The Economic and Trade Agreement between the USA and the People’s Republic of China (hereinafter the ‘Phase One Agreement’) concluded in January 2020 leaves many important questions unanswered. This article goes beyond narrow textualist approaches and seeks to conceptualize the current trade tension by providing an alternative narrative with a focus on China’s post–Trade War commitments to higher intellectual property rights standards. In particular, it focuses on the bilateral interaction between the USA and China during and shortly after the Trade War and how the interaction impacts China’s legal changes from a transnational law perspective. It further argues that US-reinforced intellectual property rights rules have potentially paved the way for further US–China trade and investment talks. However, in order to better maintain a long-term balance between preservation of policymaking autonomy and regulation of protectionist measures, an approach better aligned with the World Trade Organization framework needs to be pursued.
Objectives: To investigate the knowledge, attitudes, and practices of healthcare professionals (HCPs) working in prenatal diagnosis toward expanded non-invasive prenatal testing (NIPT) in China. Methods:We conducted a national online survey among HCPs working in prenatal diagnosis, including specialists in prenatal diagnosis and foetal medicine, obstetricians and gynaecologists, nurses in obstetrics and gynaecology, obstetric ultrasound doctors, and technicians in prenatal diagnosis laboratories. A total of 1882 questionnaires were collected, among which 1822 questionnaires met the research criteria and were included in the analysis.Results: More than 99% of all participants opted for NIPT for trisomies 21, 18, and 13. The rates of support for expanded NIPT for sex chromosome aneuploidies, rare autosomal trisomies, microdeletions and microduplications, and single-gene disorders were 93.9%, 88.6%, 89.4%, and 86.8%, respectively. Specialists in prenatal diagnosis and foetal medicine had greater knowledge but were less likely to support expanded NIPT compared to other participants. Knowledge increased with educational level, whereas support for expanded NIPT decreased with educational level.Conclusions: More than 80% of HCPs working in prenatal diagnosis in China expressed support for expanding NIPT to conditions other than common trisomies.The degree of knowledge was negatively associated with the rate of support. Key points What's already known about this topic?� Non-invasive prenatal testing (NIPT) is highly effective in detecting trisomies 21, 18, and 13 � Expanding NIPT to screening for conditions other than trisomies 21, 18, and 13 remains controversial What does this study add? � More than 80% of healthcare professionals working in prenatal diagnosis in China expressed a preference for expanding NIPT to conditions other than trisomies 21, 18, and 13 � The degree of knowledge was found to be negatively associated with support for the expanded NIPT
Background Thyroid hemiagenesis (THA) is a rare abnormality featured by the absence of one thyroid lobe, and there have been no reports of using endoscopic thyroidectomy to treat papillary thyroid carcinoma with THA. Case presentation A case of THA with a missing right lobe was reported. Ultrasonography revealed a Thyroid Imaging, Reporting and Data System (TI-RADS) 5 lesion on the thyroid. The patient underwent a gasless transaxillary endoscopic thyroidectomy (GTET) during which it was discovered that the thyroid gland was located on the opposite side and that there were anatomic malformations present. While GTET contributes to clear vision during surgery and excellent postsurgical appearance, lateral forces produced by the retractor may dislocate tissues, obscuring the targeted thyroid, thus increasing the operative difficulties. Conclusions Transaxillary endoscopic surgical strategy is not overall superior to conventional approach and should be chosen consciously.
Objectives: To investigate the attitudes toward uncertain results from prenatal exome sequencing (ES) in China. Methods: We conducted a national online survey among healthcare professionals (HPs) working in prenatal diagnosis, including specialists in prenatal diagnosis and fetal medicine, obstetricians, technicians in prenatal diagnosis laboratories, clinical geneticists, laboratory geneticists, genetic counsellors. A total of 234 questionnaires that met the including criteria were collected. Data were analysed using IBM SPSS Statistics 26. Results: Uncertain results from prenatal ES in our study include variants of uncertain significance (VUS), variants with variable penetrance/expressivity (VVPE), and secondary findings unrelated to the indication for testing (SFs). When performing the pretest counselling, only 6.8% of HPs addressed the possibility of VUS, 6.0% discussed the possibility of VVPE, 6.4% introduced the SFs, with patients with the option of opting out of reporting these variants. Whereas in post-test counselling, when uncertain results returned to patients, 9.8-23.1% of HPs recommended continuing the pregnancy (23.1% for VUS, 9.8% for VVPE, 15.4% for SFs), 5.1-10.3% recommended termination of the pregnancy (5.1% for VUS, 5.6% for VVPE, 10.3% for SFs), and 71.8-84.6% discussed with the patients but didn't make any recommendations (71.8% for VUS, 84.6% for VVPE, 74.4% for SFs). When patients felt overwhelmed by the uncertain results, 16.2% of HPs provided their own options of termination or continuation of the pregnancy, 20.1% found themselves in a dilemma and could do nothing to help patients, 17.1% signposted parents to psychological support, 27.8% made a referral, and 18.8% requested consultation by senior staff. Conclusions: Most patients didn't have the option of opting out of reporting uncertain results from prenatal ES in pretest counselling. Most HPs discussed with patients but made no recommendations for uncertain results in post-test counselling. Uncertain results from prenatal ES should be discussed with patients as part of the pretest informed consent discussion.
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