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This paper discusses the major transformation of higher education that has been under way in China since 1999 and evaluates its potential global implications. Reflecting China’s commitment to continued high growth, this transformation focuses on major new resource commitments to tertiary education and significant changes in organisational form. All of these changes have already had large impacts on China’s higher educational system and are beginning to be felt by the global educational structure. This focus on tertiary education differentiates the Chinese case from other countries who earlier at similar stages of development instead stressed primary and secondary education.

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BackgroundThere has been a growing body of evidence associating consumption of ultra-processed foods (UPF) with adverse health outcomes including depression, cardiovascular disease, all-cause mortality. However, whether UPF are associated with dementia is unknown. The authors investigated the associations between UPF and dementia incidence in UK biobank.MethodsWe included 72,083 participants (55 years or older) who were free from dementia at baseline and provided at least two times 24-h dietary assessments from the UK Biobank study. Follow-up occurred through March 2021. UPF were defined according to the NOVA classification. Incident all-cause dementia comprising Alzheimer's disease and vascular dementia was ascertained through electronic linkages to hospital and mortality records. Cox proportional hazards were used to estimate the association between the proportion (%) of UPF in the diet and the subsequent risk of dementia. In addition, substitution analysis was used to estimate the risk of dementia when substituting UPF with an equivalent proportion of unprocessed or minimally processed foods.ResultsDuring a total of 717,333 person-years of follow-up (median 10.0 years), 518 participants developed dementia, of which 287 developed Alzheimer’s disease and 119 developed vascular dementia. In the fully adjusted model, consumption of UPF was associated with higher risk of dementia (hazard ratio (HR) for 10% increase in UPF: 1.25; 95% confidence interval (CI): 1.14, 1.37), Alzheimer’s disease (HR: 1.14; 95% CI: 1.00, 1.30) and vascular dementia (HR: 1.28; 95% CI: 1.06, 1.55), respectively. In addition, replacing 10% of UPF weight in diet with an equivalent proportion of unprocessed or minimally processed foods was estimated to be associated with a 19% lower risk of dementia (HR: 0.81; 95% CI: 0.74, 0.89).ConclusionsIn this prospective cohort study, higher consumption of UPF was associated with higher risk of dementia, while substituting unpr2ocessed or minimally processed foods for UPF was associated lower risk of dementia.

Background Growing evidence supports a link between ultra-processed food consumption and human health outcomes. However, the association between ultra-processed food consumption and non-alcoholic fatty liver disease (NAFLD) is not known. We aimed to explore the association between ultra-processed food consumption and risk of NAFLD. Methods The prospective study included 16 168 participants aged 18–90 years from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Information on ultra-processed food consumption was collected at baseline using a validated food frequency questionnaire. NAFLD was defined as the presence of sonographic fatty liver in the absence of significant alcohol intake (≥210 g/week for men and ≥140 g/week for women, respectively) and other liver diseases. Multivariable Cox proportional hazards models were used to examine the association between ultra-processed food consumption and risk of NAFLD. Results During 56 935 person-years of follow-up, we documented 3752 incident NAFLD cases. After adjusting for age, sex, body mass index, smoking, alcohol drinking, education, occupation, income, physical activity, total energy intake, personal and family history of disease and overall diet quality, the multivariable hazard ratios (95% confidence interval) of NAFLD across increasing quartiles of ultra-processed food consumption were 1.00 (reference), 0.99 (0.90, 1.08), 1.13 (1.03, 1.25) and 1.18 (1.07, 1.30), respectively (P for trend <0.0001). The hazard ratio (95% confidence interval) per one standard deviation increase in ultra-processed food consumption, equivalent to a 62.7 g/1000 kcal per day, was 1.06 (1.03, 1.09), P = 0.0001. Conclusions Our study indicates that higher ultra-processed food consumption is associated with a higher risk of NAFLD. This finding suggests that ultra-processed food, which is widely consumed worldwide, might be a modifiable dietary target to reduce the risk of NAFLD.

Background & Aims Increased nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. Although these factors are closely involved in the pathogenesis of non‐alcoholic fatty liver disease (NAFLD), few studies have focused on the association between nut consumption and NAFLD in the general population. We aimed to investigate the association of nut consumption and NAFLD in an adult population. Methods A total of 23 915 participants from Tianjin Chronic Low‐Grade Systemic Inflammation and Health (TCLSIH) Cohort Study were included in this study. Information on dietary intake was collected using a validated food frequency questionnaire. Abdominal ultrasonography was done to diagnose NAFLD. Multivariable logistic regression was used to assess the association of nut consumption with NAFLD. Results After adjusting for sociodemographic, medical, dietary, and lifestyle variables, the odds ratios (95% confidence interval) for NAFLD across categories of nut consumption were 1.00 (reference) for <1 time/week, 0.91 (0.82, 1.02) for 1 time/week, 0.88 (0.76, 1.02) for 2‐3 times/week, and 0.80 (0.69, 0.92) for ≥4 times/week (P for trend < 0.01). These associations were attenuated but remained significant after further adjustment for blood lipids, glucose, and inflammation markers. Conclusions Higher nut consumption was significantly associated with lower prevalence of NAFLD. Further prospective studies and randomized trials are required to ascertain the causal association between nut consumption and NAFLD.

Summary Objective Handgrip strength (HGS) begins an accelerating decline around 50 years. Many of the studies performed in old adults have demonstrated a significant relationship between vitamin D and HGS, but the studies performed in participants with a broad age range have yielded conflicting results. The purpose of the study was to investigate the relationship between vitamin D and HGS using age 50 as a specific cut‐off. Design Population‐based, cross‐sectional study. Participants Totally 5102 participants (2911 males, 2191 females) from the TCLSIH Cohort. Measurements Serum concentration of 25‐hydroxyvitamin D (25(OH)D) was measured using an enzyme immunoassay. We divided participants into quartiles according to 25(OH)D, and the ranges for increasing quartiles were as follows: (males [≥50 years]: 10.94‐31.85, 31.88‐43.01, 43.20‐56.06, 56.20‐143.0; males [<50 years]: 11.11‐34.68, 34.71‐46.91, 46.96‐59.45, 59.50‐143.7; females [≥50 years]: 7.21‐30.01, 30.02‐40.18, 40.21‐52.44, 52.49‐275.4; females [<50 years]: 5.29‐28.91, 28.92‐40.19, 40.20‐51.90, 51.91‐140.2). HGS was measured with a hydraulic hand‐held dynamometer. Analysis of covariance was employed to explore the relationship. Results Among males aged above 50 years, the means (95% confidence interval) for HGS per body weight across the categories of serum 25(OH)D concentration were 0.523 (0.430‐0.638), 0.545 (0.447‐0.664), 0.543 (0.446‐0.661), 0.546 (0.449‐0.664) (Ptrend < 0.01) after adjustment for potential confounding factors. However, no relationships were observed between serum 25(OH)D concentration and HGS in males aged below 50 years and females in the whole age range. Conclusions Serum 25(OH)D concentration was significantly related to HGS in males aged above 50 years, independent of confounding factors. Future studies are needed to clarify the age and sex relationship between serum 25(OH)D concentration and HGS.