China's agricultural prospects and challenges

The report describes prospects and challenges for Chinese agriculture until 2030 under different scenarios, using the Chinagro welfare model. A scenario is defined as a coherent set of assumptions about exogenous driving forces (farm land, population, non-agricultural growth, world prices etc.), derived from the literature and own assessments. Under these assumptions, simulations with the Chinagro model analyze the price-based interaction between the supply behavior of farmers, the demand behavior of consumers and the determination of trade flows by merchants. The outcomes from the "Baseline scenario" seem reassuring in that foreign imports remain moderate relative to Chinas size, though quite large as fraction of world trade. It would be possible to feed people as well as animals without excessive imports. There is even a potential for significant export flows of vegetables and fruits. Regarding concerns, the trends in per capita agricultural value added are problematic, because they stay in all regions behind per capita value added outside agriculture, albeit that they are rising steadily. This leads to growing disparity in per capita incomes within and across regions. The mounting environmental pressure from fertilizer losses and unused manure surpluses is another cause of concern. The second scenario, the Trade liberalization scenario, appears to hurt farm incomes more than it benefits them and to raise the gap with non-agriculture, also because food becomes cheaper in urban areas. Hence, it highlights the difficult choice between economic efficiency and poverty alleviation that agricultural policy makers often face. The "High income growth scenario" reinforces the national food self-sufficiency result of the baseline simulation. Even with meat demand higher than under the baseline, levels of imports remain manageable. The "High R&D scenario" shows that a considerable reduction in dependence on agricultural imports is possible. However, a substantial part of the gains will accrue to consumers rather than to farmers, due to price reductions. Finally, the "Enhanced irrigation scenario" shows outcomes similar to those of the high R&D scenario. Here also the agricultural trade balance improves and consumer welfare improves, but farmers have to cope with drops in prices, and those who do not benefit from land improvement, only experience losses through falling prices. The present report is written at the onset of the CATSEI-project that will analyze policy packages with more specificity and detail after implementing the following model improvements. First, the impact of Chinas imports and exports on world markets will be represented explicitly. Second, the developments outside agriculture in rural areas will be accounted for endogenously, particularly to represent farm revenue from off-farm employment. Third, the trade and transportation margins between farm-gates and markets will be made dependent on the relative flexibility of the actors (farmers, processors, traders) along the chain. Finally, the various techniques to identify more efficient and more sustainable use of scarce water and nutrients and to address health risks will appear more explicitly

Validity of parent-reported weight and height of preschool children measured at home or estimated without home measurement : a validation study

Background: Parental reports are often used in large-scale surveys to assess children's body mass index (BMI). Therefore, it is important to know to what extent these parental reports are valid and whether it makes a difference if the parents measured their children's weight and height at home or whether they simply estimated these values. The aim of this study is to compare the validity of parent-reported height, weight and BMI values of preschool children (3-7 y-old), when measured at home or estimated by parents without actual measurement. Methods: The subjects were 297 Belgian preschool children (52.9% male). Participation rate was 73%. A questionnaire including questions about height and weight of the children was completed by the parents. Nurses measured height and weight following standardised procedures. International age-and sex-specific BMI cut-off values were employed to determine categories of weight status and obesity. Results: On the group level, no important differences in accuracy of reported height, weight and BMI were identified between parent-measured or estimated values. However, for all 3 parameters, the correlations between parental reports and nurse measurements were higher in the group of children whose body dimensions were measured by the parents. Sensitivity for underweight and overweight/obesity were respectively 73% and 47% when parents measured their child's height and weight, and 55% and 47% when parents estimated values without measurement. Specificity for underweight and overweight/obesity were respectively 82% and 97% when parents measured the children, and 75% and 93% with parent estimations. Conclusions: Diagnostic measures were more accurate when parents measured their child's weight and height at home than when those dimensions were based on parental judgements. When parent-reported data on an individual level is used, the accuracy could be improved by encouraging the parents to measure weight and height of their children at home

Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients

Scar Perception in School-aged Children After Major Surgery in Infancy

Background: The long-term effects of childhood surgery scars on health status, quality of life (QoL), self-esteem, and body image remain uncertain. This study explores these effects in school-aged children. Methods: We conducted a retrospective cohort study involving 454 children (58% boys; 8–17 years) who had undergone surgical correction of anatomical anomalies or neonatal ECMO. Data included patient-reported scar perception and scar-related embarrassment, along with psychological assessment via questionnaires. Results: About 34% of children rated their scars as 'nice-looking', 49% as 'indifferent', and 12% as 'rather ugly'. Most children (91%) never experienced scar-related embarrassment, while frequent embarrassment was reported by 3%. Surgical scar correction was desired by 6% of the 8-year-olds and 19% of the 17-year-olds. Scar perception did not significantly affect health status or QoL. However, negative scar perception was associated with lower self-esteem in girls and a more negative body image in boys. Girls were more likely to report negative scar perception (OR: 1.54, 95%-CI: 1.06–2.24) and scar-related embarrassment (OR: 4.29, 95%-CI: 1.77–10.44). Conclusion: Children who underwent surgery in the neonatal period and subsequently grew up with scars resulting thereof, mostly perceive them either indifferently or positively, with minimal effect on health status and QoL. Nonetheless, some children, particularly girls, experienced negative perceptions of their scars, although scar-related embarrassment was rare. We recommend integrating scar assessment into routine follow-up at ages 12 and 17, and offering appropriate and timely guidance and support to children at risk for negative effects of scars. Level of Evidence: III.</p

Dynamic contrast-enhanced and diffusion-weighted MRI for early detection of tumoral changes in single-dose and fractionated radiotherapy: evaluation in a rat rhabdomyosarcoma model

We aimed to examine different intratumoral changes after single-dose and fractionated radiotherapy, using diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI in a rat rhabdomyosarcoma model. Four WAG/Rij rats with rhabdomyosarcomas in the flanks received single-dose radiotherapy of 8 Gy, and four others underwent fractionated radiotherapy (five times 3 Gy). In rats receiving single-dose radiotherapy, a significant perfusion decrease was found in the first 2 days post-treatment, with slow recuperation afterwards. No substantial diffusion changes could be seen; tumor growth delay was 12 days. The rats undergoing fractionated radiotherapy showed a similar perfusion decrease early after the treatment. However, a very strong increase in apparent diffusion coefficient occurred in the first 10 days; growth delay was 18 days. DW-MRI and DCE-MRI can be used to show early tumoral changes induced by radiotherapy. Single-dose and fractionated radiotherapy induce an immediate perfusion effect, while the latter induces more intratumoral necrosis

Lifestyle, Inflammation, and Vascular Calcification in Kidney Transplant Recipients:Perspectives on Long-Term Outcomes

After decades of pioneering and improvement, kidney transplantation is now the renal replacement therapy of choice for most patients with end-stage kidney disease (ESKD). Where focus has traditionally been on surgical techniques and immunosuppressive treatment with prevention of rejection and infection in relation to short-term outcomes, nowadays, so many people are long-living with a transplanted kidney that lifestyle, including diet and exposure to toxic contaminants, also becomes of importance for the kidney transplantation field. Beyond hazards of immunological nature, a systematic assessment of potentially modifiable-yet rather overlooked-risk factors for late graft failure and excess cardiovascular risk may reveal novel targets for clinical intervention to optimize long-term health and downturn current rates of premature death of kidney transplant recipients (KTR). It should also be realized that while kidney transplantation aims to restore kidney function, it incompletely mitigates mechanisms of disease such as chronic low-grade inflammation with persistent redox imbalance and deregulated mineral and bone metabolism. While the vicious circle between inflammation and oxidative stress as common final pathway of a multitude of insults plays an established pathological role in native chronic kidney disease, its characterization post-kidney transplant remains less than satisfactory. Next to chronic inflammatory status, markedly accelerated vascular calcification persists after kidney transplantation and is likewise suggested a major independent mechanism, whose mitigation may counterbalance the excess risk of cardiovascular disease post-kidney transplant. Hereby, we first discuss modifiable dietary elements and toxic environmental contaminants that may explain increased risk of cardiovascular mortality and late graft failure in KTR. Next, we specify laboratory and clinical readouts, with a postulated role within persisting mechanisms of disease post-kidney transplantation (i.e., inflammation and redox imbalance and vascular calcification), as potential non-traditional risk factors for adverse long-term outcomes in KTR. Reflection on these current research opportunities is warranted among the research and clinical kidney transplantation community

Biomarker Potential of Interleukin-6 in Differentiating Necrotizing Enterocolitis from Late-Onset Sepsis in Neonates Born Preterm

Objective: Interleukin-6 (IL-6) is an early biomarker for sepsis and necrotizing enterocolitis (NEC). We assessed IL-6's ability to differentiate between late-onset sepsis (LOS) and NEC and between medical and surgical NEC. Study design: This retrospective cohort study included infants born preterm (birth weight &lt;1500 g, gestational age &lt;32 weeks) with ≥1 episodes of suspected late-onset sepsis (sLOS) between 2018 and 2023. Plasma IL-6 levels at sLOS onset were analyzed. Infants were grouped into (1) control (no sepsis/NEC), (2) LOS (culture negative/positive sepsis), or (3) NEC (medical/surgical), on the basis of the greatest classification of their observed episodes. IL-6's predictive value (alone and in combination with C-reactive protein) for sLOS outcomes was assessed with receiver operating characteristic analysis, with the area under the curve (AUC) quantifying its discriminative quality. Results: sLOS was observed in 421 infants (670 episodes); 131 (31%) had no LOS or NEC, 225 (53%) had LOS without NEC, and 65 (15%) had NEC. Median IL-6 values significantly differed between all groups, with highest in infants with NEC. The odds of NEC over LOS increased by a factor of 1.53 (95% CI 1.42-1.65, P &lt; .001) for every doubling of IL-measurements. IL-6 was not associated with the odds of surgical NEC compared with medical NEC. IL-6's ability to distinguish NEC from LOS was moderate (AUC 0.73). IL-6 combined with C-reactive protein (AUC 0.64) showed poor discriminative ability. Conclusions: Although elevated IL-6 levels are associated with greater odds of having NEC instead of LOS, the moderate predictive value suggests that IL-6 alone may not be sufficient for accurate early diagnosis or differentiation.</p