Bootstrapping Data Envelopment Analysis of Efficiency and Productivity of County Public Hospitals in Eastern, Central, and Western China after the Public Hospital Reform

China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis（DEA） to evaluate the technical efficiency（TE） and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals（39, 45, and 43 in Eastern, Central, and Western China, respectively） were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency（PTE）, and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Attributes of Specialized Households'Resilience and Its Impact on Rural Industrial Advancement:A Case Study of National Musical Instrument Production Specialized Households in Lankao County,Henan,China

Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.

Development of Rural Tourism Industry under the Background of New Rural Construction : A Case Study of Henghe of Boluo County in Huizhou City

Henghe Town in Boluo County of Huizhou is taken as the research object for analysis.The research and analysis on the tourism industry in Henghe Town of Boluo County are conducted,and the basic situation of rural tourism construction in Henghe Town is sorted out.The forms of tourism industry in Henghe Town and the problems in rural tourism development are identified,and some targeted suggestions and countermeasures are proposed.It hopes to provide ideas and references for the construction of beautiful rural areas in mountainous areas of Guangdong Province,and theoretical reference and practical significance for the development of rural tourism in mountainous areas of Guangdong Province.

Mapping Air Quality Using Remote Sensing Technology: A Case Study of Nairobi County

Nairobi County experiences rapid industrialization and urbanization that contributes to the deteriorating state of air quality, posing a potential health risk to its growing population. Currently, in Nairobi County, most air quality monitoring stations use low-cost, inaccurate monitors prone to defects. The study’s objective was to map Nairobi County’s air quality using freely available remotely sensed imagery. The Air Pollution Index (API) formula was used to characterize the air quality from cloud-free Landsat satellite images i.e., Landsat 5 TM, Landsat 7 ETM+, and Landsat 8 OLI from Google Earth Engine. The API values were computed based on vegetation indices namely NDVI, TVI, DVI, and the SWIR1 and NIR bands on the QGIS platform. Qualitative accuracy assessment was done using sample points drawn from residential, industrial, green spaces, and traffic hotspot categories, based on a passive-random sampling technique. In this study, Landsat 5 API imagery for 2010 provided a reliable representation of local conditions but indicated significant pollution in green spaces, with recorded values ranging from -143 to 334. The study found that Landsat 7 API imagery in 2002 showed expected results with the range of values being -55 to 287, while Landsat 8 indicated high pollution levels in Nairobi. The results emphasized the importance of air quality factors in API calibration and the unmatched spatial coverage of satellite observations over ground-based monitoring techniques. The study recommends the recalibration of the API formula for characteristic regions, exploring newer satellite sensors like those onboard Landsat 9 and Sentinel 2, and involving key stakeholders in a discourse to develop a suitable Kenyan air quality index.

Automated machine learning for rainfall-induced landslide hazard mapping in Luhe County of Guangdong Province,China

Landslide hazard mapping is essential for regional landslide hazard management.The main objective of this study is to construct a rainfall-induced landslide hazard map of Luhe County,China based on an automated machine learning framework(AutoGluon).A total of 2241 landslides were identified from satellite images before and after the rainfall event,and 10 impact factors including elevation,slope,aspect,normalized difference vegetation index(NDVI),topographic wetness index(TWI),lithology,land cover,distance to roads,distance to rivers,and rainfall were selected as indicators.The WeightedEnsemble model,which is an ensemble of 13 basic machine learning models weighted together,was used to output the landslide hazard assessment results.The results indicate that landslides mainly occurred in the central part of the study area,especially in Hetian and Shanghu.Totally 102.44 s were spent to train all the models,and the ensemble model WeightedEnsemble has an Area Under the Curve(AUC)value of92.36%in the test set.In addition,14.95%of the study area was determined to be at very high hazard,with a landslide density of 12.02 per square kilometer.This study serves as a significant reference for the prevention and mitigation of geological hazards and land use planning in Luhe County.

Practical Research on Promoting the Reform of“One Field for One Household”in Guoyang County

In recent years,the problem of farmland fragmentation has become a major obstacle to the development of modern agriculture,and the reform of“one field for one household”can effectively sort out cultivated land resources,increase contracted land area,improve land utilization rate,and effectively solve the problems of contracted land dispersion and farmland fragmentation in rural areas.This paper systematically anatomized the practice and effects of“one household,one field”reform in Guoyang County,analyzed the problems existing in the implementation process,and put forward corresponding suggestions and countermeasures,in order to provide experience and reference for the reform of one field in other regions.

Research on the Reform of"Separation of Three Rights"for Rural Homesteads in Juancheng County,Shandong Province

In order to realize rural revitalization in an all-round way and promote the sustainable and healthy development of the economy and society,China is committed to deepening the pace of building a new countryside with Chinese characteristics.The reform of the"Separation of Three Rights"of rural homesteads is a key measure,which aims to activate rural resources,enhance the vitality of rural economic development,and then promote the overall process of rural revitalization.This study selects Juancheng County,Heze City,Shandong Province as a typical case.Through an in-depth analysis of the relevant policy orientation of the national homestead reform and the specific practice of local promotion work,it systematically sorts out the registration of homestead rights,transfer of use rights and relevant policy measures adopted in paid use,qualification conversion,policy publicity and system establishment.After in-depth research on the system reform practice of the"Separation of Three Rights"of homesteads in Juancheng County,this paper reveals the main problems existing in the current reform,including the lack of clear policy support for the mechanism of paid use of homesteads,difficulties in the process of identifying qualification rights and challenges,the imperfection of the transfer mechanism of use rights,and the lack or lag of relevant policies.A series of problem-oriented policy suggestions are put forward,including establishing and improving the system of paid use of rural homesteads,improving the income distribution mechanism,promoting the innovation of the mortgage guarantee system for the right to use homesteads,and optimizing the homestead qualification certification procedures.These suggestions aim to provide a useful reference for the Juancheng County Government in promoting the reform of"Separation of Three Rights"of homesteads,and then promote the rational allocation and efficient utilization of rural homestead resources.

Ethnic Customs and Rural Tourism Development in Xinbin Manchu Autonomous County of Fushun City

The development of ethnic minority tourism is currently a hot topic in domestic tourism development.As an important component of Chinese civilization,the Manchu people have created brilliant culture in the long river of historical development.As the hometown of the Manchu people,Fushun has unique folk cultural tourism resources and a strong ethnic flavor.Nowadays,under the promotion of the rural revitalization strategy,the construction of new rural areas is constantly developing,and rural tourism is gradually becoming a new industry.Therefore,in the context of the increasingly prosperous rural tourism industry,it has become increasingly important to combine the ethnic customs of Manchu culture with rural tourism.Taking the ethnic customs and integrated development of rural tourism in Xinbin Manchu Autonomous County of Fushun City,Liaoning Province as the research object,this paper mainly sorts out the current situation and characteristics of rural tourism development in the region,systematically explores the problems in development and how to further optimize development,and proposes new models suitable for the development of folk tourism in Xinbin of Fushun,in order to achieve maximum economic and social benefits and provide a reference for promoting the development of tourism in the region.

Current Status and Challenges of the Water and Soil Conservation in Hotan County, Xinjiang

In order to thoroughly analyze the current status and challenges faced by the water and water conservation in Hotan County of Xinjiang,the use situation of water resources,the effectiveness and shortcomings of water and soil conservation work in the region are reviewed.Hotan County has achieved several remarkable achievements in the soil and water conservation project,daily management and maintenance,and ecological restoration projects.Some measures,such as terrace construction,slope protection engineering,and the construction of windproof and sandwood belts,have also had a positive impact on improving the quality of surface water resources while effectively curbing soil erosion.But there are also lack of operating policy detailed rules and implementation plans,and planning and design of some water and soil conservation projects lack of integrity and systematicness,application and promotion of new technologies,and soil loss management and ecological recovery effect assessment lack of comprehensive assessment indicators and methods.It has caused some water and soil conservation works to fail to be effectively implemented.In this regard,countermeasures and suggestions are put forward,such as strengthening the planning and management of water and soil conservation,promoting the technology and measures of water and soil conservation,increasing investment and funding support,and strengthening publicity education and personnel training.

Machine Learning and Statistical Analysis in Groundwater Monitoring for Total Dissolved Solids Assessment in Winkler County, Texas

This research aims to develop reliable models using machine learning algorithms to precisely predict Total Dissolved Solids (TDS) in wells of the Permian basin, Winkler County, Texas. The data for this contribution was obtained from the Texas Water Development Board website (TWDB). Five hundred and ninety-three samples were obtained from two hundred and ninety-eight wells in the study area. The wells were drilled at different county locations into five aquifers, including Pecos Valley, Dockum, Capitan Reef, Edward Trinity, and Rustler aquifers. A total of fourteen different water quality parameters were used, and they include Potential hydrogen (pH), Sodium, Chloride, Magnesium, Fluoride, TDS, Specific Conductance, Nitrate, Total Hardness, Calcium, Temperature, Well Depth, Sulphate, and Bicarbonates. Four machine learning regression algorithms were developed to get a good model to help predict TDS in this area: Decision Tree regression, Linear regression, Support Vector Regression, and K-nearest neighbor. The study showed that the Decision Tree produced the best model with attributes like the coefficient of determination R2 = 1.00 and 0.96 for the training and testing, respectively. It also produced the lowest score of mean absolute error MAE = 0.00 and 0.04 for training and testing, respectively. This study will reduce the cost of obtaining different water quality parameters in TDS determination by leveraging machine learning to use only the parameters contributing to TDS, thereby helping researchers obtain only the parameters necessary for TDS prediction. It will also help the authorities enact policies that will improve the water quality in areas where drinking water availability is a challenge by providing important information for monitoring and assessing groundwater quality.

Current Situation and Countermeasures of Household Waste Classification in Feixi County, Hefei City

Feixi County has made significant progress in promoting waste classification,such as establishing a comprehensive classification system,and effectively reducing environmental pollution and waste volume.However,with the increase in waste generation,the county faces multiple challenges especially in the disposal of kitchen waste and improvement of residents environmental awareness.To address these issues,Feixi County has implemented various measures,such as strengthening the construction of infrastructure for waste classification,improving regulations and clearly defining responsibilities,enhancing residents environmental awareness to encourage their participation in waste classification through education and promotion,and increasing supervision to ensure effective implementation of the work.It emphasizes community governance,encourage all parties to participate in it,and strengthen publicity,education and training to enhance residents participation.Feixi County has achieved positive results,but efforts are needed to further improve facilities,raise awareness,enhance supervision,and ensure the continuous effectiveness of waste classification work to promote urban green sustainable development.

Theoretical Analysis and Practical Reflection on the Role Conflict of Double-Qualified Teachers in University-Affiliated Hospitals

Taking role conflict as the starting point,this article examines and reflects on the development of clinical teachers.In the process of the occurrence,development,and resolution of role conflicts among clinical teachers,there are many hidden issues related to the development of clinical teachers.The development of clinical teacher teaching and role conflict management contain similar educational philosophies and practical issues.This study draws on classic theories and research achievements in the development of university teachers and conducts theoretical analysis and practical reflection on the development of clinical teachers in medical colleges from the perspective of role conflict in social psychology.Policy recommendations are proposed,including strengthening the construction of teaching systems at the hospital organizational environment level,enhancing the role identity and teacher beliefs of clinical teachers,promoting their teaching development and academic learning,and ensuring their normal teaching investment;promoting leadership support at the level of interpersonal interaction and leveraging the role of colleague support in alleviating role conflicts;enhancing individual teacher beliefs,teacher role learning,and role skills.

Exploration of Teaching Development Strategies for Double-Qualified Teachers in University- Affiliated Hospitals Based on Role Conflict Theory

This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development of clinical teachers in medical colleges,including following different stages of teacher development and designing teaching development strategies at different levels;designing the content and form of teaching development activities to meet the temporal and spatial needs of clinical teachers;and building an academic community for clinical teachers to promote the creation of teaching development behaviors.

Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.

Predictors of Fatal Outcome in Hospitalised Adult Patients with Acute Kidney Injury at Two Tertiary Hospitals in Sub-Saharan Africa

Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.

Hyperprolactinemia in Hospitals in Lomé: Diagnostic and Therapeutic Aspects

Introduction. Hyperprolactinemia represents a supraphysiological secretion of prolactin. In clinical practice, it is the most frequently encountered anterior pituitary disorder. However, its real prevalence is little known in Africa. The purpose of this study is to list all cases of hyperprolactinemia over the past four years and to make an inventory of the various etiologies found and their management. Methodology. This is a cross-sectional descriptive study on the files of patients who came for consultation in the internal medicine and endocrinology department with hyperprolactinemia retrospectively collected from January 2017 to December 2020. Included were patients followed or whose the diagnosis of hyperprolactinemia was established in endocrinological consultation during the study period. Results. This study recorded 26 cases of hyperprolactinemia. The female sex represented 73.08% (sex ratio M/F 0.37) and the average age was 33.92 years. The 40 - 50 age group was the most represented with 30.77%. In women, galactorrhea accounted for 73.07%, amenorrhea 57.69% of clinical pictures and infertility 23.08%. In men, infertility accounted for 7.69% of presentations, gynecomastia 11.54% and erectile dysfunction 15.38%. The duration of evolution of the signs was 4 months in 23.08% of the patients. The mean prolactinemia was 702.58 ng/ml. CT was performed in 80.85% of patients. The main etiologies were pituitary adenomas (77%). All our patients were treated with dopaminergic agonists. Cabergoline was prescribed in 77% of patients. The evolution was favorable in 96.25% of patients. Conclusion. Hyperprolactinemia is a pathology that exists in our regions. The main etiology remains pituitary adenomas and treatment with cabergoline.

Analysis on the Configuration Path of Improving the Quality and Efficiency of County-Level Libraries in China

County-level libraries have an inescapable responsibility for cultivating local cultural identity and realizing rural revitalization.Therefore,we analyzed factors that afect the service fficiency of gass-1oots libraries in Henan Province through a field investigation and qualitative comparative analysis(QCA),and proposed a higlh-efficiency configuration.In addition,we put forward the strategy of improving the quality and efficiency of our country's county-level libraries in the electonic information age.

Research misconduct in hospitals is spreading:A bibliometric analysis of retracted papers from Chinese university-affiliated hospitals

Purpose: The number of retracted papers from Chinese university-affiliated hospitals is increasing, which has raised much concern. The aim of this study is to analyze the retracted papers from university-affiliated hospitals in China’s mainland from 2000 to 2021. Design/methodology/approach: Data for 1,031 retracted papers were identified from the Web of Science Core collection database. The information of the hospitals involved was obtained from their official websites. We analyzed the chronological changes, journal distribution, discipline distribution and retraction reasons for the retracted papers. The grade and geographic locations of the hospitals involved were explored as well.Findings: We found a rapid increase in the number of retracted papers, while the retraction time interval is decreasing. The main reasons for retraction are plagiarism/self-plagiarism(n=255), invalid data/images/conclusions(n=212), fake peer review(n=175) and honesty error(n=163). The disciplines are mainly distributed in oncology(n=320), pharmacology & pharmacy(n=198) and research & experimental medicine(n=166). About 43.8% of the retracted papers were from hospitals affiliated with prestigious universities. Research limitations: This study fails to differentiate between retractions due to honest error and retractions due to research misconduct. We believe that there is a fundamental difference between honest error retractions and misconduct retractions. Another limitation is that authors of the retracted papers have not been analyzed in this study.Practical implications: This study provides a reference for addressing research misconduct in Chinese university-affiliated hospitals. It is our recommendation that universities and hospitals should educate all their staff about the basic norms of research integrity, punish authors of scientific misconduct retracted papers, and reform the unreasonable evaluation system.Originality/value: Based on the analysis of retracted papers, this study further analyzes the characteristics of institutions of retracted papers, which may deepen the research on retracted papers and provide a new perspective to understand the retraction phenomenon.