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Purpose This study evaluated the clinical safety and efficacy of tanfanercept (HBM9036) ophthalmic solution as a novel treatment for dry eye disease (DED) in a controlled adverse environment (CAE) study conducted in China. Methods In a single-center, double-masked, randomized, placebo-controlled study, 100 patients received 0.25% tanfanercept, or placebo, twice daily for eight weeks. A mobile international CAE® DE Model was used for patient selection with a standardized challenge endpoint. Primary efficacy endpoint was fluorescein inferior corneal staining score (ICSS) pre- to post-CAE challenge from baseline. Secondary endpoints included Schirmer’s Tear Test, Tear-Film Break-Up Time, Ocular Discomfort Score, Ora Calibra® Ocular Discomfort and 4-Symptom Questionnaire, total corneal staining score (TCSS), and drop comfort. Signs and symptoms were assessed both pre- and post-CAE to evaluate the efficacy of tanfanercept on both environmental and CAE endpoints. Results The tanfanercept treatment group showed improvement in ICSS pre- to post-CAE change from baseline scores when compared to placebo (− 0.61 ± 0.11 and − 0.54 ± 0.11, respectively; mean difference = 0.07, p = 0.65). TCSS pre–post-CAE change from baseline scores was also in favor of active when compared to placebo (− 1.03 ± 0.21 and − 0.67 ± 0.21, respectively; mean difference = 0.37, p = 0.23). Schirmer’s score improvement was demonstrated in favor of active (1.87 ± 0.62 mm) as compared to placebo (1.28 ± 0.62 mm; mean difference = 0.59 mm, p = 0.50). Change from baseline in mean Tear-Film Break-up Time favored active treatment over placebo (mean difference = 1.21 s, p = 0.45). Notably, the tanfanercept showed more obvious benefits for each DED sign in a subgroup of subjects ≥ 35 years of age. Tanfanercept was well tolerated with no serious adverse events occurring during the study. Conclusion Tanfanercept demonstrated improvements in favor of active as compared to placebo in the signs of DED, being safe and well tolerated. These data support further evaluation of tanfanercept for the treatment of DED in China. Trial registration This study was retrospectively registered at ClinicalTrials.gov (NCT04092907) on September 17, 2019.

Unprecedented economic growth in China has created a new market potential for high-quality foods in the global food industry. This has led several studies to investigate consumer preferences for food safety and quality attributes in the retail market. However, there are limited studies related to the food service sector, specifically to combine these two concepts. Therefore, this study was conducted to investigate these preferences from the perspectives of both the customers and restaurant managers in relation to ducks in the Chinese food service sector. This involved estimating the willingness-to-pays for quality and safety attributes such as branding, premium quality, safety certification, and the biotech country of origin, including the United States, the European Union, and China using regression analysis. The empirical results showed that Chinese consumers and restaurant owners/managers have a similar preference for branded, high quality, and safe domestic products. However, their relative preferences for these attributes are not identical, as indicated by the consumers' highest preference for safety certification, while managers mostly focus on the quality. These findings are expected to provide more information on the market preferences for food produced in emerging Asian economies with special diet cultures and traditions.

The ability to calculate the absolute risk of adverse pregnancy outcomes for an individual woman with gestational diabetes mellitus (GDM) would allow preventative and therapeutic interventions to be delivered to women at high-risk, sparing women at low-risk from unnecessary care. We aimed to develop, validate and evaluate the clinical utility of a prediction model for adverse pregnancy outcomes in women with GDM.A prediction model development and validation study was conducted on data from a observational cohort. Participants included all women with GDM from three metropolitan tertiary teaching hospitals in Melbourne, Australia. The development cohort comprised those who delivered between 1 July 2017 to 30 June 2018 and the validation cohort those who delivered between 1 July 2018 to 31 December 2018. The main outcome was a composite of critically important maternal and perinatal complications (hypertensive disorders of pregnancy, large-for-gestational age neonate, neonatal hypoglycaemia requiring intravenous therapy, shoulder dystocia, perinatal death, neonatal bone fracture and nerve palsy). Model performance was measured in terms of discrimination and calibration and clinical utility evaluated using decision curve analysis.The final PeRSonal (Prediction for Risk Stratified care for women with GDM) model included body mass index, maternal age, fasting and 1-hour glucose values (75-g oral glucose tolerance test), gestational age at GDM diagnosis, Southern and Central Asian ethnicity, East Asian ethnicity, nulliparity, past delivery of an large-for-gestational age neonate, past pre-eclampsia, GWG until GDM diagnosis, and family history of diabetes. The composite adverse pregnancy outcome occurred in 27% (476/1747) of women in the development (1747 women) and in 26% (244/955) in the validation (955 women) cohorts. The model showed excellent calibration with slope of 0.99 (95% CI 0.75 to 1.23) and acceptable discrimination (The PeRSonal GDM model comprising of routinely available clinical data shows compelling performance, is transportable across time, and has clinical utility across a range of predicted probabilities. Further external validation of the model to a more disparate population is now needed to assess the generalisability to different centres, community based care and low resource settings, other healthcare systems and to different GDM diagnostic criteria.This work is supported by the Mothers and Gestational Diabetes in Australia 2 NHMRC funded project #1170847.

Colorectal cancer (CRC) is a common malignancy in New Zealand, and there is increasing pressure on investigative resources for diagnosis. The national direct access referral guidelines from the Ministry of Health (MoH) guide who should be referred for investigation, but their performance in detecting CRC and other significant diseases has not been reported previously. This paper describes the yield, by direct access criterion, of all referrals through the direct access pathway to the Canterbury District Health Board (CDHB) during 2018.First referrals received through the direct access colonoscopy/computed tomography colonography (CTC) pathway for 2018 were audited. Patients were assigned to symptom groups corresponding to the MoH direct access criteria, and demographic data were captured. Diagnostic outcomes were collected through analysis of all endoscopy, CT colonography and histology reports in the 18 months following referral for primary analysis, with further follow-up through to May 2021 to detect missed pathology.Three thousand two hundred referrals were analysed, and 88.5% underwent colorectal investigation. 128 CRC were diagnosed, 176 advanced polyps, 49 cases of inflammatory bowel disease (IBD) and there were 56 other significant findings. The yield by category for the direct access criteria varied between 0-15.0%, and one urgent criterion had a CRC yield lower than two semi-urgent categories. For patients whose symptoms met at least one of the criteria, excluding those referred with suspected IBD, the combined CRC yield was 4.9%, compared with 1.8% in those who did not meet criteria. The sensitivity and specificity of the criteria for CRC (excluding IBD) was 90% and 23% respectively. There were no CRC detected during the extended follow-up period.In this referred population, the MoH direct access colonoscopy/CTC criteria varied significantly in their CRC yield, with an arbitrary distinction between urgent and semi-urgent categories. The low specificity of the criteria means the number needed to investigate to detect one CRC was one in 22. Improved diagnostic algorithms are urgently required to improve both the sensitivity and specificity, thereby more appropriately allocating finite resources to those patients who are most in need of investigation.

The pet industry has grown tremendously in China, and pet food is a major product in the market. Although characteristics of pet food are important considerations for veterinarians and consumers, t...

This article fills the gap in literature by studying consumers’ perceptions of the genetically modified (GM) food labeling systems in China, in terms of the comparison between the mandatory “Contai...

Remediation of polluted soil on arable land is mostly funded by governments, with the understanding that the public’s willingness to pay for food produced on remediated soil can help establish a soil remediation model with more stakeholders. In contrast to previous studies that have focused on soil-remediation technologies’ diffusion, this study employs choice experiments to evaluate market preferences for crops grown from lands of varying quality that are reflected in consumers’ willingness to pay (WTP). The results show that consumers are willing to pay a small premium for rice labeled with remediated-soil claims, but the WTP for remediated-soil claim is less than that of an uncontaminated-soil claim. Consumers’ WTP for remediated-soil claim increases by 29.03% when combining with a well-known brand, and it increases by 71.17% when information is provided about the efficacy of cadmium and heavy-metal-pollution remediation; however, combining with the region-of-origin label does not increase WTP. We also find that, in early stages of promotion, online stores may reach target consumers more easily. Based on these results, we propose four implications for policymakers.

Because of economic development and food safety concerns, an increasing number of middle-class consumers in China are demanding higher-quality food and more environmentally friendly food pr...

Food hoarding is prevalent during the COVID-19 pandemic. To investigate the mechanism of urban consumers' food hoarding behaviors, we categorize hoarding motives into rational and irrational ones. Using random online survey samples from three cities in China, we employ the multivariate probit model to investigate the rational and irrational motives on food hoarding behavior. Our results confirmed the existence of both rational and irrational food hoarding, and also found factors attributing to the different buying behaviors. The amount of food at hand and the expectation on the infection possibility of COVID-19 are two major factors affecting rational hoarding. Bad mood and herd psychology are factors contributing to panic buying. This study provides an empirical evidence to support intervention policies aiming at mitigating panic buying behavior.

PurposeThis paper traces the timeline and milestones of Chinese graduate students in agricultural economics and related fields at foreign universities, with an emphasis on North American universities, since the early 1980s, and assesses the contributions of Chinese doctoral recipients from foreign universities to agricultural economic research and education in North America and China.Design/methodology/approachData from department and college websites, associations of agricultural economics, university libraries and databases of theses and dissertations and selected agricultural economic journals in English and Chinese are used to attain the above purposes through graphical and bibliometric analyses.FindingsFirst, the numbers of Chinese doctoral recipients and tenure-track and tenured faculty in agricultural economics at North American universities have increased steadily and significantly. Second, Chinese scholars in North America have achieved tremendous success in agricultural economic research via high-quality publications, prestigious awards, editorship of top journals, leadership in professional organizations, etc. Third, more Chinese doctoral recipients overseas have increasingly returned to China and are playing important roles in China’s agricultural economic research, education and international collaboration. Fourth, the publications of overseas Chinese scholars in Chinese journals and those of their counterparts working in China on topics beyond China are relatively limited and more collaboration may enhance the global impacts of Chinese agricultural economists.Research limitations/implicationsThis research is limited by data availability and quality and the data problems are discussed in the paper.Originality/valueThis is likely the first study to assess the contributions of Chinese doctoral recipients from foreign universities to agricultural economic research and education in China and abroad.

Artificial intelligence is touted as the future of medicine. Classical algorithms for the detection of common bile duct stones (CBD) have had poor clinical uptake due to low accuracy. This study explores the challenges of developing and implementing a machine-learning model for the prediction of CBD stones in patients presenting with acute biliary disease (ABD). All patients presenting acutely to Christchurch Hospital over a two-year period with ABD were retrospectively identified. Clinical data points including lab test results, demographics and ethnicity were recorded. Several statistical techniques were utilised to develop a machine-learning model. Issues with data collection, quality, interpretation and barriers to implementation were identified and highlighted. Issues with patient identification, coding accuracy, and implementation were encountered. In total, 1315 patients met inclusion criteria. Incorrect international classification of disease 10 (ICD-10) coding was noted in 36% (137/382) of patients recorded as having CBD stones. Patients with CBD stones were significantly older and had higher aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin and gamma-glutamyl transferase (GGT) levels (p

PurposeIn this paper, we provide a simple conceptual framework with empirical analysis to investigate the effect of product attributes and e-vendor characteristics that are potentially included in the online shopper’s information search on their online shopping behavior in China.Design/methodology/approachThis paper examines consumers’ online shopping frequency for food/grocery using an ordered logit model and for fresh food (a subcategory of food/grocery) using a two-part model, considering product attributes, e-vendor characteristics, and consumer perceptions and characteristics.FindingsThe results show that product origin is an influencing factor in shopping for fresh food online, reflecting consumers’ growing interests in imported food or specialty food from other areas. Consumers are more likely to shop online for fresh food if they perceive online shopping as having a price advantage. But consumers who view price as a top factor are less likely to buy fresh food online frequently. Thus competitive prices might be a motive for online fresh food shopping, but consumers concerned about price do not necessarily shop frequently. Negative perceptions of product freshness reduce consumers’ likelihood and frequency of shopping for fresh food online. Concerns on food quality and e-vendors’ credibility prevent consumers from frequently shopping for fresh food online. Social and demographic characteristics also influence consumers’ decisions.Originality/valueThis paper provides a better understanding of consumer’s online grocery shopping preferences and sheds light on policy and regulation design and implementation in the e-commerce industry, which will ultimately protect and benefit consumers.

Background The online market is getting popular today, and consumers’ preferences about products are revealed differently in online and offline markets. Especially, fresh food purchasing online is very different from non-food products due to its unique features such as perishability, low cost and frequent purchases, low value-volume ratio, and highly relevance to safety and health. However, studies on online fresh food are rather few, and this study will fill the gap by investigating consumers’ preferences for fresh food online purchasing. Methods Using unique data observed from online stores, we conduct a hedonic analysis of fresh produce online market using apple market in China, avoiding hypothetical bias. Propensity Score Matching is used to check the online promotion effects. The data are apples transactions from Jingdong JD e-commerce platform with sample size 8,200, observed across six weeks from 11/26/2018 to 12/31/2018. Variables used include prices, promotions, varieties, places of origin, fruit size, labeled as organic or green food, watercore label, and customer reviews for the products as well as for the venders. Results We found place of origin, food safety and eco-certificates, and sensory features all influence apple prices which reflect consumer preferences. In addition to product features, store features such as former customers’ review for the store, a video post of the product, and other latent product features through former customers’ review for the product quality also influence consumers’ preference reflected by price. Conclusions In additional to product intrinsic features, consumer show preferences and valuation for online market special features.

This study provides an overview of Chinese meat consumption based on literature review. China, having the largest mid-income population, has become the world's largest meat consumer. Its per capita meat consumption has been growing fast over the past decades to 49 kg, half of that of the US. Chinese consumers are aware of the environmental, health and animal welfare concerns, and can accept plant-based and lab cultured meats. Their adoption rate of these meat alternatives is low and their willingness-to-pay for them is also low from 5% below to 5% above conventional meat, compatible to the level in the US and EU countries. China, as an emerging economy, takes it as a serious challenge for food and nutrition security, where meat plays an indispensable role. Malnutrition still exists among children and the low-income population due to low meat intake. Government is playing an active role in boosting its domestic meat production to meet its market demand for more meat.

Since COVID-19 was first detected in China in 2019, governments around the world have imposed strict measures to curb the spread of the coronavirus, which substantially impacted people’s life. Consumers’ food consumption behavior has also changed accordingly with reduced grocery shopping frequency, replaced in-person grocery shopping with online shopping, and increased valuation on food. In this paper, we aim to investigate the change in Chinese consumers’ food consumption and their willingness to pay (WTP) for vegetables and meat, using a dataset with 1206 online samples collected between February and March 2020. Consumers’ WTP for vegetables and meat is estimated using a double-bounded dichotomous contingent valuation design, and factors affecting their WTPs are also investigated. Results show that consumers have a higher WTP for these food products during the pandemic, and their WTP is positively affected by their anticipated duration of the COVID-19, their online shopping shares, their direct exposure to infected patients, their gender, and their income. These results imply that the food industry shall try to develop online market channels as consumers are willing to share the costs, while lower-income consumers may not be able to meet their food needs with prices increased beyond their WTP and thus may call for the government’s support.

We use a temporary ban on inter-province shipping of live hogs induced by the 2018 outbreak of African Swine Fever (ASF) in China as a natural experiment to study spatial mechanisms behind the dynamics of market integration. With a unique dataset of weekly provincial hog prices, we employ a novel spatial network model to estimate the strength of price co-movement across provinces pre and post the ban. Results indicate that, in the highly integrated national market prior to the ban, longer geographical distances between two provinces did not weaken the strength of their price linkage. The ban broken down spatial integration. Longer distances became a significant obstacle to spatial price linkage in the post-ban periods, implying faster re-integration of hog prices between proximate provinces than remote ones. The negative effect of distance can be rationalized by the interplay between arbitrage opportunities and imperfect information. Our findings highlight information transparency as a key to market integration post shipping bans used to curb animal pandemics like ASF.

Crop insurance is the most common agricultural risk management instrument. In developing countries, crop insurance is becoming popular but is often provided with lower coverage, lower premiums and less subsidy than in developed countries. We use a labelled choice experiment method to investigate Chinese smallholder corn growers’ preferences for alternative types of insurance. In addition to traditional yield insurance, we assess farmers’ willingness to pay for coverage levels in price, revenue and weather index insurance, which are currently at the experimental stage in China. We find farmer preferences for these various types of insurance to be heterogeneous. On average, farmers are willing to pay for all types of insurance and for additional coverage but only at the current high subsidy level. We explore heterogeneity in willingness to pay and find that farmers’ positive past insurance experience plays a very important role in their demand for insurance.

We use a temporary ban on inter-province shipping of live hogs induced by the 2018 outbreak of African Swine Fever (ASF) in China as a natural experiment to study spatial mechanisms behind the dynamics of market integration. With a unique dataset of weekly provincial hog prices, we employ a novel spatial network model to estimate the strength of price co-movement across provinces pre and post the ban. Results indicate that, in the highly integrated national market prior to the ban, longer geographical distances between two provinces did not weaken the strength of their price linkage. The ban broken down spatial integration. Longer distances became a significant obstacle to spatial price linkage in the post-ban periods, implying faster re-integration of hog prices between proximate provinces than remote ones. The negative effect of distance can be rationalized by the interplay between arbitrage opportunities and imperfect information. Our findings highlight information transparency as a key to market integration post shipping bans used to curb animal pandemics like ASF. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

PurposeThis research is to examine the impact of online channels on food stockpile behavior.Design/methodology/approachIn this study, we use bivariate probit models to empirically investigate the impact of online purchasing channels on Chinese urban consumer food hoarding behaviors with random survey samples.FindingsResults show that fresh food e-commerce channels are more likely to be associated with panic stockpile behaviors due to higher likelihood of supply shortages than offline channels with government assistance in logistic management. In contrast, community group buy, another format of e-commerce, appears superior in satisfying the consumer needs and easing the panic buying perception.Practical implicationsIt suggests that online channels may have diverse impacts on consumers' panic stockpiling behaviors during the extreme situations. Online channels need to develop efficient supply chains to be more resilient to extreme situations and the government shall recognize the increasing share of the online channels together with traditional offline channels when implementing supporting policies.Social implicationsWith ever increasing share of online channels, it is imperative in terms of policy implications to understand how would online channels affect hoarding behavior.Originality/valueWe are the first study in online shopping's impact on food stockpile during pandemics using a random sample. Although food stockpile behavior at times of emergency have been investigated in many literature, there are no empirical studies on the impact of online channels on stockpile behaviors under extreme situations. Unlike disasters that immediately impact every entity in supply chains covering producers, vendors, distribution centers and retailers, pandemics did not render supply chains affected immediately, but rather increase consumers' willingness to shop online to avoid virus. Thus, Covid-19 provides a natural experiment to investigate the online channels' impact on stockpile behavior.

China is the largest tea producer in the world; however, tea quality and safety issues have caught broad attention due to pesticide overuse in the growing stage. In order to control the quality and safety of their raw inputs, tea-processing firms in China are expanding their own plantations. Does this backward integration (BI) improve the food safety performance of the tea firms in China? Based on the transaction cost theory, we empirically investigate the effect of tea firms’ BI on their food safety performances, using data from 246 tea firms collected via an online survey in 2021. Controlling the basic background situation and firms’ characteristics, the empirical regression results, when controlling for the self-selection bias, support the hypothesis that BI can improve the food safety performance of the tea industry when it reaches the effective integration level, specifically, 80% or higher. Other factors include that the private brand and asset share of the plantation would also help reduce the firms’ food safety problems. Therefore, the government may consider supporting firms’ BI in the development of tea plantations through one-time subsidies and/or land and labor coordination, so as to improve the food safety situation and industry efficiency.

Consumer food waste linked to restaurants and canteens has been a long-standing serious problem in China, which hungers for an effective solution. Although government and media have launched campaigns against food waste, limited information on consumer perceptions is provided in helping to guide campaign programs. The influence of perception associated with low food waste is lacking, along with targeting campaigns based on these perceptions. This research aims to fill this gap. The purpose of this paper is to identify consumption perceptions about food waste in the Chinese urban restaurant sector, so that they can be used in social marketing to promote food waste reduction behaviors. Employing Probit models using survey data collected, we found that food security and environmental perceptions are associated with low food waste. Campaigns directed toward reducing food waste should target raising awareness of food security alert and environmental concerns that are more generally appealing to altruistic spirits.

Ready-to-eat breakfast cereals vary widely in terms of nutrition and price. The diversity in cereal offerings makes it ideal for the study of preferences for individual nutrients and the potential impact that providing nutritional information may have on consumer purchasing behavior. Using a survey of 1,265 Midwestern residents, a random parameters logit model was employed to estimate the willingness to pay for nutritional elements of ready-to-eat breakfast cereal. Household demographic data, including household food security status, were collected. Agricultural and food businesses may seek to provide product information, including nutritional information, to their customers. In addition, national and local policies may seek to empower consumers’ decision making through education. Nutritional information may not have the intended impact of influencing healthier choices. Responses from those shown educational material on nutrition were tested and found not different from respondents not shown the information.