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A core issue in the interdisciplinary study of human morality is its ontogeny in diverse cultures, but systematic, naturalistic data in specific cultural contexts are rare to find. This study conducts a novel analysis of 213 children's socio-moral behavior in a historical, non-Western, rural setting, based on a unique dataset of naturalistic observations from the first field research on Han Chinese children. Using multilevel multinomial modeling, we examined a range of proactive behaviors in 0-to-12-year-old children's peer cooperation and conflict in an entire community in postwar Taiwan. We modeled the effects of age, sex, kinship, and behavioral roles, and revealed complex interactions between these four variables in shaping children's moral development. We discovered linkages between coercive and non-coercive behaviors as children strategically negotiated leadership dynamics. We identified connections between prosocial and aggressive behaviors, illuminating the nuances of morality in real life. Our analysis also revealed gendered patterns and age-related trends that deviated from cultural norms and contradicted popular assumptions about Chinese family values. These findings highlight the importance of naturalistic observations in cultural contexts for understanding how we become moral persons. This re-analysis of historically significant fieldnotes also enriches the interdisciplinary study of child development across societies. [ABSTRACT FROM AUTHOR]

How to compute and report subscores for a test that was originally designed for reporting scores on a unidimensional scale has been a topic of interest in recent years. In the research reported here, we describe an application of multidimensional item response theory to identify a subscore structure in a test designed for reporting results using a unidimensional scale. This research also dealt with the problem of planned missing data due to low levels of item overlap among multiple test forms. Furthermore, we provided evidence for the generalizability of the multidimensional structure using multiple forms of the same test. We also compared the subscores from multiple groups to show the usefulness of the subscores. The research provides evidence that subscores can be identified and produced to provide useful information about different constructs for multiple examinee groups even though the test data were well fit by a unidimensional model.

This article uses a new theoretical and methodological framework to reconstruct a story of two children from fieldnotes collected by anthropologists Arthur and Margery Wolf in rural Taiwan (1958 to 1960). Through the case of a brother–sister dyad, it examines the moral life of young children and provides a rare glimpse into sibling relationship in peer and family contexts. First, combining social network analysis and NLP text-analytics, this article introduces a general picture of these siblings' life in the peer community. Moreover, drawing from naturalistic observations and projective tests, it offers an ethnographic analysis of how children support each other and assert themselves. It emphasizes the role of child-to-child ties in moral learning, in contrast to the predominant focus of parent–child ties in the study of Chinese families. It challenges assumptions of the Chinese "child training" model and invites us to take children's moral psychology seriously and re-discover their agency. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis japonica remains an important public health concern due to its potential to cause severe outcomes and long-term sequelae. An integrated control strategy implemented in the Peoples' Republic of China has been shown to be effective to control or interrupt the transmission of schistosomiasis. The objective of this study is to estimate the disease burden of schistosomiasis and assess the cost-effectiveness of the integrated control strategy focused on different major interventions at three stages for schistosomiasis control in a lake setting, to provide reference for policy making or planning. Methods: Annual cost data of schistosomiasis control during 2009–2019 were obtained from the control program implementers in Jiangling County, Hubei Province, China. Economic costs are provided in constant 2009 Chinese Yuan (CNY). Epidemiological data of schistosomiasis were collected from the Jiangling county station for schistosomiasis control. Disease burden of schistosomiasis was assessed by calculating years of life lost (YLLs) owing to premature death, years lived with disability (YLDs) and disability-adjusted life years (DALYs). DALYs were calculated as the sum of YLLs and YLDs. We then conducted a rudimentary cost-effectiveness analysis by determining the ratio by dividing the difference between the average cost of integrated control strategy at transmission control (2013–2016) or transmission interruption (2017–2019) and the average cost at stage of infection control (2009–2012) with the difference between the DALYs of schistosomiasis at different control stages. Descriptive statistics on the costs and DALYs were used in the analysis. Results: The total economic costs for schistosomiasis control in Jiangling County from 2009 to 2019 were approximately CNY 606.88 million. The average annual economic costs for schistosomiasis prevention and control at stages of infection control (2009–2012), transmission control (2013–2016), and transmission interruption (2017–2019) were approximately CNY 41.98 million, CNY 90.19 million and CNY 26.06 million respectively. The overall disease burden caused by schistosomiasis presented a downward trend. Meanwhile, the disease burden of advanced cases showed an upward trend with the DALY increased from 943.72 to 1031.59 person-years. Most disease burden occurred in the age group over 45 years old (especially the elderly over 60 years old). Taking the infection control stage as the control, the incremental cost-effectiveness ratio of integrated control strategy was CNY 8505.5 per case averted, CNY 60 131.6 per DALY decreased at transmission control stage and CNY −2217.6 per case averted, CNY −18 116.0 per DALY decreased at transmission interruption stage. Conclusions: The disease burden of schistosomiasis decreased significantly with the implementation of the integrated prevention and control strategy. Surveillance and management on elder population should be strengthened to decrease diseases burden. There remains a need for well-conducted studies that examine the long-term cost-effectiveness of the integrated control strategy for schistosomiasis. Graphic Abstarct: [ABSTRACT FROM AUTHOR]

Background: A steady progress on schistosomiasis control in the Peoples' Republic of China (P.R. China) was achieved and broadened into the twelve-year medium and long term national plan (MLNP) which marled the implementation of an integrated control strategy across all endemic areas in P.R. China in 2004. To understand the endemic trends of schistosomiasis to assess the effectiveness of an integrated strategy, we conducted an analysis of schistosomiasis surveillance data spanned from 2005 to 2015. Methods: The schistosomiasis sentinel surveillance data from sentinel sites were collected and analyzed from 2005 to 2015. In these sentinel sites, residents aged 6 years or above were screened annually by indirect hemagglutination assay (IHA), while only antibody positives were followed by stool examination either Kato-katz method (KK) and/or hatching technique (HT). Domestic animals raised in sentinel sites were examined by HT for confirming the infection of schistosomes. Snail investigation was conducted each year through systematic sampling method combined with environmental sampling method. The snails collected from field were tested by microscopic dissection method. The infection rates of schistosomes in residents, domestic animals and snails, as well as the indicators reflecting the snails' distribution were calculated and analyzed. ANOVA analysis was used to examine the changes of the number of eggs per gram feces in population and Chi-square test was used to examine any change in proportions among groups. Results: A total of 148 902 residents from sentinel sites attended this study and 631 676 blood samples were examined by IHA test during the 11 covered years. The annual average antibody positive rates presented a significant decrease trends, from 17.48% (95% CI: 17.20–17.75%) in 2005 to 5.93% (95% CI: 5.71–6.15%) (χ2 = 8890.47, P < 0.001) in 2015. During 2005–2015, the average infection rate of schistosomes in residents declined from 2.07% (95% CI: 1.96–2.17%) to 0.13% (95% CI: 0.09–0.16%), accompanied by significant decrease of infection intensity in population. In 2015, the stool positives were only found in farmers, fishermen and boatmen with infection rate of 0.16% (95% CI: 0.11–0.20%), 0.17% (95% CI: 0–0.50%) respectively. The infection rate of schistosomes in domestic animals dropped from 9.42% (538/5711, 95% CI: 8.66–10.18%) to 0.08% (2/2360, 95% CI: 0–0.20%) from 2005 to 2015. Infections were found in eight species of domestic animals at the beginning of surveillance while only two cattle were infected in 2015. Totally 98 ha of new snail habitats were found, while 94.90% (93/98) distributed in lake and marshland regions. The percentage of frames with snails decreased from 16.96% (56 884/33 5391, 95% CI: 16.83–17.09%) in 2005 to 4.28% (18 121/423 755, 95% CI: 4.22–4.34%) in 2014, with a slightly increase in 2015. Meanwhile, the infection rate of schistosomes in snails was decreased from 0.26% (663/256 531, 95% CI: 0.24–0.28%) to zero during 2005–2015. Conclusions: The infection rate of schistosomes declined significantly, providing evidence that the goal of the MLNP was achieved. Elimination of schistosomiasis as a public health problem defined as WHO was also reached in P.R. China nationwide. Surveillance-response system should be improved and strengthened to realize the final goal of schistosomiasis elimination. [ABSTRACT FROM AUTHOR]

Destination image plays an important role in how tourists make their travel and purchase decisions. This study examines the perceived image of Taiwan as a travel destination from the perspective of Hong Kong residents. The Hong Kong outbound tourism market is important for Taiwan. Using a self-completed questionnaire, this research examines the destination image of Taiwan among 213 Hong Kong residents. The results indicate that affective image is a stronger predictor of travel intention than cognitive image. Affective image also plays a mediating role in the relationship between cognitive image and behavioral intention. Hence, affective image is an important intangible quality for today’s destinations. [ABSTRACT FROM AUTHOR]

Background: An "integrated control" strategy has been implemented within seven provinces at highest risk for schistosomiasis along Yangtze River in Peoples' Republic of China (P. R. China) since 2004. Since Oncomelania hupensis is the only intermediate host of the blood fluke (Schistosoma japonicum), controlling the distribution of snails is considered an essential and effective way to reduce the risk of schistosomiasis infection. The study aimed to determine the snail area burden and annual trend among provinces with potential risk for schistosomiasis along the Yangtze River, above and below the Three Gorges Dam (TGD). Methods: This retrospective study utilized data previously collected from the National Parasitic Diseases Control Information Management System (NPDCIMS) on annual snail surveys from 2009 to 2017. Descriptive statistics were performed for analyzing the snail burden by provinces, counties, type of environmental location and year, and mapping was conducted to present the snails distribution. Results: From 2009 to 2017, the total snail infested area decreased by 4.22%, from 372 253 hm2 to 356 553 hm2 within the seven high risk provinces. The majority of snails were found in the marshland and lake regions, outside of control embankments. The total snail burden trend remained relatively stable in upstream regions above the TGD from 2010 to 2015, while the trend decreased within downstream regions during this period. In 2016 and 2017, the total snail burden trend increased in both upstream and downstream provinces, however, upstream saw a larger increase. From 2009 to 2017, there were a total of 5990 hm2 of newly developed snail areas in the seven study provinces and the majority were concentrated in regions below the TGD, accounting for 5610 hm2 (93.70%). Conclusions: There has been a decline in total snail counts from 2009 to 2017. Meanwhile, new snail breeding areas were formed mainly within provinces downstream the TGD due to spread of snails, indicated that the oncomelanid snail would be difficult to completely eliminate. We suggest that the national schistosomiasis integrated control strategy, including mollusciding and environmental modification, will need to be enhanced significantly going forward to achieve a greater reduction in snail burden and ultimately to achieve elimination. [ABSTRACT FROM AUTHOR]

Under Taiwan's National Health Insurance (NHI) system, it's crucial for all healthcare providers to accurately submit medical expense claims to the National Health Insurance Administration (NHIA) to avoid incorrect deductions. With changes in healthcare policies and adjustments in hospital management strategies, the complexity of claiming rules has resulted in hospitals expending significant manpower and time on the medical expense claims process. Therefore, this study utilizes the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) management approach to identify wasteful and non-value-added steps in the process. Simultaneously, it introduces Robotic Process Automation (RPA) tools to replace manual operations. After implementation, the study effectively reduces the process time by 380 min and enhances Process Cycle Efficiency (PCE) from 69.07 to 95.54%. This research validates a real-world case of Lean digital transformation in healthcare institutions. It enables human resources to be allocated to more valuable and creative tasks while assisting hospitals in providing more comprehensive and patient-centric services., (© 2024. The Author(s).)

Perfluoroalkyl acids (PFAAs) are environmentally and biologically persistent chemicals. In this study, we investigated the concentrations of six PFAAs in dust samples collected from different indoor environments in a college campus in Tainan, Taiwan, and assessed the health risk of PFAAs exposure to college students. We also analyzed the effects of dust characteristics (total organic carbon, moisture content, and dust content) on PFAAs levels. With regard to the space type, the median of total PFAAs concentrations were in the order of laboratories (528.9 μg kg -1 ) > offices (304.2 μg kg -1 ) > dormitories (180.1 μg kg -1 ) > classrooms (105.1 μg kg -1 ). With regard to the height from the ground, the median total PFAAs concentrations were in the order of dust near the floors (>2 m; 383.6 μg kg -1 ) > near the ceiling (0-2 m; 202.5 μg kg -1 ) > on the ground (0 m; 145.6 μg kg -1 ). The main species of PFAAs, perfluorooctane sulfonate and short-chain perfluoroalkyl carboxylates, accounted for respectively 30%-60% and ∼20%-37% of total PFAAs pollution in the indoor space types and sampling heights under consideration. The average daily intake (ADI) values of six PFAAs for college students were found to be 0.059-0.126 ng kg -1 BW day -1 (BW: body weight), with dormitories and workplaces (i.e., laboratories and offices) accounting for over 40% and ∼50% of the ADI, respectively. The estimated hazard quotient ranged from 0.0029 to 0.0063, three orders of magnitude lower than 1, suggesting relatively low risks for college students exposed to the six PFAAs monitored in indoor dust. The analysis of dust characteristics revealed that total organic carbon did not have a significant effect on PFAAs levels as we expected. In contrast, dust moisture and cation content dominated PFAAs accumulation., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Fat-preserving lower blepharoplasty techniques and filling techniques using autologous or non-autologous materials are increasingly used to treat tear trough deformity. However, there has been no definitive comparison of the results of fat repositioning versus autologous fat grafting for this condition. The authors used statistical analysis to compare the results of the two methods., Methods: From October 2013 to September 2015, a total of 101 patients, aged 20-43 years, underwent fat repositioning or autologous fat grafting in our department. Group 1 (51 patients, 102 eyes) underwent intraorbital fat repositioning with septal reset by transconjunctival lower blepharoplasty. Group 2 (50 patients, 100 eyes) underwent autologous fat grafting by lipoinjection., Results: No significant complications occurred in any patient postoperatively. Four of 102 eyes in Group 1 and seven of 100 eyes in Group 2 had no improvement; the rest had different degrees of improvement. In Grade II and III deformities, fat repositioning resulted in significantly greater improvement of grade compared with autologous fat grafting. The surgical method of Group 1 resulted in better curative effects than that of Group 2., Conclusion: In patients with tear trough deformity and without obvious skin or orbicularis oculi muscle laxity, both fat repositioning and autologous fat grafting are acceptable for mild deformity. In patients with higher-grade deformities, fat repositioning produced superior results than autologous fat grafting., Level of Evidence Iv: This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .