China Experts Research Articles

Construction and Validation of a Diagnostic Scoring System for Predicting Active Pulmonary Tuberculosis in Patients with Positive T-SPOT Based on Indicators Associated with Coagulation and Inflammation: A Retrospective Cross-Sectional Study.

Tuberculosis (TB) is a life-threatening single infectious disease, which remains a major global public health concern. This study was to establish and validate a clinically practical diagnostic scoring system for predicting active pulmonary tuberculosis (APTB) in patients with positive tuberculosis T cell spot test [T-SPOT] using indicators associated with coagulation and inflammation. A single-center retrospective cross-sectional study was performed to include patients with positive T-SOPT registered and hospitalized at Wuhan Jinyintan Hospital between January 2017 and December 2019. All patients were separated into the active pulmonary tuberculosis (APTB) group and the inactive pulmonary tuberculosis (IPTB) group, according to the diagnostic criteria from China's Expert Consensus for APTB and IPTB. Subsequently, the patients were randomized into a training set and a validation set at a ratio of 2:1. Indicators associated with coagulation and inflammation, including prothrombin time activity (PTA), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen concentration (Fbg-C), C-reactive protein/albumin ratio (CAR), C-reactive protein/prealbumin ratio (CPR), neutrophils count/lymphocyte count ratio (NLR), platelet count/lymphocyte count ratio (PLR), monocyte count/lymphocyte count ratio (MLR), and erythrocyte sedimentation rate (ESR) were obtained from electronic medical record system (EMRS). Stepwise logistic regression was performed in the training set to build a diagnostic model for predicting APTB, which was transformed into an easily applicable scoring system via nomogram. Receiver operating characteristic (ROC) analysis, calibration curve (CC), and decision curve analysis (DCA) were conducted to evaluate the predictive performance of the established diagnostic scoring system. A total of 508 patients [training set (211 cases of APTB and 116 cases of IPTB) and validation set (103 cases of APTB and 78 cases of IPTB)] with positive T-SPOT were recruited in the study. Stepwise logistic regression showed that CPR, MLR, ESR, APTT and Fbg-C were independent predictors for APTB. The scoring system was subsequently formulated based on the abovementioned predictors, which correspond to scores of 10, 6, 7, 5, and 5, respectively. In addition, patients are more likely to be diagnosed as APTB when the cut-off score was ≥16 scores, while patients with <16 scores are more likely to be diagnosed as IPTB. The scoring system showed good predictive efficacy in both the training set [area under the curve (AUC): 0.887] and the validation set (AUC: 0.898). Furthermore, both CC and DCA confirmed the clinical utility of the scoring system. The data suggest that the combination of indicators associated with coagulation and inflammation could serve as biomarkers to identify APTB in patients with positive T-SPOT. In addition, patients with positive T-SPOT were more prone to be diagnosed with APTB when having a combined total of scores ≥16 in the scoring system.

Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study.

The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.

Taiwan’s Critical Position in Indo-Pacific: India’s Response to China’s Reactions

“China Factor,” has always been a crucial element that shapes India’s attitude towards Taiwan. According to number of China experts, the journey of India- Taiwan relations have happened under the shadow of China only. Taiwan never featured prominently within India’s Act East Policy as always been overshadowed by much bigger Sino-Indian ties. In the last few years, the concept of Indo-Pacific region has received immense political, economic and strategic attention. Undoubtedly, India is among the politically and strategically major players in the region along with China, Japan, Australia, South Korea, the United States and countries of Southeast Asia. Taiwan constitutes a vital component of Indo-Pacific due to its crucial geographical position in the region. To a significant extent, it is also due to the island nation’s critical position in relation to Sino-US relations. Taiwan’s strategic location links the Indian Ocean to the South China Sea and the Sea of Japan. Most importantly, they are used as critical sea routes for exporting and importing of goods worth $ 5.5 trillion annually, according to Center for Strategic and International Studies (CSIS). These routes are extremely important for the import of energy resources to three East Asian countries – China, Japan and South Korea. Since the Indo-Pacific has turned into the center of global dynamism and trade agreements, undisruptive sea lines of communication are crucial for region’s growth and prosperity. However, China’s assertive policies and actions make Taiwan restless and worried. India looks at the Indo-Pacific as an open, libertarian and democratic zone. In the face of assertive China, assessing India’s reaction is crucial as it advocates rules -based, open, balanced liberal order and stable trading environment in the Indo-Pacific region. Being the largest democracy and among the fastest growing economies of the world, it is important for India to acknowledge Taiwan’s democratic position and economic capability. In fact, power dynamics in the Indo-Pacific have recently altered, and it’s the appropriate time for New Delhi to engage more politically and economically with Taiwan.

‘Our Chinese comrades are determined to split and struggle’. The influence of the Sino-Soviet split on technological cooperation between Hungary and China

ABSTRACT Using the case of a 1962 incident involving Hungarian railway experts in China, this article examines the relationship between political disputes and economic cooperation. It seeks to answer the questions of why, how and for how long could economic, and scientific and technological cooperation be maintained between Hungary, a country belonging to the Soviet sphere of interest, and China, which increasingly regarded the Soviet Union as an enemy, in a period of political disputes and deterioration of Sino-Soviet relations. Relying mainly on Hungarian archival documents, including minutes of HSWP Central Committee and Politburo meetings, Ministry of Foreign Affairs reports and analyses, and Ganz-MÁVAG files, the article argues that while the deterioration of Sino-Hungarian political relations went hand in hand with the worsening of Sino-Soviet relations, the break in trade, and scientific and technological cooperation, happened slower. Although, as political disputes escalated, the Chinese made interstate relations with the Soviet bloc countries increasingly difficult, the Beijing leadership sought to maintain partnerships in areas that it found beneficial for China’s economy. As the Sino-Hungarian economic and technological disputes fit into a larger Sino-Soviet political conflict, the article puts the case of Ganz-MÁVAG Locomotive and Railway Carriage Manufacturers and Mechanical Engineers Hungary in context by reviewing the process of deterioration of Sino-Soviet relations and its influence on Sino-Hungarian relations.

Interpretation on Consensus on drug-induced liver injury by CIOMS Working Group:liver injury attributed to herbal and dietary supplements

With the increase in the medical level, the improvement of adverse drug reaction(ADR) monitoring systems, and the enhancement of public awareness of safe medication, drug safety incidents have been frequently reported. Drug-induced liver injury(DILI), especially liver injury attributed to herbal and dietary supplements(HDS), has globally attracted high attention, bringing great threats and severe challenges to the people for drug safety management such as clinical medication and medical supervision. Consensus on drug-induced liver injury had been published by the Council for International Organizations of Medical Sciences(CIOMS) in 2020. In this consensus, liver injury attributed to HDS was included in a special chapter for the first time. The hot topics, including the definition of HDS-induced liver injury, epidemiological history, potential risk factors, collection of related risk signals, causality assessment, risk prevention, control and management were discussed from a global perspective. Based on the previous works, some experts from China were invited by CIOMS to undertake the compilation of this chapter. Meanwhile, a new causality assessment in DILI based on the integrated evidence chain(iEC) method was widely recognized by experts in China and abroad, and was recommended by this consensus. This paper briefly introduced the main contents, background, and characteristics of the Consensus on drug-induced liver injury. Significantly, a brief interpretation was illustrated to analyze the special highlights of Chapter 8, &quot;Liver injury attributed to HDS&quot;, so as to provide practical references for the medical staff and the researchers who worked on either Chinese or Western medicine in China.

Sensing as Knowing: Medicines, the Senses, and Practical Expertise in Late Imperial China

The development of the medicinal trade and markets in late imperial China increased anxiety among scholarly physicians about the authenticity of medicines. Even though the market was typically depicted by scholarly physicians as a place full of tricks and deceptions, it was a repertoire where practical knowledge about authentication was created and circulated. The specialized knowledge was mainly transmitted through oral tradition. But in some instances, it was also written down by scholarly physicians or merchants, allowing us to reconstruct the techniques and their underlying rationales. Authentication of medicines mobilized multiple sensory perceptions of the human body, consisting of observing, tasting, smelling, touching, and performing small tests. All these techniques played different roles in the practice of authentication. Even though these sensory techniques seemed like a collection of trivial and discrete records without any coherent rationales, an underlying episteme could be detected through a close investigation. Merchants and practitioners in the market did not understand the nature and materiality of medicines by any established theories. Instead, they actively engaged with the tangible form of medicines through the senses and bodily techniques. This sensory form of knowing indicates a type of practical expertise that is distant from the scholarly tradition of materia medica in late imperial China.

Good for tech: Disability expertise and labor in China's artificial intelligence sector

People with disabilities are often perceived as being “given” the opportunity to work, rather than “providing” valuable labor. Centering on disabled data workers as experts involved in the quotidian construction of artificial intelligence (AI) systems in China, this article shows that disability expertise and labor can afford a technical edge to AI systems in a certain political economy. In the case examined, the work of consistently synchronizing interpretations of the ambiguous data and elusive rules of smart home systems prefers a stable annotation workforce with coordinated cognition and trained judgment. This technical demand has come to be met by a committed team of skilled disabled workers, who are pushed out from mainstream job market by systemic ableism, and pulled in by disability-informed expertise that reconfigures space, time, and political economy to meet non-normative bodyminds. Through this exceptional case run by a disabled people led organization, I draw attention to disabled people’s under-examined role as system-builders of information technologies as opposed to users, victims, or inspirations, and highlight the transformative potential of disability expertise.

Chinese multidisciplinary expert consensus on the management of adverse drug reactions associated with savolitinib.

Savolitinib is a highly selective mesenchymal-epithelial transition (MET) tyrosine kinase inhibitor (TKI). Based on its significant efficacy shown in clinical studies, savolitinib was conditionally approved for marketing in China on 22 June 2021, for the treatment of advanced non-small cell lung cancer (NSCLC) with MET 14 exon skipping mutation. Additionally, many studies showed that MET TKIs were equally effective in patients with advanced solid tumors with MET gene amplification or MET protein overexpression. Several relevant registered clinical studies are in progress. The most common adverse reactions (ARs) due to savolitinib administration are nausea, vomiting, peripheral edema, pyrexia, and hepatotoxicity. This consensus was developed through two rounds of extensive national surveys involving multidisciplinary experts in China, aiming to guide clinicians to prevent and treat various ARs scientifically, and improve the efficacy of the drug and the quality of life of patients.

Comprehensive analysis and evaluation of ship energy efficiency practices

The IMO is working to reduce emissions from ships. One of its initiatives is the Ship Energy Efficiency Management Program (SEEMP), which is based on the Plan, Do, Check and Act (PDCA) cycle. In order to clearly describe the weight of energy efficiency improvement methods in practice, current energy efficiency practices were summarised systematically from five aspects, including optimising navigational management and operation, improving power system efficiency, reducing ship resistance, improving company management as well as the application of new energy and new technologies. Based on the Fuzzy- Analytic hierarchy process (AHP) method, a multi-level evaluation system was established by considering the importance degree of these practices. Comprehensive evaluation was carried out in accordance with the results obtained from the questionnaire survey of experienced experts in China. The evaluation results show that the management innovation has higher influence than technological alteration in achieving the energy conservation and emissions reduction of ships, and the speed optimisation is recognised as the most effective approach onboard at present. The multi-attribute decision-making architecture and comprehensive evaluation method proposed is much needed by the ship managers and crew members to determine the best practice of energy efficiency.

Examining the persuasion process of narrative fear appeals on health misinformation correction

ABSTRACT Health misinformation could distort people’s health perceptions and related behaviors. Combating such misinformation has become the common concern of the whole society. Based on the extended parallel process model (EPPM) and narrative theories, the current study recruited 415 health experts in China to participate in a 2 (threat: high vs. low) ×2 (efficacy: high vs. low) between-subjects factorial experiment. Results revealed that narrative fear appeal messages are effective in promoting health experts to correct online health misinformation for the public. Message threat can arouse the emotion of fear through the identification with the narrative character. Moreover, message efficacy plays a moderating role between fear and health misinformation correction. Theoretical implications for EPPM development and practical message strategies for motivating health experts to correction misinformation are discussed.

A round table discussion: clinical landscape of trastuzumab deruxtecan in breast cancer: a retrospective and prospective view.

The treatment landscape of breast cancer has been greatly changed by the innovative targeting therapies. Antibody-drug conjugates (ADCs) with a representative of trastuzumab deruxtecan (T-DXd) are the most successful ones. The revolutionary next-generation design of ADC transformed to the unprecedented clinical data. The DESTINY-BREAST01 and DESTINY-BREAST03 trials have changed the standard of care for HER2-positve metastatic breast cancer (MBC). At the same time the clinical data of T-DXd in HER2-postive patients with brain metastasis (BM) is numerously gaining and challenging the current treatment concept for central nerve system (CNS) involved disease. The DESTINY-BREAST series trials have quickly expanded to first-line (1L) and early setting of breast cancer. The newly reported positive result of DESTINY-BREAST04 trial has also opening the door of human epidermal growth factor receptor 2 (HER2)-low era. The breast cancer experts are facing a world of massive data and rapidly changing. Therefore, round table discussion meeting is a great way to share the information and options of among oncologists. This time, the breast cancer experts in China gathered to discuss the important clinical advances of T-DXd and its impact to clinical practice. The meeting minutes were recorded and organized as the review article. This would provide insights to better understanding of the current data and shape the further research directions of breast cancer.

Public attitudes towards experts in China

ABSTRACT Previous studies in China’s policy process have paid limited attention to public perceptions of experts. Through an original survey, we explore public attitudes on expertise, i.e., the merits of expert opinion and expert autonomy. We find that professional experience is the most important criterion on which respondents evaluate experts. The higher a respondent’s political trust is, the more likely he or she is to recognize the benefits that experts may offer. We also find an underlying populist tendency towards the role of experts in policy making, respondents in general agree that the will of the people should be prioritized over expert opinion.

Progress of clinical research studies on tuberous sclerosis complex-related epilepsy in China.

Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous syndrome, with 75.6%-83.5% and 54.1% patients presenting with epilepsy and drug-resistant epilepsy (DRE), respectively. Clinical studies on TSC, particularly surgical interventions, have achieved rapid and substantial progress. The TSC-Task Force Committee of the China Association Against Epilepsy (CAAE-TFTSC) was founded in 2012, and annual academic conferences on the surgical treatment of TSC-related epilepsy have been held since 2013. 'China experts' consensus on surgical treatment of TSC-related epilepsy' was published in 2019. This review focuses on surgical treatment, including resective surgery, neuromodulations, corpus callosotomy and mini-invasive ablations, as well as studies on phenotype, genotype and anti-seizure therapies of mammalian target of rapamycin inhibitor, vigabatrin and ketogenic diet in patients with TSC-related DRE in China.

Knowledge Communities in US Foreign Policy Making: The American China Field and the End of Engagement with the PRC

The United States’ long-standing approach to the People’s Republic of China—“engagement”—is at an end, replaced by a tougher approach, labeled “strategic competition.” Foregrounding the role of knowledge communities in the making of US foreign policy, I show that engagement’s demise followed less a rational process responding to shifts in Chinese behavior and the balance of power, and more a paradigmatic turnover in key individuals’ views of China within the government and the China expert community. Adopting a sociological perspective attuned to the social and professional underpinnings of US foreign policy, I trace the paradigmatic turnover in US views of China to three processes: politicization, professional status competition, and personalization. Drawing on a range of sources, including over one hundred original interviews with members of the US China expert community, this article traces the entanglement of engagement at once political, professional, and deeply personal.

Reconsidering communication visibility in politically restrictive contexts: organizational social media use in China

Abstract Increasing evidence reveals that social media visibility produces paradoxes in which actors simultaneously confront contradictory, even mutually exclusive, conditions. Yet limited research has explored how actors perceive these paradoxes and manage resulting tensions in a politically repressive context. Ubiquitous government oversight, information control, and Internet censorship may uniquely complicate paradoxes of visibility in non-Western environments. To address this gap, this research reconsiders the paradox(es) of visibility in politically restrictive contexts. Interview data from 50 social entrepreneurs and two field experts in China reveal the antecedents to visibility paradoxes, and suggest three novel forms of paradoxes: resource investment, public attention, and social change. We also show these paradoxes are interdependent such that one may be amplified or attenuated by the other paradoxes. Further, we identify three strategies for responding to these paradoxes and suggest implications for vulnerable actors in maintaining a public profile, especially in sensitive sociopolitical environments.

A randomized, parallel control and multicenter clinical trial of evidence-based traditional Chinese medicine massage treatment VS External Diclofenac Diethylamine Emulgel for the treatment of knee osteoarthritis

BackgroundBoth massage and topically administered NSAIDs are safe and effective treatments for knee osteoarthritis (KOA); however, different massage technique sects in China caused assessment difficulties for the treatment of KOA. In order to standardize the massage techniques and procedures, we organized multi-disciplinary experts in China to acquire an evidence-based traditional Chinese medicine massage treatment of knee osteoarthritis. The purposes of this study will be to provide clinicians a complementary and alternative therapy for patients and to evaluate the efficacy and safety of evidence-based traditional Chinese medicine massage treatment of KOA compared to External Diclofenac Diethylamine Emulgel.Methods and designA randomized controlled trial in which 300 participants diagnosed with KOA will be recruited and randomly allocated to either the experimental group or the control group in a ratio of 2:1. Two hundred participants will receive evidence-based traditional Chinese medicine massage 2 sessions per week for 10 weeks as the experimental group, and 100 participants will receive External Diclofenac Diethylamine Emulgel 3–4 times per day for 10 weeks as the control group. The patients in the two groups will receive follow-up at two time points at 5 weeks and 10 weeks from the beginning of treatment, respectively. The MRI scans and X-ray will be performed at baseline and at the end of the intervention. The primary outcome will be the changes in the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Secondary outcomes will be measured by the PRO scale for knee osteoarthritis based on the concept of traditional Chinese medicine (Chinese scale for knee osteoarthritis (CSKO)), X-ray evaluation, and MRI scan evaluation. The data of WOMAC and CSKO will be analyzed at the baseline, 5 weeks, and 10 weeks from the beginning of treatment. The data from MRI scans and X-rays will be analyzed at baseline and at the end of the intervention. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session.DiscussionThis study will provide clinicians with much-needed knowledge for the treatment of KOA through a controlled trial.Trial registrationChinese Clinical Trial Registry ChiCTR1800014400. Registered on 10 January 2018

Pediatric expert consensus on the application of aspirin in Kawasaki disease

Kawasaki disease (KD) is one of the common acquired heart diseases in children aged <5 years and is an acute systemic vasculitis. After nearly 60 years of research, intravenous immunoglobulin combined with oral aspirin has become the first-line treatment for the prevention of coronary artery lesion in acute KD; however, there are still controversies over the role and optimal dose of aspirin. The consensus was formulated based on the latest research findings of KD treatment in China and overseas and comprehensive discussion of pediatric experts in China and put forward recommendations on the dose, usage, and course of aspirin treatment in the first-line treatment of KD.

Chinese expert consensus on the surgical treatment of primary palmar hyperhidrosis (2021 version).

Primary palmar hyperhidrosis (PPH) is a pathologic condition of excessive sweating on hands that has adverse impacts on patients’ social activity, professional life, and psychological state. Endoscopic thoracic sympathicotomy (ETS) is by far the treatment choice for PPH with the most stable and durable curative effects, but special attention should be given to the side effects of the surgery, especially compensatory hyperhidrosis (CH). This consensus is the second version of the Chinese Expert Consensus on the Surgical Treatment of PPH by the China Expert Committee on Palmar Hyperhidrosis (CECPH), which was published 10 years ago. This consensus emphasizes the need for special attention and careful assessment of the patients’ feelings, as well as their emotional and mental state, and emphasizes that distress due to palmar sweating and the desire for treatment are prerequisites for diagnosis. It also provides a more nuanced delineation of CH and reviews all new attempts to prevent and treat this side effect. New evidence of the epidemiology, pathogenesis of PPH, and indications for surgery were also assessed or recommended.

Prospects for a Chilly War: China Advice at the Dawn of the Biden Era

Abstract In late 2020 and early 2021—the weeks surrounding the election of President Joseph R. Biden Jr.—a flood of China experts offered an incalculable amount of unsolicited advice to the new administration. With the exception of Taiwan, the differences between doves and hawks were extremely slight, resting more on tone than substance. Policy directions they presented largely followed those of the Trump administration minus the U.S. version of wolf diplomacy rhetoric. Views ranged from the position that the United States should do all it could to squash the rise of the People’s Republic of China (prc), to the position that the United States should pursue competition and cooperation simultaneously—but “never forget competition!” This limited range of views shared four premises. First, the prc and the United States were competitors engaged in a potentially existential struggle for global dominance. Second, the Clinton-Bush-Obama approach of “managing” the prc with the goal of incorporating it into the existing postwar and neoliberal economic structures had failed. Third, the United States had done much to weaken itself, but it could regain its strengths. Fourth, while the Cold War model was inappropriate, the United States should engage in “strategic competition” to constrain China, or in other words wage a Chilly War.

The Changing U.S. China Watching Community and the Demise of Engagement with the People’s Republic of China

Abstract Recent years have seen the rapid descent of relations between the United States and the People’s Republic of China (prc). Hopes for cooperation in places of common concern like climate change gave way to strains in almost all areas. In place of “engagement,” the administration of Donald J. Trump adopted a tougher approach of “strategic competition” that its successor so far has continued. This article explores the relationship between the demise of engagement and opinions coming from the American China expert community. Specifically, it questions the impact on engagement of five secular dynamics that these China authorities have experienced—generational turnover; the field’s vast expansion and diversification; increased disciplinary specialization; the enhanced prominence of the generalist in national security discussions in place of China specialists; and changes in the media leading to more skeptical journalistic voices on U.S.-prc relations. Without over-emphasizing either the influence of the expert community on U.S. decision-making, or underplaying the more repressive and authoritarian actions of the Chinese Communist Party, this article suggests that the China expert community has been more of a factor in the end of engagement than current accounts of academics and commentators acknowledge.