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This research aims to clarify consumer purchase intentions (PIs) for organic food (OF) in China by investigating factors, including consumers' food safety consciousness (FSC), health consciousness (HC), and attitude (AT) toward OF. To collect data for this study, online surveys were carried out sequentially among 350 respondents, and partial least squares structural equation modeling (PLS-SEM) was employed to test the proposed hypotheses regarding the direct and indirect effect of FSC on PI and the sequential mediating effect of HC and AT. The findings indicate that consumers' FSC strongly influences their intention to purchase OF and is sequentially mediated by HC and AT. PI is also significantly impacted by HC and is mediated by AT, and AT directly significantly influences PI. Through multiple group analyses, the path from HC to AT is found to be moderated by education. Accordingly, suggestions for OF businesses and future research are provided to improve public health. [ABSTRACT FROM AUTHOR]

BACKGROUND Recurrent bleeding from the small intestine accounts for 5 to 10% of cases of gastrointestinal bleeding and remains a therapeutic challenge. Thalidomide has been evaluated for the treatment of recurrent bleeding due to small-intestinal angiodysplasia (SIA), but confirmatory trials are lacking. METHODS We conducted a multicenter, double-blind, randomized, placebo-controlled trial to investigate the efficacy and safety of thalidomide for the treatment of recurrent bleeding due to SIA. Eligible patients with recurrent bleeding (at least four episodes of bleeding during the previous year) due to SIA were randomly assigned to receive thalidomide at an oral daily dose of 100 mg or 50 mg or placebo for 4 months. Patients were followed for at least 1 year after the end of the 4-month treatment period. The primary end point was effective response, which was defined as a reduction of at least 50% in the number of bleeding episodes that occurred during the year after the end of thalidomide treatment as compared with the number that occurred during the year before treatment. Key secondary end points were cessation of bleeding without rebleeding, blood transfusion, hospitalization because of bleeding, duration of bleeding, and hemoglobin levels. RESULTS Overall, 150 patients underwent randomization: 51 to the 100-mg thalidomide group, 49 to the 50-mg thalidomide group, and 50 to the placebo group. The percentages of patients with an effective response in the 100-mg thalidomide group, 50-mg thalidomide group, and placebo group were 68.6%, 51.0%, and 16.0%, respectively (PcO.001 for simultaneous comparison across the three groups). The results of the analyses of the secondary end points supported those of the primary end point. Adverse events were more common in the thalidomide groups than in the placebo group overall; specific events included constipation, somnolence, limb numbness, peripheral edema, dizziness, and elevated liver-enzyme levels. CONCLUSIONS In this placebo-controlled trial, treatment with thalidomide resulted in a reduction in bleeding in patients with recurrent bleeding due to SIA. (Funded by the National Natural Science Foundation of China and the Shanghai Municipal Education Commission, Gaofeng Clinical Medicine; ClinicalTrials.gov number, NCT02707484). [ABSTRACT FROM AUTHOR]

Chronic non-specific low back pain (CNLBP) is one of the leading causes of disability worldwide. Acupoint embedding (ACE) is widely used in China for the treatment of chronic non-specific low back pain, but there are no rigorous randomized controlled trials (RCTs) to confirm the effectiveness and safety of ACE for chronic non-specific low back pain. In this study, we design a single-center, single-blind, prospective RCT, with the aim of evaluating the efficacy and safety of ACE for CNLBP. 82 participants with CNLBP will be randomized in a 1:1 ratio into an ACE group and a sham ACE group. Participants will receive either ACE treatment or sham ACE treatment at once every 2 weeks, for an 8-week period, and followed by 6 months of follow-up. The primary outcome will be the change in visual analog scale (VAS) scores before and after treatment. Secondary outcomes will include the Oswestry Disability Index (ODI), the Roland Morris Disability Questionnaire (RMDQ) and the Short Form 36-Health Survey (SF-36). Adverse events that occur during the course of the trial will be recorded. Data will be analyzed according to a predefined statistical analysis plan. This study was approved by the medical ethics committee of Guangzhou Panyu Hospital of Chinese Medicine (202230). Written informed consent from patients is required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR2200059245). Trial results will be published in a peer-reviewed academic journal. [ABSTRACT FROM AUTHOR]

China's perspective of the Indo-Pacific as a set of strategies initially developed by Japan but mainly driven by the United States (US), appears to be shifting. Beijing originally viewed such approaches as directly countering its influence in the mega-region of the same name. Yet, more recently China has made pronouncements that seem to suggest its relative support of particular state and regional organisation's Indo-Pacific strategies. This article explores this changing perspective and the dilemmas facing China as a rising global power in a liberal international order through the lens of strategic narratives. On the one hand China understands that it needs to engage the global system and cannot isolate from it, and at the same time, Beijing seeks to challenge the US-led liberal international order to achieve its ambitions. This dual approach is explained through China's use of alternative diplomacy and is further explored through two examples. The first is China's engagement in the Western Indo-Pacific and specifically Africa (an emphasis of this journal volume), where it remains a strategic partner in the political and tangible economic sense. Secondly, at the conceptual level, the Indo-Pacific is not yet an institutionalised concept and its contours and future are left open to interpretation. Since allegiances and interests are shifting, China has the opportunity to contribute to the very ideas and norms that inform what the 'Indo-Pacific' means in ways that can further its own strategic interests. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish an effective prognostic nomogram with or without plasma Epstein-Barr virus DNA (EBV DNA) for nondisseminated nasopharyngeal carcinoma (NPC).Methods: The nomogram was based on a retrospective study of 4630 patients who underwent radiotherapy with or without chemotherapy at Sun Yat-sen University Cancer Center from 2007 to 2009. The predictive accuracy and discriminative ability of the nomogram were determined by a concordance index (C-index) and calibration curve and were compared with EBV DNA and the current staging system. The results were validated using bootstrap resampling and a prospective cohort study on 1819 patients consecutively enrolled from 2011 to 2012 at the same institution. All statistical tests were two-sided.Results: Independent factors derived from multivariable analysis of the primary cohort to predict recurrence were age, sex, body mass index (BMI), T stage, N stage, plasma EBV DNA, pretreatment high sensitivity C-reactive protein (hs-CRP), lactate dehydrogenase (LDH), and hemoglobin level (HGB), which were all assembled into the nomogram with (nomogram B) or without EBV DNA (nomogram A). The calibration curve for the probability of recurrence showed that the nomogram-based predictions were in good agreement with actual observations. The C-index of nomogram B for predicting recurrence was 0.728 (P < .001), which was statistically higher than the C-index values for nomogram A (0.690), EBV DNA (0.680), and the current staging system (0.609). The C-index of nomogram B (0.730) and nomogram A (0.681) remained higher for predicting recurrence among patients treated with intensity-modulated radiotherapy (P < .001). The results were confirmed in the validation cohort.Conclusions: The proposed nomogram with or without plasma EBV DNA resulted in more accurate prognostic prediction for NPC patients. [ABSTRACT FROM AUTHOR]

This scoping article introduces key issues surrounding the globalisation of China Central Television (CCTV), focusing on its African operations, content and reception, specifically in Kenya and South Africa. At a time when the Chinese government is seeking to enhance positive perceptions of China and China-Africa relations, and its associated media outlets are seeking to compete with other major global players like CNN and the BBC, this article takes steps towards understanding the extent to which CCTV may be succeeding in these missions. Some of the challenges identified for CCTV-Africa in our small-scale pilot study include attempting to simultaneously target 'African', 'Western' and Chinese audience groups, which may detract from its ability to appeal to specific international audiences; competition from other international and local broadcasters who already have a strong spectator base; and a lack of accessibility, awareness and sustained interest in the channel. It calls for more in-depth research into global audiences' reception of CCTV-Africa, and CCTV more generally, in order to track CCTV's brand awareness and assess whether China's global media soft power activities actually have any leverage in enhancing cross-cultural relations and international audiences' perceptions of China in Africa and the world. [ABSTRACT FROM AUTHOR]

In recent years, ghostwriting phenomenon has reached a dangerous level in China, partly due to the great ease of making ghostwriting transactions through the internet. However, there has been little literature trying to answer such questions as how many ghostwritten papers are published each year and how much monetary value is generated in the ghostwriting business. In order to answer these questions, we performed an empirical analysis to find the number and monetary value of ghostwritter papers in China. Our results show that there are nearly 1800 full-time equivalent ghostwriters in China who produced nearly 8000 ghostwritten papers in 2011, which is 0.1% of the total number of papers published in the same year in the country. Furthermore, there was a total monetary value of more than 4.46 million US dollars generated in the ghostwriting business in 2011. Our estimated results will provide firm data support for policy-making related to ghostwriting. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the use of high-resolution ultrasonography in analyzing the median nerve cross-sectional area (CSA) in healthy Han individuals from Guiyang, China. Quantitative analysis and ultrasound measurement are employed to assess CSA value. Results show that CSA values at the wrist crease, pisiform bone and hamate bone are greater in older people than the younger group while CSA values for the upper limbs can help in determining abnormal nerve conditions.

Empirical evidence has shown that domestic political competition has a great impact on triangular interaction among Washington, Beijing, and Taipei. How do policymakers play the domestic game and the international triangular game concurrently and expect to maximize their payoffs? This paper examines the relevant literature and proposes a refined sequential model to analyze the China policy of the United States since 1980. The hypothesis is that domestic political competition determines external policy during election periods. In between elections, triangular strategic calculation dominates. Specifically, the quadrennial presidential elections provide opportunities for challengers to attack the incumbent president's realist China policy, thus bringing pressure for a change of the existing policy. Whether such an attack takes place hinges on the combinations of the idealist and realist images of the PRC in the United States. Attack will occur only when the two images diverge and the president does not preempt the issue. Seven presidential elections since 1980 are examined to test this refined model. The findings will be integrated into a composite framework to analyze interaction among Washington, Beijing, and Taipei. [ABSTRACT FROM AUTHOR]

This paper applies the "strategic triangle" approach to the relations among Washington. Beijing, and Taipei in the post-Cold War period. The main argument is that the strategic triangle among the three has been gradually shifting from a "romantic triangle" with the United States playing the role of an "unwilling pivot," to a "marriage" between the United States and Taiwan--although whether that status can be sustained remains to be seen. The cause of this shift is mainly structural: an unwilling pivot tends to tilt toward the weaker of the two wings, particularly when the stronger wing is emerging as a threat. In making this argument, the paper draws a historical analogy with the Berlin-St. Petersburg-Vienna triangle between 1870 and 1914. In that triangle, the unwilling pivot, Germany, first adopted an impartial attitude toward Russia and dustria-Hungary. As the duel between St. Petersburg and Vienna intensified over the Balkans, however, Germany was forced to take sides and bind its fate with the Hapsburg Empire. A comparison of the two triangles--including their modes of entry., operation, and exit--reveals a strong tendency in the Washington-Beijing-Taipei triangle to evolve following the historical pattern of the pre-WWI Berlin-St. Petersburg-Henna triangle. Based on this comparison, we can conclude an unwilling pivot should find that the costs associated with pivot playing are likely too high, and entry into a partnership with one of the wings is deemed more favorable. It remains to be seen whether a formal marriage will come about between the United States and Taiwan, as it did between Germany and Austria-Hungary prior to WWI. [ABSTRACT FROM AUTHOR]

The article presents the response of Yu-Shan Wu, research fellow and director of the Institute of Political Science at Academia Sinica, professor of political science at National Taiwan University and convener of political science at the National Science Council, to a commentary of Professor Wing Thye Woo to his article "Chinese Economic Reform in a Comparative Perspective: Asia vs. Europe, that was published in the December 2002/March 2003 issue of "Issues & Studies." Wu believes that there is a need for the Convergence school to explain the policies derived from their position that resulted to a poor performance in Russia. Wu compares resultant economic reform in China and Russia, arguing that it succeeded in China and failed in Russia.

This article views China's economic reform in a comparative perspective. It sets out with the significant phenomenon of China's rise and Russia's fall in the 1990s. The literature is reviewed. Two main approaches are identified: the non-institutional and the institutional, with the latter holding sway. Culture, stage of economic development, international environment, and pre-reform system are the four non-institutional factors; all are found wanting in terms of explaining the performance difference between Asian and European transition economies. The institutional factors are reform philosophy, speed of reform, property rights restructuring, and role of the state--the last two of which constitute an effective analytical framework. It is argued that China's de facto privatization and active developmental state have proven more effective than Russia's de jure privatization and weak democracy in promoting growth and achieving stability. China and Russia are treated as representing two modes of exit from state socialism and two distinct development patterns. The duel between the two harks back to the competition between East Asia's capitalist developmental model and the West's neoclassic economics. China's better transition performance proves the effectiveness of the East Asian model. [ABSTRACT FROM AUTHOR]

Jiang Zemin's succession to Deng Xiaoping in the PRC can be investigated from three perspectives: change in leadership, a shift in orientation, and systemic transformation. This article argues that Deng's passing signifies more than a mere redistribution of power among the top leaders of the Chinese Communist Party (CCP). At the same time, a systemic transformation through tactical political reform is an unlikely scenario. Jiang's succession in essence ushers in a new era in the CCP's development. It formally ends the period of radical reform, and brings about the stage of bureaucratic stability. This orientation shift falls between leadership change and systemic transformation. The major factors militating for regime reorientation are evolutionary necessity, favorable economic conditions, and the Jiang regime's weaker leadership. Proof of these political changes abound in the post-1989 (especially post-1994) period. [ABSTRACT FROM AUTHOR]

The concept of the "strategic triangle" has been conventionally applied to the relationship among the United States, the Soviet Union, and the People's Republic of China (PRC). In actuality, there has also existed a mini-triangle among Washington, Taipei, and Beijing. The first part of this paper explores the various positions in a strategic triangle, ranks these roles in terms of desirability, differentiates between endogenous and exogenous factors, and identifies three sets of derivative relations based on exogenous factors. The paper then reviews the historical patterns of interactions within the great strategic triangle and the mini-triangle, as well as explores the impact of the former on the latter. The third part concentrates on the post-Tiananmen permutations of the dual triangles, evaluates the PRC's position after the dissolution of the Soviet Union, and explains U.S. behavior during the 1995-96 Taiwan Strait mini-crisis in view of the structure of the mini-triangle. [ABSTRACT FROM AUTHOR]

This paper starts with a literature review of cross-Strait relations studies. It then evolves into a proposal for an analogical model and a new research agenda. After pointing out the shortcomings of the dominant approaches in the field for not grasping the defining features of Taiwan-mainland relations (power asymmetry and sovereignty claims based on ethnic ties), it then argues that the cross-Strait relations are structurally similar to the relations between the Russian Federation and the "near abroad" countries. Taiwan, like Ukraine or the Baltics, can choose between balancing and bandwagoning under power asymmetry and sovereignty claims by a potential aggressor. Democratization and the resultant rise of Taiwanese nationalism have prompted the government to pursue balancing, while the increasing costs associated with such a strategy have given rise to political forces advocating reconciliation and bandwagoning. The learning curve derived from the Russian case is heuristic in pointing out the possible development of Taiwan's mainland policy. [ABSTRACT FROM AUTHOR]

Objective: To determine whether a single low dose of esketamine administered after childbirth reduces postpartum depression in mothers with prenatal depression., Design: Randomised, double blind, placebo controlled trial with two parallel arms., Setting: Five tertiary care hospitals in China, 19 June 2020 to 3 August 2022., Participants: 364 mothers aged ≥18 years who had at least mild prenatal depression as indicated by Edinburgh postnatal depression scale scores of ≥10 (range 0-30, with higher scores indicating worse depression) and who were admitted to hospital for delivery., Interventions: Participants were randomly assigned 1:1 to receive either 0.2 mg/kg esketamine or placebo infused intravenously over 40 minutes after childbirth once the umbilical cord had been clamped., Main Outcome Measures: The primary outcome was prevalence of a major depressive episode at 42 days post partum, diagnosed using the mini-international neuropsychiatric interview. Secondary outcomes included the Edinburgh postnatal depression scale score at seven and 42 days post partum and the 17 item Hamilton depression rating scale score at 42 days post partum (range 0-52, with higher scores indicating worse depression). Adverse events were monitored until 24 hours after childbirth., Results: A total of 364 mothers (mean age 31.8 (standard deviation 4.1) years) were enrolled and randomised. At 42 days post partum, a major depressive episode was observed in 6.7% (12/180) of participants in the esketamine group compared with 25.4% (46/181) in the placebo group (relative risk 0.26, 95% confidence interval (CI) 0.14 to 0.48; P<0.001). Edinburgh postnatal depression scale scores were lower in the esketamine group at seven days (median difference -3, 95% CI -4 to -2; P<0.001) and 42 days (-3, -4 to -2; P<0.001). Hamilton depression rating scale scores at 42 days post partum were also lower in the esketamine group (-4, -6 to -3; P<0.001). The overall incidence of neuropsychiatric adverse events was higher in the esketamine group (45.1% (82/182) v 22.0% (40/182); P<0.001); however, symptoms lasted less than a day and none required drug treatment., Conclusions: For mothers with prenatal depression, a single low dose of esketamine after childbirth decreases major depressive episodes at 42 days post partum by about three quarters. Neuropsychiatric symptoms were more frequent but transient and did not require drug intervention., Trial Registration: ClinicalTrials.gov NCT04414943., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: support from the National Natural Science Foundation of China, National High Level Hospital Clinical Research Funding, Peking University First Hospital, and Zhejiang University; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)