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In this study, direct numerical simulations were conducted to investigate turbulent channel flow under the influence of a spanwise magnetic field, at a friction Reynolds number $ \textit{Re}_{\tau } = 180$ and Hartmann numbers $\textit{Ha}$ ranging from 0 to 15. The study elucidates how the spanwise magnetic field modulates energy spectra, near-wall streaks and energy transfer. With increasing $\textit{Ha}$, near-wall streamwise streaks elongate markedly and energetic spectral peaks move away from the wall, whereas the spanwise length of streak enlarges only marginally. At $\textit{Ha}=15$, dual spectral peaks appear near the wall, reflecting coexisting high- and low-momentum regions that alternate to form a quasi-steady organisation. Concurrently, an additional very large-scale peak arises in the outer layer ($y\gt 0.3h$), indicating a very large-scale structure that abruptly amplifies the streamwise normal stress there beyond the zero-magnetic-field level. Temporal statistics show that stronger fields reduce streak density but substantially prolong streak lifetimes, attributable to suppression of the nonlinear energy cascade and the attendant decrease in turbulent decay rates. Budget analyses further reveal that, as the field intensifies, the influence of outer-layer large scales on the viscous sublayer weakens; the dominant contributors to wall-normal energy transport shift towards larger scales; and principal energy-transfer pathways migrate away from the near-wall region. Finally, the streamwise elongation of streaks is primarily driven by the wall-normal gradient of the electric potential, while their energetic amplification is effectively damped by Joule dissipation.
Functional impairment in psychosis often persists despite symptomatic remission. There is a paucity of research examining early-course psychosocial functioning trajectories, and none has been conducted to examine relationship between the trajectories and prospective long-term functional outcomes in early psychosis sample.
Methods
We conducted 12-year follow-up of a randomized controlled trial on extended early intervention for first-episode psychosis to identify early-course social-occupational functioning trajectories and their baseline predictors and associations with 12-year outcomes. Participants who completed Social and Occupational Functioning Scale (SOFAS) scores at three or more timepoints between baseline and 3-year follow-up were included in the study. Premorbid adjustment, illness characteristics, symptom severity, functioning, and treatment profiles were assessed. Latent growth mixture modeling was employed to derive early-course social-occupational functioning trajectories based on SOFAS scores over 3-year follow-up.
Results
A total of 148 participants were included in this study, with 106 patients having completed the 12-year follow-up. Our results identified four distinct trajectories, including persistently-good class, gradually-improved class, suboptimal-stable class, and persistently-poor class. Patients in persistently-poor class had more severe negative symptoms at baseline compared to patients in persistently-good class. Patients with persistently-poor trajectory had worse long-term outcomes than those with other classes in the majority of functional measures at 12-year follow-up.
Conclusions
The majority of patients were classified in early-stage suboptimal or poor functional trajectories. Above one-fourth of the participants exhibited persistently-poor social-occupational functioning trajectory, which predicted worse functional outcomes at 12-year follow-up. These findings highlighted the importance of tracking functional changes during the initial years of illness.
This study was conducted to explore the effects of organic trace elements on milk composition, serum trace element concentrations, antioxidant and immune function, and metabolites in dairy cows. Thirty Holstein cows with similar body condition scores (3.5 ± 0.25 points) and parity were randomly divided into a control group (C), a 50% organic group (O_50), and a 100% organic group (O_100), with 10 cows in each group. The C group was fed a basal diet supplemented with 3% inorganic trace element premix, the O_50 group received 1.5% inorganic and 1.5% organic trace element premix, and the O_100 group received 3% organic trace element premix. Organic trace elements were supplemented from 21 days postpartum for 90 days. The results showed that milk protein concentration showed a linear response to organic trace element supplementation, with the highest value in the O_50 group (P < 0.05). Lactose concentration showed an increased quadratic effect (P < 0.01), whereas total solids (TS) and solid-not-fat (SNF) concentrations decreased linearly and quadratically. Serum selenium (Se) concentration increased linearly with increasing organic trace element supplementation (P < 0.05). Malondialdehyde (MDA) concentration decreased linearly (P < 0.05), whereas serum immunoglobulin A (IgA), superoxide dismutase activity, and immunoglobulin G (IgG) concentration increased significantly (P < 0.05). Liquid chromatography–tandem mass spectrometry (LC–MS/MS) analysis identified 70 and 76 differential metabolites in the O_50 and O_100 groups, respectively, compared with the C group. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis indicated that these metabolites were mainly involved in inflammatory mediator regulation, lysine degradation, sphingolipid metabolism, cytochrome P450-mediated drug metabolism, and ABC transporters. In conclusion, dietary supplementation with organic trace elements improved milk composition, antioxidant capacity, immune function, and serum metabolic profiles in dairy cows.
Maternal mental health strongly influences child development and depression risk. This study investigated how positive and negative dimensions of prenatal maternal mental health differentially shape childhood depressive symptoms through cognitive mediators.
Methods
Participants were drawn from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. Of the 1198 mother–child dyads enrolled, 523 (52.6% boys) had sufficient data for the mediation analysis. Maternal mental health at 26 weeks’ gestation was assessed using a bifactor model derived from the Beck Depression Inventory-II, State–Trait Anxiety Inventory, and Edinburgh Postnatal Depression Scale. Child language ability was measured at age 2 years with the Bayley Scales of Infant Development, executive function at age 7 years with the Behaviour Rating Inventory of Executive Function, and depressive symptoms at age 9 years with the Children’s Depression Inventory-2. Serial mediation models tested hypothesized pathways.
Results
Distinct mediation pathways emerged. Positive maternal mental health was associated with enhanced early language ability, which in turn was associated with fewer depressive symptoms in later childhood (β = −0.017, 95% CI: −0.042, −0.003). Conversely, negative maternal mental health was associated with poorer executive functioning, which in turn was associated with more depressive symptoms (β = 0.040, 95% CI: 0.016–0.077).
Conclusions
Positive and negative maternal mental health are linked to childhood depressive symptoms through distinct neurocognitive pathways. By identifying language and executive function as specific developmental mediators, our findings point to targeted and developmentally sensitive intervention opportunities to disrupt intergenerational pathways of depression.
The relationship between frailty, self-efficacy, and advance care planning (ACP) remains unclear in Asia. This study examined how frailty status relates to decisional self-efficacy, ACP engagement, and advance directive completion among older adults receiving home healthcare in Taiwan.
Methods
A cross-sectional analysis was conducted using baseline data from a nationwide cohort in Taiwan. Participants (N = 358) were categorized by Clinical Frailty Scale (CFS): mildly frail (CFS 4–5, n = 60), moderately frail (CFS 6, n = 83), severely frail (CFS 7, n = 147), and very severely frail (CFS 8–9, n = 68). ACP engagement and decision-making self-efficacy were assessed using Likert scales.
Results
Patients with greater frailty had lower odds of high decisional self-efficacy (CFS: 8–9: odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.14–1.07) but higher odds of ACP engagement (CFS: 6: OR = 3.38, 95% CI = 1.40–8.17; CFS: 7: OR = 2.52, 95% CI = 1.08–5.89) compared with mildly frail individuals. However, this increase did not extend linearly to the very severely frail group. Advance directive completion remained low across all frailty levels (4.8–10.0%) and was not significantly associated with frailty status.
Conclusions
Frailty was associated with lower decisional self-efficacy but higher readiness for ACP, revealing a divergence between perceived confidence and planning motivation. Despite greater engagement, advance directive completion remained low. Stage-sensitive, values-based approaches may help bridge the gap between intention and documentation across the frailty spectrum.
Individuals with first-episode psychosis (FEP) face markedly increased excess mortality, yet the long-term trends and key contributing factors remain insufficiently characterized. This study aimed to examine long-term mortality patterns, standardized mortality ratios (SMRs), and associated factors in a FEP cohort.
Methods
This population-based cohort study included 1,389 individuals diagnosed with FEP, followed for up to 25 years. Mortality outcomes were obtained from Hong Kong’s centralized hospital database (CMS) and coroner’s court reports, with SMRs calculated. Baseline sociodemographic and clinical, as well as long-term treatment-related factors of all-cause, natural, and unnatural mortality were analyzed.
Results
Among 1,389 participants, 137 deaths (9.86%) occurred during the follow-up period with the overall SMR of 6.56 (95% CI, 5.50–7.71). The cumulative incidence rate of unnatural mortality increased sharply over the first 10 years and that of the natural cause of death started to increase after the first decade of the illness. Male gender and poorer social functioning were associated with increased all-cause mortality risk, while male gender, lower education, and baseline hospitalization raised unnatural mortality risk. Greater monthly antipsychotic variability during the first 10 years increased all-cause mortality risk in the period after the initial 10 years.
Conclusions
This 25-year follow-up study of FEP highlighted the changes in the long-term mortality pattern of FEP and thus the phase-specific needs of individuals with FEP. Therefore, it is important to integrate physical care into mental health services, as well as stage-specific and individualized care for patients with psychotic disorders to reduce long-term excess mortality.
Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population.
Methods
We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview–Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors.
Results
At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14–14.38), depression (aOR = 3.92, CI = 1.79–8.62), and generalized anxiety (aOR = 2.27, CI = 1.21–4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98–4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90–3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81–9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year.
Conclusions
Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.
Trauma exposure has been associated with the development of psychotic disorders in adolescence and young adulthood. Trauma can compromise the sense of agency, a predictor of psychosis. Symptoms of post-traumatic stress disorder (PTSD) after trauma may also imply significant cognitive impairments that predispose young people to psychotic-like experiences (PLEs). This study investigates whether the two senses of agency subtypes – positive and negative agency, and PTSD symptoms mediated PLEs in youths after trauma.
Aims
The study aimed to explore the mediation of the sense of agency and post-traumatic stress symptoms in the development of psychotic-like experiences after trauma.
Method
Participants were Hong Kong youths aged 12 to 25 who completed surveys online from May 2022 to May 2024. Self-report sense of agency, PLEs and related distress, potentially traumatic life events and PTSD symptoms from 517 youths with a mean age of 20.22 and 72.0% female were analysed. 283 participants (54.7%) experienced at least one potentially traumatic event.
Results
A series of regression analyses revealed that a positive sense of agency mediated the effect of trauma on PLEs and related distress in the full sample. In the subgroup of 283 trauma-exposed youths, PTSD symptoms but not sense of agency mediated the effect of trauma on PLEs and related distress.
Conclusions
The presence of traumatic experiences can increase PLEs by reducing positive agency in community youths. Among trauma-exposed youths, the effect of various traumatic experiences on PLEs may be better explained by PTSD symptoms. Limitations of the study and future directions are discussed.
Significant changes in Taiwan’s psychiatric services over recent decades include expansion of community-based clinics and implementation of the Schizophrenia Pay-for-Performance programme.
Aims
This study aimed to assess the trend of the quality of healthcare for individuals with schizophrenia, using various indicators of the treatment process and outcomes between 2010 and 2019.
Method
Individuals with schizophrenia were identified using Taiwan’s National Health Insurance claims database. The quality of healthcare for individuals with schizophrenia was assessed using treatment process and outcome indicators, including antipsychotic types, medication adherence, daily dose for antipsychotics and concurrent use of other psychotropic agents. Outcome indicators included all-cause mortality, suicide deaths, psychiatric hospitalisation, emergency department visits and employment status.
Results
Antipsychotic medication usage has shifted towards second-generation antipsychotics (SGAs) and long-acting injectable antipsychotics (LAIs), with declines in first-generation antipsychotics. The percentage of medication adherence declined, while that of individuals with an adequate daily dose increased. Concurrently, anticholinergic and benzodiazepine use decreased while antidepressant and mood stabiliser use increased. Outcome indicators showed no significant change in all-cause mortality or suicide rates over time, but there were reductions in psychiatric hospitalisations and emergency department visits. Employment rates increased overall, particularly in urban areas.
Conclusions
The quality of healthcare for individuals with schizophrenia, as measured by treatment process and outcome indicators, improved alongside changes in Taiwan’s psychiatric services; however, causality cannot be inferred from our findings. Future research should evaluate the effectiveness of psychiatric service policies and continuously monitor healthcare quality to further enhance the lives of individuals with schizophrenia.
Previous studies highlighted the health benefits of coffee and tea, but they only focused on the comparisons between different consumptions. Consequently, the association estimate lacked a clear interpretation, as the substitution of beverages and distribution of doses were not explicitly prescribed. We focused on the ‘relative association’ to ascertain the optimal consumption strategy (including total intake and optimal allocation strategy) for coffee, tea and plain water associated with decreased mortality. Self-reported coffee, tea and plain water intake were used from the UK Biobank. Within a compositional data analysis framework, a multivariate Cox model was used to assess the relative associations after adjusting for a range of potential confounders. The lower mortality risk was observed with at least approximately 7–8 drinks/d of total consumption. When the total intake > 4 drinks/d, substituting plain water with coffee or tea was linked to reduced mortality; nevertheless, the benefit was not seen for ≤ 4 drinks/d. Besides, a balanced consumption of coffee and tea (roughly a ratio of 2:3) associated with the lowest hazard ratios of 0·55 (95 % CI 0·47, 0·64) for all-cause mortality, 0·59 (95 % CI 0·48, 0·72) for cancer mortality, 0·69 (95 % CI 0·49, 0·99) for CVD mortality, 0·28 (95 % CI 0·15, 0·52) for respiratory disease mortality and 0·35 (95 % CI 0·15, 0·82) for digestive disease mortality than other combinations. These results highlight the importance of the rational combination of coffee, tea and plain water, with particular emphasis on ensuring adequate total intake, offering more comprehensive and explicit guidance for individuals.
Persistent malnutrition is associated with poor clinical outcomes in cancer. However, assessing its reversibility can be challenging. The present study aimed to utilise machine learning (ML) to predict reversible malnutrition (RM) in patients with cancer. A multicentre cohort study including hospitalised oncology patients. Malnutrition was diagnosed using an international consensus. RM was defined as a positive diagnosis of malnutrition upon patient admission which turned negative one month later. Time-series data on body weight and skeletal muscle were modelled using a long short-term memory architecture to predict RM. The model was named as WAL-net, and its performance, explainability, clinical relevance and generalisability were evaluated. We investigated 4254 patients with cancer-associated malnutrition (discovery set = 2977, test set = 1277). There were 2783 men and 1471 women (median age = 61 years). RM was identified in 754 (17·7 %) patients. RM/non-RM groups showed distinct patterns of weight and muscle dynamics, and RM was negatively correlated to the progressive stages of cancer cachexia (r = –0·340, P < 0·001). WAL-net was the state-of-the-art model among all ML algorithms evaluated, demonstrating favourable performance to predict RM in the test set (AUC = 0·924, 95 % CI = 0·904, 0·944) and an external validation set (n 798, AUC = 0·909, 95 % CI = 0·876, 0·943). Model-predicted RM using baseline information was associated with lower future risks of underweight, sarcopenia, performance status decline and progression of malnutrition (all P < 0·05). This study presents an explainable deep learning model, the WAL-net, for early identification of RM in patients with cancer. These findings might help the management of cancer-associated malnutrition to optimise patient outcomes in multidisciplinary cancer care.
Large-eddy simulations have been conducted to investigate the decay law of homogeneous turbulence influenced by a magnetic field within a cubic domain, employing periodic boundary conditions. The initial integral Reynolds number is approximately 1000, while the initial interaction number $N$ ranges from 0.1–100. The results reveal that the Joule cone angle $\theta$, half of the Joule cone, decays as $\cos \theta \sim t^{-1/2}$ when $N \gg 1$. In the nonlinear stage, small-scale vortices gradually recover and restore three-dimensionality. Moreover, the corresponding critical state at small scales, marking the transition from quasi-two-dimensional structure to the onset of three-dimensionality, has been quantitatively defined. During the linear stage, based on the true magnetic damping number ($\tau _t = \rho / (\sigma {\boldsymbol{B}}^2 \cos ^2 \psi )$, where $\sigma$, $\boldsymbol{B}$ and $\psi$ denote the electrical conductivity, magnetic field and the angle between the wavevector and $\boldsymbol{B}$ in Fourier space, respectively), Moffatt’s decay law, $K \sim t^{-1/2}$, manifests at distinct times and zones in the Fourier space, with $K$ signifying turbulent kinetic energy. In the nonlinear stage, for $N \gg 1$, a $-3$ slope in the energy power spectrum is prominently observed over an extended period. The near-equivalence of the characteristic time scales of inertial and Lorentz forces in the inertial subrange suggests a quasiequilibrium state between energy transfer and Joule dissipation in Fourier space, thereby corroborating the hypothesis proposed by Alemany et al. 1979 Journal de Mecanique18(2): 277–313. Additionally, it is observed that pressure mediates energy transfer from horizontal kinetic energy ($K_{\parallel }$) to vertical kinetic energy ($K_{\bot }$), accelerating the decay of $K_{\parallel }$. Notably, concurrent inverse and direct energy transfers emerge during the decay process. Our analysis reveals that the ratio $R$ of the maximum inverse to maximum direct energy flux correlates with the dimensionality of the turbulence, following the scaling law $R\sim (\cos \theta )^{-2.2}$.
Schistosomiasis is a parasitic disease that imposes a significant burden on society. The eggs are the primary pathogenic factor in schistosomiasis, and their accumulation in liver could lead to the formation of granulomas and liver fibrosis. However, the metabolic changes in liver resulting from schistosomiasis remain poorly understood. We established a mouse model of schistosomiasis japonica, where the eggs accumulate in the liver and form egg granulomas. We used mass spectrometry imaging to analyze the differences in metabolites among various liver regions, including the liver tissue from normal mice, the liver area outside the granulomas in schistosomiasis mice, and the granuloma region in schistosomiasis mice. There were significant differences in metabolites between different liver regions, which enriched in metabolic pathways such as the biosynthesis of unsaturated fatty acids, taurine and hypotaurine metabolism, glycerophospholipid metabolism, glycolysis/gluconeogenesis, purine metabolism, arachidonic acid metabolism, and bile secretion. In normal liver tissue, higher concentrations of oleic acid (FA (18:1)), eicosapentaenoic acid (FA (20:5)), and L-glutamine were observed. In liver regions outside the granulomas, D-glucose and pyruvic acid were elevated compared to those in normal mice. Taurine increased in the liver of schistosomiasis. Meanwhile, there were elevated uric acid and spermidine in the egg granulomas. We employed mass spectrometry imaging technology to investigate metabolic reprogramming in liver of Schistosoma japonicum-infected mice. We explored the spatial distribution of differential metabolites in liver of schistosomiasis including unsaturated fatty acids, taurine, glutamine, spermidine, and uric acid. Our research provides valuable insights for further elucidating metabolic reprogramming in schistosomiasis.
Isolated multi-MeV $\gamma$-rays with attosecond duration, high collimation and beam angular momentum (BAM) may find many interesting applications in nuclear physics, astrophysics, etc. Here, we propose a scheme to generate such $\gamma$-rays via nonlinear Thomson scattering of a rotating relativistic electron sheet driven by a few-cycle twisted laser pulse interacting with a micro-droplet target. Our model clarifies the laser intensity threshold and carrier-envelope phase effect on the generation of the isolated electron sheet. Three-dimensional numerical simulations demonstrate the $\gamma$-ray emission with 320 attoseconds duration and peak brilliance of $9.3\times 10^{24}$ photons s${}^{-1}$ mrad${}^{-2}$ mm${}^{-2}$ per 0.1$\%$ bandwidth at 4.3 MeV. The $\gamma$-ray beam carries a large BAM of $2.8 \times 10^{16}\mathrm{\hslash}$, which arises from the efficient BAM transfer from the rotating electron sheet, subsequently leading to a unique angular distribution. This work should promote the experimental investigation of nonlinear Thomson scattering of rotating electron sheets in large laser facilities.
Artificial sweeteners are generally used and recommended to alternate added sugar for health promotion. However, the health effects of artificial sweeteners remain unclear. In this study, we included 6371 participants from the National Health and Nutrition Examination Survey with artificial sweetener intake records. Logistic regression and Cox regression were applied to explore the associations between artificial sweeteners and risks of cardiometabolic disorders and mortality. Mendelian randomisation was performed to verify the causal associations. We observed that participants with higher consumption of artificial sweeteners were more likely to be female and older and have above medium socio-economic status. After multivariable adjustment, frequent consumers presented the OR (95 % CI) for hypertension (1·52 (1·29, 1·80)), hypercholesterolaemia (1·28 (1·10, 1·50)), diabetes (3·74 (3·06, 4·57)), obesity (1·52 (1·29, 1·80)), congestive heart failure (1·89 (1·35, 2·62)) and heart attack (1·51 (1·10, 2·04)). Mendelian randomisation confirmed the increased risks of hypertension and type 2 diabetes. Moreover, an increased risk of diabetic mortality was identified in participants who had artificial sweeteners ≥ 1 daily (HR = 2·62 (1·46, 4·69), P = 0·001). Higher consumption of artificial sweeteners is associated with increased risks of cardiometabolic disorders and diabetic mortality. These results suggest that using artificial sweeteners as sugar substitutes may not be beneficial.
The assessment of seed quality and physiological potential is essential in seed production and crop breeding. In the process of rapid detection of seed viability using tetrazolium (TZ) staining, it is necessary to spend a lot of labour and material resources to explore the pretreatment and staining methods of hard and solid seeds with physical barriers. This study explores the TZ staining methods of six hard seeds (Tilia miqueliana, Tilia henryana, Sassafras tzumu, Prunus subhirtella, Prunus sibirica, and Juglans mandshurica) and summarizes the TZ staining conditions required for hard seeds by combining the difference in fat content between seeds and the kinship between species, thus providing a rapid viability test method for the protection of germplasm resources of endangered plants and the optimization of seed bank construction. The TZ staining of six species of hard seeds requires a staining temperature above 35 °C and a TZ solution concentration higher than 1%. Endospermic seeds require shorter staining times than exalbuminous seeds. The higher the fat content of the seeds, the lower the required incubation temperature and TZ concentration for staining, and the longer the staining time. And the closer the relationship between the two species, the more similar their staining conditions become. The TZ staining method of similar species can be predicted according to the genetic distance between the phylogenetic trees, and the viability of new species can be detected quickly.
Energy loss of protons with 90 and 100 keV energies penetrating through a hydrogen plasma target has been measured, where the electron density of the plasma is about 1016 cm−3 and the electron temperature is about 1-2 eV. It is found that the energy loss of protons in the plasma is obviously larger than that in cold gas and the experimental results based on the Bethe model calculations can be demonstrated by the variation of effective charge of protons in the hydrogen plasma. The effective charge remains 1 for 100 keV protons, while the value for 90 keV protons decreases to be about 0.92. Moreover, two empirical formulae are employed to extract the effective charge.
This study aimed to compare changes in the level of health technology assessment (HTA) development from 2016 to 2021, and to inform policies and decisions to promote further development of HTA in China.
Methods
We conducted a cross-sectional and anonymous web-based survey to relevant stakeholders in China in 2016 and 2021 respectively. The mapping of the HTA instrument was used to reflect the HTA development from eight domains. To reduce the influence of confounders and to compare the mapping outcomes between 2016 and 2021 groups, we performed 1:1 propensity score matching methodology in this study. Univariate analysis was performed to compare the differences in these two groups. We also compared the overall results with that of a mapping study that included ten countries.
Results
A total of 212 and 255 respondents completed the survey in 2016 and 2021 respectively. After propensity score matching methodology, 183 cases from the 2016 group and 2021 group were matched. Overall, the mean score of 2021 in most of the domains was higher than in 2016 in China (p < 0.05), matching the level of HTA institutionalization and dissemination strategy, except for the assessment domain. Although China scored significantly lower among the three developed countries, the overall HTA development score for China was comparable among the ten countries.
Conclusions
Our study suggested the level of HTA development in China has made great progress from 2016 to 2021. Prior to HTA activities, the researcher or policy makers should first formulate an explicit assessment goal and scope, and during the assessment process, more attention should be paid to the clinical effectiveness and cost-effectiveness indicator to ensure a higher quality of HTA evidence.