks for general bacterial infections and pneumonia. Using labour and health insurance claim data from 3.3 million workers (January 2004–December 2020), a retrospective cohort was constructed to estimate occupational infection risks with Cox regression and the Anderson-Gill extension. Significantly elevated hazard ratios were found for workers in vegetable growing, crop cultivation service, mushroom growing, flower growing, and fruit growing, ranging from 1.13 to 1.39 for general bacterial infections and 1.68 to 3.06 for pneumonia infections. In afforestation and the inland fishing industry, pneumonia risk was significantly elevated with, respectively, 1.87 and 1.21. In the healthcare section, especially workers in residential care services and residential care services for elderly stand out regarding their pneumonia risk, with significant hazard ratios of 3.49 and 1.75. The methods used in this study were proven to be effective in identification of occupation environments at risk and can be used in other settings. These findings call for prioritization of bacterial infection prevention by occupation.
The role of depression in subsequent infertility, miscarriage and stillbirth remains unclear. This study aimed to examine the association of a history of depression with these adverse outcomes using a longitudinal cohort study of women across their reproductive life span.
Methods
This study used data from participants in the Australian Longitudinal Study on Women’s Health who were born in 1973–1978. Participants (N = 8707) were followed up every 3 years from 2000 (aged 22–27) to 2018 (aged 40–45). Information on a diagnosis of depression was collected from each survey, and antidepressant medication use was identified through pharmaceutical prescription data. Histories of infertility, miscarriage, and stillbirth were self-reported at each survey. Time-lagged log-binomial models with generalized estimating equations were used to assess the association of a history of depression up to and including in a given survey with the risk of fertility issues in the next survey.
Results
Women with a history of depression (excluding postnatal depression) were at higher risk of infertility [risk ratio (RR) = 1.34, 95% confidence interval (CI): 1.21–1.48], miscarriage (RR = 1.22, 95%CI: 1.10–1.34) and recurrent miscarriages (≥2; RR = 1.39, 95%CI: 1.17–1.64), compared to women without a history of depression. There were too few stillbirths to provide clear evidence of an association. Antidepressant medication use did not affect the observed associations. Estimated RRs of depression with infertility and miscarriage increased with age.
Conclusions
A history of depression was associated with higher risk of subsequent infertility, miscarriage and recurrent miscarriages.
Previous studies suggest a link between vitamin D status and COVID-19 susceptibility in hospitalised patients. This study aimed to investigate whether vitamin D concentrations in elderly individuals were associated with their susceptibility to Omicron COVID-19 incidence, the severity of the disease and the likelihood of reoccurrence during the era of the post-‘zero-COVID-19’ policies in China.
Design:
In this retrospective study, participants were categorised into three groups based on their 25(OH)D concentrations: deficiency (< 20 ng/ml), insufficiency (20 to < 30 ng/ml) and sufficiency (≥ 30 ng/ml). The demographic and clinical characteristics, comorbidities and the incidence rate, reoccurrence rate and severity of Omicron COVID-19 were retrospectively recorded and analysed by using hospital information system data and an online questionnaire survey.
Setting:
China.
Participants:
222 participants aged 60 years or older from a health management centre.
Results:
Our findings revealed significant differences in the incidence (P = 0·03) and recurrent rate (P = 0·02) of Omicron COVID-19 among the three groups. Participants with lower 25(OH)D concentrations (< 20 ng/ml) exhibited higher rates of initial incidence and reoccurrence and a greater percentage of severe and critical cases. Conversely, individuals with 25(OH)D concentrations ≥ 30 ng/ml had a higher percentage of mild cases (P = 0·003). Binary and ordinal logistic regression models indicated that vitamin D supplementation was not a significant risk factor for COVID-19 outcomes.
Conclusions:
In the elderly population, pre-infection vitamin D deficiency was associated with increased susceptibility to incidence, severity of illness and reoccurrence rates of Omicron COVID-19.
Few previous studies have established Snaith–Hamilton Pleasure Scale (SHAPS) cut-off values using receiver operating characteristic curve analysis and applied these values to compare predictors of anhedonia between clinical and nonclinical groups.
Aims
To determine the optimal cut-off values for the SHAPS and use them to identify predictors of anhedonia in clinical and nonclinical groups in Taiwan.
Method
This cross-sectional and correlational study used convenience sampling to recruit 160 patients from three hospitals and 412 students from two universities in northern Taiwan. Data analysis included receiver operating characteristic curve, univariate and multivariate analyses.
Results
The optimal SHAPS cut-off values were 29.5 and 23.5 for the clinical and nonclinical groups, respectively. Moreover, two-stage analysis revealed that participants in the clinical group who perceived themselves as nondepressed, and participants in the nonclinical group who did not skip classes and whose fathers exhibited higher levels of care and protection were less likely to attain the cut-off values. Conversely, participants in the nonclinical group who reported lower academic satisfaction and were unwilling to seek help from family or friends were more likely to attain the cut-off values.
Conclusions
Our findings highlight the importance of optimal cut-off values in screening for depression risk within clinical and nonclinical groups. Accordingly, the development of comprehensive, individualised programmes to monitor variation trends in SHAPS scores and relevant predictors of anhedonia across different target populations is crucial.
This study explored the barriers and facilitators of mask-wearing behaviors during the pandemic in Taiwan, the United States, the Netherlands, and Haiti.
Methods:
Face-to-face interviews were conducted in Taiwan and online interviews were conducted with participants in the United States, the Netherlands, and Haiti.
Results:
In general, the habit of wearing a mask before coronavirus disease 2019 (COVID-19) was reported by Taiwanese participants. Additionally, Taiwanese participants perceived that wearing a mask was a social responsibility during the pandemic, suggesting that the collectivistic context might influence mask-wearing behavior. Unlike the Taiwanese population, some people in the United States and the Netherlands were reluctant to wear masks due to perceived restrictions on their freedom. Participants from Haiti mentioned that people who wore masks encountered violence, bullying, and discrimination. The results of this study suggest that political leadership and mask mandates have a strong impact on people’s mask-wearing behavior.
Conclusions:
These findings have valuable implications for the design of diverse behavioral interventions to enhance mask-wearing as part of infectious disease preparedness. Additionally, the findings from these countries offer valuable insights for the development of effective public health interventions to enhance society’s resilience during the current pandemic and future infectious disease outbreaks.
Cancer is among the leading causes of death in the world, with about 10 million deaths, one in every six deaths, related to cancer in 2020. In Taiwan, cancer insurance is the most popular commercial health product. However, the loss ratio of cancer products increases with policy year and exceeds 100% in many insurance companies. In addition, almost all cancer benefits are significantly limited in order to avoid financial insolvency. In this study, we evaluate the risk of cancer insurance from the perspective of morbidity compression. We use the data from Taiwan's National Health Insurance Research Database. Also, we apply the standardized mortality ratio and the Lee-Carter model to estimate the trend of cancer-related values. We find that cancer incidence rates gradually increase with time, which indicates that the assumption of morbidity compression is violated. On the other hand, the mortality rates of cancer patients decrease significantly annually. Thus, length of life with cancer increases, and so does the cancer insurance premium. We suggest that cancer insurance covers only the first five years of medical expenditure after the insured is diagnosed with cancer.
With the aid of recently proposed word embedding algorithms, the study of semantic relatedness has progressed rapidly. However, word-level representations are still lacking for many natural language processing tasks. Various sense-level embedding learning algorithms have been proposed to address this issue. In this paper, we present a generalized model derived from existing sense retrofitting models. In this generalization, we take into account semantic relations between the senses, relation strength, and semantic strength. Experimental results show that the generalized model outperforms previous approaches on four tasks: semantic relatedness, contextual word similarity, semantic difference, and synonym selection. Based on the generalized sense retrofitting model, we also propose a standardization process on the dimensions with four settings, a neighbor expansion process from the nearest neighbors, and combinations of these two approaches. Finally, we propose a Procrustes analysis approach that inspired from bilingual mapping models for learning representations that outside of the ontology. The experimental results show the advantages of these approaches on semantic relatedness tasks.
Objectives: Medical devices and the hospital environment can be contaminated easily by multidrug-resistant bacteria. The effectiveness of cleaning practices is often suboptimal because environmental cleaning in hospitals is complex and depends on human factors, the physical and chemical characteristics of environment, and the viability of the microorganisms. Ultraviolet-C (UV-C) lamps can be used to reduce the spread of microorganisms. We evaluated the effectiveness of an ultraviolet-C (UV-C) device on terminal room cleaning and disinfection. Methods: The study was conducted at an ICU of a medical center in Taiwan. We performed a 3-stage evaluation for the effectiveness of UV-C radiation, including pre–UV-C radiation, UV-C radiation, and a bleaching procedure. The 3 stages of evaluation were implemented in the ICU rooms from which a patient had been discharged or transferred. We collected the data from adenosine triphosphate (ATP) bioluminescence testing, colonized strains, and their corresponding colony counts by sampling from the environmental surfaces and air. We tested 8 high-touch surfaces, including 2 sides of bed rails, headboards, footboards, bedside tables, monitors, pumping devices, IV stands, and oxygen flow meters. Results: In total, 1,696 environmental surfaces and 72 air samples were analyzed. The levels of ATP bioluminescence and colony counts of isolated bacteria decreased significantly after UV-C radiation and bleaching disinfection for both the environmental and air samples (P < .001). Resistant bacteria (vancomycin-resistant Enterococcus, VRE) were commonly isolated on the hard-to-clean surfaces of monitors, oxygen flow meters, and IV pumps. However, they were also eradicated (P < .001). Conclusions: UV-C can significantly reduce environmental contamination by multidrug-resistant microorganisms. UV-C is an effective device to assist staff in cleaning the hospital environment.
We present a theoretical explanation for why migrant workers in China should be less likely to participate in protests than other categories of workers. While grievance-based theories of protest would suggest that migrant workers have more incentive to protest than other categories of workers, resource mobilization theory suggests that their capacity to mobilize for collective action is impeded by the conditions of their work situation and their residence. Using survey data from CGSS 2010, we test propositions derived from this framework. We find that a greater sense of relative deprivation is associated with a greater likelihood of participating in protest across all categories of workers. However, we also find that migrant worker status functions as a moderator between grievances and protest participation: compared to urban registered workers, migrant workers are significantly less likely to take part in protest activities when both of them have high levels of perceived unfairness. These findings are robust across all models.
Evidence on the long-term comparative effectiveness of posttraumatic stress disorder (PTSD) psychotherapies in adults remains unknown. Therefore, we performed an extensive network meta-analysis of randomised controlled trials (RCTs) to determine the comparative effectiveness of psychotherapies for people diagnosed with PTSD.
Methods
A comprehensive search was conducted in Cochrane library, Embase, Medline-OVID, PubMed, Scopus, and Psych-Info until March 2021. Studies on the effectiveness of cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation reprocessing (EMDR), narrative exposure therapy (NET), prolonged exposure (PE), cognitive behavioural therapy (CBT), present-centred therapy (PCT), brief eclectic psychotherapies (BEP), psychodynamic therapy (PDT) or combination therapies compared to no treatment (NT) or treatment as usual (TAU) in adults with PTSD were included. Frequentist and Bayesian approaches were used for analysis in R-software.
Results
We included 98 RCTs with 5567 participants from 18 897 studies. CPT, EMDR, CT, NET, PE, CBT, and PCT were significant to reduce PTSD symptoms (SMD range: −1.53 to −0.75; Certainty: very low to high) at immediate post-treatment and ranked accordingly. Longitudinal analysis found EMDR (1.02) and CPT (0.85) as the significant therapies with large effect size in short-term and long-term follow-up, respectively. NET and CPT showed higher proportion of loss of PTSD diagnosis (RR range: 5.51–3.45) while there were no significant psychotherapies for retention rate compared to NT.
Conclusions:
Our findings provide evidence for improving current guidelines and informing clinical decision-making for PTSD management. However, the best PTSD treatment plan should be tailored to patients' needs, characteristics, and clinician expertise.
A framework for the budget of Reynolds stress, temperature and density variations, turbulent mass flux and turbulent heat flux is presented for buoyancy-generated turbulent flows with a focus on turbulent plumes. The dynamical interactions between the turbulence generated from the velocity and thermodynamic fluctuations in thermal and heated gas plumes is studied. A large-eddy simulation tool has been used to simulate heavier and lighter than air plumes released from a circular heated source for high Reynolds number (Re). The budget equations are developed using a Favre-averaging approach. Both heated air plumes and heated gas plumes, namely, heated ${\rm SO}_2$ and heated ${\rm CH}_4$ plumes, are included in the study. The study focuses on addressing key questions – does the turbulence kinetic energy (TKE) spectrum follow the classical inertial $-5/3$ spectrum or is there a $-3$ buoyancy regime with a different scaling law? Fundamental pathways for generation of turbulence through velocity fluctuations, and temperature and density fluctuations are discussed. Analysis of the TKE and scalar variance budget equations has demonstrated that multiple mechanisms dominate the transport of Reynolds stresses, and in particular that correlations between the density and the velocity dominates the turbulence production mechanisms. Entrainment is connected to the turbulent transport and pressure-dilation processes.
An increasing number of studies are exploring the benefits of automatic speech recognition (ASR)–based dictation programs for second language (L2) pronunciation learning (e.g. Chen, Inceoglu & Lim, 2020; Liakin, Cardoso & Liakina, 2015; McCrocklin, 2019), but how ASR recognizes accented speech and the nature of the feedback it provides to language learners is still largely under-researched. The current study explores whether the intelligibility of L2 speakers differs when assessed by native (L1) listeners versus ASR technology, and reports on the types of intelligibility issues encountered by the two groups. Twelve L1 listeners of English transcribed 48 isolated words targeting the /ɪ-i/ and /æ-ε/ contrasts and 24 short sentences that four Taiwanese intermediate learners of English had produced using Google’s ASR dictation system. Overall, the results revealed lower intelligibility scores for the word task (ASR: 40.81%, L1 listeners: 38.62%) than the sentence task (ASR: 75.52%, L1 listeners: 83.88%), and highlighted strong similarities in the error types – and their proportions – identified by ASR and the L1 listeners. However, despite similar recognition scores, correlations indicated that the ASR recognition of the L2 speakers’ oral productions mirrored the L1 listeners’ judgments of intelligibility in the word and sentence tasks for only one speaker, with significant positive correlations for one additional speaker in each task. This suggests that the extent to which ASR approaches L1 listeners at recognizing accented speech may depend on individual speakers and the type of oral speech.
Problematic internet use, especially in people with substance use disorder, may negatively affect their quality of life (QoL). However, it is unclear whether sleep quality is a key mediator in the association between problematic internet use and QoL among people with substance use disorder.
Aims
This study aimed to investigate the relationship between problematic internet use and QoL and how sleep quality may mediate the association between these two variables.
Method
Overall, 319 people (85% male) with substance use disorder (mean age 42.2 years, s.d. 8.9) participated in a cross-sectional study in Taiwan. The Smartphone Application-Based Addiction Scale, Bergan Social Media Addiction Scale, Internet Gaming Disorder-Short Form, Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Questionnaire Brief Version were used.
Results
The prevalence of sleep problems was 56%. There were significant and direct associations between sleep quality and two types of problematic internet use, and between sleep quality and different dimensions of QoL. All types of problematic internet use were significantly and negatively correlated with QoL. Mediated effects of sleep quality in relationships between the different types of problematic internet use and all dimensions of QoL were significant, except for problematic use of social media.
Conclusions
Different types of problematic internet use in people with substance use disorder may be directly associated with reduced QoL. Sleep quality as a significant mediator in this association may be an underlying mechanism to explain pathways between problematic internet use and QoL in this population.
We present a theory on how trust in the central government to remedy grievances combined with a lack of trust in local government to act motivates people to participate in local protests in China. Low trust in local government combined with high trust in the central government gives people expectation that protest will not be an exercise in futility. People protest to redress injustices when they believe that such protests have a chance of producing a favorable resolution of their grievances. Utilizing individual level data from the Asian Barometer Survey Wave 4, our analysis suggests that, in contemporary China, people who have greater trust in the central government than the local government are more likely than others to report having participated in protests. In a society without meaningful elections, participating in protest is an effective strategy for attracting the attention from the upper-level authorities in hope of redressing unfavorable situations.
To examine the association of household type and household composition with concurrent stunting and overweight in young children from urban and rural Indonesia.
Design:
This study is a secondary data analysis using a nationally representative cross-sectional survey. Household structure was analysed as household type, household size, number of working adults, number of dependent adults and children, and household head’s gender. We defined ‘concurrent stunting and overweight’ as height-for-age Z-score <–2 and weight-for-height Z-score >+2 based on WHO growth standards. Multivariable logistic regression to test the aforementioned association was performed separately for urban and rural areas.
Setting:
Data were from Indonesia Basic Heath Research 2013.
Participants:
Children aged 2–5 years (n 45 050).
Results:
The prevalence of concurrent stunting and overweight children was 5·6 %. In rural areas, this prevalence differed significantly by household types and the highest prevalence was among children in nuclear two-parent households (6·8 %). In rural areas, children in extended households had lower odds of concurrent stunting and overweight than those from nuclear households (OR = 0·73, 95 % CI 0·59, 0·92). In urban areas, household size and number of working adults were significantly associated with the decreased odds of concurrent stunting and overweight in children.
Conclusions:
Household structure was associated with children’s concurrent stunting and overweight in urban and rural regions of Indonesia. The patterns of the association might differ between urban and rural regions, but no significant interaction term was found.
Steroids have been shown to be beneficial in patients and mice with eosinophilic meningitis caused by Angiostrongylus cantonensis infection; however, the mechanism for this beneficial effect is unknown. We speculated that the effect of steroids in eosinophilic meningitis caused by A. cantonensis infection may be mediated by the downregulation of matrix metallopeptidase-9 (MMP-9) and oxidative stress pathways via glucocorticoid receptors (GRs). We found blood–brain barrier (BBB) dysfunction in mice with eosinophilic meningitis 2–3 weeks after infection as evidenced by increased extravasation of Evans blue and cerebrospinal fluid (CSF) albumin levels. The administration of dexamethasone significantly decreased the amount of Evans blue and CSF albumin. The effect of dexamethasone was mediated by GRs and heat shock protein 70, resulting in subsequent decreases in the expressions of nuclear factor kappa B (NF-κB), c-Jun N-terminal kinase (JNK), and extracellular signal-regulated kinase (ERK) in the CSF and brain parenchymal after 2 weeks of steroid administration. Steroid treatment also decreased CSF/brain homogenate MMP-9 concentrations, but had no effect on CSF MMP-2 levels, indicating that MMP-9 rather than MMP-2 played a major role in BBB dysfunction in mice with eosinophilic meningitis. The concentration of 8-hydroxy-2'-deoxyguanosine (8-OHdG) gradually increased after 1–3 weeks of infection, and the administration of dexamethasone significantly downregulated the concentration of oxidized derivative 8-OHdG in CSF. In conclusion, increased 8-OHdG and MMP-9 concentrations were found in mice with eosinophilic meningitis caused by A. cantonensis infection. The effect of dexamethasone was mediated by GRs and significantly decreased not only the levels of 8-OHdG and MMP-9 but also NF-κB, JNK and ERK.
This study aimed to evaluate associations between toxoplasmosis and psychiatric disorders in Taiwan based on the National Health Insurance Research Database, Taiwan (1997–2013). Patients newly diagnosed with toxoplasmosis formed the case group (n = 259), and the control group included propensity-score matched patients without toxoplasmosis (n = 1036). The primary outcome was incidence of psychiatric disorders. Cox proportional hazards regression and stratified analyses were performed to examine risk of developing specific psychiatric disorders between patients with and without toxoplasmosis. Patients with toxoplasmosis had significantly higher incidence of psychiatric disorders than those without toxoplasmosis (P = 0.016). A significant difference was found in numbers of psychiatric disorders between the two groups during 14 years of follow-up (log-rank P < 0.001). Those with toxoplasmosis had significantly higher risk of bipolar disorder [adjusted hazard ratio (aHR = 3.60, 95% confidence interval (CI) = 2.07, 7.26), depression (aHR = 4.94, 95% CI = 2.15, 11.80) and anxiety (aHR = 5.36, 95% CI = 2.98, 25.88), but no significant between-group differences were found for schizophrenia and other psychiatric disorders. In conclusion, the present nationwide population-based analysis revealed that Toxoplasma gondii infection in Taiwan significantly increases the risk for developing bipolar disorder, depression and anxiety, but not for schizophrenia and other psychiatric disorders.
Modern cosmological simulations suggest that the hierarchical assembly of dark matter halos provided the gravitational wells that allowed the primordial gases to form stars and galaxies inside them. The first galaxies comprised of the first systems of stars gravitationally bound in dark matter halos are naturally recognized as the building blocks of early Universe. To understand the formation of the first galaxies, we use an adaptive mesh refinement (AMR) cosmological code, Enzo to simulate the formation and evolution of the first galaxies. We first model an isolated galaxy by considering much microphysics such as star formation, stellar feedback, and primordial gas cooling. To examine the effect of Pop III stellar feedback to the first galaxy formation, we adjust the initial temperature, density distribution and metallicity distributions by assuming different IMFs of the first stars. Our results suggest that star formation in the first galaxies is sensitive to the initial conditions of Pop III supernovae and their remnants. Our study can help to correlate the populations of the first stars and supernovae to star formation inside these first galaxies which may be soon observed by the (James Webb Space Telescope JWST).
Shock–turbulence interactions are investigated using well-resolved direct numerical simulations (DNS) and analysis at a range of Reynolds, mean and turbulent Mach numbers ($R_{\unicode[STIX]{x1D706}}$, $M$ and $M_{t}$, respectively). The simulations are shock and turbulence resolving with $R_{\unicode[STIX]{x1D706}}$ up to 65, $M_{t}$ up to 0.54 and $M$ up to 1.4. The focus is on the effect of strong turbulence on the jumps of mean thermodynamic variables across the shock, the shock structure and the amplification of turbulence as it moves through the shock. Theoretical results under the so-called quasi-equilibrium (QE) assumption provide explicit laws for a number of statistics of interests which are in agreement with the new DNS data presented here as well as all the data available in the literature. While in previous studies turbulence was found to weaken jumps, it is shown here that stronger jumps are also observed depending on the regime of the interaction. Statistics of the dilatation at the shock are also investigated and found to be well represented by QE for weak turbulence but saturate at high turbulence intensities with a Reynolds number dependence also captured by the analysis. Finally, amplification factors are found to present a universal behaviour with two limiting asymptotic regimes governed by $(M-1)$ and $K=M_{t}/R_{\unicode[STIX]{x1D706}}^{1/2}(M-1)$, for weak and strong turbulence, respectively. Effect of anisotropy in the incoming flow is also assessed by utilizing two different forcing mechanisms to generate turbulence.