H. C. B. Liu

This review examines global human genetic resources management, focusing on genetic data policies and repositories in high- and middle-low-income countries. A comprehensive search strategy was employed across multiple databases, including official government websites and Google, to gather relevant literature on human genetic resources management policies and genetic resource databases. Documents were screened for relevance, focusing on high-income countries (United States, United Kingdom, Japan) and middle-low-income countries (China, India, Kenya). Data were extracted, coded, and analyzed to identify common themes and differences in genetic resource management practices. High-income countries benefit from robust legal frameworks and advanced technological infrastructures. The United States enforces the Health Insurance Portability and Accountability Act and the Genetic Information Nondiscrimination Act to protect privacy and facilitate data sharing, while Japan relies on the Act on the Protection of Personal Information and ethical guidelines. Additionally, high-income countries host a variety of genetic databases and biobanks that support scientific research. In contrast, middle-low-income countries like China, India, and Kenya are still developing their frameworks. China has regulations such as the Biosecurity Law and the Regulations on the Management of Human Genetic Resources, but still requires more unified standards. India’s policies focus on genetic research and data protection through the Biological Diversity Act, while Kenya seeks to improve data management through the 2019 Data Protection Act. Significant disparities exist in human genetic resources management between high-income and middle-low-income countries. High-income countries have robust systems balancing privacy protection with research facilitation, supported by comprehensive and large-scale databases for scientific research. Middle-low-income countries need to enhance legal frameworks and build population-specific databases. Promoting equitable data sharing and adopting best practices from high-income countries are essential for advancing global scientific discovery and ensuring fair management of genetic resources.

BackgroundPublished data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China.MethodsWithdrawal of treatment for children in the pediatric intensive care unit of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011.ResultsThe incidence of withdrawal of treatment for children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006–2008 decreased to 1.9% in 2015–2017. The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months in 2006 to 40.5 months in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved”. Only a few guardians ascribed treatment withdrawal to economic reasons.ConclusionsThe frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change.

The Chapter ‘Human Nature is Evil’ (Xing E 性惡)Footnote1 is a crucial text in the Xunzi that centrally addresses the theory of human nature. Unlike Mencius’s concept of ‘nature’ (xing 性), Xunzi’s discussion of ‘nature’ primarily encompasses three levels: animal instincts, cognitive faculties, and the social attribute of ‘sociality’ (qun 群), none of which includes innate moral attributes. Xunzi’s argument that human nature is evil is a value judgment grounded in the human social attribute (‘sociality’) and made possible by the cognitive capacity of the ‘heart-mind’ (xin 心). Therefore, xing e actually refers to the contradiction within human nature between its animalistic and social components. This contradiction must be apprehended through the cognitive function of the heart-mind and resolved through the social practical activity of ‘deliberate effort’ (wei 偽).

My aim in this article is to set out some counter-intuitive claims about the challenges posed by artificial intelligence (AI) applications to the protection and enjoyment of human rights and to be your guide through my unorthodox ideas. While there are familiar human rights issues raised by AI and its applications, these are perhaps the easiest of the challenges because they are already recognized by the human rights regime as problems. Instead, the more pernicious challenges are those that have yet to be identified or articulated, because they arise from new affordances rather than directly through AI modeled as a technology. I suggest that we need to actively explore the potential problem space on this basis. I suggest that we need to adopt models and metaphors that systematically exclude the possibility of applying the human rights regime to AI applications. This orientation will present us with the difficult, intractable problems that most urgently require responses. There are convincing ways of understanding AI that lock out the very possibility for human rights responses and this should be grounds for serious concern. I suggest that responses need to exploit both sets of insights I present in this paper: first that proactive and systematic searches of the potential problem space need to be continuously conducted to find the problems that require responses; and second that the monopoly that the human rights regime holds with regards to addressing harm and suffering needs to be broken so that we can deploy a greater range of barriers against failures to recognize and remedy AI-induced wrongs.

The perinatal period can leave women vulnerable to mental health disorders, and artificial intelligence (AI) holds potential to enhance prediction, diagnosis, and treatment applications, yet its clinical integration in perinatal mental health remains underexplored. Using a qualitative design supplemented by exploratory quantitative analysis of theme frequencies. Grounded in Shenzhen’s three-tier perinatal mental health prevention and intervention system, this study examined the ethical expectations, concerns, and implementation requirements for AI in perinatal mental health through semi-structured interviews with 41 participants, including 23 maternal health workers (MHWs) and 18 perinatal women. Findings revealed ethical divergences: MHWs prioritized clinical validity, diagnostic reliability, and system feasibility, whereas perinatal women emphasized data privacy, personalized care, and equitable access. Across both stakeholder groups, participants agreed that AI should serve as a supportive tool to enhance assessment, complementing rather than replacing human relational care. This study outlines a dual-stakeholder framework for AI integration in perinatal mental health, structured around four derived pillars: intelligent assessment, equity, tool governance, and clinical validation, each grounded in distinct priorities of health workers and patients.

Multiple goals balancing is an important but not yet fully validated dimension of complex problem solving (CPS). The present study used process data to explore how solvers clarify goals, set priorities, and balance conflicting goals. We extracted behavioral indicators of goal pursuit from the log data of 3,201 students on the third subtask of the “Ticket” task in the PISA 2012 CPS test. Cluster analysis was used to identify 10 groups that varied in goal pursuit behavior. Logistics and least-squares regression analysis were used to explore how goal pursuit affected task scores and CPS proficiency. The results showed that competent solvers clarified goals and weighed priorities more effectively. They also made trade-offs between conflicting goals. The importance of theoretically-driven log data analysis and coping strategies in the face of multiple goals conflict scenarios was discussed.

This paper presents a full-cycle model of national development, using China as an illustrative case, grounded in a single core principle: allocation is the primary factor, and it must be dynamically adjusted over time. The paper argues that the minimum effective dose of allocation is to activate the productive motivation of laborers—ensuring that individuals perceive a direct return from their efforts. When allocation fails to perform this function, the system stagnates. The model traces eleven sequential stages, from the survival phase (100% production orientation) through industrialization, the inflection point of overcapacity, domestic demand activation, currency internationalization, outward investment with profit repatriation, industrial chain upgrading, consumption restructuring, cultural export, national rejuvenation, and ultimately interstellar expansion—what the paper terms "the sea of stars." At each stage, the allocation ratio between production and consumption shifts in response to systemic signals and external conditions. A central formula underpins the entire pathway: wage growth > GDP + CPI, ensuring that real purchasing power continuously rises, consumption becomes the primary engine of growth, and a positive feedback loop is established. The paper also identifies two major structural "sinks" that can derail this pathway—residential housing costs and state infrastructure overinvestment—and proposes ROI-based allocation criteria to mitigate these risks. Finally, the model incorporates a "flexible protection" mechanism for extreme economic crises, allowing temporary suspension of wage and welfare adjustments without abandoning the long-term trajectory. The framework concludes that dynamic allocation is not a one-time distribution but a continuously iterating feedback cycle, co-evolving with productivity stages, system signals, and the external environment.

This paper presents a historical and theoretical framework for understanding distribution as the primary institutional nexus of human coexistence. Grounded in the axioms of existential persistence, the principle of distribution as the first bond, and the principle of least action, the paper traces three evolutionary stages of distribution—survival-based distribution (scarcity era), incentive-based distribution (industrial era), and existential distribution (AI era). The core argument is that as productivity approaches zero marginal cost, the function of distribution shifts from allocating material goods to allocating possibilities and meaning. The paper proposes a concrete institutional architecture for the post-scarcity era, including an unconditional basic security layer, a performance-based incentive layer, a free exploration quota (with risk-free failure), an honor system anchored in verifiable contributions, and an immune system for self-correction against institutional sclerosis. The framework concludes that the ultimate wealth of a civilization lies not in its productivity or territory, but in the mutual attachment between individuals and their collective—and distribution is the first bond that makes this attachment possible.

This paper presents the Existential Dual-Base Survival Game Theory — a unified framework for understanding all social systems, from individuals to civilizations, grounded in a single meta-axiom: every existent entity, once it begins to "be," has as its first and only primordial command: to continue to be. Existence is the tendency to maintain existence. From this axiom, two theorems are derived: (1) Distribution is the primary bond — when multiple existences coexist, distribution is the first institutional mechanism that enables them to coexist without mutual destruction; (2) The principle of least action (with drift) — systems, for long-term stable existence, filter and internalize the lowest-cost operational path, yet this path is never fixed — it continuously drifts as the system and its environment evolve. In the human condition, these translate into two派生 axioms: individual self-preservation and group survival through cooperation. The eternal core contradiction of all civilizations is the tension between the individual's unlimited expansive self-interest and the group's finite cooperative rules. The theory then derives seven evolutionary laws — including the Law of Institutional Substitution, the Law of Civilizational Cycles, the Law of Starlight (emergent感性光辉 that cannot be reduced to功利 calculation), and the Law of Public Instrument伪装 (systemic capture of rules by private interests) — and proposes a complete institutional architecture: a quantifiable ROI-based distribution system, a multi-tiered honor registry, an independent error-correction tribunal, and a governance AI ("Tian-shu") with five unmodifiable constitutional principles. The framework is not presented as a normative invention, but as a discovered pattern — a set of规律 that already operate in the world, which this paper merely describes. Its ultimate claim is that a well-designed system does not require selfless individuals; it aligns self-interest with public benefit, making the two mathematically equivalent.

Language control is a cognitive ability that bilinguals use to suppress interference from the language they are not currently using to accurately select and use the intended language. Adaptive language control underpins language switching and enables bilinguals to flexibly switch between languages according to context. Reinforcement learning, which models how individuals update their strategies based on reward prediction errors, provides a computational framework for studying adaptive behavior in changing environments. To investigate how bilingual language control is shaped by reward signals in social interactions, we used dual‐electroencephalography (EEG) to measure the performance of bilinguals who alternated between active and observational learner roles in voluntary language switching tasks. Computational modeling results indicated that the dual‐sensitivity model best captured behavior which showed that bilinguals adaptively updated values by assigning distinct weights to feedback from themselves and others. EEG analyses revealed that bilinguals relied on expected values during active learning and on prediction errors during observational learning to modulate delta band activity. Taken together, these findings reveal how rewards dynamically modulate language control through expected values and prediction errors, providing new evidence for the adaptability of bilingual control during social interaction.

A number of existing researches agree that digitalization would facility firms to launch ambidextrous innovations. Digitalization is not only about technological change, but more importantly, the reshaping of the firms’ knowledge structure and routines to percept and integrate knowledge. Thus, some researchers suggest that whether firms could benefit from digitalization varies across firms and industries, since innovation in different firms and industries relies on differentiated level of cognitive and reasoning of knowledge. However, existing studies mainly focus on exploring the firm-level differences, and leave the industry-level difference underdeveloped. In response, this study integrates knowledge-based view to examine how a firm’s digitalization affects ambidextrous innovation, and further explore the conjoint effect of industrial knowledge bases—the knowledge base of the industry the firm is located in—on the relationship between firm digitalization level and ambidextrous innovation. This study uses Python to conduct text mining of firms’ annual reports, and obtains data of 394 listed companies from the year 2014 to 2020. The empirical results show that digitalization level has positive effect on both exploratory innovation and exploitative innovation, and the effect on exploitative innovation is stronger than on exploratory innovation. Moreover, the moderating effect of industrial knowledge base is significant on “digitalization–exploratory innovation” but not on “digitalization–exploitative innovation” relationship. By doing so, this study refines the research on the relationship between digitalization and firm innovation, and confirms that the usage of digitalization may lead to achieve an ambidextrous situation. This study also provides a theoretical basis for industrial differences of the effectiveness of digitalization, suggesting firms considering industrial characteristics to implement digitalization-assisted innovation practices.

Sense of presence and extraneous cognitive load are the two psychological effects widely employed to explain the cognitive outcomes caused by high-immersive media. This study identified the concepts of both technological affordance and the psychological effects of VR learning. It investigated the mechanism by which immersion leads to better or worse communication in the context of art education. We operationalized the concept of immersion into two levels: a high-immersive VR system and a low-immersive tablet system. Through a between-subject experiment, we found that higher immersion not only led to a greater sense of presence but also lowered extraneous cognitive load. Enjoyment and attention increased as a sense of presence rose but were not necessarily predicted by extraneous cognitive load. This study found that sense of presence was a more robust explanatory variable than ECL and that cognitive load could be lower in a high-immersive environment with content specifically designed for VR.

This is a condensed version of the monograph. This monograph defends the compatibility of physical determinism with genuine human agency and moral responsibility. The defense does not proceed by retreating to epistemic uncertainty, invoking non-physical causation, or redefining the relevant concepts until the compatibility becomes trivial. It proceeds by showing that the inference from physical determinism to the impossibility of genuine agency contains a hidden premise that is false, and that once the false premise is identified and removed, the compatibility of mechanism and meaning follows directly. The hidden premise is what we call the settled-outcome assumption: the thesis that if physical events are causally determined, then there exists a personal-level fact—a fact about what an agent will decide, formulated in the vocabulary of decisions, values, and reasons—that obtains prior to and independently of the agent’s deliberation. This assumption, if true, would make deliberation merely revelatory: the agent would be discovering a pre-written script rather than composing it. The deliberative stance—the practical orientation from which agents take themselves to be genuine authors of their choices—would be systematically mistaken. The settled-outcome assumption is false. It fails for a reason grounded in the physical structure of complex natural systems: the relation by which personal-level descriptions are derived from physical states is many-to-one with divergent futures. A personal-level description of an agent prior to deliberation corresponds to a large equivalence class of physical states whose members evolve into different personal-level outcomes. No unique personal-level future is specified by the prior personal-level description. This is not a claim about our ignorance; it is a claim about the ontological structure of multi-level natural systems. For agents who model their own deliberative states—who represent their own values, motivations, and evaluative tendencies and use these representations as inputs to ongoing deliberation—this indeterminacy takes a recursive form. Any candidate pre-deliberative personal-level description of the outcome, if available to the deliberating agent, would itself modify the deliberation it purports to describe, generating an instability that prevents any stable pre-deliberative description from existing. Deliberation, in these agents, is genuinely constitutive of its outcome: not a mechanism for accessing a pre-existing answer, but the process through which the personal-level answer comes into existence. The constitutive model of deliberation has a normative consequence that is the monograph’s central normative claim. Deliberating agents of the relevant kind—those with hierarchically organized, reflectively accessible motivational structures—have genuine interests in the deliberative process and its outcomes. They have interests in being authors of their own evaluative lives rather than mere enactors of pre-written scripts. The constitutive model shows that these interests are satisfied: the agents’ deliberative engagement genuinely contributes to what happens. This is sufficient, on an interest-based account of moral consideration, to ground claims of moral status proportional to the richness of the agent’s deliberative engagement.

This is a condensed/abridged version of a book-length manuscript. This monograph defends the compatibility of physical determinism with genuine human agency and moral responsibility. The defense does not proceed by retreating to epistemic uncertainty, invoking non-physical causation, or redefining the relevant concepts until the compatibility becomes trivial. It proceeds by showing that the inference from physical determinism to the impossibility of genuine agency contains a hidden premise that is false, and that once the false premise is identified and removed, the compatibility of mechanism and meaning follows directly. The hidden premise is what we call the settled-outcome assumption: the thesis that if physical events are causally determined, then there exists a personal-level fact—a fact about what an agent will decide, formulated in the vocabulary of decisions, values, and reasons—that obtains prior to and independently of the agent’s deliberation. This assumption, if true, would make deliberation merely revelatory: the agent would be discovering a pre-written script rather than composing it. The deliberative stance—the practical orientation from which agents take themselves to be genuine authors of their choices—would be systematically mistaken. The settled-outcome assumption is false. It fails for a reason grounded in the physical structure of complex natural systems: the relation by which personal-level descriptions are derived from physical states is many-to-one with divergent futures. A personal-level description of an agent prior to deliberation corresponds to a large equivalence class of physical states whose members evolve into different personal-level outcomes. No unique personal-level future is specified by the prior personal-level description. This is not a claim about our ignorance; it is a claim about the ontological structure of multi-level natural systems. For agents who model their own deliberative states—who represent their own values, motivations, and evaluative tendencies and use these representations as inputs to ongoing deliberation—this indeterminacy takes a recursive form. Any candidate pre-deliberative personal-level description of the outcome, if available to the deliberating agent, would itself modify the deliberation it purports to describe, generating an instability that prevents any stable pre-deliberative description from existing. Deliberation, in these agents, is genuinely constitutive of its outcome: not a mechanism for accessing a pre-existing answer, but the process through which the personal-level answer comes into existence. The constitutive model of deliberation has a normative consequence that is the monograph’s central normative claim. Deliberating agents of the relevant kind—those with hierarchically organized, reflectively accessible motivational structures—have genuine interests in the deliberative process and its outcomes. They have interests in being authors of their own evaluative lives rather than mere enactors of pre-written scripts. The constitutive model shows that these interests are satisfied: the agents’ deliberative engagement genuinely contributes to what happens. This is sufficient, on an interest-based account of moral consideration, to ground claims of moral status proportional to the richness of the agent’s deliberative engagement.

Objectives: The aim of this study is to find and compare the current situation between common people and healthcare providers’ preferences for a good death in the context of Chinese culture. Methods: A cross-sectional anonymous questionnaire survey covering 190 ordinary Chinese people and 323 healthcare providers was conducted. An inventory of the good death was translated and the subjects were surveyed about their attitude toward it. Ethical considerations: Permission to conduct the study was granted by department chiefs, nurse managers and the participants themselves. The participants were informed that they took part on a voluntary and anonymous basis, that they could withdraw at any time, that they had the right to ignore questions they did not wish to answer, and that whatever they chose to do would not jeopardize their employment conditions. Results: The attributes that were perceived as important by major respondents for a good death were maintaining hope and pleasure, good relationship with medical staff, good relationship with family, independence, environment comfort, being respected as an individual, preparation for death, physical and psychological comfort, dying in a favorite place, and not being a burden to others. And some relatively less important characteristics were life completion, receiving enough treatment, natural death, controlling over the future, unawareness of death, pride and beauty, feeling that one’s life is worth living, and religious and spiritual comfort. We also found that healthcare providers were more likely than general out-patients to perceive “physical and psychological comfort,” “dying in a favorite place,” “good relationship with medical staff,” and “natural death” as important for a good death. Conclusion: This study offers healthcare providers in China a fundamental understanding of the normal expectations of the general public for a good death. It is believed that these findings in our study are valuable to improve palliative care in China. We compared the attitudes of Chinese and Westerners and found some differences, which suggested that cultural difference should be an important consideration to achieve a good death in China. We also found that healthcare providers see good death differently from general public, indicating that the criteria for good death warrant further study.

BackgroundTurnover intention, an employee’s intention to voluntarily leave their jobs, affects workforce sustainability. However, scarce data are available about turnover intention and its associated factors among psychiatrists in China, especially during the COVID-19 pandemic. The current research was designed to address this gap.MethodsAn anonymous, nationwide online survey was disseminated to psychiatrists in 41 psychiatric hospitals in China. We collected demographic data, job-related information, and participants’ turnover intention in the next 12 months.ResultsIn total, 3,973 psychiatrists completed the survey. The sample was predominantly female and married, and nearly three-fourths had children. More than one-third had a master’s or doctoral degree in addition to their medical degree. The overall level of job satisfaction was moderate. The rate of turnover intention was 22.0% and was comparable in males and females. Psychiatrists who had participated in the frontline work of COVID-19 were more likely to report an intention to leave their current job. Multiple regression analyses suggested that turnover intention was significantly associated with having insomnia, longer working hours, and more working days per week.ConclusionDuring the pandemic period, approximately one-fifth of psychiatrists in China reported turnover intention. Factors associated with turnover intention included high job-related burdens, low job satisfaction, participation in the frontline work against COVID-19, and insomnia. To improve psychiatric workforce sustainability, policymakers and hospital administrators need to be aware of this potential challenge and address the concerns of psychiatrists in China.

Teacher self-efficacy is one of the most critical factors influencing Students’ learning outcomes. Studies have shown that teacher-perceived principal leadership, teacher collaboration, and teaching experience are the critical factor that affects teacher self-efficacy. However, little is known about the mechanisms behind this relationship. This study examined whether teacher collaboration would mediate the relationship between teacher-perceived principal leadership and teacher self-efficacy, and the moderating role of teaching experience in the mediating process. With an analysis of a dataset from 14,121 middle school teachers in China, this study first testified to the positive role that teacher-perceived principal leadership played in teacher self-efficacy. Furthermore, it revealed that teacher collaboration mediates this relationship and the mediated path was moderated by teaching experience. Finally, it also indicated that the threshold of teaching experience linking the teacher-perceived leadership with teacher self-efficacy was approximately in the third year, and their relationship was stronger when teaching experience was below the threshold. This study highlighted the mediating and moderating mechanisms linking the teacher-perceived principal leadership and teacher self-efficacy, which has important theoretical and practical implications for intervention and enhancement of teacher self-efficacy.

From the perspective of philosophy of engineering in China, this study points out the shortcomings of the category of “Creating” and the role and advantages of the category of “Doing”. In this process, two concepts of “engineering” in the Chinese language were discovered. The research further points out that the fundamental characteristic of engineering is “Heavy result”, and the basic characteristic is planning, time limit and heterogeneity within the community. However, the accommodation of the two engineering philosophical frameworks remains to be further studied.

Objectives: The corona virus disease-2019 pandemic spread globally, and we aimed to investigate the psychosocial impact on healthcare workers in China during the pandemic.Methods: In this systematic review and meta-analysis, we searched seven electronic databases for cross-sectional studies on psychosocial impact on HWs in relation to COVID-19 from January 1, 2020 to October 7, 2020. We included primary studies involving Chinese HWs during the pandemic, and data were extracted from the published articles. Our primary outcome was prevalence of anxiety, depression, and stress disorders. We pooled prevalence value with their 95% confidence interval using random effect models and assessed study quality on the basis of an 11-item checklist recommended by the Agency for Healthcare Research and Quality. The study protocol was registered in PROSPERO.Results: We identified 25 articles comprising a total of 30,841 completed questionnaires and 22 studies for meta-analysis. The prevalence of anxiety, depression, and stress disorders was 34.4%, 31.1%, and 29.1% for HWs. The pooled prevalence of anxiety disorders for HWs from late January to early February was 46.4%, significantly higher than those in mid-term February and after late February. The pooled prevalence of depression disorders for HWs from late January to early February was 46.5%, significantly higher than those in mid-term February and after late February. HWs working in Hubei Province had a higher prevalence of anxiety and a lower prevalence of depression than those working in other regions. Nurses had a higher prevalence of anxiety and depression than other HWs.Conclusions: About one-third of HWs in China suffered anxiety, depression, and stress at the early epidemic of COVID-19. HWs in Hubei Province, especially nurses, had a higher prevalence of psychological disorders. During the pandemic, a negative psychological state may persist in a proportion of Chinese HWs, fluctuating with the control of the pandemic. The long-term impact should continue to be observed. Attention should be paid to HWs for their psychological impact due to the pandemic.Systematic Review Registration: The study protocol was registered with PROSPERO.