We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This Element examines how international heritage discourses are internalized and reshaped in China, using the Yellow Emperor cults as a lens to explore broader themes of intangible heritage, religious resurgence, and identity construction. The central argument is that cultural heritage serves as a powerful tool for shaping new religious expressions and enabling Chinese localities to assert their uniqueness while redefining historical narratives. Through case studies of several localities across China, this research illustrates how these regions engage in heritage competition by branding themselves with Yellow Emperor culture to shape their identities. This study argues that the cult of the Yellow Emperor-a legendary figure-is empowered by nationalism, a local search for tradition and religious revivals, and is further amplified by international discourses that reinforce national identity through heritage-making. Together, these forces drive the resurgence of ancestral cults and contribute to cultural identity formation in contemporary China.
This research explores a phenomenon that we see nearly every day and has implications for how we view people in other nations: Different media outlets may report the same international events either in terms of the nation (e.g., “Russia invades Ukraine”) or in terms of the leader (e.g., “Putin invades Ukraine”). Five studies, conducted during the 2022 Russia-Ukraine Conflict and involving both field and experimental data, find that readers of nation-framed news about the conflict had worse impressions of the people in the associated nation (Russians) than readers of the corresponding leader-framed version. We explain the psychology behind this framing effect and identify its moderators. Our research underscores the importance of responsible media practices in shaping global perceptions.
The estimation of model parameters in structural equation models with polytomous variables can be handled by several computationally efficient procedures. However, sensitivity or influence analysis of the model is not well studied. We demonstrate that the existing influence analysis methods for contingency tables or for normal theory structural equation models cannot be applied directly to structural equation models with polytomous variables; and we develop appropriate procedures based on the local influence approach of Cook (1986). The proposed procedures are computationally efficient, the necessary bits of the proposed diagnostic measures are readily available following an usual fit of the model. We consider the influence of an individual cell frequency with respect to three cases: when all parameters in an unstructured model are of interest, when the unstructured polychoric correlations are of interest, and when the structural parameters are of interest. We also consider the sensitivity of the parameters estimates. Two examples based on real data are presented for illustration.
The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan.
Methods
Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up.
Results
In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (p = .003), who perceived greater levels of microaggression (p < .001), and who had greater levels of problematic Internet use at baseline (p = .024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (p = .023).
Conclusion
Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.
Recent studies of viscous dissipation mechanisms in impacting droplets have revealed distinct behaviours between the macroscale and nanoscale. However, the transition of these mechanisms from the macroscale to the nanoscale remains unexplored due to limited research at the microscale. This work addresses the gap using the many-body dissipative particle dynamics (MDPD) method. While the MDPD method omits specific atomic details, it retains crucial mesoscopic effects, making it suitable for investigating the impact dynamics at the microscale. Through the analysis of velocity contours within impacting droplets, the research identifies three primary contributors to viscous dissipation during spreading: boundary-layer viscous dissipation from shear flow; rim geometric head loss; and bulk viscous dissipation caused by droplet deformation. This prompts a re-evaluation of viscous dissipation mechanisms at both the macroscale and nanoscale. It reveals that the same three kinds of dissipation are present across all scales, differing only in their relative intensities at each scale. A model of the maximum spreading factor (βmax) incorporating all forms of viscous dissipation without adjustable parameters is developed to substantiate this insight. This model is validated against three distinct datasets representing the macroscale, microscale and nanoscale, encompassing a broad spectrum of Weber numbers, Ohnesorge numbers and contact angles. The satisfactory agreement between the model predictions and the data signifies a breakthrough in establishing a universal βmax model applicable across all scales. This model demonstrates the consistent nature of viscous dissipation mechanisms across different scales and underscores the importance of integrating microscale behaviours to understand macroscale and nanoscale phenomena.
Depression is highly prevalent in haemodialysis patients, and diet might play an important role. Therefore, we conducted this cross-sectional study to determine the association between dietary fatty acids (FA) consumption and the prevalence of depression in maintenance haemodialysis (MHD) patients. Dietary intake was assessed using a validated FFQ between December 2021 and January 2022. The daily intake of dietary FA was categorised into three groups, and the lowest tertile was used as the reference category. Depression was assessed using the Patient Health Questionnaire-9. Logistic regression and restricted cubic spline (RCS) models were applied to assess the relationship between dietary FA intake and the prevalence of depression. As a result, after adjustment for potential confounders, a higher intake of total FA [odds ratio (OR)T3 vs. T1 = 1·59, 95 % confidence interval (CI) = 1·04, 2·46] and saturated fatty acids (SFA) (ORT3 vs. T1 = 1·83, 95 % CI = 1·19, 2·84) was associated with a higher prevalence of depressive symptoms. Significant positive linear trends were also observed (P < 0·05) except for SFA intake. Similarly, the prevalence of depression in MHD patients increased by 20% (OR = 1.20, 95% CI = 1.01–1.43) for each standard deviation increment in SFA intake. RCS analysis indicated an inverse U-shaped correlation between SFA and depression (Pnonlinear > 0·05). Additionally, the sensitivity analysis produced similar results. Furthermore, no statistically significant association was observed in the subgroup analysis with significant interaction. In conclusion, higher total dietary FA and SFA were positively associated with depressive symptoms among MHD patients. These findings inform future research exploring potential mechanism underlying the association between dietary FA and depressive symptoms in MHD patients.
The poor environmental stability of natural anthocyanin hinders its usefulness in various functional applications. The objectives of the present study were to enhance the environmental stability of anthocyanin extracted from Lycium ruthenicum by mixing it with montmorillonite to form an organic/inorganic hybrid pigment, and then to synthesize allochroic biodegradable composite films by incorporating the hybrid pigment into sodium alginate and test them for potential applications in food testing and packaging. The results of X-ray diffraction, Fourier-transform infrared spectroscopy, and use of the Brunauer–Emmett–Teller method and zeta potential demonstrated that anthocyanin was both adsorbed on the surface and intercalated into the interlayer of montmorillonite via host–guest interaction, and the hybrid pigments obtained allowed good, reversible, acid/base behavior after exposure to HCl and NH3 atmospheres. The composite films containing hybrid pigments had good mechanical properties due to the uniform dispersion of the pigments in a sodium alginate substrate and the formation of hydrogen bonds between them. Interestingly, the composite films also exhibited reversible acidichromism. The as-prepared hybrid pigments in composite films could, therefore, serve simultaneously as a reinforced material and as a smart coloring agent for a polymer substrate.
National health insurance (NHI) Taiwan has provided additional markups on dental service fees for people with specific disabilities, and the expenditure has increased significantly from TWD473 million (USD15 million) in 2016 to TWD722 million (USD24 million) in 2022. The purpose of this study was to determine oral health risk and to develop a risk assessment model for capitation outpatient dental payments in children with Autism.
Methods
Based on the literature and expert opinion, we developed a level of oral health risk model from the claim records of 2019. The model uses oral outpatient claim data to analyze: (i) the degree of caries disease; (ii) the level of dental fear or cooperation; and (iii) the level of tooth structure. Each factor was given a score from zero to four and a total score was calculated. Low-, medium-, and high-risk groups were formed based on the total points. The oral health risk capitation models are estimated by ordinary least squares using an individual’s annual outpatient dental expenditure in 2019 as the dependent variable. For subgroups based on age group and level of disability, expenditures predicted by the models are compared with actual outpatient dental expenditures. Predictive R-squared and predictive ratios were used to evaluate the model’s predictability.
Results
The demographic variables, level of oral health risk, preventive dental care, and the type of dental health care predicted 30 percent of subsequent outpatient dental expenditure in children with autism. For subgroups (age group and disability level) of high-risk patients, the model substantially overpredicted the expenditure, whereas underprediction occurred in the low-risk group.
Conclusions
The risk-adjusted model based on principal oral health was more accurate in predicting an individual’s future expenditure than the relevant study in Taiwan. The finding provides insight into the important risk factor in the outpatient dental expenditure of children with autism and the fund planning of dental services for people with specific disabilities.
This study exploits rich data sources to investigate city-level patterns of internal migration policies in response to the reform of Chinese household registration and the economic, political and sociocultural determinants that drive policy approaches. First, we collected and systematically coded policy documents from 231 cities. Cluster analyses showed that the majority of cities (63%) adopted less lenient selection policies while offering integrative social welfare policies. Rights to internal migration remain selectively granted in China, yet rights to welfare have become more equitable than they were in the past because of the reform. Second, multinomial regression analyses showed that economic development and growth are related to selection policies that are more lenient towards high-skilled migrants, whereas top-down controls of superior governments, local politicians’ characteristics (e.g. tenure concerns and hometown favouritism) and migrants’ sociocultural environments (e.g. pre-existing labour disputes) account for both selection and integration policies.
This study investigates what drives local variations when pursuing urban–rural equity in social welfare provision in China. We examine how internal features, top-down pressure and horizontal competition have shaped local governments’ decisions to adopt a policy that unifies (yitihua) the urban and rural eligibility thresholds of the world's largest means-tested cash transfer programme (dibao). We collected and coded policies that unify urban–rural dibao thresholds in 336 prefecture-level divisions between 2011 and 2019. Event history analysis showed that internal fiscal constraint – primarily cost concerns – drove local policy adoption; top-down pressure from provincial governments with a high degree of coercive power in policy directives exerted a significant impact; and the horizontal competition's effect was insignificant. Our findings indicate that fiscal arrangements and top-down policy directives from superior governments with higher coercive power are potent tools to accelerate the adoption of a social welfare policy that would otherwise be unappealing for local officials.
We aimed to investigate child mortality, perinatal morbidities and congenital anomalies born by women with substance misuse during or before pregnancy (DP or BP).
Methods
Taiwan Birth Registration from 2004 to 2014 linking Integrated Illicit Drug Databases used to include substance misuse participates. Children born by mothers convicted of substance misuse DP or BP were the substance-exposed cohort. Two substance-unexposed comparison cohorts were established: one comparison cohort selected newborns from the rest of the population on a ratio of 1:1 and exact matched by the child’s gender, child’s birth year, mother’s birth year and child’s first use of the health insurance card; another comparison cohort matched newborns from exposed and unexposed mothers by their propensity scores calculated from logistic regression.
Results
The exposure group included 1776 DP, 1776 BP and 3552 unexposed individuals in exact-matched cohorts. A fourfold increased risk of deaths in children born by mothers exposed to substance during pregnancy was found compared to unexposed group (hazard ratio [HR] = 4.54, 95% confidence interval (CI): 2.07–9.97]. Further multivariate Cox regression models with adjustments and propensity matching substantially attenuated HRs on mortality in the substance-exposed cohort (aHR = 1.62, 95% CI: 1.10–2.39). Raised risks of perinatal morbidities and congenital anomalies were also found.
Conclusions
Increased risks of child mortality, perinatal morbidities or congenital anomalies were found in women with substance use during pregnancy. From estimates before and after adjustments, our results showed that having outpatient visits or medical utilizations during pregnancy were associated with substantially attenuated HRs on mortality in the substance-exposed cohort. Therefore, the excess mortality risk might be partially explained by the lack of relevant antenatal clinical care. Our finding may suggest that the importance of early identification, specific abstinence program and access to appropriate antenatal care might be helpful in reducing newborn mortality. Adequate prevention policies may be formulated.
Burn patients are at high risk of central line–associated bloodstream infection (CLABSI). However, the diagnosis of such infections is complex, resource-intensive, and often delayed. This study aimed to investigate the epidemiology of CLABSI and develop a prediction model for the infection in burn patients. The study analysed the infection profiles, clinical epidemiology, and central venous catheter (CVC) management of patients in a large burn centre in China from January 2018 to December 2021. In total, 222 burn patients with a cumulative 630 CVCs and 5,431 line-days were included. The CLABSI rate was 23.02 CVCs per 1000 line-days. The three most common bacterial species were Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa; 76.09% of isolates were multidrug resistant. Compared with a non-CLABSI cohort, CLABSI patients were significantly older, with more severe burns, more CVC insertion times, and longer total line-days, as well as higher mortality. Regression analysis found longer line-days, more catheterisation times, and higher burn wounds index to be independent risk factors for CLABSI. A novel nomogram based on three risk factors was constructed with an area under the receiver operating characteristic curve (AUROC) value of 0.84 (95% CI: 0.782–0.898) with a mean absolute error of calibration curve of 0.023. The nomogram showed excellent predictive ability and clinical applicability, and provided a simple, practical, and quantitative strategy to predict CLABSI in burn patients.
The association between time-restricted eating (TRE) and the risk of non-alcoholic fatty liver disease (NAFLD) is less studied. Moreover, whether the association is independent of physical exercise or diet quality or quantity is uncertain. In this nationwide cross-sectional study of 3813 participants, the timing of food intakes was recorded by 24-h recalls; NAFLD was defined through vibration-controlled transient elastography in the absence of other causes of chronic liver disease. OR and 95 % CI were estimated using logistic regression. Participants with daily eating window of ≤ 8 h had lower odds of NAFLD (OR = 0·70, 95 % CI: 0·52, 0·93), compared with those with ≥ 10 h window. Early (05.00–15.00) and late TRE (11.00–21.00) showed inverse associations with NAFLD prevalence without statistical heterogeneity (Pheterogeneity = 0·649) with OR of 0·73 (95 % CI: 0·36, 1·47) and 0·61 (95 % CI: 0·44, 0·84), respectively. Such inverse association seemed stronger in participants with lower energy intake (OR = 0·58, 95 % CI: 0·38, 0·89, Pinteraction = 0·020). There are no statistical differences in the TRE-NAFLD associations according to physical activity (Pinteraction = 0·390) or diet quality (Pinteraction = 0·110). TRE might be associated with lower likelihood of NAFLD. Such inverse association is independent of physical activity and diet quality and appears stronger in individuals consuming lower energy. Given the potential misclassification of TRE based on one- or two-day recall in the analysis, epidemiological studies with validated methods for measuring the habitual timing of dietary intake are warranted.
Given the rising burden of palliative care and the limited human resources for its facilitation in China, volunteers are becoming increasingly indispensable. In particular, there is a high demand for volunteers who can serve as spiritual caregivers. However, a volunteer’s ability to provide good spiritual care in a palliative setting may be influenced by their attitude toward palliative care. To uncover the current state of spiritual caregiving in palliative settings in China and insights into best practices for its improvement, this study measured spiritual care competence and identified its influencing factors and explored its relationship with attitudes toward palliative care among volunteers. Notably, this study is the first to consider spiritual care competence alongside attitudes toward palliative care.
Methods
A descriptive cross-sectional study using online survey methods was conducted with 385 volunteers in Shanghai, China. Data were collected using a structured questionnaire.
Results
Volunteers demonstrated relatively low levels of spiritual care competence (58.50 ± 10.92). Statistically significant correlations were found between spiritual care competence and the following variables: age, educational background, marital status, religious beliefs, occupational status, and relevant training and practical experience. Attitude toward palliative care significantly correlated with spiritual care competence (r = 0.49, p < 0.001).
Significance of results
To continually improve volunteers’ spiritual care competence, diversified education and training programs about spiritual care should be designed for different kinds of volunteers; moreover, because attitude toward palliative care significantly impacted spiritual care competence, such programs should encourage positive attitudes toward palliative care.
What are the various ways in which local governments in China accommodate migrants through housing policies, and what are the forces that drive these variations? Through systematic coding of policy documents from 97 prefecture-level cities, this study captures the patterns of migrant housing policies using cluster analysis. We found that 18.6 per cent of the cities adopted a residual approach. Most cities adopted a rental-based approach (public and private rental, and collective rental) that could only meet migrants’ short-term housing needs. Only a few cities (12.4 per cent) adopted a citizenship-oriented approach, which best fits the central government's overarching goal of facilitating migrant workers’ long-term settlement in the host cities. Regression analyses examining the determinants of local migrant housing policies showed that the policy variations were not only shaped by economic and political concerns but also the salience of urban issues (problem-solving functions) and previous welfare generosity (path-dependency tendencies).
In the last five years, the number of periodic variable stars has increased by two million. We used the ZTF DR2 data to find and build a catalog that includes 780,000 periodic variable stars. These periodic variable stars were classified into 11 types, which greatly complemented the variable stars in Galactic disk. Based on the latest ZTF DR16 data, we found 2 million variable candidates. We trained a machine learner to classify variable stars, and the learner had a prediction accuracy of 94%. Using millions of variable stars, we carried out studies to optimize the period–luminosity relations and the Galactic structure and the extinction law. With the future China Space Station Telescope, millions of variable stars in the Local Group will be discovered. They help to study the structure of our Local Group and also to cross-check the distance ladders based on different variable stars.
RR Lyrae (RR Lyr) stars are a well-known and useful distance indicator for old stellar populations such as globular clusters and dwarf galaxies. Fundamental-mode RR Lyr (RRab) stars are commonly used to measure distances, and the accuracy of the determined distance is strongly constrained by metallicity. Here, we investigate the metallicity dependence in the period–luminosity (PL) relation of double-mode RR Lyr (RRd) stars. We find and establish a linear relation between metallicity and period or period ratio for RRd stars. This relation can predict the metallicity as accurately as the low-resolution spectra. Based on this relation, we establish a metallicity-independent PL relation for RRd stars. Combining the distance of the Large Magellanic Cloud and Gaia parallaxes, we calibrate the zero point of the derived PL relation to an error of 0.022 mag. Using RRd stars, we measure the distances of globular clusters and dwarf galaxies with an accuracy of 2-3% and 1-2%, respectively. In the future, RRd stars could anchor galaxy distances to an accuracy of 1.0% and become an independent distance ladder in the Local Group.
Whether starchy and non-starchy vegetables have distinct impacts on health remains unknown. We prospectively investigated the intake of starchy and non-starchy vegetables in relation to mortality risk in a nationwide cohort. Diet was assessed using 24-h dietary recalls. Deaths were identified via the record linkage to the National Death Index. Hazard ratios (HR) and 95 % CI were calculated using Cox regression. During a median follow-up of 7·8 years, 4904 deaths were documented among 40 074 participants aged 18 years or older. Compared to those with no consumption, participants with daily consumption of ≥ 1 serving of non-starchy vegetables had a lower risk of mortality (HR = 0·76, 95 % CI 0·66, 0·88, Ptrend = 0·001). Dark-green and deep-yellow vegetables (HR = 0·79, 95 % CI 0·63, 0·99, Ptrend = 0·023) and other non-starchy vegetables (HR = 0·80, 95 % CI 0·70, 0·92, Ptrend = 0·004) showed similar results. Total starchy vegetable intake exhibited a marginally weak inverse association with mortality risk (HR = 0·89, 95 % CI 0·80, 1·00, Ptrend = 0·048), while potatoes showed a null association (HR = 0·93, 95 % CI 0·82, 1·06, Ptrend = 0·186). Restricted cubic spline analysis suggested a linear dose–response relationship between vegetable intake and death risk, with a plateau at over 300 and 200 g/d for total and non-starchy vegetables, respectively. Compared with starchy vegetables, non-starchy vegetables might be more beneficial to health, although both showed a protective association with mortality risk. The risk reduction in mortality plateaued at approximately 200 g/d for non-starchy vegetables and 300 g/d for total vegetables.