China Institute Research Articles

A study on equity in the allocation of health human resources in maternal and child health institutions in China (2002–2021) and forecasting the five-year future trends (2022–2026)

BackgroundStrengthening health systems and ensuring equity and access to human resources can significantly reduce maternal and child mortality and improve maternal and child health outcomes. This mixed-methods study aimed at the quantity, quality, and equity of the allocation of human resources for health (HRH) in Chinese maternal and child healthcare institutions from 2002 to 2021 while providing a reference for optimally allocating HRH in the new era.MethodsRelying on health-related data obtained from statistical yearbooks in 2003–2022, the study analysed the allocation status using descriptive statistics, examined the allocation equity with the Gini coefficient and the Health resource agglomeration degree/Health resource population agglomeration degree (HRAD/HRPAD). Finally, the study predicted the future allocation trend by compiling a grey prediction model GM (1,1).ResultsHRH quantity in Chinese maternal and child healthcare institutions experienced steady growth. However, the composition of educational background and professional titles was unreasonable. The quality structure needs to be further optimized. The equity of demographic allocation (Gini < 0.2) was superior to the geographic allocation (Gini = 0.631–0.678), with significant regional differences. The HRAD values of HRH in different regions were as follows: eastern region (3.50–3.70) > central region (1.69–1.92) > western region (0.36–0.44); HRPAD (2021): western region (1.150) > central region (0.991) > eastern region (0.912). The equity of sparsely populated regions was superior to that of densely populated regions. The HRH future allocation trend is positive.ConclusionsEmphasis should be placed on the status quo of unreasonable allocation and unbalanced distribution. Careful consideration must be given to factors like service population, service radius, economic development, and population mobility while considering demographic and geographic equity to promote the reasonable allocation and full utilisation of HRH.

Management and survival trends for diffuse gliomas diagnosed at a single neurooncology center in China during 2000 to 2020

Currently reported survival outcomes for gliomas exhibit significant variability and controversy. In this study, we aim to provide survival data in Chinese populations by conducting a retrospective analysis of management and survival trends in a large cohort of glioma patients from a single institute in China. A total of 1206 patients with newly diagnosed gliomas treated between 2000 and 2020 were enrolled, including 537 glioblastoma (WHO grade 4), 450 astrocytomas (grade 2/3) and 219 oligodendroglial tumors (grade 2/3). The estimated overall survival at 5 years was 18.9% for glioblastoma, 58.8% for astrocytomas, and 80.7% for oligodendroglial tumors, while median survival was 17.2 months, 82.8 months, and not reached, respectively. The survival trend has increased over the past decades for all types of gliomas. Additionally, similar survival trends were observed between grade 2 and 3 IDH-mutant gliomas. Rising trends were observed in patients undergoing postsurgical radiation and chemotherapy. Multivariate analysis identified adjuvant radiochemotherapy as an independent factor for better prognosis in glioblastoma and astrocytomas. In summary, despite its retrospective nature, this cohort of glioma patients exhibits favorable survival outcomes compared to global statistics, indicating a geographical disparity in glioma prognosis. The promotion of adjuvant chemoradiotherapy contributes to improved prognosis.

A literature review on accounting higher education institute performance in China: The role of AI and technology readiness

This research offers a systematic and comprehensive literature review analyzing current studies on the performance of higher education institutes in China through the incorporation of technological advancements. This systematic literature review method involves 34 peer-reviewed articles published in reputable academic journals between 2012 and July 2023. This study is confined to a review of empirical papers derived from digital databases encompassing the terms "artificial intelligence or innovation or technological advancement in higher education institutes in China" in the titles. This study proposes a framework to assess the performance of higher education institutes. Further, artificial intelligence is proposed as a mediator, and technology readiness is proposed as a moderator. Significant literature gaps indicate that this field is a relatively novel phenomenon. Thus, rigorous research on the topic proves necessary to develop a holistic understanding of the subject area. This study expands the current body of knowledge by providing the first comprehensive systematic review of the performance of higher education institutes and recommending future research agendas.

Knowledge, attitude, and practice related to dementia and cognitive impairment among medical specialists with expertise unrelated to dementia

To explore the knowledge, attitude, and practice (KAP) on dementia and cognitive impairment among medical specialists with expertise unrelated to dementia. This study enrolled medical specialists with expertise unrelated to dementia from 318 medical institutions in China, between March and April 2023. A self-designed questionnaire was used for data collection and KAP assessment. A total of 1288 valid questionnaires were collected, 62.58% from female participants. The KAP scores were 11.02 ± 2.11 (range: 0–13), 22.16 ± 3.40 (range: 0–24), and 29.48 ± 6.92 (range: 0–32), respectively. The structural equation model showed that knowledge was positively associated with attitude (path coefficient = 0.503, P < 0.001), while both knowledge (path coefficient = 0.713, P < 0.001) and attitude (path coefficient = 0.797, P < 0.001) were positively associated with practice. Type of institution (path coefficient = 0.184, P = 0.035) and professional title (path coefficient = 0.133, P = 0.026) were positively associated with knowledge score. The mediation analysis revealed the significant total effects for professional title on knowledge, knowledge and professional title on attitude, and knowledge, attitude, and education on practice. Medical specialists in China with expertise unrelated to dementia might have good knowledge, a positive attitude, and proactive practice toward dementia and cognitive impairment. Tailored educational interventions should be specifically designed for individuals with lower professional titles and those working outside public tertiary hospitals.

Institutional Fragility and Entrepreneurial Activities

ABSTRACTExtensive research has shown that transition economies often experience internal friction, conflicts, and institutional fragility when different institutional dimensions evolve at an uneven pace. However, limited knowledge exists regarding how institutional fragility specifically affects entrepreneurial activities. This study develops a theoretical framework that integrates institutional theory and public choice theory to examine the impact of institutional fragility on entrepreneurship, considering both institutional costs and government intervention. Our findings reveal an inverted U‐shaped relationship between institutional fragility and entrepreneurial activity in China. Furthermore, we find that regional guanxi culture—a key informal institution in China—mitigates this relationship. Overall, this study provides a novel perspective on institutional fragility, offering new insights into how the institutional environment shapes entrepreneurial activity in China.

Changes in network centrality of anxiety and depression symptoms associated with childhood trauma among Chinese college students

BackgroundChildhood trauma is strongly linked to anxiety and depression, significantly increasing the risk of negative outcomes in adulthood. This study employed network analysis to investigate the complex interplay of anxiety and depression symptoms among Chinese college students, focusing on identifying the core symptoms most directly affected by childhood trauma and those exerting the greatest influence on others.MethodsData were collected from December 2020 to January 2021 from 2,266 college students at 16 institutions in southwestern and eastern coastal China. Depression, anxiety, and childhood trauma were assessed using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Childhood Trauma Questionnaire-28, respectively. Separate symptom networks were constructed for participants with and without childhood trauma experiences. Central indices were employed to identify the central symptom within each network. The accuracy and stability of the networks were then evaluated. Finally, a network comparison test was used to analyze differences in network properties between the trauma and non-trauma groups.ResultsLoss of Energy and Worry too much were the central symptoms in the non-trauma group, while anhedonia and nervousness were the central symptoms in the trauma group. There was a significant difference in the global strength of the network between the trauma group and the non-trauma group (pFDR< 0.01), but no significant difference in the distribution of edge weights between the two networks (pFDR =0.14). Anhedonia, Suicide ideation and Feeling afraid in the trauma group showed increased network centrality compared with the non-trauma group.ConclusionsThis study demonstrates the profound impact of childhood trauma on the central symptoms of anxiety and depression in college students. Further research is warranted to investigate the specific pathways through which these symptoms develop, with the goal of developing targeted interventions for this vulnerable population.

Politics from the Liminal Space: The Market and the Populist Articulation of Chinese Nationalism in the 1990s and 2000s

The ideological shifts within the Chinese Communist Party (CCP) created a disconnect between the developmental policies of the Chinese state and the socialist system in the reform era. This issue was further intensified by the CCP’s decision to abandon its populist political strategies in favor of top-down reforms. This article explores how the China Institute of Strategy and Management, and its flagship journal, Strategy and Management , served as a liminal political space in the reform era, facilitating an intermingling of ideas and acting as an incubator of a new discourse on nationalism by a coalition of dissenting left-wing Chinese government officials, editors, journalists, and intellectuals critical of the top-down policies of the Chinese government. Supported by market forces, this and later similar collaborations led to the blockbuster publications China Can Say No (1996) and Unhappy China (2009).

Pedagogical practices in history education: a comparative study of China and Malaysia's higher learning institutions

This comparative study examines the pedagogical practices in history education within higher learning institutions in China and Malaysia, focusing on how cultural, curricular, and institutional differences shape the teaching and learning of history. In China, traditional methods of rote memorization are gradually being replaced by critical thinking and inquiry-based learning, reflecting broader educational reforms aimed at fostering more active and analytical student engagement. In contrast, Malaysia’s history education is strongly influenced by its multicultural context, with an emphasis on national identity and civic education, often integrating more diverse teaching methods that cater to its pluralistic society. The study effectively contrasts the pedagogical practices in two distinct cultural and educational contexts, offering rich insights into how history education reflects sociopolitical and cultural values.

A novel risk stratification system for primary small-cell carcinoma of the esophagus: indication for prognostication and staging.

A novel risk stratification system for primary small-cell carcinoma of the esophagus: indication for prognostication and staging.

Enhancing vocational students' identities through program-occupation-skill alignment and learning experiences: A mediation analysis based on learning experiences

Modern vocational education, as a primary institutional vehicle for building a skill-oriented society, faces widespread identity crises. Against this background, how to enhance vocational education students' professional identities and help them successfully transition between school and professional systems has become a focal point of concern. This study conducted a questionnaire survey across 15 vocational institutions in China. Based on 886 valid questionnaires, the influence and mechanism of vocational program-occupation-skill alignment on vocational education students' professional identities under the dual system curriculum framework were examined. The findings revealed the following. First, under the dual-system curriculum framework, the degree of vocational program-occupation-skill alignment significantly influenced vocational education students' professional identities, with higher alignment correlating to higher levels of professional identity. Second, vocational program-occupation-skill alignment affected professional identity through the mediating role of learning experience, whereby high alignment enhanced professional identity by promoting students' learning experiences. To enhance the endogenous momentum of vocational education development, efforts should focus on skill formation as the core lever and on supply-demand matching as the main objective, thereby achieving the effective integration of various components in the dual-system training model and improving vocational education students' learning experiences through capacity building and teaching enhancement.

A bi-ethnographic study of the use of ChatGPT in dance teaching in Chinese and Thai higher education

ABSTRACT In the context of the increasing integration of generative artificial intelligence (AI) tools, such as ChatGPT, into higher dance education, this study examines the interaction patterns between dance educators and ChatGPT in educational institutions in China and Thailand, and their impact on the teaching and learning processes. As four dance educators in higher education, we reflect on the potential applications of AI in dance education, based on our own teaching practices. Particularly its role in constructing virtual teaching spaces and facilitating post-human educational interactions. Utilizing a bi-ethnographic approach, we collected and analyzed qualitative data on the interactions between dance educators and ChatGPT through field investigations. Combining bi-ethnographic dialogues, we explored in depth the application scenarios and impacts of ChatGPT in higher education settings. The findings indicate that, despite ongoing debates about the use of generative AI in higher education, it offers positive support for teaching and learning, especially in terms of interactions between human and non-human elements. This research reveals the innovative applications of generative AI in dance education; emphasizes the importance of exploring human-machine interactions in higher education; and provides new theoretical perspectives and practical pathways for the digital transformation of dance education.

Sultanate Oman: a New Stage in the Development of Bilateral Trade with China

The article analyzes the dynamics and structure of bilateral trade between China and the countries of the League of Arab States (LAS), primarily with the Sultanate of Oman. It has been established that there is an increase in the trade turnover between China and its partner, while the balance is often not in favor of China due to the almost exclusive import of Arab hydrocarbons from China and exports of traditional products of machinery and light industry. At this stage, China has become the largest foreign trade partner of the Arab countries, displacing Western states in this area. The relevance, as well as the scientific and practical significance of the study, is due to the need, firstly, for a deeper analysis of the bilateral trade between the People's Republic of China and the Sultanate of Oman and the partial use of this experience in the Russian economy, and, secondly, to study the specifics of the development of the national economy and trade of the Sultanate of Oman, which is an urgent need from the perspective of, increasing its share in the extractive, industrial and financial sectors. The study was conducted on the basis of statistical and analytical materials and expert assessments of international institutions (UNCTAD, UN, OECD, WTO, IMF, World Bank) and organizations (OPEC, Arab Monetary Fund, Arab League, SAM, GCC, Arab Fund for Economic and Social Development), research institutes of China, the results of the author's own research. In conclusion, the author comes to the conclusion that it is important for Arab countries to form a long-term paradigm for the development of trade and economic relations with both China and other countries, and a conceptual model for its state regulation, taking into account not only current, but also the long-term interests of their own stable socio-economic development. In our opinion, the preferred option may be, for example, a unified (within the framework of the GCC) approach to solving these problems.

Machine Learning for Resilient and Sustainable Cities: A Bibliometric Analysis of Smart Urban Technologies

With the acceleration of urbanization, the construction of smart cities has become a global focal point, with machine learning technology playing a crucial role in this process. This study aims to conduct a bibliometric analysis of the published research in the fields of smart cities and machine learning, using visualization techniques to reveal the spatiotemporal distribution patterns, research hotspots, and collaborative network structures. The goal is to provide systematic references for academic research and technological innovation in related fields. The results indicate that the development of this field exhibits distinct phases and regional characteristics. From a temporal perspective, research has undergone three stages: initial development, rapid growth, and stable consolidation, with the period from 2017 to 2021 marking a critical phase of rapid expansion. In terms of spatial distribution, countries such as China and the United States are at the forefront of this field, whereas regions like Africa and South America have a relatively low research output due to constraints in research resources and technological infrastructure. A hotspot analysis revealed that research topics are increasingly diverse and dynamically evolving. Issues such as data privacy, cybersecurity, sustainable development, and intelligent transportation have gradually become focal points, reflecting the dual demand of smart city development for technological innovation and green growth. Furthermore, collaboration network analysis indicates that international academic cooperation is becoming increasingly close, with research institutions in China, the United States, and Europe playing a central role in the global collaboration system, thereby promoting technology sharing and interdisciplinary integration. Through a systematic bibliometric analysis, this study identifies key application directions and future development trends in the research on smart cities and machine learning, providing valuable insights for academic research and technological advancements in related fields.

Preoperative prediction of textbook outcome in intrahepatic cholangiocarcinoma by interpretable machine learning: A multicenter cohort study.

To investigate the preoperative factors influencing textbook outcomes (TO) in Intrahepatic cholangiocarcinoma (ICC) patients and evaluate the feasibility of an interpretable machine learning model for preoperative prediction of TO, we developed a machine learning model for preoperative prediction of TO and used the SHapley Additive exPlanations (SHAP) technique to illustrate the prediction process. To analyze the factors influencing textbook outcomes before surgery and to establish interpretable machine learning models for preoperative prediction. A total of 376 patients diagnosed with ICC were retrospectively collected from four major medical institutions in China, covering the period from 2011 to 2017. Logistic regression analysis was conducted to identify preoperative variables associated with achieving TO. Based on these variables, an EXtreme Gradient Boosting (XGBoost) machine learning prediction model was constructed using the XGBoost package. The SHAP (package: Shapviz) algorithm was employed to visualize each variable's contribution to the model's predictions. Kaplan-Meier survival analysis was performed to compare the prognostic differences between the TO-achieving and non-TO-achieving groups. Among 376 patients, 287 were included in the training group and 89 in the validation group. Logistic regression identified the following preoperative variables influencing TO: Child-Pugh classification, Eastern Cooperative Oncology Group (ECOG) score, hepatitis B, and tumor size. The XGBoost prediction model demonstrated high accuracy in internal validation (AUC = 0.8825) and external validation (AUC = 0.8346). Survival analysis revealed that the disease-free survival rates for patients achieving TO at 1, 2, and 3 years were 64.2%, 56.8%, and 43.4%, respectively. Child-Pugh classification, ECOG score, hepatitis B, and tumor size are preoperative predictors of TO. In both the training group and the validation group, the machine learning model had certain effectiveness in predicting TO before surgery. The SHAP algorithm provided intuitive visualization of the machine learning prediction process, enhancing its interpretability.

Allogeneic hematopoietic stem cell transplantation for mucopolysaccharidosis patients: a single-center experience and assessment of quality of life

BackgroundAllogeneic hematopoietic stem cell transplantation (HSCT) has proven to be a viable treatment option for patients with mucopolysaccharidoses (MPS). We investigate the efficacy and improvements in the quality of life of HSCT in pediatric patients with MPS.MethodsA retrospective analysis of transplantation data from 46 cases of MPS from a single institution in China was conducted.ResultsThe cohort of 46 patients included 9 cases of MPS I, 16 cases of MPS II, 15 cases of MPS IVA and 6 cases of MPS VI. The median age at diagnosis was 2.59 years. The median age at transplantation was 3.80 years. The median follow-up time was 3.1 years (range, 0.8–8.1 years) and 43 patients were alive. The incidence of grades II to IV aGVHD was 17.4%, wherein the incidence of grades III and IV aGVHD was 4.3%. The incidence of moderate-to-severe cGVHD was 6.5%. GAGs urinary excretion decreased and enzyme activity levels reached normal. After HSCT, multiple bone dysplasia, upper-airway obstruction and recurrent otitis media were significantly improved; vision, corneal clouding, cardiovascular disease, hepatosplenomegaly and hydrocephalus were improved or remained stable; neurological symptoms were improved or remained stable in most patients but progressed in others; the patients with MPS IH/S and MPS II reached nearly normal growth rate of height and weight. Meanwhile, the patients with MPS IH, MPS IVA and MPS VI remained poor growth after HSCT. The Activities of Daily Living (ADL) scores were improved in most patients with MPS. ADL scores in patients with severe phenotypes were lower than health control subjects and patients with attenuated phenotypes.ConclusionsHSCT is a good therapeutic option for MPS and improves the quality of life of patients. MPS patients with attenuated phenotypes provide a better outcome in ADL after HSCT.

Exploring the new model of medical innovation and entrepreneurship talent training based on biodesign in eastern China

With the trend of economic globalization, innovation and entrepreneurship have become critical strategies for national development. College students, particularly, are a primary focus for cultivating awareness of innovation and entrepreneurship, which is essential for implementing national development strategies. The institution in eastern China has developed a program aimed at fostering medical innovation and entrepreneurship through the Biodesign framework. This study aimed to evaluate the effectiveness of this training system by surveying 479 medical students using a questionnaire designed around three stages: “identify,” “invent,” and “implement”. Factor analysis, descriptive statistical analysis, and T-tests were employed to assess the effectiveness and development pathways of the Biodesign-based cultivation of medical innovation and entrepreneurship talents. The results indicate significant improvements in students’ abilities in demand identification, demand screening, concept generation, concept selection, strategic identification, and business planning (p < 0.001), with the most notable improvement in demand identification (t = 6.383). Additionally, students have achieved notable success in writing and publishing papers and patents, as well as securing provincial and national-level awards. Particularly remarkable were the achievements in student competitions, with the number of national-level awards rising from 32 in 2019 to 66 in 2023. In conclusion, the Biodesign-based cultivation model for medical innovation and entrepreneurship has proven effective and merits further promotion among medical students.

Adaptation and Integration of Pakistani Students of Higher Education Institutions in China

This study examines Pakistani international students' adaptation and integration experiences in Chinese higher education, focusing on intellectual, social, and cultural dimensions. Using a mixed-methods approach, data was collected from 58 students via surveys and interviews. SPSS analysis highlights key challenges, including language barriers and cultural differences, which negatively affect academic performance and social interactions, often leading to isolation and stress. However, students employing proactive coping strategies, such as peer support and cultural exchange participation, experience better adaptation. Institutional support, particularly language assistance and counseling, is crucial in easing transitions and fostering a sense of belonging. The study recommends expanding language training, enhancing cultural exchange programs, and offering targeted academic support to improve international student integration. These initiatives aim to enhance student experiences and strengthen institutional support systems in Chinese universities.

Perceptions Toward Artificial Intelligence (AI) Among Animal Science Students in Chinese Agricultural Institutions—From Perspectives of Curriculum Learning, Career Planning, Social Responsibility, and Creativity

As artificial intelligence (AI) technology continues to advance and iterate, various industries have undergone intelligent reformation. China’s animal husbandry industry, given its importance for people’s livelihoods, is no exception to this transformation. Using AI technology in this field is becoming increasingly common since it not only improves production efficiency but also revolutionizes traditional business models. Animal science is a fundamental discipline that drives the progress of animal husbandry by studying the growth, breeding, nutritional needs, and feeding management of livestock and poultry. This discipline also explores advanced veterinary theories and technologies for epidemic prevention and control. The ultimate objective of this discipline is to ensure the production of high-quality and sufficient animal products to fulfill the demands of both production and daily life. It is predicted that the deep integration of AI technology into animal science will bring unprecedented opportunities to the animal husbandry industry. This study aims to explore the impact of artificial intelligence (AI) on students’ learning experiences and future educational directions. By situating the research within the context of current developments in educational technology, we hope to provide valuable insights for educators and policymakers and employ a questionnaire survey to explore the perceptions and attitudes of students majoring in animal science from various agricultural institutions in China toward this integration. The results of the study provide valuable and practical references for the cultivation and development of artificial intelligence talent in China’s livestock industry.

What has caused China’s socioeconomic rise? evidence for the neglected role of a new shared property rights model

Here, I review how China has learned from experience elsewhere in the world, developed an innovative new form of ownership, and followed a win–win path that reduces the resistance to change. In contrast with private and public property models, a new ownership model allows land users and knowledge workers to benefit from the success of their activities without owning the land or enterprise; they retain these benefits until they no longer use the land or work for the enterprise, after which those benefits are awarded to future employees. Unlike the violent revolution advocated by Marx, China's new socioeconomic institutions arise like new branches from old trees (older institutions) in the spring. The effective combination of new and old systems reduces resistance to the new systems and maintains social stability. This innovation preserves the government's role in central planning while encouraging parallel development of a market economy and an innovative new system of shared property rights. Unlike emerging industrialized countries, which mainly rely on a market economy, China's institutional transformation retains a mixture of public property rights, private property rights, and shared property rights. Allowing enterprises to choose suitable institutional forms has let China maintain both social stability and economic growth.

Dynamic monitoring and optimization of teaching quality based on biomechanical models: A case study of private universities, with Shanghai Lida University as an example

The quality of teaching in private higher education institutions has become a significant concern in recent years. Traditional evaluation methods, such as student surveys and academic performance, are often insufficient in capturing the full complexity of teaching effectiveness, particularly in terms of teacher-student interaction. This study proposes a novel approach for assessing and optimizing teaching quality at Shanghai Lida University, a private institution in China, by integrating biomechanical models to analyze non-verbal communication between teachers and students. A mixed-methods approach was adopted, combining survey data from 150 students and 20 teachers with biomechanical modeling techniques to evaluate the impact of teacher behaviors—such as gestures, eye contact, posture, and body movements—on student engagement. The findings reveal that teacher non-verbal communication, especially consistent eye contact and frequent use of hand gestures, significantly enhances student attentiveness and participation. Additionally, classroom environmental factors, such as lighting and temperature. They are found to influence student engagement levels. A multiple linear regression model identified teacher non-verbal behaviors and student engagement as the strongest predictors of teaching effectiveness. The study highlights the potential of biomechanical models to offer real-time insights into teacher-student interactions and presents actionable strategies for improving teaching practices. This research offers valuable contributions to the understanding and optimization of teaching quality in private universities.