Outcomes In China Research Articles

Atherogenic index of plasma for non-diabetic, coronary artery disease patients after percutaneous coronary intervention: a prospective study of the long-term outcomes in China

BackgroundNon-diabetic coronary artery disease (CAD) patients are thought to encounter metabolic dysfunction and while these changes may be imperceptible to the patient they probably influence outcomes. At present, there is no system to support patients sensing these subtle changes, nor is there an established model for prognoses. The Atherogenic Index of Plasma (AIP) index has already proven useful for atherosclerosis although further research is needed, especially for those without hyperglycemia.MethodsThis is a prospective study of 5538 non-diabetic CAD patients who had received percutaneous coronary intervention (PCI). Participants were assigned to one of three groups according to their AIP index. High AIP index cases were then compared to low index patients according to major adverse cardiac events (MACE). Restricted cubic spline (RCS) analysis was also conducted to investigate interrelations between AIP index levels and hazard ratios (HR) for MACEs.ResultsPatients with a high AIP index encountered metabolic dysfunction compared to those with a low AIP index i.e., higher Body Mass Index (BMI), Total Cholesterol (TC), Triglycerides (TG), and uric acid as well as lower HDL-C. Each of the aforementioned interrelations were significant with p values of less than 0.001. There was also a significant increase in the number of MACEs in the high AIP index group compared to the low AIP index group (HR: 1.37, 95% CI 1.04–1.81; p = 0.025). A J-shaped RCS curve highlighted a change in the HR after the 0.18 juncture (HR per SD: 1.20, 95% CI 0.96–1.50). Further subgroup analysis supported the main findings, all with HRs greater than one.ConclusionThe AIP index could be used in prognostics for non-diabetic CAD patients 2 years after PCI. The relationship between hazard ratio and the AIP index appears to be J-shaped. Although, further multi-center studies designed for non-diabetic patients with potential metabolic dysfunction should be conducted to determine the value of the AIP index.

Prepregnancy body mass index and gestational weight gain are associated with maternal and infant adverse outcomes in Chinese women with gestational diabetes

The gestational weight gain (GWG) range of Chinese women with gestational diabetes mellitus (GDM) remains unclear. Our objective was to identify the ranges of GWG in Chinese women with GDM and to investigate the associations between prepregnancy body mass index (BMI), GWG and maternal-infant adverse outcomes. Cases of GDM women who delivered singletons from 2013 to 2018 in a public hospital were collected. Logistic regression analysis was used to assess the joint effects of prepregnancy BMI and GWG on maternal-infant adverse outcomes. Ultimately, 14,578 women were collected. The ranges of GWG in Chinese women with GDM were different from the National Academy of Medicine’s (NAM) recommendation. The ranges of GWG of Chinese women with GDM in the underweight, normal weight, overweight and obese groups were 5.95–21.95 kg, 4.23–21.83 kg, 0.88–21.12 kg and − 1.76 to 19.95 kg, respectively. The risks of large for gestational age (LGA), macrosomia and caesarean delivery were significantly increased with the increasing prepregnancy BMI. Furthermore, the risks of LGA, macrosomia and caesarean delivery were significantly higher in the normal weight group with a GWG higher than the NAM recommendation. Similarly, in the overweight group with a GWG higher than the NAM recommendation, the risks of LGA were significantly higher, while the risks of macrosomia were significantly lower. Overall, we determined the range of GWG in different prepregnancy BMI groups. And GDM women with high prepregnancy BMI and excessive GWG were associated with the higher risks of maternal-infants adverse outcomes in China.

Flourish of Proton and Carbon Ion Radiotherapy in China.

Proton and heavy ion therapy offer superior relative biological effectiveness (RBE) in the treatment of deep-seated tumors compared with conventional photon radiotherapy due to its Bragg-peak feature of energy deposition in organs. Many proton and carbon ion therapy centers are active all over the world. At present, five particle radiotherapy institutes have been built and are receiving patient in China, mainly including Wanjie Proton Therapy Center (WPTC), Shanghai Proton Heavy Ion Center (SPHIC), Heavy Ion Cancer Treatment Center (HIMM), Chang Gung Memorial Hospital (CGMH), and Ruijin Hospital affiliated with Jiao Tong University. Many cancer patients have benefited from ion therapy, showing unique advantages over surgery and chemotherapy. By the end of 2020, nearly 8,000 patients had been treated with proton, carbon ion or carbon ion combined with proton therapy. So far, there is no systemic review for proton and carbon ion therapy facility and clinical outcome in China. We reviewed the development of proton and heavy ion therapy, as well as providing the representative clinical data and future directions for particle therapy in China. It has important guiding significance for the design and construction of new particle therapy center and patients’ choice of treatment equipment.

Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019

BackgroundHospital and ICU structural factors are key factors affecting the quality of care as well as ICU patient outcomes. However, the data from China are scarce. This study was designed to investigate how differences in patient outcomes are associated with differences in hospital and ICU structure variables in China throughout 2019.MethodsThis was a multicenter observational study. Data from a total of 2820 hospitals were collected using the National Clinical Improvement System Data that reports ICU information in China. Data collection consisted of a) information on the hospital and ICU structural factors, including the hospital type, number of beds, staffing, among others, and b) ICU patient outcomes, including the mortality rate as well as the incidence of ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs). Generalized linear mixed models were used to analyse the association between hospital and ICU structural factors and patient outcomes.ResultsThe median ICU patient mortality was 8.02% (3.78%, 14.35%), and the incidences of VAP, CRBSI, and CAUTI were 5.58 (1.55, 11.67) per 1000 ventilator days, 0.63 (0, 2.01) per 1000 catheter days, and 1.42 (0.37, 3.40) per 1000 catheter days, respectively. Mortality was significantly lower in public hospitals (β = − 0.018 (− 0.031, − 0.005), p = 0.006), hospitals with an ICU-to-hospital bed percentage of more than 2% (β = − 0.027 (− 0.034, -0.019), p < 0.001) and higher in hospitals with a bed-to-nurse ratio of more than 0.5:1 (β = 0.009 (0.001, 0.017), p = 0.027). The incidence of VAP was lower in public hospitals (β = − 0.036 (− 0.054, − 0.018), p < 0.001). The incidence of CRBSIs was lower in public hospitals (β = − 0.008 (− 0.014, − 0.002), p = 0.011) and higher in secondary hospitals (β = 0.005 (0.001, 0.009), p = 0.010), while the incidence of CAUTIs was higher in secondary hospitals (β = 0.010 (0.002, 0.018), p = 0.015).ConclusionThis study highlights the association between specific ICU structural factors and patient outcomes. Modifying structural factors is a potential opportunity that could improve patient outcomes in ICUs.

Venture capital staging under economic policy uncertainty

Drawing upon a duration analysis framework, this study investigates how economic policy uncertainty (EPU) affects investment staging decisions and exit outcomes in China's venture capital (VC) market. Analyses from a sample of 61,661 venture capital investment decisions support the prediction of the real options theory that VCs delay to refinance their portfolio companies under high EPU. However, such delay effect is largely weakened in severe-VC-competition and high-technology industries, and in better economic conditions. In addition, governmental VCs with greater exposure to economic policy uncertainty are more sensitive to EPU. We further provide evidence that the investments made in times of high EPU have a lower likelihood of successful exit.

Maternal educational inequalities about adverse pregnancy outcomes observed in a rural area of a province of China during a time period (2010–2018)

BackgroundThe relationship between maternal education and adverse pregnancy outcomes is well documented. However, limited research has investigated maternal educational disparities in adverse pregnancy outcomes in China. This study examined maternal...

Perceived Discrimination at School and Developmental Outcomes among Bai Adolescents: The Mediating Roles of Self-Esteem and Ethnic Identity.

Although discrimination is widely acknowledged to impair developmental outcomes among ethnic minority adolescents, literature differentiating discrimination based on personal characteristics and group membership is lacking, especially in Chinese contexts, and the mechanisms of those relationships remain unclear. In response, the study presented here examined whether self-esteem mediates the relationship between perceived academic discrimination and developmental outcomes among such ethnic minority adolescents, and whether ethnic identity mediates the relationship between perceived ethnic discrimination and developmental outcomes. Multistage cluster random sampling performed in Dali and Kunming, China, yielded a sample of 813 Bai adolescents whose data was analysed in structural equation modelling. The results indicate that perceived academic discrimination had a direct negative effect on adolescents’ mental health, while perceived ethnic discrimination had direct negative effects on their behavioural adjustment and social competence. Perceived academic discrimination also indirectly affected adolescents’ behavioural adjustment, mental health, and social competence via self-esteem, whereas perceived ethnic discrimination indirectly affected their behavioural adjustment and social competence via ethnic identity. These findings deepen current understandings of how perceived discrimination, self-esteem, and ethnic identity affect the developmental outcomes of ethnic minority adolescents and provide practical recommendations for policymakers and social workers to promote those outcomes in China.

Migrant Parental Decisions on Taking Children and Children's Educational Outcome in China

Migrant Parental Decisions on Taking Children and Children's Educational Outcome in China

Cost of Zero-Covid: Effects of Anti-Contagious Policy on Labor Market Outcomes in China

Cost of Zero-Covid: Effects of Anti-Contagious Policy on Labor Market Outcomes in China

The construction of the outcome-evaluating indicators of the transformation of China’s foreign trade development mode and its empirical analysis

Based on the transformation connotation of foreign trade development mode, this paper obtains the outcome-evaluating indicators of the transformation of foreign trade development mode according to trade identities. Next, it employs the method of Sharply Value in cooperative game to calculate the contribution degree of each indicator to the trade development, and evaluates the transformation outcomes of China’s foreign trade development mode from two perspectives, resource-utilizing ways and market development ways. It shows that the transformation of China’s foreign trade development mode has achieved a certain outcome, though there still exist some imperfections in the transformation. Hence the government should lay the focus of future policies related to the transformation of China’s foreign trade development mode on the improvement of the coordination between export sector and non-export sector of national economy and the elevation of innovation capabilities of enterprises.

The association between teacher‐student relationship and academic achievement: The moderating effect of parental involvement

AbstractAs an important part of adolescents' social capital, teacher‐student relationship (TSR) and parental involvement (PI) are important for student learning. However, we know little about how PI works with TSR in relation to adolescents' learning outcomes. The present study aimed to examine the association between TSR and adolescents' learning outcomes in China, as well as testing the potential moderating role of PI. Participants were 332 fourth graders and 321 eleventh graders from Shandong province, China. Student‐perceived TSR and home‐based PI, and curriculum‐based measures of academic achievement were collected in October 2019. The major findings of the study included: (1) TSR and students' academic performance positively correlate with each other; (2) PI moderates the relationship between TSR and students' academic performance; (3) High PI in primary school reduces the impacts of lower TSR on student performance; (4) High PI in secondary school has no compensating effect on low TSR, but it still reduces the influence of TSR on academic performance. The present research verifies and extends the association between TSR and academic achievement to parental factors, and holds substantive theoretical and practical implications for teacher education and family education research.

China and the Antarctic: Presence, policy, perception, and public diplomacy

China has made significant investments in Antarctica and has become an active participant in Antarctic governance. Its activities in Antarctica in particular appear to be designed to ensure that China will not be left out should there be beneficial opportunities in Antarctica in the future. In some Western narratives, China has become a so-called ‘challenger’ due to their perception of China being ‘aggressive’ in the polar regions. However, this point has its own counter argument based on the common practice of states to actively join international institutions and subsequently update their domestic law-making process. China appears to have taken a two-fold approach in Antarctic governance—being generally both supportive of the Antarctic Treaty System (ATS) and also keen to make its own mark in shaping future development of the ATS in a manner that promotes China’s interests. The outcomes of China’s polar investments may well bring as much benefit to itself as to many other interested players. It is important that China continues to support current norms that promote cooperation and limit competition or challenge them.

Green Space and Health in Mainland China: A Systematic Review.

Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China’s rapid urbanization and economic growth.

The Danwei System: Living with Production

AbstractRespectively a professor and research fellow at the Politecnico di Torino, Michele Bonino and Maria Paola Repellino explore the rejuvenation, social aspirations, architectural techniques and outcomes of China's danwei system of industrial units. This is resulting in a revitalisation of these districts, bringing cultural, employment and amenity diversity as well as blurring older boundaries between richer areas and less privileged ones.

Current situation and expectation of emergency medicine education for 8-year Doctor of Medicine degree program in China

Background: Appropriate lessons and formalized training concerning emergency medicine is becoming increasingly important in undergraduate medical education. There is an urgent need to evaluate undergraduate emergency medicine education of students enrolled on the 8-year Doctor of Medicine degree programs nationwide in China with the aim that the data extracted could ultimately be used to help develop a standardized emergency medicine curriculum in China. Objectives: The aim of the study is to accurately describe emergency medicine education of 8-year Doctor of Medicine program in China, including emergency medicine classes, clinical practice in emergency medicine department, and expectations toward emergency medicine education. Methods: An online questionnaire was distributed to all the medical students of 8-year Doctor of Medicine program who have attended emergency medicine education in 14 medical schools in China. Participation in the survey was voluntary and anonymized. Results: In total, 529 valid responses were collected. There was a clear difference between students with a career aspiration in emergency medicine and those without. Comparing to countries that have an established emergency medicine curriculum, shortage of classroom hours and clinical practice time is a major cause of unsatisfactory educational outcomes in China. A detailed uniform emergency medicine curriculum that outlines exact requirements for medical students is required as well. Conclusion: A consolidated syllabus and curriculum should be compiled by all the medical schools with the 8-year integrated Doctor of Medicine degree program in China. The specific diseases and skills that should be covered in emergency medical education remain up to debate.

The Effect of the No Pain Labor and Delivery–Global Health Initiative on Cesarean Delivery and Neonatal Outcomes in China: An Interrupted Time-series Analysis

(Anesth Analg. 2021;132:698–706) The proportion of births by cesarean delivery (CD) has been increasing in China, to an average of 34.6% in 2014, ranging from 4% to 62.5% across provinces. CD is associated with maternal and neonatal risks, and the Chinese government has begun initiatives to lower the rate of CD. The No Pain Labor and Delivery–Global Health Initiative (NPLD-GHI) conducts week-long training programs using an interdisciplinary team to teach advances of obstetrics, neonatology, and anesthesiology, aiming to help lower the rate of CD and improve outcomes. This study examined the effects of the NPLD-GHI program in a large hospital in a rural province, primarily focusing on the rate of CD.

Case-fatality, disability and recurrence rates after first-ever stroke: A study from bigdata observatory platform for stroke of China

BackgroundThere is currently a lack of data on stroke hospitalizations and long-term outcomes in China. Therefore, we investigated 12-month stroke fatality, disability, and recurrence rates after the first-ever stroke. MethodsThis was a prospective nationwide hospital-based cohort study. From August to September 2019, all patients with first-ever stroke (ischemic stroke [IS], intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) and with symptom onset within 14 days from 232 hospitals were included. Case fatality, disability, and recurrence rates for one year were estimated. ResultsIn total, 36250 first-ever stroke patients from 194 hospitals were recruited (median age was 65(IQR, 56-73) years and 61.4 % were male). The rate of intravenous thrombolysis and endovascular treatment for IS were 9.5 % and 4.4 %, respectively. In-hospital death rate was 1.9 % (95 %CI: 1.7 %–2.0 %) for stroke inpatients, ranging from 0.9 % (0.8 %–1.1 %) for IS to 5.1 % (4.6 %–5.6 %) for ICH. The 12-month fatality rate was 8.6 % (95 %CI: 8.3 %–8.9 %) for discharged stroke patients, ranging from 6.0 % (5.7 %–6.3 %) for IS to 17.7 % (16.7 %–18.7 %) for ICH. The 12-month disability rate was 16.6 % (95 %CI: 16.2 %–17.0 %) for stroke survivors, ranging from 11.1 % (9.3 %–12.8 %) for SAH to 29.2 % (27.9 %–30.4 %) for ICH. The stroke recurrence rate was 5.7 % (5.5 %–6.0 %) for stroke survivors, ranging from 2.5 % (1.7 %–3.3 %) for SAH to 6.4 % (6.0 %–6.7 %) for IS. ConclusionOur results support the hypothesis that the prognosis of Chinese stroke patients appears to have improved and is not very bad.

The peer effects of preschool: evidence from China’s middle school

ABSTRACT The paper investigates the impact of peer enrolment in preschool on students’ cognitive and noncognitive outcomes in China’s middle schools and explores the potential mechanisms through which the peer effects may operate. Using the exogenous variation in peer preschool enrolment across classes within schools, the study finds that a higher proportion of classmates who have preschool experience consistently has positive impacts on students’ academic achievement. I also find that peer preschool enrolment has spillover effects on students’ noncognitive outcomes. The mechanism analysis reveals that the peer effects may work through inter-student relationships, class and school atmosphere, and behaviours of students’ friends.

Women’s autonomy and its impact on environmental sustainability agenda

Women’s autonomy remains under pressure from male dominancy in corporate business and household affairs. Women possess natural, analytical, social, political, and economic autonomy that acknowledges the United Nations’ sustainable development goals (SDG-5) to empower women and girls in inclusive business. The study analyzes different aspects of women’s autonomy in corporate business and the natural environment, leading to sustainable business outcomes in China between 1975 and 2019. In practice, Chinese women’s political power in the decision-making process is minimal. It needs to restructure its socio-political autonomy to move toward the SDG-5 agenda. The results show that women have the political wisdom to handle corporate sustainability affairs, manage matters of corporate environmental responsibility, and increase their participation in the workforce, enabling them to sustain their lives as knowledge workers. Corporate women hold more stewardship values than men, enabling them to handle corporate sustainability matters.

Strongmen politics and investment flows: China’s investments in Malaysia and the Philippines

We examine Chinese President Xi Jinping’s close relations with Malaysian Prime Minister Najib Razak (2009-2018) and Philippine President Rodrigo Duterte (2016-), an outcome of China’s Belt & Road Initiative (BRI). We argue strongmen use their political power, shaped by their own political-economic systems, to tap into the BRI’s available capital to fuel their political agendas. We illustrate this argument in Malaysia, a country with a centralized party system, and in the Philippines, one with an oligarchy-driven economy with decentralized political parties. In Malaysia, Najib was able to directly use BRI to generate economic rents, reward business allies, and dispense patronage through company directorships and subcontracts to party members to strengthen his political position. In contrast, the Philippines’ inherently coalitional system highlights the messiness as well as compromises in states with decentralized political competition. While Duterte is perceived to be an all-powerful autocrat, in reality he needs the support of major political elites, oligarchs, and local politicians for most major decisions. Duterte still used BRI to reward his cronies, weaken the opposition, and tame the oligarchs.